@2024 Afarand., IRAN

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ISSN: 2383-2150    Journal of Education and Community Health 2014;1(3):12-19

Background
... [1-9]. The outbreak of brucellosis in human can be influenced by the prevalence of this disease in animals. By providing the necessary instructions and sensitizing people exposed to danger, the disease can be prevented from spreading to people [3, 8, 10].
Previous Studies
In recent studies, there has been an emphasis over the importance of instruction in preventing risky behaviors and reducing brucellosis [11-13].
Aim(s)
The purpose of this study was to evaluate the effectiveness of educational intervention based on Health Belief Model to empower stockbreeders against risky behaviors of brucellosis.
Research type
This study is quasi-experimental.
Research society, place and time
The stockbreeders of Charoymaq city (a city in East Azerbaijan province, Iran) were studied in 2014.
Sampling method and number
According to the same study [13] and based on the formula,the sample size was 100 for each of the intervention and control groups. Sampling was randomly stratified; that is out of five rural health centers, four villages were randomly selected from each center (among a total number of 20 villages). Then, among four selected villages, two villages were categorized as the control group and two as the intervention group (10 villages as the control group and 10 villages as the intervention group). The qualified subjects were randomly selected based on the documents of the households. The criteria for being included in the study were being a stockbreeder, age requirements of 20-50, being present in the village during the study, completing a written letter of satisfaction to participate in the study, and no records of any disease for the subjects and their family. Furthermore, the criteria for being excluded were migrating from the village during the study, the death of the subjects, and absence of more than one session during the training course and not willing to continue the study.
Used devices&materials
The data collection instrument was research-made questionnaire. These questionnaires comprised two sections: (a) demographic characteristics (age, education, gender) and (b) research-made questionnaire based on the constructs of Health Belief Model. In order to assess the appropriateness and clarity of the questionnaire, opinions of health education and health promotion professors were taken. To examine the reliability, the questionnaire was assessed using test-retest method. Twice 20 stockbreeders, who were not included in the study sample within 2 weeks, completed the questionnaire and the Cronbach's alpha was calculated for each of the constructs. To assess the knowledge, perceived susceptibility, perceived severity, perceived benefits, perceived barriers, self-efficacy and behavior ,15 questions (α=0.77), 5 items (α=0.80), 7 items (α=0.82), 9 items (α=0.85), 7 items (α=0.75), (α=0.83), 7qustions (α=0.84) and 10 questions (α=0.87) were designed, respectively. The maximum score of knowledge questions was 15 and the minimum was zero; 1 point was regarded for the correct answer and zero score for no idea and wrong response. The maximum and minimum scores of perceived susceptibility, perceived severity, perceived benefits, and perceived barriers were 25 and 5, 35 and 7, 54 and 9 and 35 and 7, respectively, all based on 5-point Likert scale. The maximum and minimum scores of self-efficacy were 35 and 7 (5-point Likert scale), respectively and for the behavior a minimum score of 10 and a maximum score of zero were calculated (yes = 1 point, no = zero point). After collecting the intervention and control groups` data, an educational program was designed and implemented for the intervention group. Interventions were presented by trained health workers in this study, such that three training and briefing sessions were held for health workers of the intervention`s villages about the goals of the research. The purpose of using trained health workers was their possibility of communicating effectively with the cases. After training health workers of the intervention villages, training sessions took place by health workers according to the constructs of Health Belief Model for the intervention group. Training sessions were in the form of lectures and panel discussions which were held by health workers of each village`s health centers for the intervention group within 45 days and in three 45-minute sessions. The educational material included the importance of an introduction to brucellosis, ways of transmission and prevention, economic losses and the effects of brucellosis in humans. Moreover, in order to increase the effectiveness on target groups in this study, one of the family members of the subjects were trained about brucellosis in schools and mosques. Finally, the data was collected, compared and analyzed after 3 months of educational intervention. The stockbreeders of the control group received the educational pamphlets. Statistical analysis: To analyze the data, the version of SPSS 21 statistical software was employed and according to the non-normal distribution of the data, descriptive statistical tests (mean standard deviation and frequency), Wilcoxon and Mann-Whitney tests were used to compare the two groups before and after the intervention. Besides, in this study, the level of significance was regarded less than 0.05 in all tests.
Findings by Text
In this study, 200 stockbreeders in Charoymaq city were studied within control and intervention groups. The two groups were similar in terms of demographic data including age, sex and education. Most of the people were illiterate in both groups (Table 1). Table 2 illustrates the subjects` intragroup and intergroup relationships before and after the educational intervention. According to the findings no significant difference was observed in the mean scores of both intervention and control groups before the educational intervention (p<0.05), whereas this difference was statistically significant after the educational intervention (p<0.001). Moreover, in this study, a significant difference was found between the mean scores of the constructs of Health Belief Model in the intervention group before and after the intervention (p<0.001). Before training, the mean scores of knowledge , perceived susceptibility, perceived intensity, perceived benefits, perceived barriers, perceived self-efficacy and the behavior were 8.86, 17.99, 14.50, 23.75, 19.71, 14.97 and 6.98, respectively, in the intervention group to which had changed 11.12, 27.59, 21.20, 40.08, 26.95, 25.56 and 9.03, respectively after intervention. Such increase was statistically significant in mean scores after the educational intervention.
Main comparison to the similar studies
... [14]. The success of disease-prevention projects requires the knowledge of the reasons behind the disease, identification the ways of transmission, recognition of risk factors and groups exposed to danger, and early detection of the diseases[15]. ... [16]. Besides, in a study by Motamedi et al. who had used the Health Belief Model for increasing preventive behaviors against cutaneous leishmaniasis, the sensitivity of the intervention group had been increased[17].... [18-22]. The findings of this study are in harmony with the results of studies by Niazi et al. [23] and Orooji et al [24].
Suggestions
What is essentially important here is planning a systematic educational intervention using the model of health interventions with an emphasis on effective individuals.
Limitations
Individuals’ self-reporting and conducting the study in only one vocational group are some of the limitations of this study.
Conclusions
The designed educational intervention based on Health Belied Model has a considerable influence on improving behaviors to prevent brucellosis in the stockbreeders.
Acknowledgments
The authors of this study are thankful to the authorities of Health Network Management of Charoymaq city as well as the colleagues in the network for their immense assistance during conducting the study.
Conflict of interest
Non-declared
Ethical Permissions
The present study is approved by the Research Council and Ethics Committee of Tehran University of Medical Sciences. At the beginning of the study, letters of consent were obtained from participants in the intervention and control groups and all of them were willing to enter the study.
Funding Sources
This article is taken from the master degree`s thesis in the field of health education in Tehran University of Medical Sciences

TABLES and CHARTS

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