A HIERARCHICAL MULTIPLE REGRESSION ANALYSIS OF ACCULTURATION
AMONG INTERNATIONAL STUDENTS AT MAHIDOL UNIVERSITY
Ketsarin Sirichuanjun1*, Chawewon Boonshuya2, Natkamol Chansatitporn3, Oranut Pacheun4
1
Affiliation of 1st author : Master of Science (Biostatistics). Department of Biostatistics, Faculty
of Public Health, Mahidol University. Bangkok, Thailand.
2,3
Affiliation of 2nd author : Department of Biostatistics, Faculty of Public Health, Mahidol University.
Bangkok, Thailand.
4
Affiliation of 4th author : Department of Community Health, Faculty of Public Health, Mahidol
University. Bangkok, Thailand.
e-mail: ketsarin_fern@hotmail.com1, chaweewon.boo@mahidol.ac.th2,
nutkamol.cha@mahidol.ac.th 3, oranut.pac@mahidol.ac.th4
Abstract Acculturation is the process whereby the attitudes and behavior of people from one
culture are modified as a result of contact with a difference culture, it has also been show to
influence knowledge and attitudes that shape and influence health behaviors. The purpose of this
cross-sectional study to simultaneously examine associations between student level and faculty
level measures of factors predicting acculturation among international graduate students at
Mahidol University. The study was conducted among the 1st year international students in
Mahidol University who enroll and studying in all graduate programs. Data was collected during
the second semester from all programs and international students who are studying in Master’s
degree, Doctoral degree and Diploma program in the Graduate School. Total 192 selfadministered questionnaires were returned from the international students from 32 international
program, 16 Faculties during January to March 2013. The Hierarchical multiple regression
analysis was used to investigate the association between student factors and faculty factors. The
result of this study showed the student level variables, health status (  = 0.93, p < 0.05), social
relationship (  = -1.69, p < 0.01), language (  = 7.33, p = 0.00), faculty level are interaction
between facilities and social relationship (  = 0.53, p < 0.01), and interaction between facilities
and language (  = -1.66, p = 0.00) were significantly related to acculturation. Further prospective
Hierarchical research is suggested to demonstrate a causal relationship between health status,
social relationship and facilities which may influence on acculturation Moreover, further
research should be conducted to investigate an effect of area and provincial level on
acculturation.
Keywords Hierarchical multiple regression, Acculturation, International Students, Mahidol
Univresity.
Introduction
International mobility has become the hallmark of the 21st century as the world increasingly
becomes a global village. Riding this trend of globalization, yet many countries have already
seen dramatic shifts in the way school and education systems are managed compared with those
of the end of the last century[1].A prime stimulus for these changes in a combination of shifts in
society, including greater migration, changes in social and family structures, and the use of
information and communications technologies. Therefore the influential is a greatest emphasis
on global village are the relative performance of each schools and education systems between
school, school systems and countries to develop to be the same one[2].
Education is an important factor to human resource development and it is the key to national
development. Every country attempts to expand the coverage of education and to reduce the
inequality of education. Thailand is a country that expands opportunity for education to
everyone. All of the university in Thailand includes public universities and private universities
develop the international courses to be accepted of foreigner.
Thailand is one of the 10-member Associations of South East Asian Nations (ASEAN). The
ASEAN Vision 2015 aims to create a stable, prosperous and highly competitive ASEAN
economic region, in which there is a free flow of goods, services, investment and capital,
equitable economic development and reduced poverty and socio-economic disparities. The
ASEAN Socio-Cultural Community envisages Southeast Asia bonded together in partnership as
a strong community of caring societies and aimed at the vigorous development of regional
identity and the preservation of the region's cultural heritage. To prepare each country’s work
force for economic integration, ASEAN will encourage investment in education, training,
science and technology development, job creation, and social protection. ASEAN will also seek
increased cooperation in public health, especially the prevention and control of infectious and
communicable diseases[3].
