The Development of Social Ecological Model and Stage-Based Workplace Health Promotion Program to Control Blood Lipid Profile in Employees

Main Article Content

Mustopa Sih
Umaporn Boonyasopun
Charuwan Kritpracha


Hyperlipidemia is a major risk factor for coronary heart disease. It is the most frequently detected
illness in workplace health examinations including in electricity generating authority of Thailand (EGAT).
Hyperlipidemia management guideline addresses health behavior modification. The previous study found that
behavior modification can be achieved but can not be sustainable. In order to achieve long-term sustainable
behavior change, both individual and environmental factors should be supported.This study aimed to develop
a social ecological model and stage-based workplace health promotion program to control blood lipid profile in
EGAT employees. Transtheoretical model, social ecological model and empirical evidence were employed as framework.
The study was divided into two phases. The development of component of the program and feasibility testing in the
employees who were working in EGAT.
The program comprised three components: 1) a program guideline (including four process are preparing phase, planning phase,
operation phase and evalution phase), 2) an activity plan and 3) a practiced manual for the prevention of hyperlipidemia.
The validity of program evaluated by three experts showing that the program is valid and appropriate to the context of
employees in the workplace. The feasibility of the program implementation revealed that the program can be used for
employees in workplace. The media is useful and interesting. The program provides detail description with simple and
clear instruction. Therefore it can be used to promote employees health in the workplace. Further experimental research
is needed to demonstrate the effectiveness and efficiency of the program.


Download data is not yet available.

Article Details

How to Cite
Sih, M., Boonyasopun, U., & Kritpracha, C. (2018). The Development of Social Ecological Model and Stage-Based Workplace Health Promotion Program to Control Blood Lipid Profile in Employees. Journal of Research in Nursing-Midwifery and Health Sciences, 38(4), 1–13. Retrieved from
Research Articles


1. Bureua of Non-Communicable Diseases. The
rate of death from heart disease and stroke
[Internet]. [Cited on 2016 Jan 20]. Available from

2. Sritara P, Patoomanunt P, Woodward M, et al.
Association between serum lipids and causes of
mortality in a cohort of 3499 urban thais: The
Electricity Generating Authority of Thailand (EGAT)
study. Angiology.2008; 58(6), 757-63 doi: 10.

3. Bangpakok 9 International Hospital. Report
employee health check up 2014-2016. Bankok.
BPK 9 publishing; 2016. Thai.

4. Limwattananon S, Limwattananon C, Cheawchan-
wattana A, et al. Forecated expenditure due to
use of expensive drugs in CivailServant Medical
Benefit Scheme: A comparison with Universal
Health Coverage Scheme. Journal of Health
Systems Research.2011; 5(2): 170 –80. Thai.

5. Leecharoen P. The effect of behavior change
program upon lipid of patients with diabetics
type II, Lower southern region [Thesis]. [Bangkok]:
Chulalongkorn University; 2009. 137 p. Thai.

6. Tipta P. Non-Pharmacological management of
dyslipidemia: Integrative review [Thesis]. [Chiangmai]
:Chiangmai University; 2013.104 p. Thai.

7. Aldwina CM, Jeong Y, Igarashi H, et al. Do
hassles mediate between life events and mortality
in older men? Longitudinal findings from the VA
Normative Aging Study. Exp Gerontol. 2014; 59,
74-80. doi:10.1016/j.exger.2014.06.019

8. Mannu GS, Zaman MJS, Gupta A, et al. Evidence
of lifestyle modification in the management of
hypercholesterolemia. Curr Cardiol Rev.2013;
9(1), 2-14.

9. Alihan MA. Social ecology: A critical analysis.
New York: Cooper Square Publisher; 1938

10. Prochaska JO, Diclemente CC, Norcross JC. In
search of how people change: application of
addictive behaviors. Am Psychol. 1992; 47(9),

11. Beyea S, Slattery M. What is Evidence-Based
Practice. In Evidence-Based Practice in Nursing:
A guide to Successful Implementation. United
States: HCPro [Internet]. [Cited 2015 August 20].
Available from
8&dq=+Evidence-Based + Practice + in + Nursing+

12. The Joanna Briggs Institute. Joanna Brigss
Institute Reviewer’s manual: 2014 edition. Australia
by Solito Fine colour Printers. The Joanna
Briggs Institute.2014.

13. Sukwatjanee A. Use behavioral change program
to decrease hyperlipidemia and hypertension in
primary health setting. GSTF Journal of Nursing
and Health Care-JNHC .2014; 1(1): 37-42.

