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The goal of this quasi-experimental study is to test the effectiveness of a digital health program designed to prevent non-communicable diseases (NCDs) in employees within a workplace setting in Thailand. The main questions it aims to answer are:
Participants will:
This quasi-experimental study titled "A Digital Health Program for Non-Communicable Disease Prevention in a Workplace Setting in Thailand" aims to evaluate the preliminary effectiveness of a digital health program in reducing weight among participants in a workplace setting. Conducted at Chulalongkorn Hospital, Bangkok, over a period of 1.5 years, the study focuses on the impact of the digital health program on various health outcomes, including Body Mass Index (BMI), blood lipid levels (triglycerides and LDL), blood sugar levels (HbA1c or fasting plasma glucose), and blood pressure. Additionally, it assesses the feasibility and acceptability of the program within the Thai workplace context, measured by participation rates, usage, and participant satisfaction.
The research adopts a single-arm quasi-experimental design to assess the weight loss efficacy of the digital health program aimed at preventing non-communicable diseases (NCDs) among employees at risk. The target population includes employees of the Faculty of Medicine, Chulalongkorn University, and/or Chulalongkorn Hospital, with an estimated sample size of 150 participants. Recruitment leverages employee health examination data, with informed consent obtained through comprehensive information sharing.
The intervention comprises four group health education sessions (1 hour each) and unlimited individual chat consultations during work hours, facilitated by a multidisciplinary team including doctors, dietitians, fitness coaches, and psychologists. Data collection spans six months, with a follow-up health examination at the six-month mark, coordinated by the Department of Preventive and Social Medicine, Chulalongkorn Hospital.
The research study conducted a series of educational sessions over six months, focusing on health goal setting, nutrition, physical fitness, psychological resilience, and health outcome evaluation. Here's a summary of the sessions conducted:
Health Goal Setting Lecture (Month 1): Participants learned about the importance of understanding their health, covering basics such as motivation for change, health risk assessment, introduction to the program's curriculum, and setting personal health goals using a realistic behavioral goal-setting framework.
Nutrition Lecture by a Dietitian (Month 2): This session introduced participants to creating a personalized eating plan and understanding individual nutrition. It explored topics like portion control and food selection, illustrated with successful case examples to demonstrate effective dietary strategies. The session concluded with the creation of a customizable eating plan and ongoing support through chat throughout the program.
Fitness Coaching Lecture (Month 3): A fitness coach introduced the appropriate amount, timing, and types of exercise, using successful case examples to show how to implement a real-life exercise plan. This laid the foundation for exercise plans aligned with health goals and encouraged participation in physical activities. The session ended with the creation of a tailored exercise plan and continuous modification support via chat throughout the program.
Psychology Lecture by a psychologist (Months 4-5): The session provided knowledge on coping plans for when goals are not met as intended, encouraging participants to develop their own coping strategies and build resilience. The importance of social support and resilience in maintaining healthy physical activities and eating habits to prevent reverting to old behaviors was emphasized. Participants were advised to review their health goals and received feedback on their physical and dietary practices.
Health Outcome Evaluation by a Doctor (Month 6): Participants met with a doctor for a scheduled physical examination six months after joining the research program. This included blood tests (6-12 milliliters, approximately 2 teaspoons) to assess laboratory results such as weight, Body Mass Index (BMI), lipid levels, blood sugar levels, and blood pressure.
All activities and processes are conducted remotely, utilizing digital platforms for both individual consultations and group training sessions. The study plans to tailor interventions to individual participants based on the Health Action Process Approach (HAPA), aiming for personalized behavior change support. Modifications to the trial, if any, will be documented upon completion. The trial's effectiveness and participant adherence will be assessed and recorded, ensuring a consistent approach throughout the program and documenting all digital platform interactions.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| The Intervention Arm | Experimental | Participants will engage in various activities, including:
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| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| A Digital Health Program for Non-Communicable Disease Prevention in a Workplace Setting in Thailand | Behavioral | The program consists of two main components: (1) Participants are invited to join health courses and/or health activities in the form of seminars or group activities, and (2) Participants will have access to an application that is part of the program, where they can consult with health experts to plan lifestyle modifications and reduce behavioral risk factors over the 6-month duration of the research project, totaling four sessions, each lasting one hour. |
| Measure | Description | Time Frame |
|---|---|---|
| Weight | To assess weight reduction. | 6 months |
| Measure | Description | Time Frame |
|---|---|---|
| BMI | To assess BMI change. | 6 months |
| Total cholesterol | To assess total cholesterol change. | 6 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Zethapong Nimmanterdwong, MD | Contact | (+66)22527864 | zethapong@gmail.com |
| Name | Affiliation | Role |
|---|---|---|
| Jate Ratanachina, MD MSc PhD | Chulalongkorn University | Principal Investigator |
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| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| Background | กลุ่มเทคโนโลยี ระบาดวิทยา และมาตรการชุมชน กองโรคไม่ติดต่อ กรมควบคุมโรค กระทรวงสาธารณสุข. รายงานสถานการณ์โรค NCDs เบาหวาน ความดันโลหิตสูง และปัจจัยเสี่ยงที่เกี่ยวข้อง. 2020. | ||
| Background | คณะกรรมการเศรษฐกิจและสังคมแห่งเอเชียและแปซิฟิก. เหตุผลสนับสนุนการลงทุนใน มาตรการป้องกันและควบคุมโรคไม่ติดต่อในประเทศไทย. 2021. | ||
| Background | มูลนิธิสถาบันวิจัยและพัฒนาผู้สูงอายุไทย. สถานการณ์ผู้สูงอายุไทย พ.ศ. 2564. 2021. | ||
| Background | World Health Organization. Noncommunicable diseases. Fact sheets 2023 16 September 2023 [cited 2023 16 November 2023]; Available from: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases. | ||
| Background | Burton, J. WHO healthy workplace framework and model: background and supporting literature and practices. 2010: Geneva. | ||
| Background | World Health Organization. World mental health report: transforming mental health for all. 2022: Geneva. | ||
| Background | World Health Organization. The impact of the COVID-19 pandemic on noncommunicable disease resources and services: results of a rapid assessment. 2020. |
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Single-arm quasi-experimental study for evaluating the effectiveness of a digital health program in weight reduction for the prevention of non-communicable diseases in the Thai workplace setting.
