The Benefits of Improving Self-care Ability for Farmers and Fishermen With Existing Cardiometabolic Diseases
Phase: NA
Conditions: Cardiovascular Disease, Diabetes, Hyperlipidemia, Stroke
Sponsor: Chang Gung Memorial Hospital

 
 
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Clinical Trial PRS Application  
 
Research Title:  
The effectiveness of enhancing self-care abilities for agriculture  
and aquaculture workers diagnosed with cardiometabolic diseases  
 
 
IRB No.: 202301844B0  
 
 
 
English Synopsis: 2023/12/01   
 

 
 
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Title: The effectiveness of enhancing self-care abilities for agriculture and aquaculture workers diagnosed 
with cardiometabolic diseases 
 
English Abstract 
Background: Community care emphasizes the three-tier, five-level preventive strategy and is also expected to 
demonstrate innovative capabilities and advocacy in promoting health equity within sustainable development 
and adapting to climate change. Agriculture and aquaculture form the cornerstone of a nation's important 
development, the livelihood of its people, and the conservation of its ecology. The southwest coastal regions of 
our country serve as a crucial hub for providing high-quality agricultural and fishery products to the nation, 
encompassing over one-third of the households and population engaged in agriculture and aquaculture 
nationwide. However, due to international economic and trade pressures and climate change, the number of 
agricultural and fishery workers (farmers and fishermen) has been gradually declining as they face reduced 
production capacity and income challenges. Based on our team's preliminary research findings, the prevalence 
and mortality rates of cardiovascular and metabolic diseases among agricultural and fishery workers in the 
southwest coastal regions are higher compared to the national average and advanced countries in Europe and 
America. Additionally, there is a higher incidence of chronic dehydration. Moreover, the overall educational 
level among these workers tends to be lower, the population is aging, and there is relatively inadequate access 
to medical resources. The literature indicates that individuals with cardiovascular and metabolic diseases can 
prevent health deterioration, such as myocardial infarction and stroke, by enhancing their self-care capabilities. 
From the perspective of aiding the sustainable development of agriculture and fisheries, how to overcome the 
health inequality resulting from societal determinants of health? The focus of this project is to enhance self-care 
capabilities effectively and address chronic dehydration by providing innovative strategies that align with their 
socioeconomic background. Our team's efforts in identifying, referring, and treating the high prevalence of 
hepatitis C virus in this region have gradually decreased the occurrence of liver cancer and other related cancers. 
Additionally, we have provided the Ministry of Agriculture with health needs and policy advocacy for farmers 
and fishermen, earning significant trust and attention from relevant authorities. This will aid us in continuing to 
promote interdisciplinary collaboration effectively. To date, there is a significant lack of domestic and 
international literature discussing and improving the health issues of farmers and fishermen. Research on 
community care aimed at preventing and alleviating the exacerbation of cardiovascular and metabolic diseases 
among this population is particularly scarce. Research Purposes: Therefore, based on the preliminary research 

 
 
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findings, this project will focus on the following investigations: (1) the self-care capabilities of farmers and 
fishermen with cardiovascular and metabolic diseases; (2) designing educational materials and tools tailored to 
the socioeconomic background of farmers and fishermen to enhance their self-care abilities; (3) validating the 
effectiveness of these educational materials and tools. These validations will serve as a basis for collaboration 
with local governments and private enterprises in academia-industry partnerships, aiming to expand the impact 
and diffusion of benefits. Research Method and Objects: This project will be based on nursing scholar 
Dorothea Orem's self-care theory, integrating the concept of the [life essential 8, LE8] proposed by the American 
Heart Association, as well as our team's recent research findings. We aim to develop educational materials and 
tools tailored for this group, termed [Self-Care Eight Essentials] aligning with these theories and previous 
research outcomes. This project is expected to be completed within three years. The first year will involve a 
cross-sectional descriptive study targeting farmers and fishermen in the southwest coastal regions. Collaborating 
with the local health bureau and regional hospitals, the study aims to identify farmers and fishermen already 
affected by cardiovascular and metabolic diseases. It will investigate their self-care abilities, chronic dehydration, 
and associated influencing factors. The estimated sample size is approximately 338 individuals. The research 
methods for the second and third years involve: (1) Developing a tabletop game educational tool tailored to the 
socioeconomic and cultural needs of farmers and fishermen, and training designated educators; (2) Employing 
a community-based quasi-experimental research design. Eligible participants will be cluster-randomized into 
intervention and control groups. Both groups will receive educational materials from the [Self-Care Eight 
Essentials (SC-8)]. The intervention group will additionally engage with the [SC-8 Monopoly-style board game] 
intervention, while the control group will follow the regular community care model. The study will assess the 
differences in self-care abilities, cardiovascular and metabolic markers, and inflammation indicators between 
the two groups. This phase anticipates an estimated sample size of around 205 individuals for each group. 
Analysis: The study will employ both descriptive and inferential statistical analyses, such as chi-square and 
analysis of variance (ANOVA), multivariate linear regression, logistic regression, and generalized estimating 
equations (GEE) to handle repeated measures data and adjust for the effects of influencing factors. Expected 
Outcomes: This study aims to present an overview of self-care abilities among farmers and fishermen with 
cardiovascular and metabolic diseases, identifying the distance from the ideal level and related influencing 
factors. It intends to establish self-care educational materials and tools tailored to the socioeconomic background 
of this specific population. Additionally, the study aims to transform these materials into tabletop game 
educational tools that possess credibility, effectiveness, and an element of entertainment. Through patents and 

 
 
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technology transfer, these tools are expected to serve as convenient and effective guidance instruments for health 
bureaus and primary healthcare units. 
  
Keywords: cardiometabolic diseases、agriculture、aquaculture、self-care、dehydration status、inflammatory 
biomarkers、board game、sustainable development goals、climate change、reduced inequalities。