Determinants of Emergency Management Behavior for Non-Communicable Disease Emergencies Among Patients with Uncontrolled Type 2 Diabetes in Rural Thailand

Effective emergency management is essential for preventing serious complications among people with poorly controlled Type 2 Diabetes Mellitus (T2DM) in rural primary health care settings. This study examined how health beliefs, social-contextual factors, and self-efficacy are associated with emergency management behavior in rural Thailand.

This cross-sectional study included 1,074 adults with poorly controlled T2DM attending rural primary health care services. Participants completed a theory-informed questionnaire. Structural equation modeling was used to examine direct and indirect relationships among health beliefs, community participation, social support, self-efficacy, and emergency management behavior.

The model explained 77.6% of the variance in emergency management behavior. Community participation was the strongest predictor of both self-efficacy and emergency management behavior. Self-efficacy was independently associated with better emergency management behavior and mediated the effects of social-contextual factors. Among Health Belief Model constructs, only perceived severity was directly associated with emergency management behavior.

Social engagement and efficacy beliefs, rather than most Health Belief Model perceptions, accounted for emergency management behavior in this population, with self-efficacy linking social-contextual resources to behavior.

Community participation, self-efficacy, and perceived severity were the factors most strongly associated with emergency management behavior in this population. Strengthening community-based diabetes care and enhancing self-efficacy may support emergency preparedness in rural primary health care settings and inform strategies for similar resource-constrained communities.