[2026-01-26] Integrated Training Program in Lifestyle Medicine and Health Literacy for Diabetes Coaches: A Research and Development Study in Community-Based Prediabetes Management

Kridsada Sirichaisit

doi:10.33165/rmj.2026.277974

Authors

Kridsada Sirichaisit Regional Health Promotion Center 8 Udon Thani, Department of Health, Ministry of Public Health, Thailand https://orcid.org/0009-0005-3475-2715

DOI:

https://doi.org/10.33165/rmj.2026.277974

Keywords:

Prediabetes, Lifestyle medicine, Health literacy, Community health coach, Diabetes prevention

Abstract

Background: Prediabetes significantly increases risk for type 2 diabetes mellitus (DM) and cardiovascular disease. Lifestyle modification represents the most effective preventive approach but requires strong health literacy and self-management skills for sustainable implementation in community settings.

Objectives: To develop and evaluate an integrated training program combining lifestyle medicine and health literacy for DM coaches in managing prediabetes within Thai communities. This evaluated whether intensive coach training could produce superior outcomes and assessed peer coaches' effectiveness in delivering lifestyle interventions.

Methods: This 12-month research and development study following the ADDIE framework was conducted across 7 provinces in northeastern Thailand. A total of 4998 participants with prediabetes were enrolled: 1127 trained as DM coaches through an intensive 2-day training which integrated lifestyle medicine, health literacy, and coaching techniques while implementing personal lifestyle modifications. The other 3871 received peer coaching from trained coaches. Primary outcomes included fasting blood glucose (FBG), blood pressure (BP), anthropometrics, body composition, knowledge, and lifestyle medicine scores. Linear mixed model (LMM) analysis assessed within-group changes and between-group differences as rates of change over time.

Results: Both groups demonstrated significant improvements in all parameters (P < .001). The DM coach group achieved substantial reductions in FBG (-8.4 mg/dL), body weight (-0.8 kg), systolic BP (-1.5 mmHg), and diastolic BP (-2.0 mmHg). LMM analysis revealed superior daily improvements in diastolic BP (-0.012 mmHg/day, P = .020) in the coach group. Knowledge scores improved by 4.5 points and coaching skills by 1.6 points in the coach group.

Conclusions: The integrated DM coach training program effectively improved clinical outcomes, knowledge, and lifestyle practices. This community-based approach offers a promising, scalable strategy for DM prevention in resource-limited settings.

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