In Thailand, Office of the National Economic and Social Development Board has drafted the
Direction of the Eleventh Plan with the participation of all stakeholders at community, regional,
and national levels. The Plan was proposed to the Cabinet for the progress of the preparation on
the 26th October 2010.Along with the Sufficiency Economy Philosophy, the framework of the
Eleventh Plan is set to be driven under the people-centered development and broad base
participation approaches towards balanced, integrated, and holistic development in order to the
agreed vision of “a happy society with equity, fairness and resilience”. Over the five decades, the
National Development Plans have uplifted Thailand to an advanced developing country with
better income, quality of life, longevity, and education[4].
In 2013,Office of the Higher Education Commission reported at the meeting in March, that
there were 20,115 foreign students studying in Thai higher educational institutions in 2011.
Mainly they were from China, Myanmar, Laos, Vietnam and Cambodia, the most common
universities are Assumption University, Mahidol University, Chulalongkorn University ,
Mission College and Thammasat University, respectively[5].
Mahidol University (MU) was founded in 1888 as School of Medical Practitioners, Siriraj
Hospital and reorganized in 1943 as University of Medical Sciences. The university originally
focused on Health Sciences and expanded to other fields in recent decades. MU hosted the first
medical school of Thailand, the Siriraj Medical School, from which the university traced its
origin. MU offers a wide range of graduate (most are international programs) and undergraduate
programs from natural sciences to liberal arts with remote campuses in Nakhon Sawan. In 2002,
MU expanded its campus to Kanchanaburi to offer its students more learning opportunities with
rural communities. The university is expanded its campus to Amnaj-Chareon Province, in the
Northeastern of Thailand in 2009. Then it became the largest university in Asia. MU entered the
Quacquarelli Symonds World University Rankings in 2006 as 322nd in the world and 3rd in
Thailand. In 2010, the university swiftly proceeded to the 228th in the world, 28th in Asian and
as Thailand's top-ranked university according to Quacquarelli Symonds 2010 Asian Ranking,
although some foreign ranking sources may provide different ranking.In 2010, according to
University Ranking by Academic Performance (URAP) it is the best university in Thailand and
351st university in the world[6].
Mahidol University was officially founded on February 7, 1943 and experienced drastic
growth since then. Many new schools and departments were established during this era. The
oldest of the three Bangkok campuses, Bangkok Noi Campus is located on 28 acres (12 hectares)
and is home to the original medical school attached to Siriraj Hospital, founded by H.M. King
Chulalongkorn( King Rama the fifth) of Thailand in 1890 which over time become to be
Mahidol University. The campus has retained its academic focus on medicine, revolving around
the Siriraj Hospital complex. In 1959, the Medical Science Preparatory School (now Faculty of
Science) was moved to Payathai area - thus beginning the Payathai campus. King Bhumipol(
King Rama the ninth) expressed his will that MU should also expand to the fields of Social
Science, so the Faculty of Social Sciences and Humanities was founded in 1969. The
construction of Salaya campus began in 1975.Due the political situation and financial shortage it
took 8 years for construction. On July 23, 1983, the Salaya campus was officially opened. All
education for freshman-year students was transferred to Salaya. Later academic developments of
the university tended to deviate from traditional Health Science area to facilitate academic
demands of the country and later developments were centered on the Salaya campus[6].
In the academic year 2008, Mahidol University offered total of 371 programs, which
comprised of 138 undergraduate programs and 233 post graduate program. Graduate Study
Programs in the Academic Year 2008 were Graduate Diploma 51 programs, Master’s degree 160
programs, Higher graduate diploma 4 programs and Doctoral degree 66 programs. From 2004 to
2008, number of international graduate students was increasing from 222 to 401[7].It could be
seen that the trend of international graduate students is increasing about 45per year. In 2008,
number of international graduate students in the Academic Graduate Diploma, Master’s degree
and Doctoral degree were 34, 282 and 85, respectively[7].
Acculturation is the process whereby the attitudes and/or behaviors of people from one
culture are modified as a result of contact with a difference culture. The acculturation process
affects a range of behaviors, value, and beliefs. Acculturation has also been shown to influence
knowledge and attitudes that shape and influence health behaviors[8].Psychologists have
considered the effects of self-concealment, social support, academic stressors, gender, English
fluency, etc. on acculturative stress[9]. Psychosocial outcomes are therefore an essential aspect
of school adjustment that, indirectly, may also become important to academic achievement[10].If
they cannot adjust from those factors, they will increase stress, associated with lower level of
anxiety and depression and with a poor quality of life, that is the major course in suicide[11-14].
