Aging with Grace: New Health and Social Care Model for Older People in Thailand: Effective model with affordable cost. Funded by WHO Center for Health Development. Press release in many international medica in 2023
Background
Many Myanmar immigrants have worked in Northern Thailand, but language barrier and acculturation issue have been identified.
Objective
The study was conducted with the aim of understanding the health status of migrant workers, verifying their relationship with socio-economic factors and cross-cultural adaptation, and identifying risk factors.
Methods
We conducted an interview questionnaire survey at a hospital in Chiangmai city.
Findings
The average age of 414 respondents was 29.5±9.0 years, 26.3% reported smoking, 40.8% had a drinking habit, 75.8% reported no exercise habit, 40.1% overweight/obese, and 27.1% hypertension. Depressive tendencies were observed in 13.0%.
53.4% of the respondents had musculoskeletal disorders, suggesting the need for early intervention, with cross-cultural adaptation being significantly associated with workers classified as marginalized and depressive tendencies.
Conclusion
In ASEAN economic zone where labor liberalization is progressing, the actual state of health damage (musculoskeletal disorder and non communicable diseases) caused by the working and living environment of migrant workers was clarified.
TNN Aung, Y Shirayama, S Moolphate, MN Aung, T Lorga, M Yuasa. Health risk behaviors, musculoskeletal disorders and associated cultural adaptation, depression: a survey among Myanmar migrant workers in Chiangmai, Northern Thailand. International Journal of General Medicie 12; 283-292, 2019.
TNN Aung, Y Shirayama, S Moolphate, T Lorga, M Yuasa, MN Aung. Acculturation and its effects on health risk behaviors among Myanmar migrant workers: A cross-sectional survey in Chiang Mai, Northern Thailand. International Journal of Environmental Research and Public Health 17(14) DOI; 10.3390/ijerph17145 108, 2020.
Background
Age-friendly environment was one of the 5 strategic priority areas identified in the global strategy and action plan on ageing and health 2016-2020.(WHO 2020). We participated in the International collaboration initiated by AIHD Mahidol to study age-Friendly Environments in ASEAN Plus Three: Case Studies from Japan, Malaysia, Myanmar, Vietnam, and Thailand University.
Objective
To measure and compare community residents’ perception of how age-friendly their environment and compare across the countries. To find out the influence of age-friendly environmental factors on quality of life, active ageing and social network diversity.
Methods
WHO: Measuring the age-friendliness of cities (2015). 20 itemed WHO age-friendliness indicators was transculturally translated and piloted to be in Japanese version.
Findings
Community residents in Japan receive a balance of care, welfare and health services. Regarding the factor significant for social network diversity, altogether 69.66% of the participants did not participate in a volunteer activity, 77.33% did not engage in paid employment and 51.30% did not have internet access at home. Regarding the factors significant for active ageing, 55.55% of the older people seemed unable to join a sociocultural activity at least once in the previous week, and 43.48% did not join group exercise activity in their leisure time. Regarding the factors significantly related to quality of life, 24.47% seemed to not have access to the local source of information about health concerns and service; 30.71% did not get their needs of personal care and assistance at home using formal care services; and 39.3% who needed assistance did not have enough income to meet their basic needs over the previous 12 months.
Conclusion
The finding from these study aims to assist public health authorities to assemble the preventative intervention for diabetes in each county and culturally similar countries.
A. Ishtiaq, M.N. Aung, S. Ueno, E.T. Khin, T.S. Latt, S. Moolphate, M. Yuasa. Physical Activity of Type 2 Diabetes Mellitus Patients and Non-Diabetes Participants in Yangon, Myanmar: A Case-Control Study Applying the International Physical Activity Questionnaires (IPAQ-S). Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 14;1729-1739, 2021.
E. T. Khin, M. N. Aung, S. Ueno, A. Ishtiaq, T. S. Latt, S. Moolphate, M. Yuasa. Social Support between Diabetes Patients and Non-Diabetes Persons in Yangon, Myanmar: A Study Applying ENRICHD Social Support Instrument. International Journal of Environmental Research and Public Health 18; 7302, 2021.
Ueno S, Aung MN, Yuasa M, Ishtiaq A, Khin ET, Latt TS, et al. Association between Dietary Habits and Type 2 Diabetes Mellitus in Yangon, Myanmar: A Case–Control Study. International Journal of Environmental Research and Public Health. 2021;18(21):11056.
