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BACKGROUND: Stroke is a global and Thai concern. Village Health Volunteers (VHVs) are vital in community healthcare but lack stroke knowledge. Prior efforts to improve their knowledge were ineffective. The "Stroke Sign by Sticker" application was created to enhance VHV literacy. To evaluate the effectiveness of the "Stroke Sign by Sticker" line application in enhancing stroke awareness among VHVs. METHODS AND MATERIAL: The study was conducted in a health community setting using a quasi-experimental design. The study was conducted within a healthcare community in Thailand. The "Stroke Sign by Sticker" mobile application was developed specifically for the LINE platform. The knowledge scores were measured using a tool that demonstrated a high validity coefficient of. 93. The intervention itself lasted for 3 weeks. The entire process, from the development of the mobile application to the assessment of its effectiveness, took place during the period of 2021-2022. The R program was used to implement the analysis of covariance method for adjusting pretest scores as a covariate. RESULTS: A total of 60 participants were included, with half assigned to the experimental group and the other half to the control group. The post-test knowledge scores were the main outcome measure of interest. The results showed a significant effect of the independent variable, with the experimental group exhibiting a higher mean knowledge score compared to the control group (F = 24.26, P < .001). CONCLUSIONS: The "Stroke Sign by Sticker" line application demonstrated its effectiveness in promoting stroke knowledge among VHVs, underscoring its potential as a valuable tool for health promotion and education within healthcare settings.

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BACKGROUND: Village health volunteers (VHVs) engaging in community-based COVID-19 prevention and control measures played a key role in mitigating effects of the COVID-19 pandemic in Thailand. We conducted a cross-sectional questionnaire survey study to investigate factors affecting VHVs' COVID-19 self-protective behaviors and social distancing in Songkhla Province during the first COVID-19 outbreak. Such information may help to understand how to support VHVs in future pandemics. METHODS: A total of 152 VHVs from 13 sub-districts participated in the study, completing a 54-item questionnaire based on the Health Belief Model (HBM). The questionnaire included items assessing susceptibility, severity, benefits, barriers, self-efficacy, social distancing, and self-protective behavior. Stepwise multiple regression analysis determined which aspects of the HBM could explain VHVs' self-protective behavior. RESULTS: The VHV population sampled broadly reflected the main demographic characteristics of the local population, although VHVs were predominantly female. Self-protective behavior was significantly associated with VHVs' role (higher perceived compliance for village leaders than non-leaders) but not with other demographic characteristics. Most VHVs reported high levels of self-efficacy (80.5%), adherence to social distancing measures (70.9%), and engagement in self-protective behavior (72.8%) against COVID-19. However, compliance with hand hygiene appeared to be suboptimal, suggesting room for improvement. Self-efficacy and perceived social distancing showed strong and moderate correlations with self-protective behavior against COVID-19 (r = 0.917, ß = 0.819; and r = 0.561, ß = 0.173 respectively; p < 0.001). The final HBM-based regression model accounted for 87.2% of the variance in VHVs' self-protective behavior. CONCLUSIONS: This study highlights the importance of VHVs' self-efficacy for achieving self-protective behavior during a COVID-19 outbreak, and suggests that self-efficacy may help to overcome barriers that might otherwise hinder behaviors to mitigate against COVID-19. Policies that support self-efficacy should be implemented in any future pandemic, and steps to support VHVs with hand hygiene compliance and empower non-leaders to increase their self-protective behavior may also be helpful. Whilst the HBM provided a useful framework for interpretation, the final model was driven mainly by self-efficacy.

