Comorbidities of diabetes and hypertension in Vietnam: current burden, trends over time, and correlated factors.

BACKGROUND: Vietnam conducted the national Noncommunicable Disease Risk-Factor Surveillance (STEPs) surveys in the years 2010, 2015, and 2021. This study aims to use STEPs data to assess the burden of comorbidity between diabetes and hypertension, analyze trends over time, and identify factors associated with this comorbidity. METHODS: The study extracted data for the population aged 25-64 years old from three STEPs surveys. Survey weight was used for all estimations of prevalence and 95% CI. Correlated factors with comorbidity were examined by a multivariate logistics model. RESULTS: The prevalence of comorbidity in 2021 was about 3.92% among Vietnamese people aged 25-64. In the last 10 years, this prevalence has increased more than 8 times (from 0.44% to 3.92%). Sub-populations demonstrating the most significant changes included the male population, people living in urban areas, and older people. Significant factors correlated with comorbidity included demographic factors, body mass index (BMI), and clustering of 4 noncommunicable diseases (NCDs) behavioral risk factors (OR = 3.48, p < 0.05). CONCLUSION: The high comorbidity between hypertension and diabetes underscores the imperative for integrated treatment and management approaches in Vietnam. Coordinated care is essential for addressing the complex interplay between these two prevalent conditions.

Smoking Cessation, Quit Attempts and Predictive Factors among Vietnamese Adults in 2020.

OBJECTIVE: This study aims to describe the updated smoking cessation and quit attempt rates and associated factors among Vietnamese adults in 2020. METHODS: Data on tobacco use among adults in Vietnam in 2020 was derived from the Provincial Global Adult Tobacco Survey. The participants in the study were people aged 15 and older. A total of 81,600 people were surveyed across 34 provinces and cities. Multi-level logistic regression was used to examine the associations between individual and province-level factors on smoking cessation and quit attempts. RESULTS: The smoking cessation and quit attempt rates varied significantly across the 34 provinces. The average rates of people who quit smoking and attempted to quit were 6.3% and 37.2%, respectively. The factors associated with smoking cessation were sex, age group, region, education level, occupation, marital status, and perception of the harmful effects of smoking. Attempts to quit were significantly associated with sex, education level, marital status, perception of the harmful effects of smoking, and visiting health facilities in the past 12 months. CONCLUSIONS: These results may be useful in formulating future smoking cessation policies and identifying priority target groups for future interventions. However, more longitudinal and follow-up studies are needed to prove a causal relationship between these factors and future smoking cessation behaviors.

Using systems-mapping to address Adverse Childhood Experiences (ACEs) and trauma: A qualitative study of stakeholder experiences.

Adverse childhood experiences (ACEs) and trauma have been linked to decreased psychosocial and physiological health functioning. While various individual and community-level interventions to address ACEs have been reported, one novel approach that has not been explored in detail is a community-engaged causal loop diagramming project, or systems mapping project (SMP), in which diverse stakeholders work together to document the forces that are creating the outcomes and patterns within the community. To better document and understand the impact of participation in an SMP, we conducted in-depth, qualitative interviews with 16 stakeholders who were involved in a systems-mapping process facilitated by a local nonprofit in Eastern North Carolina. We used an iterative, content analysis coding process to generate and analyze themes from these interviews. Three major themes emerged: 1) Recognition and understanding of own trauma, 2) Trauma as both a community issue and an individual issue, and 3) Systems-mapping as a conceptual tool with practical benefits. All participants strongly recommended the systems-mapping approach to other communities and believed that it is a valuable tool for empowerment and provided several considerations for future organizers of similar systems-mapping projects. Our findings suggest that systems mapping is a feasible, transferable, and promising modality for understanding and addressing ACEs at the individual, interpersonal, and community-levels, as well as for putting community voices at the forefront of efforts to address ACEs.

Clustering Lifestyle Risk Behaviors among Vietnamese Adolescents and Roles of School: A Bayesian Multilevel Analysis of Global School-Based Student Health Survey 2019.

