Translation and validation of the PACIC+ questionnaire: the Thai version

Background: The number of patients with chronic illness is increasing worldwide. These patients usually receive care from a primary care facility. The Patient Assessment of Chronic Illness Care (PACIC) is a tool that is increasingly used in several countries to measure how the patients perceive the care they receive. The goal of this validation study is to provide and validate an extended version of the tool, the PACIC+ questionnaire, in Thailand. Methods: In this observational validation study, patients with type 2 diabetes from the outpatient clinic at a university hospital in Thailand completed the PACIC+ at the clinic. For follow-up, they received the questionnaire per mail after four weeks. The Thai PACIC+ comprises 26 items, which map onto 5 subscales and a summary score related to the Chronic Care Model (CCM) and 5 subscales and a summary score related to the 5A model, a counseling model for behavioral changes. Data-analysis focused on the use of most extreme answering categories (> 15%), internal consistency (Cronbach’s alpha), and test-retest reliability. An exploratory factor analysis (EFA) was performed for the CCM and the 5A model separately to examine the factor structure. Results: A total of 151 patients participated. The average age of the sample was 63 ± 9 years (range 29–86 years). Fifty-three percent of the respondents were female. In the Delivery System subscale, 20% of patients reported the highest possible value; in all other subscales, relative frequencies of the most extreme categories did not exceed 15%. Cronbach’s alpha per subscale varied from 0.58 to 0.81, while that of the summary scores were 0.89 and 0.91. The mean difference from the test-retest varied from − 0.06 to 0.17 across subscales. The Kaiser-Meyer-Olkin criterion for sampling adequacy (KMO) was good for both models as well as the Bartlett’s test for sphericity p. While the factor loadings in rotated factor solution showed good concordance with the CCM, concordance was not as good for the 5A model, especially for the subscales “Assess” and “Advice”. Conclusion: A validated Thai version of the PACIC+ is now available to measure how the patients perceive the care they receive

Self-efficacy, sensation seeking, right attitude, and readiness to change among alcohol drinkers in a Thai vocational school

Introduction: The prevalence of alcohol use in teenagers has been increasing every year. The majority of alcohol drinkers were vocational students when compared with other educational settings. Sixty percent of Thai vocational students were found to use alcohol. Methods: Our research was a cross-sectional study in 306 vocational students, using the Alcohol Consumption Questionnaire, the ASSIST-Y (Alcohol, Smoking, and Substance Involvement Screening Test-Youth) screening tool and a self-administered questionnaire. The association between alcohol drinking with sensation seeking, self-efficacy, right attitude and readiness to change factors were analyzed by binary logistic regression. Results: Most students were males (57.5%) and 15–17 years of age (70.9%). Seventy-six-point eight percent of vocational students were in the lifetime drinker group. The binge drinker group was 32.7% and 10.5% were classified in a light drinker group. Sensation seeking was strongly associated with the binge drinker group and the light drinker group, especially the disinhibition dimension (adjusted odds ratio [OR] = 1.64, 95% CI: 1.34–2.00 and [OR] = 1.57, 95% CI: 1.19–2.06, respectively). Conclusions: Our research found sensation seeking, especially the disinhibition dimension was a significant factor for monitoring drinking behavior. We recommended that every vocational student should be monitored for sensation seeking factors. Keywords: Alcohol drinking, Vocational student, Self-efficacy, Sensation seeking, Right attitud

Methamphetamine use is associated with high levels of depressive symptoms in adolescents and young adults in Rural Chiang Mai Province, Thailand

Abstract Background High levels of depressive symptoms often occur among individuals that use or that are dependent on methamphetamine (MA). Thailand is currently experiencing an epidemic of MA use among youth. Understanding the nature of the relationship between depressive symptoms and MA use and identifying those most at risk can further understanding of prevention and treatment options for youth who use MA and present with depressive symptoms. Methods In 2011, we conducted a cross sectional epidemiologic study that examined associations between MA use and high levels of depressive symptoms among adolescents and young adults aged 14–29 living in Chiang Mai province, Thailand. A combination of cluster and systematic sampling was conducted to obtain a study sample of participants actively recruited in Chiang Mai province. Depressive symptoms were measured using a Thai translation of the Centers for Epidemiologic Studies Depression scale (CES-D). The independent variables measured reported lifetime and recent MA use within the past 3 months. Multivariate logistic regression models were used to assess associations between MA use and high levels of depressive symptoms. Results Approximately 19 % (n = 394) of the sample reported ever having consumed MA and 31 % (n = 124) of lifetime users reported recent MA use within the past 3 months. Recent MA use was associated with high levels of depressive symptoms (aPOR recent use: 2.60, 95 % CI: 1.20, 5.63). Conclusions This is one of the first studies to examine the association between MA use and high levels of depressive symptoms in a general Thai population. The odds of having high levels of depressive symptoms was significantly greater among recent MA users compared to non-users. These findings support the need for policies, programs and interventions to prevent and treat depressive symptoms presenting among MA using Thai adolescents and young adults in rural Chiang Mai province, Thailand to aid in cessation of MA use. Furthermore, additional research is needed to investigate treatment options for adolescents and young adults in Thailand that use MA and present with high levels of depressive symptoms

