Development of Measures to Solve the Problems Associated with Steroid Use among the Elderly through Community Participation, Bangu Subdistrict, Yangsrisurat District, Mahasarakham Province

Abstract

The objective of this study was to identify solutions associated with the use of steroids among the elderly. A concept of community participation was incorporated into the process. It was conducted in Bangpu Sub-dictrict, Yangsrisurat District, Mahasarakham province, during the period from October 2557 - May 2559. The study samples were 90 persone who were ageing people, community health volunteers, community leaders, public health officials, owner of grocery stores and teachers. The overall study protocol was comprised of 3 phases: knowledge generation, model development, and model implementation. The study tools included questionnaire survey, the AIC strategy (Appreciation-Influence-Control), individual interviews, observation, field notes and satisfaction survey. Data were analyzed qualitatively and quantitatively by using percentage, data triangulation,  and content analysis. It was found that the implementation measures to address the problems associated with stroid use included  (1) creating knowledge among partmenrs in the network with the task of performing surveillance, education and communication which were integrated into their routine work; (2) creating community surveillance teams responsible for monitoring, surveillance and monitoring in coordination with local public health officers; (3) active surveillance on local drug sale by mobile dealers; (4) establishing a common vision on “model steroid community”; (5) creating commitment by signing a memorandum of understanding (MOU) among key stakeholders in the community with an intention to prohibit mobile drug selling and ban the sale of steroid in grocery stores; (6) monthly monitoring and evaluation by the committee. After the implementation, majority of the elderly were found to have proper knowledge on the rationale use of drugs (96.00%); family caregivers, community leaders and stakeholders had good knowledge on the issue (98.00%);  and appropriate drug use behaviours were observed among 98.00% of the elderly. Steroid sale in the community was no longer available. As for the satisfaction assessment, all stakeholders were satisfied with the implementation; and had fully participated in all the program activities. The model was subsequently scaled-up to 4 nearby health promoting hospitals. In conclusion, the use of AIC with the invlovement of the community was found to be effective in addressing the problems associated with steroid use among the elderly. Such approach should be widely applied in order to obtain effective and sustainable problem solving mechanism within the communities.