Evaluating a community-based behaviour change communication model to prevent cholangiocarcinoma in Khon Kaen, Thailand (eCHEC)

Background

Cholangiocarcinoma (CCA) is a type of liver cancer that accounts for approximately 10% to 20% of primary liver cancers. In Thailand, the mortality rate of CCA is as high as 81.7% and thus a major population health concern.

In 2015, a Community-based Health Education and Communication (CHEC) model was introduced to decrease the level of O.viverrini (a type of infection and major risk factor for CCA) in Khon Kaen, Thailand. The CHEC model utilized a key communication strategy that incorporated media based on local wisdom and culture with community volunteers and leaders involved in the production and dissemination of information. The intervention resulted in a significant decrease in raw fish consumption which is a known modifiable risk factor for CCA.

Aims

The primary objective is to evaluate the effectiveness of an enhanced CHEC (eCHEC) model to decrease risk behaviours and promote knowledge of community residents in the prevention of CCA in Khon Kaen, Thailand.

Secondary aims of this projects are 1) to increase understanding of key barriers to and facilitators of (including contextual factors such as culture, governance, health systems) preventing CCA and 2) to foster the incorporation of the model into local, regional health policy.

Project plan

The study will involve four distinct phases:

Phase 1 will include a thematic analysis to qualitatively evaluate the resources, technology, and current policies in the Ban Haet district of Khon Kaen to provide insight on how to improve the CHEC model.
Phase 2 will include a pilot study to determine the feasibility of implementing and evaluating the eCHEC model in a selected primary care practice group in Khon Kaen.
In phase 3, a cluster RCT will be conducted to measure outcomes in the pre and post-intervention such as self-reported levels of fish, changes in healthy behaviour development, and knowledge regarding prevention of CCA to determine the effectiveness of the implemented eCHEC model.
Phase 4 will integrate knowledge users and stakeholders to evaluate and disseminate the impact of the study for future project planning in similar populations.

Principal investigators

Gina Agarwal McMaster University, Canada
Pattapong Kessomboon Khon Kaen University, Thailand
Ricardo Angeles McMaster University, Canada

Team members

Nusaraporn Kessomboon Khon Kaen University, Thailand
Banchob Sripa Khon Kaen University, Thailand
Zain Chagla McMaster University, Canada