Development and Effectiveness Evaluation of a Holistic Ecological Health Promotion Model for Buddhist Monks: A Participatory Case Study in Kuti Cheevaphiban, Uttaradit Province

Abstract

Noncommunicable diseases are significant health problems among Buddhist monks that require appropriate and sustainable health promotion approaches. This research aimed to (1) study health problems and needs of monks in Kuti Cheevaphiban, (2) develop a holistic ecological health promotion model for monks, and (3) evaluate the effectiveness of the developed model. This research and development study was conducted in three phases: Phase 1 investigated health problems and needs using mixed methods research with 200 quantitative samples and 41 qualitative informants. Phase 2 developed the model through participatory action research and expert consultation with 9 experts. Phase 3 implemented and evaluated the model's effectiveness using a one-group pretest-posttest quasi-experimental design with 38 monks. Research instruments included questionnaires, holistic well-being assessment forms, health behavior assessment forms, and health indicator records. Data were analyzed using descriptive statistics and the paired t-tests. Phase 1 results showed that monks had multiple chronic diseases, particularly hypertension, diabetes, and overweight, and expressed needs for health promotion approaches integrating Buddhist principles, community participation, and environmental improvement in Kuti areas. Phase 2 results revealed that the developed model comprised six main components: principles, objectives, a five-step implementation process, four-dimensional main activities, stakeholder roles, and supporting factors. Expert evaluation of the model demonstrated the highest appropriateness level. Phase 3 results on model effectiveness indicated that after program participation, monks showed statistically significant improvements in all dimensions of holistic well-being, better health behaviors, and significantly improved health indicators. In conclusion, the holistic ecological health promotion model integrating the One Health concept, community participation, and the Buddhist principle was highly effective in promoting monks' well-being. Therefore, the model should be expanded and integrated with local health policies for sustainability.