Cancer Education-Based Learning Management to Enhance Health Literacy for Cholangiocarcinoma Prevention Among Primary School Students in Endemic Areas of Thailand: The Muk-KAMSComD Model.

Abstract

Effective cancer prevention requires early interventions to enhance health literacy, particularly for Opisthorchis viverrini (OV) and cholangiocarcinoma (CCA) in the Greater Mekong Subregion. This study developed and evaluated the Muk-KAMSComD Model, a structured learning management approach, to improve health literacy and preventive behaviors among primary school students in Mukdahan Province, a high-risk area in Thailand. A four-step research and development (R&D) framework was implemented: (1) situation and needs assessment, (2) model development, (3) implementation, and (4) refinement and presentation. Thirty-six Grade 6 students were selected through multi-stage sampling, and a one-group pretest-posttest design assessed health literacy using validated questionnaires. The 12-week intervention integrated the HALO Model (Healthy School, Active Learning, Lesson Study, and Open Class) with six key health literacy skills. Data were analyzed using qualitative content analysis, descriptive statistics, and paired t-tests. The Muk-KAMSComD Model consists of Knowledge provision, Awareness and belief creation, Motivation enhancement, Self-management practice, Communication, and Decision-making and forwarding. Post-intervention, students significantly improved (p < 0.001) in knowledge, communication, self-management, media literacy, information access, and decision-making skills. Information access showed the highest improvement, while self-management remained the lowest. The model was refined to strengthen parental engagement and instructional materials for enhanced effectiveness. The Muk-KAMSComD Model effectively strengthens health literacy and preventive behaviors for OV and CCA among primary school students. Its integration into school curricula and public health programs could contribute to sustainable CCA prevention in endemic regions.