The Effect of an Integrated Savings and Community Based Health Education Program among Older Adults with Hypertension: A Quasi-Experimental Controlled Study, Bangkok Province, Thailand

Abstract

Introduction: Hypertension remains as the fifth leading cause of death in both females and males in Thailand. Complications of this disease are risk factors to both cerebrovascular and coronary artery diseases. Simultaneously, there is an increase in the proportion of older adults leading to an increase in high blood pressure cases including high incidence rate of hypertension and high burden of older adults’ health care cost while their income decline with lower rate of savings. Objective: To examine the effectiveness of savings and health education model (SHE model) program, which is an integration of savings and community based health education for older adults with hypertension in Sai Mai and Klong Sam Wa districts, Bangkok, Thailand. Methodology: Mixed methods using survey, quasi-experimental and qualitative techniques were employed. We examined KAP on hypertension in a random sample of 242 people suffering from hypertension by using the survey techniques including exploring the effectiveness of savings and health education model (SHE model) program in a random sample of 59 participants using quasi-experimental techniques from 2 communities. Focus group discussion was conducted with 27 participants to explore in-depth information related to care, prevention, and the effectiveness of SHE model program. Results: Survey data found most participants had good basic knowledge regarding hypertensive care and prevention. 65.3% and 49.6% of respondents had positive attitudes and practice toward hypertension care and prevention. Data compiled from quasi-experimental study found that knowledge on hypertension had a significant difference on pre intervention. Negative attitude towards care and control had a positive correlation with practice. SBP-negative attitudes and practices were inversely related to DBP. However with knowledge, attitude, and practices, there were recorded improvements in all groups after intervention compared to the control group. Blood pressure improvements were noted post intervention. Community savings funds and effects of blood pressure control on material impact recorded from quasi-experimental study. Conclusion: Improved hypertension health education effects had the most significant impact in controlling the disease in the community.