The effectiveness of health literacy in social media intervention: LINE sticker for liver fluke prevention among secondary school students

Liver fluke, Opisthorchis viverrini is a serious public health problem among populations in northeast Thailand. Only a few studies designed the health literacy intervention for liver fluke prevention. This study was designed intervention on social media with LINE sticker focusing to prevent new cases and modifying behavior of liver fluke prevention. The aim of study is to evaluate the effectiveness of school-based health literacy in social media intervention with LINE sticker for liver fluke prevention. The study comprised a cluster randomized controlled trial (CRTs) with three assessments (baseline, posttest, and 3-month follow-up). We recruited 1,100 students from 40 classrooms in 20 public rural secondary schools, northeastern Thailand. 55 students in 1 school were randomly allocated to an experimental group and the other 55 in different school to a control group. The experimental group received health literacy intervention which consisted of lectures, walk rally and LINE sticker that created by researcher. The control group attended regular education. The duration of intervention was 12 weeks. Repeated measures ANCOVA was used to assess the effects at posttest and follow up and generalized Estimating Equations (GEE) was used to assess overall of study. The results showed that an experimental group had higher mean scores of health literacy and liver fluke prevention behaviors than baseline and these scores were higher than those for the control group (p-value＜0.05). The overall showed that an experimental group had higher mean scores for health literacy, and liver fluke prevention behaviors (Mean difference = 6.62, 95% CI = 4.92 to 8.33, P-value＜0.001) at posttest and follow up more than baseline (p-value＜0.05). To conclude, a school-based health literacy intervention with LINE sticker is more effective than a regular educational program improving prevention of the liver fluke among secondary school students.