Development of a Health Promotion Model to Prevent Diabetes Mellitus in Primary Care Units within District Health System (DHS), Mueang District, MahaSarakham Province - การพัฒนารูปแบบการส่งเสริมสุขภาพประชาชน กลุ่มเสียงเบาหวานของหน่วยบริการปฐมภูมิ ภายใต้การขับเคลือนของระบบสุขภาพอำเภอเมือง จังหวัดมหาสารคาม

Abstract

               The objective of this research was to develop a quality service model for the prevention of diabetes mellitus in primary care units of a district health system which included 20 primary care units of Muang District, Mahasarakham province. It was conducted during October 2013 to May 2014. Two groups of samples were recruited: (1) 539 health personnel in primary care units, and (2) 1091 community people at risk of developing diabetes. Questionnaires, focus group discussion and in-depth interview were used in the study. Descriptive statistics and inferential statistic were used for quantitative data; and content analysis was used for qualitative analysis. The findings showed that the development results could be divided into 2 levels which were (1) primary care unit, consisting of 13 significant activities, and (2) district level that comprises of 10 essential activities. Those led to the 3M-S-K-H development model which consisted of 3M—Man, Management and Monitoring, S—Social network participation, K—Knowledge and skill development and H—Health promotion. After applying the 3M-S-K-H model, there was an increase in mean knowledge and perception of the pre-diabetes samples. Furthermore, the mean blood sugar level was also significantly lower (p<0.05). Primary care unit health authorities had significantly more satisfaction and got more participation (p<0.05). In conclusion, the key success factors in this development process were the components of the DHS-L comprising (D) district health system policy, (H) health volunteers  who were local health leaders, (S) sharing resources, and (L) learning continuously.

Key words: health promotion, district health system, pre diabetes mellitus, primary care unit