Thai Journal of Public Health

Effects of a Program Applying the Transtheoretical Model on Diet and Exercise Behaviors among Hospital Personnel with Metabolic Syndrome

Suphanan Pimpru — 2026-07-01

Background: Metabolic syndrome is a major public health concern associated with increased risks of type 2 diabetes mellitus and cardiovascular disease. Hospital personnel may be particularly vulnerable due to occupational demands, shift work, and limited opportunities for self-care. Objective: To evaluate the effects of a stage-tailored intervention based on the Transtheoretical Model on awareness of metabolic syndrome prevention, dietary behavior, physical activity, body weight, and waist circumference among hospital personnel with metabolic syndrome. Methods: A quasi-experimental two-group pretest–posttest design with cluster allocation was conducted among 64 hospital personnel in a private hospital in Thailand. Four departmental clusters were first identified, and cluster-level simple random allocation was used to assign two clusters to the intervention group and two clusters to the comparison group. Simple random sampling was then used to select participants until the required sample size of 32 participants per group was achieved. The intervention group received a five-week stage-tailored intervention followed by a three-week follow-up period, while the comparison group received routine health information. Data were analyzed using repeated measures ANOVA, paired t-tests, and independent t-tests (p < .05). Results: The intervention group demonstrated significant improvements in awareness of metabolic syndrome prevention and physical activity over time (p < .05). Waist circumference also showed a significant within-group reduction in the intervention group. However, no significant group-by-time interaction effects were observed for behavioral or anthropometric outcomes, and no significant between-group differences were found in body weight or waist circumference. Conclusion: A stage-tailored intervention based on the Transtheoretical Model resulted in partial improvements in awareness and selected health outcomes, particularly physical activity and waist circumference within the intervention group. These findings suggest potential benefits of readiness-based behavioral strategies in workplace health promotion; however, stronger evidence from larger and longer-term studies is needed to confirm between-group effectiveness.

Perceived Influencers of Self-management among Chinese Older Adults at Risk for Stroke: A qualitative study

Min Gao — 2026-06-30

Background: Similar to other part of the world, Stroke is a major global health issue in China due to rapid population ageing and the increasing prevalence of non-communicable diseases. Effective self-management is considered as essential for stroke prevention among high-risk older adults. However, evidence on the barriers and facilitators influencing self-management of Chinese older adults to prevent stroke were limited. Objective: This qualitative study aimed to explore multilevel perceived barriers and facilitators of self-management among Chinese community-dwelling older adults at risk of stroke. Methods: Purposive sampling was employed to select participants from a community health center in Xinxiang City. Data saturation was reached with a final number of 18 older adults at high-risk for Stroke, 8 family caregivers, and 11 health care professionals. Data were collected by a researcher using a semi-structured interview and a focus group guideline. Themes and sub-themes were extracted by using Braun and Clarke’s six-phase thematic analysis. Results: Three interconnected perceived influencers of stroke prevention self-management were identified across individual, family, and community-level factors. Individual barriers included limited health literacy, complex risk management, functional decline, financial constraints, and fatalistic beliefs; while self-efficacy and supportive environments facilitated self-management engagement. Family barriers involved fragmented caregiving roles and caregiver burden, whereas family support enhanced self-management. Community barriers included fragmented health services, limited accessibility, and heavy workloads; while integrated care, peer support, and tailored health education promoted self-management engagement. Conclusion: Strengthening multilevel strategies, professional competency, and integrated community health service can enhance sustainable self-management to prevent stroke among high-risk Chinese older adults for strengthening primary stroke prevention within community-based primary health care (CB-PHC) systems.

The Effects of the V-Card Program on Healthy Food Consumption among School Children in Thailand

Isiporn Masook — 2026-07-01

Background: Childhood obesity represents a significant and escalating public health challenge worldwide, with a particularly profound and sustained impact on low- and middle-income countries, especially in urban areas ⁽¹⁾. The rising prevalence of overweight and obesity among children leads to a cascade of adverse physical and psychological consequences. Objective: This quasi-experimental study aims to evaluate the effectiveness of the V-Card Program, developed based on self-regulation theory, in promoting healthy food consumption behaviors among Grade 5 students in Chanthaburi Province, Thailand. Methods: Thirty-five students in the intervention group participated in five intervention activities under the V Card intervention, while 35 students in the comparison group continued with the standard school curriculum. Data were collected on nutritional knowledge, attitudes, and food consumption behaviors, using a pretest-posttest design. Results: The results showed that, the post-intervention scores in the experimental group were significantly higher than those in the comparison group. (p < 0.001). Conclusion: The findings indicate that the V Card Program is an effective and feasible approach for improving nutritional knowledge, attitudes, and healthy dietary behaviors in the short term. Therefore, it is recommended that schools and public health authorities scale up the implementation of this program. Additionally, policymakers should consider integrating interactive, learner-centered tools such as the V Card and board games into national curricula to promote long-term and sustainable health behavior change from early childhood.

