Thailand Journal of Health Promotion and Environmental Health

Evaluation of Oral Health Promotion Services in Primary Care After devolution of Duties to the Provincial Administrative Organization

Nutcha Premprayoon — 2025-09-26

This mixed-methods research aimed to evaluate dental service delivery in primary care following the devolution of duties to Provincial Administrative Organizations (PAO) in terms of oral health promotion service provision, management and mechanism of service driving. Quantitative data were collected from 370 Health Promotion Hospitals after the devolution of duties to PAO (Subdistrict Health Promoting Hospital, Chaloem Phrakiat 60 th Anniversary Nawaminthrachini Health Station). Qualitative data were gathered through in-depth interviews and focus group discussions with executives and operational staff from eight provinces across four regions. Results indicated that after decentralization, basic dental service provision decreased by 6.5%. Support for dental equipment/instruments and materials also decreased by 24.1% and 20.6%, respectively. Data submission to the Health Data Center (HDC) system declined by 7.0%. Oral health examination service provisions for various age groups (pregnant women, preschoolers, schoolchildren and working-age adults) decreased by 5.4, 2.7, 3.0 and 4.1 respectively, A statistically significant relationship was observed between oral health examinations across all age groups before and after decentralization (p-value <0.05). Qualitative findings revealed increased flexibility in budget management and staff recruitment for primary care units. However, support from referral hospitals for dental personnel, budget, and medical supplies became more limited. Crucially, clear operational direction, strong cooperation, and positive relationships between primary care units and referral hospitals were continuous operations. Key facilitating mechanisms included MOU between PAOs and Provincial Public Health Offices, effective inter-agency coordinators, and ongoing support from referral hospitals, all contributing to successful primary oral health promotion and prevention services

The Study of Quality and Satisfaction with The Service Delivery of Well Child Clinic According to Maternal and Child Health Standards, Health Region 6

Wasurut Ployluan — 2025-09-26

This descriptive research aimed to evaluate the service delivery, recipient satisfaction, and operational challenges of well child clinics in one province within a Thai 6 th health region, following national maternal and child health standards. Using random sampling, seven hospitals were selected: one general/regional hospital, two community hospitals, and four sub-district health promotion hospitals. Data were collected from 21 service providers and 70 service recipients. Through questionnaires and in-depth interviews. Results showed that while over 80% of providers adhered to standard practices, gaps remained in facility readiness and service completeness particularly in areas such as physical exam rooms, growth monitoring tools, and services like vision, hearing, and blood pressure checks. For children under two, common omissions included blood tests and iron supplementation; for those aged 3-5, vision testing, emotional development assessment, and blood pressure checks were frequently missed. Overall recipient satisfaction was high (average score 4.42), with cost rated most positively and wait times and child-friendly health promotion areas notes as key concerns. The study recommends aligning clinic operations with national guidelines, improving infrastructure, staffing, and ongoing staff training to enhance service quality

Evaluation of the implementation of health promotion for working-age in the central agencies under the Department of Health

Kotthananat Pothima — 2025-09-26

This study aimed to evaluate the implementation of workplace health promotion programs for working-age personnel within the central departments of the Department of Health. A total of 59 participants were selected, comprising 50 Department of Health staff and 9 executives. The evaluation was conducted using the CIPP Model, which includes four components: Context, Input, Process, and Product. 1) Context: The health promotion activities aligned with national health policies and the specific needs of the organization. This alignment contributed to a clearer understanding of the program objectives and enabled the design of activities that were appropriate to the organizational context. However, enhancing the appeal and continuity of the activities was identified as essential for maintaining engagement. 2) Input: Information and equipment support played a vital role in initiating behavior change for better self-care practices. Nonetheless, insufficient budget allocation emerged as a potential barrier to the implementation and sustainability of the activities. 3) Process: Participatory planning and implementation were key success factors. Involving personnel in the planning process positively influenced the program structure and enabled effective monitoring of health behaviors and conditions. This participatory approach also fostered motivation among staff to engage with the activities. 4) Product: Improvements in health indicators—such as reductions in weight, waist circumference, body mass index (BMI), and blood pressure—were observed. These positive trends were attributed to nutrition and physical activity initiatives conducted by each department. However, further refinement of the activities is needed to increase participant satisfaction, which is crucial for long-term program continuity. Recommendations: The organization should enhance supportive environments for health promotion, strengthen interdepartmental collaboration, allocate appropriate budgets and materials, and improve supervision and evaluation mechanisms. These efforts will contribute to the sustainability of health promotion initiatives through effective resource development and future readiness.