Factors which may influence on acculturations among international can be classified into
individual factors and program management factors in which an international student nested in
the program. To identify an effect of both individual and program factors on acculturation,
hierarchical multiple regression analysis will be applied.
A hierarchical modeling is a statistics structure of unit of analysis where it is presented.
Hierarchical refers to units grouped at different levels, for example international students
grouped in a program level. The technique is used to determine how the structures affect the
measurement of interest. It helps to determine better estimate than single level analysis[15]. The
advantage of a multilevel model is that it is not only accommodate the hierarchical nature of data
and corrects the estimated standard error to allow for clustering of observations within unit[16],
but it also allows the identifications of clustering in the outcome. A hierarchical modeling is
considerable variability in acculturate at program level seen among international graduate
students which approach account for this source of variation to obtain more precise estimates of
the effect of international student characteristics in each program. At the same time, by including
program management level variables, it allows for estimation of the effect of program on
acculturation.
Methodology
A hierarchical multiple regression analysis was used in this cross-sectional selfadministered questionnaire study to identify determinants of acculturation among MU
International Graduate students.
Study design
A self-administered cross-sectional descriptive study was conducted to measure studentlevel factors: sex, age, marital status, length of stay, smoking, drinking, religion, experience of
going abroad, language, degree, stress management, social relation, health status and programlevel factors: student-teacher ratio, facilities, program management, activities and location that
may influence acculturation of MU International Graduate students.
Population and sample
The study was conducted among international students in Mahidol University who enroll
and studying in all graduate programs. Data was collected during the second semester from all
programs and international students there are 204 in 2012 international students from 36
programs who are studying in Master’s degree, Doctoral degree and Diploma program in the
Graduate School.
Inclusion and Exclusion Criteria
Inclusion Criteria:
International students who enroll for Master’s degree, Doctoral degree and
Diploma Program in academic year 2012 at the Faculty of Graduate Studies who agree and sign
the consent form to participate in this study.
The Director of each International Master’s degree Program, Doctoral degree Program
and Diploma Program of the Faculty of Graduate Studies in academic year 2012 who agree and
sign the consent form to participate in this study.
Exclusion Criteria:
International students who enroll for Master’s degree, Doctoral degree and
Diploma Program in academic year 2012 at the Faculty of Graduate Studies who are absent
from university at the time of data collection, disagree and do not sign the consent form to
participant in this study and desire for stop answering questionnaire while the interview.
The Director of each International Master’s degree Program, Doctoral degree Program
and Diploma Program of the Faculty of Graduate Studies in academic year 2012 who disagree at
the time of data collection and do not sign the consent form to participant in this study.
Data Collection
Method of data collection
Self-administered questionnaire as construct by the researcher based upon the
conceptual framework and operational definition of term use. Permission for data collection of
each international program was obtained from both Program Director and international students
before data collection. Program Directors and international students were explained on the
objectives and significance of the study until they are clearly understood. Objectives and
significance of the study as well as risk and benefit were also explained to international students
until all of them are clearly understood. If they agree to participate in the study, ask them to sign
the inform consent form. The questionnaires will be handed to those who agree to participate and
ask them to answer questions accordingly.
The data collections were done by researcher and colleagues who were graduate students
of the Master of Science in Biostatistics, Mahidol University, after obtaining an ethical clearance
an ethic committee of the Faculty of public Health, Mahidol University.
Research instrument
A self-administered survey questionnaire was reviewed from researcher and selected
some part of the National Latino and Asian American Study (NLAAS)[17] and The Student
Adaptation to College Questionnaire( SACQ) by Robert W. Baker, Ph.D. and Bohdan Siryk,
M.A[18], and was adjusted to appropriate with purpose of thesis field by thesis adviser and coadvisers. Questions was constructed base on the Roy’s Adaptation Model. There are two sets of
data collection forms, one program director in various faculties of MU.
Results
The cross-sectional study aimed at assessing acculturation in the first-year international
students. The data took collection in the second semester, on January to March 2013 and its
related factors was conducted in Mahidol University. Total of 204 self-administered
questionnaires were take all the international students representatives systematically and 192
were returned with the response rate 94.1% as shown in Table 1
Table 1 General Characteristics of 192 International
Students at Mahidol University
Table 1 (cont.)
