Journal of Preventive Medicine and Public Health

Original Articles

Multi-group Causal Model of Mental Health Literacy and Helping Behavior Toward People at Risk of Depression Among Thai and Vietnamese Health Science Students: Anchalee Jansem, Ungsinun Intarakamhang, Charin Suwanwong, Krittipat Chuenphitthayavut, Sudarat Tuntivivat, Khuong Le, Le Thi Mai Lien, Pitchada Prasittichok; J Prev Med Public Health. 2025;58(3):241-249. Published online January 13, 2025; DOI: https://doi.org/10.3961/jpmph.24.449

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Objectives
Depression affects 23.3% of Thai and 15.2% of Vietnamese health science students, rates that exceed the global average of 4.4%. This study compared the causal models of mental health literacy and helping behavior toward individuals at risk of depression between these 2 groups.
Methods
This cross-sectional study was conducted from April 2023 to October 2023 and included 422 students from Thailand and Vietnam, who were studying medicine, nursing, psychology, and physical therapy. Stratified random sampling was used to select 211 students from each country. Data collection was performed using a Likert scale, which showed total-item correlations ranging from 0.24 to 0.83 and Cronbach’s alpha values between 0.74 and 0.86. The data were analyzed using a structural equation model.
Results
The causal models were consistent with the empirical data. The helping behavior of students toward peers at risk of depression was significantly influenced by their mental health literacy (effect size [ES], 0.91). This influence was also mediated indirectly by self-efficacy (ES, 0.18), positive attitudes (ES, 0.29), and social support (ES, 0.77). Collectively, these factors accounted for 83% of the variance in helping behavior. Social support had a more pronounced effect on mental health literacy among Vietnamese students than among their Thai counterparts (ES, 0.46 vs. 0.27, p<0.05). Conversely, positive attitudes had a stronger influence among Thai students than among Vietnamese students (ES, 0.17 vs. 0.01, p<0.05).
Conclusions
The causal models of helping behavior among Thai and Vietnamese health science students exhibited no significant differences. However, improving mental health literacy is crucial, as it significantly impacts helping behavior.

Summary

Key Message
This study compared causal models of mental health literacy (MHL) and helping behavior toward people at risk of depression between Thai and Vietnamese health science students. Findings indicated that MHL significantly impacted helping behavior (effect size [ES], 0.91), mediated indirectly by self-efficacy (ES, 0.18), positive attitudes (ES, 0.29), and social support (ES, 0.77), with no significant differences in the overall causal models between groups. However, variations in effects were noted, such as social support having a more pronounced effect on MHL among Vietnamese students than their Thai counterparts (ES, 0.46 vs. 0.27), while positive attitudes had a stronger influence among Thai students (ES, 0.17) than Vietnamese (ES, 0.01).

Citations

Citations to this article as recorded by

Relationship between extraversion and mental health literacy in Chinese adolescents: a chain mediation model
Zhanfang Liu, Fangru Yuan, Jianzheng Du
Frontiers in Psychology.2026;[Epub] CrossRef
Health and Mental Well-Being of Academic Staff and Students in Thailand: Validation and Model Development
Ungsinun Intarakamhang, Cholvit Jearajit, Hanvedes Daovisan, Phoobade Wanitchanon, Saichol Panyachit, Kanchana Pattrawiwat
Education Sciences.2025; 15(10): 1310. CrossRef

Causal Model of Herb Use Behavior Among Working-age Adults in Thailand: Pitchada Prasittichok, Patcharee Duangchan, Sattawat Prapasiri, Ungsinun Intarakamhang; J Prev Med Public Health. 2024;57(4):399-406. Published online June 21, 2024; DOI: https://doi.org/10.3961/jpmph.23.554

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Abstract Summary PDF: Objectives
This study developed a causal relationship model of herb use from observational data and analyzed the direct and indirect effects of herb use on health according to the model.
Methods
A cross-sectional study was conducted with 400 participants aged 26-59 years, selected through multistage random sampling. The instruments used for data collection included demographic information, herb use, health literacy (HL), perceived social support, societal values, and attitudes toward herb use. The conceptual model, hypothesized based on prior evidence, was tested using confirmatory factor analysis through structural equation modeling. Path coefficients were estimated using the maximum likelihood method.
Results
The final model utilized empirical data, which showed that perceived social support had the most significant impact on herb use. This was followed by HL, positive attitudes toward herbal remedies, and societal values, with coefficients of 0.31, 0.18, and 0.16, respectively. When analyzing variables that indirectly affected herb use, it was clear that positive attitudes, perceived social support, and societal values significantly influenced herb use through HL, with influence coefficients of 0.08, 0.16, and 0.04, respectively. Together, these variables accounted for 68% of the variance in herb use.
Conclusions
The findings from this study can be utilized to develop and implement strategies that guide the use of herbal products, ultimately aiming to improve human health.; Summary

Key Message
A causal relationship model of herb use was created from observational data in this research, and the direct and indirect impacts of herb use on health were examined based on the model. The most vital factor influencing the use of herbal remedies is the level of social support perceived by an individual. Significant roles are also played by health literacy, positive attitudes toward herbal remedies, and societal values. Positive outlooks, community backing, and cultural principles indirectly influence the utilization of herbal remedies through health literacy. The research results can help develop approaches to encourage the correct usage of herbal items, ultimately improving public health.

