Participants’ experiences and perceptions of community-based healthy lifestyle clubs in Cambodia: a qualitative study

Noncommunicable diseases (NCDs) are emerging as a major public health challenge in low- to middle-income countries, including Cambodia. Although community-based health promotion programs have been emphasized to prevent these diseases, the importance of the programs is not evident among participants. We aimed to examine the participants’ experiences and perceptions of community-based health club programs in the Prek Pnov region of Cambodia. A qualitative research approach was used to assess the participants’ experiences. Thirty adult residents who had participated in such programs for 12–24 months, between 2022 and 2024, were recruited. They were stratified based on age, sex, and duration of participation, allocated evenly to six homogeneous focus groups, and interviewed on perceived program benefits and proposed improvements. Data were analyzed using a six-step thematic analysis, and a participant-informed logic model was developed to illustrate perceived pathways linking inputs, activities, outcomes, and impacts. As a result of the data analysis, five main themes were identified: (1) perceived health and psychosocial benefits, (2) improved functional capacity and self-management, (3) social and community-level impact, (4) value perception and willingness to pay, and (5) suggestions for program improvement. Participants described notable improvements in their physical and psychosocial health, including increased energy, enhanced capacity for daily work, and enhanced self-efficacy in managing their health. The program also generated positive family and peer influence and contributed to community-level behavior change. The participants valued these benefits beyond monetary terms and expressed a willingness to pay for continued participation. Finally, they proposed several program improvements, including access to indoor exercise spaces and long-term support from governmental or non-governmental organizations. The logic model demonstrated how community-based activities and peer support contributed to increased NCD awareness, improved self-efficacy for NCD self-management, sustained health behaviors, and ultimately improved perceived quality of life. Our results revealed that community-based health clubs have the potential to be effective and sustainable strategies for NCD prevention and health equity in rural Cambodia. Moreover, these health clubs can serve as effective tools for enhancing community engagement in resource-limited settings.