Developing a health literacy model to enhance health behavior according to the 3อ principles of the elderly, Narathiwat Province

Abstract

     This research and development study, utilizing a mixed-methods approach and participatory action research (PAR), aimed to create and develop a health literacy model to enhance healthy behaviors based on the 3A principles (Awareness, Action, and Appropriateness). The objectives were to construct and develop a model and test its effectiveness in promoting healthy behaviors among the elderly. The research was divided into three phases: Phase 1 involved synthesizing the health literacy model, employing both qualitative and quantitative research methods with a sample of 389 individuals. Phase 2 focused on creating and developing the model with 29 stakeholders. Phase 3 involved testing the model's effectiveness with a sample of 78 elderly members of the Suai Ko-lok Municipality Senior Citizen Club in Narathiwat Province. Data were collected using a health literacy questionnaire and a satisfaction survey regarding the model. Data were analyzed using descriptive statistics (mean). The standard deviation and paired samples t-test showed that the reliability of the health literacy scale was .820, and the reliability of the satisfaction questionnaire was .856.

     The study found that the developed model, using the V-Shape model concept, consisted of 18 activities. The effectiveness test of the model was as follows: 1) The average health literacy score of the elderly increased significantly at the 0.05 statistical significance level. 2) Satisfaction with the model was at the highest level (= 4.61, S.D.= .574). The study results show that the health literacy model to promote healthy behaviors based on the 3 principles (A3) is highly effective.

     The expansion and evaluation of the effectiveness of the model for promoting food literacy among Muslim elderly in Narathiwat Province, covering 13 districts from June 1, 2026 to July 31, 2026, showed an overall and individual improvement at the high to very high levels. After the experiment, the average health literacy score of the elderly based on the 3 principles (A3) was significantly higher than before the experiment (p<0.05), both overall and in each aspect. The overall satisfaction with the health literacy model for promoting healthy behaviors based on the 3A principles (Awareness, Action, and Awareness) among the elderly was at the highest level. Regarding its impact on the health status of the elderly, the study found that the cumulative number of elderly individuals at risk of chronic diseases was 33.04% per year. In the current year, there are 1,832 elderly individuals at risk of non-communicable chronic diseases, representing 10.26%, a decrease from the cumulative average annual percentage of those at risk of chronic diseases (22.78%).