Characteristics
Characteristics
Number
Percent
Sex
Male
Female
108
56.3
84
43.7
Private
68
35.4
Partially sponsor
28
14.6
Fully sponsor
96
50.0
4
2.1
188
97.9
20-29
90
46.9
English
30-39
70
36.5
Others
40 up
32
16.6
S.D. (year)
Min-Max (years)
No
43
22.4
6.75
Yes
149
77.6
No
133
69.3
Yes
59
30.7
No
164
85.4
Yes
28
14.6
160
83.3
Ever smoke
18
9.4
Currently smoke
14
7.3
102
53.1
84
43.8
6
3.1
25
13.0
118
61.5
49
25.5
Exclusively Thai food
24
12.5
Mostly Thai food
47
24.4
84.4
Equally Thai and local food
46
24.0
27
14.1
Mostly local food
57
29.7
3
1.5
Exclusively local food
18
9.4
Exclusively Thai food
32
16.7
Mostly Thai food
62
32.3
Equally Thai and local food
49
25.5
Mostly local food
38
19.8
Exclusively local food
11
5.7
Experience in abroad
21 - 56
Buddhist
100
52.1
Christian
29
15.1
Islam
28
14.6
Others
35
18.2
Single
96
51.1
Divorced
3
1.6
Married
89
47.3
Rent house or apartment
University’s dorm
Others
5
2.6
157
81.8
27
14.1
3
1.5
≤3
12
6.2
4-6
24
12.4
123
64.3
33
17.1
Participated degree
Doctoral degree
Certificate
No
Yes, occasionally
Yes, frequently
Exercise
No
Length of stay in Thailand (months)
Master's degree
Non-smoking
Alcohol
Current place of living
Relatives' house
Health problem
Current Smoking status
Marital status
10 - 12
Work experience
31.75
Religion
7-9
Percent
Mother tongue language
Age (years)
Mean (years)
Number
Sponsor
162
Yes, occasionally
Yes, frequently
Food preference at home/dorm
Food preference in restaurants
Table 2 Parameter estimates in Hierarchical Multiple Regression Model
Estimated coefficient
Model 2
Model 3
96.81 (12.09)
83.78 (0.13)
99.39 (40.27)
0.88*(0.13)
0.86*(0.13)
0.93*(0.45)
social relationship
0.33 (0.22)
0.27 (0.22)
-1.69*(0.79)
age
status (single§)
0.13 (0.19)
0.21 (0.19)
-0.56 (0.59)
divorce
-8.59 (8.23)
-10.54 (8.28)
-15.89 (8.68)
married
1.63 (2.50)
0.86 (2.46)
-3.39 (8.01)
language
1.05*(0.46)
1.09*(0.52)
7.33*(1.72)
length in Thailand
0.21 (0.58)
0.44 (0.52)
1.87 (2.18)
degree
sex (male§)
3.81 (3.08)
4.40 (3.06)
12.24 (9.68)
female
-1.42 (2.14)
-1.54 (2.13)
-6.04 (7.65)
-1.61 (2.33)
-1.54 (2.50)
0.40 (5.79)
0.71 (5.60)
2.98*(0.99)
-1.43 (10.53)
Effect
Fix effect
Intercept
Model 0
177.12 (2.08)
Model 1
Acculturation
student Level
health status
Faculty3Level
Campus (Salaya§)
Phayathai
Siriraj
Facilities
Interaction
Facilities*health status
-0.03 (0.12)
Facilities*social relationship
0.53*(0.20)
Facilities*age
0.19 (0.15)
Facilities*status
0.61 (0.97)
Facilities*language
-1.66*(0.44)
Facilities*length
-0.30 (0.44)
Facilities*degree
-2.25 (2.37)
Facilities*sex
1.00 (1.89)
Random effect
 2 0
5.13
3.18
0.00
0.00
766.23
727.09
723.21
712.55
Deviance
1532.45
1454.17
1446.42
1425.09
AIC
1538.45
1478.17
1476.42
1471.09
BIC
1548.03
1516.49
1524.31
1544.53
-2 Log likelihood
Note : § Reference group , * p<.05,  2 0 variance among Faculties.
