Digital Group-Based Intervention for Physical Activity Promotion Among Thai Adults During the COVID-19 Lockdown: Randomized Controlled Trial.

BACKGROUND: The COVID-19 pandemic significantly diminished the physical activity (PA) level of Thai adults belonging to Generation Y (Gen Y). As a response to the global crisis, many individuals worldwide have turned to social community platforms, recognizing their potential in promoting PA during the pandemic. Gen Y, in particular, demonstrates exceptional proficiency in using social media platforms, showcasing a remarkable aptitude for swiftly accessing new information and knowledge. However, their proclivity for reckless behavior exposes them to various health risks, potentially leading to enduring adverse health consequences. Consequently, there arises a pressing need to develop a comprehensive model aimed at elevating the PA levels among individuals belonging to Gen Y. OBJECTIVE: This research aimed to examine the effectiveness of a digital group-based activity in promoting PA among Gen Y in Thailand. METHODS: This was a parallel 2-arm randomized controlled trial with single-blind allocation to experimental and control groups and pre- and posttest measurements. Measurements were administered on the web and were designed for respondents to complete by themselves. The sample comprised 100 Gen Y individuals who met the inclusion criteria. Both groups were matched for background characteristics. The two 8-week intervention activities were (1) two weeks of education and (2) six weeks of motivation by target groups that set goals for PA together (using the Zoom meeting application), with a time limit and group consensus as to when the goal was to be achieved. The intervention activities were implemented one by one at specified intervals and delivered daily through health apps and the official LINE account. RESULTS: The intervention starts from August 22 to October 16, 2021. Of the 100 participants, 20 (20%) left the study, and the remaining 80 (80%) participated in the study (40 individuals each in the experimental and control groups). After participating in the experiment, a statistically significant difference in PA was found between the 2 groups (moderate to vigorous PA; 25/40, 63%; P=.03). Participants in the intervention group collected a higher cumulative minute of moderate to vigorous PA weekly (283 minutes) than those in the control group (164 minutes), and this was statistically significant (P=.03). For the transition to the fourth stage of behavior (ie, action), the improvement in the experimental group, after participating in the trial, was statistically significant compared to that of the control group (P=.01). CONCLUSIONS: Digital group-based activity showed its effectiveness in improving the PA of Gen Y individuals in the intervention group. It created a process-based intervention activity that corresponds to the stages of behavior changes, from contemplation to action. The digital community can also connect individuals to comparable groups locally and globally. TRIAL REGISTRATION: Thai Clinical Trials Registry TCTR20211101005; https://www.thaiclinicaltrials.org/show/TCTR20211101005.

Assessing physical activity promotion in different settings and how its associated with public participation during COVID-19 epidemic: evidence from national policy evaluation.

BACKGROUND: Various interventions, programs and policies have been implemented to improve physical activity (PA) levels worldwide. However, countries continue to face barriers and challenges in achieving their targets. To date, there is a lack of study on the evaluation of physical activity (PA) promotion and how it's associated with public participation. METHODS: This study assessed PA promotion in eight different settings in terms of policy availability, policy implementation, and public participation in PA programs. Policy availability was assessed by reviewing 384 policy and strategy documents, rules, regulations, legislation, and guidelines on PA. We scored the documents by using the Comprehensive Analysis of Policy on Physical Activity (CAPPA) framework. Data to assess policy implementation and public participation were taken from the Thailand Report Card Survey 2021 (TRC2021), and the Thailand Surveillance on Physical Activity (SPA) 2021. Both surveys comprised over 5,000 nationally-representative samples from on-screen, face-to-face interviews, and an online self-administered survey. We scored the policy implementation and public participation based on respondents' response towards policy implementation and participation indicators. A grading scheme was applied to indicate how successful an investment has been made. RESULTS: Public education and mass media received the highest average score in policy availability, implementation and public participation in PA program (67.9%, grade B), followed by active urban design (66.1%, grade B-) and active transport (63.7%, grade B-). Workplace, whole-of-school, and community-wide initiatives were the investments with the lowest scores, implying low availability, limited implementation, and less accessibility to public. Females were less likely to participate in active transport, active urban design, sports/recreation for all, workplace activity, and community-wide initiatives. Age and educational attainment were consistent predictors of utilization in all investments. CONCLUSIONS: With varying degrees of policy availability and accessibility, public participation in PA investments is likely to be constrained by biological and socioeconomic inequality. Future investments should aim at providing generalized or tailored interventions to ensure equal access and participation for all segments of the population.

