HEALTH EDUCATION BENEFIT FOR CHOLANGIOCARCINOMA PREVENTION IN THAILAND: HEALTH BELIEFS ARE ANOTHER OPTION TO CONSIDER

There are various strategies and policies for cholangiocarcinoma (CCA) prevention to reduce people's incidence and mortality rates in epidemic areas of Thailand. One of them is applying health theory, especially health belief, but the conclusion is not clear. Therefore, benefits analysis of health education programs based on the health belief model (HBM) is essential for effective prevention of CCA. This study aimed to assess the benefits of the health education programs for CCA prevention in the epidemic areas of Thailand using systematic review and meta-analysis. The research studies in electronic databases, including MEDLINE, SCOPUS, Cochrane library, and ThaiJo, were searched. The cross-sectional analytic study, experimental research, and quasi-experimental research were selected. The researchers determined articles based on the specified criteria and analyzed them based on mean and 95% confidence interval. We decided on five studies (N=344) to perform analyses with random-effects models. The effect sizes for knowledge scores (standard mean difference: SMD=1.30), perceived risk (SMD=2.09), perceived severity (SMD=1.91), perceived benefits (SMD=2.02), perceived barriers (SMD=1.96), and preventive behaviors of CCA (SMD=2.07). After implementing the health education programs based on the HBM for CCA prevention, they all increased statistically. It is noted that the health education programs based on the HBM can help people gain knowledge, correct perception, and behaviors in CCA prevention. The health education programs can be implemented at individual, family, and community levels if they are adjusted to the context of the area. They can also be developed into the health behavior modification model.