Background
Whilst policy interventions were broadly similar across the globe, there were some differences in individual and community responses. This study explored community responses to COVID-19 containment measures in different countries and synthesized a model.
Objective
This study explains the community response to pandemic containment measures in the local context, so as to be suitably prepared for future interventions and research.
Method
A multinational study was conducted from April-June 2020 involving researchers from 12 countries (Japan, Austria, U.S., Taiwan, India, Sudan, Indonesia, Malaysia, Philippines, Myanmar, Vietnam and Thailand). Steps in this research consisted of carrying out open-ended questionnaires, qualitative analyses in NVivo, and a multinational meeting to reflect, exchange, and validate results. Lastly, a community response model was synthesized from multinational experiences.
Findings
Eight themes emerged: Communication strategy, Habit and behavior of the people, sustained essential social services to enable people to stay at home, economic back up to endure the tough time, preventing the clusters as a result of cultural norms, and festivals, alternative way to have fun or to work and practice social activities, public experience of pandemics, and privacy and human right of the patients, suspects and everyone constitute community response to the pandemic and containment polices.
Conclusion
Understanding community responses to containment policies will help in ending current and future pandemics in the world.
Aung MN, Stein C, Chen WT, Garg V, Saraswati Sitepu M, Thu NTD, Gundran CPD, Hassan MR, Suthutvoravut U, Soe AN, Nour M, Gyi KK, Brandl R, Yuasa M. Community responses to COVID-19 pandemic first wave containment measures: a multinational study. J Infect Dev Ctries. 2021 Aug 31;15(8):1107-1116. doi: 10.3855/jidc.15254. PMID: 34516418.
Aung MN, Koyanagi Y, Yuasa M. Health inequality among different economies during early phase of COVID-19 pandemic. J Egypt Public Health Assoc. 2021 Feb 17;96(1):3. doi: 10.1186/s42506-021-00067-0. PMID: 33595767; PMCID: PMC7887563.
Background
Diabetes is a common NCD in Thailand and Myanmar. The prevalence of type 2 diabetes was 9.9% in Thailand and 10.5 % in Myanmar in 2014. Thailand and Myanmar share long border and common cultures. Non-communicable diseases are linked to the culture. The culture of two countries are similar but the health system and health promotion activities are very different. The aim of the present study was to identify the risk factors of T2DM in Yangon Myanmar and Chiang Mai Thailand applying case-control studies in the community setting.
Objective
To compare the physical activity level, dietary habit, social support, and salt and sugar level in the home-made food between newly diagnosed diabetes patients and controls.
Methods
Case control studies. Cases are defined with eligibility criteria and compared with community controls to find our the different in association with interested exposure variable. International physical activity questionnaires (IPAQ-short) version, combined food habit questionnaires, ENRICH social support questionaries were used. Atago Digital salt-meter ES-421 and Atago Pocket saccharimeter PAL-J were applied for salt and sugar contents in the home-made dishes.
Findings
There publications has been published to report the finding in Myanmar such as low physical activity and age older than 40 are the risk factors of diabetes. More analysis and publications are coming soon.
Conclusion
The finding from these study aims to assist public health authorities to assemble the preventative intervention for diabetes in each county and culturally similar countries.
A. Ishtiaq, M.N. Aung, S. Ueno, E.T. Khin, T.S. Latt, S. Moolphate, M. Yuasa. Physical Activity of Type 2 Diabetes Mellitus Patients and Non-Diabetes Participants in Yangon, Myanmar: A Case-Control Study Applying the International Physical Activity Questionnaires (IPAQ-S). Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy 14;1729-1739, 2021.
E. T. Khin, M. N. Aung, S. Ueno, A. Ishtiaq, T. S. Latt, S. Moolphate, M. Yuasa. Social Support between Diabetes Patients and Non-Diabetes Persons in Yangon, Myanmar: A Study Applying ENRICHD Social Support Instrument. International Journal of Environmental Research and Public Health 18; 7302, 2021.
Ueno S, Aung MN, Yuasa M, Ishtiaq A, Khin ET, Latt TS, et al. Association between Dietary Habits and Type 2 Diabetes Mellitus in Yangon, Myanmar: A Case–Control Study. International Journal of Environmental Research and Public Health. 2021;18(21):11056.
