Effectiveness of a Project-Based Learning Program on Health Literacy among Village Health Volunteers: A Quasi-Experimental Study
DOI:
https://doi.org/10.60099/prijnr.2025.272639Keywords:
Health Literacy, Project-Based Learning, Village Health VolunteersAbstract
Health literacy is a critical determinant of health and a key factor in promoting empowerment and health equity. However, limited health literacy remains a persistent challenge in many rural areas of Thailand, particularly among village health volunteers, who are vital in delivering primary healthcare and health education. This study was conducted in Nakhon Ratchasima Province, where health volunteers act as key links between health services and the local population. This study investigated the effectiveness of a project-based learning program on the health literacy of village health volunteers in the community. A quasi-experimental, two-group pre-post-test design was used to compare mean scores on health literacy scales. Seventy participants were randomly assigned to either the intervention group (n = 35) or the control group (n = 35). The five-week project-based learning approach involved engaging participants in defining health-related problems, constructing and refining the project, designing and implementing solutions, and reflecting on the outcomes. Health literacy was assessed using a questionnaire, and the data were described using descriptive statistics. Two-way ANOVA was used to compare health literacy mean scores between groups and across pretesting and post-testing.
The results revealed that the mean scores for knowledge and understanding, media and information literacy, and total health literacy in the intervention group were significantly higher than both pretest and control scores. These findings demonstrate the effectiveness of the project-based learning program in enhancing health literacy among the village health volunteers. This learner-centered strategy holds promise for integration into community health education initiatives led by community health nurses. Nevertheless, further validation across diverse settings, both rural and urban, is essential to establish the program’s generalizability and scalability.
References
World Health Organization. Shanghai Declaration on Health Promotion in the 2030 Agenda for Sustainable Development [Internet]. Geneva: WHO; 2016 [cited 2024 Nov 25]. Available from: https://www.who.int/publications/i/item/WHO-NMH-PND-17.5
Nutbeam D, Lloyd JE. Understanding and responding to health literacy as a social determinant. Annu Rev Public Health. 2021;42:159-73. doi:10.1146/annurev-publhealth-090419-102529. DOI: https://doi.org/10.1146/annurev-publhealth-090419-102529
Miller TA. Health literacy and adherence to medical treatment in chronic and acute illness: A meta-analysis. Patient Educ Couns. 2016;99:1079-86. doi:10.1016/j.pec.2016.08.003. DOI: https://doi.org/10.1016/j.pec.2016.01.020
Berkman ND, Davis TC, McCormack L. Low health literacy and health outcomes: an updated systematic review. Ann Intern Med. 2011;155(2):97-107. DOI: https://doi.org/10.7326/0003-4819-155-2-201107190-00005
Poureslami I, Nimmon L, Rootman I, Fitzgerald MJ. Priorities for action: recommendations from an international roundtable on health literacy and chronic disease management. Health Promot Int. 2017;32(4):743–54. doi:10.1093/heapro/daw003. DOI: https://doi.org/10.1093/heapro/daw003
Tangcharoensathien V, Witthayapipopsakul W, Panichkriangkrai W, Patcharanarumol W, Mills A. Health systems development in Thailand: A solid platform for successful implementation of universal health coverage. Lancet. 2018;391(10126):1205–23. doi:10.1016/S0140-6736(18)30198-3. DOI: https://doi.org/10.1016/S0140-6736(18)30198-3
Village health volunteers in Thailand: crucial components of primary healthcare [Internet]. SUPA71. 2024 [cited 2025 Feb 3]. Available from: https://www.supa71.com/village-health-volunteers-in-thailand-crucial-components-of-primary-healthcare/
Vatcharavongvan P, Kummabutr J. Thai village health volunteers: capacities for providing community-based aged care. Innov Aging. 2017;1(Suppl 1):1141. doi:10.1093/geroni/igx004.4169. DOI: https://doi.org/10.1093/geroni/igx004.4169
Chuprasert T, Chanmanee P. A study of health literacy and health behaviour of village health volunteers (VHV), Health Region 11 of Thailand [Internet]. 2019 [cited 2024 Apr 11]. Available from: http://do11.new.hss.moph.go.th:8080/fileupload_doc/2019-09-03-1-18-2840654.pdf (in Thai)
Suwannarong K, Bumrerraj S. Health literacy and eHealth literacy in the prevention and control of COVID-19 among village health volunteers in area health region number 7 of Thailand. J Health Res. 2024;38(3):251-61. DOI: https://doi.org/10.56808/2586-940X.1080
Taguchi A, Murayama H, Murashima S. Association between municipal health promotion volunteers’ health literacy and their level of outreach activities in Japan. PLoS One. 2016;11(10):e0164612. DOI: https://doi.org/10.1371/journal.pone.0164612
