Development of a Health Education Modification Program Regarding Liver Flukes and Cholangiocarcinoma in High Risk Areas of Nakhon Ratchasima Province Using Self-Efficacy and Motivation Theory

Document Type : Systematic Review and Meta-analysis


1 Parasitic Disease Research Unit, Suranaree University of Technology, Nakhon Ratchasima, Thailand

2 Parasitic Disease Research Unit,Khon Kaen University, Khon Kaen, Thailand

3 School of Family Medicine and Community Medicine Khon Kaen University, Khon Kaen, Thailand

4 Suranaree University of Technology Hospital, Suranaree University of Technology, Khon Kaen University, Khon Kaen, Thailand

5 Faculty of Public Health, Vongchavalitkul University, Nakhon Ratchasima, Khon Kaen University, Khon Kaen, Thailand

6 Faculty of Public Health, Khon Kaen University, Khon Kaen, Thailand


A quasi-experimental study was conducted to develop a health education modification program based on self-efficacy and motivation regarding liver flukes and cholangiocarcinoma development in Keang Sanam Nang district, Nakhon Ratchasima province, Thailand. A total of 36 individuals were invited to participate in the program and were screened for population at risk of liver fluke infection and cholangiocarcinoma using SUT-OV-001 and SUT-CCA-001. Development of health education modification program regarding liver fluke and cholangiocarcinoma prevention included 3 steps: (1) preparation, (2) health education program, and (3) follow-up and evaluation. The study was implemented for 10 weeks. Pre-and-post-test knowledge was measured with questionnaires, Kuder-Richardson-20: KR-20 = 0.718,and Cronbach’s Alpha Coefficient = 0.724 and 0.716 for percection and outcome expectation questionnaires. Paired and independent t-tests were applied for data analysis. The majority of the participants were female (55.6%), aged between ≤50 and 60 years old (36.1%), married (86.1%), education level of primary school (63.9%), agricultural occupation (80.6%), and income <4,000 Baht (44.4%). The results revealed that after the health education program, the experimental group had a mean score of knowledge, perception, and outcome expectation regarding liver fluke and cholangiocarcinoma prevention significantly higher than before participation and in the control group. In conclusion, this successful health education modification program for liver fluke and cholangiocarcinoma, therefore may useful for further work behavior modification in other epidemic areas.