Causal Factors Affecting Health Behavior Modification in Type 2 Diabetes Patients in the Lamlukka Subdistrict Municipality Public Health Service Center

Abstract

This causal research aimed to examine the causal relationships and effects of various factors on health behavior modification among patients with type 2 diabetes mellitus (T2DM). The sample consisted of 208 patients with T2DM selected through purposive sampling based on predetermined inclusion and exclusion criteria. Data were collected from March to May 2026. The research instruments comprised a questionnaire assessing causal factors influencing health behavior modification and a questionnaire assessing health behaviors among patients with T2DM. Content validity was evaluated by three experts, with Item-Objective Congruence (IOC) values ranging from 0.66 to 1.00. The reliability coefficients, assessed using Cronbach’s alpha, were 0.79 and 0.83, respectively. Data were analyzed using frequency, percentage, mean, standard deviation, and structural equation modeling (SEM). Statistical significance was set at p-value<0.05.

The results showed that the causal factors influencing health behavior modification among patients with T2DM, including government policy, support from public health service centers, personal factors, and family factors, were rated at the highest level. Health behaviors, including dietary practices, exercise, adherence to medical recommendations, and avoidance of health-risk factors, were also rated at the highest level. The structural equation model of factors influencing health behavior modification demonstrated a good fit with the empirical data. These findings suggest that government policy, support from public health service centers, personal factors, and family factors play important roles in promoting health behavior modification among patients with T2DM. Public health authorities should develop proactive health promotion policies targeting patients with diabetes and strengthen support systems at primary healthcare facilities. Continuous programs that support and sustain health behavior modification among patients with T2DM should also be implemented.