14. Tassanasorn P, Glangkam S, Phanprugsa P. Health
behavioral modification model for lipid reduction
among personal with dyslipidemia at fort
weerawat yothin hospital in Surin Province.
Journal of TheRoyal Thai Army Nurses. 2012;
13(2): 49-59. Thai.

15. Chantawang S. Effect of self-management
supportting program on Self-management
behaviors and serum lipid level among elders
with dyslipidemia [Thesis]. [Chiangmai]. Chiangmai
University; 2011. 111 p. Thai.

16. Boonsin K, Trethasayuth J, Chareanmak B.
Effectiveness of health education for the patient
with hyperlipidemia attending the general practice
in Songkhlanagarind Hospital, Songkla Med J.
2008; 26(6): 519-25. Thai.

17. Muatjan N, Thanasilp S. The effect of food
consumption behavior modification and qigong
program on blood cholesterol and triglyceride
level of people living with HIV/AIDS. Journal
of Bureau of Alternative Medicine. 2013; 6(1):
1-18. Thai.

18. Sriboonmark P. Behavior changes for hyperlipidemia
prevention among officers of Lampang Hospital,
Lampang province [Thesis]. [Chiangmai].Chiangmai
University; 2003.144 p. Thai.

19. Olarikchart T. The effect of a behavioral change
promotion program on health behaviors and
blood lipid of hotel staff with hyperlipidemia
[Thesis]. [Songkhla]: Prince of Songkla University;
2015. 145 p. Thai.

20. Chahal N, Wong H, Manlhiot C, et al. Education
for lifestyle-based management of hyperlipidemia
in children enhanced by a collaborative approach.
Journal of Clinical Lipidology. 2014; 8(2): 187-93.
doi: org/10.1016/j.jacl.2013.12.002

21. Ji-Yeon K, Sang-Woon C, Ji-Young L, et al.
The effect of worksite on-line health education
program on metabolic syndrome risk factors and
nutrient intakes of male workers. Korean J Nutr.
2010; 43(1): 57-68. doi: org/10.4163/kjn.2010.

22. Se-Yun P, Yoon-Joong Y, Yuri K. Effect of
nutrition education using a ubiquitous healthcare
(u-Health) service on metabolic syndrome in
Male Workers. Korean J Nutr. 2011; 44(3):
231-42. doi: 10.4163/kjn.2011.44.3.231.

23. Izumi H, Mustubara M, Saeki K, et al. The
effectiveness of hyperlipidemia prevention
intervention designed to affect behavior change:
focus on change in health behavior. Open
Journal of Nursing. 2014; 13(4):962-70. doi:

24. Sim KS, Lee KH. The effect of nutrition
education on nutrition knowledge and health
improvement in dyslipidemic industrial employees.
J Korean Diet Assoc. 2012; 18(1):43-58.

25. Thompson WG, Foster RC, Eide DS, et al.
Feasibility of a walking workstation to increase
daily walking. Br J Sports Med. 2008;42(3):
225-28. doi: 10.1136/bjsm.2007.039479

26. Whittemore R, Melkus GD, Grey M. Applying
the social ecological theory to type 2 diabetes
prevention and management. Journal of Community
Health Nursing. 2004; 21(2): 87-99. doi: 10.

27. Lagampun S.Stategy and method for health
promoting in community.In: health promotion
and disease prevention in community: An aplication
of concepts and theories to practice. 2th ed.
Bangkok: Klang nana wittaya; 201; p71.Thai.

28. Matson-Koffman DG, Brownstein JN, Neiner
JA, et al. A Site-specific literature review of
policy and environmental interventions that
promote physical activity and nutrition for
cardiovascular health: What works?Am. J Health
Promot. 2005; 19(3): 167-93.

29. Wangjhi N. Effect of Behavior Modification
Program on Medical Adherence and Blood Pressure
for Muslim Elderly with Uncontrolled Hypertension
[Thesis]. [Songkhla]: Prince of Songkla University;
2015. 139 p. Thai.

30. Müller-Riemenscheider F, Reinhold T, Nocon M.
Long-term effectiveness of interventions promoting
physical activity: A systemetic review. Prev Med.
2008; 47(4): 357-68. doi: 10.1016/j.ypmed.2008.

31. Powwattana A, Kalampakorn S. Health promotion
focus on behavior. In: Health promotion and
disease prevention in community: An aplication of
concepts and theories to practice. 2 th ed.
Bangkok: Klang nana wittaya; 2013. 95p. Thai.

32. Wantamel S. Guidelines for the prevention of
risky behaviors and health along the social
ecological. [Internet]. [Cited 2015 Apr 4]. Available
from :https://