Systematic Review

Pre-exposure Prophylaxis Adherence Among Men Who Have Sex With Men: A Systematic Review and Meta-analysis: Suchitra Hudrudchai, Charin Suwanwong, Pitchada Prasittichok, Kanu Priya Mohan, Nopphadol Janeaim; J Prev Med Public Health. 2024;57(1):8-17. Published online December 12, 2023; DOI: https://doi.org/10.3961/jpmph.23.345

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Abstract Summary PDF Supplementary Material

Objectives
The effectiveness and efficiency of pre-exposure prophylaxis (PrEP) in reducing the transmission of human immunodeficiency virus (HIV) among men who have sex with men (MSM) relies on how widely it is adopted and adhered to, particularly among high-risk groups of MSM. The meta-analysis aimed to collect and analyze existing evidence on various factors related to PrEP adherence in MSM, including demographic characteristics, sexual behaviors, substance use, and psychosocial factors.
Methods
The meta-analysis followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The search included articles published between January 2018 and December 2022, obtained from the PubMed, ScienceDirect, and Scopus databases. The studies that were included in the analysis reported the proportion of MSM who demonstrated adherence to PrEP and underwent quality appraisal using the Newcastle-Ottawa Scale.
Results
Of the 268 studies initially identified, only 12 met the inclusion criteria and were included in the final meta-analysis. The findings indicated that education (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.12 to 2.40), number of sexual partners (OR, 1.16; 95% CI, 1.02 to 1.31), engaging in sexual activities with an human immunodeficiency virus-positive partner (OR, 1.59; 95% CI, 1.16 to 2.26), substance use (OR, 0.83; 95% CI, 0.70 to 0.99), and lower levels of depression (OR, 0.55; 95% CI, 0.37 to 0.82) were associated with higher rates of PrEP adherence among MSM.
Conclusions
Despite these findings, further research is necessary to investigate PrEP adherence more comprehensively. The findings of this meta-analysis can be utilized to inform interventions aimed at improving PrEP adherence among MSM and provide directions for future research in this area.

Summary

Key Message
This systematic review and meta-analysis confirmed that factors such as education, number of sexual partners, engagement in sexual activities with an HIV-positive partner, substance use, and lower levels of depression were associated with higher rates of PrEP adherence among MSM. Healthcare providers and interventions should take these aspects into consideration when developing strategies to promote optimal PrEP adherence and reduce the risk of HIV transmission.

Citations

Citations to this article as recorded by

Socio‐economic status and adherence to HIV preventive and therapeutic interventions: exploring the mediating role of food insecurity among men who have sex with men and transgender and non‐binary persons from Brazil
Paula M. Luz, Thiago S. Torres, Victor C. Matos, Giovanna G. Costa, Brenda Hoagland, Cristina Pimenta, Marcos Benedetti, Beatriz Grinsztejn, Valdilea G. Veloso
Journal of the International AIDS Society.2025;[Epub] CrossRef
Intention to Use Pre-Exposure Prophylaxis Among Age Groups of Brazilian Men Who Have Sex With Men: National Cross-Sectional Study
Alvaro Francisco Lopes de Sousa, Caique Jordan Nunes Ribeiro, Guilherme Reis de Santana Santos, Emerson Lucas Silva Camargo, Herica Emilia Félix de Carvalho, Guilherme Schneider, Leticia Genova Vieira, Liliane Moretti Carneiro, Ana Paula Morais Fernandes,
JMIR Public Health and Surveillance.2025; 11: e58405. CrossRef
Understanding Factors Influencing HIV pre-exposure prophylaxis adherence among men who have sex with men in Western China: a data-driven exploration using bayesian networks
Qian Wang, Qin Qin, Jiaxiu Liu, Pinyi Chen, Bing Lin, Xiaoni Zhong
BMC Public Health.2025;[Epub] CrossRef
Barriers and Facilitators to Pre-exposure Prophylaxis Adherence Among Thai Men Who have Sex with Men in Bangkok: COM-B Model Analysis
Suchitra Hudrudchai, Charin Suwanwong, Thasuk Junprasert
AIDS and Behavior.2025;[Epub] CrossRef
Preferences for Starting Daily, On-Demand, and Long-Acting Injectable HIV Preexposure Prophylaxis Among Men Who Have Sex With Men in the United States (2021-2022): Nationwide Online Cross-Sectional Study
Duygu Islek, Travis Sanchez, Jennifer L Glick, Jeb Jones, Keith Rawlings, Supriya Sarkar, Patrick S Sullivan, Vani Vannappagari
JMIR Public Health and Surveillance.2024; 10: e62801. CrossRef

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