Lanna Journal of Health Promotion and Environmental Health

Development of a Driving Model for Phayao Province's TO BE NUMBER ONE Clubs Towards National Excellence

Panupan Paitoon, Sittichai Saisom — Mon, 26 Jan 2026 00:00:00 +0700

Drug problems among youth have intensified. Despite the TO BE NUMBER ONE project's expansion since 2002, Phayao Province continues to face challenges regarding budgeting, integration, continuity, and systematic monitoring. This Research and Development (R&D) study aimed to investigate the current status and needs, develop a driving model for national excellence, and evaluate the developed model. The research was conducted in four phases: situational analysis, best practice study from model provinces, model development, and evaluation. A purposive sample included provincial committees, Chiang Rai executives, experts, and eight pilot clubs. Research instruments—validated by five experts with a Content Validity Index (CVI) and Cronbach’s alpha of 0.89—included in-depth interviews and evaluation forms. Data were analyzed using content analysis and descriptive statistics.

Results indicated that Phayao possessed strengths in policy and networking but lacked resource continuity and systematic quality control. Successful elements from Chiang Rai included executive commitment and a robust mentoring system. The developed "TO BE Escalator: Result-Driven Excellence Model" integrates System Theory, the PDCA cycle, "3 Kor 3 Yor" guidelines, and four core strategies. It comprises five components: driving structure, momentum building, immunity creation, networking, and sustainability, featuring the "TO BE Mentor Network" innovation. The model's appropriateness was rated as excellent = 4.24), with the highest satisfaction level = 4.33). In fiscal year 2025, national-level contest winners increased from three to six clubs, with a 100% success rate among mentored clubs. While successful due to effective mentorship and theoretical integration, gaps remain in community/workplace clubs and regional contest performance.

A Development Model for Local Administrative Organizations in Health Region 10 Toward Becoming Healthy Cities Using the PIRAB Strategy

Supaluk Tanatamsatit, Nisit Inlee, Sutthida Suebsap — Mon, 02 Feb 2026 00:00:00 +0700

Urban expansion is a global phenomenon that drives development while creating social, economic, spatial, and health inequalities. This Participatory Action Research (PAR) aimed to develop a model for strengthening local administrative organizations in Health Region 10 toward becoming healthy cities using the PIRAB strategy—Partnership, Investment, Regulation and Legislation, Advocacy, and Build Capacity—as the core conceptual framework. The study was conducted in Saen Suk Subdistrict Municipality, Warin Chamrap District, Ubon Ratchathani Province. The sample consisted of 328 participants, including local administrators, public health and environmental officers, community leaders, and residents. Research instruments included questionnaires, in‑depth interviews, focus group discussions, and assessments based on the Department of Health’s Healthy City criteria. Data were analyzed using descriptive statistics, paired t‑test at a significance level of 0.05, and content analysis.

The findings revealed that the developed model comprised five key components aligned with the PIRAB strategy: (P) establishing collaborative networks among local government organizations, public health agencies, academic institutions, and civil society; (I) allocating budgets and resources to support health and environmental development initiatives; (R) formulating local policies and regulations to promote and protect community health; (A) enhancing awareness and encouraging behavior change through communication and advocacy campaigns; and (B) strengthening the capacity of personnel and communities through training and knowledge transfer. Evaluation results showed that Saen Suk Subdistrict Municipality achieved a “good” level in the Healthy City assessment (84.21% of the total score), demonstrating notable progress in sustainable environmental management, citizen participation, and quality‑of‑life improvement. The model is recommended for scaling up across Health Region 10 and other areas with similar contexts to promote sustainable and health‑oriented urban development.

Participatory Development of a Behavioral Modification Model for Agrochemical Use: A Case Study of Farmers in Sam Ngao District, Tak Province

Tassanee Rodsang — Mon, 09 Feb 2026 00:00:00 +0700

The continuous use of agrochemicals poses significant risks to farmers’ health, the environment, and agricultural sustainability, in Thailand where pesticide imports have been steadily increasing and
at-risk farmers often lack appropriate protective practices. This research and development study was crucial in addressing these risks and aimed to: (1) investigate the context and issues regarding chemical use among farmers in Sam Ngao District, Tak Province ; (2) develop a participatory behavioral modification model for chemical use; and (3) evaluate the effectiveness of the model by comparing knowledge, attitudes, and practices (KAP), as well as assessing satisfaction before and after implementation. The sample consisted of 50 farmers selected through purposive sampling who used chemicals and had cholinesterase levels in the “at-risk” range. The research was conducted in three phases: (1) data collection via focus group discussions and questionnaires; (2) model development through a participatory process based on the KAP Model; and (3) an 8-week implementation of the model.

