Unhealthy Dietary Patterns and Their Associations with Sociodemographic Factors as Predictors among Underweight and Overweight Adolescents in Southern Thailand.

(1) Background: Adolescence is a critical developmental phase; dietary intake and nutritional status significantly impact health outcomes. (2) Objective: This cross-sectional study investigated dietary patterns (DPs) and the association between sociodemographic factors and unhealthy DPs among adolescents in Thailand. (3) Methods: A multi-stage sampling selected 1480 participants from three public high schools in Nakhon Si Thammarat province. A food frequency questionnaire assessed dietary habits, and principal component analysis was used to identify DPs. Multinomial logistic regression examined the association between sociodemographic factors and DPs. (4) Results: The findings show that 25.9% of adolescents were underweight, 14.7% were overweight, and 5.8% were obese. Three DPs were identified: a healthy 'protein and vegetables' pattern and two unhealthy patterns: 'snacks' and 'processed foods', which explained 12.49%, 10.37%, and 7.07% of the dietary variance, respectively. Among underweight adolescents, higher snack consumption was associated with being younger (odds ratio (OR) = 3.24) and receiving a higher daily allowance (OR = 3.43). Additionally, female adolescents who engaged in frequent exercise had a 2.15 times higher intake of processed foods. Among overweight adolescents, higher snack intake was linked to being younger (OR = 8.65) and having larger families (OR = 6.37). Moreover, an increased daily allowance was associated with higher consumption of processed foods (OR = 11.47). (5) Conclusion: This study underscores the socio-demographic influence on unhealthy DPs. Insights can guide targeted interventions to foster healthier dietary habits during adolescence.

Construction of the Short-Form Thai-Home Fall Hazard Assessment Tool (Thai-HFHAT-SF) and Testing Its Validity and Reliability in the Elderly.

The Thai-Home Fall Hazard Assessment Tool (Thai-HFHAT) was developed to identify the fall risk among the elderly arising from their home environment. However, it is more time consuming for large items. Therefore, this study developed a short-form of Thai-HFHAT (Thai-HFHAT-SF). In phase I, we developed the Thai-HFHAT-SF by performing a confirmatory factor analysis (CFA) of 450 rural elderly people. In phase II, a total of 105 participants; 50 elderly people, 50 caregivers, and 5 village health volunteers (VHV) were recruited to examine the reliability of the Thai-HFHAT-SF. Intra-class correlation coefficient (ICC) was used to analyze the inter-rater and test-retest reliability. Factor analysis selected 28 out of the 69 original Thai-HFHAT items in 4 components: indoor area, garage, outdoor areas, and risky spots/areas including pets. The factor loading was 0.67, 0.60, 0.32, and 0.31 in each component. The fitness index indicated that this model was fit (χ2/df = 1.38, goodness-of-fit Index (GFI) = 0.988, adjusted goodness-of-fit index (AGFI) = 0.970, standardized root mean square residual (SRMR) = 0.030, and root mean square error of approximation (RMSEA) = 0.029). The inter-rater reliability of the Thai-HFHAT-SF was 0.82 (95% CI: 0.71-0.89). The test-retest reliability was 0.77 (95% CI: 0.60-0.87) for the older person group, 0.85 (95% CI: 0.73-0.91) for the caregiver group, and 0.60 (95% CI: 0.29-0.77) for the VHV group. The new 28-item scale focused on home fall hazards and can be conducted in 10-15 min. Thai-HFHAT-SF is suitable for home hazards assessment among elderly in Thailand.

Predictive validity of three home fall hazard assessment tools for older adults in Thailand.

This study aimed to examine the predictive validity of two internationally well-known instruments, the Modified Home Falls and Accidents Screening Tool (Modified HOME FAST) and the Modified Home Falls and Accidents Screening Tool-Self Report (Modified HOME FAST-SR), and the newly developed Thai Home Falls Hazard Assessment Tool (Thai-HFHAT) (69 items) in predicting falls among older Thai adults. It also aimed to examine the predictive validity of the two abbreviated versions (44 and 27 items) of the Thai-HFHAT, which were developed post hoc to accommodate older adults' limited literacy and poor vision and to facilitate the identification of high-impact home fall hazards that are prevalent in the Thailand context. A prospective cohort study was conducted among 450 participants aged 60 years and above who were assessed by the aforementioned tools at baseline, for which data on fall incidence were then collected during the one-year follow-up. The Cox proportional hazard model was applied to estimate hazard ratios (HRs); then, Harrell's C-statistics and receiver operating characteristic (ROC) analyses were conducted to identify the best cutoff point, sensitivity and specificity for each instrument. The results showed that the fall hazard rate was 2.04 times per 1,000 person-days. Taking into account both the predictive validity and applicability, the Thai-HFHAT (44 items) was found to be the most suitable screening tool due to its highest sensitivity and specificity (93% and 72%) at the cutoff score of 18. In conclusion, our study showed that these internationally validated home fall hazard assessment tools were quite applicable for Thailand, but further tailoring the tools into a specific local context yielded even more highly valid tools in predicting fall risk among older Thai adults. Although these findings were well reproducible by inferring from the internal validation results, further external validation in the independent population is necessary.