Mental health, fall prevention behaviors, and home environments related to fall experiences among older adults from ethnic groups in rural Northern Thailand.

Accidental falls pose significant threats to older adults' health and safety. This study investigates the associations between mental health, fall prevention behaviors, home environments, and yearly falls among older adults of various ethnicities. Conducted in rural ethnic areas of two provinces in northern Thailand, this cross-sectional study utilized multi-stage sampling to survey 462 older adults aged 60 and above, including Mien, Hmong, Karens, and indigenous people. Participants self-reported their history of accidental falls and provided mental health (GHQ-28) data. Univariate logistic regression highlighted associations between falls and mental health problems (OR = 14.87, 95%CI = 7.51-29.43) and the score of fall prevention behaviors (OR = 0.37, 95%CI = 0.31-0.45). Home environment factors, including floor type, floor risk factors, and stair safety features, were significantly related to falls (p < .05). Multivariable analysis identified gender, financial status, underlying disease, vision impairment, mental health problems, and fall prevention behaviors as independent predictors of past-year falls among ethnic older adults (p < .05), explaining 84.7 % of the variation in log odds of falling. This study underscores the heightened fall risks among ethnic minority older adults with mental health issues while emphasizing the protective role of fall prevention behaviors.

Effect of Health Literacy Intervention on Glycemic Control and Renal Function Among Thai Older Adults at Risk of Type 2 Diabetes Mellitus.

Purpose: Diabetes patients with low health literacy often have poor health and clinical outcomes. The study aimed to assess the effectiveness of a health literacy intervention on glycemic control and renal function among Thai older adults at risk of type 2 diabetes mellitus (T2DM). Methods: A quasi-experimental study was carried out in rural areas of Phayao Province in northern Thailand. The participants were older adults with T2DM who recorded blood glucose levels ranging from 140 to 180 mg/dL and who were not receiving prescribed medication. The intervention lasted 12 weeks, and data were collected at three points: baseline, post-intervention, and at 3 months' follow-up. The study outcomes included the measurement of fasting blood sugar (FBS), hemoglobin A1C (HbA1c), and glomerular filtration rate (eGFR) levels after the intervention. A linear mixed model and generalized estimating equations model were used to assess the intervention effect for continuous and binary outcomes, respectively. Results: From baseline to post-intervention, FBS and HbA1c decreased more in the intervention group than in the control group by 8.2 mg/dL (p < 0.001) and 0.1% (p = 0.029), respectively, whereas eGFR increased by 8.0 mL/min/1.73m2 (p < 0.001). The absolute effect of the intervention at follow-up was -9.8 units for FBS, -0.4 units for HbA1c, and 14.0 units for eGFR. Abnormal HbA1c level (≥6.5%) of the intervention group was reported as 70.3% at baseline, 31.3% at post-intervention, and 9.4% at follow-up. Compared to baseline levels, the T2DM patients who received the intervention were 0.31 times less likely to have abnormal HbA1c levels than the control subjects at follow-up (p = 0.003) who received no intervention. Conclusion: Our findings suggest that this intervention may potentially improve diabetes self-management and prevention behaviors, thereby reducing the diabetes burden in rural communities in northern Thailand.

Ergonomic Risk Factors for Musculoskeletal Disorders among Ethnic Lychee-Longan Harvesting Workers in Northern Thailand.

Musculoskeletal disorders (MSDs) are one of the leading causes of occupational injuries and disabilities. The purpose of this study was to assess the prevalence of MSDs and occupational factors affecting MSDs among ethnic lychee-longan harvesting workers in northern Thailand. A cross-sectional study was conducted in the areas of three upper northern provinces of Thailand. The study areas are located in the highlands and rural plains, where many ethnic minority groups live, including Indigenous, Mien, Karen, and Lua. The majority of them work in a farm of perennial fruit trees, mainly lychee and longan. During the harvest season, 404 participants were recruited for the study using the convenience sampling technique. Data were collected using questionnaires that included general information, an ergonomic risk assessment, and a standardized Nordic questionnaire for assessing MSDs in 10 body parts. The average age of lychee-longan harvesting workers was 48.8 years. Almost all (99.5%) reported MSDs in one or more body regions in the previous seven days of work. The prevalence of MSDs was highest in the hands (82.9%), followed by the shoulders (82.2%) and the neck (79.7%). The total ergonomic risk scores, which included awkward posture, heavy carrying and lifting, repetitive activity, land slope, and equipment, were found to be significantly associated with MSDs in part of the neck (AOR = 1.17, 95%CI = 1.11-1.23), shoulder (AOR = 1.15, 95%CI = 1.10-1.21), elbow (AOR = 1.18, 95%CI = 1.12-1.24), hand (AOR = 1.12, 95%CI = 1.07-1.18), finger (AOR = 1.33, 95%CI = 1.24-1.44), upper back (AOR = 1.14, 95%CI = 1.09-1.20), lower back (AOR = 1.16, 95%CI = 1.11-1.22), hip (AOR = 1.11, 95%CI = 1.06-1.15), knee (AOR = 1.18, 95%CI = 1.12-1.24), and feet (AOR = 1.21, 95%CI = 1.15-1.28) when adjusting for ethnicity, sex, age, BMI, and work experience. Many parts of ethnic workers' bodies have been affected by occupational injuries, with a high risk of upper extremity injury. As a result, using an ergonomic approach to improving the working environment and appropriate posture movement is very beneficial in preventing MSDs among ethnic harvesting workers.

