Questions/Answers

Wat Phaidam Buddhist School in Sing Buri province is an educational institution under the General Education Section conducted by the monk teachers and Buddhist layman teachers. The school is opening in Grade 7 – 12 for 12 – 19 year old Buddhist novices across all regions in Thailand. Faculty of Nursing, Mahidol University has started to initiate a program to develop and enhance the well-being of the novices by having coordination and endorsement from Foundation under the royal patronage of Her Royal Highness Princess Maha Chakri Sirindhorn (Sirindhorn Foundation) since 2003. From the project organized continually to the present year, it is discovered that there are health problems in physical, mental, intellectual, social and environmental dimensions, such as overweight, decayed teeth, intellectual and mental health problems, cohabitation problems, irregular mood disorders, the problem of bullying from senior novices, and also the lack of knowledge and understanding about basic hygiene care. The Faculty of Nursing realizes that the health promotion of the novices, who will be a vital force in Buddhism and social development in the future, is very important. Over the past 18 years, the Faculty has created a working network in conformity with the health promotion of novices with Mahidol University’s Faculty of Dentistry and Faculty of Veterinary Science, and District Public Health Office and Provincial Public Health in Sing Buri. In accordance, the project has been organized to promote health and well-being as well as providing knowledge and accurate understanding for novices to deal with communicable diseases, increasing basic hygiene care skills, positive thinking skills, and making decisions for a safe and non-violent life. Additionally, the project helps the novice of Wat Phaidam Buddhist School to have good health in all dimensions and sustainably, aligned with the goal 3 of SDG.

The project has been in collaboration with at least three health partner agencies for nearly twenty years. All parties have been working together to develop the novice's health promotion for sustainability. There are activities for building a mainstay to be a health-promoting leader continually as a role model of other novices. Also, there is a mental health promotion by teaching positive thinking skills, life skills that build self-assurance in safety and not being bullied, leading to the wellbeing of all novices.

The goals of SDGs related to the Novice Health Promotion Project at Wat Phaidam Buddhist School is SDG 3: Good Health (Health and Wellbeing of Novices) as this is a joint project of at least 3 health agencies. The operation has been organized according to PDCA (Plan-Do-Check-Act) approach by organizing the activities for physical, mental, intellectual, and environmental assessment; in addition, gathering information and planning with the working network, the monk teachers and Buddhist layman teachers, and novice representatives. Subsequently, the working team started the fieldwork such as providing initial treatment and dental care, providing knowledge and counseling, developing a healthy environment, giving dog vaccination, and also building a mainstay for hygiene and health care. The result indicated that the activities met the goal of primary health promotion for all novices in the school and the working team and involved units cooperated in operating professionally. Besides, novices have increased knowledge of self-care and can assess their own primary health condition so that they are able to receive treatment promptly and can take care of their own health. The results of each assessment are always adjusted for further improvement.

The structure of Novice Health Promotion Project at Wat Phaidam Buddhist School has a working system creating cooperative learning from real practice. Besides, it builds network and collaboration among faculty members and staff of the Faculty of Nursing Mahidol University and also creates health network including the monk teachers and Buddhist layman teachers of Wat Phaidam Buddhist School and staff from local health service units.

From the implementation of the project, it was found that having the Faculty of Nursing as the main agency for coordinating cooperation from other agencies makes the management controllably accomplished. All collaborating agencies had assemblies both online and on-site to provide empirical information and work together for solving problems. Hence, from activities including health screening, monitoring the growth, developing a healthy environment, oral and dental health checkup, hand washing and brushing demonstration, and promotion and prevention of mental health problems among novices, it was found that the novices had improved health behaviors and ability to take care of their own well-being.

The target group is adolescent novices who are boys aged 12-19. Most of them come from poor families, so the families send them to study and be ordained at Wat Phaidam Buddhist School until they finish their secondary school. As a result of the implementation of the Health Promotion Program for the novices, the novices have effectively grown having healthy lifestyles, have more time for self-care. Moreover, they can also reduce the family burden and stress of the mother so that it beneficially effect mother's mental health.

