Safety and health measures compliance during the COVID-19 pandemic for community-based tourism in Nakhon Si Thammarat, Thailand: A cross-sectional descriptive study

Community-based tourism (CBT) in Thailand faces challenges in adapting to COVID-19 prevention measures. The purpose of the study was to evaluate levels of knowledge, practice, and compliance regarding safety and health measures of the entrepreneur in managing CBT under the Safety and Health Administration (SHA) standard in the new normal situation. A descriptive cross-sectional study was conducted on twenty-one entrepreneurs from three CBTs in three districts in Nakhon Si Thammarat, in the months of February-May 2021. Levels of knowledge and practice were evaluated by questionnaires and compliance level was evaluated by SHA standard checklist. The level of knowledge and practice were categorized sufficient and insufficient, while compliance level was categorized as high or low if scores met or exceeded 80%, based on Bloom's cut-off point. Information on sociodemographic characteristics was also gathered. Fisher's exact test with a 95% confidence level (α < 0.05) was used for statistical analysis. The findings revealed that 66.7% and 38.1% of the establishments in the study had sufficient knowledge (Mean ± SD: 46.9 ± 7.2, Max: 55.0, Min: 33.0) and sufficient practice (Mean ± SD: 40.4 ± 9.2, Max: 55.0, Min: 29.0), respectively. In addition, the study found that knowledge level was significantly associated with practice level at a p-value of 0.018. However, compliance level was not related to knowledge and practice. In conclusion, the low level of compliance was due to a lack of understanding and motivation to comply with the standard, and the budget of small establishments in CBT for bringing them up to the SHA standard was quite limited. Therefore, the related organizations should use a variety of strategies to encourage entrepreneurs, such as partnership building and resource support.

Breast Cancer and Screening Prevention Programmes: Perceptions of Women in a Multicultural Community in Southern Thailand

BACKGROUND

Breast cancer is a leading cause of morbidity and mortality among women worldwide and in Thailand.

OBJECTIVE

To explore perceptions of breast cancer and screening prevention programmes among a group of at-risk women in a multicultural setting in southern Thailand.

METHODS

Semi-structured in-depth interviews were used for data collection with 30 at-risk group women. Women from Muslim and Buddhist backgrounds were purposively included in this study. The thematic analysis method was used to analyse the data.

RESULTS

Four themes were identified from our data: perceptions of breast cancer, being diagnosed with breast cancer and anxiety, stigma: effects of breast cancer, and breast self-screening and prevention of breast cancer. The participants had some knowledge about the risk factors for breast cancer. However, participants perceived that breast cancer could occur to individual women at any time and that it was not possible to entirely prevent the disease, even when following a breast self-examination programme. However, most participants perceived that whether one would be afflicted by breast cancer depended also on Allah and their own karma. All participants were encouraged to attend breast self-screening training by healthcare providers of local health centres, but they had no confidence to perform self-screening soon after finishing the training programme. This became the reason for a lack of regular self-screening with responsibility left to health practitioners. Although participants were aware that breast self-screening should be their routine practice, there were multiple barriers to this, including accurate knowledge about breast cancer, belief, self-awareness, screening skills and healthcare facilities. Breast self-screening was recognised as an important means of early detection. However, most women did not perform this regularly, which could increase their risk of developing breast cancer.

CONCLUSIONS

Public health providers need to be more concerned about the perceptions, beliefs and practices regarding breast cancer and develop prevention practices that work better for women living in more diverse cultural locations so that they may be able to follow preventive practices and reduce their vulnerability to breast cancer.

Correctional Officers' Health Literacy and Practices for Pulmonary Tuberculosis Prevention in Prison

Tuberculosis (TB) prevention in prisons remains a problem that requires advocacy and partnership action. A correctional officer (CO) is responsible for enforcing the rules and maintaining routines at a prison and has the authority to support TB prevention under the limitations of health manpower in prisons. The objective of this cross-sectional study was to determine the health literacy (HL) and practices of TB prevention and their association among Thailand's COs. A total of 208 COs participated using a random sampling method. A self-administered questionnaire on HL and TB prevention practices was used for data collection. Descriptive statistics, Pearson's chi-square test, and binary logistic regression were used for the association analysis. The majority of the participants were male (71.2%), married (60.1%), had a bachelor's degree (60.6%), and had never been trained in TB prevention (90.9%). In total, 63.0% had adequate HL, whereas 78.4% had good practices, and this corresponded with personal prevention (75.5%) and work prevention (74.6%). Significant associations were identified for education, and communication, decision-making, and self-management skills (p < 0.05). The probability (adjusted odds ratio [95% CI]) of good practices was higher among participants with adequate communication skills (7.92 [2.15-29.24]), adequate decision-making skills (6.00 [1.86-19.36]), bachelors' degree or higher-level education (3.25 [1.12-9.39]), and adequate self-management skills (2.95 [1.08-8.11]). The study findings show that most of the COs have adequate HL which is associated with good practices in TB prevention. Prisons should support HL development among COs for partnership and sustainable TB prevention under the constraint of health personnel.

