Village Health Volunteers Research Articles

Reliability of the 44-question Home Fall Hazard Assessment Tool and demographic characteristics associated with home hazards among the Thai elderly

Background: The 44-question Thai Home Fall Hazard Assessment Tool (Thai-HFHAT) was developed to assist healthcare professionals in identifying the risk of falls among community-dwelling older adults from their home environment. However, the reliability of this tool has not been studied. This study aimed to examine the reliability of the 44-question Thai-HFHAT and determine the demographic characteristics associated with home hazards. Methods: A descriptive cross-sectional study design was used to evaluate inter-rater reliability. The participants in this study were 51 older people from various types of Thai houses: a one-story elevated house, a one-story non-elevated house, and a house with two or more floors, 51 caregivers of older patients, and 5 village health volunteers (VHV). A prospective design was used to evaluate test-retest reliability with older people at different times in their homes. All participants answered 44 Thai-HFHAT questions to determine inter-rater and test-retest reliabilities. The reliabilities were analyzed using an intra-class correlation coefficient (ICC). Demographic characteristics including sex, occupation, and education were used to identify the factors affecting home hazards, and linear regression was used to analyze. Results: The ICC of inter-rater reliability of the 44-question Thai-HFHAT was 0.74 (95% CI: 0.57-0.84) and the test-retest reliability was 0.80 (95% CI: 0.64-0.88) for the older adults, 0.80 (95% CI: 0.65-0.89) for the caregivers and 0.70 (95% CI: 0.477-0.83) for the VHV. In demographic variables, personal business career and education level (grades 1-3) had significant relations with the total number of home hazards in the 44-questions Thai-HFHAT. Conclusions: The 44-question Thai-HFHAT is suitable for home hazard assessment among older adults in Thailand. Further studies are needed to investigate changes in the house environment after using the 44-question Thai-HFHAT to determine which changes can reduce fall risk.

Assessing the acceptability and feasibility of reactive drug administration for malaria elimination in a Plasmodium vivax predominant setting: a qualitative study in two provinces in Thailand

BackgroundReactive case detection (RACD) or testing and treatment of close contacts of recent malaria cases, is commonly practiced in settings approaching malaria elimination, but standard diagnostics have limited sensitivity to detect low level infections. Reactive drug administration (RDA), or presumptive treatment without testing, is an alternative approach, but better understanding regarding community acceptability and operational feasibility are needed.MethodsA qualitative study was conducted as part of a two-arm cluster randomized-controlled trial evaluating the effectiveness of RDA targeting high-risk villages and forest workers for reducing Plasmodium vivax and P. falciparum malaria in Thailand. Key informant interviews (KIIs) and focus group discussions (FGDs) were conducted virtually among key public health staff, village health volunteers (VHVs), and household members that implemented or received RDA activities. Transcriptions were reviewed, coded, and managed manually using Dedoose qualitative data analysis software, then underwent qualitative content analysis to identify key themes.ResultsRDA was well accepted by household members and public health staff that implemented it. RDA participation was driven by fear of contracting malaria, eagerness to receive protection provided by malaria medicines, and the increased access to health care. Concerns were raised about the safety of taking malaria medicines without having an illness, particularly if underlying health conditions existed. Health promotion hospital (HPH) staff implementing RDA noted its operational feasibility, but highlighted difficulty in traveling to remote areas, and requested additional travel resources and hiring more VHVs. Other challenges were highlighted including the need for additional training for VHVs on malaria activities and the inability of HPH staff to conduct RDA due to other health priorities (e.g., Covid-19). More training and practice for VHVs were noted as ways to improve implementation of RDA.ConclusionsTo maximize uptake of RDA, regular education and sensitization campaigns in collaboration with village leaders on the purpose and rationale of RDA will be critical. To alleviate safety concerns and increase participant safety, a rigorous pharmacovigilance program will be important. To accelerate uptake of RDA, trust between HPH staff and VHVs and the communities they serve must continue to be strengthened to ensure acceptance of the intervention.Trial registrationThis study was approved by the Committee on Human Research at the University of California San Francisco (19–28,060) and the local Ethics Committee for Research in Human Subjects at Tak Provincial Health office (009/63) and Kanchanaburi Provincial health office (Kor Chor 0032.002/2185). Local authorities and health officers in the provinces, districts, and villages agreed upon and coordinated the implementation of the study. All methods in this study were carried out in accordance with relevant guidelines and regulations.