The target group of the project was every novice at Wat Phaidam Buddhist School, and also working network. From the implementation of the health promotion project for novices of Wat Phaidam Buddhist School, the focus was on personal health promotion activities of novices to take care of their own health according to the issues discussed. It led to the result that the novice gained the ability to initially assess and take care of their own health on the mild disease. For example, a novice can conduct the health assessment, based on the training knowledge, whether they had fever and skin rash and consumed to have a dengue fever so that they can be hospitalized promptly. Besides, the result showed that novices could take care of their health continuously and sustainably, and the inter-professional team worked together in a systematic manner.

Guidelines for the implementation of this project started in 2003. Faculty of Nursing, Mahidol University operated by the following steps: 1. Evaluating health conditions of all novices and exploring health care needs for basic information, and 2.Surveying opinions about health and environmental issues, and stray dogs problems and survey the need for solutions by allowing novices and monks as well as temple staff to express their opinions and jointly solve the problem continuously and sustainably. In 2003, the Faculty of Nursing managed to prioritize the problems and needs to sort out the order and jointly developed sub-projects to facilitate the promotion of novice health, such as a project to change health behaviors and improve residential and surrounding areas to be clean and hygienic and a project to prepare the temple staff in the provision of health services. Later in 2015, it was found that the novice had oral and dental health problems, so they organized an oral health examination and teaching, demonstration and practice of brushing and flossing properly by themselves. In addition, the faculty organized mental health promotion activities and prevent mental health problems in novices. Due to specific life styles of novices unlike the average layman led to the stress of adaptation, the novices should receive mental health promotion in order to survive the critical stages of adolescence. Each of these activities, the Faculty of Nursing has collaborated with various agencies such as the Faculty of Dentistry, Faculty of Veterinary Science, Provincial Public Health Office, and Inburi Hospital in order to implement the project to achieve the main goals of health promotion for all novices. Afterward, lessons learned were taken to improve work processes to be more efficient.

1. As activities were not organized consistently throughout the year, there were some problems to not be promoted continuously. The solution was to schedule activities in advance throughout the year, and to use online communication systems for monitoring the result of health promotion in various dimensions and for data forwarding performance. 2. The role of Buddhist layman teachers who was close to novices was passive, so it could lack of protection and promoting health. The solution was to encourage teachers to take a more proactive role to be a mainstay in activities for novices.

The approach of health promotion for novices at Wat Phaidam Buddhist School is different from general health promotion as it is a strong and solid cooperation from at least 5 networks consisting of Sirindhorn Foundation, Mahidol University’s Faculty of Nursing, Faculty of Dentistry, Faculty of Veterinary Science, and District Public Health Office and Provincial Public Health in Sing Buri. The units have been working together continuously with the school including a fieldwork for assessing the problem, joint planning and taking action to solve problems together by considering sustainability, and also assessing and improving weaknesses every year.

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Telecommunication systems were used via Zoom, Microsoft Teams, and Google Classroom in conferences, lectures, demonstrations, and monitoring.

The working group intends to develop the "Novice Health Promotion Model for All-Dimension Wellbeing". It is expected that this model can be applied to novices across all regions of the country. The proficient working group consists of agencies with accurate knowledge and expertise in solving related health problems. Therefore, the working group can forward knowledge from experience and let the trainees see the actual concrete in their practice.

The working group intends to develop the "Novice Health Promotion Model for All-Dimension Wellbeing". It is expected that this model can be applied to novices across all regions of the country. The proficient working group consists of agencies with accurate knowledge and expertise in solving related health problems. Therefore, the working group can forward knowledge from experience and let the trainees see the actual concrete in their practice.

The Faculty of Nursing has developed this project in the 5-year strategic plan of the Faculty. The Faculty allocates a budget for the project operation every year. In addition, most of the activities are volunteer activities that faculty members and staff, and networks always cooperate.

1) The administrators of all affiliated agencies placed importance on the implementation of activities and provided budget and manpower support. 2) Staff of Wat Phaidam Buddhist School trust and cooperate in promoting the health of novices. 3) Novices trust the working group and are enthusiastic about promoting their health.

