Introduction: Unvaccinated older adults with COVID-19 are at higher risk for severe illness and complications compared with those have been vaccinated. Vaccine literacy and attitudes are important factors that enhance healthy behaviors and choices, including vaccination intention. Objective: To explore vaccine literacy, attitudes, and vaccination intention toward COVID-19 among Thai older adults and examine associations between vaccine literacy, attitudes, and vaccination intention. Methods: This study used a cross-sectional online design. We surveyed 408 older adults who met our inclusion criteria. Participants were recruited online via social media and websites. The survey covered demographic data, vaccine literacy, attitudes, and intention to get the COVID-19 vaccine. Results: COVID-19 vaccination intention among Thai older adults was high (81.3%). Females and those aged 60– 69 years had higher COVID-19 vaccine literacy scores than males (t = − 2.120, p < 0.05) and those aged ≥ 70 years (t = 2.438, p < 0.05). Participants with postgraduate education and those who were health professionals scored higher for vaccine literacy than less educated (t = − 3.501, p < 0.01) and non-health professional (t = 5.437, p < 0.001) participants. Those with an adequate income or that had been vaccinated against COVID-19 scored significantly higher for vaccine literacy and attitudes toward the COVID-19 vaccine than participants with an inadequate income (t = 4.626, p < 0.001) or that had not been vaccinated (t = 2.842, p < 0.01). Vaccine literacy (r = 0.219, p < 0.001) and attitudes (r = 0.459, p < 0.001) were significantly associated with vaccination intention. Conclusion: COVID-19 vaccine literacy and attitudes are significant factors related to vaccination intention. Health professionals could play an important role in enhancing vaccine literacy among older adults. Positive attitudes and COVID-19 vaccine literacy may enhance vaccination uptake in older adults.

Introduction: Owing to the increased prevalence of type 2 diabetes mellitus (T2DM) and the high proportion of patients with uncontrolled T2DM, effective interventions for disease management are needed. Objective: The study aim was to test the effects of brief motivational interviewing (MI) on patients’ self-management, medication adherence, and glycemic control. Methods: A single-group repeated measures trial was used to examine the effects of usual care only and usual care plus telephone-based brief MI. Participants were 29 patients with uncontrolled T2DM recruited from a rural primary care setting in Nakhon Sawan, Thailand. Participants received usual care during the first 4 weeks, followed by usual care plus brief MI during weeks 4– 8. Outcomes of self-management, medication adherence, fasting blood sugar (FBS) levels, and hemoglobin A1c (HbA1c) levels were assessed at baseline, 4 weeks, and 8 weeks. Data were analyzed using descriptive statistics, one-way repeated measures analysis of variance, and Friedman test. Results: Significant changes in self-management (p < 0.001), medication adherence (p < 0.001), and FBS (p < 0.05) were observed over the 8-week study. In multiple comparisons, self-management was the only parameter significantly different across baseline, 4, and 8 weeks (p < 0.05, < 0.001, and < 0.001, respectively); medication adherence was significantly different between 4 and 8 weeks (p < 0.05), and between baseline and 8 weeks (p < 0.001); and FBS was significantly different between 4 and 8 weeks (p < 0.05). HbA1c declined over the 8-week study, but not significantly. Conclusion: An intervention combining telephone-based brief MI with usual care significantly increased self-management, medication adherence, and glycemic control (ie, FBS) after 4 weeks, whereas usual care only significantly increased self-management. Phone-based brief MI may be an effective way for healthcare providers to remotely enhance patients’ self-management and glycemic control, thus reducing barriers related to time and geographic location.

Background: The global exclusive breastfeeding (EBF) rate during the first six months is < 50%. This rate is particularly low among employed mothers, who may face obstacles in accessing in-person lactation services. Given that telelactation services can increase EBF rates, we conducted this study to assess the effects of real-time telelactation services (vs. usual lactation services) on breastfeeding outcomes among employed mothers. Methods: The Preferred Reporting Items for Systematic Reviews Meta-Analyses guidelines were followed. Studies published between 2012 and 2023 were identified from the Academic Search Ultimate, Cochrane, CINAHL Complete, Embase, ProQuest, SAGE journals, ScienceDirect, Scopus, Springer Link, Google Scholar, and Thai Journal Online databases. Randomized controlled trials and quasi-experimental studies that met the inclusion criteria were included. The JBI critical appraisal tool was used to assess the studies selected for the systematic review. Categorical data were analyzed using relative risk (RR) with 95% confidence intervals (CIs) and a random-effects model. Results: Of the 18 studies selected for the review, 13 were included in the meta-analysis with a total of 4,564 participants. Of these, 3,582 were employed mothers. We identified three types of real-time telelactation services based on the activities of the provider and client: proactive, reactive, and mixed services. The results showed that real-time telelactation services had a statistically significant positive effect on the EBF rate during the first six months compared to usual care (Relative risk (RR): 1.31, 95% Confidence interval (CI) [1.10, 1.54]; p = 0.002). Proactive and mixed services significantly enhanced the rate of EBF (RR: 1.59, 95% CI [1.23, 2.05]; p = 0.0004 and RR: 1.38, 95% CI [1.01, 1.87]; p = 0.04, respectively). Reactive services did not significantly affect the EBF rate during the first six months compared to usual care (RR: 0.98, 95% CI [0.93, 1.04]; p = 0.54). Conclusions: Real-time telelactation services delivered by lactation/trained professionals in a proactive or combined proactive/reactive manner (i.e., via scheduled appointments and on demand) were the most effective. These service models should be considered by lactation service providers and healthcare policymakers seeking to increase EBF among the majority of participants who were employed mothers. Review registration: This review has been registered in the International Prospective Register of Systematic Reviews (PROSPERO) (ID: CRD42023429900).

