Background: Work engagement is important for employee well-being and work performance. However, no intervention study has investigated the effect of an eMental Health intervention on work engagement among workers in low- and middle-income countries (LMICs). Objective: The aim of the study was to examine the effects of a newly developed smartphone-based stress management program (ABC Stress Management) on improving work engagement among hospital nurses in Vietnam, an LMIC. Methods: Full-time registered nurses (n=949) were randomly assigned to one of 2 intervention groups or a control group. The intervention groups were a 6-week, 6-lesson program offering basic cognitive behavioral therapy (CBT-based stress management skills), provided in either free-choice (program A) or fixed order (program B). Work engagement was assessed at baseline and 3-month and 7-month follow-ups in each of the 3 groups. Results: The scores of work engagement in both intervention groups improved from baseline to 3-month follow-up, and then decreased at the 7-month follow-up, while the score steadily increased from baseline to 7-month follow-up in the control group. Program B showed a significant intervention effect on improving work engagement at the 3-month follow-up (P=.049) with a small effect size (Cohen d= 0.16; 95% CI 0.001 to 0.43]). Program A showed nonsignificant trend (d=0.13; 95% CI –0.014 to 0.41; P=.07) toward improved engagement at 3 months. Neither program achieved effectiveness at the 7-month follow-up. Conclusions: The study demonstrated that a fixed order (program B) delivery of a smartphone-based stress management program was effective in improving work engagement in nurses in Vietnam. However, the effect was small and only temporary. Further improvement of this program is required to achieve a greater effect size and more sustained, longer lasting impact on work engagement. Trial Registration: University Hospital Medical Information Network Clinical Trials Registry UMIN000033139; tinyurl.com/55gxo253 International Registered Report Identifier (IRRID): RR2-10.1136/bmjopen-2018-025138

Background: Early detection of autism spectrum disorders (ASDs) is essential given the under-reported cases in low- and middle-income countries. This first national representative survey was conducted to explore the prevalence of ASDs amongst 18 and 30 months in seven provinces in Vietnam. Design and methods: During 2017-2018, a national cross-sectional and population-based survey for autism spectrum disorder (ASD) amongst 40,243 children aged 18 to 30 months was conducted in 7 provinces representing the socio-economic regions of Vietnam. M-CHAT was used to screen children and then confirmed by diagnostic assessment using DSM-IV criteria. Results: The prevalence of ASDs amongst children aged 18 and 30 months in Vietnam was high (0.758% or 1 in 132 children). Urban setting, male gender, and hereditable genes were associated with ASD prevalence. Conclusions: ASDs amongst children aged 18 and 30 months in Vietnam tend to be increasing and are similar to this rate in other middle-income countries but lower than that in Western countries. This under-recognized public health problem amongst children should be addressed by early detection and intervention for families with affected children.

Vietnam is a country most at risk for experiencing climate change effects, especially increasing temperatures. Agricultural production is one of the biggest contributors to Vietnam’s economy. Recent research has explored how climate change will impact agriculture in Vietnam. However, the impact of climate change to the health, safety, and wellbeing of Vietnamese farmers is often overlooked. In this study, we conducted five focus groups with 46 farmers representing three provinces of Vietnam. We used a convergent mixed-methods design and a Total Worker Health^® framework to assess how farmers in Vietnam experience climate-change-related hazards and describe how famers associate these hazards with impacts to their health, safety, and wellbeing. Multi-dimensional scaling suggests farmers conceptualize hazards separately from health, safety, and wellbeing outcomes, but a thematic analysis of our data indicated that farmers perceive both direct and indirect impacts of climate change to their health, safety, and wellbeing. Direct impacts of climate change described included physical health effects such as heat stress. Indirect impacts included mental health stressors due to productivity demands. Gaps in available health and safety trainings for farmers were also identified. This project demonstrates the need to co-develop safety and health trainings with farmers. System-level approaches both at the societal and community levels are needed. The local governments, cooperatives, Women’s Unions, and Farmers’ Unions are trusted sources of information that could implement and disseminate these trainings.

