Using Email Communication to Increase Expatriate Parents' Knowledge of the Human Papillomavirus

Expatriates face a unique set of determinants to health which may influence their level of knowledge, perception of available preventative health care alternatives and their health seeking behaviors. The objective of this study is to understand the effect of an email communication intervention on expatriate parents' level of knowledge of the Human Papillomavirus (HPV). Repeated measurement of knowledge was conducted pre- and post-intervention among parents who received the study intervention (group 1) and those who received standard care (group 2). Intervention effect was measured by any change in knowledge within and between groups. The group 1 had a significant rise in knowledge mean from baseline to first and then second follow-up (m = 0.57 (SD 0.39), m = 0.84 (SD 0.16) and m = 0.87 (SD 0.11), respectively). In addition, after receiving the intervention, group 1 felt they had sufficient information to make an informed decision of whether to vaccinate their child(ren), with a significant difference from baseline to first post test, (χ² (1) = 8.50, p < 0.05). Based on an increase in knowledge, the study's email intervention proved effective mode to disseminating HPV-related information

An integrated program with home blood-pressure monitoring and village health volunteers for treating poorly controlled hypertension at the primary care level in an urban community of Thailand

Sawitree Visanuyothin,1,2 Samlee Plianbangchang,1 Ratana Somrongthong1 1College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand; 2Social Medicine Department, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand Purpose: Hypertension (HT) is accountable for death in half of the patients suffering from heart disease and stroke. Many treatment strategies have been used, but little research exists on an integrated program with home blood pressure monitoring (HBPM) and village health volunteers (VHVs) in an urban area of Thailand. The present study aims to determine the effectiveness of the integrated program, HBPM, and VHVs in supporting the target population. Patients and methods: This quasi-experiment was conducted from July to November 2017. Patients with poorly controlled HT were randomly selected from each of the two primary care units in Nakhon Ratchasima, Thailand. The participants were separated into an experiment (n=63) and control group (n=65). The experiment group participated in the integrated program, which was based on the 20-item Health Literate Care Model. A valid and reliable questionnaire was used to collect data from participant interviews. Blood-pressure monitoring was used to measure systolic home blood pressure and diastolic home blood pressure. Descriptive statistics, chi-squared tests, Fisher’s exact test, the independent t-test, and the Wilcoxon–Mann–Whitney test were used to compare the baseline data. Multiple logistic regression was used to compare the differences between the mean changes in the outcomes. Results: At the end of the 3-month follow-up appointment, significant statistical changes were found. Systolic home blood pressure, diastolic home blood pressure, and body mass index changed −4.61 (95% CI −8.32, −0.90) mmHg (P-value=0.015), −3.5 (95% CI −5.31, −1.72) mmHg (P-value <0.001), and −0.86 (95% CI −1.29, −042) (P-value <0.001) respectively. Participant scores in lifestyle and management knowledge, and self-management behaviors significantly increased by 0.76 (95% CI 0.15–1.38) point (P-value=0.016) and 0.15 (95% CI 0.06, 0.24) point (P-value=0.001), respectively. Conclusion: The integrated program, HBPM, and VHVs were effective in decreasing blood pressure and body mass index, and increasing knowledge and self-management behaviors among urban patients with poorly controlled HT. Keywords: self-management behaviors, lifestyle and management knowledge, health literacy of chronic diseases, adherence of hypertension patient

The association of sociodemographic characteristics and sexual risk behaviors with health literacy toward behaviors for preventing unintended pregnancy among university students

