Enhancing Village Health Volunteers' Capacity in Health Promotion for NCD Risk Groups via Digital Technology: An Action Research Study in Sing Buri, Thailand¬

Background: Non-communicable diseases (NCDs) pose a major public health challenge in Sing Buri Province, Thailand. This action research examined the effectiveness of digital health communication innovations delivered through Village Health Volunteers (VHVs) to support NCDs management among at-risk populations. Methods: Employing the Plan-Act-Observe-Reflect cycle (PAOR), the study engaged 8 VHVs, 40 at-risk individuals, and 6 public health officers at Pikhun Thong Health Promotion Hospital, Sing Buri Province from February to September 2024. Digital interventions included pedometer apps, LINE-based dietary tracking, and peer learning groups with competitions and rewards. Quantitative data were analyzed using z-tests and Wilcoxon signed-rank tests, while qualitative data underwent thematic analysis. Results: Digital tools and group-based competition strategies effectively promoted positive health behavior change among at-risk individuals. Quantitative results showed significant improvements in exercise (z = 6.293, p < 0.001) and dietary behaviors (z = 6.563, p < 0.001), as well as significant reductions in systolic and diastolic blood pressure (p = 0.048 and p = 0.035). However, no significant changes were observed in BMI or fasting blood sugar, suggesting that a longer intervention period may be required. Conclusion: Integrating digital technology into community-based health promotion enables, with VHVs to function as effective behavioral change agents. Sustained system support and broader community implementation are essential for long-term program sustainability of digital health interventions to prevent and manage NCDs Keywords: Village Health Volunteers, Non-Communicable Diseases, Digital Health Technology, Health literacy, Community Health Promotion, Thailand