Reliability of the 44-question Home Fall Hazard Assessment Tool and demographic characteristics associated with home hazards among the Thai elderly.

Background: The 44-question Thai Home Fall Hazard Assessment Tool (Thai-HFHAT) was developed to assist healthcare professionals in identifying the risk of falls among community-dwelling older adults from their home environment. However, the reliability of this tool has not been studied. This study aimed to examine the reliability of the 44-question Thai-HFHAT and determine the demographic characteristics associated with home hazards. Methods: A descriptive cross-sectional study design was used to evaluate inter-rater reliability. The participants in this study were 51 older people from various types of Thai houses: a one-story elevated house, a one-story non-elevated house, and a house with two or more floors, 51 caregivers of older patients, and 5 village health volunteers (VHV). A prospective design was used to evaluate test-retest reliability with older people at different times in their homes. All participants answered 44 Thai-HFHAT questions to determine inter-rater and test-retest reliabilities. The reliabilities were analyzed using an intra-class correlation coefficient (ICC). Demographic characteristics including sex, occupation, and education were used to identify the factors affecting home hazards, and linear regression was used to analyze. Results: The ICC of inter-rater reliability of the 44-question Thai-HFHAT was 0.74 (95% CI: 0.57-0.84) and the test-retest reliability was 0.80 (95% CI: 0.64-0.88) for the older adults, 0.80 (95% CI: 0.65-0.89) for the caregivers and 0.70 (95% CI: 0.477-0.83) for the VHV. In demographic variables, personal business career and education level (grades 1-3) had significant relations with the total number of home hazards in the 44-questions Thai-HFHAT. Conclusions: The 44-question Thai-HFHAT is suitable for home hazard assessment among older adults in Thailand. Further studies are needed to investigate changes in the house environment after using the 44-question Thai-HFHAT to determine which changes can reduce fall risk.

Seated push-up tests: Reliable and valid measures for older individuals when used by primary healthcare providers.

Body composition decline, lower limb impairments, and mobility deficits affect independence of older people. The exploration for a practical measure involving upper extremities may offer an alternative tool to be used by primary healthcare (PHC) providers for these individuals. To explore reliability and validity of seated push-up tests (SPUTs) among older participants when used by PHC providers. Older participants (n= 146) with an average age of > 70 years were cross-sectionally assessed using various demanding forms of SPUTs and standard measures to assess validity of the SPUTs. Reliability of the SPUTs were assessed in nine PHC raters, including an expert, health professionals, village health volunteers, and care givers. The SPUTs demonstrated very good agreement, with excellent rater and test-retest reliability (kappa values > 0.87 and ICCs > 0.93, p< 0.001). Moreover, the SPUT outcomes significantly correlated with lean body mass, bone mineral contents, muscle strength and mobility of older participants (r, rp⁢b=-0.270 to 0.758, p< 0.05). SPUTs are reliable and valid for older adults when used by PHC members. The incorporation of such practical measures is particularly important during this COVID-19 pandemic with limited people's hospital access.

Health Literacy and Preventive Behaviors towards COVID-19 among Village Health Volunteers and Residents in Urban and Rural Areas of Upper Southern Thailand