A Model Development of Maternal and Child Health Handbooks to Promote Health Literacy among Pregnant Women and Early Childhood Caregivers in Thailand

Surat Piwsawang — 2025-09-26

This action research aimed to develop a maternal and child health handbook to promote health literacy among pregnant women and early childhood caregivers in Thailand. The study was divided into three phases: 1) investigating the problems and needs of users and public health personnel through questionnaires and in-depth interviews; 2) planning the development of the handbook's content and format through a participatory process involving multidisciplinary professionals; and 3) piloting the new handbook prototype in four regions and evaluating its impact on knowledge, attitudes, health behaviors, and satisfaction. The results showed that the redesigned handbook, utilizing the LEAN concept and categorizing content according to the 4P principles for pregnant women (Plan for pregnancy, antenatal care, delivery, and postpartum) and 4D principles for early childhood (Disease prevention, Diet, Development, and Dental health), featured clear categorization and ease of use. Knowledge content was enhanced via QR codes to reduce page count and allow for flexible, up-to-date information adjustments. Participants in both the pregnant women and early childhood caregiver groups demonstrated a statistically significant increase in health literacy, as measured by pre- and post-intervention assessments using a one-group pretest-posttest design (t-statistic = 2.17 and 3.97, p-value = 0.043 and 0.0008, respectively). User satisfaction in each group was very high, ranging from 90% to 100%. Recommendations include expanding the use of this new handbook nationwide and developing a digital version to accommodate modern user behaviors and enhance long-term accessibility

Predictive Factors for Obesity Preventive Behaviors Among Risk Working-Age in Metropolitan Area

Kotchanan Nakarat — 2025-09-26

This predictive correlational descriptive research aimed to examine the relationships among predisposing, enabling, and reinforcing factors, as well as to identify predictors of obesity prevention behaviors among at-risk working-age individuals in Bangkok. The study was based on the PRECEDE-PROCEED Model. The sample consisted of 323 working-age individuals in Bangkok, aged 20–30 years, with a body mass index (BMI) between 23 and 24.9 kg/m². Participants were selected through stratified random sampling and completed self-administered questionnaires. Data were analyzed using descriptive statistics, chi-square tests, relative risk, and binary logistic regression. Statistical significance was set at p < .05. The study found that the factors positively associated with obesity prevention behaviors (p-value < .05) included gender, age, monthly net income, nature of work, perceived barriers to obesity prevention, food purchasing costs, and appraisal support. Predictive factors for obesity prevention behaviors among at-risk working-age individuals in metropolitan area were identified as being female, having a desk-based nature of work, having a high level of perceived barriers to obesity prevention, having low food expenditure, and low levels of appraisal support. These factors collectively accounted for 24.7% of the variance in obesity prevention behaviors (R² = .247). This study offers recommendations for supporting policy development and provides foundational data to relevant agencies. It also informs the organization of targeted activities among at-risk working-age individuals in metropolitan areas to effectively prevent obesity in ways that are contextually appropriate and aligned with their actual needs. The findings provide valuable insights into policy and program development tailored to at-risk working populations in Metropolitan.

Situation of toothbrushes in the Thai market (2014-2025)

Siriwan Pitayarangsarit — 2025-09-26

This study aimed to compare toothbrush characteristics from surveys conducted in 2014 and 2019 and to identify factors associated with the quality of toothbrushes in the Thai market in 2019, as well as to study the market sales continuity between 2019 and 2025. By using cross-sectional analytical study, the first part used data on toothbrush characteristics, which was secondary data from toothbrush quality surveillance surveys conducted in 2014 and 2019 from databased of the Dental Health Bureau, Department of Health. The second part consists of interview data with toothbrush sellers from 10 stores and data on toothbrushes sold in 2025 in stores or online, along with data displayed on websites from e-Marketplace platforms during the study period of 2025. The study found that the number of brush models sold increased from 270 and 293 in 2014 and 2019 to 557 in 2025. The proportion of toothbrushes that did not pass quality standards in 2019 was higher than in 2014. The factors “imported from abroad” together with “price not exceeding 20 baht” had a statistically significant negative effect on the quality of toothbrushes. Toothbrushes with the two factors had a risk of failing the quality criteria 8.7 times higher than toothbrushes priced higher than 20 baht and produced domestically. The most common failures were due to defective bristle tips, which were more commonly found in tapered tips than rounded tips, followed by tuft retention failures. Toothbrush which model name still listed on the market until 2025 is 2.6 times more likely to pass the quality criteria than an outdated toothbrush. The store used the criteria for selecting products to sell based on customer demand, first considering past sales, along with the frequency of advertising in the media/sales promotion, and the reliable brand/manufacturer. Therefore, the results of toothbrush quality testing and methods for checking the condition of the bristles should be communicated to consumers, both the public and organizations with toothbrush purchasing projects, to use as guidelines for purchasing products.

