Development and Validation of a Sexual Health Literacy Measurement Tool for Pregnancy Prevention Among Adolescents (SHL-PPA).

Purpose: Several measurement tools have been developed for health literacy. However, little emphasis has been placed on the development of sexual health literacy (SHL) in adolescents. This paper describes the development and validation of an SHL measurement tool for pregnancy prevention among adolescents (SHL-PPA). Methodology: This study explores research and development (R&D) and presents three stages of R&D, including a literature review, the Delphi approach, and a valid and reliable questionnaire. Three groups were used for the population and sampling: 18 experts, five competent people, and 654 adolescents. An online self-assessment tool was used. The data analysis methods used were median, interquartile range, content validity index, Cronbach's alpha coefficient, and exploratory factor analysis. Results: The results show that the definition of SHL for adolescents was "cognitive, social, and cultural skills that determine the motivation and ability of an adolescent to access and sufficiently understand sexual health information and services, which results in them being capable of sexual health assessment and making decisions to prevent pregnancy". The final devised SHL-PPA included 33 items and the three following components: 1) accessibility to sexual health information and services, 2) an understanding of sexual health information and services and appraisal of sexual health to prevent pregnancy, and 3) applying the obtained sexual health information and skills to prevent pregnancy. Conclusion: This study proves that the SHL-PPA is appropriate for Generation Z teenagers, particularly for online self-assessment of SHL. An online self-evaluation using the SHL-PPA demonstrated that related organizations should develop online activities or programs to improve teenage girls' pregnancy-prevention behavior.

Sexual health literacy and preventive behaviors among middle-school students in a rural area during the COVID-19 situation: A mixed methods study.

Background: This study explored the association between sexual health literacy (SHL) and preventive behaviors of pregnancies and sexually transmitted diseases (STDs) among middle-school students during the COVID-19 outbreak to aid in the development of an informative program. Methods: Mixed-method study with stratified two-stage cluster sampling was used to obtain 730 students from 20 middle schools in a rural province of Thailand. Online self-administered questionnaire was used to collect data from February 2020 to February 2021. Two brainstorming sessions were conducted with a purposeful sample of 25 stakeholders. Multiple linear regressions were used to assess the relationships. Results: The associated significant factors with the preventive behaviors were sex (b=2.06, 95% CI: 1.07, 3.05), nightlife (b=-2.33, 95% CI: -3.99, -0.67), drinking alcoholic beverages (b=2.24, 95% CI: -3.24, -1.23), sexual intercourse experience (b=-2.64, 95% CI: -4.56, -0.72), and SHL (b=0.12, 95% CI: 0.08, 0.16). The stakeholders recommended an edutainment online program via Facebook. Conclusion: This study investigated factors associated with SHL and preventive behaviors among middle school students. The most effective variable in this model was SHL. Therefore, a trial of an online program emphasizing SHL improvement should be examined for effectiveness among these students and seems appropriate, considering their rural area context and middle-school status.

Promoting Health Literacy to Prevent Depression Among Workers in Industrial Factories in the Eastern Economic Corridor of Thailand.

PURPOSE: This study aimed to identify the factors associated with depression among workers in industrial factories in the Eastern Economic Corridor (EEC) of Thailand. Additionally, a guidebook was created to evaluate the suitability and appropriateness of the health literacy of the workers to prevent depression. METHODS: This study applied a mixed method from May 2019 to May 2020. Two-stage sampling was used to recruit samples. A total of 416 workers were surveyed using a self-administered questionnaire. Moreover, 20 stakeholders enrolled in two focus group discussions (FGDs) using a semi-structured interview questionnaire to explore situations and develop a guidebook. Descriptive statistical, multivariable logistic regression, and content analysis were applied to analyze the data. Both quantitative and qualitative data were used in the development of the guidebook, which were further tested and evaluated by interviewing the 20 stakeholders. RESULTS: Depression was found in 17.1% of the workers. Job position (adjusted odds ratio [ORadj] = 7.14), hours of online media use (ORadj = 1.87), moody/anxious (ORadj = 5.35), avoiding people (ORadj = 9.12), and self-behavior modification to prevent depression (ORadj = 2.41) were associated with significant depression. The FGDs revealed that stakeholders had blurred perceptions of stress and depression. The sample of industrial factory workers was subjected to workload time constraints but had low level of screening for depression. Online media was used only for working in industries. The guidebook was very interesting and useful for stakeholders and contained definitions and symptoms of depression, self-screening and self-care strategies, consultation and hotline contacts, and health literacy improvement guidelines for factory and health personnel to prevent depression. CONCLUSION: This study confirmed that online media and health literacy were imperative factors to address depression among workers in industrial factories. The guidebook was developed based on health literacy and help prevent depression among workers in industrial settings.

