Ruchakron Kongmant

Background/Objectives: Depressive symptoms, malnutrition and falls are common geriatric syndromes with shared risk factors, yet they are usually studied separately. We aimed to identify latent subgroups defined by their co-occurrence among older adults in Northeast Thailand and the factors associated with membership. Methods: In this cross-sectional survey (October–December 2025), 12,115 community-dwelling adults aged ≥60 years in 39 subdistricts of Maha Sarakham Province were interviewed. Latent class indicators were the Thai 9-item depression scale, Mini Nutritional Assessment Short-Form, calf circumference, recent falls and gait impairment. Associated factors and concurrent correlates were estimated with bias-adjusted three-step models and cluster-robust standard errors. Results: Depressive symptoms affected 8.4%, malnutrition risk 24.5% and fall risk 17.0%; all three co-occurred in 2.2%, 6.2 times more often than expected under independence, mainly reflecting pairwise associations. Three classes emerged: robust (77.3%), nutritional risk (16.2%) and complex multidomain (6.5%). The complex multidomain class featured gait impairment (78.2%) and malnutrition risk (70.2%), with elevated depressive symptoms (40.9%) and recent falls (26.8%). Membership was associated with age ≥80 years (adjusted odds ratio 4.39, 95% CI 2.68–7.18), not working (4.23, 2.59–6.90), high household debt (2.45, 1.29–4.65), ≥2 chronic conditions (3.54, 2.23–5.64), polypharmacy (2.45, 1.73–3.47) and per additional home hazard (1.44, 1.29–1.61). Members more often rated their health as worse than peers (38.6% vs. 1.8% in the robust class). Conclusions: An estimated 6.5% of older adults (5.0–8.5% across closely agreeing specifications) formed a subgroup characterised by mobility impairment, malnutrition risk and socioeconomic disadvantage. Interpreting existing screening results jointly may help target integrated primary care, social welfare and home-modification support; prospective evaluation is needed.

Microplastic contamination has become a major environmental health concern because of its widespread occurrence and potential risks to human health. Although environmental health literacy (EHL) is recognized as an important determinant of health-related decision-making, evidence regarding its influence on behaviors that reduce potential microplastic exposure remains limited, particularly in riverine communities of developing countries. This study assessed EHL, environmental health behaviors associated with potential microplastic exposure, and factors associated with these behaviors among urban residents living along the Mekong River in Thailand. A community-based cross-sectional study was conducted among 420 adults in Mueang Nakhon Phanom District, Thailand, between October and December 2024 using multistage random sampling. Face-to-face interviews were performed using a content-validated questionnaire assessing six EHL domains and environmental health behaviors related to microplastic exposure. Multivariable logistic regression was used to examine factors associated with poor environmental health behaviors. Overall, 41.7% of participants demonstrated good environmental health behaviors, whereas 58.3% exhibited poor behaviors. Participants had a moderate level of EHL (mean score, 2.30 ± 0.46), with decision-making representing the weakest domain. Insufficient EHL was strongly associated with poor environmental health behaviors (AOR = 8.06, 95% CI: 2.86–10.04; p < 0.001). Additional factors associated with poor environmental health behaviors included consumption of untreated river or other water sources, no physician visit during the previous month, age older than 60 years, and obtaining aquatic foods through self-capture, whereas trade occupation was associated with lower odds of poor behaviors. These findings support community-based EHL programs led by local authorities and public health practitioners that strengthen critical appraisal and decision-making skills, provide accessible and evidence-based information on microplastic risks, and promote practical actions such as reducing single-use plastics and improving household waste management.

