DEVLEOPMENT OF THE HEALTH LITERACY MODEL FOR PREVENTING HEALTH IMPACTS FROM PARTICULATE MATTER LESS THAN 2.5 MICRONS (PM2.5) AMONG VILLAGE HEALTH VOLUNTEERS THROUGH COMMUNITY NETWORK IN THA PLA DISTRICT, UTTARADIT PROVINCE

Abstract

The objectives of this research were to 1) assess health literacy and preventive behaviors related to the health impacts of PM2.5 exposure among village health volunteers, 2) develop a participatory health literacy model involving community network partners, and 3) evaluate the effectiveness of the developed model in Tha Pla District, Uttaradit Province. The study was conducted in four phases: planning, action, observation, and reflection. Participants in the action research phase included VHVs, community representatives, and relevant governmental network partners. The model was evaluated among 100 VHVs selected through purposive sampling and equally assigned to an experimental group and a control group. Data were collected using questionnaires and focus group discussions, and analyzed using descriptive statistics, paired-sample t-tests, and independent-sample t-tests. The findings indicated that the overall levels of health literacy and preventive behaviors related to the health impacts of PM2.5 exposure among village health volunteers were moderate, with mean scores of 3.64 (0.69) and 3.69 (0.73), respectively. Drawing upon the findings from the planning phase and the participatory process involving relevant stakeholders, the SMART–PM Model was developed. This model consisted of five key components: Strengthen knowledge, Monitor and Motivate, Apply and Act, Role Model, and Transfer and talk. In the action phase, the model was implemented among VHVs in the experimental group over a seven-week period, emphasizing participatory learning, practical skills development, surveillance, risk communication, and the promotion of preventive behaviors for individual and community protection. In the observation phase, the experimental group demonstrated significantly higher post-intervention mean scores for both health literacy and preventive behaviors than the control group (p < 0.001, t = 20.79; p < 0.001, t = 30.60, respectively). In the reflection phase, the model was found to be appropriate and consistent with the local context, enabling VHVs to promote preventive behaviors against PM2.5-related health impacts among community members. These findings indicate that the SMART–PM Model effectively enhanced health literacy and preventive behaviors among VHVs and may serve as a practical guideline for relevant agencies to strengthen VHV capacity in PM2.5 risk areas.