EFFECT OF INSTITUTION-BASED MANAGEMENT FOR ELDERLY HEALTH PROMOTION PROGRAM IN NORTHEASTERN THAILAND.

The increasingly aging population raises a major challenge for health care in Thailand and worldwide. Health promotion has been considered a strategy for improving elderly quality of life. There are a small number of elderly people living in government elderly services in Thailand, and little is known about their health promotion behaviors and how these behaviors have been shaped in an institution-based setting. This study aimed to examine the current situation and effectiveness of the Institution-based Management for Elderly Health Promotion (IBM-EHP) program in enhancing the health and health promotion behaviors of the elderly living in two out of five government elderly home service institutes (GEHSI) in northeastern Thailand. The elderly participants in one GEHSI were assigned into the management group and received the IBM-EHP program (n=60), and those in another GEHSI were in the control group and received the usual care provided by the institution (n=55). Before and after (six months) the program implementation, assessments of knowledge, self-efficacy, received social support, health promotion behaviors, and health status depicted by fasting plasma glucose level and lipid profile of the participants in both groups were performed. Data collection used an interview guide, and clinical and diagnostic measurement methods. Data analysis used frequency, mean, standard deviation, paired simple t-test, independent t-test, and multiple regression. Results indicated that the management group, compared to the control group, demonstrated improvements in perceived self-efficacy, received social support, health promotion behaviors, and HDL-C level (p<0.05). Perceived self-efficacy and received social support were predictive factors, which contributed to explain 50.6% of the health promotion behaviors of the institutionalized elderly participants in the management group. Modification solutions for suitable health promotion behaviors of the institutionalized elderly persons should emphasize on enhancing their self-efficacy and social support from the elderly home service institute and their peers.

Caffeine Consumption Behaviors of the Working-Age Population in Rural Communities in Northeastern Thailand.

Background: Caffeine use is on the rise among working-age population in Thailand. Little is known about caffeine consumption and potential risk practices of the population group in a rural setting in northeastern Thailand. Objective: Examine caffeine-consumption behaviors (CCB) and contributing factors catering to potential risk practices of CCB pattern among the working-age population. Material and Method: This cross-sectional analytical research study used multi-stage random sampling included 1,321 out of 3,332 working-age participants in rural communities in northeastern Thailand. Data collection used a caffeine consumption survey interview guide and a seven-day-caffeine consumption diary. Data analysis used descriptive and inferential statistics, frequency, percentage, mean, standard deviation, binary logistic regression, odds ratio, and 95% confidence interval (95% CI). Results: The results showed that 39.6% of the working-age population in the rural communities consumed caffeine. Their age ranged from 15 to 59 years with a mean ± SD of 40.2±8.3 years. The woman comprised 49.4% of the group. They consumed caffeine on an average ± SD of 302.5±176.9 mg/day. Sixty-seven point four percent of them were everyday caffeine users. Their caffeine sources were from coffee, energy drinks, chocolate milk, cocoa drinks, carbonated soft drinks, and tea drinks. Their potential "at risk" practices of CCB included excessive consumption of caffeine greater than 300 mg/day (44.7%), frequent consumption of caffeine (67.4%), modification of caffeine consumption method by mixing it with other substances (44.4%), and consumption of caffeine while having illness (29.1%). Income, status in a household, and occupation were factors contributing to "at risk" practices of CCB of this population group (p<0.01-0.05). Conclusion: Rural working-age residents in northeastern Thailand were potentially vulnerable for adverse effects from their "at risk" practices of CCB. Modification solutions for suitable caffeine consumption behavior should be targeted to higher income individuals and household members of certain occupations.

FACTORS RELATED TO MOTORCYCLE ACCIDENT RISK BEHAVIOR AMONG UNIVERSITY STUDENTS IN NORTHEASTERN THAILAND.

