A Model Development of Maternal and Child Health Handbooks to Promote Health Literacy among Pregnant Women and Early Childhood Caregivers in Thailand

Abstract

This action research aimed to develop a maternal and child health handbook to promote health literacy among pregnant women and early childhood caregivers in Thailand. The study was divided into three phases: 1) investigating the problems and needs of users and public health personnel through questionnaires and in-depth interviews; 2) planning the development of the handbook's content and format through a participatory process involving multidisciplinary professionals; and 3) piloting the new handbook prototype in four regions and evaluating its impact on knowledge, attitudes, health behaviors, and satisfaction. The results showed that the redesigned handbook, utilizing the LEAN concept and categorizing content according to the 4P principles for pregnant women (Plan for pregnancy, antenatal care, delivery, and postpartum) and 4D principles for early childhood (Disease prevention, Diet, Development, and Dental health), featured clear categorization and ease of use. Knowledge content was enhanced via QR codes to reduce page count and allow for flexible, up-to-date information adjustments. Participants in both the pregnant women and early childhood caregiver groups demonstrated a statistically significant increase in health literacy, as measured by pre- and post-intervention assessments using a one-group pretest-posttest design (t-statistic = 2.17 and 3.97, p-value = 0.043 and 0.0008, respectively). User satisfaction in each group was very high, ranging from 90% to 100%. Recommendations include expanding the use of this new handbook nationwide and developing a digital version to accommodate modern user behaviors and enhance long-term accessibility