Multifactorial Fall Prevention Intervention with Tai Chi on Physical Function in Urban Community-Dwelling Older Adults with Fall History

Siriwan Khruesanit — 2026-06-30

Background: Falls among older adults are a significant public health concern associated with reduced lower extremity muscle strength and balance. Objective: This study aimed to evaluate the effectiveness of a multifactorial fall prevention intervention with Tai Chi on lower extremity muscle strength and balance among community-dwelling older adults with a fall history in Bangkok, Thailand. Methods: A quasi-experimental, two-group pretest–posttest design was employed (n = 60; experimental = 30, comparison = 30). The experimental group received an 8-week program incorporating fall prevention education and fall risk assessment, Tai Chi training, scenario-based risk management, home hazard assessment, digital reinforcement via LINE Official Account, and family-engaged home visits. The comparison group received usual care and a fall prevention manual. Results: Post-intervention, the experimental group demonstrated a statistically significant improvement in lower extremity muscle strength compared with the comparison group. The mean Five Times Sit-to-Stand Test (FTSST) completion time decreased from 11.64 ± 2.07 seconds to 9.63 ± 1.53 seconds in the experimental group, whereas only a minimal change was observed in the comparison group (15.08 ± 3.40 seconds to 15.74 ± 3.75 seconds). ANCOVA-adjusted means confirmed a significant between-group difference in lower extremity function, with the experimental group demonstrating a shorter FTSST completion time than the comparison group (11.04 vs. 14.20 seconds; F (1,57) = 36.33, p < .001, partial η² = .389). Dynamic balance also improved significantly in the experimental group compared with the comparison group. Dynamic balance improved significantly following the intervention. The mean Timed Up and Go (TUG) test time decreased from 10.45 ± 1.86 to 8.75 ± 1.55 seconds in the experimental group, compared with a marginal reduction from 14.13 ± 3.95 to 13.93 ± 4.08 seconds in the comparison group. ANCOVA-adjusted mean TUG times demonstrated a significant between-group difference, favoring the experimental group (10.34 vs. 12.34 seconds; F(1,57) = 17.53, p < .001, partial η² = .235). Static balance also showed significant improvement. Within the experimental group, Wilcoxon signed-rank test results indicated a significant increase in static balance performance (pre-intervention: median = 40.00 s, IQR = 7.75; post-intervention: median = 40.00 s, IQR = 0.00; Z = -2.437, p = .015). Furthermore, post-intervention static balance was significantly better in the experimental group than in the comparison group, as demonstrated by the Mann–Whitney U test (Z = -2.762, p = .006). Conclusion: This multifactorial program incorporating Tai Chi significantly improved lower extremity muscle strength and balance, providing a feasible, low-cost model to improve physical function and reduce fall risk among community-dwelling older adults.

Peer, Parental, and Educational Influences on Sexual and Reproductive Health Literacy Among Young Adults

Shihua Zhang — 2026-07-01

Background: Sexual and reproductive health literacy (SRHL) is a public health challenge for young adults, who are vulnerable to issues such as unintended pregnancy and STIs. This study aimed to assess SRHL and its predictors. Methods: A cross-sectional study was conducted at a university in Guangzhou, China. The study employed a two-stage cluster sampling design. In Stage 1, five faculties were randomly selected from twenty using simple random sampling. In Stage 2, within each selected faculty, classes were selected using probability-proportional-to-size (PPS) sampling. A Totally of 557 participants aged 18 – 24 years who were currently in a romantic relationship were enrolled from five faculties. SRHL was measured using the 12-item Sexual and Reproductive Health Literacy questionnaire (SRHL-12Q). Data were analyzed using Pearson correlation and linear regression analysis. Results: Among 557 participants in relationships (mean age 20.52 ± 1.38 years; 50.3% male), most reported poor levels of peer influence (47.6%), parental communication (49.4%), and SRH education (45.1%). Regarding SRHL, 35.0% had low, 43.4% moderate, and 21.5% high literacy. Multiple linear regression (adjusted R² = 0.601) identified peer influence (β = 0.329, p < 0.001) and SRH education and services (β = 0.454, p < 0.001) as significant predictors of SRHL. Parental communication was not a significant predictor (β = 0.051, p = 0.281). Conclusion: One-third of university students in relationships demonstrated inadequate SRHL, highlighting an urgent public health concern. Peer-led SRH education and enhanced university-based SRH services are recommended as evidence-based intervention targets. Parent–child communication regarding SRH should be initiated earlier, prior to the transition to young adulthood, as it was not a significant predictor in this university-age sample.

Why Blood Pressure Remains Uncontrolled Among Working Adults in Thailand: A Qualitative Study

Romthanika Faimuenwai — 2026-06-30

Background: Uncontrolled hypertension remains a major public health concern and a leading risk factor for stroke and other cardiovascular diseases. Despite effective treatments, blood pressure control among working adults remains suboptimal, particularly at the community level. Working adults often face challenges related to occupational demands, family responsibilities, and limited access to continuous care, which may hinder adherence to hypertension management and stroke prevention behaviors. Understanding these barriers may help guide interventions that are more appropriate for community settings. Objective: This qualitative descriptive study aimed to explore barriers to blood pressure control among working adults with uncontrolled hypertension receiving care at sub-district health promoting hospitals in Pathum Thani Province, Thailand, guided by the Ecological Model. Methods: Data were collected from 39 working adults with uncontrolled hypertension and 5 community health nurses through focus group discussions and semi-structured interviews. Audio-recorded interviews were transcribed verbatim and analyzed using thematic analysis. Results: Three main themes emerged across ecological levels. Individual-level barriers included knowledge gaps and low awareness, inconsistent medication adherence, and work–life imbalance. Family-level barriers involved caregiving responsibilities, financial and family obligations. Healthcare system and social-level barriers included workforce constraints, lack of social support and traditional education limitations. Conclusion: Improving health literacy, strengthening family support, and increasing access to flexible healthcare services may help working adults better manage their blood pressure.

