GRF 2nd One Health Summit 2013: Presentation by YODMAI, Korravarn, College of Public Health Science, Chulalongkorn University

1. Effects of Home-Based Lifestyle Change
Program toward Quality of Life among Aging
People
in Khon Kean Province, Thailand
Korravarn Yodmai, Ratana Somrongthong, Tipawan Dansawadikul
 College of Public Health Sciences, Chulalongkorn University, Thailand
 Faculty of Nursing Science, College of Asian Scholar, Thailand
Korravarn Yodmai, PhD candidate in Public
Health

2. Thailand


Thailand located Southeast of Asia
Thailand connected with
Laos, Cambodia, Myanmar, and Malaysia

3. Introduction




Increasing the proportion of elderly in Thailand
Thailand is become “ an Aging Society”
The increased of elderly proportion was
affected from baby boom reach retirement and
an increased of life expectancy.
In 2050, Thais elderly is expected increasing
to 25% of whole population (UNFPA, 2006).

4. 4 regions of Thailand
Study area: KhonKean Provinc
(Northeast of Thailand)
Source of Picture: http://www.learnthailanguage.org/tag/regions/

5. Aging in European countries Vs
Thailand
Aging in European
Aging in Thailand

6. The 2nd National Plan for Older
Persons (Plan for 2002 – 2019)


We were set up with 5 implementation
strategies to protect and support Thai elderly
which included preparation for the quality of
life in aging, promoting well-being among
elderly, providing social security for older
people
Thailand created many projects to promote
well-being and improve quality of life in aging
but some aging people reply that there are not
be able to join those activities due to housing
duty

7. Lifestyle behaviors changed


This project aims to develop intervention to
improve the quality of life.
We were applied the network theory and the
knowledge of community-based education into
our study by links between participant with
their neighbors
One person can be link to several people that human
behavior is influence to other people by copy the behavior
and idea of important people as their close friends and
family.

8. Social Network
O
R
J
A
P
P
E
K
D
C
G
This study applied the link between people and their
network’s people are affect to each other to change their
attitude and behavior.

9. Step 1:Recruitment
 One hundred elderly aged between 60 to 75
years at baseline survey was explanted and
encouraged them to enroll this study.
 Respondent who are interested that their home
must located connected with other group
members and/or usually spend day times with
other member group
 They were separated into 5 groups (11
participants per group) by using community
selection
 Two persons are vote to be team leader

10. Step 1: Provided the training of Triple Etraining for all participants
Three days of Triple-E training was provided to
participants who was enrolled in this study
Triple – E training included:
E-Exercises
E-Eating nutrition foods
E-Emotional Focused Coping
Management
Exercis
e
Food
Emotion
al

12. Step 2: Provided the training on
Empowerment technique and group
Monitoring for team leader
 Two team leaders in each group was provided
the training on empowerment technique and
how to monitoring their group member to be
more practices of triple –E (more exercise and
activities, eating healthy food, and have a
good emotional in their daily living
 The training was conducted 1 day for
technique and 6 days for practices.

13. Step 3: Home-based activities
- Home visits by team leaders
- Routine activities in their home
- Group advisory by team leaders

14. Step 4: Monthly Meeting
Monthly meeting was done at community
center. It was conducted by researcher and
health volunteers. The activities were
• Demonstrated of an exercise by group
member
• Sharing their experience of their life after
used triple-e education
• Discussion on
• Meditation
• Appointment for next meeting

15. Process of study
Intervention
baseline
X
OI0
Control
baseline
OC0
6th
month
O I1
9th month
O I2
6th month
9th month
O C1
O C2
O: Observation, I: Intervention group, C: Control group
X: HBLC intervention

16. Data collection

17. RESULTS

18. Figure 1: mean score of quality of life at baseline, 6 th
month, and 9th month

19. Table 9: Effects of HBLC intervention on QOL at F/U 1&
Outcome variable
Follow – Up 2
Follow-Up 1
Estimate Mean
95% CI
P-value
Change
TQOL
Estimate Mean
95% CI
P-value
Change
8.23
1.28-15.19
0.021
3.53
(-2.15-9.23)
0.220
SAB
0.25
-1.87-2.37
0.815
-0.94
-2.76-0.87
0.307
AUT
3.96
2.35-5.56
<0.001
2.59
1.34-3.85 <0.001
PPF
1.64
0.10-3.18
0.036
1.89
0.59-3.19
0.005
SOP
1.60
0.38-2.82
0.010
2.54
1.20-3.89
0.000
DAD
-1.84
-4.02-0.33
0.095
-3.89
-6.20-1.59
0.001
INT
2.14
0.52-3.75
0.010
1.34
-0.37-3.05
0.124
*Linear Mixed Model with Unadjusted

20. Discussions
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However, total QOL was not statistically
significant after intervention due to SAB is
found commonly in elderly that it needs to be
add in to an account in order to support
sensory aids for elderly
AUT, PPF, and SOP was improved after
intervention at 9 months.
Those improvement may due to training
grogram that increased of social activity of
participants

21. Discussion (con’t)
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
Negative- affect of an intervention on DAD is
not clear. It needs to be study on this facet. As
observation that it may link to the increasing of
relationship between their friends that it
influence to their fear to be alone.
Intimacy is not improve after intervention may
due to individual attitude of participants and
their culture.

22. Limited of this study


Selection bias due to the network of
participants
Limitation of quasi-experimental study could
not control all external confounders and cointervention

Limitation of generalization, the finding may
not be able to transferrable to other community

Limitation of eating behavior in study area

23. Recommendation
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HBLC can be benefits to improve
AUT, SOP, and PPF facets of QoL in
elderly, especially in elderly in developing
counties as Asian people that neighbors are
important key to pass though the messages
to elderly.
Health provider should consider of the
linking between people and apply it in their
community, especially vulnerable people

24. Acknowledgement

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This work was a financial supported by 90th year
King Anniversary
Thesis Research funding
Scholarship, Chulalongkorn University
Thankful to Prof. Dr. Robert Chapmen for Data
Analysis

25. Ethical Approval
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Research Ethical was approval from
Chulalongkorn University Research Ethics
Committee
Respondents were signed informed consent form
before the data collection
Participants information was commitment to
keep it confidentially

26. Thank you for your attention