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|
| Triglycerides | To assess triglycerides change. | 6 months |
| HDL | To assess HDL change. | 6 months |
| LDL | To assess LDL change. | 6 months |
| HbA1c | To assess HbA1c change. | 6 months |
| Fasting plasma glucose | To assess fasting plasma glucose change. | 6 months |
| blood pressure | To assess blood pressure change. | 6 months |
| Feasibility (number of consented participants to all eligible participants ratio) | number of consented participants to all eligible participants ratio | 3 months (recruitment period) |
| Acceptability | Net Promoter Score assessed by 1 verbal question at the end of the intervention. | 6 months |
| Background | วารณี บุญช่วยเหลือ, ทิพาพร พงษ์เมษา, และ กมลภัทร ไชยกิตติโสภน. การดําเนินงานลดเสี่ยงต่อโรคหัวใจและหลอดเลือดในกลุ่มวัยทํางาน ที่มีความคุ้มค่าหรือมีประสิทธิผล ในชุมชน สถานบริการสุขภาพและสถานที่ทํางาน. 2018. |
| Background | World Health Organization. Global Strategy on Diet, Physical Activity and Health. 2004, World Health Organization: Global Strategy on Diet, Physical Activity and Health. |
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| 14656957 | Background | Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA, Izzo JL Jr, Jones DW, Materson BJ, Oparil S, Wright JT Jr, Roccella EJ; Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. National Heart, Lung, and Blood Institute; National High Blood Pressure Education Program Coordinating Committee. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension. 2003 Dec;42(6):1206-52. doi: 10.1161/01.HYP.0000107251.49515.c2. Epub 2003 Dec 1. |
| 12453955 | Background | Diabetes Prevention Program (DPP) Research Group. The Diabetes Prevention Program (DPP): description of lifestyle intervention. Diabetes Care. 2002 Dec;25(12):2165-71. doi: 10.2337/diacare.25.12.2165. |
| Background | Schwarzer, R. Modeling Health Behavior Change: How to Predict and Modify the Adoption and Maintenance of Health Behaviors. Applied Psychology, 2008. 57(1): p. 1-29. |
| Background | Schwarzer, R. Health action process approach (HAPA) as a theoretical framework to understand behavior change. Actualidades en Psicología, 2016. 30(121): p. 119-130. |
| 11832527 | Result | Knowler WC, Barrett-Connor E, Fowler SE, Hamman RF, Lachin JM, Walker EA, Nathan DM; Diabetes Prevention Program Research Group. Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. N Engl J Med. 2002 Feb 7;346(6):393-403. doi: 10.1056/NEJMoa012512. |
| 35151522 | Result | Katula JA, Dressler EV, Kittel CA, Harvin LN, Almeida FA, Wilson KE, Michaud TL, Porter GC, Brito FA, Goessl CL, Jasik CB, Sweet CMC, Schwab R, Estabrooks PA. Effects of a Digital Diabetes Prevention Program: An RCT. Am J Prev Med. 2022 Apr;62(4):567-577. doi: 10.1016/j.amepre.2021.10.023. Epub 2022 Feb 10. |
| 31079517 | Result | Aekplakorn W, Tantayotai V, Numsangkul S, Tatsato N, Luckanajantachote P, Himathongkam T. Evaluation of a Community-Based Diabetes Prevention Program in Thailand: A Cluster Randomized Controlled Trial. J Prim Care Community Health. 2019 Jan-Dec;10:2150132719847374. doi: 10.1177/2150132719847374. |
| ID | Term |
|---|---|
| D002908 | Chronic Disease |
| D000073296 | Noncommunicable Diseases |
| ID | Term |
|---|---|
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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| ID | Term |
|---|---|
| D013619 | Tacrine |
| ID | Term |
|---|---|
| D000609 | Aminoacridines |
| D000166 | Acridines |
| D006575 | Heterocyclic Compounds, 3-Ring |
| D000072471 | Heterocyclic Compounds, Fused-Ring |
| D006571 | Heterocyclic Compounds |
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