Muadthong Sukunta, Brar Jasdeep, Kessomboon Pattapong, Kessomboon Nusaraporn, Catenacci Vanessa, Nualnetr Nomjit, Angeles Ricardo, Agarwal Gina
Department of Pharmacy Technique, Sirindhorn College of Public Health, Khon Kaen, Faculty of Public Health and Allied Health Sciences, Praboromarajchanok Institute Khon Kaen, Khon Kaen, Thailand.
Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
J Cancer Educ. 2025 Sep 12. doi: 10.1007/s13187-025-02705-z.
Cholangiocarcinoma (CCA) is highly prevalent in Northeast Thailand and has a poor prognosis. The Community-based Health Education and Communication (CHEC) model is a complex health education intervention designed to prevent CCA. This review aims to identify complex health interventions for cancer and CCA prevention and determine the necessary evidence to enhance the CHEC program for evaluation in Khon Kaen, Thailand. A systematic review was conducted across nine electronic databases for articles published from January 1, 2012, to March 2024. Search terms were relevant to experimental study designs assessing community-based complex interventions for cancer and CCA prevention. Titles, abstracts, and full-text articles were screened according to PRISMA guidelines and the inclusion criteria by two independent reviewers. The Mixed Methods Appraisal Tool was used to assess the risk of bias of included studies, and the data was analyzed using a narrative approach. A total of 92 studies were included in this review: 32 studies focused on complex interventions for CCA prevention, while 60 studies addressed non-CCA cancer prevention. From 11 randomized controlled trials with significant positive outcomes and low risk of bias, five major intervention components were identified: health education, participant engagement, reminders, patient support, and health influencers. Health education was the most frequently implemented component, reinforcing its essential role in cancer prevention efforts. These components will be integrated into the CHEC model, with their development and implementation tailored to the Northeast Thailand community to prevent and improve CCA outcomes. This review offers actionable insights for public cancer education globally, particularly in low- and middle-income countries, by emphasizing the value of culturally tailored, multi-component, community-based education to enhance cancer prevention efforts.
胆管癌（CCA）在泰国东北部极为常见，且预后较差。基于社区的健康教育与沟通（CHEC）模式是一种旨在预防CCA的复杂健康教育干预措施。本综述旨在确定用于癌症和CCA预防的复杂健康干预措施，并确定加强CHEC项目以便在泰国孔敬进行评估所需的证据。我们对九个电子数据库进行了系统综述，以查找2012年1月1日至2024年3月发表的文章。检索词与评估基于社区的癌症和CCA预防复杂干预措施的实验性研究设计相关。两名独立评审员根据PRISMA指南和纳入标准对标题、摘要和全文进行筛选。使用混合方法评估工具评估纳入研究的偏倚风险，并采用叙述性方法对数据进行分析。本综述共纳入92项研究：32项研究聚焦于CCA预防的复杂干预措施，60项研究涉及非CCA癌症的预防。从11项具有显著阳性结果且偏倚风险较低的随机对照试验中，确定了五个主要干预组成部分：健康教育、参与者参与、提醒、患者支持和健康影响者。健康教育是最常实施的组成部分，强化了其在癌症预防工作中的重要作用。这些组成部分将被纳入CHEC模式，其开发和实施将根据泰国东北部社区的情况进行调整，以预防和改善CCA的结局。本综述通过强调文化定制、多组成部分、基于社区的教育对加强癌症预防工作的价值，为全球公共癌症教育，尤其是低收入和中等收入国家的公共癌症教育提供了可操作的见解。