The results showed that after implementation of the developed model, the mean knowledge score increased from 0.37 ± 0.08 to 0.93 ± 0.56 (t = −2.45, p = 0.02). The mean attitude score increased from 2.84 ± 0.15 to 3.02 ± 0.32 (t = −3.65, p = 0.001), and the mean behavior score increased from 1.81 ± 0.27 to 2.53 ± 0.46 (t = −2.12, p = 0.04). These findings indicated that the developed model significantly improved chemical use behaviors at the 0.05 level of significance. Additionally, participants reported high satisfaction with the model (mean = 4.45 out of 5.00, SD = 0.52).

In conclusion, this participatory model was effective and could be applied to promote chemical safety among farmers. It also had the potential to be expanded to other areas with similar contexts to support long-term safe and sustainable agriculture.

Factors Affecting the Achievements of Environmental Health Management at Khaochamao Community Hospital Commemorating His Majesty The King’s 80th Birthday Anniversary, Rayong Province

Siriyanan Naksakul, Associate Professor Dr.Theerawut Thammakun — Fri, 30 Jan 2026 00:00:00 +0700

The global public health system is facing increasing challenges from environmental factors that directly affect human health. In response, the Ministry of Public Health has promoted environmental management policies within healthcare facilities. This study aimed to (1) examine personal factors, internal organizational factors, external organizational factors, and the achievements of environmental health management; (2) analyze the influence of personal, internal, and external organizational factors on the achievements of environmental health management; and (3) explore problems, obstacles, and suggestions for improving environmental health management at Khaochamao Community Hospital commemorating His Majesty The King’s 80^th Birthday Anniversary, Rayong Province.

This study was a cross-sectional analytical study. The population consisted of 113 personnel working at Khaochamao Community Hospital commemorating His Majesty the King’s 80^th Birthday Anniversary. This independent study instrument was a questionnaire with a reliability coefficient of 0.98. Data were analyzed using frequency, percentage, mean, standard deviation, and multiple linear regression analysis.

The study revealed the following. (1) Most respondents were female, aged 31–40 years, graduated with a bachelor’s degree, worked as professional staff, had an average working period of 8.61 years, and were government officers. Both internal and external organizational factors were rated at a high level. The overall achievement of environmental health management, assessed according to the Ministry of Public Health’s Environmental Health Development Criteria, was also at a high level. (2) The factors that significantly influenced the achievements of environmental health management at the 0.05 level were staff, shared values, and system, respectively. These factors collectively accounted for 76.9% of the variance in the achievement of environmental health management. Additionally, (3) the main problems and obstacles identified were unclear policies and strategies, a lack of consistent communication and monitoring, and insufficient use of modern technology in environmental management. The study suggests that the hospital should establish clear policies and work systems, ensure effective communication at all levels, and apply innovative and modern technologies to enhance the efficiency of environmental health management.

Development of a Financial Management Model and Access to Healthcare Services for Transnational Population in Thailand-Myanmar Border Areas, Tak Province.

Tassanee Rodsang, Chamnan Pinna, Maneerat Jiokaew — Mon, 02 Feb 2026 00:00:00 +0700

The Tak border area hosts a significant migrant population, posing challenges to the public health system due to geographical, linguistic, cultural, and financial barriers. Despite existing health insurance schemes, gaps remain, leading to substantial financial burdens on local hospitals. This study aimed to: 1) investigate healthcare access among migrants, 2) analyze the budgetary impact on health services, and 3) develop healthcare access and budget management models for border districts in Tak Province. A parallel mixed methods design was employed, encompassing three phases: planning, implementation, and evaluation. Data collection involved in-depth interviews, focus groups, and workshops.

