Developing a diabetes prevention education program for community health care workers in Thailand: translation of the knowledge to at-risk people
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To evaluate the effects of a randomized education program for community health care workers (CHCWs) on the knowledge, awareness and understanding of key messages related to healthy eating among community members at risk for diabetes (at-risk-DM) identified through community diabetes screening.
Subjects and methods
Sixty-nine health centers from five districts in Chiang Mai Province, Thailand, were randomized into the intervention (CHCWs-IG, n = 35) and control group (CHCWs-CG, n = 34). CHCWs-IG participated in a diabetes prevention education program (DPEP) over 4 months. No training/support materials were provided to the CHCWs-CG. The knowledge of all CHCWs was assessed at baseline and the 4- and 8-month follow-ups. To test knowledge dissemination from CHCWs to at-risk-DM, awareness of key messages and other risk factors was tested between at-risk-DM in the CHCW intervention group (at-risk-DM-IG, n = 511) compared with controls (at-risk-DM -CG, n = 405) at baseline and 8 months.
CHCWs-IG knowledge scores improved from baseline [mean (SD), 56.5% (6.26)] after 4-month training [75.5% (6.01), p < 0.001] and 8-month follow-up [71.3%(7.36), p < 0.001) while those of CHCW-CG remained unchanged. Body weight, body mass index, waist circumference and systolic blood pressure within at-risk-DM-IG and at-risk-DM-CG at baseline and 8 months were not significantly different. Knowledge test scores of both groups after 8 months had increased from baseline (p = 0.001) but were not different from each other.
DPEP for CHCWs was effective in improving knowledge. However, it was likely that multiple influences resulted in improvements in community member knowledge. As expected, no difference between groups in physical measures was observed at 8 months. Long-term lifestyle changes towards the health outcome of diabetes prevention are suggested for future study.
KeywordsCommunity health care workers Diabetes prevention education program At-risk people for diabetes Thailand Nutrition knowledge
This research was supported by grants from the Nestlé Foundation, Switzerland. The authors acknowledge the team staff of the health care offices in Chiang Mai Province, Thailand, and particularly thank the staff of The Office of Disease Prevention and Control 10 Chiang Mai Province, Ministry of Public Health, for their facilities and hospitality. The authors thank Ms. Julia Verhaeghe for editing the English grammar.
This research was supported by the Nestlé Foundation in Switzerland.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interests.
Ethical consideration of this study was sent for approval by the Chiang Mai Public Health Office Institutional Review Board, Ministry of Public Health, Thailand. All the respondents signed an informed consent form.
- Armstrong SJ, Bryce J, de Savigny D, Lambrechts T, Mbuya C, Mgalula L, Wilczynska K, Tanzania IMCI Multi-Country Evaluation Health Facility Survey Study Group (2004) The effect of integrated management of childhood illness on observed quality of care of under-fives in rural Tanzania. Health Policy Plan 19:1–10CrossRefGoogle Scholar
- Eriksson J, Lindstrom J, Valle T, Aunola S, Hamalainen H, Parikka-Ilanne P, Keinänen-Kiukaanniemi S, Laakso M, Lauhkonen M, Lehto P, Lehtonen A, Louheranta A, Mannelin M, Martikkala V, Rastas M, Sundvall J, Turpeinen A, Viljanen T, Uusitupa M, Tuomilehto J (1999) Prevention of type II diabetes in subjects with impaired glucose tolerance: the diabetes prevention study (DPS) in Finland. Study design and 1-year interim report on the feasibility of the lifestyle intervention programme. Diabetologia 42(7):793–801CrossRefPubMedGoogle Scholar
- Hair JF, Anderson RE, Tatham RL, Black WC (1998) Multivariate data analysis, 5 edition. Prentice Hall Inc., LondonGoogle Scholar
- Keeratiyutawong P, Hanucharurnkul S, Melkus GD, Vorapongsathon OPT (2006) Effectiveness of a self-management program for Thai with type 2 diabetes. Thai J Nurs Res 10:85–97Google Scholar
- Raine KD (2004) Overweight and obesity in Canada: A population health perspective. CIHI/CPHIGoogle Scholar
- Schulz AJ, Zenk S, Odoms-Young A, Hollis-Neely T, Nwankwo R, Lockett M, Ridella W, Kannan S (2005) Healthy eating and exercising to reduce diabetes: exploring the potential of social determinants of health frameworks with the context of community-based participatory diabetes prevention. Am J Public Health 95(4):645–651CrossRefPubMedPubMedCentralGoogle Scholar
- Sranacharoenpong K, Hanning RM, Sirichakwal PP (2009) Chittchang U (2009) process and outcome evaluation of a diabetes prevention education program for community healthcare workers in Thailand. Educ Health (Abingdon) 22(3):335–346Google Scholar
- Wibulpolprasert S (ed) (2002) Thailand health profile 2001–2004. Express Transportation Organization Printing Press, BangkokGoogle Scholar
- Wibulpolprasert S (Editor) (2007) Thailand health profile 2005–2007. Bangkok: Express Transportation Organization. http://www.hiso.or.th/hiso/picture/reportHealth/report/ThaihealthProfileE2007.pdf. Accessed 26 March 2016
- World Health Organization (2002) Globalization, Diets and Noncommunicable Diseases. WHA55.23. Geneva, Switzerland. http://whqlibdoc.who.int/publications/9241590416.pdf. Accessed 5 Jan 2016
- World Health Organization (2005) IMCI Integrated Management of Childhood Illness. (NLM classification: WS 200). Geneva, Switzerland. http://apps.who.int/iris/bitstream/10665/42939/1/9241546441.pdf. Accessed 12 Feb 2016