نبذة مختصرة : Competing Interests: Declarations. Ethical approval: This study obtained ethical approval from the Research Ethics Review Committee for Research Involving Human Research Participants, Health Sciences Group, Chulalongkorn University (COA number 086/2018), and was conducted in accordance with the Declaration of Helsinki. Written informed consent was obtained after participants were informed of the study’s risks and benefits. While formal ethical review mechanisms are available in Myanmar, this study was conducted as part of the first author’s doctoral research at an academic institution in Thailand. Given the non-clinical nature of the intervention and the institutional affiliation, ethical approval was obtained from the university’s recognized ethics committee in Thailand. A meeting was organized with the township’s general administrative department, health department, industrial zone management committee, industry (company) owners and managers, and the Directorate of Investment and Company Administration (DICA), Mandalay Region, to explain the study and ensure compliance with local regulations, cultural norms, and legal requirements, which are critical to the ethical conduct of research. Following the meeting, verbal permission to conduct the study was granted by all these relevant authorities. After the study, the findings were also interpreted back to these authorities to ensure transparency and collaboration. Additionally, prior coordination with the Mental Health Hospital in Mandalay under the Ministry of Health ensured support for participant well-being, with arrangements for referral if needed; however, no participants required clinical referral during the study. At the time of the study, two Myanmar citizen authors, who worked within non-governmental organizations, led the project and liaised with local stakeholders. They were directly involved in executing the research, with the collaboration of co-authors further strengthening oversight throughout the process. The research upheld key ethical principles, including anonymity and confidentiality, voluntary participation, freedom to withdraw, access to findings, and data protection, ensuring a comprehensive approach to ethical standards and privacy. Patient consent for publication: Not applicable. Provenance and peer review: Not commissioned; externally peer reviewed. Competing interests: The authors declare no competing interests.
Background: Comprehensive interventions are needed for smoking concerns among industrial workers. This study aimed to evaluate the effectiveness of a Health Belief Model-based integrated health education and mobile phone short message service intervention on improving health knowledge, perception, and self-efficacy toward smoking among industrial workers in Myanmar. This study uniquely integrates Health Belief Model-based health education sessions with short message service over three months, addressing the specific needs of this demographic.
Methods: A quasi-experimental study involved 146 workers per group in Mandalay Industrial Zone, Myanmar. A Health Belief Model-based intervention included six health education sessions and daily short message service with weekly repeated content for the intervention group. The outcomes were health knowledge, perception (susceptibility, severity, barriers, and benefits), and self-efficacy, assessed at baseline, immediately after the 3-month training, and 3 months post-training completion in both groups. Homogeneity between groups at baseline was assessed using the chi-square test and the independent t-test. Between-group differences were compared using the independent t-test, and within-group changes were evaluated using repeated measures ANOVA. Generalized Estimating Equations was applied to adjust for baseline differences between groups, accounting for variables such as age, marital status, education status, income, age at first cigarette smoked, and years of smoking cigarettes. Significance level was set at p < 0.05.
Results: Health knowledge in the intervention group significantly increased at immediately after the 3-month training but slightly declined at 3 months post-training completion (p < 0.001). Compared to the control group, perceived susceptibility, severity, barriers, and benefits, as well as self-efficacy, improved significantly immediately after the 3-month training (p < 0.001). Generalized Estimating Equations analysis revealed significant Group × Time interaction effects, showing positive effects on health knowledge (B = 0.991, p < 0.001), and notable improvements in perceived susceptibility (B = 5.091, p < 0.001), severity (B = 3.973, p < 0.001), barriers (B = 3.823, p < 0.001), benefits (B = 1.797, p < 0.001), and self-efficacy (B = 1.742, p < 0.001).
Conclusions: This study's intervention significantly improved the health knowledge, perception, and self-efficacy toward smoking among industrial workers in Myanmar, highlighting the importance of targeted workplace interventions.
(© 2025. The Author(s).)
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