Socio-demographic and geographic disparities of population-level food insecurity during the COVID-19 pandemic in Thailand.

Introduction: This study investigated the prevalence of food insecurity, and the association between socio-demographic and geographic factors and food insecurity in Thailand during the COVID-19 pandemic. Methods: The study extracted data on 5,066 persons age 15 years or older from a nationally-representative sample survey of Thai households, conducted during June-December 2021. The respondents were asked about food insecurity, socio-demographic characteristics, debt, and role of the primary household food provider. Binary logistic regression analysis was used to investigate the association between the variables and food insecurity. Results: Of the total sample, 28.6% had food insecurity. The highest probability of having food insecurity (p < 0.001) was observed in persons age 15-29 years, with no formal education, and in the lowest quartile of income. The highest probability of having food insecurity was found among respondents residing in the northeast, which is the poorest and with the least development status among geographic regions in Thailand. Respondents who reported having onerous personal debt and being the main household food provider were 1.4 and 2.3 times as likely to have food insecurity as those with no debt and not being the main food provider, respectively (p < 0.001). Conclusion: This suggests that government attention is required in developing policies and strategies to improve food security through addressing the socio-economic determinants, and buffer the negative impact of a national crisis on diets. Investment to improve household income and raise the educational profile of the population is needed. Addressing the regional disparities in food security requires area-specific measures which target the most vulnerable population groups.

Socio-demographic and geographic disparities of population-level food insecurity during the COVID-19 pandemic in Thailand

Introduction This study investigated the prevalence of food insecurity, and the association between socio-demographic and geographic factors and food insecurity in Thailand during the COVID-19 pandemic. Methods The study extracted data on 5,066 persons age 15 years or older from a nationally-representative sample survey of Thai households, conducted during June-December 2021. The respondents were asked about food insecurity, socio-demographic characteristics, debt, and role of the primary household food provider. Binary logistic regression analysis was used to investigate the association between the variables and food insecurity. Results Of the total sample, 28.6% had food insecurity. The highest probability of having food insecurity (p < 0.001) was observed in persons age 15–29 years, with no formal education, and in the lowest quartile of income. The highest probability of having food insecurity was found among respondents residing in the northeast, which is the poorest and with the least development status among geographic regions in Thailand. Respondents who reported having onerous personal debt and being the main household food provider were 1.4 and 2.3 times as likely to have food insecurity as those with no debt and not being the main food provider, respectively (p < 0.001). Conclusion This suggests that government attention is required in developing policies and strategies to improve food security through addressing the socio-economic determinants, and buffer the negative impact of a national crisis on diets. Investment to improve household income and raise the educational profile of the population is needed. Addressing the regional disparities in food security requires area-specific measures which target the most vulnerable population groups.

Refining index to measure physical activity inequality: which group of the population is the most vulnerable?

BACKGROUND: The existing body of research mostly discusses inequality in physical activity (PA) based on the difference in the level of moderate-to-vigorous physical activity (MVPA). Evidence is lacking on the quantified inequality measures (e.g., how big the inequality is, and the distribution) in order to identify the most vulnerable groups of a population. This study measured PA inequality among Thai adults by using three parameters to construct an inequality index: (1) Proportion of the population with sufficient MVPA; (2) Cumulative minutes of MVPA; and (3) The Gini coefficient. METHODS: This study employed three rounds of data from Thailand's Surveillance on Physical Activity (SPA) 2019-2021. In each round, over 6,000 individuals age 18-64 years were selected as nationally-representative samples, and were included in the analysis. PA inequality was constructed by using three parameters, with a combination of the three as the final measure, to identify the sub-groups of the Thai adults who are most vulnerable: groups with the least MVPA, highest insufficiency, and highest inequality index (Gini). RESULTS: Covid-19 containment measures have widened the gap in PA inequality, as shown by a declining proportion of the population meeting the recommended guidelines, from 74.3% in 2019 to 56.7% in 2020 and 65.5% in 2021. PA inequality existed in all sub-populations. However, by combining three parameters, the most vulnerable groups during the Covid-19 epidemic were identified as follows: (1) Those with no income; (2) The unemployed; (3) Those who have no access to PA facilities; (4) Older adults aged 60 + years; and (5) Those earning < 3,500 baht per month. Further, residents of Bangkok, young adults aged 18-24, individuals who attained primary level education or less, those who had no exposure to a PA awareness campaign and those who have a debilitating chronic disease also had elevated risk of PA insufficiency. CONCLUSION: A concerning level of PA inequality existed in all sub-populations. The use of combined indicators in measuring PA inequality should aid in determining the most vulnerable groups of the population with a refined procedure. This method can be applied in many settings since the baseline data used to measure inequality (i.e., percent sufficient and cumulative minutes of MVPA) are widely available.