Background
JICA Maternal and Child project assisted to implement community-based health promotion (HP) actions.
Objective
The study aimed to evaluate the effect of HP intervention in Potoｓi and Oruro.
Methods
Cluster randomized trial was conducted. The verified questionnaire of self-efficacy, social capital, and health-related QOL. A difference in difference analysis was performed.
Findings
In Potosi, Social capital and QOL in Int. were significantly improved. In Oruro, Self-efficacy and Social capital in Int. were increased.
Conclusion
HP intervention was effective in human & social capital of community residents.
Fig 1. Result of Potosi province
Fig 2. Result of Oruro province
Yuasa M, Sirayama Y, Osato K. Miranda C. Condore J. Siles R.: Cross-sectional analysis of self-efficacy and social capital in a community-based healthy village project in Santa Cruz, Bolivia. BMC International Health & Human Rights 2015, doi:10.1186/s12914-015-0054-y.
Background
In JICA Maternal and Child Health Network Strengthening Project carried out in Oruro Department, Bolivia, a competency survey of health care workers was conducted to measure the effect of training for health care workers including doctors, nurses, and associate nurses.
Objective
The "Competence Survey" measured the ability of health care workers to care for mothers and children.
Methods
The study participants were doctors, nurses, and associate nurses engaged in medical centers in three intervention health divisions (intervention group) and three non-intervention divisions (control group) in Oruro Province. Surveys were conducted before and after the project using originally developed questionnaire based on UNICEF/WHO guideline.
The number of doctors, nurses, and ass. Nurses were 97, 62 & 93 in int. and 41, 13, & 41 in con. before Int., and 118, 72 & 105 in int. and 44, 12 & 57 in con. After Int. The intervention had been provided for three years.
Findings
The mean of competence scores of the intervention grope was significantly improved in doctors, nurses and ass. nurses in intervention group that those of control group for three years.
Fig 1. Competency survey
Background
The JICA Oruro project aimed to improve patient’s satisfaction at health centers as one of the outcome of the project.
Objective
The project measure the patient’s satisfaction which was provided at the intervention health centers.
Methods
The questionnaire of HCAHPS (Hospital consumer assessment of healthcare providers and system) was used to measure the satisfaction. The number of patients were 228 (M; 55, F; 173) in int. and 247 (M; 63, F; 184) in con before Int., and 138 (M; 48, F; 90) in int. and 146 (M; 53, F; 93) in con. After Int.
Findings
The mean of patient’s satisfaction score of the intervention grope was significantly improved to doctors and nureses in intervention group that those of control group for three years.
Fig 2. Satisfaction survey
Objective
Smoking cessation is an achievable behavioral change, which reduces the risks of cardiovascular diseases, cancers and tobacco-related diseases. There is a need for an effective smoking cessation service for low and middle income country settings where the smoking rate is generally very high whilst a cessation service is not usually accessible. This study devised a new smoking cessation service package and assessed its effectiveness in the primary health care setting of northern Thailand.
Methods
Randomized controlled trial A total of 319 eligible patients who consented to participate in the study, were randomly allocated to an intervention arm (160) and a control arm (159), applying block randomization. The multi-component intervention service consisted of: (1) regular patient motivation by the same nurse over a 3-month period; (2) a monthly piCO+ Smokerlyzer test for 3 months; (3) continual assistance from a trained family member, using a smoking-cessation- diary; and (4) optional nicotine replacement chewing gum therapy. The control group received the routine service comprising of brief counseling and casual follow-up. Smoking cessation, confirmed by six months of abstinence and the piCo+ Smokerlyzer breath test, was compared between the two services after a year follow-up. The trial is registered as an international current control trial at the ISRCTN registry. ISRCTN89315117.
Findings
The intervention arm participants achieved a significantly higher smoking cessation rate than the control arm 25.62% vs 11.32%, with an adjusted odd ratio of 2.95 and 95% confidence interval 1.55-5.61.
Conclusion
Utilizing community resources as major intervention components, the evidence from this trial may provide a useful and scalable smoking cessation intervention for low and middle income countries.
