Factors Associated with 3Aor 2Sor Health-Promoting Behaviors among Village Health Volunteers in Chao Chet Sub-district, Sena District, Phra Nakhon Si Ayutthaya Province

Abstract

This cross-sectional descriptive study aimed to investigate the factors associated with health behaviors based on the 3Aor 2Sor principle (Eating, Exercise, Emotion, Smoking cessation, and Alcohol reduction) among Village Health Volunteers (VHVs) in Chao Chet Sub-district, Sena District, Phra Nakhon Si Ayutthaya Province. The sample consisted of 73 VHVs, selected through purposive sampling. Data were collected using a multiple-choice questionnaire, which was validated for Content Validity by three experts (IOC: 0.67 – 1.00). The instrument’s reliability was tested with 30 individuals with characteristics similar to the study sample.The knowledge questionnaire demonstrated acceptable reliability with a KR-20 coefficient of 0.76. The questionnaires assessing attitudes, enabling factors, reinforcing factors, and health behaviors were analyzed using Cronbach’s alpha coefficient, yielding an overall reliability of 0.87. Data analysis was performed using descriptive statistics,while relationships between variables were examined using the Chi-square test and Fisher’s exact test in cases where more than 20% of the expected cell counts were less than 5. The results revealed that the majority of the participants were female (86.30%) and primarily elderly (58.90%). Two-thirds of the sample suffered from non-communicable diseases (NCDs) (68.49%). Most participants demonstrated high levels of knowledge (69.86%) and positive attitudes (79.54%). Regarding external factors, enabling factors were reported at a moderate level (49.32%), while reinforcing factors were at a high level (72.60%). More than half of the participants (57.53%) exhibited overall health behaviors based on the 3Aor 2Sor principle at a moderate level. When categorized by dimension, the highest-rated behaviors were emotional management (84.93%), followed by alcohol avoidance (64.38%) and smoking cessation (60.27%). The analysis revealed that predisposing factors, including gender, presence of non-communicable diseases, and level of knowledge, as well as reinforcing factors, were significantly associated with health behaviors based on the 3A 2S principles (p < 0.05)

The findings reflect that knowledge management models must account for gender differences and health status. Crucially, reinforcing factors from families, communities, and society play a vital role in shaping individuals' attitudes and behaviors. Consequently, Sub-District Health-Promoting Hospitals alone cannot effectively drive communities toward a healthy society. It is imperative to engage families and communities in promoting health behaviors to foster positive motivation. This engagement establishes social norms that transform health maintenance from a perceived burden into a collective recreational activity. Notably, health promotion among Village Health Volunteers must account for gender differences, literacy levels, and individual health statuses, alongside strengthening support from families, communities, and the healthcare system. Such a multi-dimensional approach is essential for achieving appropriate and sustainable behavioral changes.