Journal of Health Science of Thailand

Introduction

Wiwat Rojanapithayakorn — 2026-05-27

cover

Wiwat Rojanapithayakorn — 2026-05-27

Editorial Board

Wiwat Rojanapithayakorn — 2026-05-27

Epidemiological Trends and Influencing Factors of Influenza Virus Infections in Respiratory Tract Infection Patients at Ramathibodi Hospital: A Decade of Molecular Surveillance (2012-2022)

Kingkan Rakmanee — 2026-05-27

The objective of this study was to study epidemiological trends and factor influencing on the detection of influenza virus in Ramathibodi Hospital, Mahidol University, Thailand. It was conducted by analyzing epidemiological data from 42,940 patients presenting with respiratory tract infections and screened for influenza virus using real-time reverse transcription polymerase chain reaction (real-time RT-PCR) between January 2012 and December 2022. The findings indicated that 3,020 cases (7.03%) were positive for the influenza virus. The distribution of influenza cases included 1,845 cases (61.09%) of influenza A, 1,160 cases (38.41%) of influenza B, 8 cases (0.26%) of influenza C, and 7 cases (0.23%) with co-infection of both influenza A and B. Of these, 656 cases (35.56%) were H1N1 subtype A, 900 cases (48.78%) were H3N2, and 289 cases (15.66%) were of an unidentified strain. The period of peak influenza infection extends from August to October, while the season with the lowest number of infections occurs between April and June. The relationship between age and the risk of influenza infection indicates that young children and adults exhibited a significantly higher risk of influenza infection compared with older adults. The relative risk values for this relationship are 1.85 (p<0.001, OR = 1.85, 95%CI = 1.54 - 2.24) and 1.44 (p<0.001, OR = 1.44, 95%CI = 1.25 - 1.66), respectively. After the emergence of the COVID-19 pandemic, a statistically significant association with the detection of influenza virus was observed (p<0.001, OR = 1.28, 95%CI = 1.13 – 1.45). The study found no statistically significant correlation between gender and sample type on the presence of the influenza virus. These findings may be used to inform preparedness strategies to prepare for future influenza pandemics.

A Study of Factors Related to the Dependency Status of Thai Elderly and Projections for 2040

Benjawan Tawatsupa — 2026-05-27

The objective of this study was to analyze the situation and associated factors of dependency among Thai older adults and to project the number of dependent older adults in the year 2040 (B.E. 2583). The study utilized secondary data from the Elderly Health Notebook system (Blue Book) of the Department of Health between 2021 and 2024 (B.E. 2564–2567), covering 1,491,881 older adults aged ≥60 years who had undergone the Activities of Daily Living (ADL) assessment. The results showed that the proportion of dependent older adults remained relatively stable during 2022–2024 (B.E. 2565–2567). Among males, the prevalence of homebound older adults was 2.2–2.5% and bedridden older adults were 0.8–0.9%. Meanwhile; among females, the prevalence of homebound older adults was 3.2–3.5% and bedridden older adults were 1.0–1.2%. Multinomial logistic regression analysis revealed that: female older adults had a 1.19 times higher risk of being homebound than males (95%CI: 1.09–1.29). Older adults aged ≥85 years had a 14.03 times higher risk of being homebound (95%CI: 11.03–17.85) and 5.61 times higher risk of being bedridden (95%CI: 3.84–8.19) when compared to the 60–64 age group. Additionally, older adults with low or no physical activity, consumed fruits and vegetables less than 3 days/week, smoked or had a history of smoking, consumed alcohol, had depression, suffered from abnormal oral health; and resided in areas with high PM2.5 levels were found to be associated with an increased risk of dependency. The projection of dependent older adults in 2040 (B.E. 2583) using a deterministic model found that there will be approximately 94,000 homebound males and approximately 210,000 homebound females. For bedridden older adults, the number is projected to increase to approximately 370,000 males and approximately 211,000 females, which reflects a rising trend of dependency, especially in the bedridden male group. This study highlights the importance of using systematic, national-level health databases to analyze risk factors and project the health status of older adults. This information is valuable for surveillance, policy planning, and developing healthcare services to accommodate the future increase in dependent older adults. Further research should investigate the effectiveness of targeted measures to reduce dependency and extend the study to groups approaching old age for a more comprehensive health prognosis.