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INTRODUCTION: Chronic kidney disease (CKD) is a major health problem in Thailand and health behaviors are central to its risk and progression. Because of the shortage of healthcare personnel, village health volunteers (VHVs) have been collaborating in the primary health care system. However, the contribution of VHVs to CKD reduction has not been evaluated yet. This study aimed to evaluate the efficacy of the VHV-integrated model in preventing and slowing down CKD and its risk factors. METHODS: The population-based cohort study was conducted in a rural community of Thailand between 2017 and 2019. Baseline clinical and behavioral characteristics including CKD, diabetes, hypertension, and other high-risk factors of the participants were collected. The integrated care model was initiated by the multidisciplinary care team that facilitated, empowered, and trained VHVs targeting risk factors of CKD, health literacy, and health promotion. Then the participants were educated and trained for lifestyle modification and were monitored continuously for 18 months by VHVs. Changes in the CKD risk factors, and kidney functions before and after the application of integrated care model were compared. RESULTS: A total of 831 subjects participated in the study with an average age of 57.5 years, and 69.5% were female. Among them, 222 participants (26.7%) were diagnosed as having CKD, the vast majority (95%) of which were in the early stages (G1-G3 and A1-A2). CKD risk factors such as high salt intake, smoking, alcohol consumption, self-NSAID (non-steroidal anti-inflammatory drugs) use were significantly decreased after application of the care model. Also, hemoglobin A1c was significantly reduced in diabetic patients, and blood pressure was controlled better than before in the hypertensive patients. Most importantly, a decline of estimated glomerular filtration rate of the CKD group was improved and lower than the non-CKD group. CONCLUSION: The integrated care model through VHV significantly attenuated the risk factors associated with CKD in the general and high-risk population and effectively slowed down the progression of CKD.

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Background: The COVID-19 pandemic has posed a global challenge, leading different nations to adopt diverse strategies for prevention and control. In Thailand, Village Health Volunteers (VHVs) have played a pivotal role in the fight against the virus. As the pandemic unfolded, the critical role of VHVs became apparent, prompting a closer examination of their practices and the underlying factors contributing to their effectiveness. Objective: This study aimed to uncover the underlying factors and indicators contributing to the successful prevention and control of COVID-19 by VHVs in Thailand. Methods: The sample group included 10,400 VHVs nationwide. Data were collected from October 2020 to February 2021 using five-point Likert rating scale online questionnaires. Data were analyzed using the Exploratory Factor Analysis technique, with Principal Component Analysis and the orthogonal Varimax method. Results: The study revealed nine effective factors and 52 indicators contributing to the prevention and control of COVID-19 in Thailand. The identified factors are as follows: 1) Personal precautions, 2) Proactive disease control strategy, 3) Awareness of COVID-19 severity, 4) Pride and job motivation, 5) Adequate medical equipment and support, 6) Communication, planning, and monitoring processes, 7) Self-care for health, 8) Data collection, record maintenance, and report submission, and 9) Proper hand washing. Conclusion: This research emphasizes the importance of a holistic approach to community-based health interventions. It highlights the crucial role of VHVs in disseminating information, ensuring preparedness, and fostering a sense of responsibility among community members. This strategic approach will effectively contribute to ongoing efforts to successfully prevent and control the spread of COVID-19 and potential future outbreaks.

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Objectives: This study aimed to investigate the effect of a peer-training program for village health volunteers (VHVs) to improve chronic disease management among older adults in rural Thailand. Methods: The study was guided by community-based participatory research (CBPR). The peer-training program was developed by engaging diverse stakeholders, including community organizations, healthcare services, VHVs, older adults with chronic illnesses, and folk scholars in remote communities with high healthcare needs. The peer-training program comprised a three-day training workshop that convened once a week for three weeks with the following six sessions: knowledge sharing, peer support and empowerment, health literacy and health behavior, the general caring procedure for older adults with chronic illnesses, information sharing and communication, and home visit. From January to April 2021, a total of 28 VHVs completed the peer training program in a rural area in Chiang Rai province, Thailand. The Health Literacy and Health Behavior-3E2S (HLHB-3E2S), the Management of Non-Communicable Diseases Questionnaire (MNCDQ), and a self-confidence questionnaire were used to survey pre (week 1) and post-intervention (week 12), respectively. Then VHVs were interviewed to collect attitudes, and opinions about the intervention. Results: After the intervention, the HLHB-3E2S scores (49.39 ± 5.54 vs. 52.35 ± 4.26, P = 0.001), the MNCDQ scores (44.10 ± 6.27 vs. 50.60 ± 4.84, P < 0.001), and the self-confidence questionnaire scores (22.28 ± 2.46 vs. 23.21 ± 1.81, P = 0.01) of VHVs significantly increased. VHVS also reported that the peer-training program enhanced their healthcare services, including health education, chronic disease management, leadership skills, and improving their relationship with healthcare providers. Conclusion: Peer training programs are a practical strategy to improve VHVs' capacities.Healthcare professionals should provide a continuous training program for VHVs with their peers to increase capacities, confidence, and satisfaction in caring for the older adults with chronic diseases in the community.

