Relationship between health literacy in substance use and alcohol consumption and tobacco use among adolescents, Northeast Thailand.

BACKGROUND: Health literacy (HL) is an important role-play in health risk behaviors such as alcohol drinking and smoking. Inadequate HL in substance use (HLSU) is a barrier to reduce the risk of alcohol and tobacco use. This study aims to investigate the association of HLSU with alcohol consumption and tobacco use among Thai adolescents. Hence, the strengthening of HL program intervention may applied to reduce substance abuse among Thai adolescents. MATERIALS AND METHODS: This was a cross-sectional study conducted on 1087 university students studying in three universities located in northeastern area with multistage sampling methods by geographical areas. The data were collected by self-administered questionnaire. Multiple logistic regression was applied to determine the effect of HLSU of alcohol consumption and tobacco use. RESULTS: Most adolescents were drinkers (60.7%) and about 20.7% were smokers. Approximately 40% of them reported as inadequate HLSU. Adolescents with inadequate HLSU and a high level of positive alcohol expectancies and smoking outcome expectancies (SOE) were more likely to drink alcohol and smoke. Conversely, those who had a high level of negative alcohol drinking and SOE were less likely to consume alcohol and tobacco. CONCLUSION: Adolescents' alcohol consumption and tobacco use were influenced by HL, hence improving adolescents' HLSU could help prevent or reduce the risk of drinking and smoking behaviors.

The Perceived Stigma of Addiction and Treatment Utilization among Cannabis Addicts in Thailand.

CONTEXT: A major social problem among clients with substance use disorders is stigmatization related to health conditions, which contributes to poor mental and physical health circumstances and becomes hazardous to substance abuse treatment. Meanwhile, decreased stigmatization among cannabis users might occur because some people use cannabis without experiencing harm or believe it to be a harmless substance and might not be receiving treatment. Several studies have investigated stigma toward substance use disorder and treatment. However, less is known about how stigmatization influences treatment. AIMS: To investigate the association between the perceived stigma of addiction and treatment utilization among cannabis addicts. MATERIALS AND METHODS: A cross-sectional design was conducted with consecutive sampling techniques among 977 cannabis users recruited from all 7 compulsory drug detention centers in Thailand. The data were collected by standardized interviewers with a structured interviewing questionnaire. Binary logistic regression was applied to determine the effect of perceived stigma of treatment utilization. RESULTS: Most clients were male (84.5%), had a family history of drug problems (54.5%), and had a history of mental health problems (5.1%). Most of them reported moderate-to-high levels of perceived stigma (87.2%) and received treatment (28.9%). Greater perceived stigma was associated with decreased treatment for cannabis abuse. CONCLUSIONS: The perceived stigma of addiction is a barrier to cannabis abuse treatment utilization. Thus, a better understanding of stigma could reduce its negative impact on seeking and engaging in treatment.

The Perceived Neighborhood Crime and Hazardous Alcohol Use Among Youth in University of the Northeastern Thailand Context.

BACKGROUND: The residents' perceptions of the crime and lack of safety with their neighborhood environment, associated with stress that confers risk for drinking. While many studies have focused on adult drinking, less is known about how subjective neighborhood crime influences drinking during adolescent. We aimed to determine the association of perceived neighborhood crime and youth alcohol use. STUDY DESIGN: A cross-sectional study. METHODS: This study was conducted on 1087 university youths from 30 neighborhood clusters in Northeastern Thailand from May 2019 to Mar 2020. The data were collected by self-administered questionnaire. A multilevel logistic regression model was applied to examine the effect of perceived neighborhood crime on hazardous alcohol use. RESULTS: Most of youths were female, approximately 60.7% reported hazardous alcohol use, and the average perceived neighborhood crime score was 65.1 (standard deviation, 2.1). The perceived neighborhood crime was associated with hazardous alcohol use; a 1-unit increase in the scores for perceived neighborhood crime corresponded to a 20% increase in hazardous alcohol use. The role of perceived neighborhood crime on alcohol use varied among males, but not females. CONCLUSION: The perceived neighborhood crime plays a role in the increase likelihood of hazardous alcohol use. The consideration of neighborhood crime context is important to design the alcohol preventive and intervention strategies.

Associations of the Neighborhood Environment With Substance Use: A Cross-sectional Investigation Among Patients in Compulsory Drug Detention Centers in Thailand.

