HEALTH EDUCATION BENEFIT FOR CHOLANGIO-CARCINOMA PREVENTION IN THAILAND: HEALTH BELIEFS ARE ANOTHER OPTION TO CONSIDER
Keywords:
Health belief model, Cholangiocarcinoma, Health education program, PreventionAbstract
There are various strategies and policies for cholangiocarcinoma (CCA) prevention to reduce people’s incidence and mortality rates in epidemic areas of Thailand. One of them is applying health theory, especially health belief, but the conclusion is not clear. Therefore, benefits analysis of health education programs based on the health belief model (HBM) is essential for effective prevention of CCA. This study aimed to assess the benefits of the health education programs for CCA prevention in the epidemic areas of Thailand using systematic review and meta-analysis. The research studies in electronic databases, including MEDLINE, SCOPUS, Cochrane library, and ThaiJo, were searched. The cross-sectional analytic study, experimental research, and quasi-experimental research were selected. The researchers determined articles based on the specified criteria and analyzed them based on mean and 95% confidence interval. We decided on five studies (N=344) to perform analyses with random-effects models. The effect sizes for knowledge scores (standard mean difference: SMD=1.30), perceived risk (SMD=2.09), perceived severity (SMD=1.91), perceived benefits (SMD=2.02), perceived barriers (SMD=1.96), and preventive behaviors of CCA (SMD=2.07). After implementing the health education programs based on the HBM for CCA prevention, they all increased statistically. It is noted that the health education programs based on the HBM can help people gain knowledge, correct perception, and behaviors in CCA prevention. The health education programs can be implemented at individual, family, and community levels if they are adjusted to the context of the area. They can also be developed into the health behavior modification model.
References
Chayngam, T., Ruangjarat, L., and Dechan, S. (2020). Effect of health education program on health belief model application with social support for behavioral change to prevent opisthorchiasis and cholangiocarcinoma of people aged 40 years over in Muangmai Sub-district, Sriboonruang District, Nong Bua Lamphu Province. J. Council Community Public Health., 3:1-15.
Higgins, J.P.T., Altman, D.G., and Sterne, J.A.C. (2017). Chapter 8: Assessing risk of bias in included studies. Available from: www.training.cochrane.org/handbook. Accessed date: Jun, 2017)
Imsamran, W., Pattatang, A., Supaattagorn, P., Chiawiriyabunya, I., Namthaisong, K., Wongsena, M., Puttawibul, P., Chitapanarux, I., Suwanrungruang, K., Sangrajrang, S., and Buasom, R. (2018). Cancer in Thailand, Vol. IX, 2013-2015. Bangkok: New Thammada Press (Thailand) Co., Ltd.
Kaewpitoon, S.J., Thanapatto, S., Nuathong, W., Rujirakul, R., Wakkuwattapong, P., Norkaew, J., Kujapun, J., Padchasuwan, N., and Kaewpitoon, N. (2016). Effectiveness of a health educational program based on self-efficacy and social support for preventing liver fluke infection in rural people of Surin Province, Thailand. Asian Pac J. Cancer Prev., 17: 1,111-1,114.
Kim, C.S., Smith, J.F., Suwannatrai, A., Echaubard, P., Wilcox, B., Kaewkes, S., Sithithaworn, P., and Sripa, B. (2017). Role of socio-cultural and economic factors in cyprinid fish distribution networks and consumption in Lawa Lake region, Northeast Thailand: Novel perspectives on Opisthorchis viverrini transmission dynamics. Acta Trop., 170:85-94.
Korsura, P., Songserm, N., Charoenbut, P., and Pramual, P. (2020). Risk behaviors and prevention behaviors of liver fluke infection: situation assessment based on community context of Thai-Khmer people in Sisaket Province. UBRU J. Public Health Res,. 9: 133-141.
Modesti, P.A., Reboldi, G., Cappuccio, F.P., Agyemang, C., Remuzzi, G., Rapi, S., Perruolo, E., Parati, G., and ESH Working Group on CV Risk in Low Resource Settings (2016). Panethnic differences in blood pressure in Europe: a systematic review and meta-analysis. PloS One., 11:e0147601.