Executive Functions of Preschool Children Based on Mothers’ Perception in Ramrat Subdistrict, Tha Uthen District, Nakhon Phanom Province

Nedruetai Punaglom — 2026-05-27

This descriptive qualitative study aimed to explore executive functions in preschool children as perceived by their mothers. The key informants were 15 mothers of children aged 3–5 years residing in Ramrat Subdistrict, Tha Uthen District, Nakhon Phanom Province. Participants were purposively selected according to inclusion criteria. Data were collected through in-depth interviews, observations, and field notes. Content analysis was employed for data analysis. Trustworthiness was ensured through data triangulation and validation by experts and participants. The findings revealed that mothers conceptualized executive functions in three main themes: (1) cognitive ability, including simple reasoning, understanding right from wrong, and distinguishing appropriate from inappropriate behaviors; (2) communication ability, reflected in the capacity to express needs and narrate experiences appropriately for age, using polite language and showing respect toward adults; and (3) practical ability, demonstrated through age-appropriate self-help skills and the performance of daily routines. Children who were perceived as possessing executive function skills were characterized by three attributes: (1) smart thinking, defined as thinking before speaking or acting, planning to solve problems, and maintaining concentration; (2) smart speaking, characterized by gentle speech, avoiding shouting, and being inquisitive; and (3) smart doing, reflected in self-responsibility, age-appropriate self-reliance, helping with family tasks according to ability, and good behavior with obedience to parents. Mothers’ perceptions were influenced by social and cultural contexts as well as their parenting experiences. The findings enhance understanding of how mothers perceive executive functions in preschool children and provides foundational knowledge for developing culturally and socially appropriate approaches to promote executive functions in early childhood.

Effectiveness of a Gender Awareness Program on Gender Equality Awareness among University Students

Jakkrite Pinyaphong — 2026-05-27

This quasi-experimental research aimed to evaluate the effectiveness of a gender awareness program on gender equality awareness among university students. The sample consisted of 50 students aged 18 years and older, who were purposively selected to participate in a four-session gender awareness program. Assessments were conducted pre-intervention, immediately post-intervention, and at a onemonth follow-up. Data were collected using seven questionnaires, with content validity assessed using the index of congruence (IOC) values between 0.67 and 1.00, and reliability determined by Cronbach’s alpha coefficient values between 0.72 and 0.86. Data were analyzed using descriptive statistics, Friedman test for variance analysis, and Wilcoxon Signed ranks test for pairwise comparisons. The results of the study, comparing the pre-intervention, immediate post-intervention, and one-month follow-up phases, revealed that the mean ranks of gender awareness differed significantly in at least one pair at the 0.05 level across several dimensions. These dimensions included: human dignity and gender equality in Thai society (mean rank = 1.51, 2.71, 1.78); roles of women and men in the Thai family (mean rank = 1.61, 2.56, 1.83); roles of women and men in the community/workplace (mean rank = 1.59, 2.84, 1.57); power relations (mean rank = 1.55, 2.84, 1.61); and gender (mean rank = 1.69, 2.74, 1.57). Specifically, the mean ranks were found to be highest at the immediate post-intervention phase. However, no statistically significant difference was found in awareness of the Gender Equality Act. Therefore, it is recommended to organize activities that promote awareness of gender equality, or establish clubs or organizations to foster gender equality awareness among all students, enabling them to learn and understand each other’s attitudes.

Development of Self-Registration Kiosk in Hospital and Performance Evaluation Using Queueing Theory

Teerawat Pantawong — 2026-05-27

Digital technologies are currently being widely implemented in hospitals. Hospitals with limited resources can develop their own service technologies to enhance service efficiency. The purpose of this study was to develop a self-registration kiosk at Mae Fah Luang University Hospital, Chiang Rai Province, and to assess its effectiveness through the application of queuing theory. The quasi-experimental study began with creating an automatic check-up program known as the Institute of Thai-Chinese Traditional Medicine, Mae Fah Luang Hospital (ITCM), designed to interface with the database system and facilitate the verification of treatment entitlement for Mae Fah Luang University Hospital service users. The service efficiency of the conventional medical records counter and the ITCM Kiosk were evaluated using secondary data from the hospital information system, including waiting time, service time, and the number of patients. Data from both systems were collected over three consecutive working days between 8:00 AM and 12:00 PM. System performance was analyzed using queueing theory, and differences were assessed using a paired sample t-test. The findings indicate that the ITCM Kiosk significantly enhanced service efficiency relative to the conventional process (p<0.05) and resulted in a substantial cost reduction of 69.8%. It also reduced queueing indicators, including the average number of patients in the system, the average number of patients in the queue, and the average waiting time in the queue, by 45–60%, although these decreases were not statistically significant. Therefore, the ITCM Kiosk was found to significantly reduce service costs and had potential to improve service efficiency by increasing speed and reducing waiting times. These findings suggest its feasibility for implementation in hospitals with resource constraints.