Phase 1 (Planning) revealed approximately 400,000 migrants in the area, 60% of whom were uninsured. This lack of coverage resulted in an annual uncollectible debt of 150 million THB for five border hospitals. Utilization rates were 24.7% for out-patients and 34.7% for in-patients, indicating that existing facilities and personnel are insufficient for the growing population. Phase 2 (Implementation) introduced a dual-strategy model: 2.1) establishing Border Health Centers (BHC) to expand coverage and 2.2) promoting affordable health insurance. Phase 3 (Evaluation) showed that BHC utilization increased by 26.1% between June and November 2025. Furthermore, enrollment in Ministry of Public Health insurance and the M-Fund rose 4.0 and 4.4 times, respectively. This surge significantly mitigated financial losses, reducing uncollectible debt by 19.5% compared to the 2022–2024 period.

The findings suggest that decentralized service points and accessible insurance schemes are vital for enhancing healthcare equity and ensuring the financial sustainability of border health systems.

Development of a health and nutrition curriculum management model based on health literacy principles as a model for elderly schools in Phayao Province

Grichakhun Khammapun, Wittawas Sajjapong — Fri, 06 Feb 2026 00:00:00 +0700

Thailand is transitioning into a fully aged society, accompanied by a rising burden of non-communicable diseases (NCDs). This trend is particularly evident in Phayao Province, where the proportion of older adults exceeds the national average. These demographic and health challenges underscore the need to strengthen health literacy and nutritional education to enhance the self-management capacity of older adults and support sustainable health outcomes.

This study aimed to develop a health and nutrition curriculum integrating the concept of Health Literacy for older adults enrolled in an elderly school in Phayao Province, and to evaluate its effects on knowledge, health behaviors, clinical health indicators, and participant satisfaction. A one-group pretest–posttest experimental design was employed within an action research framework. The sample consisted of 51 older adults attending the Maega Tokwak Elderly School, selected through purposive sampling. Research instruments included the developed curriculum, a knowledge test, a health behavior assessment, a satisfaction questionnaire, and clinical health measurements. Data were collected before and after participation in a 12‑session curriculum delivered over a 3‑month period. Descriptive statistics and paired t‑tests were used for data analysis.

The results showed significant improvements in participants’ knowledge and health behaviors (p < 0.001). Although no significant changes were observed in blood glucose, blood urea nitrogen, creatinine, or estimated glomerular filtration rate (p > 0.05), total cholesterol and low-density lipoprotein cholesterol decreased significantly (p < 0.05). Participant satisfaction was high, with an overall mean score of 9.86 (SD = 0.34).

In conclusion, the Health Literacy–based curriculum effectively enhanced knowledge, promoted healthier behaviors, and reduced selected health risks among older adults, demonstrating strong potential for broader community application.

ผลของการส่งเสริมสุขภาพด้วยดิจิทัลแพลตฟอร์มส่งเสริมกิจกรรมทางกายระดับชาติ ที่มีต่อความรอบรู้ด้านสุขภาพกิจกรรมทางกาย ระดับการมีกิจกรรมทางกาย ดัชนีมวลกาย และเส้นรอบเอว

Wasan Unanan , Supitcha Wongchan , Nattanun Samphet — Thu, 05 Mar 2026 00:00:00 +0700

Background: Sedentary behavior and physical inactivity are primary risk factors for non-communicable diseases (NCDs). Digital health technology has emerged as a crucial mechanism for promoting health on a large scale. Objectives: This quasi-experimental research aimed to compare physical activity literacy, physical activity levels (MET-minutes/week), body mass index (BMI), and waist circumference before and after the implementation of the “Kao ta jai” digital platform. Methods: The study was conducted among 701 users of the Kao ta jai platform across all regions of Thailand who participated continuously for three months. Data were analyzed using descriptive statistics. Differences between pre- and post-intervention outcomes were tested using the Paired Sample t-test for normally distributed variables and the Wilcoxon Signed-Rank Test for non-normally distributed physical activity data. The effect size was determined using Cohen’s d.

