Development of a Tuberculosis Care Model Through Community Participation in Chang Klang District, Nakhon Si Thammarat Province

Abstract

     This action research aimed to develop a tuberculosis care model through community participation in Chang Klang District, Nakhon Si Thammarat Province. The study was conducted from August 2023 to September 2024 and consisted of three phases: (1) situational analysis, (2) model development, and (3) model evaluation. The total target group included 484 participants, comprising 16 tuberculosis patients and 12 tuberculosis care staff selected through purposive sampling, as well as 456 individuals involved in tuberculosis care in the community, selected through systematic sampling. Data were collected using both quantitative and qualitative methods, including questionnaires, in-depth interviews, and focus group discussion guides. Data analysis was performed using mean, standard deviation, frequency, percentage, paired t-tests, and independent t-tests.

     The study found that the process of developing the tuberculosis care model in the community, following the PAOR steps, included: 1) studying the context, situation, and problems in the community; 2) planning in collaboration with the community; 3) implementing the plan; 4) observing and monitoring the results; and 5) reflecting on the outcomes and drawing lessons learned. The model developed from this study is "Chang Klang TB-FAST," which consists of six components: 1) Teamwork, 2) Best Service, 3) Find (increasing the rate of tuberculosis case detection), 4) Access to Service (access to tuberculosis diagnosis services), 5) Success (success in tuberculosis treatment), and 6) Technology for Health (tuberculosis care with technology). After the model development, the sample group showed significantly higher mean scores for competence, behavior, participation, and satisfaction with the Chang Klang district health network's tuberculosis care in the community compared to before the model development (p-value < .05).

     The factors for the success of developing tuberculosis care through community participation in Chang Klang District, Nakhon Si Thammarat Province, included teamwork, harnessing the potential of public health staff from different sectors to participate in tuberculosis care, and creating a practical care model that could be implemented. This was achieved through a process of listening to real problems from stakeholders. Most importantly, it involved listening to the problems and needs of tuberculosis patients. Through collaboration, the model was developed, implemented, and tested, with reflections shared based on the operations of the newly developed model.