Development of a Community-Based Participatory Approach for Drug Screening, Case Finding, and Patient Care: The “Roi-Et Model” in Phanom Phrai District, Roi Et Province

Abstract

Purposes: This study aimed to investigate the current situation and challenges of substance abuse; to develop, implement, and evaluate an operational guideline for community-participatory screening, identification, and care for individuals with substance use disorders; and subsequently to refine and disseminate the guideline.

Study Design: Research and Development (R&D).

Materials and Methods: The study, conducted from December 2023 to December 2024, employed a research and development (R&D) design. Three target groups were involved: 1) 260 individuals for a situational analysis survey; 2) 31,910 people aged 16-65, selected through purposive sampling for a screening program; and 3) 390 research collaborators comprising 13 sub-district operational teams (30 members each). Data were collected using a survey questionnaire with a Cronbach's alpha coefficient of 0.92, a focus group discussion guide, and record forms validated with an Item-Objective Congruence (IOC) index ranging from 0.80 to 1.00. Data were analyzed using descriptive statistics (frequency, percentage) and content analysis.

Main findings: The situational analysis revealed a severe methamphetamine abuse problem in Roi Et province, particularly in the Phanom Phrai district, prevalent among adolescents and the working-age population, leading to increased crime rates and social unrest. Fear and mistrust were identified as significant barriers to intervention despite the existence of reporting channels. The study led to the development of a six-step model: 1) Preparation; 2) Identification and Screening; 3) Summarizing screening results and providing community feedback; 4) A 9-session Community-Based Treatment (CBTx) program and evaluation; 5) Transitioning to sustainable follow-up; and 6) Monitoring and relapse prevention. The guideline's implementation showed that of the 31,910 individuals screened, 1,118 (3.5%) had positive urinalysis results. These individuals were classified as users (n=21, 1.88%), abusers (n=1,069, 95.62%), and addicts (n=28, 2.50%). Among the positive cases, 20 (1.79%) exhibited red-level aggression. Following the intervention, of the 1,064 'abusers' who completed the 9-session CBTx program, 177 (16.64%) subsequently tested positive for substance use, and 123 (11.56%) were identified as having relapsed.

Conclusion and recommendations: The implementation of the community-participatory guideline positively impacted the community. The CBTx model proved to be an effective approach for mitigating the adverse effects of drug abuse and supporting the sustainable recovery of individuals with substance use disorders.