Jaikaew Jariya, Songserm Nopparat, Charoenbut Pattaraporn, Thongchai Comsun, Chada Wilawun
Department of Public Health, Faculty of Public Health, Ubon Ratchathani Rajabhat University, Ubon Ratchathani, Thailand.
Huai Kha Subdistrict Administrative Organization, Huai Kha Subdistrict, Buntharik District, Ubon Ratchathani, Thailand.
Asian Pac J Cancer Prev. 2024 Dec 1;25(12):4305-4311. doi: 10.31557/APJCP.2024.25.12.4305.
Despite the Ministry of Public Health's initiative to involve local governments in waste management through the establishment of sewage treatment ponds aimed at disrupting the life cycle of Opisthorchis viverrini (OV), the majority of areas still lack adequate sewage treatment facilities. This action research sought to develop an environmental management model (EMM) to prevent OV and cholangiocarcinoma (CCA) in a high-risk region of Thailand.
The study identified two primary target groups: a process development group comprising 20 participants and an evaluation group comprising 32 participants. Research tools involved structured interviews using questionnaires and focus group discussions. Quantitative data were analyzed using descriptive and inferential statistics, with a paired t-test employed for specific comparisons. Qualitative data were examined through content analysis.
The findings were categorized into three key aspects: (1) The contextual factors and challenges related to OV and CCA were analyzed using an epidemiologic triangle framework. (2) Model development: The Appreciation-Influence-Control (A-I-C) method facilitated several activities, including knowledge dissemination, raising awareness among local administrators, training environmental surveillance volunteer leaders (ESVL), developing public relations materials, conducting food waste management training, and constructing a sewage treatment system. (3) Model evaluation: Significant improvements (p<0.05) were observed in participants' knowledge, attitudes, behaviors, and health beliefs regarding OV and CCA prevention. The outcome of these efforts led to the creation of a new model, termed the "KALMeFS Model," which comprises K=Knowledge; A=Authority (raising awareness among administrators); L=Leader (establishing ESVLs); Me=Media development; F=Food waste management; and S=Sewage management.
The initial steps toward establishing an effective EMM for OV and CCA prevention involved comprehensive planning, knowledge dissemination, standard-setting, and implementation. Monitoring and evaluation are critical to ensuring the long-term success of CCA prevention efforts in Thailand.
尽管公共卫生部发起了一项倡议，通过建立污水处理池让地方政府参与废物管理，旨在破坏华支睾吸虫（OV）的生命周期，但大多数地区仍然缺乏足够的污水处理设施。这项行动研究旨在开发一种环境管理模式（EMM），以预防泰国高危地区的OV和胆管癌（CCA）。
该研究确定了两个主要目标群体：一个由20名参与者组成的流程开发组和一个由32名参与者组成的评估组。研究工具包括使用问卷进行的结构化访谈和焦点小组讨论。定量数据采用描述性和推断性统计进行分析，采用配对t检验进行具体比较。定性数据通过内容分析进行审查。
研究结果分为三个关键方面：（1）使用流行病学三角框架分析了与OV和CCA相关的背景因素和挑战。（2）模型开发：欣赏-影响-控制（A-I-C）方法促进了多项活动，包括知识传播、提高地方行政人员的认识、培训环境监测志愿者领袖（ESVL）、开发公共关系材料、开展食物垃圾管理培训以及建设污水处理系统。（3）模型评估：在参与者关于OV和CCA预防的知识、态度、行为和健康信念方面观察到显著改善（p<0.05）。这些努力的结果导致创建了一个新的模型，称为“KALMeFS模型”，其中K=知识；A=权威（提高行政人员的认识）；L=领导者（建立ESVL）；Me=媒体开发；F=食物垃圾管理；S=污水管理。
建立有效的预防OV和CCA的EMM的初步步骤包括全面规划、知识传播、标准制定和实施。监测和评估对于确保泰国CCA预防工作的长期成功至关重要。