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Soil-transmitted helminth infections are most prevalent in rural populations. Village health volunteers (VHVs) are the key individuals for Thai primary healthcare. Therefore, this study aimed to investigate the knowledge, attitudes, and practices regarding soil-transmitted helminthiasis in VHVs. A questionnaire survey was conducted among 552 VHVs randomly selected from four subdistricts in a southern province of Thailand. Sociodemographic variables and information regarding the knowledge, attitudes, and practices related to soil-transmitted helminthiasis were collected using a structured questionnaire. The results demonstrated that VHVs had poor knowledge (70.47%) and practices (66.49%); however, 69.57% had good attitudes. Most VHVs had inadequate knowledge and practices regarding soil-transmitted helminthiasis. VHVs who had been trained in parasitic infection control measures were 2.18 times more likely to have good knowledge. VHVs with a monthly family income of more than 307 USD were 1.58 times more likely to have a good attitude. VHVs with good knowledge were more likely to have good practices. In conclusion, the development of training programs and health promotion should be considered to enhance the knowledge, attitudes, and practices related to soil-transmitted helminthiasis in VHVs, who are the key individuals for providing health education to community members.

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Since the early stage of the pandemic outbreak between 2019-2020, the capacity and preparedness of Thailand in coping with the crisis were reconfirmed with ranking the country sixth among a total of 195 countries in terms of health security and making it the only developing country worldwide on the top 10 list and number 1 in Asia. In the ongoing COVID-19 outbreak, the Village Health Volunteers (VHVs) play an important role as a representative and gatekeeper of the community in the response to the pandemic. Previous research paid less attention to explore how local communities in the northeast of Thailand are able to prevent themselves from the pandemic by utilizing certain form of local resources. The research pays attention to the roles and functions of VHVs, as well as to the process of social network formation of the VHVs in Nakhon Phanom. It applies anthropological research methods: focus group, observations and in-depth interviews with five VHVs. Following the "network" and "social capital" concepts (Lin and Huang, 2005), this paper argues that local communities in the northeast of Thailand attempt to cope with the risks and challenges of the COVID-19 pandemic by mobilizing a variety of local resources, and such mobilization is operated and maintained by numerous local agencies or relevant stakeholders. The VHVs formulate "socio-political networks," or can be seen as a "pluralistic network" based on a "collaborative system" between numerous agents/stakeholders in the community, including VHV groups, villagers, families/households, local politicians/officials, and private sector actors. This research can be used as fundamental research applying to understand the larger societies where community collaborations, social networks, and social capital are key mechanisms empowering agencies to encounter the invasion of a global pandemic.

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Management of advanced-stage oral cancer adds a great burden to individuals and health care systems. Community-based oral cancer screening can be beneficial in early detection and treatment. In this study, a novel oral cancer screening program was conducted utilizing an existing network of health care personnel, facilities, and digital database management for efficient coverage of a large population. The screening program considered 392,396 individuals aged ≥40 from four northeastern provinces in Thailand. Three levels of screening were performed: S1 by village healthcare volunteers to identify risk groups, S2 by dental auxiliaries to visually identify abnormal oral lesions, and S3 by dentists for final diagnosis and management. A total of 349,318 individuals were interviewed for S1, and 192,688 were identified as a risk group. For S2, 88,201 individuals appeared, and 2969 were further referred. Out of 1779 individuals who appeared for S3, oral potentially malignant disorders (OPMDs) were identified in 544, non-OPMDs in 1047, doubtful lesions in 52, and no results in 136 individuals. Final treatment was carried out in 704 individuals that included biopsies of 504 lesions, exhibiting 25 cancerous lesions and 298 OPMDs. This study is so far one of the largest oral cancer screening programs conducted in Thailand and showed effective implementation of community-based oral cancer screening.