This study aimed to assess health literacy (HL), preventive behaviors (PBs), and the factors associated with PBs toward COVID-19 among village health volunteers (VHVs) and residents in urban and rural areas in the upper south of Thailand. A cross-sectional study was conducted using valid questionnaires administered using an online platform. Data were analyzed using descriptive statistics, t-tests, and binary logistic regression analysis. A total of 846 people participated in this study, and 62.8% of participants had an adequate level of HL. Furthermore, 55.0% of participants had an adequate level of PBs. Among VHVs, PB levels were adequate, whereas among residents, they were inadequate. Moreover, among VHVs, underlying diseases (adjusted odds ratio (OR): 1.77, 95% CI: 1.13–2.76), access to HL (adjusted OR: 4.28, 95% CI: 1.42–12.88), appraisal of HL (adjusted OR: 3.09, 95% CI: 1.90–5.02), and application of HL (adjusted OR: 2.51, 95% CI: 1.52–4.12) were associated with COVID-19 PB. Additionally, among residents, only marital status (adjusted OR: 1.59, 95% CI: 1.04–2.44), appraisal of HL (adjusted OR: 1.78, 95% CI: 1.18–2.84), and application of HL (adjusted OR: 3.85, 95% CI: 2.39–6.20) were associated with PBs towards COVID-19. Furthermore, individuals with inadequate HL demonstrated noteworthy significance in all dimensions of PBs. To prioritize and optimize preventive programs aimed at enhancing PBs, the government must take proactive initiatives in implementing robust health communication strategies across diverse media platforms, both in the present and future.

Spatial Association Patterns with Cultural and Behaviour with the Situations of COVID-19

This study was a cross-sectional study. The study of spatial association patterns and the influences on the Coronavirus Disease 2019 (COVID-19) epidemic situation in Thailand was performed using secondary data from the COVID-19 interactive dashboard, Department of Disease Control, Ministry of Public Health, between January 1st, 2020, and December 31st, 2021. Moran’s I, Local Indicators of Spatial Association (LISA), and Spatial Regression was applied for statistical analysis. In the epidemic situation of COVID-19, the highest of 11,512.65 per one hundred thousand population, and the spatial association between the nighttime light average, the prevalence of smokers in Thailand, the proportion of population per village health volunteer, and the proportion of population per health care center with the epidemic situation of COVID-19 has Moran’s I = 0.309, 0.396, 0.081 and 0.424, respectively. From the Spatial Lag Model (SLM), a factor that has a spatial association with the epidemic situation of COVID-19 is the nighttime light average, the prevalence of smokers in Thailand, and the proportion of population per healthcare center, which can predict the epidemic situation of COVID-19 by 47.8 percent (R2 =0.478). The growth factor of a large city is an important factor for population density which is a major cause of spread of the coronavirus easily. Moreover, smoking behavior has encouraged the epidemic to spread rapidly. The situation is serious as the number of hospitals is not enough to support the treatment and screening of patients to cover the entire population of Thailand. Therefore, it is urgent that the government plan to mitigate the situation with maximum efficiency by having Covid-19 centers and increase the number of beds and facilities.

Aunty Next Door - A Qualitative Study of Community Prevention and Control for COVID-19

Introduction:The Thai government has established public health policies to cope with COVID-19 and reduce the spread of disease by promulgating the Emergency Decree since March 26th 2019 in concept “stay at home, stop the spread of the virus for the sake of nation.” Those measures had been affected to people in all social levels whether it be urban or rural. The objective of this qualitative study was aimed to study the mechanisms and experiences of village health volunteers who work to control COVID-19 at the community level.Method:Forty village health volunteers in the 8th health region were included in the study. Data collection by using focus group discussion combined with audio recordings and the data were analyzed by content analysis.Results:The community’s context in the upper northeastern region of Thailand live in kinship. This is a factor supporting the operation of village health volunteers (VHVs) in the surveillance, prevention, and control of disease in the community. The mechanisms for disease prevention and control in the community are a virtual "Spider web" that connects people in the community, VHVs, Community Leaders, Public Health Officers, and Sub-district Administrative Organization (SAO) officers that operate together. While people in the community, especially "women", act in surveillance in the form of "watchdogs" that report abnormalities of community member movements to the VHV for coordination in surveillance, prevention, and control of disease in their community. The VHV and partners use management guidelines as prescribed by the Ministry of Public Health and adapted to the social and cultural context.Conclusion:The community's COVID-19 surveillance mechanism that mediates kinship begins with fear and panic from a lack of knowledge in the early stages of the outbreak. The kinship of people in the community is one of the strengths and factors of success in preventing and controlling the disease.

