The Muslim community is prominently characterized by extended families with sound family relationships. Children and grandchildren that marry remain in their original families, which expand into a larger community with the features of a family-oriented society [1]. Additionally, in the Muslim family, women have the duty to care for the family’s health and prepare food for everyone in the family. From the previous study [2], it was found that Thai Muslims are becoming ill with inappropriate consumption behaviors and a lack of sufficient exercise. They have diseases, such as high blood pressure, high cholesterol, diabetes mellitus, and heart disease and obesity at higher rates than Thai Buddhists. These conditions are found to be more prevalent among females than in males. Additionally, Thai Muslims consume salty foods, fat-rich foods, and fried foods in the starch and sugar groups in daily life [2, 3]. These items have adversely impacted the health of Muslim people.

Women have high average life spans and live longer than men, and, in Thai society, women have the role of safeguarding and promoting the health of everyone in the family, the promotion of sound health thus requires the leader to build a health network that could be implemented as a strategically-important means of communication, conveying both knowledge and guidelines to women. They can then relay their experiences to one another for the promotion of their own holistic health.

The Thai nation’s policy has realized the importance of health problems and social equality for every age group. Health literacy is important for changing the behavior of people. Knowledge which is well-known as “tacit knowledge” or “explicit knowledge,” the former referring to the knowledge of the individual that develops from her accumulated experiences and behaviors [4]. It is characterized by specific attributes that emanate from inside. This tacit knowledge cannot be enhanced in any way, whether it is being exchanged, shared, or transferred for use by others. People contribute a mix of tacit knowledge blended with the explicit knowledge for which there are records in the form of documents, annals, and knowledge that can be distinguished from actual practice. Processes such as these are referred to as knowledge management (KM) or, alternatively, the “sprouting” of existing knowledge, outputting the desired product through a leader whose management brings it to the surface. This form of management helps a certain number of women that are in good health to help themselves, or to acquire experience in the promotion of health among themselves. It also helps them to develop themselves continually as leading figures in the area of holistic health promotion.

The researcher team developed a program based on the knowledge exchange concept and the SECI model [5] that stresses lifelong learning, practicing, and a learners’ center. The KMSDP emphasizes health-oriented research studies in personal lifestyles and acknowledges the need for developing leadership roles for Muslim women regarding their own health promotion. It applies qualitative data to develop the original program so that it may find acceptance and be implemented efficiently with good results, ultimately benefitting the women and people of the Muslim community. When Muslim women develop into health-promotion leaders, it can be expected that these women will build good states of family happiness that will help to connect to their communities.

The objectives of the present research were to develop the KMSDP and to study the effects of using the KMSDP for knowledge-management behaviors regarding the holistic health promotion of Muslim women leaders.

The sample group under study demonstrated higher levels of health promotion knowledge-management behaviors after entering the program than before entering the program, with a statistical significance level of 0.5.

The SECI model of knowledge management and the qualitative data were applied to develop the KMSDP [5]. It consisted of five components: women’s needs, holistic health, the knowledge-management concept, the knowledge-management process, and the religion/belief principle. The researchers reviewed the relevant concepts, theories, and literature, and present a conceptual framework as follows (Fig. 1).

Fig. (1). Conceptual framework.

This research is of an exploratory sequential mixed-methods design [6, 7]. The qualitative data were collected until saturation with 24 informants that were selected using the purposive and snowball sampling technique and analyzed using the content analysis. Then the researcher applied the qualitative data and SECI concept to develop the KMSDP. The effects of this program were examined regarding knowledge-management behaviors in relation to the holistic health promotion of Muslim women leaders in the Muslim community by comparing the pretest and posttest mean scores. Simple randomly assigned to the experimental group (n=35). Descriptive statistics and independent t-test were used for the data analyses.

The results of the study on the states of health of Muslim women showed that a majority of them have chronic diseases. In the Muslim family, women have the duty of caring for the family’s health and preparing food for everyone in the family. The prominent feature of the Muslim community is the extended family, with good family relationships. Even after marrying, children and grandchildren remain in their original families, which then expand into larger communities; these communities will accordingly show the features of a relative society [1]. Contrary to the study, however, was the discovery that the sample group contained single families alongside the extended families, probably because the communities under study were located in urban areas. Children and grandchildren are increasingly separated from their families to form single families, and some of them are finding work outside their communities. Additionally, from the previous study [2], it was found that Thai Muslims that are obese and that have chronic diseases derived from inappropriate consumption behaviors. Further, they are not getting enough exercise. As a result, they have high blood pressure, high blood cholesterol levels, diabetes, heart disease, and obesity at rates greater than Thai Buddhists [2]. These problems are more prevalent among females than males. In addition, it was found that Thai Muslims are fond of consuming salty foods, fat-rich foods, and fried foods in the starch and sugar categories [3]. Further, Thai Muslims are fond of eating sweets and fat-rich foods, in the mistaken belief that foods of this type are actually good for them [2, 3]. Yet, these things still affect the states of health of Thai Muslims, and not for the better. These findings are consistent with the results of the present research, where it was seen that 80% of Muslim people are obese, followed by those that have diabetes, high blood pressure, high blood fat, and asthma and allergies.

