Abstract
Introduction: Developmental delay can have negative long-term cognitive and psychiatric sequelae. In Roi Et Province, 31.70% of preschool children were identified as having suspected developmental delay. However, evidence on participatory community-based health promotion models for improving preschool child development remains limited. Therefore, this study aimed to explore parents’ needs regarding preschool child development and to develop, implement, and evaluate a community-based health promotion model.
Methods: This participatory action research comprised three phases. Phase I explored the actual situation and parents’ needs using quantitative and qualitative methods. Phase II involved the development of the model, and Phase III implemented and evaluated the developed model using a cluster-allocated quasi-experimental pretest–posttest control group design with 60 participants in each group. Data were collected using the Developmental Surveillance and Promotion Manual (DSPM), parental knowledge and behavioral questionnaires, in-depth interviews, and focus group discussions. Data were analyzed using descriptive statistics, t-tests, and content analysis.
Results: Phase I identified four themes: limited parental knowledge and confidence in promoting child development, lack of continuity between home- and preschool-based developmental promotion, inadequate home and community environments, and limited monitoring and follow-up of child development. At baseline, most parents demonstrated moderate levels of knowledge (86.7%) and parental caregiving behaviors (74.2%). Based on these findings, Phase II developed a community-based health promotion model comprising seven components: (1) parent education and skills training, (2) individualized developmental activity planning, (3) establishment of community-based parent support networks, (4) strengthening the continuity and sustainability of developmental monitoring and promotion at Preschool Child Development Centers, (5) guidance on creating safe home environments and promoting child development, (6) establishment of experiential learning spaces within Preschool Child Development Centers, and (7) policy recommendations. Following implementation in Phase III, parents in the experimental group demonstrated significantly higher knowledge and parental caregiving behavior scores than at baseline. Furthermore, preschool children with developmental delays in the experimental group showed significantly greater developmental improvement than those in the control group (P<0.001).
Conclusion: The community-based health promotion model improved parental knowledge, parental caregiving behaviors, and developmental outcomes among preschool children with developmental delays. The model may serve as a practical community-based approach to promoting sustainable preschool child development in rural communities resulting in a continuity and sustainability.