FACTORS PREDICTING SELF-MANAGEMENT BEHAVIORS AMONG PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE 3 IN SUPHANBURI PROVINCE, THAILAND

This research examined factors predicting self-management behaviors of patients with chronic kidney disease (CKD) stage 3 in Suphanburi Province. A multi-stage sampling technique was used to recruit participants from 10 hospitals in 10 districts of Suphanburi Province. A total of 228 participants have been diagnosed with CKD stage 3. Data were collected using a questionnaire with an overall Cronbach’s alpha coefficient of 0.96. Data were analyzed using descriptive statistics and stepwise multiple regression at the significant level of 0.05. The results showed that the social support scores from medical personnel had high levels (52.20%). Meanwhile, the score of healthcare providers, village health volunteers, and families had low levels (76.80%, 98.20%, and 85.10%, respectively). For illness perception, perceived benefits, self-efficacy, and self-management behaviors of patients with CKD stage had high levels (62.30%, 92.10%, 95.60%, and 50.90%, respectively). Meanwhile, CKD knowledge had moderate levels of 58.30%. The strongest predictor of self-management behaviors in a patient with CKD stage 3 was social support from healthcare providers (Beta = 0.348, p-value &lt; 0.001), followed by perceived benefits (Beta = 0.299, p-value &lt; 0.001) and self-efficacy (Beta = 0.266, p-value &lt; 0.001), respectively. These factors account for 42.70% of predicting self-management behaviors of a patient with CKD stage 3. In conclusion, healthcare providers should encourage the self-management behaviors of patients with stage 3 CKD by enhancing their perceived benefits and self-efficacy to modify behaviors in order to slow the progression of CKD.

Thai village health volunteers’ employment of self-directed learning and collective power in time of pandemic

ABSTRACT The article examines how Thai village health volunteers employed self-directed learning and collective power to overcome working challenges during the COVID-19 pandemic. Qualitative data was collected from 30 VHVs in ten communities across Thailand. Semi-structured interviews and focus groups were employed as the data collection techniques. The findings indicate that the VHVs took initiatives to learn unfamiliar technologies which became important working tools in the context of the pandemic. While such initiatives highlight their independent learning attributes involving individuality or “self” learning concepts, the way they incorporated a collaborative learning method, reflects “selves” learning practices. The VHVs also utilized collective power both in-group and inter-group power to through different networking systems. This study illustrates the possible intertwinement of collectivistic and individualistic values found in the process of self and selves-directed learning practices, and the implication of collective power as a cultural force in the field of community health promotion.

Health workers' capability, opportunity, motivation, and behavior to prevent and control COVID-19 in a high-risk district in Thailand.

Village health volunteers have been an important group who plays the role in prevention and control of COVID-19 pandemic situations at primary care units, Thailand. The objective of this cross-sectional analytic study was to assess the level and analyze the association between personal information, capability, opportunities, motivations, and behaviors to prevent and control COVID-19 among Village healthy volunteers in a high risk district, Southern Thailand. G*power program was used to calculate the sample size of 145 VHVs recruited for this study. Data collection was done using a well-structured questionnaire with 5-point Likert scale for capability, opportunities, motivations, and behaviors component, and multi-stage sampling of 18 sub-district health promoting hospitals was carried out. Data analysis was done using descriptive, Chi-square and Fisher Exact test. Majority (89.7%) of the VHVs were female, and 62.8% were 28-59 years old. More than half, 55.9% (81) have been VHVs for 11-36 years. Generally, higher capacity was found among 59.3% (86) of the VHVs, low opportunity level among 81.4% (118), high motivation among 53.8% (78) and a good behavior towards the prevention and control of COVID-19 among 72.4% (105). The VHVs' age and duration of practicing were significantly (P< 0.01 and P < 0.05 respectively) associated with COVID-19 prevention behavior (x2 =6.894 and 5.255 respectively). Likewise, there are significant association between capacity (p ≤ 0.001 and x2 = 31.014), opportunity (p≤ 0.05 and x2 = 9.473), motivation (p ≤ 0.001 and x2 = 0.0001) and VHVs' behaviour to prevent and control COVID-19. HVHs' opportunity is very low in the study area and it negatively affects good behavior for the prevention and control of COVID-19. All stakeholders in the district can use the association among the capability, opportunity, motivation and behavioral model to develop practice guideline and set policy for preventing COVID-19 in the community.

