Development of a Lifestyle-Coaching Model to Prevent Complication among Muslim Older Adults with Type 2 Diabetes in Yala Province

Abstract

This research and development study aimed to investigate the situation, develop a lifestyle-coaching model, and examine its effectiveness for preventing complications among older adults from Muslim communities with type 2 diabetes. Study was divided in three phases. First one was a situation analysis, including a quantitative study among 250 older adults with type 2 diabetes, as well as a qualitative study, using focus group discussions with 35 participants, including 15 older adults with type 2 diabetes, 10 caregivers, and 10 healthcare providers. Quantitative data were analyzed using descriptive statistics, while qualitative data were analyzed using content analysis. The second phase consisted in the development of a lifestyle-coaching model, based on the concept of lifestyle coaching and validated by five experts. Third phase was dedicated to the model implementation and evaluation. The effectiveness of the model was tested using a one-group pretest–posttest quasi-experimental design with 35 older adults, determined through G*Power analysis. Data were analyzed using descriptive statistics and paired t-test. The results showed as follows.

1. The self-care behavior of Thai older adults from Muslim cultural background with type 2 diabetes was at a moderate level. The highest-performing behavior was dietary management (75.20%), followed by medication adherence (40.40%). Qualitative data indicated that lifestyle coaching is a new approach that requires coaching skills, and no prior studies were found on providing coaching services for this population.

2. The developed lifestyle-coaching model emphasized three dynamic components (HBC) that interact continuously and dynamically to promote sustainable behavioral change including health service system (H), behavior changer coaching (B), and communication (C).

3. After implementation, participants showed significantly higher mean scores in self-care behaviors and overall health status compared to before the intervention (p-value < .05). The incidence of diabetes-related complications decreased, and satisfaction with the coaching activities was at the highest level.

This study suggest that the developed model is effective in improving health behaviors and enhancing well-being. It supports the Ministry of Public Health’s strategic plan for reducing and preventing the severity of non-communicable diseases. Therefore model can be expanded to health promotion units across all health regions.