Community-based interventions to enhance knowledge, protective attitudes and behaviors towards canine rabies: results from a health communication intervention study in Guangxi, China

Abstract

BackgroundIn China canine rabies poses a serious public health problem in that human mortality ranks the second highest globally. While rabies health education interventions are advocated by WHO to be critical components of modern rabies control and prevention programs, available studies have not adequately investigated the relative efficacy of their implementation in at-risk populations. This study aims to measure and compare the effect on knowledge and protective behavior towards rabies of health education interventions that include a novel Short Messaging Service via cell phone (SMS) and rabies health information sessions (IS).MethodsThe study used a between-subject design involving repeated measures of rabies-related KAP (knowledge, attitude and practice). A total of 350 randomly selected villagers were randomly allocated into three intervention (SMS, IS and SMS + IS) and one control group. The content of SMS and IS covered topics about rabies prevention and route of transmission. The SMS intervention consisted of ten separate messages delivered three times two weeks after the pretest; the IS intervention was conducted once immediately after the pretest. A validated questionnaire was used to capture demographic information and KAP information. Ordinary Least Squares regression was used to contrast the effects of interventions.ResultsOur results indicate that overall SMS outperforms IS at improving knowledge and protective behavior against rabies. Our results suggest that a combined intervention of SMS and IS can result in higher scores than any of the two in isolation. The impact of SMS, IS and SMS + IS is greatest on knowledge, followed by attitude and practice scores.ConclusionThis study demonstrated that health communication modes based on SMS, IS and a combination of the two are all effective to improve rabies-related KAP in the short term. These findings highlight the potential usefulness of SMS as an additional tool for public health communication and promotion; further studies are needed to investigate the long term benefits of these interventions on the reduction of dog bites and resulting human rabies incidence.

The addition of mobile SMS effectively improves dengue prevention practices in community: an implementation study in Nepal

“…This finding may be because people are more accepting of the information through mobile SMS and might have read the information repeatedly. This result is closely similar to a study in China that explored different communication interventions to improve rabies-related KAP and reported that combining SMS and regular information sessions can produce better effects [23]. The result is also in accordance with a field experiment conducted in Peru which reported that positive changes were seen in household behavior when exposure of preventive health information related to dengue was given through mobile phones in order to study participants’ responses and reactions [14].…”

Epidemiological characteristics and post-exposure prophylaxis of human rabies in Chongqing, China, 2007–2016

“…The reasons that cases did not receive recommended PEP after exposure were not investigated in our study, it may be related to several factors, such as the prohibitive costs of vaccine and RIG, the lack of awareness about necessity of PEP and inadequate access to vaccine and RIG in primary health services especially in rural areas [ 25 ] (see Additional file 1 : Supporting file 6 for details). Therefore, appropriate actions should be implemented and strengthened including (1) increase subsidies for rabies medication by expanding the scope of medical insurance for rabies PEP, just as some high-incidence human rabies provinces in China like Hunan and Guangdong, which have included rabies PEP expenditures into the new rural cooperative medical reimbursement coverage, (2) educate the public on the need of rapid treatment post exposure [ 26 ] and use education approaches such as short-message-service or WeChat, which might be useful tools for health promotion [ 27 ], (3) educate public health workers to evaluate and identify potential exposures to rabies and provide adequate PEP [ 28 ], (4) establish “animal bite treatment centers” in rural areas for better treatment and surveillance of rabies and animal bites in Chongqing.…”

Impact of Integrating Rabies Education Into the Curriculum of Public Elementary Schools in Ilocos Norte, Philippines on Rabies Knowledge, and Animal Bite Incidence

“…A few studies have shown increases in rabies-awareness and more specific knowledge related to rabies and dog bite treatment using a variety of different educational methods. These include a 1 h educational intervention for school children in Sikkim, India (1), a curriculum integration program for elementary school children in El Nido, Philippines (2), rabies education information sessions and rabies information text messages in China (3), an “edutainment” campaign for schoolchildren in Sri Lanka (4) and an awareness campaign using posters, leaflets and text messages in Azerbaijan (5). However, in most of these studies, the assessment of knowledge increases was conducted over a very short timescale (days to months), and it is unclear how long this knowledge was retained, or whether it resulted in any change in behavior regarding the disease.…”