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The project was assessed by both internal and external agencies. After finished, lesson learned from the project was discussed and make plans for the next operation. There was a report to be assessed by the Sirindhorn Foundation, which is the external agency responsible for all activities related to Wat Phaidam Buddhist School, and has decision-making authority to allow the working group to operate continuously for 18 years. In addition, the report was sent to experts within the Faculty of Nursing to evaluate results and make recommendations to be submitted to the board of directors of the Faculty of Nursing.

The project evaluation was a measure based on indicators including the number of collaborating networks, the number of novices with solved or forwarded problems, and the satisfaction of all related persons and networks. The tools used in evaluation developed by the working group were satisfaction questionnaires, record of personal health information and participating activities, and recorded number of novices and problems that had been forwarded.

The results showed the priorities of a novice's health problem, so it made a strong working network covering all aspects of health. The challenge was how to make the health promotion of the novice to be an important agenda that must be sustained. The approach agreed upon by the working group was to raise awareness of novices and influencers about health promotion and to create successors with the same goals in a collaborative network. Therefore, each year, every network invites a new working group to replace the soon-to-be-retired working group. The activities cultivate awareness through educating, building understanding for novices, and influencers to recognize the importance of taking action on health promotion for novices in all dimensions. In addition, there are meetings with all parties to share the assessed data and jointly plan, which will follow up at least every 3 months. This networked operating system makes the health promotion of novices more sustainable.

The project implementation creates a network for health promotion for novices as follows: 1) Faculty of Nursing is the main health promotion agency including preliminary screening, coordination of care for education and monitoring and evaluation 2) Faculty of Dentistry, Mahidol University is responsible for oral and dental care activities by organizing oral and dental health examination activities for novices. 3) The Faculty of Veterinary Science is responsible for mental and social and environmental health, such as the safety of staff from animals in the temple. 4) Sing Buri Provincial Public Health Office, In Buri District Public Health Office, Thong Ain Sub-District Health Promoting Hospital, in collaboration with the Faculty of Nursing to promote physical, mental, and intellectual well-being. 5) The monk teachers and Buddhist layman teachers of Wat Phaidam Buddhist School keep tracking health promotion causing continuity and sustainability.

Another significant key of the program operation was that the working group, comprised of internal and external health networks, and Wat Phaidam Buddhist School that continuously evaluated together every year and also explored whether the novice had other health issues. For example, if it was found that there were possible mental health issues, the working group planned to assess the novice's mental health before the activity by inquiring from monk teachers and letting the novice write down the problems. Afterward, the working group brought the matter to discuss for organizing the activity and planning the activity format. The working group also designed oral and dental health examinations for novices with dental problems. The working process created a working system forming a collaborative learning from real practice and the teamwork of Mahidol University’s Faculty of Nursing, Faculty of Dentistry, Faculty of Veterinary Science, along with agencies of Sing Buri Province, the monk teachers and Buddhist layman teachers of Wat Phaidam Buddhist School, and staff from local health service units. In addition, the working created an integration with the research.

The health promotion for novices has been successful over 18 years because of the working idea "Professional, Comprehensive, and Wholehearted Working". The working group learned that sustainability started with a strongly built system. Volunteer workers dedicated to promoting the well-being of novices with a passion so they can gain trust as a family. The working group is aware of problems affecting the health of the novice in all dimensions, including physical, mental, intellectual, social, and environmental dimensions. This leads to periodic joint planning between the novice and the working network, the distribution of responsibilities, covering all dimensions, and immediate action to solve problems, starting with raising knowledge and awareness to the novice to see the importance of health enhancement, demonstrating the accurate technique to novices, and conducting cooperative assessments and use the assessment results to improve their health promotion practices. The project successfully supported more than 1,000 novices to grow up well in both global and dharma society. There has a plan to extend sustainability by building strong successors in the network, both within the Wat Phaidam Buddhist School and collaborative health agencies to develop the novice health promotion model.