The Development of Causal Relationship Model and Effectiveness of Health Literacy Promotion Program for Self-care of Village Health Volunteers with Hypertension

Abstract

Abstract

The purposes of this research were to examine the causal relationship model of factors affecting self-care behavior and to study the effectiveness of a health literacy promotion program for self-care among village health volunteers suffering from hypertension. The research was divided into two phases: Phase 1 involved a comparative causal study, and Phase 2 involved quasi-experimental research. The research instruments included a standardized questionnaire, a true-false questionnaire, and a health literacy promotion program for self-care. Data analysis was conducted using descriptive statistics, structural equation modeling, chi-square, t-tests, one–way MANOVA, and repeated measures ANOVA.

The results of first phase indicated that the developed causal relationship model of factors influencing self-care behavior was consistent with empirical data (Chi-Square = 7.02, df = 3, p-value = 0.07, RMSEA = 0.06, CFI = 1.00, GFI = 0.99, SRMR = 0.02). The results of second phase showed that after the intervention, the experimental group had higher mean scores in health literacy and self-care behavior compared to before the intervention (t = 3.42, 3.86, p-value = 0.00, 0.00, respectively), and a lower average body mass index (BMI) than before the intervention (t = -2.04, p-value = 0.05). Additionally, the experimental group had higher mean scores in health literacy and self-care behavior compared to the control group (F = 5.19, 18.79, Sig. = 0.03, 0.00, respectively), while BMI differences from the control group were not statistically significant. Furthermore, self-care behavior in the experimental group showed a trend of improvement (F = 4.21, p-value = 0.02), with the average self-care according to the 3A2S principle score at the 3-month follow-up being higher than at the 2-month and 1-month.

Keywords : Health literacy; Self-care; Hypertension; Village health volunteers