Sexual health, risky sexual behavior and condom use among adolescents young adults and older adults in Chiang Mai, Thailand: findings from a population based survey

Abstract Background Sexual health is one of the key dimensions of health across all ages. Understanding risky sexual behaviors remains an important area of public health research. This study aimed to explore sexual health, risky sexual behaviors and factors associated with recent condom use as condom use is considered a main intervention proven to reduce negative health consequences of risky sexual behaviors, specifically related to sexually transmitted infections and unintended pregnancies. A stratified two-stage cluster sampling technique survey was conducted in Chiang Mai, Thailand. Information was obtained about age of first sexual intercourse, sexual activity, condom use, number of partners and history of drug/alcohol use prior to sexual activities within the past 3 months. A weighted analysis was performed to account for data clustering. Results It is estimated that most men (93%) and women (86%) in Chiang Mai have engaged in sexual intercourse. More than 70% of the people in Chiang Mai over age 30 remained sexually active in the past 3 months, even for populations over age 50. Eight percent of male teenagers reported having more than one sexual partner in the past 3 months. Regular condom use was reported in less than 5% of the population (6.6% men and 3.1% women). Conclusions Our study demonstrated that sexual health is an important public health issue across all age groups. Condom use has been promoted as one way to minimize and prevent unintended consequences of sexual behavior but overall use remains low

Risky injection practices and HCV awareness in Chiang Mai Province, Thailand: a respondent-driven sampling study of people who inject drugs

Background People who inject drugs (PWID) are the most exposed to hepatitis C virus (HCV). In Thailand, drug use is highly criminalized, and harm reduction services are scarce. This study estimates risky injection practices and assesses the proportion of HCV awareness and screening in the PWID population in Northern Thailand. Methods We used respondent-driven sampling (RDS) to recruit PWID in Chiang Mai Province. Social and behavioural data were collected through face-to-face interviews at an addiction treatment facility. Weighted population estimates were calculated to limit biases related to the non-random sampling method. Univariate and multivariate analyses were performed to study factors associated with HCV awareness and screening. Results One hundred seventy-one PWID were recruited between April 2016 and January 2017. Median age was 33 (Interquartile range: 26–40) years, 12.2% were women, and 49.4% belonged to a minority ethnic group. Among participants, 76.8% injected heroin, 20.7% methadone, and 20.7% methamphetamine. We estimate that 22.1% [95% CI: 15.7–28.6] of the population had shared needles in the last 6 months and that 32.0% [95% CI: 23.6–40.4] had shared injection material. Only 26.6% [95% CI: 17.6–35.6] had heard of HCV. Factors independently associated with knowledge of HCV included belonging to a harm reduction organization (adjusted odds ratio (aOR) = 5.5 [95% CI: 2.0–15.3]) and voluntary participation in a drug rehabilitation programme (aOR = 4.3 [95% CI: 1.3–13.9]), while Lahu ethnicity was negatively associated (aOR = 0.3 [95% CI: 0.1–0.9]). We estimate that 5% of the PWID population were screened for HCV; the only factor independently associated with being screened was membership of a harm reduction organization (aOR = 5.7 [95% CI: 1.6–19.9]). Conclusion Our study reveals that the PWID population is poorly informed and rarely screened for HCV, despite widespread risky injection practices. A public health approach aimed at reducing the incidence of HCV should target the PWID population and combine harm reduction measures with information and destigmatization campaigns. Civil society organizations working with PWID are a major asset for the success of such an approach, based on their current positive interventions promoting awareness of and screening for HCV

Not just the needle: The state of HIV-prevention science among substance users and future directions

Successes in preventing HIV transmission among substance using populations have focused primarily among injection drug users, which have produced measurable reductions in HIV incidence and prevalence. By contrast, the majority of substances used worldwide are administered by non-injectable means, and there is a dearth of HIV prevention interventions that target non-injecting substance users. Increased surveillance of trends in substance use, especially cocaine (including crack) and methamphetamine in addition to new and emerging substances (e.g., synthetic cannabinoids, cathinones and other amphetamine analogs) are needed to develop and scale-up effective and robust interventions for populations at risk for HIV-transmission via sexual behaviors related to non-injection substance use. Strategies are needed that address unique challenges to HIV prevention for substance users who are HIV-infected and those who are HIV- uninfected and at high risk. We propose a research agenda that prioritizes: (1) ) combination HIV prevention strategies in substance users; (2) behavioral HIV prevention programs that reduce sexual transmission behaviors in non-treatment seeking individuals; (3) medical and/or behavioral treatments for substance abuse that reduce/eliminate substance-related sexual transmission behaviors; and (4) structural interventions to reduce HIV incidence

Additional file 2: of Translation and validation of the PACIC+ questionnaire: the Thai version

Thai pacicplus. The Thai version of the PACIC+ questionnaire. (PDF 71 kb

MOESM1 of Sexual health, risky sexual behavior and condom use among adolescents young adults and older adults in Chiang Mai, Thailand: findings from a population based survey

Additional file 1: Table S1. Characteristics of sampled population and source population. Table S2. Relationship status by age group and sex