The Development of Environmental Health Management of Special Economic Zone with Health Impact Assessment: a Case Study of Waste Management in Mukdahan, Thailand

Darika Permporn — 2026-05-27

This action research applied the Health Impact Assessment (HIA) process as a mechanism for environmental health management. The objectives were to assess health impacts and establish measures to prevent and mitigate health effects with public participation. The study involved identifying health issues, collecting environmental data based on public concerns, and surveying environmental health impacts. Subsequently, a health risk assessment was performed, and recommendations for preventive and mitigating measures were developed collaboratively. The study found that the public had several concerning issues, including groundwater contamination with pathogens and chemicals, fly infestations, foul odors, unattractive scenery, noise pollution, airborne waste, soil degradation, and traffic congestion. However, groundwater contamination was the first issue that the public was concerned about. Groundwater samples were collected at distances of 165 and 200 meters from the landfill’s wastewater pond. The result indicated that the water was acidic (pH = 5.5) and contaminated with coliform bacteria and E. coli. Additionally, multiple heavy metal contaminants were detected, with arsenic - a known carcinogen — being of particular concern. The cancer risk assessment demonstrated that the level of risk was unacceptable. The overall environmental impact on the community surrounding the landfill was at a moderate level (Mean= 2.24±0.657).The most significant environmental impacts included disease-carrying flies, airborne waste, and foul odors. Based on the projected health impacts, recommendations were formulated for preventive and mitigating measures and environmental monitoring strategies. The participatory process enabled community members to exchange knowledge about health threats, access to additional information, and verification methods. This empowered them to implement preventive actions and disseminate information within their community to minimize health risks from the landfill. Therefore, relevant agencies should monitor the implementation of these measures, evaluate their effectiveness, and refine them for improved public health outcomes. Furthermore, the HIA-based environmental health management model should be applied to other areas facing similar issues.

Research and Development of a Lifestyle Medicine Clinic Model for Type 2 Diabetes Patients at Udon Thani Municipality Hospital

Kridsada Sirichaisit — 2026-05-27

Type 2 diabetes mellitus is a significant public health issue both globally and in Thailand. Traditional treatment often emphasizes medication, but lifestyle modifications have been increasingly recognized as a more effective approach. This research aimed to develop a lifestyle medicine clinic model for patients with type 2 diabetes at Udon Thani Municipality Hospital. It was conducted as a research and development (R&D) study divided into three phases: (1) situation and needs analysis, (2) design and development of the clinic model, and (3) pilot implementation and evaluation. The study was carried out from October 2024 to March 2025. The situation analysis revealed that the hospital had 969 diabetic patients,of whom only 29% achieved glycemic control (HbA1C <7%). The traditional care approach lacked structured guidance on physical activity, stress management, and sleep hygiene.Therefore, the newly developed clinic model incorporated multidisciplinary care focusing on six lifestyle behavior domains in accordance with lifestyle medicine principles. The study collected data from 22 patients who participated in the program for 3 months.The results showed that after 3 months of participation, HbA1C levels significantly decreased from 7.9±1.3% to 6.5±1.3% (p<0.001), average systolic blood pressure decreased from 144.3 to 135.0 mmHg (p=0.014), average waist circumference reduced by 4.0 cm (p<0.001), and health behavior scores increased from 33.9 to 41.5 points (p<0.001). Additionally, patients expressed very high satisfaction with the service. The study results demonstrate that the developed lifestyle medicine clinic model is effective in improving clinical outcomes and health behaviors among patients with type 2 diabetes. However, long-term studies should be conducted to confirm the effectiveness and feasibility of implementation in diverse contexts.

