Effectiveness of a Randomized Intervention Trial Utilizing the PRECEDE Planning Model for Brucellosis Prevention and Control in Rural Iranian Communities

Leila  Jahangiry; Parvin  Sarbakhsh; Towhid  Babazadeh; Koen  Ponnet

doi:10.18502/jimc.v9i1.20479

Leila Jahangiry Health Services Management Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
Parvin Sarbakhsh Department of Statistics and Epidemiology, School of Public Health, Tabriz University of Medical Sciences, Tabriz, Iran
Towhid Babazadeh Department of Health, Sarab Faculty of Medical Sciences, Sarab, Iran
Koen Ponnet Faculty of Social Sciences, Imec-Mict-Ghent University, Ghent, Belgium

DOI: https://doi.org/10.18502/jimc.v9i1.20479

Keywords: Attitudes, Arm, Control groups, Follow-up studies, Health, Humans, Iran, Knowledge, Practice, Rural population, Self efficacy, Social support

Abstract

Background: This study developed a community-based intervention program for brucellosis prevention and control.

Methods: A two-armed parallel cluster randomized controlled trial investigated the effectiveness of the program over six months in a rural population in Ahar, East Azerbaijan, Iran. Sixteen village health houses were randomly allocated to the intervention and control groups (eight per arm), and 400 participants were recruited via household health records in the health houses. The Predisposing, Reinforcing, and Enabling Constructs in Educational Diagnosis and Evaluation (PRECEDE) model was employed to design, implement, and evaluate the brucellosis prevention and control program. Knowledge, attitudes, self-efficacy, social support, environmental, enabling, and behavioral factors were measured at the baseline and the six-month follow-up. A generalized mixed-effects model was used to analyze the data.

Results: The intervention led to significant improvements in individual factors such as attitudes and self-efficacy. In the intervention group, attitudes increased from 51.1 to 57.1, while in the control group, there was minimal change from 41.1 to 41.3. Similarly, self-efficacy improved in the intervention group (from 27.6 to 33.2) but decreased in the control group (from 24.3 to 19.8). These changes were statistically significant. Furthermore, behavioral factors also showed significant positive changes in the intervention group compared to the control group (p<0.001).

Conclusion: The intervention program, guided by the PRECEDE model, proved effective in enhancing brucellosis prevention and control in a rural population. The six-month randomized controlled trial demonstrated significant improvements in individual factors, including attitudes and self-efficacy, among the intervention group compared to the control group.