Development of a Dietary Promotion Model for Colorectal Cancer Prevention among People in Tha Maka District, Kanchanaburi Province, Thailand
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Abstract
BACKGROUND: Colorectal cancer (CRC) is a leading cause of cancer mortality worldwide, with increasing incidence in Thailand. Modifiable dietary factors, including the high consumption of processed/charred meats and low fiber intake, are strongly associated with CRC development. Evidence for effective community-based prevention models in local Thai contexts remains limited.
OBJECTIVES: To develop and evaluate a community-based dietary promotion model for CRC prevention, grounded in Bandura’s Self-Efficacy Theory and community participation, among individuals aged ≥25 in Tha Maka District, Kanchanaburi.
METHODS: This research and development (R&D) study used a one-group pretest-posttest design (March–December 2025). Multistage sampling recruited 440 participants. The intervention integrated Bandura’s theory with community participation. Validated questionnaires were used to assess knowledge (KR-20=0.78), attitudes (α=0.84), and behaviors (α=0.86). Data were analyzed using paired t-tests and Chi-square tests (p<0.05).
RESULTS: Participants' mean age was 56.4±10.8 years. Overall scores for knowledge (p=0.88), attitudes (p=0.60), and dietary behaviors (p=0.06) showed no significant post-intervention differences. However, item-level analysis demonstrated significant reductions in three specific high-risk behaviors, comprising the consumption of charred grilled meat (p<0.001), processed foods (p=0.01), and processed/canned foods (p=0.02).
CONCLUSIONS: The community-based model potentially showed meaningful behavioral changes that reduced specific high-risk dietary behaviors related to CRC. The lack of overall significant changes may be attributed to high baseline scores (ceiling effect) and a short follow-up period. This model is applicable for primary healthcare and community health promotion. Randomized controlled trials with longer follow-ups are recommended to evaluate sustained behavioral change.
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