title: Developing a diabetes prevention education programme for community health-care workers in Thailand: formative findings.
abstract: OBJECTIVE
  The aim of this study was to investigate barriers to and supports for implementing a diabetes prevention education programme for community health-care workers (CHCWs) in Chiang Mai province, Thailand. The study also aimed to get preliminary input into the design of a tailored diabetes prevention education programme for CHCWs.
  
  
  BACKGROUND
  Thailand has faced under-nutrition and yet, paradoxically, the prevalence of diseases of over-nutrition, such as obesity and diabetes, has escalated. As access to diabetes prevention programme is limited in Thailand, especially in rural and semi-urban areas, it becomes critical to develop a health information delivery system that is relevant, cost-effective, and sustainable.
  
  
  METHODS
  Health-care professionals (n = 12) selected from health centres within one district participated in in-depth interviews. In addition, screened people at risk for diabetes participated in interviews (n = 8) and focus groups (n = 4 groups, 23 participants). Coded transcripts from audio-taped interviews or focus groups were analysed by hand and using NVivo software. Concept mapping illustrated the findings.
  
  
  RESULTS
  Health-care professionals identified potential barriers to programme success as a motivation for regular participation, and lack of health policy support for programme sustainability. Health-care professionals identified opportunities to integrate health promotion and disease prevention into CHCWs' duties. Health-care professionals recommended small-group workshops, hands-on learning activities, case studies, and video presentations that bring knowledge to practice within their cultural context. CHCWs should receive a credit for continuing study. People at risk for diabetes lacked knowledge of nutrition, diabetes risk factors, and resources to access health information. They desired two-way communication with CHCWs. Formative research supports the need for an effective, sustainable programme to support knowledge translation to CHCWs and at-risk populations in the communities they serve. Ultimately, this should support chronic disease prevention in Thailand.
authors.affiliation: Institute of Nutrition, Mahidol University, Nakhon Pathom, Thailand. nuksn@mahidol.ac.th
authors.forename: Kitti
authors.initials: K
authors.lastname: Sranacharoenpong
authors.forename: Rhona M
authors.initials: RM
authors.lastname: Hanning
mesh_terms: D000328:Adult; D003153:Community Health Services / Q000379:methods*; D003920:Diabetes Mellitus / Q000517:prevention & control*; D004493:Education; D005260:Female; D017144:Focus Groups; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006282:Health Personnel; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D009752:Nutritional Status; D011315:Preventive Medicine / Q000379:methods*; D016730:Program Development / Q000379:methods*; D018570:Risk Assessment / Q000379:methods; D040241:Social Marketing; D013637:Tape Recording; D013785:Thailand