Effectiveness of Program to Slow Progression of Chronic Kidney Disease Among T2DM With HT With CKD 3 in the Community: A Randomized Controlled Trial.

Chronic kidney disease (CKD) is a significant threat to the quality of life of the global population. Thus, slowing kidney disease progression is considered vital in the treatment of CKD patients. The study aimed to evaluate the effectiveness of a program designed to slow the progression of CKD among Type 2 diabetes mellitus patients with HT with stage 3 CKD (CKD 3) in Thailand by adopting the information-motivation-behavioral skills (IMB) model and applying technology. This study was conducted as a cluster randomized controlled trial. The program activities comprised: (i) providing disease information and teaching behaviors to slow the progression of kidney disease to patients and family members via a 2-h session; (ii) teaching practical behavioral skills for appropriate diet and exercise to patients and family members via a 2-h session; (iii) enhancing personal motivation via the Line application and motivational interviewing via telephone calls; (iv) enhancing social motivation with the support of a family member; (v) employing technology to monitor behaviors and increase patient motivation; and (vi) assessing behaviors that were not practical, exploring barriers to behavior modification, and teaching further practical behavioral skills via the Line application. The data were analyzed using percentages, means, standard deviations, chi-square tests, t-tests, and a 2-way repeated-measures analysis of variance. The results showed that after the experiment, the experimental group had significantly higher mean scores in terms of knowledge, perceived benefits, perceived severity, self-efficacy, and behaviors to slow the progression of kidney disease than the control group (P < .05). Further, the experimental group had significantly better clinical outcomes (SBP, DBP, eGFR, BUN, creatinine, albuminuria, FBS, and HbA1c) than the control group (P < .05). In summary, the findings indicate that the program improved clinical outcomes, especially kidney function, effectively slowing the progression of kidney disease.

Helping teachers conduct sex education in secondary schools in Thailand: overcoming culturally sensitive barriers to sex education.

PURPOSE: The purpose of this quasi experimental study was to evaluate the effects of Culturally Sensitive Sex Education Skill Development, a teacher-led sex education program in secondary schools in Thailand. METHODS: Two public secondary schools in the suburban areas of Bangkok were randomly selected. One was designated as the experimental school and the other as the comparison school. Ninety grade seven and eight teachers, 45 from each school, were selected to participate in the study. Self efficacy theory and culturally appropriate basis were applied to develop the program which included 4 weeks of intervention and 2 weeks of follow up. Primary outcomes were attitudes toward sex education, perceived self efficacy, and sex education skills. Statistical analysis included independent and paired t test, and repeated one-way analysis of variance. RESULTS: At the end of the intervention and during the follow-up period, the intervention group had significantly higher mean scores of attitudes toward sex education, perceived self efficacy, and sex education skills than their scores before (p < .001), and than those of the comparison group (p < .001). CONCLUSION: The results showed that Culturally Sensitive Sex Education Skill Development could enhance attitudes and sex education self efficacy to promote the implementation of sex education among teachers.