Women on the frontline of Covid-19: understanding local women village health volunteers in the northern province of Thailand

BackgroundThis paper investigates the role of local women village health volunteers, women on the frontline, during COVID-19 in the northern province of Thailand.MethodsThis research employs a qualitative method with grounded-based analysis of primary data from in-depth interviews of 40 local women village health volunteers that were selected by a purposeful sampling of 10 key informants per district, live in 4 sub-districts in Chiang Mai, the northern province of Thailand: Suthep Subdistrict, Mae Hia Subdistrict, Fa Ham Subdistrict, and Tha Sala Subdistrict.ResultsThe role of local women village health volunteers during COVID-19 is diverse, such as community health caregivers, the Surveillance and Rapid Response Team (SRRT), health facilitators and mediators, and the manager of community health funds and resources mobilization. Volunteering for local women in community health services at the local level, participating based on personal desire and foreseeable opportunities, could create meaningful participation for the local women in terms of empowering them and as a driver of local community (health) development.ConclusionsFindings reveal that understanding local women’s perspectives on their roles could be made through the lens of the intersection of femininity, social role, motivation, and their contribution to their community.

Reliability of the 44-question Home Fall Hazard Assessment Tool and personal characteristics associated with home hazards among the Thai elderly

Background: The 44-question Thai Home Fall Hazard Assessment Tool (Thai-HFHAT) was developed to assist healthcare professionals in identifying the risk of falls among community-dwelling elderly from their home environment. However, the reliability of this tool has not been studied. This study aimed to examine the reliability of the 44-question Thai-HFHAT and determine the personal characteristics associated with home hazards. Methods: A descriptive cross-sectional study design was used to evaluate interrater reliability. The participants in this study were 51 elderly people from various types of Thai houses: a one-story elevated house, a one-story non-elevated house, and a house with two or more floors, 51 caregivers of elderly patients, and 5 village health volunteers (VHV). A prospective design was used to evaluate test-retest reliability with older people at different times in their homes. All participants answered 44 Thai-HFHAT questions to determine inter-rater and test-retest reliabilities. The reliabilities were analyzed using an intra-class correlation coefficient (ICC). Personal characteristics including sex, occupation, and education were used to identify the factors affecting home hazards, and linear regression was used to analyze. Results: The ICC of inter-rater reliability of the 44-question Thai-HFHAT was 0.74 (95% CI: 0.57-0.84) and the test-retest reliability was 0.80 (95% CI: 0.64-0.88) for the elderly, 0.80 (95% CI: 0.65-0.89) for the caregivers and 0.70 (95% CI: 0.477-0.83) for the VHV. Personal business career and education level grades 1-3 are less than 0.05, which showed these factors had a significant relationship with the 44-question Thai-HFHAT score as the dependent variable. Conclusions: The 44-question Thai-HFHAT is suitable for home hazard assessment among the elderly in Thailand. Further studies are needed to investigate changes in the house environment after using the 44-question Thai-HFHAT to determine which changes can reduce fall risk.

The impact of vaccine information and other factors on COVID-19 vaccine acceptance in the Thai population.

