The Effects of a Health Risk Communication Program on the Prevention of Complications among Older Adults with Type 2 Diabetes in an Urban Area of Sukhothai Province
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Abstract
This quasi-experimental two-group pretest–posttest study aimed to examine the effects of a health risk communication program on the prevention of complications among older adults with type 2 diabetes living in an urban area of Sukhothai Province. The participants were 60 older adults aged 60–75 years with type 2 diabetes who met the inclusion criteria and were selected using simple random sampling. They were equally assigned to an experimental group and a comparison group of 30 participants each. The comparison group received routine nursing care, whereas the experimental group participated in the health risk communication program designed to prevent diabetes complications. The program was developed based on Rohrmann’s risk communication framework and implemented over eight weeks. Research instruments included (1) a health risk communication program for the prevention of complications, (2) a complication prevention behavior questionnaire, and (3) a health risk communication manual. The instruments were validated by five experts, yielding a content validity index of .82 and a Cronbach’s alpha coefficient of .90. Data were analyzed using descriptive statistics, t-test, Mann–Whitney U test, and Wilcoxon Signed-Rank test.
The findings revealed that, after the intervention, the experimental group demonstrated significantly higher complication-prevention behavior scores compared with their baseline and with the comparison group (p<.05). However, there was no statistically significant difference in blood glucose levels between the two groups after the program.
The study suggests that the health risk communication program effectively enhanced complication-prevention behaviors among older adults with type 2 diabetes. Nurses are encouraged to apply this program in routine care and ongoing health promotion for this population.
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References
American Diabetes Association. (2021). Standards of medical care in diabetes 2021. Diabetes Care, 44(Supplement_1), S1–S232. doi.org/10.2337/dc21-Sint.
American Diabetes Association. (2024). Standards of care in diabetes 2024. Diabetes Care, 47(Supplement_1), S1–S350. doi.org/10.2337/dc24-Sint.
Akpharakorn, W., Puckcharern, H. & Satheannoppakao, W. (2022). Report of 6th Thai health survey by physical examination 2019 - 2020. Bangkok: Augsorn Graphic and Design. (in Thai).
Bhardwaj, R., Agrawal, U., Vashist, P. & Manna, S. (2024). Determination of sample size for various study designs in medical research: A practical primer. Journal of Family Medicine and Primary Care, 13(7), 2555–2561. doi.org/10.4103/jfmpc.jfmpc_1675_23.
Chayarut, P., Roojanavech, S. & Chatdokmaiprai, K. (2019). The effects of a health risk communication program among diabetic retinopathy patients in a community in Samut Sakhon Province. Journal of The Royal Thai Army Nurses, 20(3), 206 – 217. (in Thai).
Colberg, S. R., Sigal, R. J., Yardley, J. E., Riddell, M. C., Dunstan, D. W., Dempsey, P. C., Horton, E. S., Castorino, K. & Tate, D. F. (2016). Physical activity/exercise and diabetes: A position statement of the American Diabetes Association. Diabetes Care, 39(11), 2065–2079. doi.org/10.2337/dc16-1728.
Department of Disease Control. (2024). Report on diabetes morbidity and complications in Sukhothai Province 2024. Bureau of Non-Communicable Diseases. Retrieved (2025, September 17). from https://ddc.moph.go.th. (in Thai).
Dermkhuntod, N., Kwancharoen, R., Chuantantikamol, C., Paholpak, P. & Suraamornkul, S. (2021). Effects of telehealth monitoring on glycemic control and medication adherence in patients with poorly controlled type 2 diabetes. Vajira Medical Journal: Journal of Urban Medicine, 65(Suppl November), S75–S90. (in Thai).
Diabetes Association of Thailand. (2023). Clinical practice guideline for diabetes 2023. Bangkok: Srimung Printing. (in Thai).
Evert, A. B., Dennison, M., Gardner, C. D., Garvey, W. T., Lau, K. H., MacLeod, J., Mitri, J., Pereira, R. F., Rawlings, K., Robinson, S., Saslow, L., Uelmen, S., Urbanski, P. & Yancy, W. S. (2019). Nutrition therapy for adults with diabetes or prediabetes: A consensus report. Diabetes Care, 42(5), 731–754. Retrieved (2025, September 17), doi.org/10.2337/dci19-0014.
