Effects of health behavioral modification program on metabolic diseases in risk Thai clients

Background: Being overweight is a major risk factor for chronic diseases. In 2008, the health screening for chronic diseases in 273,171 Thai workers in Bangkok reported that 85% of them were at risk. Objective: We evaluated the health behavioral modification programs conducted by the participating hospitals in Bangkok. We also compared behavior change and biomedical indicators between before and after program completion. Methods: The behavioral modification program was conducted by 17 public hospitals in Bangkok between May and December 2009. Two thousand nine hundred seventy outpatients at-risk for metabolic diseases were recruited. The intervention program included the various activity lessons focusing on client-centered techniques based on the behavioral and managerial model (PROMISE model). Data was collected using interviewing forms based on Context, Input, Process, Product Evaluation model (CIPP model). Information was obtained from three groups of people including program leaders, commanders of program leaders, some clients, questionnaires for assessing 3-self behavior including self-efficacy, self-regulation, and self-care were prepared for behavioral assessment changes. Results: At the beginning of program implementation, it was found that results from supervision and evaluation of the feasibility for program success revealed that opinions on the context, input, process, and product were at the very good level among the three groups. After the program application, the 3-self health behavior of clients improved significantly (p <0.05). Therefore, after program participation for a certain period, clients had an improvement in biomedical indicators as follows, FBS, BP, waist, weight, and BMI (p <0.05). In addition, after participation, clients with lower BMI tended to have better self-regulation and self-care than those with higher BMI group (p <0.05). Conclusion: The health behavioral modification program based on PROMISE model conducted by the participating hospitals were considered successful and effective in producing improved 3-self behavior and decreased in biomedical indicators.