Development of a Community-Participatory Health Modification Model for NCDs High-Risk
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Abstract: This participatory action research aimed to develop a Community-Participatory Health Behavior Modification Model for NCD-high-risk individuals and to evaluate the effectiveness of the model. The study was conducted in two phases: 1) model development through community participation with 20 stakeholders, and 2) effectiveness testing among 50 NCD-high-risk participants. Research instruments demonstrated content validity (CVI = 0.91–0.95) and reliability (KR-20 = 0.82, Cronbach’s alpha = 0.88–0.91). Qualitative data were examined via content analysis, while quantitative outcomes were analyzed using descriptive statistics and paired t-tests. The findings revealed that the developed model, driven by the 'PROMISE' process, consists of five pivotal components: Positive reinforcement combined with Optimum state to encourage participant self-care; Result-based management; Individual or client-centered approaches promoting self-regulation; Motivation; and Self-esteem and Empowerment fostering participant self-efficacy. Observation and evaluation, integrated within a systematic community participation mechanism, were conducted. Following the intervention, participants demonstrated significantly higher mean scores in knowledge (t = 19.30, p < .001) and all dimensions of preventive behaviors (t = 5.97-7.71, p < .001). Clinical outcomes significantly improved, including reductions in systolic blood pressure (t = 3.45, p < .05), body weight and waist circumference (t = 4.36-4.46, p < .001), fasting blood sugar (t = 7.09, p < .05), and HbA1c (t = 5.65, p < .01). The developed model serves as a sustainable community-based prototype for health behavior modification.
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