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OBJECTIVE: This research aimed to examine the relationship between perceived self-efficacy and cervical cancer screening of village health volunteers. METHODS: The researchers conducted this descriptive research with 279 samples, each recruited using the stratified random samplings. Data were collected in August 2020 using two research instruments included general data and the self-efficacy assessment. The self-efficacy assessment was tested, yielding a reliability score of 0.90. Data were then analyzed using descriptive statistics and point- biserial correlation. RESULTS: The results revealed that the mean scores of perceived self-efficacy were at a high level in (Mean= 4.35, S.D.= 0.77) and perceived self-efficacy of each has the mean scores of at a high level in strength, generality, and magnitude dimension (Mean= 4.27, S.D.= 0.76; Mean= 4.40, S.D.= 1.01; Mean= 4.35, S.D.= 0.76) respectively. There were significantly positive correlations between the perceived self-efficacy and cervical cancer screening at a very high level (r= 0.81, p <0.001). The relationship between the perceived self-efficacy of each in the strength dimension and magnitude dimension with cervical cancer screening was at a very high level of relationship significantly (r= 0.84, 0.82, p < 0.001). The generality dimension was at a high level of relationship significantly. (r= 0.66, p < 0.001). CONCLUSION: This study showed that village health volunteers with high perceived self-efficacy correlated with their confidence screening for cervical cancer. Therefore, village health volunteers should emphasize that women learn and acknowledge the importance of obtaining cervical cancer screening to prevent cervical cancer effectively. 
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This study investigated the effectiveness of rehabilitation services provided by trained Village Health Volunteers (VHVs) on community integration and quality of life (QOL) for stroke patients in Thailand. Community integration and QOL were measured before receiving rehabilitation and at three months post-intervention. Twenty-five stroke subjects from four rehabilitation centers were recruited by purposive sampling. The statistics used were descriptive and paired t-test. The community integration scores increased significantly (p < .05) from pre-test (mean = 9.80 ± 3.96) to post-test (mean = 11.44 ± 4.68). The QOL scores also significantly (p < .05) increased from pre-test (mean = 71.44 ± 8.38) to post-test (mean = 84.88 ± 12.07). Results demonstrate that rehabilitation services provided by trained VHVs can promote community integration and QOL for stroke survivors.

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BACKGROUND: Intestinal parasitic infections remain prevalent and constitute a public health problem in certain rural areas of Thailand. Village health volunteers (VHVs), who are members of a Thai healthcare alliance, function as key providers of health prevention measures, disease control, and health education and share national health promotion campaigns with community members. This study is aimed at evaluating the prevalence, intensity, and risk factors for intestinal parasitic infection in VHVs in order to design community awareness and health education campaigns for the target population. METHODS: This cross-sectional study was conducted between January to April 2016 among village health volunteers (VHVs) from four sub-districts of Nopphitam District, Nakhon Si Thammarat Province, southern Thailand. Subjects for the study were selected using a simple random sampling method. Socio-demographic variables and risk factors were collected by a structured questionnaire. Stool specimens were collected and processed using direct wet mount and formol-ether concentration techniques to determine the presence of parasites and modified Kato-Katz thick smear to determine the intensity of infection. RESULTS: A total of 324 VHVs were enrolled. The overall prevalence of intestinal helminths was 9.3% (95% confidence interval [CI]: 6.3-13.0). The prevalence of hookworm, Strongyloides stercoralis, and Trichuris trichiura were 8.0% (95% CI: 5.3-11.5), 0.9% (95% CI: 0.2-2.7), and 0.3% (95% CI: 0-1.7), respectively. Mean intensity of hookworm infection was 1732 eggs per gram of stool. The prevalence was lower for protozoan infection than for helminth infection. Blastocystis hominis accounted for the highest percentage of intestinal protozoan infections 4.0% (95% CI: 2.2-6.8), followed by Giardia intestinalis 0.6% (95% CI: 0-2.2). No statistically significant difference was observed in the prevalence of intestinal parasitic infection among sub-districts (p > 0.05). Having dogs at home was associated with soil-transmitted helminth (STH) infection in study participants (Crude prevalence ratio [CPR]: 2.3; 95% CI: 1.0-5.2). CONCLUSIONS: This study is the first to describe the prevalence of intestinal parasitic infection VHVs from southern Thailand. Hookworm infection is more prevalent than other types of STH infection. The development of community awareness campaigns and appropriate control measures should be considered to reduce the prevalence of hookworm infection, especially among VHVs who are the key persons providing health education to the community.

