Strengthening the capability of family health leaders for sustainable community-based health promotion.

ABSTRACT

The Family Health Leader (FHL) Project was initiated in 1997 to encourage self-care and health promotion. Since then, there has been no retraining. This study aimed to strengthen the FHLs' capability to sustain community-based health promotion and network establishment. The study, of a quasi-experimental design, was conducted in a village in Phan Thong district, Chon Buri Province, Thailand. The intervention emphasized enhancing the FHLs' knowledge, ability, leadership and motivation to advance health promotion activities. Before implementing the main intervention, 5 community health workers were trained as facilitators to strengthen 36 FHL capabilities. The curriculum and manual for training facilitators and FHLs were also developed. The intervention for strengthening FHLs' capabilities lasted for 7 months using participatory training. A within-subject repeated ANOVA was used to measure changes in the main outcome variables immediately, and at three and six months after the intervention. A qualitative methodology was utilized to assess network establishment. The results indicate that the FHLs' knowledge of self-care and health promotion, ability, leadership and motivation had increased significantly after the intervention (p < 0.001). The FHLs also sought to extend their network by involving both the community committee and the local authorities. The intervention appeared to be successful in strengthening the FHLs' capabilities to sustain health promotion within the community, and it established networks vertically and horizontally. The FHLs were the key persons to bring good health to family members. Periodical participatory learning and group empowerment are recommended for encouraging the FHLs to maximize their potential for family self-care and health promotion.