The purpose of the project was to (1) conduct a baseline survey of health behavior
in type 2 diabetic patients with low risk of cardiovascular disease (CVD) (less than 10%) and
those with high risk of CVD (20% and more), according to the 10 year risk of cardiovascular
events prediction chart developed by the World Health Organization (South-East Asia: SEAR
B) and (2) explore factors associated with health behavior in type 2 diabetic patients with
risk of cardiovascular disease. The PRECEDE-PROCEED Model was used as a framework to
guide the survey development for data collection. The methods of data collection consisted
of 2 phases as follows;
The 1st Phase: The development of the survey instruments. In this phase, the data
was collected from a hospital in Samutsakorn province. At the beginning phase, focus group
was conducted in 10 type 2 diabetic patients to develop the questions, and then sent to
experts to examine how well the questions corresponded to components of The PRECEDEPROCEED
Model. The questionnaire was pilot-tested in 30 type 2 diabetic patients and
refined. To further test and refine the survey, 228 type 2 diabetic patients completed the
final version of the questionnaire. The items of the questionnaire were analyzed by using
factor analysis to determine if there were unnecessary items and identify sets of measures
reflecting different dimensions of the questionnaire. After removing or adding some items,
this process resulted in a final 60-item questionnaire for associated factors and 38-item
questionnaire for health behavior.
The 2nd Phase: The survey administration of factors related to health behavior. In this
phase, 566 type 2 diabetic patients with risk of CVD, who received treatment from a hospital
in Ayutthaya province from May to October 2014, were recruited and asked to complete the
questionnaire. These participants included 169 high risk of CVD group (20% and more) and
397 low risk of CVD group (less than 10%). The result showed that there was no significant
difference in health behavior between diabetic patients with low and high risk group. No
difference among groups in food consumption, risk behavior, and physical activity, whereas
treatment plan adherence was greater in the diabetic patients with low risk group compared
to those in the high risk group. Self-efficacy, perceived barriers, and social support were
accounted for approximately 19% of total variance in predicting health behavior. Recommendation of the study was that health service should be designed to initially
increase patients’ perception in their efficacy and reduce perception in obstacle to perform
health behavior in order to motivate their awareness in the possibility to get the
cardiovascular disease and then affect their readiness to manage their own health.
Engagement of patients’ social support should be concerned when conducting the lifestyle
modification program including family members and friends. Knowledge and health
promotion skill improvement program for health volunteer should be established due to
the findings that information availability from them was the least compared to those from
another resource.