Ishikawa H, Yamaguchi I, Nutbeam D, Kato M, Okuhara T, Okada M, et al. Improving health literacy in a Japanese community population: a pilot study to develop an educational programme. Health Expect. 2018;21(4):814–21. doi:10.1111/hex.12674 DOI: https://doi.org/10.1111/hex.12678
Dehghankar L, Panahi R, Hasannia E, Hemmati F, Samiei Siboni F. The effect of an educational intervention on health literacy and the adoption of nutritional preventive behaviors related to osteoporosis among Iranian health volunteers. J Prev Med Public Health. 2021;54(6):404–11. doi:10.3961/jpmph.21.325. DOI: https://doi.org/10.3961/jpmph.21.183
Fauziah D, Susiyawati E, Budiyanto M. Implementation of project-based learning models to improve science literacy of junior high school students. J Pijar MIPA. 2023;18(2):176–82. doi:10.29303/jpm.v18i2.5055. DOI: https://doi.org/10.29303/jpm.v18i2.4795
Winarni EW, Purwandari EP. Project-based learning to improve scientific literacy for primary education postgraduate students in science subject. Jurnal Prima Edukasia. 2020;8(1):67–77. doi:10.21831/jpe.v8i1.30404 DOI: https://doi.org/10.21831/jpe.v8i1.30618
Hanklang S, Sivasan S. Effectiveness of the project-based learning program on Thai nursing students' competency for elderly care in the community. J Health Res. 2021;32(2):132–46. doi:10.1108/JHR-10-2020-0479 DOI: https://doi.org/10.1108/JHR-07-2019-0160
Krutnoi N, Wongkongdech A, Promasatayaprot V. Factor analysis of the village health volunteers’ core competencies in Thailand. J Public Health Dev. 2024;22(2):54–67. doi:10.55131/jphd/2024/220204 DOI: https://doi.org/10.55131/jphd/2024/220205
Visanuyothin S, Chatanulak C, Saengsuwan S, Rojanavarapong A, Pornchanya P. Health literacy of village health volunteers in municipality, Nakhon Ratchasima, Thailand. J Public Health Dev. 2015;13(1):37-54.
Tachavijitjaru C, Srisupornkornkul A. Health literacy of village health volunteers regarding dietary control based upon nutrition therapy for diabetic mellitus type II patients. J Royal Thai Army Nurses. 2022;23(3):215–26. doi:10.33207/jrtan.v23i3.256089. (in Thai)
Nutbeam D. Improving health literacy: how to succeed. Public Health Res Pract. 2023;33(1):e3312307. doi:10.17061/phrp3312307 DOI: https://doi.org/10.17061/phrp3312301
Health Education Division, Department of Health Services and Support, Ministry of Public Health, Thailand. Health literacy assessment [Internet]. 2019 [cited 2024 Dec 6]. Available from: http://www.hed.go.th/menuHome/file/320. (in Thai)
Jaroensook K. The effectiveness of the development program on health literacy and behaviors of village health volunteers in Singburi municipality, Singburi province. 2021;30(1):72-90. (in Thai)
Ngonsamrong C, Kokkrathok N. Effects of health literacy and health behavior promotion program among village health volunteers in Thongchai Nuea Subdistrict, Pak Thong Chai District, Nakhon Ratchasima Province. 2024;9(1):115-129. (in Thai)
Moustafa A, Al-Rashaida M. Fostering students' critical thinking through the implementation of project-based learning. In: Safar A, editor. Handbook of research on critical thinking and teacher education pedagogy. Hershey (PA): IGI Global; 2024. p. 43–60. doi:10.4018/979-8-3693-0880-6.ch004. DOI: https://doi.org/10.4018/979-8-3693-0880-6.ch004
Gonzalez RL, Garza JA, Flores A. Community participation in health education: a case study of project-based learning with village health volunteers. J Health Commun. 2022;27(3):224-32.
Saliba R, Mussleman P, Fernandes M, Bendriss R. Promoting information literacy of pre-medical students through project-based learning: a pilot study. Int J Educ Literacy Stud. 2017;5(4):1–15. doi:10.7575/aiac.ijels.v.5n.4p.1 DOI: https://doi.org/10.7575/aiac.ijels.v.5n.4p.1
Mansyur M, Putri DN, Rizal R. Village health volunteers as key actors in health promotion: an analysis of project-based learning implementation. Health Promot Perspect. 2022;12(1):39–48. doi:10.34172/hpp.2022.06 DOI: https://doi.org/10.34172/hpp.2022.06
Likens D. Sample size justification. Collabra Psychol. 2022;8(1):33267. doi:10.15252/collabra.33267. DOI: https://doi.org/10.1525/collabra.33267
Mukhalalati BA, Taylor A. Adult learning theories in context: A quick guide for healthcare professional educators. J Med Educ Curric Dev. 2019;6:1–10. doi:10.1177/2382120519840332 DOI: https://doi.org/10.1177/2382120519840332
Dewi NK, Usman A. The effectiveness of project-based learning in public health education: a study on health literacy improvement. Int J Public Health Sci. 2020;9(3):234–43. doi:10.11591/ijphs.v9i3.20468 DOI: https://doi.org/10.11591/ijphs.v9i3.20468
Khan MA, Arshad M, Bhan R. Empowering village health volunteers through project-based learning: skills, confidence, and community engagement. J Public Health Res. 2021;10(3):123–30. doi:10.4081/jphr.2021.2144 DOI: https://doi.org/10.4081/jphr.2021.2144
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