BACKGROUND: Adolescence is a vulnerable period for many lifestyle risk behaviors. In this study, we aimed to 1) examine a clustering pattern of lifestyle risk behaviors; 2) investigate roles of the school health promotion programs on this pattern among adolescents in Vietnam. METHODS: We analyzed data of 7,541 adolescents aged 13-17 years from the 2019 nationally representative Global School-based Student Health Survey, conducted in 20 provinces and cities in Vietnam. We applied the latent class analysis to identify groups of clustering and used Bayesian 2-level logistic regressions to evaluate the correlation of school health promotion programs on these clusters. We reassessed the school effect size by incorporating different informative priors to the Bayesian models. FINDINGS: The most frequent lifestyle risk behavior among Vietnamese adolescents was physical inactivity, followed by unhealthy diet, and sedentary behavior. Most of students had a cluster of at least two risk factors and nearly a half with at least three risk factors. Latent class analysis detected 23% males and 18% females being at higher risk of lifestyle behaviors. Consistent through different priors, high quality of health promotion programs associated with lower the odds of lifestyle risk behaviors (highest quality schools vs. lowest quality schools; males: Odds ratio (OR) = 0·67, 95% Highest Density Interval (HDI): 0·46 - 0·93; females: OR = 0·69, 95% HDI: 0·47 - 0·98). INTERPRETATION: Our findings demonstrated the clustering of specific lifestyle risk behaviors among Vietnamese in-school adolescents. School-based interventions separated for males and females might reduce multiple health risk behaviors in adolescence. FUNDING: The 2019 Global School-based Student Health Survey was conducted with financial support from the World Health Organization. The authors received no funding for the data analysis, data interpretation, manuscript writing, authorship, and/or publication of this article.

Impact of Central Quarantine Inside a Lockdown Hospital Due to COVID-19 Pandemic on Psychological Disorders among Health Care Staffs in Central Hospitals of Hanoi, Vietnam, 2020.

This study aims to examine the impact of undergoing a central quarantine due to the lockdown of Bach Mai hospital on the psychological disorders and identify associated factors with depression among hospital employees in central hospitals of Hanoi, Vietnam. Employing a cross-sectional design, the study collected data from staff working in the lockdown hospital and other central hospitals during 1 week after the lockdown happened. The sample size included 373 staff from 3 hospitals, the study time was. Depression was tested using PH-Q9 scale. Multivariate logistics regression was employed to test for the impact of central quarantine on depression and identify other significant related factors. The study confirmed a high burden of psychological issues that hospital employees were facing. Staff working in the lockdown hospital had 2.3 times higher odds of being perceived depression than others. Those who contact directly about 21 to 20 patients/day had 3.19-times higher odds of being perceived depression than others. Staff who being stigmatization associated with COVID-19 had 2.63 times higher odds of perceived depression than others. Reducing these associated factors to depression may help to reduce the psychological burden HEs have to cope with during the pandemic.

Self-reported non-communicable diseases and associated socio-demographic status among ethnic minority populations in Vietnam, 2019.

The aim of this study was to report the prevalence of self-reported non-communicable diseases among ethnic minority populations in Vietnam and related factors. A total of 5033 individuals aged 15 years and older who belonged to ethnic minority populations from 12 provinces in Vietnam completed a household survey. The overall prevalence of self-reported non-communicable diseases was 12.4% (95% CI: 11.5%-13.4%). Cardiovascular diseases were the most prevalent, followed by diabetes. Ethnicity was shown to have an independently significant correlation to having any non-communicable diseases. Older people, near-poor and non-poor people had significantly higher odds of having non-communicable diseases as compared to younger and poor people.

Relationship between family functioning and health-related quality of life among methadone maintenance patients: a Bayesian approach.

PURPOSE: To examine the relationship of family functioning on health-related quality of life (HRQoL) among methadone maintenance patients using the Bayesian approach. METHODS: A cross-sectional study was conducted on 182 patients at Go Vap Methadone Clinic, Ho Chi Minh City, Vietnam. Family functioning and HRQoL were measured by the APGAR scale and World Health Organization Quality of Life short-form instrument (WHOQoL-BREF), respectively. Directed Acyclic Graphs were used to present the conceptual framework and to identify a set of confounders of the relationship between family functioning and HRQoL. Bayesian multivariable linear regressions were fitted with four different priors to determine the effect size of the relationship of interest. RESULTS: The mean score of APGAR was 6.0 (SD = 3.3), and the mean scores of HRQoL were from 47.1 (SD = 17.6) in the social relationships dimension to 69.0 (SD = 10.3) in the environment dimension. Patients with a higher score of family functioning were likely to have a higher score of HRQoL, with coefficients and 95% highest density interval (HDI) greater than 0 in all priors. Family functioning had the most substantial impact on the psychological health dimension, with 99.9% to 100% and 44.6% to 83.7% of posterior distribution greater than 1 and 2, in different priors, respectively. CONCLUSION: Family functioning is intimately associated with HRQoL. Treatment plans for patients undergoing methadone maintenance treatment should aim to involve the families appropriately and effectively to maximize the benefits for patients and improve their overall well-being.