Learning Methods During School Closure and Its Correlation With Anxiety and Health Behavior of Thai Students.

Background: The sequential waves of epidemic spread of COVID-19 in Thailand have caused periodic closures of schools, and exposed students to different learning methods that require multiple adjustment strategies. This study aimed to examine how different learning methods may correlate with anxiety and health behavior (e.g., physical activity, active play, screen time, sleep) of primary and secondary school students in Thailand. Methods: Thailand Report Card (TRC) Data (2021) was employed. The sample of the TRC was drawn by multi-stages random sampling stratified by region, district, urban/rural, school size, sex, and age to ensure national representativeness. A total of 6,078 Thai primary (64%) and secondary (36%) school students were included in the analysis. Results: About two-thirds (66.4%) of the sample experienced a shift from traditional classroom to fully online learning, 6.9% experienced partial online instruction, 23.6% received handouts or written assignments, and 3.1% resumed traditional classroom learning. Compared to fully online learning, students who experienced traditional classroom (onsite) teaching were 37.8% less likely to report moderate-to severe anxiety (OR 0.6; p-value 0.021). There was no significant correlation between school closure-induced anxiety with overall physical activity (PA) and active play, but anxiety was significantly associated with screen time and sleep duration. Receiving handouts/written assignments only as the learning method was significantly correlated with PA, but two methods (handouts and onsite/traditional classroom) was significantly correlated with active play. Students who experienced classroom learning were also more likely to comply with recommended durations of screen time and sleep. Conclusion: Although online learning was probably the most convenient choice during COVID-19 containment measures in Thailand, this method did not provide sufficient opportunity for PA and play. Online learning also encouraged an excessive use of screen media, and disrupted sleeping patterns. Online learning also pressured Thai students to make various adjustments in their daily routines that may have further aggravated anxiety.

Results from the Thailand 2022 report card on physical activity for children and youth.

Background/objective: The effort to create physical activity (PA) opportunities for Thai youth, prior to 2020, was making good progress. However, the unexpected advent of the Covid-19 epidemic has posed significant challenges to maintain PA level of youth. The Thailand 2022 Report Card on Physical Activity for Children and Youth presents measurements of PA-related indicators based on the Global Matrix, with additional indicators that are relevant for childhood development. Methods: Several data sources were employed to develop the indicators, namely: 1) The Thailand Report Card Survey 2021; 2) School health and facility data; 3) Student health indicators from the Ministry of Public Health; and 4) Relevant resources to support the development of the policy indicator. Results: Overall, only 27% of Thai children and youth met the 60-min PA daily threshold (grade D). While behavioral indicators were mostly graded 'poor' (between C and F), the source of influence (i.e., family) indicators showed better grades (between A and C). One-third (33%) of the youngsters suffered from moderate-to-severe level of stress/anxiety (grade B). Overweight and sleep indicators received grades of A or A-, whereas bullying and student engagement received a grade of B. The performance on the physical literacy indicator was graded C+. Conclusion: With the main message "Let's Move - Boost Happiness," the results from Thailand 2022 Report Card call for a collaborative effort involving multiple sectors to improve PA and happiness of children and youth. A more comprehensive PA promotion strategy is required to provide clear direction and guidance for schools, families, and communities in order to maintain gains and raise the overall level of youth PA in Thailand.

Learning Methods During School Closure and Its Correlation With Anxiety and Health Behavior of Thai Students