Health Service Delivery within the Area Health System Model for Promoting Equity among Older Adults in Thailand

Methinee Intarates — 2026-05-27

This study aimed to explore the patterns of health service delivery within regional health systems that promote health equity among older adults under Thailand’s universal health coverage scheme. A qualitative case study design was employed, using in-depth interviews with 18 key informants comprising eight regional and provincial health administrators and ten health practitioners at district and primary care levels from area health region 2 and 3. Participants were purposively selected based on their involvement in health service management for the elderly. Data were collected using a semi-structured interview guide developed from the Six Building Blocks Plus (SBBP) framework, which covers seven components: health service delivery, health workforce, health information systems, access to essential medicines, health financing, leadership and governance, and community participation. Data were analyzed through content analysis to identify core categories and thematic analysis to synthesize systemic mechanisms influencing health equity among the elderly. The findings revealed that regional health systems played a crucial role in fostering equity through four key mechanisms: area-based management and health financing that enhance service accessibility, evidence-informed budgeting at the regional level, governance and leadership that strengthen monitoring and coordination, and public and elderly participation in planning processes. Overall, the study highlights that regional health systems can drive sustainable equity for the ageing population through decentralized management, transparent information use, and multi-sectoral collaboration.

Effectiveness and Safety of Cha-Nu-Ruk Herbal Poultice for Knee Pain Relief in Patients with Osteoarthritis of Knee (Chappong)

Kanlaya Sangchawee — 2026-05-27

This retrospective cross-sectional study aimed to compare pain intensity levels in patients with effusion (Chappong Nam) and dry knee osteoarthritis (Chappong Heng) before and after treatment, measure knee circumference changes in patients with effusion knee osteoarthritis, and assess the safety of Chanurak knee poultice. The study examined data from 1,047 patients with knee osteoarthritis (Chappong) who received three applications of Chanurak knee poultice, comprising 432 patients with effusion knee osteoarthritis and 615 patients with dry knee osteoarthritis. The research instruments consisted of data collection forms validated for content validity by three experts (CVI= 1.00). Data analysis was performed using percentage, mean, standard deviation, paired samples t-test, and repeated measures ANOVA statistics. The demographic results revealed that most of the patients were females (65.90%) and males (34.10%) with the mean age of 56.25±11.00 years. A comparison of knee poultice application and pain intensity levels in patients with effusion knee osteoarthritis and dry knee osteoarthritis between before and after poultice application showed that patients exhibited a significant reduction in mean pain scores of 2.22 and 2.24 after receiving the intervention, (p<0.001). The formular could reduce pain from week 1 onwards. For knee poultice application and knee circumference in patients with effusion knee osteoarthritis, a comparison between before and after poultice application also demonstrated that patients reported a reduction in mean knee circumference of 59.03 centimeters, with statistical significance (p<0.001). There were no adverse effects from the Chanurak knee poultice formula reported in this study. Thus, the Chanurak knee poultice formula can help relieve knee pain and is safe for use in supporting and promoting care for patients with knee osteoarthritis.

Using GIS and Geocoded Health Facility Databases to Develop Primary Care Catchment Area Policy in Urban Settings

Siwaporn Mahathamnuchock — 2026-05-27

Primary healthcare catchment areas in Thailand are commonly defined based on administrative boundaries, which may not reflect actual accessibility through transportation networks. This study aimed to assess the consistency between administratively assigned service areas based on household registration and spatial accessibility to healthcare services, and to examine whether these patterns correspond with actual service utilization. This study employed a spatial analytical design using Geographic Information Systems (GIS). Six villages in Pang Mu Subdistrict, Mae Hong Son Province, Thailand, were purposively selected as case studies. Data sources included diabetes patient registry records to identify village locations, geographic coordinates of health facilities collected through field surveys using a portable Global Positioning System (GPS), official records of village boundaries and assigned service areas, road network data from government agencies, and healthcare utilization statistics from the previous 12 months. Spatial analysis was conducted using QGIS version 3.40.15 and the QNEAT3 plugin to calculate network-based service areas. A distance threshold of 2,500 meters (approximately five minutes of travel time) was applied to estimate accessible service areas along the road network. The results were then compared with administrative service boundaries and actual healthcare utilization patterns. The findings revealed that all six sampled villages were located outside the five-minute network-based service area of their administratively assigned primary healthcare facilities. Service utilization patterns also differed from the official administrative boundaries, indicating a mismatch between administrative catchment definitions and real-world geographic accessibility. These findings highlight the importance of integrating spatial analysis with healthcare utilization data in defining primary healthcare service areas and underscore the need for a national database of health facilities with standardized geographic coordinates to support spatially informed health service planning.

