ระดับการรับรู้และประสิทธิผลของประกาศกระทรวงศึกษาธิการ พ.ศ. 2563 และประกาศสำนักงานคณะกรรมการการศึกษาขั้นพื้นฐาน พ.ศ. 2564 ต่อการจัดสิ่งแวดล้อมที่เอื้อต่อการควบคุมการบริโภคน้ำตาลและการสร้างเสริมสุขภาพในโรงเรียน จังหวัดเชียงใหม่

Rakchanok Noochpoung

Authors

Rakchanok Noochpoung Chiang Mai Provincial Public Health Office

Keywords:

policy awareness, policy implementation, health promoting environment, health literacy

Abstract

Background & Rationale: Creating school environments conducive to health is a key strategy for school-age children health promotion. The Ministry of Education (MOE) announced the measures and guidelines for promoting oral health literacy in 2020, and the Office of the Basic Education Commission (OBEC) issued a directive on the sale of health promoting food and beverages in school in 2021.

Objective: To study the level of awareness of both announcements and to examine the relationships between the awareness and the school’s managed environments, knowledge, behavior, and health conditions of students.

Methodology: A mixed-methods study with a cross-sectional design, consisting of 1) quantitative research by surveying directors and health teachers from 81 schools and 715 sixth-grade students using questionnaires, analyzed with chi-square statistics and binary logistic regression, and 2) qualitative research of in-depth interviews with 30 administrators and health teachers, and 5 representatives from educational service areas, analyzed with thematic analysis.

Results: Administrators including health teachers were aware of the MOE and the OBEC announcements at 49.4% and 72.8% respectively. Awareness schools managed to have higher health promoting environments than non-awareness schools. Students in awareness schools were more likely to have a higher level of food knowledge (over 80%) than students in non-awareness schools (odds ratio=2.18, 95% confidence interval: 1.43-3.32). They were more likely to practice daily post-lunch tooth brushing (OR=2.15, 95% CI: 1.37-3.37), and had lower sugary drink consumptions. Awareness schools had stricter control over the sale of snacks and beverages compared to non-awareness schools (p<0.01). In-depth interviews revealed that awareness and adherence to guidelines was related to the support from administrators, the monitoring systems, and the coordination with public health agencies.

Summary: Awareness of the 2021 OBEC announcement was related to the creation of health promoting environments and better student health literacy and behaviors. These findings suggest that accessible policy guidelines may serve as a key enabling factor for school-level implementation. Continuous promotion of both announcements, supported by practical guidelines and systematic monitoring mechanism, is recommended.

References

World Health Organization. Ottawa charter for health promotion. In First International Health Promotion Conference, Ottawa, Canada, 1986.

Moynihan P, Petersen PE. Diet, nutrition and the prevention of dental diseases. Public Health Nutrition. 2004 Feb;7(1a):201-26.

Langford R, Bonell CP, Jones HE, Pouliou T, Murphy SM, Waters E, et al. The WHO Health Promoting School framework for improving the health and well-being of students and their academic achievement. Cochrane database of systematic reviews. 2014 Apr 16;2014(4):CD008958.

World Health Organization. Global standards for health promoting schools. WHO: Geneva; 2018.

Bureau of Health Promotion. Guidelines for operating a health promoting school [internet]. (revised edition 2015). Bangkok: Department of Health; 2015. Available from: https://drive.google.com/file/d/0B3cSZpkBuNS8TW9iZzE2a28zQkU/view?resourcekey=0-f24tsjMIdL11ralLgtGfmg. (in Thai)

Bureau of Dental Health. Guidelines for public dental health operations [internet]. 2024 Mar 29 [cited 2026 Jan 5]. Available from: https://dental.anamai.moph.go.th/th/guidelines. (in Thai)

Department of Disease Control. Guidelines for providing Covid-19 vaccines to school-aged children [internet]. 2024 Mar 29 [cited 2026 Jan 5]. Available from: https://ddc.moph.go.th/uploads/publish/1301620220810140027.pdf. (in Thai)

Chiang Mai Provincial Public Health Office. Chiang Mai children and youth health report [internet]. 2024 Mar 29 [cited 2026 Jan 5]; Available from: https://hdc.moph.go.th/center/public/standard-report-detail/35652a40027c24bbc3653428d3577b72?subcatalogId=db30e434e30565c12fbac44958e338d5. (in Thai)

Office of Permanent Secretary, Ministry of Education. Ministry of Education Announcement from the Ministry of Education Regarding Measures and Guideline for Promoting Knowledge and Skills in Oral Health Care and the Selection of Dental Services. June 11, 2020. (in Thai)