Report card grades on physical activity for children and adolescents from 18 Asian countries: Patterns, trends, gaps, and future recommendations.

Background: Physical inactivity is a persistent and worsening population health concern in Asia. Led by the Active Healthy Kids Global Alliance, Global Matrix (GM) initiative provides an opportunity to explore how regional and cultural differences across 18 Asian countries relate to physical activity (PA) participation among children and adolescents. Objectives: To synthesize evidence from the GM2.0 to GM4.0 (2016-2022) in Asian countries. Methods: Report Card grades on behavioral/individual and sources of influence indicators were reported from 18 Asian countries. Letter grades were converted into numerical values for quantitative analyses. Based on this, cross-sectional and longitudinal analyses were conducted to investigate patterns and trends. Qualitative evidence synthesis was performed based on Report Card grades and published papers to identify gaps and suggest future recommendations. Results: In total, 18 countries provided grades for at least one round of GM, 12 countries provided grades for at least two rounds, and seven countries provided grades for all three GMs. Of possible grades, 72.8%, 69.2%, and 76.9% of the grades were assigned from GM 2.0 to GM 4.0, respectively. In terms of the Report Card grades, there was a slight decrease in behavioral/individual indicators from "D+" in GM 2.0 to "D-" in GM 3.0 but this reverted to "D" in GM 4.0. For the sources of influence, a "C" grade was given in all three rounds of GM. Longitudinal observation of seven Asian countries that provided grades in all three rounds of GM revealed that grades are generally stable for all indicators with some country-specific fluctuations. In future GM initiatives and research, considerations should be made to provide more accurate and rich data and to better understand contextual challenges in evaluating certain indicators such as Active Transportation, Active Play, and Physical Fitness in particular. Further, macro level factors such as socioeconomic/cultural disparities and gender-specific barriers, ideology, or climate change should also be proactively considered in future research as these factors are becoming increasingly relevant to indicators of GM and United Nation's Sustainable Development Goals. Conclusions: Participation from Asian countries in GM has increased over the years, which demonstrates the region's enthusiasm, capacity, and support for global PA promotion efforts. The efforts to promote a physically active lifestyle among children and adolescents should be a collective interest and priority of the Asia region based on the gaps identified in this paper.

Refining index to measure physical activity inequality: which group of the population is the most vulnerable?

BACKGROUND: The existing body of research mostly discusses inequality in physical activity (PA) based on the difference in the level of moderate-to-vigorous physical activity (MVPA). Evidence is lacking on the quantified inequality measures (e.g., how big the inequality is, and the distribution) in order to identify the most vulnerable groups of a population. This study measured PA inequality among Thai adults by using three parameters to construct an inequality index: (1) Proportion of the population with sufficient MVPA; (2) Cumulative minutes of MVPA; and (3) The Gini coefficient. METHODS: This study employed three rounds of data from Thailand's Surveillance on Physical Activity (SPA) 2019-2021. In each round, over 6,000 individuals age 18-64 years were selected as nationally-representative samples, and were included in the analysis. PA inequality was constructed by using three parameters, with a combination of the three as the final measure, to identify the sub-groups of the Thai adults who are most vulnerable: groups with the least MVPA, highest insufficiency, and highest inequality index (Gini). RESULTS: Covid-19 containment measures have widened the gap in PA inequality, as shown by a declining proportion of the population meeting the recommended guidelines, from 74.3% in 2019 to 56.7% in 2020 and 65.5% in 2021. PA inequality existed in all sub-populations. However, by combining three parameters, the most vulnerable groups during the Covid-19 epidemic were identified as follows: (1) Those with no income; (2) The unemployed; (3) Those who have no access to PA facilities; (4) Older adults aged 60 + years; and (5) Those earning < 3,500 baht per month. Further, residents of Bangkok, young adults aged 18-24, individuals who attained primary level education or less, those who had no exposure to a PA awareness campaign and those who have a debilitating chronic disease also had elevated risk of PA insufficiency. CONCLUSION: A concerning level of PA inequality existed in all sub-populations. The use of combined indicators in measuring PA inequality should aid in determining the most vulnerable groups of the population with a refined procedure. This method can be applied in many settings since the baseline data used to measure inequality (i.e., percent sufficient and cumulative minutes of MVPA) are widely available.

