Acculturation and Its Effects on Health Risk Behaviors among Myanmar Migrant Workers: A Cross-Sectional Survey in Chiang Mai, Northern Thailand

Translation and validation of the East Asian Acculturation Measure (EAAM) among Myanmar migrants in Thailand

Background

Acculturation provides a framework for exploring the health behaviors of ethnic minority or cultural groups. Research on the acculturation level and patterns of Myanmar migrants is crucial since there is ample evidence that acculturation promotes health-promoting behaviors. However, no Myanmar version has undergone cross-cultural validation.

Objective

This study aimed to translate the original East Asian Acculturation Measure (EAAM) into the Myanmar version (EAAM-M) and investigate its psychometric properties.

Methods

The validation study was conducted on a sample of 200 Myanmar migrants in three factories in Bangkok, Thailand, by a multistage random sampling method from August to September 2023. Brislin's back translation technique was applied to convert the original EAAM into its modified version, EAAM-M. The reliability, content validity, and construct validity of the EAAM-M were examined, and confirmatory factor analysis (CFA) was employed to test the appropriateness of the model that underpins the EAAM-M structure.

Results

The average age of the participants was 38.39 years (SD = 5.56), and 68% of participants reported they earned less than 9000 baht. In terms of how long they stayed in Thailand, slightly over half (52.5%) did so for 1-5 years. Nearly half of them (46%) cannot communicate at all regarding their proficiency in speaking Thai. The score regarding the comparability of language and similarity of interpretability between the original EAAM and the EAAM-M was satisfactory. The overall alpha reliability of the EAAM-M was 0.76. Based on the CFA, the measurement model was well fit, with acceptable goodness-of-fit values (Chi-square test of model fit (p = 0.05), CMIN/df = 1.70 (χ2 = 624.931, df = 366), RMSEA = 0.02, CFI = 0.98, and SRMR = 0.06). The validity and reliability of the factors were affirmed through appropriate factor loadings and satisfactory levels of composite reliability (0.942) and average variance extracted (0.538).

Conclusion

The EAAM-M is a reliable and valid instrument to measure the acculturation patterns of Myanmar migrants. It is beneficial for scholars across various disciplines, including health professionals and nurses, to deliver culturally tailored care for migrants.

Prevalence and social determinants of depression: A cross-sectional survey of Myanmar migrant workers in Chiang Mai, Northern Thailand

BACKGROUND

Depression is a common mental disorder and the sixth leading cause of disability in Thailand. Chiang Mai has historically been a city of attraction for labour migration for Shan migrants from the adjacent Southern Shan State of Myanmar. Currently, only infectious diseases are screened during the pre-employment period. Prevention and early detection of noncommunicable diseases can improve a healthy workforce and reduce the healthcare burden on the host country. Therefore, we aimed to determine the prevalence of depression and associated factors.

METHODS

A cross-sectional survey was done among Myanmar migrant adults legally working in Chiang Mai, Thailand.

RESULTS

The final analysis included 360 participants and the prevalence of depression was 14.4%. Being female, duration of stay in Thailand of more than 10 years, co-residence with co-workers, and marginalisation pattern of acculturation were significant associated factors affecting depression in a multivariate regression analysis model.

CONCLUSION

Although the culture and dialect were not different between the host and country of origin, Myanmar migrant workers of Shan ethnicity suffered from depression. Our findings highlighted the importance of social determinants beyond common predictors of depression among migrants and the need for public health measures to promote migrants' integration into the host culture.

Do Electronic Health Literacy and Online Health Information-Seeking Behavior Mediate the Effects of Socio-Demographic Factors on COVID-19- and Non-communicable Disease-Related Behaviors Among Myanmar Migrants in Southern Thailand?