Exploring Readiness towards Effective Implementation of Safety and Health Measures for COVID-19 Prevention in Nakhon-Si-Thammarat Community-Based Tourism of Southern Thailand

Thailand's community-based tourism (CBT) faces a challenging adaptation in response to COVID-19 prevention. This study aimed to assess the readiness for effective implementation of the Safety and Health Administration (SHA) for COVID-19 prevention in the tourism community. A qualitative approach was adopted for this study. Three communities covering all types of CBT in Nakhon-Si-Thammarat province, southern Thailand were purposively chosen. Fifteen key informants were invited to participate in the study. Semi-structured in-depth interviews were conducted, and the data were analysed using the thematic analysis method. The readiness stage was assigned by consensual comprehensive scores. The overall readiness of CBT is pre-planning stage, a clear recognition of the SHA benefit, and there are sufficient resources for implementation. At this stage, there is no planning because the business owners feel that they have inadequate knowledge about the SHA protocol. Another main barrier is having limited accessibility for SHA information which mainly provides through with technology platform. The CBT owner needs to improve public health-based knowledge, technology and cooperation skills to operate SHA efficiently. However, in order to embed SHA to the CBT, tourism and public health organisation should provide suitable methods at the initiation stage by considering the community readiness and need.

Work ability of Thai older Workers in Southern Thailand: a comparison of formal and informal sectors

BACKGROUND

Thai society is becoming an ageing society. Independent older persons need to be able to continue to work after retirement. The Work Ability Index (WAI) is an assessment tool for improving the health and work environment of the older workers. The objective of this study is to explore work ability and its related factors among older workers in formal and informal sectors in southern Thailand.

METHODS

This cross-sectional study with multistage sampling focused on 324 Thai older workers, aged between 45 and 70 years, working in Nakhon Si Thammarat province. Data on sociodemographic status, health history, and work-related factor questionnaires were collected, including anthropometric measures and the WAI instrument between March and September 2019. Descriptive and logistic regression analyses were used to examine associations.

RESULTS

The participants were predominantly general labourers (23.8%) and female (70.7%). Nearly half of them had noncommunicable chronic diseases (NCDs) (48.2%) and were obese (more than 60%). Approximately 60% (59.9%) engaged in safe working practices. The participants sometimes received occupational health services (51.9%) and frequently accessed health promotion services (78.1%). There was a significant difference in the total average WAI score of the formal and informal workers: 40.6 (S.D. = 4.6) and 37.5 (S.D. = 5.0), respectively. The multivariate analysis showed that workers aged 55 years and older (adj. OR = 1.45; 95% CI [1.21, 1.74]), those with NCDs (adj. OR = 2.85; 95% CI [1.69, 4.80]), and those who were exposed to unsafe working practices (adj. OR = 2.11; 95% CI [1.26, 3.55]) had a higher risk of a poor to moderate WAI.

CONCLUSIONS

Most of the older workers had good to excellent work ability. Older age and the presence of NCDs were negatively associated with good to excellent work ability. Safe working practices improved older workers' work ability. Integrated occupational health protections and health promotion programmes for older informal workers should be provided by community health services to improve work ability.

Health Status and Occupational Health and Safety Access among Informal Workers in the Rural Community, Southern Thailand

Purpose

Thailands’ informal workers are faced with job insecurity and poor working conditions. Good health status can promote lifelong working and increase quality of life. This study analyzed factors associated with the health status of the community informal workers.

Methods

A cross-sectional study was conducted with 390 informal workers aged 15 to 59 years in Thasala district, Nakhon Si Thammarat, southern Thailand. A multi-stage sampling method using proportional to size selection was employed in various types of informal workers. The interviews on self-reported health status, health behaviors, occupational hazards, healthcare utilization, occupational health and safety (OHS) access are reported as descriptive. The multivariate association was explored using the simple logistic regression.

Findings

The results revealed that 80.77% of the participants had good health, 57.44% had healthy behavior, 76.41% had safe work practices, 22.05% had moderate to high exposed of occupational hazards, and 56.41% had the low OHS access. Safe work practices, moderate to high OHS access, low exposed to occupational hazards, and low income were more likely to produce good health status, which yielded the adj. OR 2.57, 1.86, 0.39, and 0.48, respectively.

Conclusions

The community informal workers health status was associated by income, work practices, occupational hazards, and OHS access. To strengthening the informal workers’ health, the OHS program should be managed intensively by the primary care services, especially the OHS risk management.

Profile of hospital charges for chronic conditions by health status and severity level: a case study of 4 provinces in Thailand

The objective of this study is to identify charges for common chronic patients, by health status and severity of illness. Patients having 4 common chronic diseases-diabetics, hypertension, chronic lower respiratory diseases, and chronic renal failure-from 4 provinces were included (between 2002 and 2004). Patients were classified into clinically defined and health plan categories; charges were analyzed according to core health status and severity level of the chronic disease groups. Patients classified as single chronic condition (69.8%) had mean annual charges between 4089 and 7461 baht. Patients with multiple chronic conditions (30.2%) had mean annual charges varying, by health status and severity, from 611 to 16 794 baht, accounting for 40% of the total charges. Distribution of charges varied across health status groups. 1 USD = 35.1 baht The percentages of chronic health expenditures vary according to health status and severity of illness. This analysis can be used to identify patients for various purposes.