BACKGROUND:
Opisthorchiasis remains a neglected tropical disease and a major public health concern in the Greater Mekong Subregion, where foodborne trematode infections affect communities across national borders.¹ Prevalence of Opisthorchis viverrini infection remains high in many areas, influenced by sociocultural dietary practices and inequitable access to preventive health services.²–⁴ Understanding health belief patterns related to preventive behaviors is essential for developing equitable and sustainable disease control strategies.

METHODS:
A cross-sectional study was conducted among 354 adults residing in rural Mekong border communities in Northeastern Thailand. Data were collected using a structured questionnaire based on the Health Belief Model, assessing perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and self-efficacy. Associations between health belief constructs and preventive behaviors were analyzed using Spearman’s rank correlation coefficient.

RESULTS:
Most participants were female agricultural workers, with approximately two-thirds reporting low income and educational attainment below secondary level. Although most reported no prior diagnosis of opisthorchiasis, 62.4% continued to consume raw freshwater fish. Fewer than half reported regular stool examination. Overall health belief patterns were moderately correlated with preventive behaviors (rₛ = 0.5507, p < 0.001). Perceived barriers (rₛ = 0.5964), self-efficacy (rₛ = 0.5178), and perceived benefits (rₛ = 0.4335) showed stronger associations than perceived susceptibility and severity (p < 0.001).

CONCLUSIONS:
Preventive behaviors toward opisthorchiasis are influenced more by perceived barriers, self-efficacy, and perceived benefits than by risk perception alone. Interventions addressing cultural and structural barriers while strengthening individual and community empowerment are essential for equitable and sustainable prevention in rural Mekong border communities.