Background: Informal sewing workers are widely exposed to ergonomic and workload-related risks but remain largely excluded from formal occupational health protection, particularly in low- and middle-income countries. This study evaluated integrated physical and mental workload risks associated with WMSDs among informal sewing workers to develop contextually feasible preventive guidelines based on the Hierarchy of Ergonomic Control. Methods: A mixed-methods study was conducted among 150 informal sewing workers in Ubon Ratchathani Province, Thailand. Quantitative data were collected using a structured questionnaire, the Rapid Upper Limb Assessment (RULA), the Nordic Musculoskeletal Questionnaire (NMQ), and the NASA Task Load Index (NASA-TLX). Associations between sociodemographic characteristics, ergonomic risks, and WMSDs were analyzed using chi-square tests and correlation analysis. Qualitative data were obtained through a focus group discussion with key stakeholders to develop ergonomic control strategies guided by the HEC framework. Results: The majority of participants were female and middle-aged, with widespread exposure to high-risk ergonomic conditions, including prolonged sitting, repetitive tasks, and awkward postures. A high prevalence of WMSDs was observed, particularly in the neck, shoulders, and back. Younger workers and those with lower educational attainment experienced significantly higher ergonomic risk exposure and WMSD prevalence. NASA-TLX results indicated that physical demand and performance pressure were the main contributors to overall workload. Application of the HEC framework showed that elimination and substitution controls were the most effective strategies for reducing ergonomic risks, followed by engineering controls, while administrative measures and personal protective equipment were less effective. Conclusions: Informal sewing workers face substantial ergonomic and mental workload risks that contribute to a high burden of WMSDs. Prioritizing higher-order ergonomic controls, integrating workload management, and implementing community-based ergonomic interventions are essential to improving occupational health and reducing inequities among informal workers.

Background: Microplastic contamination in freshwater systems poses increasing environmental and public health risks, particularly for riverine communities. Health literacy may critically influence individuals’ capacity to recognize exposure pathways and adopt preventive behaviors. Objective: This study assessed health literacy and preventive behaviors related to microplastic contamination and examined factors associated with poor health literacy and preventive practices among communities in northeastern Thailand. Methods: A cross-sectional survey was conducted among 942 adults residing along the Mekong, Chi, and Mun River basins. Health literacy and preventive behaviors were assessed using a structured questionnaire. Multivariable logistic regression was performed to identify associated factors, whilst adjusted odds ratios (aOR) with 95% confidence intervals (CI) and statistical significance set at p < 0.05. Results: Nearly half of the participants exhibited insufficient health literacy, with decision-making identified as the weakest domain. While approximately half reported good preventive behaviors, insufficient health literacy was the strongest determinant of poor preventive practices (aOR=9.18; 95%CI: 6.62–12.72). Residents of rural (aOR=6.47; 95%CI: 4.47–9.37) and semi-urban (aOR=2.45; 95%CI: 1.76–3.41) communities and younger age groups were significantly more likely to have poor health literacy. Community type (semi-urban: aOR=2.61; 95%CI: 1.81–3.78) and longer duration of residence (>60 years: aOR=2.36; 95%CI: 1.37–4.06) were also significantly associated with preventive behaviors. Conclusion: Health literacy is a critical determinant of microplastic-related preventive behaviors. Interventions targeting higher-order literacy skills, particularly decision-making, should be integrated into environmental health and public health strategies to reduce microplastic exposure and promote sustainable preventive practices in riverine communities .

Background: Informal sewing workers are widely exposed to ergonomic and work-load-related risks but remain largely excluded from formal occupational health protection, particularly in low- and middle-income countries. This study aimed to assess ergonomic risk factors, mental workload, and work-related musculoskeletal disorders (WMSDs) among informal sewing workers and to develop preventive guidelines based on the Hier-archy of Ergonomic Controls (HEC). Methods: A mixed-methods study was conducted among 150 informal sewing workers in Ubon Ratchathani Province, Thailand. Quantita-tive data were collected using a structured questionnaire, the Rapid Upper Limb Assess-ment (RULA), the Nordic Musculoskeletal Questionnaire (NMQ), and the NASA Task Load Index (NASA-TLX). Associations between sociodemographic characteristics, ergo-nomic risks, and WMSDs were analyzed using chi-square tests and correlation analysis. Qualitative data were obtained through a focus group discussion with key stakeholders to develop ergonomic control strategies guided by the HEC framework. Results: The majority of participants were female and middle-aged, with widespread exposure to high-risk er-gonomic conditions, including prolonged sitting, repetitive tasks, and awkward postures. A high prevalence of WMSDs was observed, particularly in the neck, shoulders, and back. Younger workers and those with lower educational attainment experienced significantly higher ergonomic risk exposure and WMSD prevalence. NASA-TLX results indicated that physical demand and performance pressure were the main contributors to overall work-load. Application of the HEC framework showed that elimination and substitution con-trols were the most effective strategies for reducing ergonomic risks, followed by engi-neering controls, while administrative measures and personal protective equipment were less effective. Conclusions: Informal sewing workers face substantial ergonomic and mental workload risks that contribute to a high burden of WMSDs. Prioritizing high-er-order ergonomic controls, integrating workload management, and implementing community-based ergonomic interventions are essential to improving occupational health and reducing inequities among informal workers.