Background The sequential waves of epidemic spread of COVID-19 in Thailand have caused periodic closures of schools, and exposed students to different learning methods that require multiple adjustment strategies. This study aimed to examine how different learning methods may correlate with anxiety and health behavior (e.g., physical activity, active play, screen time, sleep) of primary and secondary school students in Thailand. Methods Thailand Report Card (TRC) Data (2021) was employed. The sample of the TRC was drawn by multi-stages random sampling stratified by region, district, urban/rural, school size, sex, and age to ensure national representativeness. A total of 6,078 Thai primary (64%) and secondary (36%) school students were included in the analysis. Results About two-thirds (66.4%) of the sample experienced a shift from traditional classroom to fully online learning, 6.9% experienced partial online instruction, 23.6% received handouts or written assignments, and 3.1% resumed traditional classroom learning. Compared to fully online learning, students who experienced traditional classroom (onsite) teaching were 37.8% less likely to report moderate-to severe anxiety (OR 0.6;p-value 0.021). There was no significant correlation between school closure-induced anxiety with overall physical activity (PA) and active play, but anxiety was significantly associated with screen time and sleep duration. Receiving handouts/written assignments only as the learning method was significantly correlated with PA, but two methods (handouts and onsite/traditional classroom) was significantly correlated with active play. Students who experienced classroom learning were also more likely to comply with recommended durations of screen time and sleep. Conclusion Although online learning was probably the most convenient choice during COVID-19 containment measures in Thailand, this method did not provide sufficient opportunity for PA and play. Online learning also encouraged an excessive use of screen media, and disrupted sleeping patterns. Online learning also pressured Thai students to make various adjustments in their daily routines that may have further aggravated anxiety.

Prevalence and Trends of Physical Activity in Thai Children and Young People: Pooled Panel Data Analysis from Thailand's Surveillance on Physical Activity 2012-2020.

This study aims to describe the level and trends of physical activity (PA) in Thai children and young people and examine PA changes during transitional periods. Employing nine rounds of Thailand's Surveillance on Physical Activity (SPA) 2012-2020, this study pooled three sets of data and included children and young people aged 6-17 years in the analysis: 1595 in SPA2012-2016, 1287 in SPA2017-2019, and 853 persons in SPA2020. Face-to-face interviews were conducted in five regions, 13 provinces, and 36 villages in SPA2012-2019, whereas an online survey was administered in all provinces in SPA2020. The prevalence of sufficient moderate-to-vigorous PA (MVPA) among Thais aged 6-17 years ranged from 19.0 percent to 27.6 percent, with a significant drop during the period of COVID-19 spread in 2020. The average daily MVPA ranged from 46 to 57 min and dropped to 36 min during the pandemic. Boys were consistently more active than girls in all nine rounds of the SPA, and girls had more difficulty in maintaining or improving their PA level. A significant increase in the proportion of Thai children and young people with sufficient MVPA was observed during their transition from late primary to early secondary school grades.

The effects of the COVID-19 pandemic on the physical activity of the Thai population: Evidence from Thailand's Surveillance on Physical Activity 2020.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has undoubtedly disrupted the physical activity (PA) of the Thai population. This study examined the effect of the COVID-19 pandemic on moderate-to-vigorous PA (MVPA) of Thai adults and assessed the effects of the national curfew policy and health-promotion campaigns on influencing PA during the pandemic. METHODS: Thailand's Surveillance on Physical Activity (SPA) 2019 and 2020 datasets were employed to compare the PA level of Thai adults aged 18-64 years before and during the COVID-19 pandemic. Samples of 4460 respondents from SPA 2019 and 4482 respondents from SPA 2020 were included in the analysis. Global Physical Activity Questionnaires (Version 2.0), were used to measure PA in both periods. Sufficient MVPA for adults was defined based on the recommendation of 75 min of vigorous PA or a combination of 150 min of MVPA per week. RESULTS: The proportion of Thai adults who had sufficient MVPA declined from 74.6% before the pandemic to 54.7% during the pandemic, and that decline was accompanied by a reduction in the cumulative minutes of MVPA from 580 min to 420 min. During the COVID-19 pandemic, male and middle-aged individuals were 1.3 times and 1.2 times more likely to have sufficient MVPA, respectively. Those who were unemployed, resided in an urban area, and/or had chronic disease(s) were 27%, 13%, and 27% less likely to meet the recommended level of PA during the pandemic, respectively. Those who were exposed to the Fit from Home campaign were 1.5 times more likely to have sufficient MVPA. CONCLUSION: The pandemic measures imposed by the government have reduced the cumulative min of work-related PA, transportation PA, and recreational PA and have slowed Thailand's progress toward its PA goals. Although the Fit from Home campaign has probably contributed to a slight increase in MVPA, it will take some time for Thais to return to the pre-COVID-19 level of PA. Health promotion messages need to be continuously delivered to reduce irrational fear of infection and to boost the PA level of the Thai population as a health-promoting intervention.