Effects of Compassion-Focused Therapy Training Program on Self-Compassion and Mental Health among University Students

Thitaporn Kaewboonchoo — 2026-06-30

Background: There has been a substantial increase in the concern regarding mental health among university students, with an increasing number of evidence that students are experiencing high level of psychological distress including stress, anxiety, and depression. Objective: This quasi-experimental study aimed to examine the effectiveness of the compassion focused therapy (CFT) training program for enhancing self-compassion and mental health among university students. Methods: The intervention sought to improve self-compassion as well as promote mental health using dual-factor model framework of Greenspoon and Saklofske. Undergraduate students from a university in Northern Thailand were recruited and randomly assigned to either experimental group (n = 30) or control group (n = 30). Assessments tools including Self-Compassion Scale (SCS), Flourishing Scale (FS) and Patient Health Questionnaire-9 (PHQ-9) were conducted at baseline, post-intervention, and one-week follow-up. Results: The repeated measures multivariate analysis revealed a significant increase of self-compassion and psychological well-being as well as significant decrease of psychopathology in the experimental group compared to the control group. Conclusion: These findings indicate that CFT training program was effective in improving both positive and negative dimensions of mental health for university students. Integrating compassion-based practices into mental health program may offer sustainable approach to enhance well-being and reducing psychological distress. Future research should examine the long-term effects and broader application in more diverse populations.

Burden of Lower Urinary Tract Symptoms among Nepalese Adults with Type 2 Diabetes Mellitus

Anjan Rijal — 2026-06-30

Background: Lower urinary tract symptoms (LUTS) represents a significant burden in patients with Type 2 Diabetes Mellitus (T2DM). With a wide range of LUTS prevalence, a cross-sectional study aimed to assess the prevalence and burden of LUTS among Nepalese patients with Type 2 Diabetes. Methods: The burden was assessed in terms of quality adjusted life years (QALYs) and QALYs lost. Data were collected from patients with DM who lived in nine districts in Nepal during 2022-2023. Results: Among 480 respondents, more than a half of them were male with mean age of 59.90 ± 12.13 years. The LUTS was more present in Nepalese female (79.9%) than males (75.2%), with no statistical difference between sex (p = 0.27). There was statistically significant difference of Euro Quality of life (EQ-5D) between people who had only DM compared to people with DM and LUTS (p <.001). Using bivariate analysis, there was an association between LUTS and QALYs (p <.001). The QALYs lost was significantly higher in people who had both LUTS and DM. People with DM alone were three times more likely to have perfect health than those with DM and LUTS. Significant positive correlation between age, blood sugar levels, duration of diabetes and LUTS were found; whereas significant negative correlations between health behavior, social support, access to health and LUTS were reported. Conclusion: These findings suggest that diabetic patients should be screened for LUTS. Further, social perceptions and access to care should be managed to reduce the burden of LUTS among older DM patients.

Effects of A Nurse - Led Integrated Care Model for Older Adults with Uncontrolled Chronic Diseases in Bangkok Metropolitan

Penrung Nualchaem — 2026-07-01

Background: Uncontrolled non-communicable disease is a significant challenge for older adults, who have multimorbidity. In Bangkok, older adults with multimorbidity have difficulties in self-management due to fragment health services and continuing care, leading to poor control. Objective: This two-group pretest-posttest quasi-experimental research was conducted to evaluate the effects of a Nurse-led integrated care model for older adults with uncontrolled chronic disease, living in Bangkok. Methods: A total of 60 older participants with uncontrolled chronic disease were recruited from two public health centers and allocated by sites to an intervention group (n=30) or a comparison group (n=30). The intervention group received the 12-week Nurse-led ICM program, consisting of 1) a comprehensive geriatric assessment; 2) health education and skill training; 3) monthly home visits by multidisciplinary team; 4) bi-weekly self-management support by a nurse case manager using self-monitoring application; and 5) two group sharing sessions. While, those in a comparison group received usual care. Results: According to Paired t-test and Independent sample t-test results, the mean score of self-management, functional status, blood sugar, and blood pressure within the intervention group were significantly improved and better than the comparison group (p < 0.001) at week 12^th. Conclusion: Findings suggest that this integrated care model is feasible and effective for older adults with uncontrolled chronic diseases in primary care context. Thus, it could be applied to those older adults with chronic diseases, living in other community in Bangkok. In addition, self-management support competency of public health nursing should be strengthened to promote quality of care and patient outcome.