Effectiveness of educational intervention based on the protection motivation theory in promoting brucellosis preventive behaviors in ranchers

Effectiveness of educational intervention based on the protection motivation theory in promoting brucellosis preventive behaviors in ranchers | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Article Effectiveness of educational intervention based on the protection motivation theory in promoting brucellosis preventive behaviors in ranchers Hosein Rohani, Jafar Osanloo, Mahdi Moshki, Ali Mohammad Mokhtari, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6468910/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 02 Sep, 2025 Read the published version in Scientific Reports → Version 1 posted 12 You are reading this latest preprint version Abstract Background and objectives : In this regard, the main goal of the current research was to determine the effect of educational intervention based on the protection motivation theory on the promotion of preventive behaviors against brucellosis among ranchers of Khodabandeh city through health care providers. Methods: This quasi -experimental study was conducted in two groups of intervention and control in the before, immediately and 2 months after intervention. A total of 126 ranchers were investigated with the multi-stage sampling method and were included in two control groups (n=64) and the test (n=62). The standard motivational theory questionnaire was used to collect data. The data collected in SPSS-22 software was analyzed using the independent sample t-test, Mann–Whitney and Friedman test. Results: The results in the test group showed a significant difference in the general knowledge score during the three stages before, immediately, and 2 months after the intervention (P = 0.007). The results in the test group showed a significant difference in perceived sensitivity, perceived intensity of self-efficacy, response efficiency, perceived reward, fear, protection motivation, and preventive behavior showed a perceived response cost during the three stages before, immediately, and 2 months after the intervention (P < 0.001). Conclusions: The results indicate the high impact of education by the area and the importance of paying attention to the culture and customs of the areas in education. Also, given the stability of the effects in most cases, it can be of interest to experts. Health sciences/Diseases/Infectious diseases Health sciences/Health care/Patient education Brucellosis Models Educational Health behavior Ranchers Introduction Brucellosis is one of the most common diseases between humans and animals around the world [ 1 ]. According to the World Health Organization data, there are about 50 human brucellosis reports in the world [ 2 ]. Milk fertilizer is a job disease and is most commonly found in ranchers, farmers, veterinarians and slaughterhouse workers who deal with their contaminated animals or tissues [ 3 ]. The cause of the disease is brucella, which is one of the forced parasites of animals and humans [ 4 ]. In humans, and especially in children, it can cause complications such as meningitis, endocarditis, nephritis and pan-cytopenia [ 5 ]. The disease is more common among men and those who use non -pasteurized dairy products [ 3 ]. The prevalence of the disease varies from country to country and is more prevalent in countries around the Mediterranean (South Europe, North and East Africa), Middle East, India, and Central Asia [ 6 ]. The prevalence of disease in countries such as Australia and Canada is very rare and in developing countries such as Syria and Iran is more [ 7 ]. The disease is scattered throughout all parts of Iran, and the highest prevalence of the disease is in the Zanjan, Hamedan, Markazi and East Azarbaijan provinces [ 4 ]. The most common way to transmit brucella is through the consumption of raw milk and unpasteurized dairy products, fresh meat, and raw liver. It is also possible to transmit the disease by contact with the placenta and aborted fetus of animals. Since early diagnosis and treatment of the disease does not have much effect on the control of the disease, the importance of prevention and teaching people to control the disease has been highly emphasized [ 8 ]. Evidence recommended that the prevalence of the disease can be prevented by providing the necessary training to those at risk [ 1 ]. Although the prevalence of disease in humans is reduced by vaccination and reduced disease in ranchers, preventive behaviors are one of the most important factors in protecting human health [ 7 , 9 ]. In numerous studies, the impact of health education on awareness in various fields, especially healthy behaviors, has been proven. To have effective and scientific evidence-based interventions, it is necessary to plan and implement educational programs based on patterns and theories that have been proven [ 9 – 14 ]. In this regard, some studies recommended that interventions must have a motivational component [ 15 ]. A theory used to examine the factors affecting motivation and ultimately one's behavior is the protection motivation theory (PMT). This theory was developed in 1975 by Rogers to explain the effects of fear of health risk on health attitudes and behaviors and whether the arousal of fear has an important effect on choosing behaviors. In this theory, it is assumed that accepting the recommended health behavior against a health risk is a direct act due to one's motivation to protect herself or himself [ 16 ]. Also, given the community's trust in health care providers and their important role in promoting community health, this group can play an important role in promoting preventive behaviors. Accordingly, this study aimed to determine the effectiveness of an educational intervention based on the PMT in promoting brucellosis preventive behaviors in ranchers of Khodabandeh city (Zanjan province, Iran). Methods This semi-experimental study was designed with the intervention and control groups. The studied persons were selected using the multi-stage sampling method. In this way, in the first stage, 3 centers of 25 Khodabandeh city comprehensive rural health service centers were selected. In the second stage, 2 villages were randomly selected from each center (6 villages in total), and in the third stage, one village was randomly selected as the control group and one village was randomly selected as the intervention group. Finally, the samples of qualified ranchers were selected from each village. According to the results of a similar study (14) and taking into account the confidence interval of 95% and the power of 90%, the sample size was calculated as 59 persons in each group and increased to 64 persons with a 10% chance of attrition. The inclusion criteria were being a rancher, not having brucellosis, and having at least minimal literacy. The study exclusion criteria were absence of more than one session in the educational phase and unwillingness to continue participating in the study. Data were collected before, immediately, and 2 months after the educational intervention in both the intervention and control groups. In order to collect data, the validated questionnaire of the PMT was used [ 17 ]. The first part of the questionnaire was the demographic variables. The second part included questions related to knowledge, which consists of 5 questions related to the knowledge of the general causes and symptoms of the brucellosis, 8 questions about the knowledge of the brucellosis transmission, and 7 questions about the ways of prevention and treatment of brucellosis (each correct answer scored 2 points, don't knowing the answer also negative answer scored 1 and 0 point respectively). The maximum score in this section was 20 and 0 points is considered the minimum). The third part of the questionnaire included; 66 items to measure 9 constructs of PMT. Which contained the perceived sensitivity construct with 6 items, perceived intensity 6 items, self-efficacy 7 items, response efficiency 7 items, perceived reward 7 items, fear construct 5 items, protection motivation 10 items, perceived response 9 items. The questions related to the constructs were measured using a five-point Likert scale from completely agree (score 5) to completely disagree (score 1). Also, 9 questions related to the construct of preventive behavior were measured with a four-choice scale: always (score 4) most of the time (score 3) Sometimes (score 2) and never (score 1). The maximum and the minimum score of this section were 321 and 66 score, respectively. The validity of this questionnaire was determined by the content validity ratio of the questionnaire (0.62) and the content validity index 0.79. To determine the reliability of the questionnaire, the test-retest method and Cronbach's alpha were used. For this purpose, the questionnaire was completed by 15 members of the target population at a time interval of 10 days, and the results showed a correlation of over 70%. Also, the internal reliability of the questionnaire showed that all the constructs Cronbach's alpha are more than 0.70. The educational content of the study was prepared based on the constructs of the PMT. Educational intervention was provided to ranchers through health care providers whose oriented by the research team. The educational intervention program was implemented in 7 sessions that took 45 minutes for 5 weeks. Lectures, brainstorming and forum method were used in the educational sessions. Also 6 educational videos were made based on PMT in the local language and in accordance with the cultural customs of the region. A summary of the educational activity is presented in Table 1 . In order to comply with ethical points, after ending the study, the educational intervention was implemented for the control group. Data analysis was done using SPSS 22 software using independent sample t-test, Mann–Whitney and Friedman test. Table 1 Educational intervention contents Content Session 1 - Creating - Explanation about the aims of the study and group rules - Presenting the statistics of brucellosis and conducting the pre-test - Obtaining consent and grouping the participants - Review the educational content and determine the time and topic of the next session. 