Development of models for prevention and control of liver fluke disease and Cholangiocarcinoma by the District Health Board in collaboration with local administrative organizations of Prang Ku District Sisaket Province.

Abstract

     This research and development study aims to integrate identified factors into the implementation of prevention and control measures for Opisthorchis viverrini (liver fluke) infection and cholangiocarcinoma in Prang Ku District, Sisaket Province. The study identifies four key factors: self-efficacy, attitudes toward liver fluke infection, perceived benefits of prevention and control, and coverage of stool examination for liver fluke eggs among individuals aged 15 years and older. These factors collectively explain 42.6% of the variance in prevention and control behaviors for liver fluke infection and cholangiocarcinoma among the population of Prang Ku District (R² = 0.426, R²_adj = 0.420, SE_est = 1.853, F = 71.538, p < 0.001), with statistical significance at the 0.05 level. The findings serve as input data for developing a district-level prevention and control model, particularly in areas facing implementation challenges that contribute to persistent disease outbreaks. The researcher developed the model in collaboration with the District Quality of Life Development Committee and local administrative organizations, using a prototype subdistrict in Prang Ku District, Sisaket Province. The model development involved 103 stakeholders and 90 community members from Ku Sub-district, following Kemmis and McTaggart's (1968) Action Research process, which consists of two iterative cycles, each comprising four stages: planning, action, observation, and reflection. Data collection and research activities took place between May 2024 and February 2025, with data analyzed through categorization, content analysis, and paired t-test comparisons of pre- and post-intervention mean scores.

     The research results found that knowledge, attitude, social norms, social support, the promotion of the use of the sub-district health charter, and participation in the development, use and control of the sub-district health charter after the experiment were significantly higher than before the experiment at a statistical significance level of 0.05.