The Effectiveness of a Health Promotion Program on Perceived Self-efficacy, Outcome Expectation, and Self-care Behaviors among Adults with Metabolic Syndrome
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Abstract
Metabolic syndrome is a major public health problem in Thailand and worldwide, closely associated with unhealthy lifestyle behaviors and increasing the risk of diabetes, hypertension, and cardiovascular disease. Enhancing perceived self-efficacy and outcome expectation may help individuals modify their health behaviors and self-care more effectively. This quasi-experimental study aimed to examine the effectiveness of a health promotion program on perceived self-efficacy, outcome expectation, self-care behaviors, and clinical outcomes among adults with metabolic syndrome in Nonghin District, Loei Province.
A two-group pretest–posttest design was employed. Participants were adults aged 25–59 years diagnosed with metabolic syndrome according to the NCEP ATP III criteria (at least 3 of 5 components). The sample size was determined using G*Power, yielding 42 participants per group (84 in total), allocated to an experimental group and a control group. The experimental group received a 12-week health promotion program developed from Bandura’s Self-efficacy Theory combined with the 3-Es-2-Ns health behavior modification principles (diet, exercise, emotional management, non-smoking, and non-alcohol use), while the control group received routine care. Data were collected using questionnaires with verified content validity (IOC = 1) and reliability (Cronbach’s alpha 0.84–0.90), together with clinical indicators including waist circumference, fasting blood glucose, and blood pressure. Data were analyzed using descriptive statistics, dependent t-test, and independent t-test, with effect sizes (Cohen’s d) and 95% confidence intervals reported.
After the intervention, the experimental group showed significantly higher scores of perceived self-efficacy, outcome expectation, and self-care behaviors than at baseline and than the control group (p < .05). Clinical outcomes in the experimental group improved significantly, with reductions in fasting blood glucose and in both systolic and diastolic blood pressure (p < .05), whereas waist circumference showed a decreasing trend that was not statistically significant (p = .483).
In conclusion, the health promotion program applying Bandura’s Self-efficacy Theory together with the 3-Es-2-Ns approach effectively enhanced perceived self-efficacy, outcome expectation, and self-care behaviors, and improved several clinical outcomes among adults with metabolic syndrome. The program can be applied in primary healthcare settings to promote self-care and prevent non-communicable diseases.
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This article is published under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND 4.0), which allows others to share the article with proper attribution to the authors and prohibits commercial use or modification. For any other reuse or republication, permission from the journal and the authors is required.References
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191–215. https://doi.org/10.1037/0033-295X.84.2.191
Bandura, A. (1997). Self-efficacy: The exercise of control. W. H. Freeman.
Chen, J., Zhang, Y., Sun, H., Li, Q., & Wang, K. (2021). Effects of a mobile app-based self-management program combined with individual counseling on metabolic syndrome: A randomized controlled trial. JMIR mHealth and uHealth, 9(4), e24886. https:// doi.org/ 10.2196/24886
Chen, S. M., Creedy, D. K., Lin, H. S., Wu, S. F. V., & Chang, Y. P. (2021). Self-management interventions for adults with metabolic syndrome: Effects on health behaviors and clinical outcomes. Journal of Advanced Nursing, 77(2), 719–731. https://doi.org/ 10.1111/jan.14598
Fahed, G., Aoun, L., Bou Zerdan, M., Allam, S., Bou Zerdan, M., Bouferraa, Y., & Assi, H. I. (2022). Metabolic syndrome: Updates on pathophysiology and management in 2021. International Journal of Molecular Sciences, 23(2), 786. https://doi.org/10.3390/ ijms23020786
Kruse, C. S., Heinemann, K., Phillips, E., Lemos, K., Vela, J., & Brooks, M. (2022). Telehealth and patient satisfaction: A systematic review and narrative analysis. BMJ Open, 12(4), e059951. https://doi.org/10.1136/bmjopen-2021-059951
National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. (2002). Third report of the NCEP expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III). Circulation, 106(25), 3143–3421. https://doi.org/ 10.1161/circ.106.25.3143
Saklayen, M. G. (2018). The global epidemic of the metabolic syndrome. Current Hypertension Reports, 20(2), 12. https://doi.org/10.1007/s11906-018-0812-z
Wichit, N., Mnatzaganian, G., Courtney, M., Schulz, P., & Johnson, M. (2017). Randomized controlled trial of a family-oriented self-management program to improve self-efficacy, glycemic control and quality of life among Thai individuals with type 2 diabetes. Diabetes Research and Clinical Practice, 123, 37–48. https://doi.org/ 10.1016/j.diabres.2016.11.013
กองโรคไม่ติดต่อ กรมควบคุมโรค กระทรวงสาธารณสุข. (2566). รายงานประจำปี 2566. https://www.ddc. moph.go.th/uploads/files/4155620240314033823.pdf
โรงพยาบาลกรุงเทพ. (2568). เมแทบอลิกซินโดรม ลงพุงรอบเอวหนาเสี่ยงโรคร้าย. https://www.bangkok hospital.com/content/metabolic-syndrome
สถาบันวิจัยระบบสาธารณสุข. (2562). การสำรวจความรอบรู้ด้านสุขภาพของประชาชนไทย อายุ 15 ปีขึ้นไป พ.ศ. 2562. https://kb.hsri.or.th/dspace/handle/11228/5216
สุนีย์ ละกำปั่น, พิมพันธ์ สุริยวงศ์, และอารีย์วรรณ อยู่สำราญ. (2563). ผลของโปรแกรมส่งเสริมการจัดการตนเองต่อพฤติกรรมการดูแลตนเองและการควบคุมระดับน้ำตาลในเลือดของผู้ป่วยเบาหวานชนิดที่ 2. วารสารพยาบาลศาสตร์ มหาวิทยาลัยมหิดล, 41(2), 1–15.