Perinatal depressive symptoms among Thai women: A hospital-based longitudinal study.

The authors of this longitudinal study investigated risk factors for postpartum depressive symptoms and differences in depressive symptoms at late pregnancy and at 1 and 3 months postpartum. In Sakhonnakhon Province, in northeastern Thailand, 449 women were recruited during late pregnancy and followed at 1 and 3 months postpartum with the use of psychosocial factors. Depressive symptom scores were measured using the Edinburgh Postnatal Depression Scale (EPDS). The scores were compared using dependent-samples t-tests, and multiple linear regression analyses were used to identify risk factors for depressive symptoms at 1 and 3 months postpartum. EPDS scores decreased from late pregnancy to 1 month postpartum and remained on the same level until 3 months postpartum. Low psychological well-being scores and low personal monthly income were risk factors for increased EPDS scores at 1 and 3 months postpartum. Pregnant women in Thailand who have a low income, have limited social support, and report low psychological well-being are at increased risk for postpartum depression. Results of this study suggest they should be screened for depressive symptoms during pregnancy, referred for diagnosis, and provided treatment to reduce the risk of ongoing depressive symptoms during the postpartum period.

Genetic Polymorphisms of CXCL8 (-251) Are Associated with the Susceptibility of Helicobacter pylori Infection Increased the Risk of Inflammation and Gastric Cancer in Thai Gastroduodenal Patients.

CXC Chemokine Ligand 8 (CXCL8) plays an important role in gastric inflammation and in the progression of gastric cancer induced by Helicobacter pylori (H. pylori) infection. The association of CXCL8, CXC Chemokine Receptor 1 (CXCR1), and CXC Chemokine Receptor 2 (CXCR2) polymorphisms with H. pylori infection and gastric cancer progression needs to be investigated in a population within an enigma area consisting of multiple ethnicities, such as Thailand. To analyze the relative risk of H. pylori infection and gastric cancer among Thai gastroduodenal patients, gene polymorphisms in CXCL8 (promoter region -251) and in CXCR1 and CXCR2 (receptors for CXCL8) were detected by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and allele specific-PCR (AS-PCR). We also determined the presence of cytotoxin-associated gene A (cagA) in Thai patients with H. pylori infection. Correlation between the CXCL8 (-251) polymorphism and CXCL8 gene expression was evaluated by quantitative reverse transcriptase-PCR (qRT-PCR). We found a significant association between the T/A and A/A genotypes of CXCL8 (-251) with H. pylori infection. However, no significant correlation was found between the CXCR1 (+2607) and CXCR2 (+1208) gene polymorphisms with H. pylori infection among Thai gastroduodenal subjects. Within the H. pylori-infected group of Thai gastroduodenal patients, no significant differences in cagA were observed. In addition, the A/A genotype of CXCL8 (-251) significantly correlated with the risk of gastric cancer and correlated with higher CXCL8 gene expression levels in Thai gastroduodenal patients. These results suggest that CXCL8 (-251) polymorphisms are associated with H. pylori infection, an increased risk of stronger inflammatory responses, and gastric cancer in Thai gastroduodenal patients.

Effects of a group activity-based motivational enhancement therapy program on social media addictive behaviors among junior high school students in Thailand: a cluster randomized trial.