2 Constructs : Perceived sensitivity and severity Educational method : Forum, lectures, pamphlets reading, watching educational videos, and educational booklets - Educational content : Explaining common diseases between humans and animals, geographical spread of Brucellosis and how animals get infected also the ways of transmission of brucellosis 3 Constructs : Preventive behaviors, self-efficacy, and motivation Educational method : Educational video, speech, and brainstorming Educational content : Teaching how to properly boil milk and how to practically prepare salt water through an educational video - teaching how to properly wash hand video - Explain the importance of animal vaccination and emphasize that vaccination is free. 4 Constructs : preventive behaviors, cost of response and efficiency of response Educational method : speech, educational video Educational content : ways to prevent brucellosis, how to treat brucellosis, and the importance of correct behaviors 5 Constructs : Fear and self-efficacy Educational method : Lectures, forum, brainstorming, pamphlets and educational slides. Educational content : Ways to prevent brucellosis, the importance of prevention and the fear of the disease 6 Constructs : Motivation and perceived rewards based on lectures, question and answer. Educational method : Brainstorming, educational videos, handouts and educational slides. Educational content : rewards for correct behaviors and appropriate alternatives for incorrect behaviors. 7 - Reviewing and summarizing the contents of the previous sessions, presenting the points of view of the participants in the group discussions and completing the questionnaires. Results In this quasi -experimental study, 126 ranchers were present, and the mean (± standard deviation) age in the intervention and control groups was 44.74 (± 12.01) and 42.45 (± 13.28), respectively, and the two groups were homogeneous in terms of age (p = 0.313). Also, the type of ranchers in 32.54% of the participants was sheep and goats (Table 2 ). Table 2 Frequency of the examined ranchers based on demographic characteristics Variable Total control group intervention group Frequency % Frequency % Frequency % Marriage Single 14 11.11 5 7.81 9 14.52 Married 112 88.89 59 92.19 53 85.48 Education Elementary 50 39.68 22 34.38 28 45.16 Guidance 45 35.71 26 40.63 19 30.65 Diploma 20 15.88 10 15.62 10 8.06 University 11 8.73 6 9.37 5 19.36 Monthly income less than enough 79 62.69 39 60.94 40 64.52 Enough to live 46 36.51 25 39.06 21 33.87 More than enough 1 0.8 0 0 1 1.61 Type of ranchers Cow 28 22.22 19 29.68 9 14.52 The sheep 24 19.05 7 10.94 17 27.2 Sheep and cow 9 7.14 5 7.81 4 6.45 Sheep and goats 41 32.54 22 34.37 19 30.64 Sheep, cows and goats 24 19.05 11 17.2 13 20.97 According to the Table 3 , there was no significant difference between the two groups before the intervention (P 0.05). Table 3 Comparison of the score of PMT constructs in three periods before, immediately, and 2 months after the intervention Variable Before the intervention Immediately after the intervention Two months after the intervention P-Value (within groups) Median IQR * Median IQR * Median IQR * General Knowledge of brucellosis Control group 7 2 5 1.5 6 2 0.012 Intervention group 8 3.25 8 0 8 0 0.007 P-Value (Between groups) 0.553 < 0.001 < 0.001 - Knowledge of ways of transmission Control group 8 3 10 5 8 4 < 0.001 Intervention group 9 6.25 16 1.25 15 2 < 0.001 P-Value (Between groups) 0.078 < 0.001 < 0.001 Knowledge of the prevention methods Control group 10 3 9 2.5 9 3 < 0.001 Intervention group 11 5 13 2 12.5 2 < 0.001 P-Value (Between groups) 0.042 < 0.001 < 0.001 - Perceived sensitivity Control group 24 6 22 3 21 3 0.011 Intervention group 25 7.25 30 0 30 0 < 0.001 P-Value (Between groups) 0.464 < 0.001 < 0.001 - Perceived intensity Control group 22 6.5 21 3 20 4.5 < 0.001 Intervention group 24 5.5 28.5 2 28 2.25 < 0.001 P-Value (Between groups) 0.034 < 0.001 < 0.001 - Perceived self-efficacy Control group 28 6.5 25 5 24 3 0.001 Intervention group 28 9 35 1 33 2 < 0.001 P-Value (Between groups) 0.858 < 0.001 < 0.001 - Response efficiency Control group 28 7.5 25 6 24 5 0.013 Intervention group 28 8 35 1 35 0 < 0.001 P-Value (Between groups) 0.077 < 0.001 < 0.001 - Perceived reward Control group 22 8.5 25 7 27 5 < 0.001 Intervention group 23.5 9.25 8 2 10.5 2 < 0.001 P-Value (Between groups) 0.133 < 0.001 < 0.001 - Fear Control group 20 4 20 2 18 4.5 < 