The Development of a Participatory Model for Improving the Quality of Life of Vulnerable Groups in Health by the District Health board in Wang Sombun District, Sakaeo.

Abstract

This study employed a Participatory Action Research (PAR) approach using a mixed-methods research design. The objectives were to: (1) examine the problems and needs related to quality-of-life development among health-vulnerable groups in Wang Sombun District, Sa Kaeo Province; (2) develop a participatory quality-of-life development model for health-vulnerable groups through the District Quality of Life Development Committee; and (3) evaluate the effectiveness of the developed model. The research process was conducted in four stages following the PAOR cycle: planning, action, observation, and reflection. The sample and key informants were selected through purposive sampling and consisted of four groups: 21 members of the District Quality of Life Development Committee, 21 members of the Subdistrict Quality of Life Development Committees, 30 members of the District Public Health Coordinating Committee, and 190 health-vulnerable individuals older adults aged 60–70 years with type 2 diabetes mellitus and HbA1c levels greater than 7 mg/dL. Research instruments included a biomarker measurement tool (HbA1c), interview guides, questionnaires, participatory observation forms, and lesson-learned synthesis guidelines. Quantitative data were analyzed using descriptive statistics and paired-samples t-tests, while qualitative data were analyzed through content analysis.
The results revealed that health-vulnerable groups in the study area experienced significant challenges in diabetes control and multidimensional quality of life. The developed model, named the WANGSOMBOON PAOR CHRONIC CARE Model (WS-PAOR CCM Model), systematically integrated the Chronic Care Model with the participatory action research process. Effectiveness evaluation indicated that, after implementation, participants demonstrated high levels of quality of life and satisfaction. HbA1c levels decreased significantly at the .05 level, and participation among district- and subdistrict-level quality-of-life development committees and the district public health coordinating committee was high.