How to make physical activity promotion work in Thai schools: Perspectives of multiple stakeholders

Background: This study aimed to determine current practice in physical activity (PA) promotion in Thai schools, explore barriers and facilitators to PA promotion within the school setting, and identify strategies to support schools’ future practice. Methods: A qualitative study design was applied comprising document analysis, focus groups, in-depth interviews, and onsite observations. The focus groups and in-depth interviews were conducted with 144 informants, purposively recruited through 24 schools in 4 regions across Thailand. Inductive content analysis was used. Results: Most schools were promoting PA in the absence of written policies, and without an accurate understanding of PA. Nonalignment of school performance indicators and policies, concerns about children’s academic performance, and lack of budget were raised as barriers to PA promotion, whereas strong partnerships with multiple local stakeholders facilitated school-based PA promotion. Mandated government PA policies and more information support were suggested as strategies to enhance schools’ future practices. Conclusions: For PA promotion to be successful in the school setting, significant challenges will need to be addressed. Results from this study help the government and concerned stakeholders to better understand the situation at the school level, and further strive for achieving the target PA levels specified in the National PA Plan

ปรากฏการณ์ แบบแผน และภาพจำลองทางความคิดของพฤติกรรมการจำหน่ายผลิตภัณฑ์ยาสูบให้เยาวชนของผู้ประกอบการร้านค้าปลีกในชุมชนชนบท

Phenomenon Patterns and Conceptual Model of Retailers in Rural Areas Affecting Casual Factors in Selling Tobacco Products to Youth Abstract   This qualitative research aims to understand and explain the phenomenon, pattern and conceptual model of retailers in a rural community, which affect casual factors in selling tobacco products to minors. Methods of the study in collecting data are semi-structured interviews, participant observations and non-participant observations. Key informants are 12 retailers who have been selling tobacco products to minors. The quantitative data analysis is descriptive statistics and the qualitative data analyses are content analysis and thematic analysis. The findings reveal the following three results. First, the level of phenomenon of 12 key informants have the behavior of selling tobacco to minor consumers with 7 characteristics: neglect to check the age of the buyers of the tobacco products, display the tobacco products at the point of sale, selling tobacco to minors by self-service,  selling single cigarettes or small packages to minor consumers, hide the sign saying their shops sell no tobacco products to children under 18,  provide lighters for minor consumers without charge, and provide a smoking area for consumers. Second, these patterns consist of three sub-patterns, which are the pattern for constructing a typology of minor customers, the pattern for selling tobacco the minors, and the pattern of buying the tobacco products among minors. Third, the level of the conceptual model are the economic value and motivation of income from selling tobacco products to minor consumers, perception of law and misuse of rules, the definition of a minor that distorts the legal norm, and the flexibility of the behavior of selling tobacco product to the reference group. The result is useful for the development of an approach for rural retailers’ behavioral change concerning tobacco sale to minors in the next phase.   Keywords: tobacco products, retailers, selling tobacco products to mino

personnel of primary care units in the

Predictors of burnout among community healt

A harm reduction model for environmental tobacco smoke exposure among Bangladeshi rural household children: A modified Delphi technique approach.

This paper aimed to develop a harm reduction model to reduce exposure to environmental tobacco smoke among children of rural households in Bangladesh. A mixed-methods exploratory sequential design has been applied, and data has been collated from six randomly selected villages of Munshigonj district, Bangladesh. The research was divided into three phases. In the first phase, the problem was identified through key informant interviews and a cross-sectional study. In the second phase, the model was developed by focus group discussion, and in the third phase, the model was evaluated through the modified Delphi technique. The data was analyzed by thematic analysis and multivariate logistic regression in phase one, qualitative content analysis for phase two, and descriptive statistics in phase three. The key informant interviews showed attitude toward environmental tobacco smoke, lack of awareness, inadequate knowledge as a reason and smoke-free rules, religious beliefs, social norms, and social awareness as preclusion of environmental tobacco smoke. The cross-sectional study detected that households with no smoker (OR 0.006, 95% CI 0.002-0.021), high implantation of smoke-free household rules (OR 0.005, 95% CI 0.001-0.058), moderate (OR 0.045, 95% CI 0.004-0.461) to strong (OR 0.023, 95% CI 0.002-0.224) influence of social norm and culture along with neutral (OR 0.024, 95% CI 0.001-0.510) and positive (OR 0.029, 95% CI 0.001-0.561) peer pressure had been significantly associated with environmental tobacco smoke exposure. The final components of the harm reduction model consist of a smoke-free household, social norms and culture, peer support, social awareness and religious practice identified by the FGDs and modified Delphi technique

Use of electronic cigarettes and associated factors among thai vocational students: An institution-based cross-sectional study

Introduction: The use of young electronic cigarettes (e-cigarettes) is increasing worldwide, including in Thailand, where there are strict regulations governing the availability of e-cigarettes. This study explored e-cigarette use among vocational students and associated factors in Thailand. Methods: We enrolled 1150 students from six vocational institutions in the upper northern region of Thailand using a multistage design and gathered the data through a self-administered questionnaire. Multivariate logistic regression models were used to examine the variables and their association with e-cigarette use. Results: Most of the participants (66.5%) were male, and the average age was 17 ± 1.7 years. The prevalence of e-cigarette use in the past 30 days was 18.4%. We found that the perceived price of e-cigarettes being affordable (adjusted odds ratio [AOR] = 1.7, 95% confidence interval [CI]: 1.0–2.8), traditional cigarette smoking in the past year (AOR = 3.5, 95% CI: 2.4–5.1), a high positive attitude toward e-cigarettes (AOR = 2.6, 95% CI: 1.7–3.9), alcohol consumption in the past year (AOR = 1.8, 95% CI: 1.1–2.8), having close friends who used e-cigarettes (AOR = 4.4, 95% CI: 3.1–6.3), and having low self-esteem (AOR = 1.6, 95% CI: 1.1–2.3) were significantly associated with e-cigarette use in the past 30 days. Conclusion: The use of e-cigarettes is prevalent among Thai vocational students, suggesting that continued maintenance of the enforcement policy on banning the importation of e-cigarettes into the country is thus needed. Furthermore, the government should improve law enforcement, especially against online marketing, and strengthen school-based anti-smoking programs

Secondhand smoking among children in rural households:A community based cross-sectional study in Bangladesh

Objectives: This study aimed to determine the factors associated with reducing exposure to secondhand smoke among children in households of rural Bangladesh. Methods: A cross-sectional study of 410 smokers and non-smokers, in 6 villages of Munshigonj district was conducted. Data were collected randomly using a self-administrative questionnaire. Differences between variables were assessed using Chi-square or Fisher's exact test (as appropriate). Univariate and multivariate logistic regression models were used to investigate associations. All results were presented as unadjusted and adjusted odds ratios with a 95% confidence interval. The level of statistical significance was reached when p < 0.05. Results: A smoker in the household was determined to be a risk factor associated with exposure of other household members to secondhand smoke (p < 0.001). Higher education, strict implementation of household smoke-free rules, a higher influence of social norms and culture, as well as moderate knowledge on exposure to secondhand smoke were considered as preventive factors associated with exposure of others in the home to secondhand smoke. Conclusion: Exposure to secondhand smoke is an extensive and preventable risk factor for children, and reducing exposure to secondhand smoke will have a largely positive effect in the community. An effective public health intervention model may reduce secondhand smoking