Increased misinformation circulating among the population during the COVID-10 pandemic can trigger rejection to take up vaccines. This study assesses the influence of vaccine information and other factors on vaccine acceptance in the Thai population. Between March and August 2021, six rounds of cross-sectional surveys through village health volunteer networks and online channels were conducted; as well as qualitative interviews with frontline health workers, patients with chronic diseases, and religious believers and leaders. Descriptive and multiple logistic regression with 95% level of confidence were used for survey findings while deductive thematic analysis was used for in-depth interview findings. Among the total 193,744 respondents, the initial COVID-19 vaccine acceptance rate decreased from 60.3% in March 2021 to 44.0% in April 2021, then increased to 88.8% in August 2021. Participants who were able to differentiate true and false statements were 1.2 to 2.4 times more likely to accept vaccine than those who were not. Those who perceived a high risk of infection (Adjusted odds ratio; AOR = 2.6-4.7), perceived vaccine safety (AOR = 1.4-2.4), judged the importance of vaccination (AOR = 2.3-5.1), and had trust in vaccine manufacture (AOR = 1.9-3.2) were also more likely to accept the vaccine. Moreover, higher education (AOR = 1.6-4.1) and living in outbreak areas (AOR = 1.4-3.0) were significantly related to vaccine uptake, except in people with chronic diseases who tended not to accept the vaccine (AOR = 0.7-0.9). This study recommends effective infodemic management and comprehensive public communication, prioritising vulnerable groups such as those with a low level of education and people with chronic conditions. Communication through reliable channels can support higher vaccine acceptance and rapid vaccine rollout. Finally, regular monitoring of misinformation is important such as fact checking support, timely legal actions and specific debunking communication.

The Use of a Single-Time Sit-To-Stand Test in Ambulatory Individuals With Spinal Cord Injury by Primary Health Care Providers.

The uncertain health care situations, such as that created by the COVID-19 pandemic, has limited hospital access and facilitated a paradigm shift in health care toward an increased demand for standard home visits and community-based rehabilitation services, including by ambulatory individuals with spinal cord injury (SCI). This 6-month prospective study explored the validity and reliability of a single-time sit-to-stand (STSTS) test when used by primary health care (PHC) providers, including a village health volunteer, caregiver, individual with SCI, and health professional. Eighty-two participants were assessed for the STSTS using four arm placement conditions (arms on a walking device, arms on knees, arms free by the sides, and arms crossed over the chest) and standard measures, with prospective fall data follow-up over 6 months. Thirty participants involved in the reliability study were also assessed and reassessed for the ability to complete the STSTS conditions by PHC providers. Outcomes of the STSTS test, except the condition with arms on a walking device, could significantly discriminate lower extremity muscle strength (LEMS) and mobility of the participants (rpb = -0.58 to 0.69) with moderate concurrent validity. Outcomes of the tests without using the arms also showed moderate to almost-perfect reliability (kappa = 0.754-1.000) when assessed by PHC raters. The findings suggest the use of an STSTS with arms free by the sides as a standard practical measure by PHC providers to reflect LEMS and mobility of ambulatory individuals with SCI in various clinical, community, and home-based settings.

Inequalities in access to new medication delivery services among non-communicable disease patients during the COVID-19 pandemic: findings from nationally representative surveys in Thailand

BackgroundThis study describes the inequalities in access to a medication delivery service (MDS) during the COVID-19 pandemic and identifies the social determinants of health-related inequalities among non-communicable disease (NCD) patients.MethodsData were obtained from a study on the impact of health behaviours and modifications in health behaviours during the COVID-19 pandemic in the Thai population in 2021. The participants were recruited from Bangkok and all four regions of Thailand. The concentration index was used to examine the inequality among income quintiles, which were standardised by age, sex, living area, job type, health insurance scheme, and education level. Logistic regression was used to examine the associations between socio-demographics and access to regular services and new NCD MDSs, adjusted for age, sex, and other covariates.ResultsAmong 1,739 NCD patients, greater income inequalities in accessing regular NCD services and collecting medicines at registered pharmacies during the COVID-19 pandemic were observed, for which the concentration index indicated utilisation inequalities in favour of richer households. In contrast, receiving medicine at primary care centres, by postal delivery, and delivered by village health volunteers were the new NCD MDSs, which favoured less wealthy households. NCD patients living in rural areas were more likely to access new NCD MDSs, compared to those in urban areas (adjusted odds ratio = 2.30; 95% confidence interval [CI]: 1.22–4.34). Significant associations with receiving medicine at hospitals were also observed for the income quintiles. Individuals in the lowest and 2nd lowest income quintiles were more likely to access new MDSs than those in the richest quintiles.ConclusionsThis study highlighted a disproportionate concentration of access to new NCD MDSs during the COVID-19 pandemic in Thailand, which was more concentrated in lower-income groups. The government should further study and integrate MDSs with the highest cost benefits into nationwide regular systems, while addressing systematic barriers to access to these services, such as the lack of shared health data across health facilities and tele pharmacy equipment. This will promote access to public services among patients in the less advantaged groups and reduce the health inequality gap.

