Development of a Health Literacy Promotion Service Model for Colorectal Cancer Prevention in At-Risk Groups in the Surgical Outpatient Department, Sam Phran Hospital, Nakhon Pathom Province

Abstract

This study is an action research project aimed at developing a service model to enhance health literacy for the prevention of colorectal cancer among at-risk groups. The implementation was divided into three phases. Phase 1 involved studying the current situation and identifying problems from both at-risk service recipients and healthcare personnel to determine their needs representing the planning stage. Phase 2 focused on developing a service model based on the principles of health literacy promotion. Phase 3 consisted of implementing the developed model with at-risk individuals, following the steps of action, observation, and reflection. Quantitative data were analyzed using descriptive statistics and the Paired Sample t-test to compare mean scores, while qualitative data were analyzed using content analysis. The research findings revealed that Phase 1 showed existing service models were inadequate, lacking coverage and health literacy components for disease prevention. Phase 2 developed a new service model consisting of three main steps: (1) situation study and problem analysis (2) service model development and (3) health behavior enhancement for colorectal cancer prevention. The newly developed model comprised four steps: 1. General health assessment 2. History taking and screening of self-care behaviors for colorectal cancer prevention and health literacy assessment 3. Consultation with a surgeon involving (a) assessment of colorectal cancer risk (b) providing preventive self-care information using easy-to-understand media and (c) teaching access to reliable information sources while encouraging questions through health literacy promoting techniques such as repetition, creating a safe atmosphere for asking questions, and using visual aids 4. Appointment scheduling, incorporating health literacy–promotion strategies including repetition, use of three key questions, organizing educational and skill-building activities, positive communication, using comprehension-enhancing media, and encouraging participation in self-care among at-risk group In Phase 3 after implementation, participants showed significantly higher mean scores of health literacy and self-care behaviors for colorectal cancer prevention compared to pre-intervention (p < 0.001). Recommendations: Sam Phran Hospital and other healthcare units with similar contexts should organize activities that promote preventive behaviors against colorectal cancer among at-risk service users, emphasizing health literacy development processes to enhance their capacity and effectiveness in self-care for colorectal cancer prevention.