Abstract
The purpose of this research was to study the patient journey, health literacy, and operations in fighting against type 2 diabetes in Thailand as well as to establish communication strategies to combat type 2 diabetes using mixed methods which consisted of: 1) an in-depth interview using selective sampling of 31 people residing in provinces with a high prevalence of type 2 diabetes from each region and Bangkok, 2) a survey research using a sample size of 1,600 people in Thailand aged 20-60 years who have type 2 diabetes or are at risk of developing type 2 diabetes, selected by simple randomization, 3) a document analysis of documents related to operations in fighting against diabetes in Thailand including reports, articles, research papers, symposium papers, and news, and 4) the research synthesis to develop communication strategies to combat type 2 diabetes in which the accuracy, appropriateness, and applications were reviewed by specialists in health campaigns, public health, and communication arts. The research findings are as follows: The patient journey of type 2 diabetes consists of 3 stages which are 1) the pre-diabetic stage, the stage before the patient meets the criteria of the disease, shows symptoms, and receives the diagnosis, 2) the treatment stage, the stage that the patient receives the diagnosis, decides to get treatments, and acknowledges lifestyle changes according to the doctors’ recommendations on how to manage the symptoms, 3) the long-term living with the disease stage, the stage in which the patient acknowledges the changing life conditions, sees the physicians regularly, and watches out for worsening symptoms, which is related to the patient’s future lifestyle. The survey findings indicated that 37.6% of the respondents started testing for diabetes when they were 41-50 years old, followed by 30.0% who started testing when they were 31-40 years old. Also, 79.1% of the respondents who have been diagnosed with diabetes were previously unaware that they were at risk. There were also more female than male respondents who have obesity (55.1%). In terms of health literacy regarding type 2 diabetes, the respondents had some skills to access to health information. Moreover, their ability to utilize health information, take actions to control and prevent the disease, and screen the information from friends and online media were moderate, while their ability to see through the advertisements on food and desserts as a cause of the disease and their skills of health communication were high. Finally, their knowledge on health is at the highest level. The document analysis results revealed that Thailand acknowledges the importance of operations in fighting against type 2 diabetes and puts an emphasis on promoting good health and fitness for Thai people. This is reflected in different levels of strategic plans including the 20-year national strategy that is linked to the plans of the public health authorities and includes the developments of policies, partnerships, databases, bodies of knowledge, communications, community capacity, health service system competency, and appropriate environments to aid the changes in behaviors of children, working adults, and senior citizens. All research findings were used to create three communication strategies to combat type 2 diabetes as follows: Strategy 1: Public campaigns to fight against type 2 diabetes. The objective of this strategy is to raise awareness and encourage changes in behaviors that will lead to the reduction in the risks of the disease. This strategy is aimed at young working adults (18-29 years old) and middle-aged working adults (30-44 years old). Strategy 2: Health education. The objective of this strategy is to raise knowledge and understanding on type 2 diabetes as well as to prevent the disease. This strategy is aimed at young children to university-aged individuals. Strategy 3: Policy advocacy to fight against type 2 diabetes. The objective of this strategy is to encourage the public to exchange ideas and engage in discussions about type 2 diabetes to contribute to the changes in policies on the fight against type 2 diabetes.