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BACKGROUND: In developing countries, renal specialists are scarce and physician-to-patient contact time is limited. While conventional hospital-based, physician-oriented approach has been the main focus of chronic kidney disease (CKD) care, a comprehensive multidisciplinary health care program (Integrated CKD Care) has been introduced as an alternate intervention to delay CKD progression in a community population. The main objective is to assess effectiveness of Integrated CKD Care in delaying CKD progression. METHODS: We carried out a community-based, cluster randomized controlled trial. Four hundred forty-two stage 3-4 CKD patients were enrolled. In addition to the standard treatments provided to both groups, the patients in the intervention group also received "Integrated CKD Care". This was delivered by a multidisciplinary team of hospital staff in conjunction with a community CKD care network (subdistrict healthcare officers and village health volunteers) to provide group counseling during each hospital visit and quarterly home visits to monitor compliance with the treatment. Duration of the study was 2 years. The primary outcome was difference of mean eGFR between the intervention and the control groups over the study period. RESULTS: The mean difference of eGFR over time in the intervention group was significantly lower than the control group by 2.74 ml/min/1.73 m2 (95%CI 0.60-4.50, p = 0.009). Seventy composite clinical endpoints were reported during the study period with significantly different incidences between the control and the intervention groups (119.1 versus 69.4 per 1000 person-years; hazard ratio (HR) 0.59, 95% CI 0.4-0.9, p = 0.03). CONCLUSION: Integrated CKD Care can delay CKD progression in resource-limited settings. TRIAL REGISTRATION: ( NCT01978951 ). Prospectively registered as of December 8, 2012.

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<b>Objective</b><BR>  The trend of population aging in the 21^st century is especially prominent in Thailand. Hence, age related diseases such as diabetes, hypertension and chronic obstructive pulmonary disease has become top ranked causes of mortality in Thailand. As those functional limitations increase, the assistance by village health volunteers (VHVs) has become more necessary. However there is high turnover rate of VHVs in Thailand. This study, therefore, aimed to identify predictors that lead to the VHVs’ intention to leave their roles as elderly caregivers. <BR><b>Methods</b><BR>  A cross-sectional descriptive study was conducted in February, 2014. A total of 415 self-administered questionnaires were distributed to the VHVs who have engaged in elderly home care in Mueang district in Nakhon Ratchasima province, Thailand. Chi-square tests and multiple logistic regression analyses were employed to identify significant predictors of the VHVs’ turnover intention. <BR><b>Results</b><BR>  Approximately one-third of VHVs (33.5%) intended to leave volunteering in elderly care. Significant predictors of VHVs’ intention to leave elderly care were: volunteering duration of≤6 years (Adjusted Odds Ratio (AOR)＝2.69, 95% CI＝1.33-5.40), having no other responsibilities (AOR＝2.40, 95% CI＝1.38-4.18), being absent more than once a month (AOR＝2.25, 95% CI＝1.28-3.95) and low level of job satisfaction (AOR＝5.62, 95% CI＝2.26-13.99). VHVs who were poorly satisfied with their roles were 5.62 times more likely to leave elderly care than those who highly satisfied when adjusting for other factors.<BR><b>Conclusion</b><BR>  Improving work place supports and incentives to promote job satisfaction will result in a reduction in VHVs’ turnover intention.