Background: Type 2 diabetes mellitus (T2DM) is a major public health problem in Thailand, particularly in rural areas where individuals have limited access to structured diabetes care and education. Poor self-management contributes to uncontrolled glycemic levels and long-term complications. Objectives: This study evaluated the effectiveness of a community-based health care program on glycemic control and self-care behaviors among adults with uncontrolled T2DM. Methods: A quasi-experimental study was conducted among 80 patients with uncontrolled T2DM in Kalasin Province. Participants were assigned to either an intervention group (n = 40) or a comparison group (n = 40). The 12-week intervention consisted of diabetes self-management education, individualized lifestyle support, and community/family engagement. Diabetes self-care behavior and glycated hemoglobin (HbA1c) were assessed at baseline and Week 12. Statistical analyses included paired t-test, independent t-test, and 95% confidence intervals. Results: The intervention group demonstrated a significant improvement in self-care behavior (MD = 14.83; p < 0.0001), compared with a minimal change in the comparison group (0.80; p = 0.756). HbA1c levels significantly decreased in the intervention group (−0.47%; 95% CI: −0.61 to −0.33; p < 0.0001), while a slight nonsignificant increase was observed in the comparison group (0.11%; p = 0.210). The between-group analysis showed a significant reduction in HbA1c favoring the intervention (−0.92%; p < 0.0001), supported by a large effect size (Hedges’ g = 0.87). Conclusions: This community-based health care program effectively enhanced diabetes self-management behaviors and improved glycemic control. Integrating such behavioral support into primary health care services may strengthen long-term diabetes management and reduce complications among patients with uncontrolled T2DM.

The rise in infectious waste during the COVID-19 pandemic exposed critical challenges in Thailand’s waste management systems, particularly within sub-district public health facilities. This study aimed to develop and implement an infectious waste management database system for 14 Sub-District Health Promoting Hospitals (HPHs) in Kantharawichai District, Maha Sarakham Province. Using a Research and Development (R&D) model and the knowledge-attitudes-practices (KAP) model to understand behaviors. The development phase engaged 145 community caregivers, of whom 95.17% were female and 74.48% aged between 30–59 years. Results showed that 56.55% of participants had a high knowledge of infectious waste management, while 42.76% expressed a high level of positive attitudes. In terms of behavior, 37.93% demonstrated high compliance with appropriate waste handling practices. Data derived from KAP, and interviews were used as the main inputs to develop the database system. The system included real-time dashboards, GPS-tagged data inputs, automated alerts, and data visualization tools using Microsoft Excel and Power BI. This research offers a scalable digital solution for enhancing infectious waste management, particularly in resource-limited community health settings.

Thailand’s aging population poses challenges for rural caregivers with limited access to healthcare support. This study aimed to develop and evaluate CG Care, a mobile application designed to enhance caregiving for dependent individuals in Samut Songkhram Province. Methods: A Research and Development (R&D) design using the ADDIE model was employed. The study involved 214 caregivers, with 30 participating in a pre-test/post-test pilot to assess knowledge gains. Quantitative and qualitative data were collected through structured questionnaires. Results: The application featured modules for patient records, home visits, health resources, and emergency contact. Post-intervention results showed a significant increase in knowledge scores (Mean difference = 3.80, p < .001). The Technology Acceptance Model evaluation confirmed the app’s usefulness, ease of use, and user intention to adopt it. Conclusion: CG Care demonstrates strong potential to support rural caregivers by improving knowledge, reducing isolation, and enhancing care quality. Broader adoption may improve community health outcomes in aging populations.

This study evaluates the application of virtual reality (VR) technology in disaster prevention and mitigation education at the Sichuan Provincial Disaster Prevention and Mitigation Education Center. We conducted a comparative analysis between two groups: one using traditional emergency training methods (control group) and the other using VR-based training (experimental group). Data from 472 participants revealed that the experimental group, which experienced VR-based training, reported greater satisfaction and perceived the training as more immersive and effective compared to the control group. Additionally, the experimental group demonstrated shorter learning times and higher willingness to adopt VR in the future. This study highlights the potential of VR technology to improve emergency preparedness training and offers insights into the benefits and challenges of its implementation in disaster education.