Background In recent years, behavioral activation (BA) has attracted increased interest as an effective depression treatment. However, empirical evidence supporting its effectiveness in non-Western countries is currently limited. Objective To examine the effectiveness of BA in reducing depressive symptoms, stress, and anxiety among Thai older adults with subthreshold depression. Methods and Subjects A clustered randomized controlled trial was conducted in two health promoting hospitals (HPHs) in the Samut Songkhram province of Thailand. One hospital was used for the intervention (BA+usual care group) and the other for the control (usual care-only group). Each HPH randomly selected 41 eligible older adults residing in their jurisdictions to take part in the study. Mental health outcomes were assessed using the Thai Geriatric Depression Scale (TGDS) and Depression Anxiety Stress Scales (DASS). The BA effectiveness was evaluated using generalized estimating equations (GEE) at a group level and the reliable change index (RCI) at the individual level. Results Over 9 months, the adjusted mean change in depression (TGDS) scores [−2.47 (95% CI: −3.84, −1.00)], mental health status (DASS), specifically depression and stress score [−1.47 and −1.87 (95% CI: −2.43, −0.50 and −2.94, −0.79, respectively)], improved significantly in the BA+usual care group compared to the usual care-only group, whereas anxiety score improved significantly only at 6 months [−0.87 (95% CI: −1.52, −0.23)]. Additional RCI analysis showed that BA was directly associated with 14.63 to 24.39% points increase in the reliable improvement of depressive outcome compared to the usual care-only group. Conclusion This study showed that the BA effectively improved depression, stress, and anxiety in older adults with subthreshold depression in a Thai community setting. Future research should evaluate the longer-term effectiveness of BA in diverse population groups.

Background Increased prevalence of depression highlights the need for effective interventions. Behavioral activation (BA), which can easily be adapted for non-clinical populations, has been the recommended treatment for depression. It is based on a model of psychopathology explaining that losses or chronically low levels of positive reinforcement yield behavioral and emotional changes in depression and that encouraging individuals to increase their engagement in reinforcing activities can improve their mood and enhance their valuable life experiences. Heart rate variability (HRV) provides indices of autonomic function related to depression, but only a few studies have investigated the effect of BA on HRV, particularly among older adults with subthreshold depression. Accordingly, we aimed to investigate the effect of BA on HRV in older adults with subthreshold depression. Methods We conducted a 9-month cluster randomized controlled trial in two Health Promoting Hospitals (HPHs). Eighty-two participants were randomized into either intervention (BA with usual care) or control (usual care only) groups, with 41 participants per group. Daily step count was collected weekly during the 12-week BA intervention period, while HRV parameters, including the Standard Deviation of the Normal-to-Normal interval (SDNN), High Frequency (lnHF), Low Frequency (LF), and Low Frequency/High Frequency ratio (LF/HF), were examined at 0, 3, 6 and 9 months. Generalized Estimating Equations (GEEs) were used in the data analysis. Results Over nine months, the intervention and control groups differed significantly in the unadjusted mean change of HRV, SDNN [7.59 ms (95% CI: 1.67, 13.50)], lnHF [0.44 ms2 (95% CI: 0.04, 0.85)], and LF [0.53 ms2 (95% CI: 0.09, 0.98)], whereas the groups did not differ significantly in LF/HF ratio [0.01 ms2 (95% CI: -0.04, 0.06)]. Conclusion Our results suggest that BA may have a therapeutic effect on depression symptoms of older adults with subthreshold depression via improved HRV. Trial registration TCTR20211019003, thaiclinicaltrials.org, retrospectively registered on 19 October 2021.

Background Fall risk screening using multiple methods was strongly advised as the initial step for preventing fall. Currently, there is only one such tool which was proposed by the U.S. Centers for Disease Control and Prevention (CDC) for use in its Stopping Elderly Accidents, Death & Injuries (STEADI) program. Its predictive validity outside the US context, however, has never been investigated. The purpose of this study was to determine the predictive validity (area under the receiver operating characteristic curve: AUC), sensitivity, and specificity of the two-step sequential fall-risk screening algorithm of the STEADI program for Thai elderly in the community. Methods A 1-year prospective cohort study was conducted during October 2018–December 2019. Study population consisted of 480 individuals aged 65 years or older living in Nakhon Ratchasima Province, Thailand. The fall risk screening algorithm composed of two serial steps. Step 1 is a screening by the clinician’s 3 key questions or the Thai Stay Independent brochure (Thai-SIB) 12 questions. Step 2 is a screening by 3 physical fitness testing tools including Time Up and Go test (TUG), 30-s Chair Stand, and 4-stage balance test. Participants were then followed for their fall incidents. Statistical analyses were conducted by using Cox proportional hazard model. The AUC, sensitivity, specificity, and other relevant predictive validity indices were then estimated. Results The average age of the participants was 73.3 ± 6.51 years (range 65–95 years), and 52.5% of them were female. The screening based on the clinician’s 3 key questions in Step 1 had a high AUC (0.845), with the sensitivity and specificity of 93.9% (95% CI 88.8, 92.7) and 75.0% (95% CI 70.0, 79.6), respectively. Appropriate risk categorization however differed slightly from the original STEADI program. Conclusions With some modification, the fall risk screening algorithm based on the STEADI program was applicable in Thai context.

