Songserm Nopparat, Woradet Somkiattiyos, Bureelerd Onanong, Thongchai Comsun, Thongprung Sumaporn, Ali Akhtar
Department of Community Health, Faculty of Public Health, Ubon Ratchathani Rajabhat University, Ubon Ratchathani, Thailand.
Department of Public Health, Faculty of Health and Sports Science, Thaksin University, Phatthalung, Thailand.
J Cancer Educ. 2021 Dec;36(6):1306-1315. doi: 10.1007/s13187-020-01768-4.
Cholangiocarcinoma (CCA) still affects the health of rural people in northeast Thailand. Most people had a high level of overall risk according to CCA risk assessment in 2014. The question is how to make prevention of CCA as cost-effective as possible. The most appropriate answer is that someone should become a health leader to transfer knowledge to the public. This is the reason for developing the training program for village health volunteers (VHVs)-who play the role of change agents-to transfer knowledge to villagers. As for the evaluation of success, it is not evaluated if VHVs have increased knowledge or not, but it is assessed if people have better knowledge/attitudes, which lead to the correct behavior modification or not. After the program had been implemented for 2 years, people were evaluated on knowledge, attitudes, perception, and satisfaction with the operation of VHVs in providing people with the knowledge and ability to prevent CCA. It was found that people had a higher level of knowledge and attitudes in preventing CCA than before implementing the program. Also, they perceived that VHVs transferred knowledge to villagers so that they had the ability to prevent CCA. Nowadays, VHVs in the digital era (VHVs 4.0) is very useful in solving CCA problems in Thailand because they are the main drivers of success. Potential development of VHVs together with use of digital technology is an advantage for high-risk area with limited public health personnel.
胆管癌（CCA）仍然影响着泰国东北部农村人口的健康。根据2014年的CCA风险评估，大多数人的总体风险水平较高。问题是如何使CCA预防尽可能具有成本效益。最合适的答案是，应该有人成为健康领导者，向公众传播知识。这就是为乡村健康志愿者（VHVs）——他们充当变革推动者——制定培训计划，以便向村民传播知识的原因。至于成功评估，不是评估VHVs的知识是否增加，而是评估人们是否有更好的知识/态度，这是否导致正确的行为改变。该计划实施两年后，对人们在知识、态度、认知以及对VHVs在向人们提供预防CCA的知识和能力方面的运作满意度进行了评估。结果发现，人们在预防CCA方面的知识和态度水平比实施该计划前更高。此外，他们认为VHVs向村民传授了知识，使他们有能力预防CCA。如今，数字时代的VHVs（VHVs 4.0）在解决泰国的CCA问题方面非常有用，因为他们是成功的主要驱动力。VHVs与数字技术的潜在发展对公共卫生人员有限的高风险地区来说是一个优势。
