Sustainable Prevention of Cholangiocarcinoma Through Community Participation in a High-incidence Area in Thailand

Opisthorchiasis and cholangiocarcinoma (CCA) are major public health problems in Northeast Thailand, especially in Ubon Ratchathani, which are the alluvial plains. Those with poor food habits are mostly at risk of having diseases. This study was a participatory action research (PAR) aimed to define the models/plans for CCA prevention. The samples consisted of 40 community representatives. The data were collected by the PAR method. Qualitative data were analyzed by content analysis. The samples coordinately analyzed and prioritized the problems and presented information to the community. The plans consisted of (1) cultivating the right values and behaviors of eating food safe from CCA in children, (2) supervising the shops not to sell foods that are the main risk factors for CCA, (3) supporting the community leaders to act as good role models to the people, (4) assigning every housewife to cook clean and safe food from CCA, and (5) encouraging the villagers to have knowledge and awareness, which can protect them from CCA. After the community designed these plans, responsible persons were assigned to implement them. Two years later, researchers evaluated the outcome. The average scores on knowledge and attitude toward CCA were significantly higher than before implementation. For the impact of projects, prevalence of opisthorchiasis in 2016 was significantly lower than that in 2014. CCA prevention by community participation employed a combination of quantitative and qualitative studies. This study has been successful and sustainable since the community has human resources, budget, and appropriate management of the project.