title: Community-based interventions to enhance knowledge, protective attitudes and behaviors towards canine rabies: results from a health communication intervention study in Guangxi, China.
abstract: BACKGROUND
  In 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).
  
  
  METHODS
  The 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.
  
  
  RESULTS
  Our 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.
  
  
  CONCLUSIONS
  This 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.
authors.affiliation: College of Journalism and Communication, Guangxi University, Nanning, Guangxi, China. whr1970@gxu.edu.cn.
authors.forename: Hairong
authors.initials: H
authors.lastname: Wu
authors.affiliation: College of Journalism and Communication, Guangxi University, Nanning, Guangxi, China.
authors.forename: Jiao
authors.initials: J
authors.lastname: Chen
authors.affiliation: Center for Animal Disease Prevention and Control of Guangxi, Nanning, Guangxi, China.
authors.forename: Lianbin
authors.initials: L
authors.lastname: Zou
authors.affiliation: Center for Animal Disease Prevention and Control of Guangxi, Nanning, Guangxi, China.
authors.forename: Liefeng
authors.initials: L
authors.lastname: Zheng
authors.affiliation: College of Journalism and Communication, Guangxi University, Nanning, Guangxi, China.
authors.forename: Weichao
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Zhenmu Meng, Center for Animal Disease Prevention and Control of Baise, Baise, Guangxi, China.
authors.forename: Zhenmu
authors.initials: Z
authors.lastname: Meng
authors.affiliation: School of Veterinary Science, University of Queensland, Gatton, 4343, Australia.|Child Health Research Centre, University of Queensland, Herston, 4006, Australia.
authors.forename: Ricardo J Soares
authors.initials: RJ
authors.lastname: Magalhaes
authors.affiliation: China Animal Health and Epidemiology Centre, Ministry of Agriculture of the Peoples Republic of China, Qingdao, Shandong, China.
authors.forename: Youming
authors.initials: Y
authors.lastname: Wang
authors.affiliation: China Animal Health and Epidemiology Centre, Ministry of Agriculture of the Peoples Republic of China, Qingdao, Shandong, China.
authors.forename: Jingli
authors.initials: J
authors.lastname: Kang
authors.affiliation: China Animal Health and Epidemiology Centre, Ministry of Agriculture of the Peoples Republic of China, Qingdao, Shandong, China.
authors.forename: Xiangdong
authors.initials: X
authors.lastname: Sun
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D002681:China; D004285:Dogs; D005260:Female; D005500:Follow-Up Studies; D058015:Health Communication / Q000379:methods*; D007722:Health Knowledge, Attitudes, Practice; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011818:Rabies / Q000517:prevention & control*; D011795:Surveys and Questionnaires; D060145:Text Messaging
keywords: Canine rabies; China; Health education; Intervention study