Development of a Health Literacy Model for Preventing E-Cigarette Use Among Secondary School Students in a Pilot Area, Phayao Province

Abstract

              E-cigarette use among adolescents has been increasing, particularly among secondary school students in Thailand. Although import and sales are prohibited, access remains easy through peers and online platforms, while empirical studies on health literacy models to prevent e-cigarette use in the context of Thai youth are limited. This study aimed to develop a health literacy model for preventing e-cigarette use among secondary school students in a pilot area, Phayao Province.

                  This research and development (R&D) study, employing a mixed-methods exploratory sequential design, was conducted from April to September 2025. The participants were 100 upper secondary school students selected by purposive and matched sampling, and equally divided into experimental and control groups. Research tools included the adapted HLS-EU-Q47 questionnaire (Cronbach’s α = 0.88), structured observation, and a satisfaction survey. Quantitative data were analyzed using Paired t-test and ANCOVA, while qualitative data were analyzed with thematic analysis.

               The results showed that the developed model demonstrated high effectiveness. Prior to the intervention, there was no significant difference in health literacy levels between the two groups (p>.05). After the intervention, health literacy scores of the experimental group were significantly higher than the control group (p<.001). The proportion of students with excellent of health literacy in the experimental group increased from 0.0% to 44.0%, And the activities in which the students participated most prominently were making agreements and role-playing.

                  In conclusion, the developed model, which integrated the Health Literacy Model with Active Learning, was effective in enhancing students’ health literacy and self-prevention skills. It is recommended for school implementation and further extension to younger adolescents (e.g, those under 15 year of age) as a proactive, long-term prevention strategy.