Young motorcycle drivers in Thailand are at high risk for road traffic accidents. We conducted this study to identify factors associated with motorcycle accident risk behavior (MARB). We studied 372 randomly selected university students aged 18-22 years (mean 20.2 years; women comprised 68.0% of our participants), who attend a government university in northeastern Thailand. Each student was asked to fill out a questionnaire asking about MARB and factors associated with this behavior. The respondents had an average of 6.2 years (SD+3.09) motorcycle driving experience, 72.3% had a motorcycle driver's license and 83.0% had accident insurance. The prevalence of self-reported motorcycle accident injuries was 42.7%. Their major MARB were using a telephone while driving (69.3%), speeding (45.4%), driving with more than one passenger (40.1%), drunk driving (22.1%), and not wearing a helmet (23.3%). Factors related to MARB were: gender, with men engaged in risky behavior more often than women (p < 0.05); duration of motorcycle driving--drivers with > 5 years experience were more likely to engage in risky behavior (p < 0.05); and knowledge of safe driving, those with a greater knowledge of safe driving were more likely to drive safely (p < 0.001). Having a greater awareness of MARB was associated with lower risk of engaging in risky behavior (p < 0.001). Students who engaged in risky behavior were more likely to view it as normal behavior (p < 0.001) and less likely to have adequate self-control (p < 0.001). Our findings indicate a need to strengthen accident prevention programs for university students in northeastern Thailand.

Model development for substance abusing surveillance system in communities.

BACKGROUND: There is growing evidence that the number of substance abusers have increased. Use of public health surveillance system in substance abuse at the community level is limited. OBJECTIVE: Study and develop a suitable Model for Substance Abusing Surveillance System (MSASS) in communities. MATERIAL AND METHOD: Thirty-eight volunteers, including five direct responsible officers, five local leaders, five people representatives and four university specialists participated in the development of the model. The present study utilized ten sets of database, reported on a monthly basis. These included substance abuse arrested cases, substance abuse treatment seekers, anonymous notification of drug abuse, notification of obstacles and problems of the responsible organizations and notification of substance abuse by the local community leaders. The seven approaches of the model included situational analysis, prototype design, trial test, system design, system running test, model improvement and model dissemination. The study was conducted in 47 communities in four sub-districts in Phakdichumphon District, Chaiyaphum Province. RESULTS: The MSASS model application was created at the community level. The model assessed and monitored substance abuse practices of population aged 12 to 65 years and triggered prevention and control actions in communities. The five important constituents of the model were 1) organizations of substance abuse networks, 2) indicators of substance abuse situations, 3) criteria for investigation of magnitude of the problems, 4) data collection tools and 5) dissemination of information. The model comprised of six core activities (detection, registration, confirmation, reporting, analysis and feedback) and four support activities (communication through meeting and brainstorming, training, supervision and resource-provision). After one year the authors were able to develop indicators and criteria for measuring magnitude of the substance abuse problems. The current developed MSASS was effective in terms of representativeness (93.0%), sensitivity (92.7%), timeliness (84.7%), prediction ability (84.5%), acceptability (82.5%), simplicity (82.5%) and validity (80.3%). CONCLUSION: The developed MSASS is an effective form of public health surveillance suitable for communities at a district level.

Factors Predicting Sexual Risk Behaviors of Adolescents in North-Eastern Thailand.

The number of young people who have had sex at an early age increases in proportion, it concerns unsafe sexual behaviors, teenage pregnancy, HIV aids and sexually transmitted infections (STIs). This study examines the health behaviors and factors predicting sexual risk behaviors pertaining to teenage pregnancy among adolescents in Thailand. Adolescents consulted the reproductive health center about problems with the same gender. The factors of adolescent reproductive behaviors were significantly associated with age, education level, and the perception of peer norms. Receiving social support from media information also significantly correlated with those behaviors. The results recommend that to prevent premature pregnancy, adolescents should protect themselves. Parents should take the issue of social media use by their teenagers very seriously.

Uncovering a family caregiving model: insights from research to benefit HIV-infected patients, their caregivers, and health professionals.

The purpose of this study was to understand family caregiving practices for HIV-infected patients, including problems and needs based on experiences of primary family caregivers and persons living with HIV (PLWH) in Rayong province, Thailand. The participants were 48 PLWH and 48 primary family caregivers. Data collection consisted of individual in-depth interviews of PLWH and family caregivers, plus focus groups with the primary family caregivers and observations. Content analysis was performed to analyze the qualitative data. Results indicated that there was a transformation in family caregivers from the time of initial diagnosis to their offering of loving, caregiving practices. The most unexpected result was that primary family caregivers evolved their own model for caregiving practices; the most concerning result was their fear of stigmatization. Caregiving practices included seeking treatment and help, providing support and care, keeping the closure of diagnosis, coping with stress, requesting the truth about diagnosis, and maintaining family values and dignity.