Thai stakeholders’ awareness and perceptions of the patient adverse event reporting system for herbal medicines: a qualitative study

BackgroundIn Thailand, the consumption of herbal medicines has been increasing. Adverse events (AEs) of herbal medicines have been identified through the spontaneous reporting system. However, the number of patients reporting AEs of herbal medicines remains limited.AimTo explore the awareness and perceptions about the patient reporting system and to explore attitudes towards safety of herbal medicines, experiences, and intention to report AEs of herbal medicines.MethodSemi-structured in-depth interviews were conducted with stakeholders (patients, community pharmacists, village health volunteers, and consumers who had experienced submitting a complaint about health products to the Consumers Foundation). Additionally, a focus group discussion was held with stakeholders (academics, herbal medicine manufacturers, healthcare professionals, policy maker who was responsible for promoting the use of herbal medicines, pharmacovigilance staff, patient, and representative from patient organisations). The data were audio recorded, transcribed verbatim and analysed using thematic analysis.ResultsFifty participants were interviewed and the focus group discussion included 12 participants. Patients had positive attitudes towards the safety of herbal medicines. Lack of awareness of the patient reporting system was identified. Nevertheless, all stakeholders acknowledged the importance of the safety monitoring of herbal medicines and indicated a willingness to report AEs via the patient reporting system in the future. A simple reporting system, a variety of reporting channels, the provision of feedback, and providing rewards would motivate patients to report AEs.ConclusionAlthough there is a lack of awareness, this provides a great opportunity to improve patient AE reporting system for herbal medicines in Thailand.

Oral Health Literacy and Health Seeking Behavior of Older Adults in Rural Community

Objectives: This community-based cross-sectional study aimed to examine health information seeking behavior regarding oral health and oral health literacy and their relationship in older adults. Methods: The research was conducted with 432 participants from the rural area of, Noen Maprang District, Phitsanulok province, Northern Thailand. To measure oral health literacy, modified Short Test of Functional Health Literacy in Dentistry for Older Adults was used. The adapted questionnaire was used to collect health information seeking behavior in the past 3 months. Results: Only 12.3% demonstrated adequate oral health literacy. Some 27.1% presented active health information seeking behavior, 57.3% presented passive health information seeking behavior and 15.6% had never obtained or sought any oral health information. The association between health information seeking behavior and oral health literacy could not be observed. Television, health personnel, family members/relatives and village health volunteers were the most popular information sources. Conclusions: By adding oral health information and improving skills of oral health information for village health volunteers, it is possible to develop oral health literacy in older adults in rural areas.

“Four Joints of Power” Innovation of Community Involvement in Medical Waste Management of Bed-Bound Patients in Thailand

This study aims to encourage innovative participation in the management of medical waste by bedridden patients in the research region of Khon Sawan, Chaiaphum Province, through research and development. The steps were as follows: Phase 1: Study of bedridden patient waste management situations using the amount of waste generated through innovation with relatives, non-relatives, village health volunteers (VHVs), and community leaders. Phase 2: Developing creative waste management engagement requires two steps: (1) analyzing the problem or its cause and generating management alternatives through collaborative brainstorming with a community member and (2) gathering the thoughts and suggestions of a number of agency specialists. The outcome is a novel model of participation in waste management by bedridden patients termed “Four Joins of Power,” which includes (1) participatory activities and enhancing community knowledge and attitudes, and (2) providing information on the management of each type of waste. (3) cooperation in waste management (analytical thinking, planning, execution, etc.) and regulation by mutually agreed-upon rules. (4) joint expansion of the waste management network: Phase 3 is the innovation trial, and Phase 4 is the innovation assessment. The paired t-test was used to compare pre-and post-development knowledge and attitudes, and to conduct qualitative data analysis. In Phase 3, after implementing collaborative innovations, the average knowledge (X¯ = 13.23) and attitudes (X¯ = 4.14) regarding waste management increased considerably (p &lt; 0.05), and in Phase 4, waste management behavior comprising sorting, storage, and disposal was observed. There were progressively substantial gains (X¯ = 4.25 and X¯ = 4.27). Among the most collaborative participants, 93.50% were satisfied. To reduce the amount of waste that must be sorted and collected, it is necessary to emphasize the participation of people and networks from all sectors in the area through joint thinking, planning, and comprehensive analysis, to ensure the sustainability of waste management in the community.