Results from the Thailand 2022 report card on physical activity for children and youth.

Background/objective: The effort to create physical activity (PA) opportunities for Thai youth, prior to 2020, was making good progress. However, the unexpected advent of the Covid-19 epidemic has posed significant challenges to maintain PA level of youth. The Thailand 2022 Report Card on Physical Activity for Children and Youth presents measurements of PA-related indicators based on the Global Matrix, with additional indicators that are relevant for childhood development. Methods: Several data sources were employed to develop the indicators, namely: 1) The Thailand Report Card Survey 2021; 2) School health and facility data; 3) Student health indicators from the Ministry of Public Health; and 4) Relevant resources to support the development of the policy indicator. Results: Overall, only 27% of Thai children and youth met the 60-min PA daily threshold (grade D). While behavioral indicators were mostly graded 'poor' (between C and F), the source of influence (i.e., family) indicators showed better grades (between A and C). One-third (33%) of the youngsters suffered from moderate-to-severe level of stress/anxiety (grade B). Overweight and sleep indicators received grades of A or A-, whereas bullying and student engagement received a grade of B. The performance on the physical literacy indicator was graded C+. Conclusion: With the main message "Let's Move - Boost Happiness," the results from Thailand 2022 Report Card call for a collaborative effort involving multiple sectors to improve PA and happiness of children and youth. A more comprehensive PA promotion strategy is required to provide clear direction and guidance for schools, families, and communities in order to maintain gains and raise the overall level of youth PA in Thailand.

Prevalence of sufficient MVPA among Thai adults: pooled panel data analysis from Thailand's surveillance on physical activity 2012-2019.

BACKGROUND: The role of data in informing decision makers in formulating policy to improve population health is undeniably important. During the past few years, the Thai government has undertaken continuous health promotion campaigns and programs. Nevertheless, evidence of how physical activity (PA) has improved is lacking. This study aims to present PA prevalence and trends from nationally-representative surveillance data collected during 2012-2019. METHODS: This study employed 8 rounds of Thailand's Surveillance on Physical Activity (SPA) survey from 2012 to 2019 as a pooled analysis from two-panel data (SPA2012-2016 and SPA2017-2019). Multistage random sampling was applied to select Thai adults aged 18 or over to produce a nationally-representative dataset, by considering the place of residence (urban or rural), gender, and single year of age. Face-to-face interviews using a structured questionnaire were conducted in 5 regions, 13 provinces, and 36 villages to follow up 5648 individuals in Panel 1 (SPA2012-2016) and 6074 persons in Panel 2 (SPA2017-2019). RESULTS: The prevalence (%) of Thai adults who met WHO recommendations on sufficient PA tended to increase over time, from 66.6 (CI 65-68) in SPA2012 to 70.1 (CI 69-71), 69.5 (CI 68-71), 73.1 (CI 72-74), 70.6 (CI 69-72), 73.0 (CI 72-74), 75.6 (CI 74-77), and 74.3 (73-75) in SPA2013-2019, respectively. Thai females are less physically active than males, and the prevalence of sufficient moderate and vigorous PA (MVPA) was highest among middle-aged adults (35-64 years), and lowest among older adults (65+ years). Work-related PA dominated the cumulative minutes of MVPA per week, followed by recreational PA. CONCLUSION: The prevalence of sufficient MVPA has fluctuated over time with a tendency to increase in the most recent years. Work-related is the most common modes of PA among Thai adults, implying further improvement in recreational physical activity is required. Workplace intervention should also be the focus in improving PA of Thai adults by encouraging their work force to engage in more occupational PA.

Physical activity level of Thai children and youth: Evidence from Thailand's 2018 report card on physical activity for children and youth.

