Developing Patterns of Behavioral Health at High Risk Groups of Diabetes and Hypertension through a Participatory Process of Network Partners following the Transfer of Responsibilities of the Sub-district Health Promoting Hospital to the Provincial Administrative Organization In Wan Yai District, Mukdahan Province

Abstract

This participatory action research aimed to develop a health behavior modification model for diabetes and hypertension risk groups through the participation of network partners, after mission transferring of the Sub-district Health Promoting Hospital (SHPH) to the Provincial Administrative Organization in Wan Yai District, Mukdahan Province. The study was conducted between April and July 2024. The participants included 48 people of public health officers and community network partners, and included 80 people of diabetes and hypertension risky person. The research followed a four-step process: planning, implementation, observation, and reflection. Qualitative data were analyzed inductively, while quantitative data were analyzed using frequency, percentage, standard deviation, mean, and paired t-tests.

The study found several challenges in behavior change operations for diabetes and hypertension risk groups during the mission transfer. These challenges included issues with the quality of the screening process, risk identification, and referrals for treatment. The leadership team were lacked knowledge, skills, and a clear understanding of their roles in conducting activities. The risky group was lack of awareness regarding self-care, while the community was non participation and support for behavior change efforts. There was limited use of technology to communicate about diabetes and hypertension, a lack of shared community resources, and no team designated to monitor and evaluate the operations. The pattern of behavioral modification was 2SPHTWE. The components were Self-awareness, Participation & Communication, Service System, Health-Promoting Environment, Technology & Innovation, Wellness Club and Evaluation & Empowerment. Seven activities were implemented; 1) group meetings and brainstorming using the AIC process to develop new-generation leaders, 2) enhancing knowledge and adjusting attitudes in risk groups to support behavior changes, 3) designing a seamless service system between the original and new service units, 4) promoting modern, accessible, and practical communication methods, 5) supporting the establishment of health behavior change clubs, 6) creating supportive areas and environments conducive to health improvement, and 7) providing mentoring for follow-up and empowerment. The evaluation of model implementation revealed significant improvements in participants' knowledge, attitudes, disease severity perception, risk perception, self-efficacy, participation, and preventive behaviors related to diabetes and hypertension. These improvements were statistically significant at the 0.05 level. Additionally, the sample group experienced significant reductions in fingertip blood sugar levels, blood pressure, and body mass index, also at the 0.05 statistical level.