Developing innovative programs tamarind 3 in the prevention and control of diabetes, In the pilot areas of Chaiyaphum.

Abstract

Innovation development of Tamarind 3 models program aimed to change health behavior, and to evaluate the efficiency of the program for decreasing health risk among risk group and patient group.  The design was based on the economic community, and appropriate for target groups; risk group (unripe tamarind program), patients (mature tamarind program), and patients with diabetes complications (moldy tamarind program). Body mass index, Waist, HbA1C, and eGFR were measured at 6 months (Oct. 2018-Apr., 2019) of study at Phakdeechumpol District, Chaiyaphum province. Action Research was designed, of 1,104 people with age > 35 years were screened. and role model was applied for changing for health behavior. Trainers were separated into 4 groups including; nurses, teachers, priests, and health volunteers. Health education was given for individual persons and groups of people by the multidisciplinary team. Individual health education was conducted by family medication doctors for patients who had complications. All processes were monitored and evaluated by the health volunteers. Statistic paired t-test and Z-test were used for qualitative data analysis. Content analysis was used for qualitative data analysis. The results found that 37 people (prevalence = 3.4; 95% CI: 2.4, 4.6) were risk to have diabetes mellitus, and those were BMI decreasing from 25.66 to 24.99 (Mean diff. = 0.67; 95% CI: 0.46, 0.88). Moreover, their waist was reduced from 82.59 to 80.84 cm. (Mean diff. = 1.76; 95% CI: 1.05, 2.47), and the DTX decreased by 12.32 mg% statistically significantly. About 3 of 36 patients died when finishing this study. The study revealed that 16 patients could not control blood sugar (HbA1C >7) in the first round of intervention, and then only 6 patients could not be done when the second round was finished. Finally, only 3 (proportion difference = 36.1, 95% CI: 17.5, 54.7) patients were failure to diabetes mellitus control. The kidney function of diabetes patients who had complications accounted for 5 patients were improved. Key success including; 1) the intervention was appropriate for the target group, 2) Using personal role model for communication of community, 3) health volunteers were selected by community processes, then their competency was tested by health care providers. 

Keywords: Tamarind 3 program, Non-communicable diseases (NCDs), blood sugar levels