Association between Herbal Use Behavior and Hemoglobin A1c among Ethnic Minorities in Thai Border Communities

Monchanok Choowanthanapakorn1, *, Katekaew Seangpraw1, Parichat Ong-Artborirak2, Nisarat Auttama1, Sorawit Boonyathee3, Prakasit Tonchoy1, Supakan Kantow1
1 School of Public Health, University of Phayao, Phayao56000, Thailand
2 Faculty of Public Health, Chiang Mai University, Chiang Mai50200, Thailand
3 School of Medicine, University of Phayao, Phayao56000, Thailand



Herbal use is a conventional wisdom of health care that falls under complementary alternative medicine. The purpose of this research was to study factors affecting herbal-use behavior and glycated hemoglobin (HbA1c) levels in ethnic minorities living at the northern border of Thailand.


A cross-sectional study was conducted in the three northern border provinces located in the highlands and rural plains between May–July 2022 among ethnic groups, including Hmong, Karen, Lua, and Indigenous. A total of 413 people were recruited for the study using a convenient sampling method. The data were obtained from face-to-face interviews using questionnaires and from blood samples.


The mean age of the participant was 50.2 years. More than half of the participants had abnormal HbA1c (> 6.5) (55.7%). The mean score for herbal-use behavior was 19.2 (SD = 3.77). An analysis of Pearson’s correlation coefficient found that herbal-use behavior was positively correlated with health literacy (r = 0.918). HbA1c was negatively correlated with health literacy and health behavior (r = -0.628, r = -0.557). Factors including age and people with diabetes were statistically significantly associated with herbal-use behavior, accounting for 42.3% of the variance. When adjusted for factors, health literacy was found to be statistically significantly associated with herbal-use behavior, which affected HbA1c levels.


Health education programs among ethnic minorities should be focused on increasing health knowledge of the types and properties of herbs and herbal-use behavior to help lower blood sugar levels and understand the health effects and consequences of herbal-use.

Keywords: Herbal-use behavior, Health literacy, Hemoglobin A1c, Ethnicities, Thai border communities, Health behavior.

Abstract Information

Identifiers and Pagination:

Year: 2023
Volume: 16
DOI: 10.2174/18749445-v16-230809-2023-59

Article History:

Electronic publication date: 13/09/2023
Collection year: 2023

© 2023 Choowanthanapakorn et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the School of Public Health, University of Phayao, Phayao 56000, Thailand; E-mail: