Development of alcohol drinking behavior modification program in Village health volunteers at Traph-Anant, Chonburi, Thailand

Background: Alcohol consumption poses a significant public health challenge in Thailand, particularly in culturally permissive environments like Chonburi Province. Village health volunteers (VHVs), as frontline public health agents, often face difficulties in both addressing and personally managing alcohol consumption behaviors. This study aimed to develop an evidence-based behavior modification program tailored to the context of VHVs in Traph-Anant Village to reduce alcohol consumption and promote healthier lifestyles. Methods and Materials: A mixed-methods approach was used. Qualitative data were collected through in-depth interviews and focus group discussions with VHVs to explore patterns, motivations, and cultural influences on alcohol use. Quantitative surveys assessed attitudes, self-efficacy, and alcohol-related behaviors. The program design was informed by health promotion theories and behavior change models such as the Health Belief Model and Stages of Change. Expert evaluation and community stakeholder input validated the program's feasibility and relevance. Results: Findings indicated that most VHVs consumed alcohol frequently, especially in the evenings or during cultural events. Key drinking triggers included social obligations, stress relief, and cultural norms. A majority believed alcohol enhanced appetite and sleep. The final behavior modification model included components such as refusal skill training, community alcohol-free event policies, leadership role modeling, and environmental control strategies (e.g., time/place limitations for drinking). Expert review confirmed the program as culturally appropriate, practical, and adaptable. Conclusion: The developed behavior modification program offers a practical framework to support VHVs in reducing alcohol consumption. It highlights the need for integrated, community-level strategies that respect cultural traditions while promoting behavioral change. Implementation of this model could serve as a blueprint for similar rural health volunteer initiatives across Thailand and other culturally rich settings.