The first Hierarchical multiple regression analysis was used to test the fit of the random
intercept or null model (model 0). The model was fitted with no independent variable. The
intercept estimated was 177.12 .This model provided an intra-class correlation (ICC) which was used to
investigate faculty differences in individual acculturation status. In this step, random variation between
faculty was significantly identified at p-value< 0.001. An estimated intra-class correlation (  ) was
0.0869 suggesting that 8.69% of the variability in acculturation status of individual lies among faculty.
Model 1 demonstrated the effect of student-level factors on acculturation. Fitting model process
began with an empty model and sequentially added the most predictive variable. The student-level
variable with the strongly significant LR test was determined as candidate variable for hierarchical
multilevel regression analysis in structuring the best model to predict acculturation status. The selection
of student-level factors procedure proceeded until all variables has been evaluated and re-evaluated until
the model reached at all student-level factors were significantly provided to the model, using likelihood
ratio (LR) test to evaluate the model for each step. After added the variable into the model, it was found a
reduction of the intercept from null model. The intercept estimated was 96.81.
For the model 2, it was sequentially added all significant faculty-level factors related to
acculturation status from univariate regression analysis. Model 1 with the student-level factors that
significantly predicted their acculturation was used as baseline model and then added all variables of
faculty-level were added into model 2. The intercept estimated was 83.78.
The last model, it was sequentially added all significant interaction between faculty-level factors
and student-level factors base on model 2. After added the variable into the model, it was found a
reduction of the intercept from model 3. The intercept estimated was 99.39.
Discussion and Conclusion
The cross-sectional study was performed among 192 international students, among those
responded to the self-administered questionnaire, 56.3% was male. Their age ranged from 21- 56
years old with an average of 32 years old. Regarding marital status, 51.1% was single.
Considering their length of stay in Thailand, 64.4% was stayed in Thailand on the ranged from 79 months. Current of their living, 81.8% were rented house or apartment. For education level,
84.4% was Master’s degree and half of international students was gotten the fully sponsor.
Mother tongue language of them, 97.9% was not English, 77.6% was have no work experience
and 69.3% was have no experience in abroad before study in Graduate Studies. About their
health problem, 85.4% was having no health problem. Current smoking status, 88.3% were nonsmoking. Current alcohol status, 53.1% were non-alcohol. Health care status, 61.5% were
occasionally exercised. Food for daily life living, 29.7% made their local food at home/dorm and
32.3% eaten Thai food in the restaurants.
Among 16 faculties recruited into this study, There were 3 campus; Salaya, Phayathai
and Siriraj ,66.8% of faculties were in Salaya Campus. Work load ratio, 66.8% non-workload of
Student-Teacher Ratio. The total number in each faculties ranged from 1-45 persons with an
average 11 persons. Currently facilities for student, 56.2% in ranged score from 13-15. All
activities, 43.7% in ranged score from 23-25. Score of program management, 50% in ranged
score from 10-12.
The Hierarchical multiple regression analysis to investigate the association between
student factors and faculty factors, the model fitting process started with an empty model. This
was the first Hierarchical multiple regression which was fitted with no variable; this model
provided an intra-class correlation (ICC) indicating that 8.69% of the score of acculturation of
respondents lies among faculty level, then it indicates that we need not consider the level in
representing the variance of the outcome. Next step, the effect of both student-level and facultylevel characteristics on score of acculturation was considered to be included to the model 2. This
model show a statistically significantly, they were health status, language and facilities were
significantly related to acculturation. The last step, added all significant interaction between
student-level factors and faculty-level factors. After added the variable into the model, this
variable are significantly, health status, social relationship, language and interaction between
facilities and social relationship were significantly related to acculturation (all p-value<0.05). It
was found a reduction of the intercept from model 2. Therefore, the final model could be
represented as;
acculturation = 99.39 + 0.93 (health status) - 1.69 (social relationship) + 7.33 (language)
+ 0.53 (facilities*social relationship) – 1.66 (facilities*language)
Further prospective Hierarchical research is suggested to demonstrate a causal
relationship between health status, social relationship and facilities which may influence on
acculturation Moreover, further research should be conducted to investigate an effect of area and
provincial level on acculturation.
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