一种新颖的基于剧场的行为改变方法，用于影响社区对血吸虫病控制措施的采纳。
A novel theatre-based behaviour change approach for influencing community uptake of schistosomiasis control measures.
机构信息
Department of Civil and Environmental Engineering, Imperial College London, London, UK.
Cranfield Water Science Institute, School of Water, Energy and Environment, Cranfield University, Bedford, UK.
出版信息
Parasit Vectors. 2022 Aug 25;15(1):301. doi: 10.1186/s13071-022-05421-5.
BACKGROUND
Appropriate behaviour change with regard to safe water contact practices will facilitate the elimination of schistosomiasis as a public health concern. Various approaches to effecting this change have been trialled in the field but with limited sustainable outcomes. Our case study assessed the effectiveness of a novel theatre-based behaviour change technique (BCT), in combination with cohort awareness raising and capacity training intervention workshops.
METHODOLOGY
Our study was carried out in four rural communities in the Mwanza region of Tanzania and in the semi-urban town of Kemise, Ethiopia. We adapted the Risk, Attitude, Norms, Ability and Self-regulation (RANAS) framework and four phases using a mixed methods approach. Participatory project phase engagement and qualitative formative data were used to guide the design of an acceptable, holistic intervention. Initial baseline (BL) data were collected using quantitative questionnaire surveys with 804 participants in Tanzania and 617 in Ethiopia, followed by the theatre-based BCT and capacity training intervention workshops. A post-intervention (PI) survey was carried out after 6 months, with a participant return rate of 65% in Tanzania and 60% in Ethiopia.
RESULTS
The intervention achieved a significant improvement in the knowledge of schistosomiasis transmission being associated with poorly managed sanitation and risky water contact. Participants in Tanzania increased their uptake of preventive chemotherapy (males: BL, 56%; PI, 73%, females: BL, 43%; PI, 50%). There was a significant increase in the selection of sanitation (Tanzania: BL, 13%; PI, 21%, Ethiopia: BL, 63%; PI, 90%), safe water and avoiding/minimising contact with infested waters as prevention methods in Tanzania and Ethiopia. Some of the participants in Tanzania followed on from the study by building their own latrines.
CONCLUSIONS
This study showed that substantial positive behaviour changes in schistosomiasis control can be achieved using theatre-based BCT intervention and disease awareness training. With the appropriate sensitisation, education and stakeholder engagement approaches, community members were more open to minimising risk-associated contact with contaminated water sources and were mobilised to implement preventive measures.
背景
采取适当的行为改变措施，规范安全用水行为，有助于消除血吸虫病这一公共卫生问题。为实现这一目标，已经在实地尝试了各种方法，但可持续效果有限。本病例研究评估了一种新型基于戏剧的行为改变技术（BCT）与群体意识提高和能力培训干预工作坊相结合的效果。
方法
我们的研究在坦桑尼亚姆万扎地区的四个农村社区和埃塞俄比亚半城市城镇凯米斯进行。我们改编了风险、态度、规范、能力和自我调节（RANAS）框架，并采用混合方法，分四个阶段进行。参与式项目阶段的参与和定性形成性数据用于指导设计可接受的整体干预措施。在坦桑尼亚收集了 804 名参与者和在埃塞俄比亚收集了 617 名参与者的初始基线（BL）数据后，进行了基于戏剧的 BCT 和能力培训干预工作坊。6 个月后进行了干预后（PI）调查，坦桑尼亚的参与者返回率为 65%，埃塞俄比亚为 60%。
结果
该干预措施显著提高了对血吸虫病传播与卫生管理不善和危险用水接触相关的认识。坦桑尼亚的参与者增加了预防性化疗的使用率（男性：BL，56%；PI，73%，女性：BL，43%；PI，50%）。坦桑尼亚和埃塞俄比亚选择卫生设施（坦桑尼亚：BL，13%；PI，21%，埃塞俄比亚：BL，63%；PI，90%）、安全用水和避免/减少接触受感染水域作为预防方法的比例显著增加。坦桑尼亚的一些参与者在研究后建造了自己的厕所。
结论
本研究表明，通过基于戏剧的 BCT 干预和疾病意识培训，可以实现血吸虫病控制方面的重大积极行为改变。通过适当的宣传、教育和利益相关者参与方法，社区成员更加愿意减少与受污染水源相关的风险接触，并动员他们采取预防措施。
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