Background: High rates of population immunity are needed to control the COVID-19 pandemic. This study aimed to assess parents’ intention to have their children, aged 5–11 years, vaccinated against COVID-19 and its influencing factors in Thailand. Methods: A cross-sectional online survey was conducted before the nationwide COVID-19 vaccine rollout for children aged 5–11 years in Thailand. A sample of 542 parents with children in this age group was recruited online. Results: In total, 58.8% of parents intended to vaccinate their child against COVID-19. Logistic regression analysis revealed that influencing factors include child age, parents’ education, interactive/critical vaccine literacy, attitudes that the COVID-19 vaccine is safe and effective for children, that the vaccine can reduce the severity of COVID-19 in children, that there were other ways to prevent children from contracting COVID-19 superior to vaccination, and that COVID-19 vaccination in children can be fatal. The main reasons for having an intention to vaccinate their children included to reduce the severity of symptoms if infected with COVID-19 and to protect them from contracting COVID-19 when they go to school. Conclusions: Our study provides evidence regarding factors influencing parents’ intention to vaccinate their children. The findings can be used to design future interventions to promote COVID-19 vaccine uptake in children.

Nurses are healthcare workers at high risk of contracting COVID-19 and are prioritized for COVID-19 vaccination. This study aimed to explore COVID-19 vaccine acceptance, vaccine literacy, and attitudes toward COVID-19 vaccines, and determine factors associated with COVID-19 vaccine acceptance among nurses in Thailand. A cross-sectional survey was conducted using online questionnaires between May and June 2021. A total of 510 nurses were recruited during the pandemic’s third wave in Thailand. Data were analyzed using descriptive and inferential statistics. Ten percent (n = 51) of the participants were men, all of whom showed COVID-19 vaccine acceptance. Of the 459 female nurses, 94.8% (n = 435) accepted COVID-19 vaccination and 91.3% (n = 419) reported previous influenza vaccination. In multiple logistic regression models, previous influenza vaccination, interactive–critical vaccine literacy, and attitudes toward COVID-19 vaccines were significant predictors of COVID-19 vaccine acceptance among female nurses in Thailand. Those who had previously received influenza vaccination were more likely to accept COVID-19 vaccination. Higher scores for interactive–critical vaccine literacy and positive attitudes toward the COVID-19 vaccine increased the odds of accepting vaccination, while negative attitudes were associated with decreased vaccine acceptance. Vaccine literacy, together with attitudes toward the COVID-19 vaccine, had a strong positive effect on increasing vaccination acceptance and reducing vaccine hesitancy. The results suggest that policymakers should consider both attitudes and vaccine literacy when establishing prospective strategies for promoting vaccine acceptance among nurses beyond the COVID-19 pandemic.

Introduction: Vaccination is an important strategy to prevent or reduce hospitalizations and mortality caused by COVID-19 infection. However, some people with chronic diseases are hesitant to get the COVID-19 vaccination. Objective: This study aimed to assess the acceptance of COVID-19 vaccination and associated factors among people with chronic diseases. Methods: A cross-sectional online survey was conducted between May and August 2021. A sample of 457 Thai adults living with one or more chronic diseases was drawn from a larger online survey. Results: Participants were 19 to 89 years old. The three most commonly reported chronic diseases were hypertension, diabetes, and obesity. The acceptance rate of COVID-19 vaccination was 89.1%. Forty-six percent of respondents had received the COVID-19 vaccination, and 43.1% intended to get the vaccine. Reasons for vaccine hesitancy/refusal included concerns about adverse side effects from the vaccines including long-term effects that might complicate their disease condition. Multiple logistic regression analyses revealed that having a bachelor’s degree or higher [aOR 4.40; 95% CI: 2.12– 9.14], being employed [aOR 2.11; 95% CI: 1.03– 4.39], and having positive attitudes [aOR 2.36; 95% CI: 1.69– 3.29] and negative attitudes [aOR 0.38; 95% CI: 0.27– 0.55] predicted acceptance of the COVID-19 vaccination. Vaccine literacy was significantly associated with acceptance of COVID-19 vaccination in binary logistic regression analyses, but it was not retained in the multiple logistic regression model. Conclusion: Vaccine literacy and attitudes influence acceptance of COVID-19 vaccination in people with chronic diseases.