Introduction Myanmar migrants in Thailand are vulnerable to COVID-19 and non-communicable disease (NCD) risk behaviors, influenced by socio-demographic factors. In the digital age, migrants can seek extensive health information online, and their ability to understand and use electronic health information, which is known as electronic health literacy (e-Health literacy), becomes critical in making decisions about their health behaviors. This study aims to investigate the potential mediating roles of online health information-seeking and e-Health literacy in the associations between socio-demographic factors and COVID-19- and NCD-related behaviors. Methods Our study was conducted in 2022, involving 1,050 Myanmar migrants in two southern Thai cities. Data on socio-demographic factors, e-Health literacy, online health information seeking, COVID-19-related behaviors (adherence to COVID-19 protective behavior (CPB), vaccination), and NCD risk behaviors (smoking, betel chewing, alcohol consumption, substance abuse) were collected. Structural equation modeling (SEM) was employed to analyze the hypothesized relationships. Results Nearly all migrants received the COVID-19 vaccination in two doses and above, with reasonable good adherence to CPB. Migrants exhibited risky NCD-related behaviors, including current smoking (26.8%), alcohol consumption (17.5%), and betel chewing (25.8%). Approximately three-quarters (73.4%) had a limited e-Health literacy level, and the vast majority did not search for online health information. Their COVID-19- and NCD-related behaviors were directly influenced by socio-demographic factors without the significant mediation roles of e-Health literacy and online health information seeking. Conclusions Myanmar migrant workers in Southern Thailand had reasonably good practices in COVID-19-related behaviors despite engaging in risky NCD-related behaviors. These outcome behaviors were directly influenced by their socio-demographic factors, without the significant mediation roles of e-Health literacy and online health information seeking. The findings suggest that diverse interventions beyond e-Health strategies for future pandemic mitigation and enhancement of their health behaviors are needed.

Prevalence and Risk Factors for Hypertension among Myanmar Migrant Workers in Thailand

Background: Non-communicable diseases (NCDs) are showing an increasing trend worldwide, and the COVID-19 pandemic may interrupt or delay NCD care, the leading cause of mortality in Thailand, which is hosting 2–3 million migrant workers. The transition of epidemiological risk factors, limited access to health-promoting activities, and pandemic containment measures may adversely impact NCD risks. Therefore, hypertension and associated risk factors were determined among registered Myanmar migrant workers in Thailand. Methods: A cross-sectional survey with structured questionnaires was conducted in Thailand in 2017. Having hypertension was analyzed as a dependent variable, and the associated risk factors were explored by binary logistic regression analysis. Results: A total of 414 participants with a mean age of 29.45 ± 9.03 years were included, and 27.8 percent of the study participants were hypertensive, which was a rate higher than that in their host country (24.7%) and country of origin (26.4%). An older age, being male, current alcohol drinking, and being overweight and obese with reference to the body mass index (BMI) were significantly associated with hypertension. Conclusions: Our findings reaffirmed the idea that NCDs are important public health concerns, and a simple BMI measurement would be a valuable tool with which to determine hypertension risks. Targeted surveillance and an appropriate health policy are necessary for such a vulnerable population in Thailand.

Case Study of Tobacco Use among Myanmar Migrant Factory Workers in the Seafood Industry in Thailand

Migrant workers commonly face many health disparities when they relocate to a foreign work environment. Many workers migrating to Thailand are young unskilled workers from Myanmar. In this study, we examine factors associated with Myanmar migrant workers’ smoking status and characterized smoking-related knowledge, attitudes, and behavior in one seafood factory in Thailand. This descriptive study utilized person-to-person interviews among 300 Myanmar migrants in one seafood factory in Thailand, of which 94.3% were young males between 18 and 39 years of age. Results demonstrated that 90% were current daily smokers, over 90% smoked 30–60 times per month, and 95% spent less than 500 baht (US $16) per month on smoking. About 70% of current smokers had 6–10 friends who smoked, compared with 40% of non-smokers (chi-square, p-value ≤ 0.07). Among this sample of mainly male migrant workers, smoking is very common, in part driven through social contact, but levels of dependence appear relatively low. The results suggest potential intervention approaches to reduce high smoking prevalence among this population, such as targeting young males and addressing their concerns about negative attitudes by peers to tobacco use and the unhealthful exposures of women and children in their families and the larger community.

Adaptation and Validation of a Short Acculturation Scale in a Multi-Ethnic Asian Population

The Short Acculturation Scale (SAS) has been widely used for assessing the level of the acculturation of migrants in Western countries. However, the validity of SAS for use in cosmopolitan settings without a single prevailing culture is unclear. We examined the validity and reliability of a version of the SAS adapted to a multi-ethnic Asian society. We used cross-sectional data from 12,610 Singaporean citizens and permanent residents, aged 21–75 years, of Chinese, Malay, and Indian ethnicity. Our version used 11 items, with 5 questions on language use, 3 on media use, and 3 on ethnic social relations, to measure acculturation. Our version of the SAS had good internal consistency. The three-factor CFA model had a good fit to our data. The results from the multiple group CFA supported metric invariance and partial scalar invariance across the three ethnic groups. The total score was positively correlated with generation in Singapore and the number of languages spoken. Among first generation immigrants, country of origin, but not the duration of residence was significantly associated with the acculturation score. Our three-factor version of the SAS is a reliable and valid tool for measuring acculturation in Singapore residents. These findings indicate that adapted SAS can be used to assess acculturation in multicultural settings.