Figure1: Conceptual model
Figure2: Smoking cessation diary
Myo NA, Yuasa M, Lorga T, Moolphate S, Fukuda H, Kitajima T, Yokokawa H, Minematsu K, Tanimura S, Hiratsuka Y, Ono K, Naunboonruang P, Thinuan P, Kawai S, Suya Y, Chumvicharana S, Marui E: Evidence-based new service package vs. routine service package for smoking cessation to prevent high risk patients from cardiovascular diseases (CVD): study protocol for randomized controlled trial. Trials 2013, 14: 419 doi:10.1186/1745-6215-14-419.
MN Aung, M Yuasa, S Moolphate, T Kitajima, T Lorga, H Yokokawa, H Fukuda, S Tanimura, Y Hiratsuka, K Ono, PT Thinuan, K Minematsu, J Deerojanawong, Y Suya, E Marui. Effectiveness of a new multi-component smoking cessation service package for patients with hypertension and diabetes in northern Thailand: a randomized controlledtrial (ESCAPE study). Substance Abuse Treatment, Prevention, and Policy 14, 10, 2019. DOI; 10.1186/s13011-019-0197-2.
Background
Global sodium intake remains above the recommended levels to control blood pressure (BP).
Objectives
We aimed to evaluate the efficacy of a dietary intervention on BP through salt reduction among community-dwelling participants with high risk of cardiovascular disorders.
Method
This cluster randomized trial (February 2012 to January 2013) included cooking instruction using the pocket salt meter among patients with diabetes and/or hypertension who were treated at health center in Thailand. Based on health centers, 8 clusters of eligible participants were randomly allocated to the 4 intervention and 4 control groups. Dietary intervention was performed at baseline, 1 month, and 3 months in intervention group. In both groups, systolic and diastolic BPs, and estimated 24 hours salt intake based on overnight urine samples were measured at baseline, 6 months, and 12 months.
Findings
There were significant difference in systolic BP and estimated salt intake after adjusting covariates at 6 months. However, these differences were not observed at 12 months. There were no differences in diastolic BP in both follow-ups.
Findings
The results suggest the effectiveness of a visually based dietary intervention targeting salt intake reduction in short term, but the effectiveness discontinued in long term.
Figure1: Flow chart for enrollment and follow up
Figure2: (A) Change in systolic BP. (B) Change in diastolic BP. (C) Change in estimated daily salt intake
Aung MN, Yuasa M, Moolphate S, Nedsuwan S, Yokokawa H, Kitajima T, Minematsu K, Tanimura S, Fukuda H, Hiratsuka Y, Ono K, Kawai S, Marui E: Reducing salt intake for prevention of cardiovascular diseases in high-risk patients by advanced health education intervention (RESIP-CVD study), northern Thailand: study protocol for a cluster randomized trial. Trials 13: 158 doi: 10.1186/1745-6215-13-158, 2014.
H Yokokawa, M Yuasa, S Nedsuwan, S Moolphate, H Fukuda, T Kitajima, K Minematsu, S Tanimura, E Marui. Daily salt intake estimated by overnight urine collections indicates a high cardiovascular disease risk in Thailand. Asia Pac J Clin Nutr 25(1); 39-45, 2016.
H Yokokawa, M Yuasa, S Nedsuwan, S Moolphate, H Fukuda, T Kitajima, K Minematsu, S Tanimura, E Marui. An impact of dietary intervention on blood pressures among diabetic and/or hypertensive patients with high cardiovascular disorders risk in northern Thailand by cluster randomized trial. J Gen Fam Med 22: 28–37, 2021.
Backgrond
Hokkaido is the prefecture with the highest adult smoking rate in Japan. Raising public awareness through cancer education from a younger age is a key to prevent and control cancer and other NCDs. Two health educational DVDs were developed by Hokkaido-Sapporo Cancer Seminar Foundation.
Objective
The study aims to evaluate the effects of the anti-smoking education using these DVDs at randomly selected schools in four geographically various prefectures.
Methods
We measured….
1) The change in children’s image of tobacco smoking, before and after the education, using the Kano Test for Social Nicotine Dependence (KTSND).
2) One month after the class, what kind of interactions actually occurred among children, parents, and adults in their community
Findings
The survey elucidated the high smoking rate (62.9%) among adults surrounding the children. This explains the result that the 299 (13.2%) showed higher tolerance to smoking.
