Effectiveness of the Community Engagement Program in Preventing Chronic Obstructive Pulmonary Disease in Risk Groups, Surin Province

Abstract

Introduction Chronic obstructive pulmonary disease (COPD) is a significant public health problem in both Thailand and globally. Promoting community engagement in the management of COPD at the local level, particularly through the involvement of community health leaders, caregivers, and health network stakeholders, can enhance the effectiveness of disease prevention efforts. Community engagement among these groups is especially crucial for improving outcomes among people at risk for developing COPD. 

Objectives This study aimed to investigate the effectiveness of a community engagement program in preventing COPD among people at risk by comparing outcomes both between and within groups, including community engagement of community leaders, knowledge on COPD prevention, COPD preventive behaviors, and pulmonary function (peak expiratory flow rate and the six-minute walk distance) of risk groups in a community located in Surin Province, Thailand.

Design A quasi-experimental design with two-group pretest and posttest was used. The researchers applied Martha Walker’s concept of community engagement to develop a community engagement program in preventing COPD. The program was divided into four steps: 1) health leaders and health personnel meeting, serving as a collaborative planning process with the community; 2) selecting a problem-solving approach, which entailed gathering relevant data on the issues and their impacts; 3) implementation of the plan and plan for evaluation; and 4) evaluation the plan as process in accordance with the established plan.

Methods The study participants consisted of two groups: 1) community leaders, selected through purposive sampling and assigned to either the experimental or control group, with 24 participants in each group; and 2) people at risk of COPD, selected through simple random sampling and matched by age and gender, with 35 participants in both the experimental and control groups. The research instruments included: a simplified COPD screening tool, a community engagement questionnaire, a knowledge questionnaire on COPD prevention, a COPD preventive behavior questionnaire, pulmonary function assessments using a spirometer and a six-minute walk test, and an 8-week community engagement program in preventing COPD, comprising workshops and group discussions. Content validity was assessed by experts, revealing content validity index (CVI) of .89 for the program, and .94, .92, and .98 for the community engagement, knowledge, and behavior questionnaires, respectively. Reliability was confirmed using Cronbach’s alpha coefficients, which were .84 for the community engagement questionnaire, .93 for the knowledge questionnaire, and .90 for the behavior questionnaire. Data analysis was conducted using descriptive statistics, Independent t-tests, and Paired t-tests.

Results The majority of participants in both the experimental and control groups of community leaders were female, accounting for 87.5% in each group. Their mean ages were 67.45 years (SD = 4.51) and 51.33 years (SD = 0.33), respectively. Similarly, in the at-risk group for COPD, 87.1% of participants in both the experimental and control groups were female. The experimental group had a mean age of 48.74 years (SD = 5.47), while the control group had a mean age of 49.57 years (SD = 5.19); the difference between the two groups was not statistically significant. After participating in the program, community leaders in the experimental group demonstrated significantly higher levels of community engagement in COPD prevention (M = 4.26, SD = 0.43) compared to before the program (M = 2.28, SD = 0.19) and the control group (M = 2.11, SD = 0.15), with statistical significance (p < .001). Participants in the at-risk experimental group showed significantly greater knowledge of COPD prevention (M = 12.62, SD = 1.46) than before the program (M = 7.25, SD = 0.97) and the control group (M = 8.57, SD = 0.69), with statistical significance (p < .001). Their overall preventive behavior (M = 4.00, SD = 0.10) was also significantly higher than before the program (M = 2.75, SD = 0.18) and those in the control group (M = 2.78, SD = 0.18) (p < .001). Additionally, pulmonary function in the experimental group improved significantly compared to both their baseline and the control group.

Recommendation The community engagement program in preventing COPD, which emphasized the role of community leaders, demonstrated strong effectiveness in this study. It holds potential for adaptation and implementation in communities with similar contexts to prevent or delay the onset of COPD among at-risk populations.