Developing and Evaluating a Health Literacy Training Model for Volunteer Elderly Caregivers to Prevent and Control NCDs in Thailand: An Action Research Study

<b>Background/Objectives:</b> Limited health literacy among older adults with noncommunicable diseases (NCDs) remains a major challenge in community and primary-care settings. This action research aimed to develop and evaluate a community-based health literacy training model for volunteer caregivers for the elderly (VCEs) to support the prevention and control of diabetes and hypertension among older adults in the community. <b>Materials and Methods:</b> This study was conducted in a primary care-based community setting and comprised two phases: Phase 1 (model development) and Phase 2 (implementation and evaluation). The primary analytic sample consisted of 38 volunteer caregivers for the elderly, each providing home-based health education to one older adult (n = 38). The intervention combined structured health literacy education based on the K-shape framework (Knowledge, Comprehension, Thoughtful Inquiry, Decision-making, and Implementation) with SKT meditation/exercise. The program was delivered weekly over 8 weeks. Outcomes included health literacy (20-item scale) and disease prevention and control behaviors (12-item scale), assessed at baseline, immediately post-intervention, and 1 month after program completion. <b>Results:</b> Among VCEs, mean health literacy scores increased significantly from baseline to post-intervention and were further improved at 1-month follow-up (<i>p</i> < 0.001), indicating sustained gains in health literacy. Preventive behavior scores also increased significantly from baseline to post-intervention (<i>p</i> < 0.001); however, no additional improvement was observed at 1 month compared with immediately after the program (<i>p</i> > 0.05). The magnitude of improvement suggested a meaningful effect of the intervention on health literacy, while behavioral changes appeared to plateau after program completion. <b>Conclusions:</b> The community-based training model effectively and sustainably improved health literacy among volunteer caregivers for the elderly. Although preventive health behaviors improved immediately after the intervention, no further gains were observed at 1 month, suggesting that ongoing reinforcement may be required to sustain behavioral change. This model supports the role of community participation in primary care-based NCD prevention among older adults.