As regard the research results from the intervention section, the hypothesis can be accepted that Muslim women in their communities within the District of Khlong Luang exhibit higher-level “knowledge-management behaviors in the area of health promotion” following their training than they did prior to the training, with a statistical significance (P < .001). From these research results, it was found that their average knowledge scores in the areas of holistic health, knowledge management, and knowledge-management skills after participation in the KMSDP program were higher than they were prior to their entrance into the program, with a significance (P < .001). This result can be explained by the KMSDP program for Muslim women leaders, which was developed from the training curriculum for older adult leaders in the Province of Chonburi, and which has since been implemented in one of the communities in the District of Khlong Luang [8]. In the present research, the curriculum was modified in order to adapt it to a Muslim context and to conform it specifically to females. The curriculum was modified for these purposes by applying the behavioral principles of the Islamic religion that Muslims follow in their day-to-day lifestyles [10]. Activity management was modified in three ways: to be in accordance with the Muslim way of life, to conform to rubric religious principle, and to agree with the family leader [11, 13]. This program was accepted by Muslim women, their family, and the religious and community leader.

Adapting the activities to harmonize with the needs of Muslim women, avoiding any conflict with their religious principles or community lifestyle that they have thus far been following, and being careful of any display that a Muslim would find offensive will help Muslim women and their communities appreciate the positive aspects of the activities. The Muslim women leadership development program on holistic health promotion will, as a result, become more efficient. The women themselves will then have a greater store of knowledge, as well as good knowledge-management skills in the form of health promotion knowledge-management behaviors that will be at a higher level after joining the program. In this sense, it can be seen that the KMSDP program was effective in developing Muslim women leaders in terms of holistic health promotion.

Moreover, the key principles stemming from this research are being applied jointly to generate the acceptance of female leadership in Muslim group settings. Specifically, the acceptance issue involves what is called “gender sensitivity” [14, 15]. It especially applies to the authority relationship and role between men and women, which affects the way people act in their everyday life [16, 17]. The acceptance issue also involves what is known as “cultural sensitivity” [18, 19]. Planning curriculum activities to be compatible with the needs and desires of Muslim women enables Muslim women to join the training program with the permission of their husbands and family heads. In this way, women find a sense of contentment and become interested in what they are learning because there is no conflict with their religious practices and beliefs. In addition, everyone becomes more knowledgeable.

An atmosphere of learning, everyone is equal, and every comment is regarded as being equally important. The capacities of women are drawn out to lead their groups in joint activities. Examples of such activities include standing in front of the classroom as a group representative to express an opinion or to respond to any questions there may be; and campaigns to limit the amount of trash in the community [20, 21]. Participation of this sort causes every woman that joined the research group to see herself as a person of worth and to gain acceptance. She is benefitting her own community, and this takes place through the principle of instilling power and authority in the woman, or what is known as “empowerment.” This empowerment manifests a person’s inherent capabilities, a matter in which many women feel they are inferior [22, 23]. It draws out one’s embedded knowledge, or “tacit knowledge,” to become one’s overtly-discernible knowledge or “explicit knowledge” [5, 24]. It also induces Muslim women to develop a sense of pride in themselves, and ultimately it empowers this program to develop health promotion leadership behaviors.

Proposals for applying the research results are as follows.

1. In the area of health promotion nursing, nurses are capable of applying the KMSDP program to develop Muslim-women leadership in other regions or if it is applied to the development of women leadership in other groups, consideration should be given to the context and similarities of the population. To do so will help increase the efficiency of the program.

2. As regard the research, the efficiency of the Muslim women leadership development program should be studied, modeled on a double-group comparison of the experimental group with the control group. This approach will be useful later.

3. The results derived from this study have shown that, in the development of any program, developing only from theory is not sufficient studying in some context or location, and incorporating an understanding gained from the opinions and needs of the involved individuals into the development, will promote increased efficiency in the use of the program.