Office of the Basic Education Commission. Announcement Regarding Measures to Promote the Consumption of Healthy Food and Beverages in Educational Institutions. June 22, 2021. (in Thai)

Tanguthaisuk A, Lenanan A. A study of Activity Results and Guidelines for Driving Activities Announced by the Office of the Basic Education Commission. Sweet Enough Network and Thaihealth (Chapter 5). 2023. Available from: https://drive.google.com/drive/folders/14hRcdWZl7BODwYbvz4ecLRQE5Yuxx63D. (in Thai)

Sirilers S, Chaowachai S, Jansila V. A guideline for educational institutions in epidemic prevention of the covid-19 of school in remote area under the Primary Educational Service Area Office Kanjanaburi 1. J of Roi Kaensarn Academi. 2022;7(6):224-35. (in Thai)

Intarapanit S, Siriburee D. Trends and directions for the development of educational information systems the digital era: a systematic literature review. J Res Innov Sustain Soc. 2025;2(1):1-7. (in Thai)

Lapying P, Agrasuta V. Health and oral healthcare policy for persons with disabilities. Th Dent PH J. 2017;22(2):13-27. (in Thai)

Savanglap V. Environmental management in elementary schools. IPacific. 2023;9(3):431-45. (in Thai)

Dumklang A. Management of health promoting schools under the Buriram Primary Educational Service Area Office3. JISDIADP. 2025;3(3):754-68. (in Thai)

Ajzen I. The theory of planned behavior. Organ Behav Hum Decis Process. 1991;50(2):179-211.

Langford R, Bonell C, Jones H, Campbell R. Obesity prevention and the health promoting schools framework: essential components and barriers to success. Int J Behav Nutr Phys Act. 2015;12:15.

Doungkam K. Strategies for internal supervision of Border Patrol Police Schools. (master’s thesis). Bangkok: Chulalongkorn University; 2023. (in Thai).

Ditsala P, Subruangthong S, Charernporn K. Implementing educational policies into practice in educational institutions. 2025;5(1):108-15. (in Thai)

Macías MJ. El lado no visible del gobierno de los centros escolares: mujeres direct oras. Agora digital. 2002;(4):14. (in Spanish)

Morrissette V, Jesme S, Hunter C. Teacher and administrator perceptions of gender in the classroom. Educational Studies. 2018;44(3):295–312.

Combaz G, Morin-Messabel C. Égalité professionnelle et genre en contexte: l’exemple des chef. fes d’établissement du secondaire. Psychologie du Travail et des Organisations. 2021;27(2):89-104. (in French)

Vamos CA, Thompson EL, Avendano M, Daley EM, Quinonez RB, Boggess K. Oral health promotion interventions during pregnancy: a systematic review. Community Dent Oral Epidemiol. 2015;43(5):385-96.

Kelly RK, Peralta L, Nash R. Promoting food literacy in primary school classrooms through the HealthLit4Kids Program in Australia. Health Promotion International. 2022;37(6):daac166.

Ares G, De Rosso S, Mueller C, Philippe K, Pickard A, Nicklaus S, et al., Development of food literacy in children and adolescents: implications for the design of strategies to promote healthier and more sustainable diets. Nutrition Reviews. 2024;82(4):536-52.

Nathan N, Wolfenden L, Bell AC, Wyse R, Morgan PJ, Butler M, et al., Effectiveness of a multi-strategy intervention in increasing the implementation of vegetable and fruit breaks by Australian primary schools: a non-randomized controlled trial. BMC Public Health. 2012;12:651.

Josupeit J, Dadaczynski K, Quilling E. The relevance of networking in school health promotion. Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz. 2022;65(7-8):829-35.

Hernández-Torrano D, Bessems K, Buijs G, Lassalle C, Datema W, Jourdan D. Health promotion in the school context: a scientific mapping of the literature. Health Education. 2025;125(1):68-84.

Paulauskiene N. Strengthening children's health in a health-promoting school provides the opportunity to learn to live healthier lives. Public Health. 2024 May 30;105(2).

Petersen PE, Hunsrisakhun J, Thearmontree A, Pithpornchaiyakul S, Hintao J, Jürgensen N, et al., School-based intervention for improving the oral health of children in Southern Thailand. Community Dent Health. 2015;32(1):44-50.

Micha R, Karageorgou D, Bakogianni I, Trichia E, Whitsel LP, Story M, et al., Effectiveness of school food environment policies on children's dietary behaviors: a systematic review and meta-analysis. PLoS One. 2018;13(3):e0194555.

Jaime PC, Lock K. Do school-based food and nutrition policies improve diet and reduce obesity? Prev Med. 2009;48(1):45-53.