BACKGROUND: While enabling and supporting factors have been in place to facilitate the pupils to be more active, only a fourth of Thai children have met the WHO recommendation. OBJECTIVE: This study aims to present the physical activity (PA) level of Thai children and youth, based on the indicators established by Active Health Kids Global Alliance's Report Card (RC). METHODS: The 2016 Thailand RC Survey and the 2015-2017 Thailand's Surveillance on Physical Activity (SPA) were employed for the analysis. PA of Thai children aged 6-17 years old was assessed in 9 aspects 1) Overall PA, 2) Organized Sports and PA, 3) Active Play, 4) Active Transportation, 5) Sedentary Behavior, 6) Family and Peers, 7) School, 8) Community and Environment, and 9) Government. RESULTS: Only 26.2% of Thai children and youth met the recommended level of 60 min MVPA. Boys are generally more active compared to girls in all age groups (34.9% versus 16.3%, respectively). Almost half had participated in organized sports and/or PA program, but only 8.7% of Thai children and youth engaged in unstructured/unorganized active play. The settings and source of influence indicators achieved better grades, shown by 71.0% of family members (e.g., parents, guardians) facilitated PA and sports opportunities for their children. CONCLUSION: Although schools' facilities are available, Thai curriculum provides less opportunity for the children to move during classes and have enough playing time during recess. As there is no standardized guidance for PA in Thai schools, Thailand needs to promote a unified PA in order to improve PA and to reduce recreational screen time of children and youth.

Development and validation of the Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ) in 14 countries: study protocol.

INTRODUCTION: Global surveillance of physical activity (PA) of children and adolescents with questionnaires is limited by the use of instruments developed in high-income countries (HICs) lacking sociocultural adaptation, especially in low- and middle-income countries (LMICs); under-representation of some PA domains; and omission of active play, an important source of PA. Addressing these limitations would help improve international comparisons, and facilitate the cross-fertilisation of ideas to promote PA. We aim to develop and assess the reliability and validity of the app-based Global Adolescent and Child Physical Activity Questionnaire (GAC-PAQ) among 8-17 years old in 14 LMICs and HICs representing all continents; and generate the 'first available data' on active play in most participating countries. METHODS AND ANALYSIS: Our study involves eight stages: (1) systematic review of psychometric properties of existing PA questionnaires for children and adolescents; (2) development of the GAC-PAQ (first version); (3) content validity assessment with global experts; (4) cognitive interviews with children/adolescents and parents in all 14 countries; (5) development of a revised GAC-PAQ; (6) development and adaptation of the questionnaire app (application); (7) pilot-test of the app-based GAC-PAQ; and, (8) main study with a stratified, sex-balanced and urban/rural-balanced sample of 500 children/adolescents and one of their parents/guardians per country. Participants will complete the GAC-PAQ twice to assess 1-week test-retest reliability and wear an ActiGraph wGT3X-BT accelerometer for 9 days to test concurrent validity. To assess convergent validity, subsamples (50 adolescents/country) will simultaneously complete the PA module from existing international surveys. ETHICS AND DISSEMINATION: Approvals from research ethics boards and relevant organisations will be obtained in all participating countries. We anticipate that the GAC-PAQ will facilitate global surveillance of PA in children/adolescents. Our project includes a robust knowledge translation strategy sensitive to social determinants of health to inform inclusive surveillance and PA interventions globally.

Recovery shape of physical activity after COVID-19 pandemic.

BACKGROUND: Since the shutdowns associated with the coronavirus disease 2019 pandemic, there has been limited discourse on physical activity (PA) recovery (i.e., the ability of individuals to resume PA at pre-pandemic levels), including recovery rate, speed of recovery, which individuals are able to return quickly, who is left behind, and what are the causes of those differences. This study aimed to estimate the level and shape of PA recovery rate in Thailand. METHODS: This study employed 2 rounds (2020 and 2021) of Thailand's Surveillance on Physical Activity dataset for the analysis. Each round included over 6600 samples from individuals aged 18 years or older. PA was assessed subjectively. Recovery rate was calculated from the relative difference in the cumulative minutes of moderate-to-vigorous PA (MVPA) from 2 different periods. RESULTS: The Thai population experienced a medium level of recession of PA (-26.1%) and a moderate level of recovery of PA (37.44%). PA recovery in the Thai population resembled an imperfect V shape, reflecting a sharp decline followed by an immediate upturn; still, recovered PA remained lower than pre-pandemic levels. The quickest recovery was found among older adults, whereas students, young adults, residents of Bangkok, the unemployed, and those who had a negative attitude toward PA experienced the highest recession of PA and were among the slowest to recover. CONCLUSION: The level of recovery of PA among Thai adults is largely determined by the preventive behaviors demonstrated by groups within the population who have a higher awareness of their health. The effect of the mandatory coronavirus disease 2019 containment measures on PA was temporary. However, the slower recovery rate of PA among some individuals was caused by a combination of restrictive measures and socioeconomic inequality, which required more time and effort to overcome.

