Outcome of 7steps Model for Changing Health Behavior of Diabetes Mellitus (DM) Risk Group, Health Region 10th Ubon Ratchathani

Abstract

This research was aimed to study outcomes of the 7-steps ladder program implementation for changing health behavior of DM risk group in public health region 10. The study area was Public Health Region 10, Ubon Ratchathani. The study unit was Sub-district Health Promotion Hospital (SHPH), 15 SHPH from 5 provinces. Target groups were divided into two groups: the first group was Public Health Personnel (PHP), consisting of PHP from SHPH and health volunteer’s specialists (HVS) 45 people, and the second was Diabetes Mellitus Risky Group (DMRG), 30 people for each SHPH, total was 450 people. The tools comprised a 7-step ladder program of changing health behavior, which was developed from the 3E 2S and divided into three phrases: 1st is the preparing phases, 2nd is the intensive phases of promoting activities for changing health behavior as well as knowledge sharing among DMRG and empowerment site visits, and 3rd is the evaluation phases, to evaluate Capillary Blood Glucose (CBG) in the 3rd, 6th, and 9th months, and the final phases was to evaluate the Hemoglobin A1c (HbA1c). Data was analyzed by descriptive statistics, Wilcoxon Rank test, and Friedman test.

The results found that after participation a 7-step ladder program for changing health behavior, 438 DMRG, mostly female (70.5%). It was found that the DMRG had significantly higher knowledge of the 3E2S principles (p-value < 0.001). The mean behavior scores of the 3E2S principles in the 2nd, 3rd, and 9th months increased from the 0th month with statistical significance (p-value < 0.001). The the 7-steps ladder program was able to prevent new diabetes cases by 87.7%. However, the incidence of new diabetes cases was still found at 12.3%. The obstacle in implementing the program is that some high-risk individuals did not consistently engage in the program because they believe they are not sick.