Saowanee Thongnopakun, Tepanata Pumpaibool, Ratana Somrongthong College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand Purpose: The aim of this study was to determine whether there is an associated effect between sociodemographic characteristics and sexual risk behaviors with health literacy in preventing unintended pregnancy among university students in Chon Buri province, Thailand. Participants and methods: A cross-sectional study design was used. The data were collected between February and May, 2017. A self-administered questionnaire was developed by the Ministry of Public Health and supported by the evolving concept of health literacy of Nutbeam. This questionnaire was then applied to collect data from 418 university students. Descriptive statistical and binary logistic regression methods were used for data analysis in this study. Results: Half the students exhibited inappropriate behaviors to prevent unintended pregnancies. However, half the respondents had been educated to prevent unintended pregnancies. Nearly one-third of the students had experienced sexual intercourse. Binary logistic regression was used to analyze an association between the behavior for unintended-pregnancy prevention with sociodemographic characteristics and the health literacy of university students. The factors assessed were current residence type (the adjusted odds ratio [aOR]=1.897, 95% CI=1.123–3.205), previous sexual intercourse (aOR=3.263, 95% CI=1.735–6.139), cognitive health to prevent unintended pregnancy (aOR=1.095, 95% CI=1.019–1.176), decision skills in choosing appropriate practices to prevent unintended pregnancy (aOR=1.289, 95% CI=1.182–1.405), and self-management to prevent unintended pregnancy (aOR=1.113, 95% CI=1.005–1.232). Conclusion: This study indicated that university students who had experienced sexual intercourse and had low health literacy were more likely to exhibit inappropriate behaviors concerning the lack of prevention of unintended pregnancies. The results will provide health professionals with information to develop more effective prevention and intervention programs. Keywords: health literacy, behaviors for preventing unintended pregnancy, adolescen

Appearance and potential predictors of poorly controlled hypertension at the primary care level in an urban community

Sawitree Visanuyothin,1,2 Samlee Plianbangchang,2 Ratana Somrongthong2 1Social Medicine Department, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima, Thailand; 2College of Public Health Sciences, Chulalongkorn University, Bangkok, Thailand Purpose: Hypertension (HT) is the major risk factor for cardiovascular diseases because of its poor control. To control HT at the primary care level in urban communities, there is a demand for deeper comprehension of the manifestations of poorly controlled HT. This study aimed to examine appearance of HT, including the association between the appearance and home blood pressure (HBP) control at the primary care level in urban communities.Patients and methods: A cross-sectional study was conducted in July–October 2017 in an urban community in Thailand. The total sample size from randomization was 125 poorly controlled HT patients who were diagnosed with an average clinic blood pressure ≥140/90 mmHg in their last three visits. Data were collected by face-to-face interviews, HBP monitoring (HBPM), and blood and urine testing. Data analysis was conducted via descriptive statistics and the chi-square tests, with a significance level of p<0.05.Results: HBPM revealed that 58.4% of patients with poorly controlled blood pressure from clinic measurement had a systolic blood pressure and diastolic blood pressure that were below the HBP target. Most patients were overweight/obese, but they were nonsmokers and nondrinkers. As comorbidities, they had hyperlipidemia (64.0%) and diabetes mellitus (53.0%). One-quarter of them had good levels of knowledge and literacy. Nearly half had good health self-care literacy. Only 13% exhibited adequate self-management behaviors, but more than half had biochemistry results within normal limits. There were significant associations of smoking history and having hyperlipidemia as a comorbidity with HBP control (p =0.010 and 0.046, respectively).Conclusion: The role of HBPM is important in practice when it comes to monitoring HT control at the primary care level in an urban context. Smoking cessation and control of the blood lipid levels should be highlighted not only at the practice, but also at the policy level. Keywords: characteristics, risk factors, association, home blood pressure, knowledge, health literacy, self-management behaviors, biochemistr

Using Email Communication to Increase Expatriate Parents’ Knowledge of the Human Papillomavirus

Expatriates face a unique set of determinants to health which may influence their level of knowledge, perception of available preventative health care alternatives and their health seeking behaviors. The objective of this study is to understand the effect of an email communication intervention on expatriate parents' level of knowledge of the Human Papillomavirus (HPV). Repeated measurement of knowledge was conducted pre- and post-intervention among parents who received the study intervention (group 1) and those who received standard care (group 2). Intervention effect was measured by any change in knowledge within and between groups. The group 1 had a significant rise in knowledge mean from baseline to first and then second follow-up (m = 0.57 (SD 0.39), m = 0.84 (SD 0.16) and m = 0.87 (SD 0.11), respectively). In addition, after receiving the intervention, group 1 felt they had sufficient information to make an informed decision of whether to vaccinate their child(ren), with a significant difference from baseline to first post test, (χ² (1) = 8.50, p < 0.05). Based on an increase in knowledge, the study's email intervention proved effective mode to disseminating HPV-related information