0.001 Intervention group 21 4 25 2 25 1 < 0.001 P-Value (Between groups) 0.08 < 0.001 < 0.001 - Protection motivation Control group 40 8 35 7 36 5 0.002 Intervention group 43.5 14 50 1 50 0 < 0.001 P-Value (Between groups) 0.333 < 0.001 < 0.001 - Preventive behavior Control group 27 8 23 6 20 3 < 0.001 Intervention group 27.5 16.25 36 1 36 2 < 0.001 P-Value (Between groups) 0.845 < 0.001 < 0.001 - Response costs Control group 23 16 35 7 36 6.5 < 0.001 Intervention group 23 15 11 1 14 4.25 < 0.001 P-Value (Between groups) 0.888 < 0.001 < 0.001 - * Interquartile range In the intervention group, the results obtained from the Friedman test showed a significant difference in the scores of the constructs of the PMT (except for two constructs) during the three periods before, immediately and 2 months after the intervention, and the score in this group compared to before the intervention had increased (P < 0.05). The score of perceived cost-response constructs and perceived reward in this group had decreased compared to before the intervention (P < 0.05). In the control group, the score of the constructs of the PMT, immediately after of the intervention and 2 months later had significantly decreased compared to before the intervention (P < 0.05), except the score of the constructs Perceived cost-response and perceived reward increased compared to before the intervention (P < 0.05). Discussion Because brucellosis is known as one of the common diseases between humans and animals, it is essential to investigate the factors related to the transmission of this disease and provide solutions for its prevention. These measures can help reduce the spread of disease and maintain the health of animals and humans. This study was conducted to determine the effect of education based on the theory of protected motivation on the promotion of preventive behaviors against brucellosis in Khodabandeh city ranchers using health care providers. The results of the present study showed that after the implementation of the educational intervention, there was a significant difference in the knowledge about the general aspects of human brucellosis between the two groups. Also, after the implementation of the educational program, the awareness of ranchers about the ways of brucellosis transmission increased, and this difference was also significant. The results of Jahani et al.'s study [ 18 ] showed that educational programs could significantly increase the level of awareness about Malaria disease in the intervention group compared to the control group. which is consistent with the results of the present study. The results of the semi-experimental study by Alah Verdipour [ 19 ] and colleagues showed that the educational program was able to significantly improve the level of awareness about brucellosis in the intervention group, compared to the control group, which is in line with the results of this study. Therefore, it can be claimed that the implementation of the educational program can lead to an increase in people's awareness of brucellosis and the importance of knowledge and prevention in disease control will be revealed. It was observed that after the implementation of the educational intervention, there was a significant difference in the perceived sensitivity score between the two Intervention and control groups. Also, study results showed that the sensitivity constructs perceived in the intervention group increased significantly immediately and 2 months after the intervention [ 20 ]. The study of Khosravi et al., [ 21 ] and Khazaian study et al., [ 22 ] showed that an increase in perceived susceptibility can lead ranchers to imagine the fact that they are at risk of contracting brucellosis and then adopt preventive behaviors. There was a significant difference in the perceived severity scores between the intervention and control groups at different phases of data collection. Then, using the PMT can be effective for increasing the perceived severity of the brucellosis. The study of Farzadmehr et al., also showed that after the implementation of the educational intervention, the mean scores of perceived severity in the intervention group increased significantly compared to the control group [ 23 ]. Also, results a study showed that implementation of the educational intervention increased the perceived severity between the intervention and the control group [ 1 ]. In general, education can increase the severity perceived by ranchers and improve understanding of the risk of brucellosis, leading to the reduction of risky behaviors. It was observed that there was no significant difference in self-efficacy between the two groups before the intervention, but after the intervention and 2 months later, the difference between the two groups was significant. Self-efficacy is one of the most important constructs of PMT, which was investigated based on this study. The results