Conclusion
Our DVDs encouraged young children to talk to their own parents and adults in the community. Many of them did actually talk and they perceived some changes in their parents and other adults. We continue to promote cancer education from younger age.
Yuasa M, Sirayama Y, Kigawa M, Chaturanga I, Mizoue T, Kobayashi H.: A health promoting school (HPS) program among primary and secondary school children in Southern Province, Sri Lanka: A qualitative study on the program’s effects on the school children, parents, and teachers. Journal of International Health 30, 93-101, 2015
Background
The Japan International Cooperation Agency (JICA) has focused its attention on appraising health development assistance projects and redirecting efforts towards health system strengthening.
Objective
The study aimed to describe the type of project and targets of interest, and assess the contribution of JICA health-related projects to strengthening health systems worldwide.
Methods
We collected a web-based Project Design Matrix (PDM) of 105 JICA projects implemented between January 2005 and December 2009. We developed an analytical matrix based on the World Health Organization (WHO) health system framework to examine the PDM data and thereby assess the projects’ contributions to health system strengthening.
Findings
The majority of JICA projects had prioritized workforce development, and improvements in governance and service delivery. Conversely, there was little assistance for finance or medical product development.
Conclusion
Our study confirmed that JICA projects met the goals of bilateral cooperation by developing workforce capacity and governance. We also showed that the analytical matrix methodology is an effective means of examining the component of health system strengthening to which the activity and output of a project contributes.
Fig 1. An example of PDM
Fig 2. WHO health system framework
Fig 3. Association between outputs and activities of JICA project by Correspondence analysis
Except for financing, outputs of other blocks were associated with activities.
Fig 4. Association between JICA project type and system block by correspondence anal.
There were association between products & EPI, Service & RH/MCH.
Yuasa M, Yanaguchi Y, Imada M: Contribution of Japan International Cooperation Agency health-related projects to health system strengthening. BMC Internal Health and Human Right 13: 39, 2013, doi: 10.1186/1472-698X-13-39.
Background
Recently, Japanese life expectancy has been the longest in the world. 70% of the life expectancy extension from 1921 to 2010 (male 35.66, female 41.40) was achieved before the establishment of the universal health insurance system in 1961. Infant mortality decline was most contributed to the life expectancy extension (30-40%) .
Objective
The study aims to identify determinants that improved life expectancy of Japanese from 1961 to 2009.
Methods
A panel data analysis is performed with multiple regression analysis and structural equation modeling method.
Fig 1. Life expectancy of Japanese male and female in 1921-25, 1954-56, 2005
Discrepancy among provinces had been decreased, but gap between male and female had been increased.
Fig 2. Male life expectancy in developed countries
After WW2, life expectancy of Japan had dramatically improved.
Fig 3. Analysis procedure to elucidate factors affecting life expectancy of Japanese people from 1961 to 2009
Background
The oriental view of the world and life is vaguely recognized by subject and object, and has a strong tendency to be introverted, sensory, and subconscious.
Objective
The study aimed to identify oriental stress coping sensations based on the above characteristics.
Methods
The first edition of the questionnaire was created by the facet method for the results of interviews with local government officials and tsunami victims. Next, using this questionnaire, the first survey was conducted on 358 local government employees, and the results were promax-rotated by factor analysis to extract the sub-concept. In addition, the second survey was conducted for 280 general residents and corporate employees, and the results were promax-rotated by factor analysis to extract the final sub-concept.
Findings
When the questions were asked by the facet method, a total of 26 questions were created, including 6 questions of counter-adherence, disidentification, and inclusiveness, and 8 embracement. As a result of the second survey, the number of questions with a factor loading of 0.6 or more was 3 questions of counter-adherence (Cronbachα=0.708), 2 questions of disidentification (α=0.718), and 2 questions of inclusiveness (α=0.650), and 3 questions of embracement (α=0.763). The Pearson correlation coefficient between SOA and WCCL positive cognition and social support was 0.524 (p<0.001). The correlation coefficient between SOA and SOC (Univ. of Tokyo ver. 3 questions) was 0.586 (p<0.001).
Conclusion
The 10 items in the SOA questionnaire were considered to be useful indicators as a measure of emotional stress coping.