Goh, M. C. W., Kelly, P. J. & Deane, F. P. (2021). Enhancing Type 2 diabetes risk communication with message framing and tailored risk feedback: An online randomised controlled trial. Australian Journal of Psychology, 73(4), 499–511.
doi.org/10.1080/00049530.2021.1997554
Hashim, J., Luna Puerta, L., Foong, P. S., Tai, E. S., Yi, H. & Smith, H. E. (2024). Codesigning a digital Type 2 diabetes risk communication tool in Singapore: Qualitative participatory action research approach. JMIR Formative Research, 8, e50456. doi.org/10.2196/50456
International Diabetes Federation. (2025). IDF Diabetes Atlas (11th ed.). Retrieved (2025, September 17), from https://diabetesatlas.org.
Kai-nunna, P., Kleechaya, P. & Wannataworn, A. (2023). Patient journeys and proposed contents for communication strategies to reduce new cases of type 2 diabetes in Thailand. Journal of Health Systems Research, 17(1), 54-67. (in Thai).
Likert, R. (1932). A technique for the measurement of attitudes. Archives of Psychology, 22, 5-55.
Ministry of Public Health, Bureau of Policy and Strategy. (2024). Public health statistics, 2024. Retrieved (2025, October 8). from https://bps.moph.go.th (in Thai).
Mongkolsucharitkul, P., Surawit, A., Manosan, T., Ophakas, S., Suta, S., Pinsawas, B., Pongkunakorn, T., Pumeiam, S., Ratanasuwan, W., Homsanit, M., Charoencholvanich, K., Udomphorn, Y., Suktitipat, B. & Mayurasakorn, K. (2024). Metabolic and genetic risk factors associated with pre-diabetes and type 2 diabetes in Thai healthcare employees: A long-term study from the Siriraj Health (SIH) cohort study. PloS one, 19(6), e0303085. doi.org/10.1371/journal.pone.0303085
Moungkum, S., Srisopa, P., Kunsongkeit, W., Ponpinij, P., Wiseso, W., Chantamit-O-Pas, C. & Deerochanawong, C. (2020). Factors influencing microvascular complications among persons with type 2 diabetes. The Journal of Faculty of Nursing Burapha University, 28(2), 74-84. (in Thai).
Ong-Artborirak, P., Seangpraw, K., Boonyathee, S., Auttama, N. & Winaiprasert, P. (2023). Health literacy, self-efficacy, self-care behaviors, and glycemic control among older adults with type 2 diabetes mellitus: A cross-sectional study in Thai communities. BMC Geriatrics, 23, 297. doi.org/10.1186/s12877-023-04010-0.
Rohrmann, B. (2008). Risk communication: Fundamentals and practice. In Proceedings of the International Emergency Management Society Conference (TIEMS). https://rohrmannresearch.net/pdfs/rohrmann-rrr.pdf
Rohrmann, B. (2008). Risk perception, risk attitude, risk communication, risk management: A conceptual appraisal. Paper presented at the 15th International Emergency Management Society (TIEMS) Annual Conference, Prague, Czechia. University of Melbourne. https://rohrmannresearch.net/pdfs/rohrmann-rrr.pdf
Saenrak, N., Juwa, S. & Srisookkum, T. (2020). Health literacy on self-care among patients with diabetes mellitus in Mae Ka Sub-district, Phayao Province. Academic Journal of Community Public Health, 6(3), 174-184. (in Thai).
Thongphuthon, P. & Lowirakorn, S. (2020). Food consumption behaviors of uncontrolled diabetic patients at the diabetic clinic, Kut Chap Hospital, Udon Thani Province. KKU Journal for Public Health Research, 13(1), 22-32. (in Thai).
Tongdee, J., Thapinta, D., Panuthai, S. & Chintanawat, R. (2023). A causal model of health literacy among Thai older adults with uncontrolled diabetes. Pacific Rim International Journal of Nursing Research, 28(1), 5–20. doi.org/10.60099/prijnr.2024.262563
World Health Organization. (2024). Diabetes fact sheet 2024.