PURPOSE: This study aimed to assess the effects of a group activity-based motivational enhancement therapy (GA-MET) program on social media addictive behaviors among junior high school students. MATERIALS AND METHODS: This cluster randomized trial was performed in 245 junior high school students who used social media in the lower part of northeast Thailand. The GA-MET program group and the control group sessions lasted 8 weeks and were followed up 4 weeks later. The addictive social media behaviors, average duration of social media usage during weekdays and weekends (hours/day), child behaviors, self-esteem, and depression were investigated using a self-reported questionnaire. Multivariable linear regression was used to compare the mean and 95% CIs between two groups. RESULTS: The GA-MET program significantly decreased the average duration of social media usage during weekdays and weekends (hours/day) (-1.27, 95% CI: -2.18,-0.37 and -1.25, 95% CI: -2.22, -0.29, respectively), emotional behavior (-0.69, 95% CI: -1.18, -0.19), and depression (-4.03, 95% CI: -6.07, -1.99) in the treated group compared to the control group. CONCLUSION: The GA-MET program could reduce the risk of social media addictive behaviors in junior high school students in Thailand by decreasing time spent on social media, emotional behaviors, and depression.

Facebook Addiction and Its Relationship with Mental Health among Thai High School Students.

OBJECTIVE: To investigate the relationship between Facebook addiction and mental health among high school students. MATERIAL AND METHOD: This cross-sectional analytic study was performed among 972 high school students from four provinces associated with high economic prosperity in Thailand: Bangkok, ChiangMai, Ubon Ratchathani and Songkhla, utilizing a multistage cluster sampling technique. Facebook addiction was assessed using the Thai version of the Bergen-Facebook Addiction Scale (Thai-BFAS), while a Thai version ofthe General Health Questionnaire (Thai GHQ-28) was used for mental health evaluation. The relationship between Facebook addiction and mental health was analyzed through multiple logistic regressions. RESULTS: The prevalence of Facebook addiction and abnormal mental health were 41.9% (95% CI; 38.6, 45.2), and 21.9% (95% CI; 19.2, 24.8), respectively. After adjustment for confounding factors (sufficiency of household income, school location, level of education, GPAX learning deficits and attention deficit hyperactivity disorder), the individuals identified as having Facebook addiction were discovered to be at a high risk of developing abnormal general mental health (ORadj = 1.7, 95% CI: 1.1, 2.4), somatic symptoms (OR = 1.2, 95% CI: 0.9, 1.7), anxiety and insomnia (ORadj = 1.3, 95% CI: 0.9, 1.8), social dysfunction (OR = 1.5, 95% CI: 1.1, 2.1) and severe depression (ORadj = 1.5, 95% CI: 1.0, 2.2). Moreover; there were pronounced trends of increasing risk according to the level of Facebook addiction (Ptrend < 0.05). CONCLUSION: It was found that Facebook addiction among high school students could be associated with abnormal, general mental health status, somatic symptoms, anxiety & insomnia, social dysfunction, and severe depression. Therefore, it is essential that the relevant authorities educate young people about the mental health impacts linked with Facebook addictive usage and impose appropriate public health policies by screening Facebook addiction and mental health issues in risk groups.

Validation of the Thai version of Bergen Facebook addiction scale (Thai-BFAS). .

OBJECTIVE: To determine the validity ofthe Thai version ofthe Bergen FacebookAddiction Scale (Thai-BFAS) using Facebook addiction screening in Thai high school students. MATERIAL AND METHOD: The original BFAS was authorized for translation and validation in Thai. After content validity and usability were approved by three Thai psychiatrists, the Thai-BFAS was adjusted again by the authors and back translated by an English expert. Thisfinal version was investigated using the internal consistency method among 874 high schools students in Bangkok, Chiang Mai, Ubon Ratchathani and Songkhla, and confirmatoy factor analysis (CFA) was employed to prove that the six-component model could be representative of addiction behaviors. In addition, test-retest reliability was performed separately among 30 pilot high school students in Bangkok. RESULTS: The Thai-BFAS has six items, which are each scored on a 5-point scale with total score ranges from 0 to 24; the cutoff score for Facebook addition stands at least 12 points. The Cronbach s alpha coefficient was 0.91 (95% CI; 0.90, 0.92) and the inter-class correlation coefficient was 0.80 (95% CI; 0.49, 0.92). The CFA showed that the six items accurately represent the six-component model of addiction such as salience, mood modification, tolerance, withdrawal, relapse and conflict. CONCLUSION: The Thai-BFAS is consistent as a screening testfor Facebook addiction among high school students due to good reliability and validity. It also conforms well to the original version. The six items in the Thai-BFAS are a good representation of the addiction behaviors. Further studies should be undertaken in cases of sensitivity and specificity when compared with other similar tests of addiction as well as in various additional populations and circumstances.

