A Contribution of PAR for the Prevention and Control of Hypertension and Diabetes among the Elderly in Thailand

Abstract

BACKGROUND: A rise in the number of elderly people in society increases the need for disease prevention and health promotion services as the growing figure entails more patients suffering from chronic illnesses, such as hypertension and diabetes. In order to prevent and control these non-communicable diseases, Participation Action Research (PAR) can be a powerful mechanism for engaging the elderly in PAR, and has the potential to provide a way to enhance the health of the elderly, consequently; it is necessary to design an appropriate health promotion model involving community participation.OBJECTIVE: This participation action research aims to develop a health promotion model integrating community participation for the prevention and control of hypertension and diabetes in the elderly and to implement a local intervention.METHODS: Mixed methodologies of mainly a qualitative approach and a supported quantitative approach with a questionnaire were employed. This was community-based participatory action research in which the researchers and community partners were the main participants. The PAR model was developed interactively in collaboration with the setting of local administration, the public sector, and the private sector. The process involved assessing the situation, taking action to promote community participation based on the analysis, implementing the solution, and testing the model and evaluating the model applying the After Action Review (AAR) approach.RESULTS: A health promotion model was developed and then piloted by the community team. The model is designed to improve the health behavior of the elderly; preventing and controlling hypertension and diabetes; providing continuous health education, especially regarding the importance of nutrition; physical activity; stress management; and facilitating the access of the vulnerable elderly to health services. The results showed that all the sectors, namely, families, schools, and temples, were involved in every stage of the research. The research results indicate that the model can build community health-promotion capacity, partnership development, community health plans, and community innovation and build a supportive environment.CONCLUSION: The paper illustrates that PAR has the potential to provide a way to make the significant role of community participation in a project for the prevention and control of hypertension and diabetes and for the promotion of healthy aging in a rural setting. Moreover, PAR can enhance program design and implementation based on the sharing of best practices and the active engagement of community members. In this way, the elderly can perceive benefits of group participation in enhancing their self-care ability, their sense of empowerment, and their ability to learn to prevent, control and sustain changes in their health behavior.