Development and Evaluation of a Community Nursing Model Focused on Enhancing Health Literacy in Low-Sodium Dietary Consumption to Prevent Hypertension among At-Risk Populations.

Abstract

This research and development study aimed to develop and evaluate a community nursing model for enhancing health literacy in low-sodium dietary consumption for hypertension prevention among an at-risk population in the service area of Ban Muang Ta Rot Subdistrict Health Promoting Hospital, Thap Luang Subdistrict, Mueang District, Nakhon Pathom Province. The study was conducted in three phases. Phase 1 examined the situation and problems related to health literacy in low-sodium dietary consumption and low-sodium dietary behaviors among the at-risk population. The sample consisted of 250 at-risk individuals selected by simple random sampling. Data were collected using a questionnaire. The key informants consisted of 10 community leaders and village health volunteers who were purposively selected based on the eligibility criteria. The research instruments included an in-depth interview guide and a focus group discussion guide. Phase 2 focused on community nursing model development to enhance health literacy in low-sodium dietary consumption. The key informants consisted of 10 participants, including professional nurses, public health technical officers, representatives of village health volunteers, community leaders, local administrative organizations, the at-risk population, and food vendors in the community. They were purposively selected based on the eligibility criteria. The research instruments included a focus group discussion guide and meeting records. Phase 3 involved implementing and evaluating the effectiveness of the developed community nursing model. The sample consisted of 40 participants from the at-risk population who were purposively selected based on the eligibility criteria. The research instruments included the developed community nursing model and the same questionnaire used in Phase 1. Data were analyzed using the paired-samples t-test. Results: The results revealed that: 1) health literacy in low-sodium dietary consumption among the at-risk population was predominantly at a moderate level (98.40%), followed by a high level (1.60%). Low-sodium dietary behaviors were predominantly at a moderate level (73.20%), followed by a low level (22.00%) and a high level (4.80%); 2) the developed community nursing model for enhancing health literacy in low-sodium dietary consumption was the “3L Model,” consisting of Learn: learning and understanding information about sodium; Look: reading nutrition labels and identifying sodium content; and Limit: limiting sodium consumption; and 3) after implementation of the model, the participants had significantly higher percentage mean scores for health literacy in low-sodium dietary consumption, both overall and in each domain, and a significantly higher percentage mean score for low-sodium dietary behavior than before the intervention (p < 0.05). Conclusion: The developed community nursing model for enhancing health literacy in low-sodium dietary consumption was effective in improving both health literacy in low-sodium dietary consumption and low-sodium dietary behaviors among the at-risk population.