OBJECTIVES: To identify the associations of characteristics of the neighborhood environment with substance abuse among clients receiving treatment for drug abuse in Thailand. METHODS: A cross-sectional study was conducted of 1128 drug addicts from 28 neighborhoods who were receiving treatment at all 7 compulsory drug detention centers in Thailand. A trained interviewer conducted structured interviews with the subjects about substance use and the perceived neighborhood environment in their community. A multilevel logistic regression model was applied to estimate the effects of the neighborhood environment on substance use. RESULTS: The majority of participants, 53.8% only used methamphetamine pills, 31.3% used other illicit drugs as well as methamphetamine pills, and 14.9% used an illicit drug other than methamphetamine. Three neighborhood characteristics were associated with substance use. A 1-unit increase in the perceived neighborhood cohesion score was associated with a 15% reduction in methamphetamine pill use and an 11% reduction of the use of both methamphetamine pills and another illicit drug. Conversely, a 1-unit increase in perceived neighborhood crime predicted 19 and 14% increases in the use of methamphetamine pills and the use of both methamphetamine pills and another illicit drug, respectively. In addition, a 1-unit increase in the scores for stigma surrounding addiction corresponded to a 25% increase of the use of methamphetamine pills and a 12% increase in the use of both methamphetamine pills and another illicit drug. CONCLUSIONS: Substance use among drug addicts was influenced by characteristics of the neighborhood environment. Therefore, prevention and intervention strategies should be designed based on a consideration of the impact of neighborhood context on substance use behaviors.

A randomized controlled trial to improve the quality of life of type 2 diabetic patients using a self-help group program.

The purpose of study was to determine the effect of a self-help group program on the quality of life among type 2 diabetic patients. The study subjects were type 2 diabetic patients attending one of six studied health centers or a community hospital in Saraburi Province, Thailand. At each health center/hospital, the patients were randomly allocated into the intervention group attending the self-help group program or the control group receiving diabetic services. Information was collected from September 2007 to April 2008 using a structured questionnaire with interview technique at baseline, 12 and 24 weeks. One hundred forty-six patients completed the program. Five self-help group programs carried out for 16 weeks gave instruction regarding building-up good relationships, improvement of knowledge about diabetes and skills for dietary control, skills in physical exercise, improvement of group structure, improvement of training skills for group leaders, self-monitoring, motivation in self-care activities and sharing experiences among group members. Descriptive statistics were used to provide basic information regarding the two groups. For analytical purposes the chi-square test and t-test were applied. The majority (77.4 %) of study participants were females. Most patients were either > or = 50 years old (52%) or 40-49 years old (37%). The intervention resulted in significantly higher scores in quality of life compared to controls at 12 and 24 weeks (p < 0.05). The findings indicate the program is effective for improving perceived quality of life. The program focused on enhancement of experience sharing among group members and participation in problem-solving. We recommend implementing this program for diabetic patients and patients with other chronic diseases at primary health care level.

Quality of life and compliance among type 2 diabetic patients.

A cross-sectional study was conducted to explore the quality of life (QOL) and compliance among type 2 diabetic patients in Saraburi Province, Thailand. Compliance was assessed by evaluating dietary intake and life style patterns useful for diabetes patients to maintain health and prevent complications of the disease. A multistage sampling technique was used for selecting patients from 2 districts (Wihan Daeng and Nong Don) and subjects were classified into 2 groups according to a quality of life (QOL) score (good = 70, poor to moderate = 94) using WHOQOL-BREF-THAI criteria. Data were collected from September to December 2007 using a self-administered questionnaire. Simple descriptive statistics were used to provide basic information about the two groups and for analytical purposes the chi-square test and multiple logistic regression were applied. The majority (78.7%) of study participants were females. Most patients belonged to the age groups of either > 50 years (50%) or 40-49 years (36.6%). Bivariate analysis revealed socio-demographic factors were not significantly associated with QOL (p > 0.05). As far as compliance was concerned dietary control and drug intake were significantly associated with QOL (p < 0.05). Multivariate analysis indicated that overall compliance was associated with QOL (OR = 1.91, 95% CI = 1.02-3.57). We conclude that good QOL is significantly related to good compliance. Therefore, diabetic patients should be made aware that following the suggestions to prevent side effects of the disease and trying to stay healthy despite suffering from the disease will significantly improve their QOL.