Risk factors for cholangiocarcinoma in the lower part of Northeast Thailand: a hospital-based case-control study.

BACKGROUND: Cholangiocarcinoma (CCA) is the most common cancer in Northeast Thailand. It is also a crucial health problem for Thai people. Various risk factors for CCA have been identified in the upper part of Northeast Thailand, but no similar studies of risk factors have been conducted in the lower parts of the region. This study aimed to investigate factors associated with CCA in the resident population. MATERIALS AND METHODS: A hospital-based case-control study was conducted during 2009-2012 with the recruitment of 123 CCA cases and 123 non-CCA patient controls, matched for sex, age and residential area. Information was collected by interview with a structured questionnaire. Blood samples were collected for assays of anti-OV antibodies. Associations between various personal factors, dietary habits, family history, the presence of anti-OV antibodies and CCA were analyzed using multiple conditional logistic regression. RESULTS: Patients who consumed raw meat (beef, pork) and alcoholic beverages ≥3 times per week had a higher risk of CCA than non-consumers (ORadj=4.33; 95%CI=1.14-16.35 and ORadj=2.13; 95%CI=1.00-4.55, respectively). Patients who had a family history of cancer had a higher risk than those who did not (ORadj=4.34; 95%CI=1.80-10.43). Also, patients who had anti-OV antibodies (AU>23.337) had a higher risk than those whose anti-OV antibodies were below the cut-off (AU≤23.34) (ORadj=3.09; 95%CI=1.04-9.16). CONCLUSIONS: As is the case in the upper part of Northeast Thailand, OV infection is a crucial risk factor for CCA in people who live in lower part of the region. Similarly, a family history of cancer and the consumption of alcohol are risk factors for CCA.

Effects of a cigarette smoking prevention program among junior high school students in north-east Thailand: a pilot survey.

OBJECTIVE: Evaluate the implementation of a smoking prevention program via a questionnaire. Both knowledge and attitudes toward smoking behavior and smoking cessation were also investigated MATERIAL AND METHOD: An experimental study was conducted between October 2011 and July 2012. Two hundred twenty six school students from Mathayom 1 to 6 participated into the present study. They were divided into either a study group (n = 99) or a control group (n = 127). Participants in the study group underwent two days of a smoking prevention program and the control group was not subjected to this program. Both groups completed a questionnaire containing questions related to the knowledge of the dangers of cigarette, attitudes toward smoking behavior, and smoking cessation at three different stages, pre-program, immediate post-program, and one month post-program. All data was analyzed via statistical methods. RESULTS: Participants in the study group were smokers and non-smokers, aged between 13 and 15, studied in Mathayom 1 to 6. It was reported that 75% of smokers had tried to quit smoking at least once. For those who quit smoking successfully, 83.6% sought advice from their families. Regarding knowledge related to the dangers of cigarettes, the study group had significantly higher scores than the control group at the three different stages (pre-program, immediate post-program, and one month post-program p = 0.001, 0.001, and 0.024 respectively). The attitudes toward smoking cessation behavior between the groups were significantly different at the three different stages (p = 0.03, 0.01, and 0.001 respectively). The influential factor significantly related to decision-making related to quitting cigarettes was advice, especially from friends andfamilies (p < 0.05). CONCLUSION: School students aged between 13 to 15 years of age studying in Mathayom 3 (grade 9) represented the majority of smokers. The study found the smoking cessation prevention program was able to improve knowledge of the dangers of cigarettes. After the completion of the program, the effect offactors on their lives such as medical conditions, social norms, andfriends and families made smokers realize the importance of quitting smoking.