The Prevalence and Determinants of PRECEDE Framework and Health Literacy Associated with Overweight and Obesity among Adolescents: A Population-Based Survey of 12-19-Years-Old in the Northeast of Thailand

Introduction: Obesity is a serious chronic disease that damages both physical and mental health. The global prevalence and trends of overweight and obesity among adolescents and children had increased. Aim: This study was aimed to investigate the prevalence and determinants of PRECEDE Framework and health literacy associated with overweight and obesity among adolescents (12-19 years of age) in the Northeast of Thailand. Materials and Methods: This cross-sectional analytical study was conducted among 1,129 samples selected through multistage random sampling among 4 provinces from 20 provinces of the Northeast of Thailand, between September 2017 to March 2018 after they which completed constructive questionnaires using the PRECEDE Framework Model including three factors; predisposing factors, enabling factors and reinforcing factors and health literacy including cognitive, access, communication, self-management, media literacy and decision. Multiple logistic regression was administered to determine the association using the PRECEDE Framework Model and health literacy to find associated with overweight and obesity. Results: It was found that the prevalence of overweight and obesity was 10.63% (95% CI: 8.89-12.57) and 10.45% (95% CI: 8.72-12.38), respectively. Multivariate analysis suggests that these factors were statistically significant in association with overweight and obesity included watching television hours >= 3 per day (Adjusted OR=1.94; p<0.001), time to surf internet >5 hours per day (Adjusted OR=1.82; p=0.007), the PRECEDE Framework Model including low levels of attitude (Adjusted OR=2.61; p=0.001) and low levels of reinforcing factors (Adjusted OR=1.79; p=0.030), health literacy including: low levels of media literacy skills (Adjusted OR=3.64; p<0.001) and the low levels of decision skills (Adjusted OR=5.12; p<0.001). Conclusion: The present study's result reveal the prevalence of overweight and obesity among adolescents were found to be high. It was essentially associated with determinants of PRECEDE Framework Model include low levels of attitude and reinforcing factors, low levels of health literacy including media literacy skills, decision skills and other covariates including watching television. time to surf Internet. This study indicates that future prevention programs must take these risk factors into account.