Enablers and Barriers of Healthcare Services for Community-Dwelling Elderly in Rural Indonesia: A Qualitative Evidence Synthesis: Facilitadores e barreiras dos serviços de saúde para os idosos das comunidades nas zonas rurais da Indonésia: uma síntese qualitativa das provas.

Introduction: Healthcare services for elderly populations in Indonesia have been arranged in both institutional and community services. However, only a small number of elderly individuals reside in this residential aged care home setting because of cultural norms in Indonesian communities. Poor health infrastructure is still the main constraint, particularly in rural communities, although they have the adequate social capital to deal with restrictions. It is important to explore the existing implementation of healthcare services for elderly populations in rural Indonesia to shed light on appropriate policy interventions. This review aimed to identify and synthesize relevant evidence in Indonesia regarding the barriers and enablers of healthcare for elderly individuals in rural settings. Methods: This study used a qualitative evidence synthesis method. The search strategy aimed to locate published studies. An initial limited search of PubMed, Web of Science, ScienceDirect, Embase, PsycINFO, and CINAHL was conducted to identify articles on the topic that were published in English from 2010 to 2020. A meta-aggregation approach was used to pool qualitative study findings, employing JBI SUMARI software. Results: Four synthesized statements emerged from the study analysis: (1) integration needs among institutional and community-based healthcare for elderly people in rural areas, (2) the quality of integrated health services for elderly populations must be improved, (3) community support will improve and ensure the sustainability and implementation of community-based healthcare for elderly populations, and (4) community and family awareness must be improved to support care for the elderly. These were substantial insights that can be used to address key challenges in existing healthcare services and improve the system by considering specific features of enablers and barriers. Conclusion: A collaboration between communities, healthcare institutions, families, and government authorities was needed to support the success of the program and maintain the sustainability of services, which will result in adequate healthcare for the elderly population and improved health overall in rural Indonesia.

Introdução: Os serviços de saúde para populações idosas na Indonésia foram organizados em serviços institucionais e comunitários. No entanto, apenas um pequeno número de idosos residem neste lares residenciais de idosos devido às normas culturais nas comunidades indonésias. A má infraestrutura sanitária continua a ser o principal constrangimento, particularmente nas comunidades rurais, embora estas tenham capital social adequado para lidar com as restrições. É importante explorar a atual implementação de serviços de saúde para as populações idosas na Indonésia rural, a fim de esclarecer as intervenções políticas adequadas. O objetivo desta análise foi identificar e sintetizar provas relevantes na Indonésia relativamente às barreiras e facilitadores dos cuidados de saúde para idosos em ambientes rurais. Métodos: Este estudo utilizou um método qualitativo de síntese de evidências. A estratégia de pesquisa visou a localização de estudos publicados. Foi realizada uma pesquisa inicial limitada do PubMed, Web of Science, ScienceDirect, Embase, PsycINFO, e CINAHL com o objetivo de identificar artigos sobre o tema que foram publicados em inglês de 2010 a 2020. Foi utilizada uma abordagem de meta-agregação para reunir resultados de estudos qualitativos utilizando o software JBI SUMARI. Resultados: Quatro declarações sintetizadas emergiram da análise do estudo: (1) a necessidade de integração entre os cuidados de saúde institucionais e comunitários para idosos nas zonas rurais; (2) a qualidade dos serviços de saúde integrados para as populações idosas deve ser melhorada; (3) o apoio comunitário melhorará e garantirá a sustentabilidade e implementação de cuidados de saúde baseados na comunidade para as populações idosas, e (4) a consciência comunitária e familiar deve ser melhorada para apoiar os cuidados de saúde dos idosos. Estas foram informações fundamentais que podem ser utilizadas para enfrentar os principais desafios dos serviços de saúde existentes e melhorar o sistema, considerando as características específicas dos facilitadores e barreiras. Discussão/Conclusão: Foi necessária uma colaboração entre comunidades, instituições de saúde, famílias e autoridades governamentais para apoiar o sucesso do programa e manter a sustentabilidade dos serviços, o que resultará em cuidados de saúde adequados para a população idosa e na melhoria geral da saúde nas zonas rurais da Indonésia.

