Thailand Journal of Health Promotion and Environmental Health

Effects of a Kidney Deterioration Retardation Program on Self-management and Clinical Outcomes in Patients with Stage 3 Chronic Kidney Disease, Mae Sariang Hospital, Mae Hong Son Province: An Explanatory Sequential Mixed-Methods Study

2026-06-19T15:50:29+07:00

Chronic kidney disease (CKD) is a growing public health problem, and Mae Sariang District, Mae Hong Son Province has the highest CKD incidence in the province, with ethnic minorities comprising the majority of the population. This explanatory sequential mixed-methods study evaluated a 12-week Lewin's Change Management Model-based kidney deterioration retardation program on self-management behaviors and clinical outcomes, and developed program improvement guidelines for 37 purposively sampled stage 3 CKD patients. Self-management (30-item, 4-domain, Likert 4-level, max 90 points) was measured at weeks 0, 5, 9, 12; eGFR, UPCR, blood pressure and fasting blood glucose were compared pre-post. Qualitative data (n=8; in-depth interviews and focus groups) and Expert Review (n=2 specialists) were conducted. Total self-management scores improved significantly from 46.44 to 66.38 (p<0.001; dz=1.350, very large effect). eGFR showed a favorable trend (p=0.183); 21.6% advanced from G3a to G2. Five qualitative themes and 17 Expert Review-endorsed program improvements across 6 domains were identified. This program provides a scalable model for remote multicultural communities.

Effectiveness of Motivational Interviewing Program on Self-care Behaviors among Type 2 Diabetes Mellitus Patients at The Lifestyle Medicine Clinic Metropolitan Health and Wellness Institution.

2026-06-08T11:10:18+07:00

This quasi-experimental research aimed to evaluate the effectiveness of a motivational interviewing program on self-care behaviors among patients with type 2 diabetes mellitus at the Lifestyle Medicine Clinic, Metropolitan Health and Wellness Institution. The sample consisted of type 2 diabetic patients attending the Lifestyle Medicine Clinic at the Metropolitan Health and wellness Institute, Department of Health, Bangkok, Thailand. The sample size was calculated using G*Power 3.1.9.7 (Effect size = 0.80, Power = 0.95), yielding 70 participants; an additional 10% was added to account for attrition, resulting in a total of 78 participants. They were randomly assigned into either the experimental group (n = 39) or the control group (n = 39) using simple random sampling via drawing. The study was conducted from June to December 2025. The experimental group received a 4-session motivational interviewing program (the first and final sessions lasted 30 minutes in person at the clinic, supplemented by 2 telephone follow-ups lasting 5–10 minutes each). The control group received routine care. Baseline characteristics were analyzed using descriptive statistics, including frequency, percentage, mean, and standard deviation. Mean scores of self-care behaviors and glycated hemoglobin (HbA1c) levels were compared using Paired t-test and Independent t-test.

The results showed that after receiving the program, the experimental group had significantly higher mean scores of diabetes self-care behaviors than before the intervention and than the control group (p < .001), with a mean score of 113.73 (SD = 6.37). In addition, the glycated hemoglobin (HbA1c) level of the experimental group decreased from 7.97% to 6.48%, which was significantly different from the control group (p < .001). Based on these findings, the motivational interviewing program was highly effective in promoting health behaviors and controlling HbA1c levels. Therefore, this program should be integrated into routine health care services to enhance the self-care capacity of patients with type 2 diabetes mellitus continuously and sustainably.

Factors Associated with Quality of Life among Residents in the Lower Huai Luang River Basin Development Project Area

2026-06-02T21:32:12+07:00

This cross-sectional survey study aimed to investigate the quality of life and factors associated with quality of life among residents living in the Lower Huai Luang River Basin Development Project area, Thailand. The study included 440 participants selected through multistage sampling. Data were collected between July and August 2025 using a structured questionnaire consisting of personal characteristics, health-promoting behaviors, access to health services, social support, and quality of life. Data were analyzed using descriptive statistics, Pearson’s product-moment correlation coefficient, and multiple linear regression. The results showed that the overall quality of life of the participants was at a moderate level. Health-promoting behaviors, access to health services, and social support were also found to be at moderate levels. Correlation analysis revealed that age was negatively associated with quality of life (r = -0.113, p < 0.05), whereas household income (r = 0.156, p < 0.01) and health-promoting behaviors (r = 0.119, p < 0.05) were positively associated with quality of life. The multiple linear regression analysis showed that age, average family income, and health-promoting behaviors were significantly associated with quality of life, explaining 6.4% of its variance (R² = 0.064, p < .05). The findings suggest that promoting healthy behaviors, strengthening household economic stability, and supporting older adults are essential strategies for improving the quality of life of populations living in water resource development project areas.

Development of a Legionella spp. Surveillance and Control Model for Hotels in Thailand's Tourist Cities

2026-07-17T10:22:35+07:00

This study aimed to examine the situation of Legionella contamination and environmental health management practices, develop a surveillance and control model, and to formulate policy recommendations for Legionella prevention and control for hotels in tourist cities. The study samples consisted of Type 3 and Type 4 hotels. Quantitative data on outbreak occurrence and Legionella management were collected from 463 hotels using structured survey questionnaires. Qualitative data were obtained through water sampling for Legionella detection, questionnaires, and pre - post assessments of prevention and control measures. Focus group discussions and stakeholder consultations were conducted with representatives from 50 hotels and relevant sectors. Data were analyzed using descriptive and inferential statistics. Data collection was conducted between February and August 2025. The results showed that 263 hotels responded to the survey (56.8%), including 194 Type 3 hotels (73.8%) and 69 Type 4 hotels (26.2%). Among 176 hotels that conducted Legionella testing, 21 hotels (11.9%) reported positive Legionella findings, with tap water identified as the most frequently contaminated water source. Overall, 56.5% of hotels had established prevention plans, while 48.7%had implemented control measures; however, systematic monitoring and evaluation of these measures remained limited. Water sampling from 50 hotels detected Legionella in 14 hotels (28%) during the first survey and in 5 of the 14 positive hotels (35.7%) during follow-up sampling. Hot water from showerheads was the most commonly contaminated source. The temperature of contaminated hot water ranged from 37.0 to 50.0 °C, whereas free residual chlorine concentrations in contaminated cooling tower water and potable water systems ranged from non-detectable to 2.15 mg/L. Compliance with the Department of Health guidelines before the first and second rounds of water sampling was associated with effective reduction of Legionella contamination. Significant improvements were observed in the maintenance of cooling towers, potable water systems, and hot water systems following implementation of the intervention (p < 0.05). The proposed 3R2P Model provides a practical framework for strengthening Legionella surveillance and control in hotel settings. Policy recommendations include establishing a centralized surveillance and reporting system, promoting effective Legionella control technologies, developing national regulations and standardized guidelines, and strengthening intersectoral collaboration to support integrated policy implementation.

Development of a teaching guideline for human research ethics for graduate students, Faculty of Public Health, Mahidol University

2026-09-02T15:12:32+07:00

In modern public health research, researchers need to understand both scientific methodologies and ethical standards in human research. This article aims to present a teaching guideline on human research ethics for public health graduate students. The development process began with defining learning objectives and content based on three core principles of human research ethics: respect for persons, beneficence and non-maleficence, and justice. It also includes instruction on relevant laws and regulations related to human research ethics, key research characteristics, and the process of obtaining informed consent prior to data collection. Additionally, the guideline covers teaching methods, as well as evaluation and approval criteria. This learning approach aims to enhance students’ understanding and ultimately facilitate the process of applying for ethical approval from an institutional Ethics Committee.