Sexual and reproductive health communication between parents and high school adolescents in Vientiane Prefecture, Lao PDR.

BACKGROUND: Adolescent health has become a priority on the global health agenda. Parent-adolescent communication regarding sexual and reproductive health (SRH) issues can help to reduce adolescent risk-taking sexual behaviours. OBJECTIVE: This study was to describe the situation of SRH communication, and to determine the factors associated with SRH communication between high school students and their parents in Vientiane Capital prefecture, Lao PDR. METHODS: A multistage sampling technique was applied. A self-administered questionnaire was implemented among a sample of 384 high school students aged 14-17 in Vientiane. SRH communication in this study was recorded as the frequency with which adolescents discussed with their parents at least four topics on SRH issues during a six-month period prior to the interview. Data were entered and analysed using Epi Data software version 6.0 and STATA software version 14.2. RESULTS: Slightly more than one-fifth of the students (21.3%) communicated with parents on SRH issues. The multivariate logistic regression model showed that being a male adolescent (AOR = 2.1; 95% CI 1.2 to 3.5), urban school locations (AOR = 0.2; 95% CI 0.1 to 0.5), a mature father (AOR = 1.7; 95% CI 1.0 to 2.9), positive attitudes towards general communication with parents (AOR = 2.2; 95% CI 1.1 to 4.2) and accessibility to multiple SRH information sources (AOR = 5.2; 95% CI 2.4 to 11.4) were significantly associated with adolescent-parent communication on SRH issues. CONCLUSION: This study showed that student-parent communication on SRH issues was low, so policymakers should develop programs to improve SRH communication skills in all schools and encourage open discussion among family members, especially with respect to the participation of adolescent girls. The positive attitudes of students and multiple sources of SRH information were also important factors in improving SRH communication.

Online time, experience of cyber bullying and practices to cope with it among high school students in Hanoi.

This study is conducted to learn about experiences and practices to cope with cyberbullying among high school students in Hanoi and to explore the association between the average time of Internet used per day among high school students in Hanoi, Vietnam, and the risk of being cyberbullied. A total of 215 students aged 13-18 years completed an online survey using respondent-driven sampling method. The experience of being cyberbullied was examined using the modified Patchin and Hinduja's scale. The prevalence of experiencing at least one type of cyberbullying was 45.1%. The most common type of cyberbullying was being called by names/made fun of. The average daily time spent on Internet showed dose-response association with the risk of being cyberbullied. The prevalence of having experienced cyberbullying was 54% among subjects who used Internet >3 hours/day compared to 39% among those who used 1-3 hours and 30% among those who used <1 hour. In terms of practices to cope with this, most students chose to ignore it and not share information with their family or teacher. The most frequent method to overcome this problem was talking with friends (60.8%). Research shows that the prevalence of cyberbullying victimization in Hanoi was high, and student's practices to cope with this new form of bullying were not efficient. Online time had dose-response association with risk of cyberbullying. More attention is needed to increase level of society/school awareness to prevent cyberbullying in Hanoi.

Adverse influence of multilevel socioeconomic status on physical activity: results from a national survey in Vietnam.

BACKGROUND: This study aims to explore associations of individual- and provincial-level socioeconomic status (SES) and the combined interaction among these SES with individual physical activity (PA). METHOD: This analyze used data of 3068 Vietnamese people aged 18-65 years from the national representative STEPS survey in 2015 (STEPS2015). The survey collected PA-related data using the Global PA Questionnaire Version 2 and those on provicial-level characteristics from two surveys in 2014, namely the Intercensal Population and Housing Survey (IPHS) and The Vietnam Household Living Standard Survey (VLSS2014). Multilevel linear analyze was performed with individual and provincial characteristics as independent variables and the metabolic equivalent (MET) score - the indicator of individual PA - as the dependent variable. RESULTS: Male and female participants with insufficient PA accounted for 20.2 and 35.7%, respectively. Both individual- and provicial-level SES were inversely associated with the individual PA level. As the provincial-level monthly income increased by 1 million Vietnam Dongs, the total PA score of individuals residing in that province reduced by 1900 METS. A buffering effect was reported between provincial and individual SES, as the provincial average income increased, the differences in PA scores between different SES groups decreased. CONCLUSION: Our data suggest that Vietnamese individuals in low SES groups tended to be more physically active than those in high SES groups because their PA was largely related to work.

