The development of health literacy for the prevention and control of liver fluke infection and cholangiocarcinoma among at-risk populations in Nong Mee Subdistrict, Rasi Salai District, Sisaket Province.

Abstract

This study is action research aimed at developing health literacy for the prevention and control of liver fluke infection and cholangiocarcinoma among high-risk groups in Nong Mi Sub-district, Rasi Salai District, Sisaket Province. The research participants consisted of 40 individuals who tested positive for parasite eggs in their stool and exhibited high-risk behaviors. The study was conducted from August 2025 to January 2026. The research was divided into three phases: Phase 1: Assessment of health literacy levels. Phase 2: Development of health literacy interventions; Phase 3: Evaluation of health literacy development outcomes. The research instruments included a health literacy assessment form, a health literacy development program, and an in-depth interview guide for focus group discussions. Data were collected through questionnaires, interviews, and workshops. Quantitative data were analyzed using descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (paired sample t-test). Qualitative data were analyzed using content analysis.

The study findings revealed that the development of health literacy for the prevention and control of liver fluke and cholangiocarcinoma, applying the program from the Health Education Division, Department of Health Service Support, consisted of four key activities: Activity 1: Learning about the risks and severity of liver fluke infection and setting health goals for a disease-free life. Activity 2: Analyzing risk behaviors, identifying alternatives, and planning behavioral changes. Activity 3: Enhancing health access, understanding, and decision-making, while advocating for and motivating families and communities. Activity 4: Follow-up, lesson learned synthesis, and health behavior change outcomes. Regarding the development outcomes: 57.50% of the participants achieved a "Fair" level of health literacy, followed by 42.50% at a "Good" level. For health awareness, the majority (92.50%) were at a "Good" level, with 7.50% at a "Fair" level. In terms of disease-free behaviors, 100.00% of the participants reached a "Good" level. Comparative analysis of the mean score differences for health literacy, health awareness, and disease-free behaviors before and after the intervention showed that the post-development scores were significantly higher than the pre-development scores (95%CI = 9.96–12.54,
p < 0.001) at a statistical significance level of 0.05.

Conclusion: The systematic development of health literacy, integrating knowledge, skills, social support, and real-world practice, leads to clear and measurable behavioral changes among groups at risk for liver fluke infection and cholangiocarcinoma.