Abstract
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. 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. 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. 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. 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.
Highlights
Cancer is a leading cause of illness and death throughout the world (WHO, 2010; Center for Alcohol Studies (CAS) Board, 2014; Gupta and Johnson, 2014; Oh et al, 2014; Arora et al, 2015)
Excessive regular consumption of alcoholic beverages is a known risk factor which can lead to mouth cancer, laryngeal cancer, esophageal cancer, liver cancer, colo-rectal cancer and breast cancer, according to studies conducted by the World Health Organization (WHO, 2010) and recent meta-analyses
Concerns are growing about the increasing use of alcohol and the consequences it is likely to have in terms of causing such cancers and a range of chronic diseases (CAS Board, 2014)
Summary
Cancer is a leading cause of illness and death throughout the world (WHO, 2010; CAS Board, 2014; Gupta and Johnson, 2014; Oh et al, 2014; Arora et al, 2015). This paper reports findings from a qualitative study of the experiences of family health leaders who were involved in the development and implementation of a family and community social capital based approach which aimed to reduce the use of alcohol. As any such approach requires to be culturally appropriate and sensitive, it is firstly useful to consider Thai culture and its relationship with alcohol. 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. The lessons learned may have relevance in Thailand but in other countries seeking to prevent and mitigate behavior that conduces to diseases such as cancer
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