Patterns of Raised Blood Pressure in Vietnam: Findings from the WHO STEPS Survey 2015.

This study aims to describe the prevalence of raised blood pressure and the situation of management for raised blood pressure among the adult population in Vietnam. It also aims to examine the association between diversified socioeconomic and behavioral factors of raised blood pressure and awareness of raised blood pressure. Data were obtained from the STEPS survey conducted in Vietnam in 2015. Survey sample was nationally representative with a total of 3,856 people aged 18-69 years old. The study outcomes included raised blood pressure and awareness of and control of raised blood pressure. Multiple logistic regression was used to examine the association of socioeconomic and behavior risk factors with the outcome variables. The overall prevalence of raised blood pressure in Vietnam in 2015 was 18.9% (95% CI: 17.4%-20.6%). The prevalence of raised blood pressure was higher among men. Significantly correlated factors with raised blood pressure were age, sex, body mass index, and diabetes status. Levels of awareness of raised blood pressure were higher among the older age group and overweight people and lower among ethnic minority groups. Raised blood pressure in Vietnam is a serious problem due to its magnitude and the unacceptably high unawareness rate in the population. Public health actions dealing with the problems of raised blood pressure are urgent, while taking into account its relationship with sex and socioeconomic status. It is clear that the interventions should address all people in society, with a focus on disadvantaged groups which are the rural and ethnic minority peoples.

Blood Glucose Disorders and Access to Health Care Services Among Adults Aged 30 to 69 Years in Chi Linh, Hai Duong, Vietnam.

Planning for control of diabetes in Vietnam needs valid information about the burden of diseases in general population. This study employed a cross-sectional design among population aged 30 to 69 years to measure the burden of type 2 diabetes and gaps in access to health care to explore the negative effects of rapid economic growth and urbanization in Chi Linh in recent years. A total of 594 adults were interviewed and had their fasting blood glucose tested. Results indicated that the prevalence of impaired fasting glycaemia was 11.8% and of diabetes was 12.1%. Only 16.8% diabetes cases detected in this study were diagnosed before, indicating a high level of unmet needs for detecting/managing diabetes in Chi Linh population. Significant associated factors with abnormal blood glucose included age and body mass index level. Without effective intervention programs for diabetes control and management, its burden will continue raising in the coming years. Chi Linh need to strengthen the diagnostic/treatment services at primary health care levels to ensure that people at early stage of raised blood pressure, raised blood glucose can be detected and provided with proper management to avoid serious complications, and to reduce hospital overload at central level.

Students' Knowledge and Attitudes Towards Smoke-Free Universities: Changes Since Enactment of Vietnamese Tobacco Control Legislation.

BACKGROUND: In 2013, legislation in Vietnam regulated smoking in public areas. Included was a ban on indoor smoking at universities. OBJECTIVE: Since awareness and attitude are moderators of the effectiveness of smokefree policy, ou aim was to assess changes in students' knowledge and attitude tosecond hand smoke (SHS) and awareness and support of smoke-free legislation at four Vietnamese universities, one year after legislative changes. METHODS: A two-phase cross sectional study of undergraduate students using self-administered questionnaires (based on the Global Adult Tobacco Survey and the Thrasher survey) was conducted at the introduction of the legislation and one year thereafter. RESULTS: One-year post legislation there were significant increases in knowledge of smoke-free legislation and awareness of universities as smoke-free environments. There was a significant increase in knowledge of harmful effects of SHS on diseases such as examples in the heart and lung, including lung cancer, and miscarriage. Students expressed strong support of smoke-free environments in universities, hospitals, schools, workplaces, public transport, libraries, cinemas and theatres; support was also increased post legislation. Changes were seen in attitude to SHS, and rights of non-smokers and smokers. CONCLUSIONS: Positive changes have occurred in knowledge and attitude toward smoke-free environments and SHS in universities since enactment of Vietnamese tobacco control legislation.