Using the Health Belief Model to Predict Vaccination Intention Among COVID-19 Unvaccinated People in Thai Communities.

Background: The coronavirus disease 2019 (COVID-19) pandemic has become one of the biggest challenges to individual health and the public health system worldwide. COVID-19 morbidity and mortality are increasing, impacting almost every country including Thailand. This study used the Health Belief Model (HBM) as a framework to examine the intention of unvaccinated people living in northern Thailand to receive COVID-19 vaccines. Methods: This cross-sectional study was conducted during October and November 2021. A total of 1,024 participants who are currently living in four northern provinces of Thailand, Chiang Mai, Chiang Rai, Lamphun, and Phayao, were recruited to participate in the study. The questionnaire was developed using an HBM structure to obtain information about the perceived severity, perceived susceptibility, self-efficacy, perceived benefits and barriers, cues to action, and preventive behaviors relating to COVID-19 vaccination and the decision to become vaccinated. Multiple linear regression was used to analyze the data. Results: The unvaccinated participants were an average of 44.45 ± 16.63 years of age and more than half were women (54.5%). The COVID-19 preventive behavior score used perceived severity (B = 0.26), self-efficacy (B = 0.51), perceived benefits and barriers (B = 0.11), and cues to action (B = 0.18) after adjusting for age, underlying disease, and body mass index (R 2 = 42.5%). The COVID-19 vaccination decision score was positively correlated with perceived severity (B = 0.13), perceived susceptibility (B = 0.25), perceived benefits and barriers (B = 0.21), and cues to action (B = 0.27) after adjusting for underlying disease (R 2 = 38.7%). Discussion: The results demonstrated the usefulness of using the HBM structure to understand individual intention to receive a COVID-19 vaccine. Communities should consider a COVID-19 health campaign and programs that use the HBM model as a framework for altering perceptions and beliefs about the COVID-19 vaccine and improving vaccination rates among unvaccinated people in rural northern Thailand.

Health Behavior, Level of Hemoglobin A1c, and Quality of Life Among Agricultural Workers of Various Ethnicities in Thai Border Communities.

BACKGROUND: Little is known about the glycated hemoglobin (HbA1c) levels and quality of life (QoL) in ethnic minority agricultural workers. We investigated the links among health behaviors, HbA1c levels, and QoL ethnic agricultural workers living in rural areas. METHODS: A cross-sectional study was conducted in three northern Provinces of Thailand. Agricultural workers of Indigenous, Hmong, Karen, and Lua communities were recruited. The number of 468 samples were selected using multistage sampling. Data collection was done from interviews using questionnaires, and blood samples were taken. RESULTS: We revealed 56.8% of participants to be female, with an average age of 49.6 years. Also, 56.0 and 34.8% of participants had low and moderate levels of knowledge on non-communicable diseases, respectively. In addition, 56.8 and 30.6% of participants had moderate and low health behaviors, respectively. Also, 51.5% had a HbA1c level (≥6.5%). We found that 64.7, 22.9, and 12.4% had moderate, low, and high QoL, respectively. Multiple linear regression analysis revealed that having an underlying disease and knowledge score were both significantly related to the health behaviors score (p < 0.05), accounting for 68.6% of the variance. Five variables (ethnicity, BMI, having an underlying disease, smoking, and health behaviors) were significantly related to the HbA1c level (p < 0.05), accounting for 24.6% of the variance. Education, health behaviors, and HbA1c level were significantly associated with QoL (p < 0.05). These three factors could explain 79.4% of the variance in QoL among ethnic agricultural workers. CONCLUSION: Health behaviors of ethnic minority agricultural workers influenced their HbA1c level and QoL. Effective health behaviors modification programs should be developed in accordance with the problems and needs among ethnic minority agricultural workers to enhance their QoL.

Knowledge of COVID-19 and Its Relationship with Preventive Behaviors and Vaccination among Adults in Northern Thailand's Community.

