Village Voices: Lessons about Processes for Disease Prevention from a Qualitative Study of Family Health Leaders in a Community in Northeastern Thailand

Abstract

Background: Cancer is a primary source of concern in Thailand and other countries around the world, including the Asian-Pacific region. Evidence supports that an important contributing cause of cancer and other chronic illnesses such as stroke, diabetes, and hypertension is excessive alcohol consumption. Studies conducted in Thailand reveal a worrisome rise in the number of new and regular drinkers in communities. Therefore, actions for primary, secondary and tertiary prevention of problem drinking are necessary. In recent years nurses in North East Thailand have been developing and implementing the Khon Kaen Family Health Nursing model to embed disease prevention in communities through the actions of family health nurses and local family health leaders. Aim: The aim of this qualitative research was to better understand the experiences of the local family health leaders using this model and to synthesize lessons learned. Materials and Methods: As part of a participatory action research approach involving analysis of focus group discussions and individual interviews, the experiences of 45 family health leaders were synthesized. Results: Four main themes were identified, namely: i) Family first: role modeling beginning at the personal and family level. ii) Local leverage: using village community forums to reduce alcohol drinking. iii) Gentle growth: making the first step and treading gently; and iv) Respect, Redemption, Rehabilitation: valuing the person to re-integrate them in the village society. Conclusions: As alcohol consumption in the village declined significantly following the prevention program, these findings illuminate how low-tech integrated prevention approaches may be very useful, particularly in rural communities. The lessons learned may have relevance not only in Thailand but in other countries seeking to prevent and mitigate behavior that conduces to diseases such as cancer.

Lifestyle Interventions through Participatory Research: A Mixed-Methods Systematic Review of Alcohol and Other Breast Cancer Behavioural Risk Factors

“…The studies’ response rates, defined as eligible participants consented to participate, were 85% [ 48 ], 64% [ 49 ], 47% [ 50 ], 35% [ 51 ], and 24% [ 52 ]. The response rates were not provided by three studies reducing ability to assess selection bias [ 53 , 54 , 55 ]. As seen in Table 2 , a randomized control trial design was used by four studies increasing methodological rigor by minimising the risk of allocation bias and providing baseline differences in comparison groups [ 48 , 50 , 52 , 53 ].…”

“…Moderate retention rates were achieved at 79% [ 48 ] and 68% was reported by two studies [ 50 , 51 ].The Thai-based community cluster RCT study used a second random sample for the follow-up survey from the intervention and control communities, and therefore retention rates were not applicable [ 53 ]. Loss to follow-up was not appropriate to examine for the qualitative studies [ 54 , 55 ].…”

“…However, the literature was diverse in terms of study designs, settings, and populations, reducing the ability to interpret effectiveness. Five interventions were conducted in the United States of America (US) [ 48 , 49 , 50 , 51 , 52 ], and three in Thailand [ 53 , 54 , 55 ]. Two of the articles came from a related Thailand-based study [ 54 , 55 ].…”

Health Promotion in Care for People With Chronic Non-Transmitable Disease: Integrative Review

“…This action opened opportunities for people to talk about their situation, develop and establish guidelines for working with other problems together in the community. 30 The importance of working with people with CNTDs in their own homes in the context of their daily lives was also emphasized. Promote a look at the health model focusing on social determinants, being the nurse an essential professional in the multidisciplinary team to develop self-care, the empowerment of these people.…”

“…They encouraged dialog and the expression of demands, emphasized approaches that assessed the clinical situation, social environment and psychological condition, from the history of life, health and disease, the doing of these professionals sought the coordination of care. 26,30,33,35,38,50,[54][55] Home visits are seen as an instrument that aims to bring health closer to families, breaking with the biomedical model. They also consider the conditions of the environment, so it was possible to identify the factors that influence the quality of life and contextualize their problems with the determinants of the health/disease process, establishing promotion measures for people, their families and community.…”