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.

Online fraud threatens the well-being of older adults, with disparities in digital literacy and socioeconomic conditions amplifying their vulnerability. This study examined digital literacy and fraud victimization behavior among older adults in urban and rural settings, identifying key factors influencing victimization and its consequences. This cross-sectional analytical study, using multi-stage sampling, included 864 participants from Southern Thailand. The findings revealed that 46.3% of participants had adequate digital literacy, while 75.3% experienced fraud victimization, with higher rates of health impacts in rural areas. Higher age (Adjusted Odds Ratios; AOR: 1.83, p = 0.004), income (AOR: 2.28, p = 0.003), and rural residence (AOR: 3.03, p < 0.001) were significantly associated with an increased likelihood of fraudulent victimization. Conversely, being non-Buddhist (AOR: 0.47, p = 0.001) and having an adequate digital literacy (AOR: 0.50, p < 0.001) were protective factors. Fraud victimization significantly affected older adults’ health, with 29.5% reporting the following adverse outcomes: physical (AOR: 5.55), emotional (AOR: 7.80), social (AOR: 4.97), and overall heightened health risks (AOR: 7.71, p < 0.001). This research highlights the importance of improving digital literacy, fostering community awareness, and implementing tailored fraud-prevention strategies to protect older adults. This study provides a foundation for evidence-based policies aimed at mitigating digital risks and enhancing older adults’ well-being in the digital era.

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.

Village Health Volunteers (VHVs) play an important role in Thailand’s community-based public health system, yet limited evidence is available on how their digital engagement relates to their own health behaviors. This cross-sectional study examined associations between sociodemographic characteristics, digital use frequency, digital literacy, and health behavior scores among 426 VHVs in southern Thailand. Data were collected using an online questionnaire that included the Mobile Device Proficiency Questionnaire (MDPQ-16) and a 23-item health behavior measure based on the Thai 3A2S framework. The median health behavior score was 61.0 (IQR 13.25). After adjustment, rural residence was associated with higher health behavior scores (β = 1.97, p = 0.043), whereas frequent digital use was associated with lower scores than infrequent use (β = −2.72, p = 0.010). Digital literacy was not independently associated with health behavior scores. The final model explained 4% of the variance, suggesting that additional factors may influence VHVs’ health behaviors. Overall, the findings indicate that digital literacy alone may not explain differences in health behaviors and that context may also play a role. Future research should examine these relationships using broader and more context-sensitive measures.

Rice farmers in Chiang Rai are increasingly exposed to recurrent drought under climate change. Although previous studies have applied Knowledge–Attitude–Practice (KAP) frameworks to drought adaptation, evidence on ageing farming populations and the interaction between behavioral and institutional factors remains limited. This study aimed to identify behavioral and institutional factors associated with drought adaptation practices among rice-farming households. A cross-sectional study was conducted among 180 rice-farming households. Quantitative data were collected using a structured questionnaire validated through expert review (IOC) and pilot testing to assess socio-demographic characteristics and drought-related perception, knowledge, attitudes, and practices (KAP). Pearson correlation and binary logistic regression were applied to examine relationships and factors associated with higher drought adaptation practices. Qualitative data from open-ended questionnaire responses regarding government support and drought management recommendations were analyzed thematically to provide contextual insights into farmers’ experiences and adaptation challenges. Farmers demonstrated high drought perception (M = 4.86 ± 1.05/5) but only moderate knowledge (16.75 ± 3.36/25), attitudes (2.77 ± 1.33/5), and practices (22.57 ± 6.04/35). Knowledge was positively associated with adaptation practices (r = 0.224, p < 0.01), whereas perception showed no significant direct association, indicating a gap between awareness and adaptive action. Regression analysis showed that higher drought-related knowledge (aOR = 4.60, p = 0.003) and prior water scarcity experience (aOR = 4.45, p = 0.002) were significantly associated with higher drought adaptation practices. In contrast, older age, male gender, and off-farm employment were significant constraints. Qualitative findings highlighted persistent concerns regarding the adequacy, timeliness, and equity of government support, suggesting that institutional barriers limited farmers’ ability to translate awareness into adaptive action. These findings indicate that both behavioral and structural factors shape drought adaptation practices. While drought-related knowledge represents an important component of adaptive capacity, effective adaptation also depends on institutional support and resource accessibility. Strengthening agricultural extension services and improving the responsiveness and equity of government support may enhance the adaptive capacity and resilience of smallholder rice farmers in drought-prone regions.