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Complex Interventions for Cancer and Cholangiocarcinoma: A Systematic Review and Applications for Public Education
Sukunta Muadthong1, Jasdeep Brar2,3, Pattapong Kessomboon4
1Department 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.
Summary
This review identified key components for community-based cancer prevention programs, like the Community-based Health Education and Communication (CHEC) model, to combat cholangiocarcinoma (CCA) in Thailand. These findings aim to improve CCA prevention and outcomes in high-risk regions.
Area of Science:
- Public Health and Preventive Medicine
- Health Education and Promotion
- Cancer Epidemiology
Background:
- Cholangiocarcinoma (CCA) presents a significant public health challenge in Northeast Thailand, characterized by high prevalence and poor patient prognosis.
- The Community-based Health Education and Communication (CHEC) model is a complex intervention strategy developed for CCA prevention.
- Enhancing the CHEC program requires understanding effective complex health interventions for cancer and CCA prevention.
Purpose of the Study:
- To systematically review complex health interventions for cancer and CCA prevention.
- To identify essential evidence-based components for enhancing the CHEC program in Khon Kaen, Thailand.
- To inform the development and evaluation of culturally tailored, community-based cancer prevention strategies.
Main Methods:
- A systematic review of nine electronic databases (January 2012 - March 2024) using search terms for experimental community-based interventions in cancer and CCA prevention.
- Screening of titles, abstracts, and full texts following PRISMA guidelines by two independent reviewers.
- Risk of bias assessment using the Mixed Methods Appraisal Tool and narrative data analysis.
Main Results:
- A total of 92 studies were included: 32 on CCA prevention and 60 on broader cancer prevention.
- Eleven randomized controlled trials with positive outcomes and low risk of bias identified five key intervention components: health education, participant engagement, reminders, patient support, and health influencers.
- Health education emerged as the most consistently implemented and crucial component across studies.
Conclusions:
- The identified intervention components (health education, engagement, reminders, support, influencers) will be integrated into the CHEC model for Northeast Thailand.
- Culturally tailored, multi-component, community-based health education is vital for effective cancer prevention, particularly in low- and middle-income countries.
- This review provides actionable insights for global public cancer education initiatives to improve CCA outcomes.
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