Background Adolescence is a vulnerable period for many lifestyle risk behaviors. In this study, we aimed to 1) examine a clustering pattern of lifestyle risk behaviors; 2) investigate roles of the school health promotion programs on this pattern among adolescents in Vietnam. Methods We analyzed data of 7,541 adolescents aged 13–17 years from the 2019 nationally representative Global School-based Student Health Survey, conducted in 20 provinces and cities in Vietnam. We applied the latent class analysis to identify groups of clustering and used Bayesian 2-level logistic regressions to evaluate the correlation of school health promotion programs on these clusters. We reassessed the school effect size by incorporating different informative priors to the Bayesian models. Findings The most frequent lifestyle risk behavior among Vietnamese adolescents was physical inactivity, followed by unhealthy diet, and sedentary behavior. Most of students had a cluster of at least two risk factors and nearly a half with at least three risk factors. Latent class analysis detected 23% males and 18% females being at higher risk of lifestyle behaviors. Consistent through different priors, high quality of health promotion programs associated with lower the odds of lifestyle risk behaviors (highest quality schools vs. lowest quality schools; males: Odds ratio (OR) = 0·67, 95% Highest Density Interval (HDI): 0·46 – 0·93; females: OR = 0·69, 95% HDI: 0·47 – 0·98). Interpretation Our findings demonstrated the clustering of specific lifestyle risk behaviors among Vietnamese in-school adolescents. School-based interventions separated for males and females might reduce multiple health risk behaviors in adolescence. Funding The 2019 Global School-based Student Health Survey was conducted with financial support from the World Health Organization. The authors received no funding for the data analysis, data interpretation, manuscript writing, authorship, and/or publication of this article.

ObjectiveTo do resource and cost projections for the entire Cambodian health sector using the OneHealth tool, during the development of the third national health strategic plan 2016–2020.MethodsThrough a consultative process, the health ministry estimated the needed and available resources to implement the strategic plan. The health ministry used the OneHealth Tool to estimate costs of expanding public sector service provision and compared these to estimates of projected available financing. Cost estimates covered implementation of health programmes including commodities and programme management costs, and six cross-cutting health system strengthening components. The tool is populated with local demographic, epidemiological, programmatic and unit cost data. We present costs in constant 2015 United States dollars (US$).FindingsWe estimated the five-year cost of the strategic plan to be US$ 2973.8 million. Costs are split between health systems strengthening components (US$ 1516.3 million) and investments in individual disease or public health programmes (US$ 1457.5 million). Health programmes for maternal and neonatal health (US$ 367 million), child health and immunization (US$ 197 million) and noncommunicable disease (US$ 157 million) have the highest costs. Although projected resource needs increase over time, a financial space analysis with ambitious projected increases in government funding indicates that government and donor funding jointly could be sufficient to cover the cost of the strategic plan from 2018 to 2020.ConclusionThe results both informed development of the strategic plan, and contributed to the evidence base for improved budgeting, resource mobilization strategies and stronger overall public sector financial planning.

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Introduction: Vietnam is among the countries with the highest smoking prevalence among male adults, as well as high prevalence of secondhand smoke exposure at indoor places. In many countries, including Vietnam, exposure to tobacco smoking is greatest in restaurants/bars and hotels. This study aims to analyze the compliance of hotels and restaurants to smoke-free environment regulations before and after an intervention. Methods: Direct observations were done at the receptions, conference rooms, designated smoking areas, restaurants, and lobbies of 140 hotels and the dining rooms, kitchens, and toilets of 160 restaurants before and after an intervention. The intervention was a training course conducted by police officers followed by 3 monthly supervision visits by police officers. Compliance with smoke-free enviornment regulations was observed and assessed to generate a compliance score for each location and overall. Tobit regression was used to examine the relationship between compliance scores and the intervention and other variables such as hotel and restaurant characteristics. Results: Before the intervention, the highest compliance rates were found for “no tobacco advertisement” and “no cigarette selling” regulations (95%-100%) in almost all sites in hotels and restaurants. The lowest compliance rates were found for “having nonsmoking signs.” The rate of compliance with all regulations was only 5% for hotels and 0.06% of restaurants. Improvement after intervention was clearly observed, in the rate of compliance with all regulations by more hotels (15.7%) and overall compliance scores of hotels and restaurants. Conclusions: The intervention with participation of the police officers proved to be effective in improving compliance with smoke-free regulations. It is recommended to continue this intervention in the same areas as well as to expand the intervention to other areas.

doi: medRxiv preprint NOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.