Development of a School-Based Health Literacy Model for Liver Fluke Prevention and Control Using Participatory Action Research.

BACKGROUND: Liver fluke caused by Opisthorchis viverrini is a serious health problem in the northeastern region of Thailand. It is associated with endemic cholangiocarcinoma (CCA) in this region. This study was performed to develop a school-based health literacy model for liver fluke prevention and control using participatory action research.   Method: The participants of this study included 3 school administrators, 5 teachers, 45 senior high school students, 2 health officers, and 5 health volunteers. in Phanom Phrai District, Roi-et Province, Thailand. The study employed mixed methods for data collection, including qualitative methods namely policy analysis, interview, and problem-solving as well as quantitative methods namely pre and post-tests and implementation of health literacy. Six months later, researchers evaluated the outcome. The average scores of the participants' health literacy and their practical skills were measured. RESULT: The participants' health literacy and practical skill mean score increased after the intervention (mean difference=20.20, 95%CI 15.37-25.03, p-value <0.001) and (mean difference=21.10, 95%CI 19.10-23.10, p-value <0.001). School activities were concluded regarding public relations for one time a week, exhibitions, learning summary speech contests, and organizing a school food safety club. In addition, school rules were agreed and included: (1) cooked food consumption (2), stopping undercooked cyprinoid fish by the household cooker (3), correcting misunderstanding in each household in the community (4), hygienic defection, and (5) reminding friends to stop consumption of undercooked food. CONCLUSION: The results indicated that school-based model was effective. The stakeholder experiences and learning processes using teamwork will help the development of skills to cooperate and coordinate students choosing the best method for Liver fluke prevention and control. Moreover, they should continue to improve the suitable network for each school to ensure that the models are sustainable.

OVCCA Web Application as Supplementary Material to Facilitate Health Literacy Regarding Carcinogenic Human Liver Fluke: A Randomized Controlled Trial in Thailand.

BACKGROUND: Liver fluke, Opisthorchis viverrini, is associated to cholangiocarcinoma which is found frequently in some areas of Southeast Asian countries particularly in Thailand, Lao People Republic Democratic, Cambodia.  This study sought to investigate the effects of an O. viverrini and cholangiocarcinoma (OVCCA) web application to facilitate health literacy regarding O. viverrini in Northeast Thailand. METHODS: A randomized controlled trial study was performed among an intervention group (n=63) and a control group (n=63) during a one-year period from July 2019 to May 2020. The intervention group received the health literacy promotion program of O. viverrini information through the OVCCA web application for 6 weeks. The control group received an activity package from the public health department. The success of the program was evaluated at week 24 after the groups finished the last activity. ANCOVA, t-test and multiple logistic regression were used for data analysis for both groups. RESULTS: The scores for knowledge; ability to access, understand, appraise, and apply information; motivation for protection; and practice of O. viverrini prevention were significantly higher for the intervention group than for the control group. The results indicated that a health literacy promotion program through an OVCCA web application could be advantageous for preventing and controlling O. viverrini infection. CONCLUSION: This intervention may be used as a potential strategy and guideline for self-care and health promotion in other endemic areas.