Abstract Liver fluke and Cholangiocarcinoma (CCA) infestations pose significant health challenges, particularly in northeastern region of Thailand. Addressing health issues through an educational lens is of paramount importance to stakeholders in various fields of education, including health education and social education. Collaboratively, stakeholders strive to develop initiatives that enhance understanding of this disease among people in the region. An essential step toward achieving this objective involves recognizing the variations in individuals' responses to educational activities, thereby facilitating the development of locally contextualized and effective learning programs. This study was to explore the differences among elementary teachers participating in training courses for the prevention of cholangiocarcinoma and liver fluke disease in Khon Kaen province. Employing a pre-experimental design, the study involved one hundred and thirty-nine elementary teachers as research participants. Pre- and post-test served as the research instrument, and data analysis entailed the use of descriptive statistics and a t-test. The findings revealed that most of the participants were female, held bachelor's degrees, and were affiliated with schools in Ban Phai district. Moreover, the study demonstrated a significant enhancement in participants’ understanding of liver fluke and CCA prevention following the training. Notably, the study identified a significant impact of the school’s geographical location on training effectiveness. This study contributes to the existing knowledge base, offering insights to tailor more precise training programs in regions where liver fluke and Cholangiocarcinoma disease are prevalent.