การวิเคราะห์สถานการณ์การดำเนินงานคลินิกไร้พุงในผู้ที่มีภาวะ ก่อนเบาหวาน ในชุมชนตำบลหนองแดง อำเภอแม่จริม จังหวัดน่าน

Abstract

The implementation of community diet and physical activity clinics is a service designed to change the health behaviors of people in the community according to the regulations of the Public Health Department. This descriptive study aimed to analyze diet and physical activity clinic implementation among people with pre-diabetes in the Nong Daeng sub-district community. The study was conducted with 20 facilitators and 72 acceptors. Data were collected via interviews and questionnaires. The questionnaires had a content validity index of 0.86 and reliability of 0.91. Data were analyzed by using descriptive statistics and content categorization. In terms of policy and place, it was found that 1) the community did not participate in defining implementation policy, 2) the plan and project conformed to the policy, 3) the policy was not widely or continually publicized in all services areas, and 4) people easily accessed the clinic, but in uncertain ratios. In terms of staff and personnel, it was revealed that 1) the structure and responsibilities of the staff were explicit, 2) there were at least 2-3 operator in the clinic, 3) 37.5 percent of the operators passed the training criteria, and 4) not every operators attended annual knowledge improvement events. In terms of service, supervision, follow-up, and evaluation, it was found that 1) the service procedures complied with the regulations of the Public Health Department, 2) the data record was not detailed enough for planning to change behavior, 3) there was a lack of continuous follow-up, and 4) the evaluation did not cover the criteria. This independent study provides basic information which could help the creation of an effective development plan for diet and physical activity clinics designed to serve people with pre-diabetes, especially regarding policy specification and propagation, clinic location selection in community, team work formation, man power arrangement and personnel development, service systems and procedure improvements, provision, follow-up, and evaluation.