Effect of Educational Intervention Based on the Health Belief Model and Self-Efficacy in Promoting Preventive Behaviors in a Cholangiocarcinoma Screening Group

J Cancer Educ. 2019 Dec;34(6):1173-1180. doi: 10.1007/s13187-018-1424-7.

Abstract

Cholangiocarcinoma (CCA) is a neoplasm known as one of the most common causes of cancer-related deaths in Southeast Asia, particularly in Thailand, Laos, and Cambodia. Prevention and health education are required. Therefore, this study aimed to determine the effectiveness of an educational intervention to prevent CCA among a rural population in Thailand based on the health belief model (HBM) and self-efficacy frameworks. In this quasi-experimental study, 60 participants (30 participants in the experimental group and 30 participants in the control group) were selected in 2017. The educational intervention for the experimental group consisted of seven training sessions (introduction to CCA, risk factors, complications, benefits and barriers to proper consumption of cooked fish, carcinogenic agents, behavioral protection, and self-efficacy in applying preventive behaviors). A questionnaire that consisted of demographic information, knowledge, and HBM constructs (perceived susceptibility, severity, benefits, barriers, cues to action, and self-efficacy) was used to measure CCA preventive behaviors before and 3 months after the intervention. Data were analyzed using SPSS-22 via chi-squared, paired t-tests, and independent samples t tests at a significance level of 0.5. Three months after the intervention, the experimental group showed a significant increase in the knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, cues to action, self-efficacy, and CCA preventive behaviors compared to the control group. This study showed the effectiveness of the intervention based on the HBM constructs and self-efficacy in the adoption of CCA preventive behaviors 3 months post intervention in the risk group. Thus, these models may serve as a framework for designing and implementing educational interventions for the prevention of CCA.

Keywords: Cholangiocarcinoma; Educational intervention; Health belief model; Promoting preventive behaviors; Self-efficacy.

MeSH terms

  • Adult
  • Aged
  • Bile Duct Neoplasms / diagnosis
  • Bile Duct Neoplasms / epidemiology
  • Bile Duct Neoplasms / prevention & control
  • Bile Duct Neoplasms / psychology
  • Cholangiocarcinoma / diagnosis
  • Cholangiocarcinoma / epidemiology
  • Cholangiocarcinoma / prevention & control*
  • Cholangiocarcinoma / psychology
  • Culture*
  • Female
  • Health Behavior*
  • Health Education / methods*
  • Health Knowledge, Attitudes, Practice*
  • Health Promotion*
  • Humans
  • Male
  • Middle Aged
  • Models, Educational*
  • Risk Factors
  • Rural Population
  • Self Efficacy
  • Surveys and Questionnaires
  • Thailand / epidemiology