Willingness-to-pay in physical activity: how much older adults value the community-wide initiatives programs?

Background: Previous studies have shown insufficient physical activity (PA) as a significant global health concern and a major risk factor for non-communicable diseases (NCDs). Community-wide initiatives in physical activity (CWIPA) is considered as a best-buy for Community-wide initiatives in physical activity (CWIPA) is considered as a best-buy for NCDs prevention. However, assessment regarding resource allocation and cost-effectiveness of existing programs is lacking. This study investigated local residents' willingness-to-pay (WTP) for community PA programs in Southern Thailand. Methods: The contingent valuation method (CVM) using the payment card approach was employed to elicit the WTP of 472 residents aged 45 years and over in selected provinces in which community PA programs had been implemented. Respondents were asked to indicate their WTP for the continuous offering of free CWIPA by choosing how much they were willing to pay from eight bid-value options, payable through their monthly electricity bill. Results: The mean WTP of Thai older adults was found to be 72 baht/month ($2/month) or 868 baht/year ($25/year). This indicated the maximum amount an older person was willing to pay for any community-based PA program. More than half the sample (54.2%) chose zero as their answer, while there was a fairly large variation in other levels of WTP. The WTP was lower among older respondents and those who resided in rural areas but was higher among those with a history of participation in an organized PA program. Conclusion: The level of WTP can be interpreted as an indicator of community satisfaction with CWIPA. That finding can be used as evidence for the government and policy makers in allocating resources and designing future CWIPA. A variety of organized PA programs should be offered to all community members to ensure inclusivity and also to provide equal access for senior citizens.

Learning Methods During School Closure and Its Correlation With Anxiety and Health Behavior of Thai Students.

Background: The sequential waves of epidemic spread of COVID-19 in Thailand have caused periodic closures of schools, and exposed students to different learning methods that require multiple adjustment strategies. This study aimed to examine how different learning methods may correlate with anxiety and health behavior (e.g., physical activity, active play, screen time, sleep) of primary and secondary school students in Thailand. Methods: Thailand Report Card (TRC) Data (2021) was employed. The sample of the TRC was drawn by multi-stages random sampling stratified by region, district, urban/rural, school size, sex, and age to ensure national representativeness. A total of 6,078 Thai primary (64%) and secondary (36%) school students were included in the analysis. Results: About two-thirds (66.4%) of the sample experienced a shift from traditional classroom to fully online learning, 6.9% experienced partial online instruction, 23.6% received handouts or written assignments, and 3.1% resumed traditional classroom learning. Compared to fully online learning, students who experienced traditional classroom (onsite) teaching were 37.8% less likely to report moderate-to severe anxiety (OR 0.6; p-value 0.021). There was no significant correlation between school closure-induced anxiety with overall physical activity (PA) and active play, but anxiety was significantly associated with screen time and sleep duration. Receiving handouts/written assignments only as the learning method was significantly correlated with PA, but two methods (handouts and onsite/traditional classroom) was significantly correlated with active play. Students who experienced classroom learning were also more likely to comply with recommended durations of screen time and sleep. Conclusion: Although online learning was probably the most convenient choice during COVID-19 containment measures in Thailand, this method did not provide sufficient opportunity for PA and play. Online learning also encouraged an excessive use of screen media, and disrupted sleeping patterns. Online learning also pressured Thai students to make various adjustments in their daily routines that may have further aggravated anxiety.