Padchasuwan, N., Kaewpitoon, S.J., Rujirakul, R., Wakkuwattapong, P., Norkaew, J., Kujapun, J., Ponphimai, S., Chavenkun, W., Kompor, P., and Kaewpitoon, N. (2016). Modifying health behavior for liver fluke and cholangiocarcinoma prevention with the health belief model and social support theory. Asian Pac J. Cancer Prev., 17:3,721-3,725.
Phatisena, P., Eaksanti, T., Wichantuk, P., Tritipsombut, J., Kaewpitoon, S. J., Rujirakul, R., Wakkhuwattapong, P., Tongtawee, T., Matrakool, L., Panpimanmas, S., Norkaew, J., Kujapun, J., Chavengkun, W., Kompor, P., Pothipim, M., Ponphimai, S., Padchasuwan, N., and Kaewpitoon, N. (2016). Behavioral modification regarding liver fluke and cholangiocarcinoma with a health belief model using integrated learning. Asian Pac J. Cancer Prev., 17:2,889-2,894.
Saenna, P., Hurst, C., Echaubard, P., Wilcox, B. A., and Sripa, B. (2017). Fish sharing as a risk factor for Opisthorchis viverrini infection: evidence from two villages in north-eastern Thailand. Infect Dis Poverty., 6:66.
Sithithaworn, P., Andrews, R.H., Nguyen, V.D., Wongsaroj, T., Sinuon, M., Odermatt, P., Nawa, Y., Liang, S., Brindley, P.J., and Sripa, B. (2012). The current status of opisthorchiasis and clonorchiasis in the Mekong Basin. Parasitol Int., 61:10-16.
Songserm, N., Bureelerd, O., Thongprung, S., Woradet, S., and Promthet, S. (2015). Community participation in cholangiocarcinoma prevention in Ubon Ratchathani, Thailand: relations with age and health behavior. Asian Pac J. Cancer Prev., 16: 7,375-7,379.
Songserm, N., Charoenbut, P., Bureelerd, O., Pintakham, K., Woradet, S., Vanhnivongkham, P., Cua, L. N., Uyen, N., Cuu, N. C., and Sripa, B. (2020a). Behavior-related risk factors for opisthorchiasis-associated cholangiocarcinoma among rural people living along the mekong river in five greater mekong subregion countries. Acta Trop., 201:105221.
Songserm, N., Woradet, S., Bureelerd, O., Thongchai, C., Thongprung, S., and Ali, A. (2020b). Effectiveness of leader village health volunteers training program on preventing cholangiocarcinoma in Thailand: advantages for high-risk area with limited public health personnel. J. Cancer Educ., 36(6):1,306-1,315.
Songserm, N., Woradet, S., and Charoenbut, P. (2016). Fruit and vegetables consumption: a pointer for cholangiocarcinoma prevention in northeast Thailand, the highest incidence area in the world. Nutr Cancer., 68:1,289-1,294.
Songserm, N., Woradet, S., Sripa, B., and Ali, A. (2020c). Sustainable prevention of cholangiocarcinoma through community participation in a high-incidence area in Thailand. Asian Pac J Cancer Prev., 21:777-782.
Sripa, B., Kaewkes, S., Sithithaworn, P., Mairiang, E., Laha, T., Smout, M., Pairojkul, C., Bhudhisawasdi, V., Tesana, S., Thinkamrop, B., Bethony, J.M., Loukas, A., and Brindley, P.J. (2007). Liver fluke induces cholangiocarcinoma. PLoS Med., 4:e201.
Srithongklang, W., Panithanang, B., Kompor, P., Pengsaa, P., Kaewpitoon, N., Wakkhuwatapong, P., and Kaewpitoon, S.J. (2019). Effect of educational intervention based on the health belief model and self-efficacy in promoting preventive behaviors in a cholangiocarcinoma screening group. J. Cancer Educ., 34:1,173-1,180.
Tananchai, R. and Choowattanapakorn, T. (2018). The effect of health belief modification program on complications preventing behaviors among older persons with cholangiocarcinoma undertaking percutaneous transhepatic biliary drainage. J. Police Nurse, 10:298-307.
Vatanasapt, V., Uttaravichien, T., Mairiang, E. O., Pairojkul, C., Chartbanchachai, W., and Haswell-Elkins, M. (1990). Cholangiocarcinoma in north-east Thailand. Lancet., 335:116-117.