The purpose of this research was to study factors affecting stress of online learning due to the COVID-19 situation at the Faculty of Education, Thailand National Sport University Chonburi Campus, and to create equations to predict the stress of students. The samples consisted of 280 students in the Faculty of Education, Thailand National Sport University Chonburi Campus. The research instruments were the Suanprung Stress Test and a questionnaire gauging emotional and mental status, perceived severity of stress, opportunity for risk of stress, perceived usefulness of stress management, university policies that promote stress management, environment, and social support. The data were analyzed in terms of frequency, percentage, mean, standard deviation and Stepwise Multiple Regression Analysis. The results indicated that 1) study stress levels during the COVID-19 situation were at a moderate level: subjects had a mild level of stress 8.93 percent, moderate level of stress 56.78 percent, high level of stress 33.93 percent and severe level of stress 0.36 percent; 2) The subjects’ emotional and mental well-being, perceived severity of stress, perceived usefulness of stress management, University policies that promote stress management, environment, social support were at a high level, and Opportunity for risk of stress moderate level. 3) The factors that related to the stress of online learning due to the COVID-19 situation comprised were 4 variables: achievement perceived usefulness of stress management, opportunity for risk of stress, university policies that promote stress management, and social support. There was a statistically significantly difference at the 0.1 level. These 4 factors could predict the Stress about percentage of 70.50. The significantly predicted equations were as follows: In term of raw scores: Y/ = 75.425 + (-5.180) (X4) + 3.816 (X3) + (-3.465) (X5) + (-2.689) (X7) In term of standard scores: Z / Y = (-0.324) (Z X 4) + 0.280 (Z X 3) + (-0.225) (Z X3) + (-0.165) Z X 7)

The objectives of this research were 1) study on the parenting style effects on vegetable having behavior of small children 2) to study vegetable having behavior of small children and 3) to study the relation between parenting style and vegetable having behavior of small children. The samples used include the parents of 120 small children both male and female studying in pre-kindergarten level of preschool training center, Wat Phetsamut at Maeklong Sub-district, Mueng District, Samutsongkhram Province. Statistics used in the analysis were percentage, mean, standard deviation and the relation between parenting style and vegetable having behavior of small children by Pearson’s coefficient. The research found that the parenting style with attention is in high level (=4.40), the parenting style with control and the parenting style with indulgence are in the intermediate level (=3.33) and = 2.56) respectively and the parenting style with abandon is in low level ) (=1.86). Vegetable having behavior of small children found that the most are in intermediate level = 3.35). The relation between parenting style of parent and vegetable having behavior of small children found that parenting style with attention and control have positive relation to vegetable having behavior of small children but parenting style with indulgence and abandon have negative relation to vegetable having of small children.

This study aimed to assess health literacy (HL), preventive behaviors (PBs), and the factors associated with PBs toward COVID-19 among village health volunteers (VHVs) and residents in urban and rural areas in the upper south of Thailand. A cross-sectional study was conducted using valid questionnaires administered using an online platform. Data were analyzed using descriptive statistics, t-tests, and binary logistic regression analysis. A total of 846 people participated in this study, and 62.8% of participants had an adequate level of HL. Furthermore, 55.0% of participants had an adequate level of PBs. Among VHVs, PB levels were adequate, whereas among residents, they were inadequate. Moreover, among VHVs, underlying diseases (adjusted odds ratio (OR): 1.77, 95% CI: 1.13–2.76), access to HL (adjusted OR: 4.28, 95% CI: 1.42–12.88), appraisal of HL (adjusted OR: 3.09, 95% CI: 1.90–5.02), and application of HL (adjusted OR: 2.51, 95% CI: 1.52–4.12) were associated with COVID-19 PB. Additionally, among residents, only marital status (adjusted OR: 1.59, 95% CI: 1.04–2.44), appraisal of HL (adjusted OR: 1.78, 95% CI: 1.18–2.84), and application of HL (adjusted OR: 3.85, 95% CI: 2.39–6.20) were associated with PBs towards COVID-19. Furthermore, individuals with inadequate HL demonstrated noteworthy significance in all dimensions of PBs. To prioritize and optimize preventive programs aimed at enhancing PBs, the government must take proactive initiatives in implementing robust health communication strategies across diverse media platforms, both in the present and future.

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