The results revealed that after using the “Kao ta jai” digital platform, participants demonstrated statistically significant improvements in all evaluated areas. Specifically, physical activity health literacy scores increased from a mean of 32.77 to 33.42 (p= 0.03), although the effect size was very small (d = 0.095). Regarding Physical activity levels (MET-minutes/week) rose significantly (Z = -9.82, p < .001), with the median increasing from 2,650 to 2,950 (d = 0.430). Simultaneously, body mass index (BMI) decreased from 23.94 to 23.29 kg/m² (p = 0.03) with a very small effect size (d = 0.144), while waist circumference significantly declined from 81.15 to 80.51 cm (p = 0.05), representing a small effect size (d = 0.314). These findings clearly indicate that the “Kao Ta Jai” digital platform is an effective tool for successfully promoting healthy behaviors and leading to tangible, positive physical changes.

In conclusion, the “Kao ta jai” digital platform serves as an effective instrument for health behavior modification, particularly in enhancing physical activity levels and reducing waist circumference. However, given the relatively small effect sizes observed for health literacy and BMI, it is recommended that in-depth educational modules be integrated alongside the platform's use to facilitate more substantial and tangible health outcomes in practice.

Investigation of Environmental Impact, Quality of Life, and Waste Management Behaviors of Residents Surrounding a Solid Waste Landfill: A Case Study of Mukdahan Sub-district, Mueang Mukdahan District, Mukdahan Province

Chatchanan Pookaew, Darika Permporn, Sutthida Suebsap — Thu, 22 Jan 2026 00:00:00 +0700

Ineffective solid waste management adversely affects the environment and public health, particularly in communities near landfill sites. This cross-sectional descriptive study assessed the environmental impacts, quality of life, and waste management behaviors of residents in Mukdahan Subdistrict, Mukdahan Province. Data were collected from 186 participants using a structured questionnaire and analyzed via descriptive statistics.

The results indicated that residents experienced a moderate level of environmental impact
(Mean = 2.17, SD = 0.74). The most significant concerns were disease vectors, specifically flies
(Mean = 2.70, SD = 0.55), and air pollution characterized by unpleasant odors and particulate matter
(Mean = 2.68, SD = 0.51). Regarding quality of life, residents reported high negative impacts on mental (Mean = 2.37, SD = 0.57) and physical health (Mean = 2.34, SD = 0.61), while economic and social dimensions were moderately affected. Although most residents demonstrated appropriate household practices—including waste separation (99.5%) and proper disposal in bins (97.8%)—structural challenges persist. Major issues identified were the lack of designated waste collection points (54.5%) and insufficient waste bins (33.3%).

These findings suggest that local policy planning must emphasize vector control and the reduction of odor and dust. Recommendations include establishing adequate waste collection points commensurate with volume. Furthermore, implementing respiratory and mental health surveillance, alongside improved community-agency communication, is essential to mitigate environmental impacts and enhance residents' long-term quality of life.

Development of a Surveillance and Referral System for Stroke Patients at the Community Level in Chiang Rai Province

Tue, 24 Feb 2026 00:00:00 +0700

Abstract

Stroke is one of the leading causes of death and disability in Thailand. Timely access to treatment, such as the Stroke Fast Track system, is critical for reducing disability and mortality. However, in Chiang Rai Province, village health volunteers (VHVs) still lack adequate knowledge and skills in assessing warning signs and recognizing risks among high-risk groups and stroke patients. This gap contributes to delays in accessing treatment, resulting in disability and death. Objectives To examine the current situation of the surveillance and referral system for stroke patients at the community level in Chiang Rai Province, to develop a community-based surveillance and referral system through the involvement of VHVs, and to evaluate the outcomes of the developed system.Methods This research employed a research and development (R&D) design, combining qualitative and quantitative approaches. The qualitative sample consisted of 108 stakeholders from district and subdistrict health services, while the quantitative sample comprised 503 VHVs and an intervention group of 56 VHVs from Phangam Subdistrict, Wiangchai District. Research tools included interviews, questionnaires, knowledge tests, and a VHV training manual. Data was analyzed using content analysis, descriptive statistics, and paired t-tests.

Results The primary issue identified was the VHVs’ lack of knowledge and skills in stroke assessment. The developed system incorporated stroke warning sign education, stroke awareness campaigns, risk-screening training, development of educational media, and establishment of emergency communication channels. After the intervention, VHVs’ knowledge and skills significantly improved (p<0.05), enabling faster patient access to treatment. The referral process and access to the Stroke Fast Track system became more effective.

Keywords: Stroke, Surveillance system, Referral system, Village health volunteers, Community