Effects of an empowerment program on health behaviors and stroke risk reduction of at-risk group in Thai rural community.

BACKGROUND: Unhealthy behaviors such as being overweight, have hypertension, diabetes, and dyslipidemia increase the risks of stroke. Promoting healthy behaviors could reduce the incidence of stroke, death, and disabilities. Empowerment was used in this study to help people change their health behaviors. OBJECTIVE: To determine the effects of an empowerment program on health behaviors and stroke risk factors reduction of people at-risk for stroke in a rural community in Thailand. MATERIAL AND METHOD: A quasi-experimental study was conducted in sixty participants identified with moderate risk for stroke, according to the Standard Operation Procedure to Prevent and Control of Stroke 2007 of the Bureau of Non Communicable Disease, from two villages in Phitsanulok. Participants were enrolled in experimental (n = 30) and control (n = 30) groups using match pair for sex, age, blood pressure, and blood sugar. The experimental group received empowerment based on the Gibson's model of empowerment (discovering reality, critical reflection, taking charge, and holding on) at week 1, 4, and 8 while the control group received routine care. The study duration was 12 weeks. Instruments used were a questionnaire regarding health behaviors and a form for recording the BMI, blood pressure, blood sugar cholesterol, and triglyceride. Data analyses included the Analysis of Variance (ANOVA), repeated measure, and independent t-test. RESULTS: Following the implementation of the empowerment program, health behaviors of participants in the experimental group were significantly better than those of the control group (p < 0.001). Risk factors, body mass index, blood pressure, blood sugar, cholesterol, and triglyceride of participants in the experimental group were significantly lower than those in the control group (p < 0.01, p < 0.001). CONCLUSION: The empowerment program was effective in decreasing stroke risk behaviors and stroke risk factors. Future research using this empowerment intervention program should be conducted in high cardiovascular risk group and patients with other chronic diseases.

The development of health-promoting hospitals using the Primary Care Award (PCA) standard in Muang District, Phitsanulok, Thailand

The purposes of this descriptive study were to : (1) determine the level of understanding of hospital personnel using the Primary Care Award (PCA) standard, and (2) determine the progress of implementation of the standard. The instruments used a questionnaire and a semi-structured interview form. The questionnaire was composed of three parts: the demographic data; the opinionaire focused on the implementation of the PCA and the roles of the stakeholders; and the evaluation of progress of implementing the PCA Standards. Respondents were hospital personnel working in each of the twenty four hospitals in Muang district, Phitsanulok province, Thailand. The results of the study revealed that the opinion of the hospital regarding the implementation of the PCA in all dimensions was high, however the actual implementation was at intermediate level. The Ministry of Public Health (MOPH) had high commitment towards the implementation of the PCA, while the provincial health office and the district health office had medium level of commitment. The participation of the local government and the village health volunteers were at the low level.

The enhancement of adaptation and psychological well-being among victims of flooding and landslide in Thailand.

OBJECTIVE: To explore the needs of potential enhancement for adaptation and to examine the effectiveness of the potential enhancement program for adaptation and psychological well-being among victims of flooding and landslide in Lublae district Uttaradit Province, Thailand. MATERIAL AND METHOD: 3 step of research and development; the needs of potential enhancement for adaptation among victims of flooding and landslide were analyzed by focus group discussion, the potential enhancement program (PEP) was designed by brainstorming of three groups of stakeholder; victims, health volunteers and health personnel and the effectiveness of PEP was tested by the difference of adaptation and psychological well-being perception among victims of flooding and landslide between before and after intervention. SETTING: Thumbun Maepou, Lublae district, Uttaradit Province, Thailand. RESULTS: The needs of potential enhancement among victims of flooding and landslide were set up warning network along the risk canal and mountain, first aid training for health volunteer, and program of psychological health promotion. The PEP composed of community flooding and landslide rehearsal training, health education and dissemination and knowledge management. Total adaptation and psychological wellbeing of samples after intervention were significantly higher than that of before intervention at 0.05 and 0.001, respectively. CONCLUSION: The restoration of adaptation and psychological well-being among victims of flooding and landslide were essential to maintained holistic health.