Factors affecting the effectiveness of knowledge development programs for village health volunteers in diabetic patient care in Nong Ngu Lueam sub-district, Benchalak district, Sisaket province

Abstract

This research entitled "Factors Affecting the Effectiveness of Knowledge Development Programs for Village Health Volunteers in Diabetic Patient Care in Nong Ngu Lueam Sub-district, Benchalak District, Sisaket Province." To examine factors affecting the effectiveness of health literacy development programs for Village Health Volunteers (VHVs) in diabetes care and to develop guidelines for enhancing program effectiveness. This mixed-methods research employed sequential explanatory design comprising three phases: 1) Qualitative research to explore context and develop the program; 2) Quantitative research using the One-Group Pretest-Posttest Design with 70 VHVs and 171 diabetes patients; and 3) Action research to monitor knowledge implementation. Research instruments included questionnaires, in-depth interviews, and observation forms. Data were analyzed using descriptive statistics, paired t-tests, Pearson's correlation, and multiple regression analysis with statistical significance set at 0.05.

Overall program effectiveness significantly increased from 65.42 to 82.68 points (t = 15.84, p < 0.001). Factors significantly affecting program effectiveness, ranked by importance, were program design factors, VHV personal factors, organizational and environmental factors, and community factors. The model explained 79.60% of effectiveness variance (F(14,55) = 16.85, p < 0.001). Stepwise analysis identified seven most important variables: content quality, intrinsic motivation, staff support, teaching methods, community participation, self-confidence, and supervision system, explaining 75.80% of variance. Component analysis revealed that VHV health literacy increased by 49.5%, VHV performance was at an excellent level (mean = 4.23, SD = 0.54), patients with controlled blood sugar levels increased from 42.3% to 68.5%, and patient satisfaction with VHV care was at a high level (mean = 4.35, SD = 0.58). Thus, the effectiveness of VHV health literacy development programs depends on balanced integration of all four factor domains, with program design factors having the highest influence. Effective program development should emphasize context-appropriate quality content, participatory teaching methods, VHV motivation and confidence building, strong support systems, and community participation promotion. These findings provide guidelines for developing policies and VHV development programs suitable for rural community contexts to sustainably enhance primary care quality for diabetes patients.