Development of a Participatory Multi-stakeholder Network Model for Behavior Modification to Prevent Opisthorchiasis and Cholangiocarcinoma in Bueng Kan Province

Abstract

This research and development study aimed to develop a behavioral modification model for the prevention of opisthorchiasis and cholangiocarcinoma. The study was conducted in three phases. Phase 1 involved situational and contextual analysis, in which focus group discussions were conducted with 30 network partners, and knowledge, attitudes, and behaviors were assessed among 393 individuals of the general population. Phase 2 involved model development through a participatory process with 30 core network partners, who engaged in brainstorming and designed activities based on the Social Cognitive Theory and Health Belief Model. Phase 3 involved model implementation in 3 pilot subdistricts, where satisfaction, knowledge, attitudes, and practices were assessed among a target group of 41 individuals, purposively selected based on the inclusion criterion of having provided data during Phase 1.

The results showed that in Phase 1, the population had a low level of knowledge regarding the prevention of opisthorchiasis and cholangiocarcinoma (Mean = 11.45, S.D. = 3.20), with risk attitudes and behaviors arising from personal taste preferences and social pressure, and network mechanisms lacked integration. In Phase 2, the developed model, the "Bueng Kan Model (BKN-OV Model)," comprised four components: 1) a subdistrict-level network management mechanism with a clear structure; 2) behavioral modification activities emphasizing role-model leaders and social measures such as raw-fish-free merit-making events; 3) media and innovations in the local dialect; and 4) an empowerment-based monitoring and evaluation approach. In Phase 3, the implementation results showed that knowledge, attitudes, and disease-prevention behaviors were significantly higher than before implementation (p <0.001). Satisfaction with the model was at the highest level. The key success factors were strong leadership and culturally consistent communication. The policy recommendation is that local ordinances should be promoted and integrated into subdistrict development plans to ensure sustainability.