Village Voices: Lessons about Processes for Disease Prevention from a Qualitative Study of Family Health Leaders in a Community in Northeastern Thailand

Background: Cancer is a primary source of concern in Thailand and other countries around the world,including the Asian-Pacific region. Evidence supports that an important contributing cause of cancer and otherchronic illnesses such as stroke, diabetes, and hypertension is excessive alcohol consumption. Studies conductedin Thailand reveal a worrisome rise in the number of new and regular drinkers in communities. Therefore,actions for primary, secondary and tertiary prevention of problem drinking are necessary. In recent yearsnurses in North East Thailand have been developing and implementing the Khon Kaen Family Health Nursingmodel to embed disease prevention in communities through the actions of family health nurses and local familyhealth leaders. Aim: The aim of this qualitative research was to better understand the experiences of the localfamily health leaders using this model and to synthesize lessons learned. Materials and
Methods: As part of aparticipatory action research approach involving analysis of focus group discussions and individual interviews,the experiences of 45 family health leaders were synthesized.
Results: Four main themes were identified, namely: i)Family first: role modeling beginning at the personal and family level. ii) Local leverage: using village communityforums to reduce alcohol drinking. iii) Gentle growth: making the first step and treading gently; and iv) Respect,Redemption, Rehabilitation: valuing the person to re-integrate them in the village society.
Conclusions: As alcoholconsumption in the village declined significantly following the prevention program, these findings illuminatehow low-tech integrated prevention approaches may be very useful, particularly in rural communities. Thelessons learned may have relevance not only in Thailand but in other countries seeking to prevent and mitigatebehavior that conduces to diseases such as cancer.