Development of a Participatory Behavioral Modification Model for Prevention of Opisthorchiasis and Cholangiocarcinoma in Yang Talat District, Kalasin Province

Abstract

This research and development study aimed to develop a participatory behavioral modification model for liver fluke and cholangiocarcinoma prevention in Yang Talat District, Kalasin Province. The study employed both qualitative and quantitative data analysis methods. The sample consisted of household representatives aged 15 years and above, along with stakeholder network representatives from all levels in the area, selected through purposive sampling. The study was conducted from October 2022 to September 2023. Research instruments included in-depth interviews, risk behavior questionnaires, and health literacy assessments. Statistical analyses utilized frequency, percentage, mean, standard deviation, and Wilcoxon Signed Ranks test for within-group comparisons.

The results revealed that residents in Yang Talat District had high to very high-risk behaviors for liver fluke infection (73.4%), particularly raw fish consumption (42.2%). Regarding health literacy skills, cognitive skills were at a low level (Median=10.0, IQR=8.0-12.0), while information access skills (Median=3.0, IQR=2.0-4.0) and communication skills (Median=3.0, IQR=2.0-4.0) were at high levels. Self-management skills, media literacy, and decision-making skills were at moderate levels. After implementing the behavioral modification model, scores for information access, communication, self-management, and media literacy skills were significantly higher than before the intervention. The prevalence of liver fluke infection decreased from 18.0% to 7.1%, and the proportion of at-risk populations receiving cholangiocarcinoma screening increased from 76.3% to 90.3% (p<0.05).