Age-Friendly City Model, Nakhon Sawan Province

Pornthip Anutarapong — 2025-09-26

This research on the age-friendly city model in Nakhon Sawan Province aims to study the development model of age-friendly cities based on the World Health Organization's framework in local administrative organizations that can manage age-friendly cities in a consistent manner and conducive to a good quality of life for older adults in Nakhon Sawan Province. The research employs a quantitative research method combined with qualitative research, with the objectives of conducting a cross-sectional survey and community participatory action research (PAR). Questionnaires were used as tools to collect data for evaluating age-friendly cities based on WHO's 8 components in 142 local administrative organizations. Subsequently, 14 areas were selected to participate in the development of age-friendly cities. The research was conducted from February 2024 to February 2025, divided into 3 phases: Phase 1: Study the context of the area, assess the situation of the area, and collaboratively analyze the situation against the standard criteria of WHO's 8 components to identify issues that need development. Phase 2: Select 14 areas that need development and are ready to participate. Organize focus group discussions with 10 stakeholders in the selected areas. Phase 3: Evaluate the results after development using the age-friendly city assessment tool based on WHO's 8 components and monitor the quality of life using the WHOQOL–BREF–THAI quality of life assessment tool's 4 domains. The statistics used were frequency, percentage, mean, standard deviation, and Paired t-test. The research findings indicate that local administrative organizations in Nakhon Sawan Province perceive age-friendly cities, across all 8 components, as mostly excellent, followed by good. When considering each component, the component with the highest mean was community services and health services, followed by buildings, outdoor spaces, and respect and social inclusion. The selection of areas for participatory development and the comparison of age-friendly city assessment results showed improvement in all areas: 2 areas improved from fair to very good, 10 areas improved from fair to good, and 2 areas improved from developing to good. In terms of comparing and analyzing the quality of life assessment results for older adults before and after the development of age-friendly cities, it was found that the quality of life of older adults in all 4 domains before and after the development of age-friendly cities differed significantly at the 0.05 level. This indicates that the development of age-friendly cities requires local administrative organizations, government, private sector, and community networks to promote an environment conducive to a good quality of life for older adults in the community

Assessing the Cost-Effectiveness of Environmental Health and Safety Management in Tourist Attractions

Chamaiporn Pensuk — 2025-09-26

The evaluation of the cost-effectiveness of environmental health and health safety management in tourist attractions has the objective of studying the cost-effectiveness of managing environmental health and health safety within tourist attractions and developing policy recommendations for promoting sustainable health and environmentally friendly tourism. The study was conducted using qualitative data from 13 tourist attractions which received the first-place GREEN Health Attraction award, through In-depth interviews with key personnel directly involved in implementing health and environmental initiatives at the attractions. An assessment tool for evaluating the cost-effectiveness of environmental health and health safety management in tourist attractions was applied, and data were analyzed using Social Return on Investment (SROI). The results of the analysis revealed that the SROI values ranged between 1.01 and 3.95, with every tourist attraction showing an SROI value greater than 1. This reflects the cost-effectiveness of investing in environmental health and health safety management, as one baht of investment can generate more than one baht in social return. Moreover, investments in environmental health management, such as maintaining public restrooms, managing solid waste, providing safe drinking and utility water, and ensuring safety in tourist areas were found to be cost-effective in both economic and social terms. These also enhanced tourist satisfaction and created a positive long-term image of tourist attractions. This study provides policy recommendations for the development and upgrading of environmental health and health safety management in tourist attractions, as well as for promoting tourist satisfaction through such management. Government agencies should push forward environmental health and health safety management in tourist attractions as a key standard for developing sustainable tourism that is both health-friendly and environmentally friendly in Thailand’s tourism industry.