(1) Background: the 2019 coronavirus disease outbreak (COVID-19) has posed a major threat to public health and had a significant impact on all areas of people's lives. Vaccines against COVID-19 have been developed to control the disease, and an array of personal hygiene measures has been introduced. As a result, information that will support and promote vaccination among populations as well as other health measures against COVID-19 are urgently needed. The goal of this research was to look into the knowledge about COVID-19 and how it relates to preventive behaviors and vaccination among people living in rural areas of northern Thailand. (2) Methods: a cross-sectional study was performed in four upper northern provinces of Thailand. A total of 1524 participants were recruited using the probability sampling technique. Questionnaires were distributed to collect data on general health information, as well as knowledge and preventive behaviors regarding COVID-19. (3) Results: more than half (55.9%) of the participants were female and had not received the COVID-19 vaccine (67.2%). Their mean age was 44.13 years. The majority had moderate COVID-19 knowledge and engaged in preventive behaviors (65.5% and 42.0%, respectively). A linear regression model showed that the COVID-19 knowledge score was related to the COVID-19 preventive behaviors score, with a standardized coefficient of 0.510, after adjusting for age, underlying disease, and body mass index (B = 2.64; 95%CI = 2.42, 2.87). Binary logistic regression revealed that after controlling for age, education, occupation, financial status, and current disease (AOR = 1.87; 95%CI = 1.64-2.13), the score of COVID-19 knowledge was significantly associated with having the COVID-19 vaccine. (4) Discussion: knowledge of COVID-19 is very important for people in rural regions to engage in COVID-19 prevention behaviors and vaccination. Relevant government agencies and health network partners should support proactive education campaigns emphasizing the risk of contracting the disease and its severity in order to promote vaccination against COVID-19 among unvaccinated groups. These campaigns can highlight COVID-19's positive benefit-risk balance in the short and long term and ensure public safety measures against COVID-19.

Risk Factors Associated with Fall Awareness, Falls, and Quality of Life Among Ethnic Minority Older Adults in Upper Northern Thailand.

BACKGROUND: Falls are a major public health issue and one of the leading causes of morbidity and mortality among the older adults in many countries. Falls and their consequences have an impact on people's quality of life, particularly the older adults. However, there have been very few studies on falls among ethnic minority groups living in rural areas. The aim of this study was to examine factors related to fall awareness, falls, and quality of life among ethnic minority older adults living in northern Thailand. METHODS: A cross-sectional study was conducted among 462 older adults from ethnic minority groups living in rural communities in Phayao and Lamphun provinces of northern Thailand using a multi-stage sampling technique. The data were collected through face-to-face interviews, with structured questionnaires covering health information, fall awareness, and quality of life (WHOQOL-OLD). The factors were determined using simple linear regression and binary logistic regression. RESULTS: The mean age of the participants was 68.2, Karen (35.5%), Mien (24.2%), indigenous (20.8%), and Hmong (19.5%). In the previous 12 months, 20.6% of elders had experienced a fall, and 4.5% of them had experienced multiple falls. More than half of the elders had moderate fall awareness and quality of life (71.6% and 68.6%, respectively). Univariate analysis revealed that minority group, sociodemographic characteristics, sleep duration, and fear of falling were all found to be associated with fall awareness, falls, and quality of life score (p<0.001). There was a significant relationship among fall awareness, falls, and quality of life score (p<0.001). Compared to those who had not fallen in the previous year, the quality of life of the older adults who had fallen was about 11 points lower. CONCLUSION: Several independent variables were discovered to be fall risk factors and quality of life indicators. It is critical to recognize the risk factors to promote fall prevention programs that are appropriate for the older adults among ethnic minorities. Therefore, public health agencies and local government should be aware of the problem and initiate an implementation program and policy to prevent falls and improve the quality of life among ethnic minority older adults.

Effects of a social support family caregiver training program on changing blood pressure and lipid levels among elderly at risk of hypertension in a northern Thai community.

Hypertension is becoming increasingly prevalent among the elderly. Family caregivers play an important role in caring for elderly people and empowering them to care for themselves. This study's goal was to see how social support training for family caregivers affected changes in hypertension, total cholesterol, and high-density lipoprotein (HDL), and how such support led to the prevention of hypertension behaviors among the elderly in rural areas. This was a quasi-experimental study with 268 elderly people at risk of hypertension and their caregivers. Sixty seven pairs of elderly people and their caregivers were assigned to the intervention and control groups. Baseline data were collected in November 2020. The intervention group received the Social Support Family Caregiver Training Program (SSFCTP), while the control group received a regular program from the local health authority. The activity lasted 12 weeks, with home visits and telephone check-ups along the way, and data collection took place after the program ended. The final data were collected three months after the end of the intervention. An analysis of repeated measures ANOVA showed the overall effect of the SSFCTP on knowledge, self-efficacy, health care behaviors, and blood pressure among elderly people during three different time periods (p<0.05). Furthermore, the intervention program had a time-dependent effect on knowledge, blood pressure, and total cholesterol levels (p<0.05). In terms of caregiver outcomes, there was an overall difference among the degrees of knowledge, self-efficacy, and behaviors toward health care displayed by elderly hypertensive patients during the three different time periods (p<0.05). The average knowledge and self-efficacy of the participants improved after the intervention. As a result, better self-care behaviors and lower blood pressure and total cholesterol levels were observed among the elderly participants after the intervention. The programs emphasized the importance of caregivers' roles in providing social support, boosting confidence, and encouraging participation in caring, monitoring, and assisting the elderly in controlling blood pressure and other health issues.