The Effect of Containment Measures during the Covid-19 Pandemic to Sedentary Behavior of Thai Adults: Evidence from Thailand's Surveillance on Physical Activity 2019-2020.

Measures to contain the spread of coronavirus disease 2019 (Covid-19) imposed by governments have undoubtedly impacted on preventing its spread but may have also produced longer periods of sedentary living across all segments of society. To examine this phenomenon, this study compared the sedentary behavior (SB) of Thai adults before and during the Covid-19 pandemic. The 2019 and 2020 datasets of Thailand's Surveillance on Physical Activity (SPA) were employed. A total of 5379 (SPA2019) and 6531 (SPA202020) persons age 18-64 years who had access to the Internet were included in the analysis. Measures imposed to contain the spread of Covid-19 infection were significantly associated with lower opportunity of Thai adults for work-related physical movement, and that increased their SB, particularly with the shift from onsite to online working platforms. Cumulative SB increased from 824 (before the pandemic) to 875 min/day during the pandemic. The odds of accumulating >13 h/day of SB was highest among females, young adults, those who completed post-secondary education, unemployed or working in the non-agriculture sector, having a chronic disease/condition, residing in an urban area, and living in a 'higher-risk' pandemic zone. The insignificant association of physical activity (PA) and the Fit from Home (FFH) intervention in reducing SB during the pandemic suggests that PA is not directly associated with SB, and that the FFH intervention was insufficient to prevent SB.

Prevalence and Trends of Physical Activity in Thai Children and Young People: Pooled Panel Data Analysis from Thailand's Surveillance on Physical Activity 2012-2020.

This study aims to describe the level and trends of physical activity (PA) in Thai children and young people and examine PA changes during transitional periods. Employing nine rounds of Thailand's Surveillance on Physical Activity (SPA) 2012-2020, this study pooled three sets of data and included children and young people aged 6-17 years in the analysis: 1595 in SPA2012-2016, 1287 in SPA2017-2019, and 853 persons in SPA2020. Face-to-face interviews were conducted in five regions, 13 provinces, and 36 villages in SPA2012-2019, whereas an online survey was administered in all provinces in SPA2020. The prevalence of sufficient moderate-to-vigorous PA (MVPA) among Thais aged 6-17 years ranged from 19.0 percent to 27.6 percent, with a significant drop during the period of COVID-19 spread in 2020. The average daily MVPA ranged from 46 to 57 min and dropped to 36 min during the pandemic. Boys were consistently more active than girls in all nine rounds of the SPA, and girls had more difficulty in maintaining or improving their PA level. A significant increase in the proportion of Thai children and young people with sufficient MVPA was observed during their transition from late primary to early secondary school grades.

Rethinking early childbearing in Indonesia: is it preceded by a premarital first birth?

PURPOSE: This study aimed to present the level and patterns of premarital first births in Indonesia, and its association with early childbearing. METHODS: This study used three rounds of the Indonesia Demographic and Health Survey, including a total of 29,483 women in 2002; 32,895 in 2007 and 45,607 in 2012. Those women who had their first child before reaching 19 years of age were defined as early child bearers, otherwise, the women were known as later child bearers. All conceptions that occurred 9 months after the first marriage were defined as timely births within marriage, thus, premarital first birth is a first birth that occurred less than 7 months after the first marriage. FINDINGS: About 7-11% of Indonesian women conceived their first child before marriage. Both early and later child bearers experienced their first birth less than 7 months after their first marriage, however, women who experienced conception before marriage were twice as likely to become early child bearers compared to women who had their first birth occurred timely. CONCLUSION: The results of the present analysis show that some Indonesian women had their first child before marriage. Although the unavailability of marriage and birth registrations is the most plausible explanation for the decline in premarital first births among the youngest cohort, regional differences suggest there is also an influence of socio-cultural diversity in the premarital sexual practices of Indonesian women.

Prevalence and determinants of condom use among male adolescents in Indonesia.

