The Influence of Health Literacy, the Health Belief Model, and Preventive Practices against Food Poisoning in the Service Area of Phanat Nikhom Hospital
Main Article Content
Abstract
BACKGROUND: Food is a fundamental factor directly impacting human health. However, when food is contaminated with pathogens, toxins, or foreign substances, it leads to “food poisoning,” a critical public health issue worldwide. In Thailand, food poisoning can occur acutely and significantly affects the economy, healthcare resources, and the quality of life of consumers. According to the World Health Organization, the primary causes are microorganisms, microbial toxins, chemical contaminants, and natural toxins.
OBJECTIVES: The aim of this study was to investigate the demographic characteristics, Health Literacy, Health Belief Model (HBM) factors, and food poisoning Preventive Practices among residents in the service area of Phanat Nikhom Hospital. Furthermore, the influence of these variables was analyzed.
METHODS: This research is a cross-sectional analytical study. The sample consisted of 354 residents selected through convenience sampling. Data were analyzed using descriptive statistics and multiple regression analysis.
RESULTS: The majority of the participants were female, ranging from working age to early elderly, with primary to secondary education, and low income. Most were the primary food preparers in their households. Although Health Literacy was generally high, both the Health Belief Model and Preventive Practices were at a moderate level.
CONCLUSIONS: Health Literacy and Health Belief Model showed a statistically significant positive correlation with Preventive Practices (p<0.05). Therefore, health education programs should focus on reducing perceived severity and enhancing communication skills to effectively bridge the gap between knowledge and practice. Specifically, interventions should aim to heighten perceived susceptibility by illustrating how even ‘mild’ cases can lead to long-term health complications or economic loss for the family. By enhancing communication skills, residents can more effectively advocate for food safety standards within their households and local markets. Ultimately, focusing on reducing perceived barriers and enhancing self-efficacy will empower residents to manage household hygiene effectively.
Thaiclinicaltrials.org number, TCTR20260327001
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References
World Health Organization. Food safety [Internet]. Geneva: World Health Organization;
[cited 2026 Jan 10]. Available from: https://www.who.int/news-room/fact-
sheets/detail/food-safety
Department of Disease Control. Surveillance report of food poisoning and food
safety. Bangkok: Ministry of Public Health; 2024.
Department of Disease Control. Situation report of food poisoning (January 1 –
February 3, 2023). [Internet]. 2023 [cited 2025 Sep 28]. Available from:
Department of Disease Control. Food poisoning situation as of 14 March 2025.
[Internet]. 2025. Available from: https://thailand.prd.go.th
Meesawat T, et al. The Investigation of a Food Poisoning Outbreak in a School, Muang
District, Uthai Thani Province on June 2021. Journal of Disease and Health Risk DPC.3.
;17(2):118-131.
Thamronglakkul B, Pinit K. Food poisoning outbreak in travelers at a resort, Klang
Subdistrict, Meuang District, Rayong Province. Weekly Epidemiological Surveillance
Report. 2017;48 Supplement: March 2017:21-30.
Konjamnong P, Apasuwanakul S. Effects of Developing health literacy promotion
Enhancement Model on food poisoning Disease prevention among primary school students
in Reginal Health 9. Department of health Service Support Journal. 2024;20(3):48-61.
Yomma R, Samart W. A large outbreak of Staphylococcus aureus among Cub Scouts and
Girl Guides camp activities at Ban Khai District, Rayong Province, in February 2024.
Weekly Epidemiological Surveillance Report. 2015;56(3):1-12.
Jarupoonphon S, Matsalee M, Sarachoom R. Outbreak investigation of food
poisoning in a school in Bangrak District, Bangkok. Weekly Epidemiological
Surveillance Report. 2015;46(27):417-424.
Thai Health Promotion Foundation. Food poisoning prevention guidelines.
[Internet]. 2018 [cited 2025 Sep 28]. Available from: https://www.thaihealth.or.th/
Chonburi Provincial Public Health Office. District report of Phanat Nikhom.
[Internet]. 2025. Available from: https://3doctor.hss.moph.go.th/main/rp_tambon
Donla A, Janthepa P, Promsiri S. Thestudy of food poisoning outbrakeinvestigation on
Vibrio parahaemolyticus: Sakhrai Sub-district, Sakhrai district, Nongkhai Province during
July31- August2,2019. Journal of Office of Disease Prevention and Control Region 10.
;17(2):87-97.
Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process.
;50(2):179-211.
Allport GW. Attitudes. In: Murchison C, editor. A handbook of social psychology.
Worcester, MA: Clark University Press; 1935.
Department of Medical Sciences. Microbiological safety of ready-to-eat foods in
Thailand. J Health Sci. 2019;28(3):543-53.
Eagly AH, Chaiken S. The psychology of attitudes. Fort Worth, TX: Harcourt
Brace Jovanovich; 1993.
Fishbein M, Ajzen I. Belief, attitude, intention, and behavior: An introduction to
theory and research. Reading, MA: Addison-Wesley; 1975.
Kickbusch I, Pelikan JM, Apfel F, Tsouros AD. Health literacy: The solid facts.
Copenhagen: WHO Regional Office for Europe; 2013.
MedPark Hospital. Food poisoning. [Internet]. 2025. Available from:
https://www.medparkhospital.com/disease-and-treatment/food-poisoning
Nutbeam D. Health literacy as a public health goal: A challenge for contemporary
health education and communication strategies into the 21st century. Health
Promot Int. 2000;15(3):259-67.
Krejcie, R. V., & Morgan, D. W. Determining sample size for research activities.
Educational and Psychological Measurement. 1970;30, 607–610.
Nunnally JC, Bernstein IH. The assessment of reliability. In: Psychometric theory.
rd ed. New York: McGraw-Hill; 1994. p. 248-292.
Hochbaum GM. Public participation in medical screening programs: A socio-
psychological study. Washington, DC: U.S. Government Printing Office; 1958. Public
Health Service Publication No. 572.
Rosenstock IM. Historical origins of the Health Belief Model. Health education
Monographs Winter. 1974;2(4):328-335.
Office of Disease Prevention and Control 6, Chonburi. Surveillance report on food and
waterborne diseases in Health Region 6, as of April 30, 2021 [Internet]. 2021 [cited 2025
Dec 31]. Available from:
https://www.ddc.moph.go.th/uploads/publish/1143220210520034430.pdf
UK Health Security Agency. National surveillance of gastrointestinal infections: annual
report 2023-2024. London: HM Government; 2024.
UK Health Security Agency. Investigation into an outbreak of Shiga toxin-producing
Escherichia coli (STEC) O145:H28 in the UK [Internet]. London: HM Government; 2024
[cited 2026 DEC 31]. Available from: https://www.gov.uk/government/news/stec-
outbreak-cases-update