Advertisement

Journal of Public Health

, Volume 26, Issue 5, pp 515–522 | Cite as

Developing a diabetes prevention education program for community health care workers in Thailand: translation of the knowledge to at-risk people

  • Kitti Sranacharoenpong
  • Panrawee Praditsorn
  • Piyanit Churak
Original Article

Abstract

Aim

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.

Results

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.

Conclusion

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.

Keywords

Community health care workers Diabetes prevention education program At-risk people for diabetes Thailand Nutrition knowledge 

Notes

Acknowledgements

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.

Funding

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 approval

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.

References

  1. Aekplakorn W, Bunnag P, Woodward M, Sritara P, Cheepudomwit S, Yamwong S, Yipintsoi T, Rajatanavin R (2006) A risk score for predicting incident diabetes in the Thai population. Diabetes Care 29(8):1872–1877CrossRefPubMedGoogle Scholar
  2. Aekplakorn W, Chongsuvivatwong V, Abbott KJ, Suwanprapisa T, Premgamone B, Tiptarado S, Chaikittipon C, Lim SS (2007) Prevalence and management of diabetes and associated risk factors by regions of Thailand. Diabetes Care 30(8):2007–2012CrossRefPubMedGoogle Scholar
  3. Amend A, Melkus GD, Chyun DA, Galasso P, Wylie-Rosett J (2007) Validation of dietary intake data in black women with type 2 diabetes. J Am Diet Assoc 107:112–117CrossRefPubMedGoogle Scholar
  4. 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
  5. Baker EA, Kreuter M, Homan SM, Starkloff-Morgan S, Schonhoff R, Francioni A (2002) Using community-based participatory processes to bring health education technology to communities. Health Promot Pract 3(1):83–94CrossRefGoogle Scholar
  6. Baumgartner TA, Chung H (2001) Confidence limits for intraclass reliability coefficients. Meas Phys Educ Exerc Sci 5:179–188CrossRefGoogle Scholar
  7. Briggs FH, Turner MB, Gary TL, Brancati FL, Hill MN, Levine DM, Bone LR (2006) Training community health workers as diabetes educators for urban African Americans: value added using participatory methods. Prog Community Health Partnersh 1(2):185–193CrossRefGoogle Scholar
  8. Bryant CA, McCormack Brown KR, McDermott RJ, Forthofer MS, Bumpus EC, Calkins SA, Zapata LB (2007) Community-based prevention marketing: organizing a community for health behavior intervention. Health Promot Pract 8(2):154–163CrossRefPubMedGoogle Scholar
  9. 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
  10. Flynn MAT, McNeil DA, Maloff B, Mutasingwa D, Wu M, Ford C, Tough SC (2006) Reducing obesity and related chronic disease risk in children and youth: a synthesis of evidence with ‘best practice’ recommendations. Obes Rev 7(suppl 1):7–66CrossRefPubMedGoogle Scholar
  11. French SA, Story M, Jeffery RW (2001) Environmental influences on eating and physical activity. Annu Rev Public Health 22:309–335CrossRefPubMedGoogle Scholar
  12. Hair JF, Anderson RE, Tatham RL, Black WC (1998) Multivariate data analysis, 5 edition. Prentice Hall Inc., LondonGoogle Scholar
  13. 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
  14. Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM, Diabetes Prevention Program Research Group (2002) Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med 346:393–403CrossRefGoogle Scholar
  15. Lindstrom J, Louheranta A, Mannelin M, Rastas M, Salminen V, Eriksson J, Uusitupa M, Tuomilehto J (2003) The Finnish diabetes prevention study (DPS): lifestyle intervention and 3-year results on diet and physical activity. Diabetes Care 26:3230–3236CrossRefPubMedGoogle Scholar
  16. Mochari H, Gao Q, Mosca L (2008) Validation of the MEDFICTS dietary assessment questionnaire in a diverse population. J Am Diet Assoc 108:817–822CrossRefPubMedPubMedCentralGoogle Scholar
  17. Raine KD (2004) Overweight and obesity in Canada: A population health perspective. CIHI/CPHIGoogle Scholar
  18. Richard L, O’Loughlin J, Masson P, Devost S (1999) Healthy menu intervention in restaurants in low-income neighbourhood: a field experience. J Nutr Educ Behav 31:54–59CrossRefGoogle Scholar
  19. Salter D, Richards L, Carey T (2004) The ‘T5’ design model: An instructional model and learning environment to support the integration of online and campus-based course. EMI Educ Media Int 207–217CrossRefGoogle Scholar
  20. Satterfield DW, Burd C, Valdez HG, Eagle SJ (2002) The in-between people: participation of community health representatives in diabetes prevention and care in American Indian and Alaskan Native communities. Health Promot Pract 3(2):166–175CrossRefGoogle Scholar
  21. 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
  22. Segal-Isaacson C, Wylie-Rosett J, Gans KM (2004) Validation of a short dietary assessment questionnaire: the rapid eating and activity assessment for participants short version (REAP-S). Diabetes Educ 30:774–781CrossRefPubMedGoogle Scholar
  23. Sirichakwal PP, Sranacharoenpong K (2008) Practical experience in development and promotion of food-based dietary guidelines in Thailand. Asia Pac J Clin Nutr 17(Suppl 1):63–65PubMedGoogle Scholar
  24. 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
  25. Sranacharoenpong K, Hanning RM (2011) Developing a diabetes prevention education programme for community health care workers in Thailand: formative findings. Prim Health Care Res Dev 12:357–369CrossRefPubMedGoogle Scholar
  26. Sranacharoenpong K, Hanning RM (2012) Diabetes prevention education program for community health care workers in Thailand. J Community Health 37:610–618CrossRefPubMedGoogle Scholar
  27. Story M, Kaphingst KM, Robinson-O’Brien R, Glanz K (2008) Creating healthy food and eating environments: policy and environmental approaches. Annu Rev Public Health 29:253–272CrossRefPubMedGoogle Scholar
  28. Wibulpolprasert S (ed) (2002) Thailand health profile 2001–2004. Express Transportation Organization Printing Press, BangkokGoogle Scholar
  29. 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
  30. Witmer A, Seifer SD, Finocchio L, Leslie J, O’Neil EH (1995) Community health workers: integral members of the health care work force. Am J Public Health 85:1055–1058CrossRefPubMedPubMedCentralGoogle Scholar
  31. World Health Organization (2002) Globalization, Diets and Noncommunicable Diseases. WHA55.23. Geneva, Switzerland. http://whqlibdoc.who.int/publications/9241590416.pdf. Accessed 5 Jan 2016
  32. 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

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Kitti Sranacharoenpong
    • 1
  • Panrawee Praditsorn
    • 1
  • Piyanit Churak
    • 1
  1. 1.Department of NutritionInstitute of Nutrition, Mahidol UniversityNakhon PathomThailand

Personalised recommendations