BACKGROUND Work engagement is important for employee well-being and work performance. However, no intervention study has investigated the effect of an eMental Health intervention on work engagement among workers in low- and middle-income countries (LMICs). OBJECTIVE The aim of the study was to examine the effects of a newly developed smartphone-based stress management program (ABC Stress Management) on improving work engagement among hospital nurses in Vietnam, an LMIC. METHODS Full-time registered nurses (n=949) were randomly assigned to one of 2 intervention groups or a control group. The intervention groups were a 6-week, 6-lesson program offering basic cognitive behavioral therapy (CBT-based stress management skills), provided in either free-choice (program A) or fixed order (program B). Work engagement was assessed at baseline and 3-month and 7-month follow-ups in each of the 3 groups. RESULTS The scores of work engagement in both intervention groups improved from baseline to 3-month follow-up, and then decreased at the 7-month follow-up, while the score steadily increased from baseline to 7-month follow-up in the control group. Program B showed a significant intervention effect on improving work engagement at the 3-month follow-up (P=.049) with a small effect size (Cohen d= 0.16; 95% CI 0.001 to 0.43]). Program A showed nonsignificant trend (d=0.13; 95% CI –0.014 to 0.41; P=.07) toward improved engagement at 3 months. Neither program achieved effectiveness at the 7-month follow-up. CONCLUSIONS The study demonstrated that a fixed order (program B) delivery of a smartphone-based stress management program was effective in improving work engagement in nurses in Vietnam. However, the effect was small and only temporary. Further improvement of this program is required to achieve a greater effect size and more sustained, longer lasting impact on work engagement. CLINICALTRIAL University Hospital Medical Information Network Clinical Trials Registry UMIN000033139; tinyurl.com/55gxo253 INTERNATIONAL REGISTERED REPORT RR2-10.1136/bmjopen-2018-025138

Objective: To assess the status of medical solid waste (MSW) segregation and identify influencing factors at Buon Ma Thuot City General Hospital, Dak Lak Province, in 2024. Methods: A mixed-methods study was conducted, including quantitative direct observation of 190 waste bins across 14 departments and qualitative interviews with hospital leadership and healthcare personnel in 2024. Compliance was evaluated against 7 standard segregation criteria. Results: Overall compliance with segregation at source was 92.11%. Full compliance (100%) was achieved for high-risk infectious waste and anatomical waste, while sharp waste segregation showed the lowest rate (64.52%). Key facilitators included the availability of formal procedures and internal training. Barriers involved lack of dedicated personnel, multitasking among staff, limited funding for equipment, degraded infrastructure, and nonspecific supervisory activities. Conclusions: MSW segregation compliance at the hospital were generally adequate, especially for high-risk waste. However, low compliance in sharp waste handling and operational limitations highlight the need for targeted investments in infrastructure, staff training, and dedicated monitoring systems.

Objectives: Type 2 diabetes is among the most prevalent non-communicable, chronic diseases associated with endocrine disorders. Effective management and treatment of type 2 diabetes patients are crucial for glycemic control. This study aimed to analyze the current status of treatment management of type 2 diabetes at Buon Ma Thuot City General Hospital in 2024. Methods: A mixed-method study, combining cross-sectional quantitative and qualitative components, was conducted from February 2024 to October 2024. The quantitative sample included medical records of 368 type 2 diabetes patients managed and treated from March 1, 2023, to March 31, 2024. The qualitative sample comprised four in-depth interviews with relevant stakeholders and one focus group discussion with outpatient type 2 diabetes patients. Results: The prevalence of type 2 diabetes in 2024 was 17.2%. One hundred percent of patients diagnosed with type 2 diabetes had their electronic medical records established and managed, received treatment plans and protocols, and were provided with outpatient treatment adherence monitoring logs. They also received reminders on follow-up appointments with access to health counseling and education information provided by the hospital via videos at the registration counter and direct advice from doctors and nurses. Conclusion: Outpatient treatment management of type 2 diabetes at Buon Ma Thuot General Hospital have considerably good performance. However, the hospital should ensure the availability of diabetes drug and improve the infrastructure for diabetes testing and communication to support consultation and education on diabetes and other non-communicable diseases.