Reliability of the 44-question Home Fall Hazard Assessment Tool and personal characteristics associated with home hazards among the Thai elderly

Background: The 44-question Thai Home Fall Hazard Assessment Tool (Thai-HFHAT) was developed to assist healthcare professionals in identifying the risk of falls among community-dwelling elderly from their home environment. However, the reliability of this tool has not been studied. This study aimed to examine reliability of the 44-question Thai-HFHAT and determine the person characteristics associated with home hazards. Methods: A descriptive cross-sectional study design was used for this research. The participants in this study were 51 elderly people from various types of Thai houses: a one-story elevated house, a one-story non-elevated house, and a house with two or more floors, 51 caregivers of elderly patients and 5 village health volunteers (VHV). All participants answered 44 Thai-HFHAT questions to determine inter-rater and test-retest reliabilities. The reliabilities were analyzed using an intra-class correlation coefficient (ICC). Personal characteristics including sex, occupation, and education were used to identify the factors affecting home hazard and linear regression was used to analyze. Results: The ICC of inter-rater reliability of the 44-question Thai-HFHAT was 0.74 (95% CI: 0.57-0.84) and the test-retest reliability was 0.80 (95% CI: 0.64-0.88) for the elderly, 0.80 (95% CI: 0.65-0.89) for the caregivers and 0.70 (95% CI: 0.477-0.83) for the VHV. Personal business career and education level grade 1-3 are less than 0.05, which showed these factors had a significant relationship with the 44-question Thai-HFHAT score as dependent variable. Conclusions: The 44-question Thai-HFHAT is suitable for the home hazards assessment among the elderly in Thailand. Further studies are needed to investigate changes in the house environment after using the 44-question Thai-HFHAT to determine which changes can reduce the risk of fall.

Performance motivation and Dhammanamai health literacy according to Thai traditional medicine among village health volunteers in Uthaithani province

This cross-sectional study aimed to explain levels of Dhammanamai health literacy, investigate relevant factors, and identify the predicting factors of Dhammanamai health literacy according to Thai traditional medicine among village health volunteers (VHVs). The reliability and validity from 390 VHVs were selected by proportional multi-stage sampling. Data were collected through a questionnaire from March - May 2022 in Uthaithani Province, Thailand. Data were analyzed through descriptive analysis, Mann Whitney U test, Kruskal–Wallis test and logistic regression. The results of the study showed that most of the VHVs had adequate levels of Dhammanamai health literacy ( X ̅= 61.22, SD. = 13.87), while gender (p = 0.023), occupation (p = 0.026), monthly income (p = 0.004), ability to use a smartphone/computer (p = 0.029), recognition of volunteer roles and duties (p &lt; 0.001), performance motivation (p &lt; 0.001), and social support (p &lt; 0.001) were significantly related to Dhammanamai health literacy. The predicting factors that influenced Dhammanamai health literacy among VHVs were as follows: 1) performance motivation (OR= 1.175, CI=1.055–1.309); 2) age (OR= 1.041, CI=1.012–1.071); 3) occupation (OR= 1.878, CI=1.179–2.990). A very strong variable was performance motivation. In combination, all these factors could predict the Dhammanamai health literacy of the VHVs at 20.7%. We recommend interventions on performance motivation, age, and occupation with the organization of a program to promote Dhammanamai health literacy for VHVs to be ready to perform their duties in the community, including the provision of knowledge to the public.