Effects of a Supportive and Educative Program on Self-Care Behaviors, Back Pain, Flexibility and Strength of Back Muscle Among Hand Weaving Workers

Piyaporn Penprapai — 2026-05-27

cative program on self-care behaviors, back pain, flexibility, and back muscle strength among hand weaving workers. The sample consisted of 45 hand weavers, divided into an experimental group (n=22) and a control group (n=23). The experimental group received a 16-week supportive and educative program based on Orem’s theory, comprising health education, 13 stretching and strengthening postures, performed 3 days per week, and 2 weekly telephone follow-ups. The control group received usual care. Research instruments included the supportive and educative program, a handbook, exercise logbooks, a self-care behavior questionnaire, a pain assessment scale, a sit-and-reach box, and a back and leg dynamometer. Data were analyzed using independent t-test and repeated measures ANOVA. The results revealed that the experimental group had significantly higher mean scores for self-care behaviors than the control group (p<0.05). Significant group-by-time interactions were found for all variables (p<0.05). Pairwise comparisons showed that the experimental group had significantly greater back muscle flexibility than the control group at weeks 8, 12, and 16 (p<0.05). Regarding back pain and back muscle strength, the experimental group showed significantly lower pain and higher strength than the control group at weeks 12 and 16 (p<0.05). Recommendations include promoting this program for sedentary occupations, and emphasizing adherence for at least 12-16 weeks.

Effects of Online Ruesi Dadton Exercise on Physical Fitness and Body Composition in Overweight Volunteers

Ratchadaphorn Pisaipan — 2026-05-27

This objective of this study was to investigate the effects of online Reusi Dat Ton exercise on body composition and physical fitness among individuals with overweight. It was conducted as a pilot study with random allocation. Twenty participants were allocated into two groups (n = 10 per group). The intervention group performed Reusi Dat Ton exercise at home via an online platform using a Reusi Dat Ton exercise video, for 40 minutes per session, three sessions per week, for 4 weeks. The control group continued their usual lifestyle and did not participate in Reusi Dat Ton exercise. Body composition and physical fitness were assessed before and after the intervention period. For physical fitness outcomes, the Reusi Dat Ton group showed significant improvements in left-hand grip strength and the sit-to-stand chair test repetitions after training (p<0.05). In particular, left-hand grip strength in the intervention group was significantly greater than that in the control group (p<0.05). Regarding body composition, fat-free mass (FFM), muscle mass, total body water (TBW), and basal metabolic rate (BMR) increased significantly (p<0.05). In conclusion, four weeks of online Reusi Dat Ton exercise improved left-hand grip strength and sit-to-stand performance; and increased fat-free mass, muscle mass, total body water, and basal metabolic rate in individuals with overweight.

Evaluation of the Data Information System of the Sub-district Health Promoting Hospital That Has Been Transferred to the Provincial Administrative Organization

Udom Tumkosit — 2026-05-27

This research aimed to evaluate the status of information systems in sub-district health promotion hospitals (SHPHs) that were transferred to provincial administrative organizations (PAOs) after the transfer. Specifically, it examined how the system had generally changed from its original state, and if so, how. The research team reviewed the literature and developed an evaluation research framework in the form of five research questions to guide the search for answers. In terms of research methodology, a qualitative multiple-case study approach was employed. Purposive sampling was used to select 32 SHPHs across 8 provinces representing 4 regions. Data collection methods included surveys, in-depth interviews with data recorders, and focus group discussions. Data analysis and interpretation to answer the research questions were conducted using the ATLAS.ti software. The evaluation results revealed that: (1) after the transfer, the general characteristics of SHPHs’ information systems largely remained unchanged, continuing to be designed primarily to support the Ministry-level management of the primary healthcare system rather than the management needs of the SHPHs themselves; (2) the SHPHs’ databases did not yet comprehensively cover their core functions and were not integrated with the PAO systems; (3) most SHPHs lacked sufficient computer equipment as well as qualified personnel and system administrators; and (4) the quality of data was not well-aligned with the primary healthcare mission, as health promotion data which constituted a major activity of SHPHs had been given insufficient attention. Policy proposal recommends establishing a dedicated database and data set specifically for the primary healthcare system, while ensuring its integration into the broader health information infrastructure.