Adolescent sexual and reproductive health problems remain a public health concern in Indonesia. An increase of premarital sex as well as early sexual debut among adolescents without any protection leads to a high risk of adverse sexual and reproductive health consequences. This study aimed to assess condom use prevalence and identify its determinants among male adolescents who are sexually active in Indonesia. This was a cross-sectional study using secondary data from the Adolescent Reproductive Health component of the Indonesia Demographic and Health Survey (IDHS) 2012. The sample for this study was 1341 sexually active male adolescents aged 15-24 years old. Data were analyzed descriptively and using binary logistic regression for bivariate and multivariate analysis. This study found that condom use prevalence among male adolescents at first and last sex accounted for 25.0% and 27.4%, respectively. Determinants of condom use varied by time of sexual intercourse. Knowledge of sexual and reproductive health and obtaining information about condoms were consistently related to condom use at first and last sexual encounter. Meanwhile, residential type, age at first sex, and sexual partner were significant determinants of condom use at sexual debut whilst educational level was only associated with condom use at last sex. As the level of protected sex among male adolescents was very low, providing comprehensive sexuality education (CSE) is suggested in order to develop the capacity among adolescents in making informed decisions and preventing unsafe sex.

Android Application Model of "Suami Siaga Plus" as an Innovation in Birth Preparedness and Complication Readiness (BP/CR) Intervention.

Objective: WHO recommends Mobile health, a practice of medicine and public health supported by mobile devices, to improve community health status and change people's behavior for the health purposes. The present study sought to examine the effectiveness of the android application program of Suami Siaga Plus in increasing husband's scores in birth preparedness and complication readiness (BP/CR) intervention. Materials and methods: It was a randomized controlled trial with pretest-posttest design. A total of 38 couples of husbands and pregnant women from three health centers at three sub districts in Semarang was selected by proportional systematic random sampling technique and equally distributed into control and intervention group. A questionnaire related to BP/CR published by JHPIEGO was employed in data collection. Statistical analysis was performed to obtain the frequency distribution and percentage of the variables, and also to assess the mean difference of BP/CR score of husbands. Results: Husbands' knowledge of key danger signs and five standard elements in BP/CR practices in both intervention and control group increased after counseling. Moreover, the proportion of husbands who understand the key danger signs during pregnancy was higher among those who were exposed by Suami Siaga Plus application delivered via mobile phone. Counseling only increased husbands' score from 61.5 to 62.6 (2%), whilst the combination of counseling and the application boosted 20% of husbands' score from 60.4 to 72.9 (p-value 0.000). Conclusion: A combination of counseling and Suami Siaga Plus application significantly improves husbands and wives' score on BP/CR compared to those who received counseling only. The data suggests the application would be able to suppress the three delays, which in turn can reduce the maternal mortality rate. The study results could be important information for the Department of Health and health professionals to use android application program, in particular to the husband whose wife is in pregnancy, childbirth and postpartum periods.

How do laboratory technicians perceive their role in the tuberculosis diagnostic process? A cross-sectional study among laboratory technicians in health centers of Central Java Province, Indonesia.

PURPOSE: Detection of acid-fast bacilli in respiratory specimens serves as an initial pulmonary tuberculosis (TB) diagnosis. Laboratories are the essential and fundamental part of all health systems. This study aimed to describe how laboratory technicians perceived their own self and work. This included perceived self-efficacy, perceived role, perceived equipment availability, perceived procedures, perceived reward and job, and perceived benefit of health education, as well as level of knowledge and attitudes related to work performance of laboratory technicians. METHODS: This was a cross-sectional quantitative study involving 120 laboratory technicians conducted in Central Java. Interviews and observation were conducted to measure performance and work-related variables. RESULTS: Among 120 laboratory technicians, 43.3% showed fairly good performance. They complied with 50%-75% of all procedures, including sputum collection, laboratory tools utilization, sputum smearing, staining, smear examination, grading of results, and universal precaution practice. Perceived role, perceived self-efficacy, and knowledge of laboratory procedures were significantly correlated to performance, besides education and years of working as a laboratory technician. Perceived equipment availability was also significantly correlated to performance after the education variable was controlled. CONCLUSION: Most of the laboratory technicians believed that they have an important role in TB patients' treatment and should display proper self-efficacy in performing laboratory activities. The result may serve as a basic consideration to develop a policy for enhancing motivation of laboratory technicians in order to improve the TB control program.