Background: The coverage of breast and cervical cancer screening has only slightly increased in the past decade in Thailand, and these cancers remain leading causes of death among women. This study identified socioeconomic and contextual factors contributing to the variation in screening uptake and coverage. Materials and Methods: Secondary data from two nationally representative household surveys, the Health and Welfare Survey (HWS) 2007 and the Reproductive Health Survey (RHS) 2009 conducted by the National Statistical Office were used. The study samples comprised 26,951 women aged 30-59 in the 2009 RHS, and 14,619 women aged 35 years and older in the 2007 HWS were analyzed. Households of women were grouped into wealth quintiles, by asset index derived from Principal components analysis. Descriptive and logistic regression analyses were performed. Results: Screening rates for cervical and breast cancers increased between 2007 and 2009. Education and health insurance coverage including wealth were factors contributing to screening uptake. Lower or noneducated and poor women had lower uptake of screenings, as were young, unmarried, and non-Buddhist women. Coverage of the Civil Servant Medical Benefit Scheme increased the propensity of having both screenings, while the universal coverage scheme increased the probability of cervical screening among the poor. Lack of awareness and knowledge contributed to non-use of both screenings. Women were put off from screening, especially Muslim women on cervical screening, because of embarrassment, fear of pain and other reasons. Conclusions: Although cervical screening is covered by the benefit package of three main public health insurance schemes, free of charge to all eligible women, the low coverage of cervical screening should be addressed by increasing awareness and strengthening the supply side. As mammography was not cost effective and not covered by any scheme, awareness and practice of breast self examination and effective clinical breast examination are recommended. Removal of cultural barriers is essential.
Health interventions have been shown to be associated with an increase in effectiveness of changing people's behaviors. However, interventions to change snack food consumption are perceived as complex intervention strategies. This systematic review aimed to identify interventions targeted at changing snack food eating behaviors and theory used in interventions. A comprehensive search strategy was performed using databases including Medline, Scopus, Web of Science, and Google Scholar. Articles published between 2010-2019, intervention studies were included and coded to determine whether and how theory was used. More than half of eligible studies on snack food consumption behavior (56.6%) used theory in interventions. 30 articles were identified for inclusion (n = 444). The most-often-used theories were Social Cognitive Theory, Theory of Planned Behavior/Theory of Reasoned Action, and Transtheoretical Model. Intervention strategies targeting the individual level included tailored health communication and goal setting. Commonly used strategies at the interpersonal and organizational level include social support programs and ecological models, respectively. Community-based participatory strategy was used at the community level. These strategies most construct from theories providing information that needs to be changed to promote healthy behavior. Application of theories in interventions enhanced the effectiveness to promote nutrition behavior change. Striving to use theory more thoroughly by applying and testing theories would be crucial to recommend.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.