Survival of SARS-CoV-2 and Other Pathogens in the Environment of a University Hospital and a Thai-Malaysia Border Control Post: A Cross-sectional Study

Thitiworn Choosong — 2026-05-27

The rapid global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) since December 2019 has highlighted the importance of understanding its modes of transmission, including through large droplets, contact with contaminated surfaces (fomites), and airborne aerosols. Environmental factors such as ventilation conditions can influence SARS-CoV-2 transmission rates. The objective of this study was to investigate airborne transmission of SARS-CoV-2 and other respiratory pathogens in hospital and customs environments in Songkhla, Thailand, amidst the COVID-19 pandemic. Air monitoring was conducted at various locations, including hospital wards and customs offices, using multiple bioaerosol samplers. Two phases of sampling were carried out in August-September 2020 and in June-September 2021. Bioaerosol sampling was conducted using four types of samplers: N6 Single Stage Andersen Cascade Impactor, midget impinger, liquid impinger, and polyvinyl chloride (PVC) filters. Additionally, a biosampler was utilized for measuring viable microbial load. Respiratory pathogens were identified using real-time RT-PCR assays. Frequencies, percentages, Pearson’s correlation coefficient (r), and linear regression were used for data analysis. Pathogen results were reported qualitatively (detected/non-detectable) and as percentages. No airborne transmission of SARS-CoV-2 or other respiratory pathogens was detected in the monitored environments during the study period. There were 3 potential risk areas of SARS-CoV-2 survival conditions with the relative humidity (45-50%RH) and temperate (24-25 OC), especially the isolation rooms did fall in the range allowing SARS-CoV-2 survival. There was no evidence of transmission of SARS-CoV-2 or other airborne pathogens in thehospital or the Customs and Immigration environments. However, the relative humidity and temperate of ICU and isolation rooms were fit for SARS-CoV-2 survival. Therefore, the setting of ventilation system in both enclosed office and hospital should be considered the transmission of airborne pathogens.

Content

Wiwat Rojanapithayakorn — 2026-05-27

Delirium in Hospitalized Older Adults: Nursing Care with Clinical Reasoning

Natsala Longphasuk — 2026-05-27

Delirium is a geriatric syndrome, particularly among older adults experiencing acute illness and hospitalization. It has complex, multifactorial causes, which can be divided into two main groups: predisposing and precipitating factors. This condition involves an acute onset and fluctuation in consciousness, awareness, concentration, and physical function, often manifesting with non-specific signs and symptoms. Delirium is temporary and usually reversible, and it can be categorized as hyperactive, hypoactive, or mixed. Literature reviews support the preventability of delirium through several assessments, including history-taking, physical examinations, laboratory results, and cognitive assessment tools. Early detection and appropriate management are essential to prevent both short-term and long-term consequences for older adults, their families, and healthcare agencies. Caring for delirium in hospitalized older adults requires the cooperation of a multidisciplinary team, as well as family members. Nurses, as practitioners who provide continuous and direct care to older adults, should possess adequate knowledge and understanding of the causes, symptoms, and assessment tools related to delirium. This competence enables nurses to deliver both non-pharmacological and pharmacological management appropriately and effectively, ensuring individualized care aligned with each older patient’s condition.

Application of the Ecological Model Concept to Promote Male Access to The HPV Vaccine in Thailand

Nannaphat Somkaew — 2026-05-27

Human papillomavirus (HPV) infection is common among men in Thailand and is associated with several HPV-related cancers. However, HPV vaccination services in Thailand have predominantly targeted females, and male vaccination remains limited, leaving gaps in prevention and increasing long- term health risks. This article proposes strategies to improve male access to HPV vaccination in Thailand using the Social Ecological Model as an organizing framework. A literature review was conducted using ThaiJo, Google Scholar, and PubMed, covering studies published from 2014 to the present. Relevant evidence was synthesized through content analysis by extracting and categorizing factors related to HPV vaccine access among men and mapping them onto five ecological levels:intrapersonal, interpersonal, organizational, community, and policy. Improving vaccination uptake among men requires coordinated multi-level actions, including: strengthening knowledge, risk perception, and vaccine confidence (individual level); leveraging family, peers, and healthcare-provider recommendations (interpersonal level); establishing proactive and convenient vaccination services in schools, universities, and workplaces (organizational level); implementing community and mass-media communication to correct misconceptions and create supportive social norms (community level); and expanding policy and financing mechanisms to reduce cost barriers and increase coverage for males (policy level). Applying the Social Ecological Model highlights that male HPV vaccination is shaped by interacting personal, social, organizational, and policy determinants. A multi-level approach can inform the design of health-service interventions and policies to increase vaccination coverage among men and reduce HPV-related morbidity and mortality in the long term.

Full Issue

Wiwat Rojanapithayakorn — 2026-05-27