of this research showed that emphasizing self-efficacy can have a positive effect on a person's final behavior, and increasing confidence in people's ability to use protective behaviors increases the likelihood of their compliance. In addition, other studies have shown that educational programs based on self-efficacy can improve people's confidence in their abilities and increase disease prevention behavior[ 1 , 20 ]. There was no significant difference in the response efficiency scores between the two groups before the intervention, but after the implementation of the intervention and 2 months later, a significant difference was observed between the two groups. Response efficacy refers to a person’s expectation that adaptive responses and protective behaviors against a health hazard can eliminate the hazard. According to the research findings of Matlabi et al., after an educational intervention based on response efficiency, performing preventive behaviors against Corona significantly increased [ 24 ]. This finding is in agreement with the results of other studies that show that the response efficiency increased after the intervention. However, some studies have shown that there was no statistical difference in the mean response efficiency scores between the intervention and control groups, which may be due to the short duration of the intervention to change the attitude [ 25 , 26 ]. In general, education increases the adoption of protective behaviors by ranchers and increases the effectiveness of the response. According to the findings, it was observed that there was no significant difference in the preventive behavior scores between the two groups before the intervention, but after the intervention and 2 months later, a significant difference was observed between the two groups. The results show that using the PMT can be effective for increasing preventive behaviors. Studies have shown that education as an effective factor can be effective in reducing diseases. This study also shows that the implementation of educational programs has increased preventive behaviors by ranchers. According to the findings, it was observed that there was no significant difference in protection motivation between the two groups before the intervention, but after the implementation of the intervention and 2 months later, a significant difference between the two groups was clearly observed. According to the findings of Matlabi et al., the protection motivation scores increased after the implementation of the educational program in the intervention group. This may be due to the educational programs provided [ 24 ]. On the other hand, the results from Magai et al.'s research showed that after the educational intervention based on this model, protection motivation in women increased significantly [ 27 ], which is consistent with the findings of the present study and shows that education may have a positive effect on the motivation of ranchers. Before the intervention, there was no significant difference in the perceived response cost between the two groups. However, after the intervention and after 2 months of follow-up, a significant difference was observed between the two groups. Based on studies, the higher the perceived response efficacy and self-efficacy and the lower the perceived costs, the more likely the protective behaviors. In agreement with the findings of a study, the educational program significantly decreased the perceived response cost in the intervention group compared to the control group[ 28 ]. Helmes’ research also found that lower perceived costs can increase the motivation to undergo genetic testing. These findings recommended that if people rationalize the costs associated with prevention behaviors, they are likely to perform these behaviors [ 29 ]. According to the information, it was observed that there was no significant difference in the perceived reward between the two groups before the intervention, but after the implementation of the intervention and 2 months follow-up, a significant difference was observed between the two groups. As the study of Matlabi et al., this study showed, after the implementation of the educational program, the perceived reward decreased in the intervention group [ 24 ]. The lower the internal and external rewards of maladaptive behavior (lack of self-protection), can cause more likely to protective behaviors. Regarding the construct of fear, it was observed that there was no significant difference in the scores of this construct between the two groups before the intervention, but after the implementation of the intervention and 2 months follow-up, a significant difference was observed between the groups. Fear acts through protection motivation and can influence health behaviors. The conformity of the results of this research with the reports of other studies [ 27 , 30 , 31 ] shows that the increase in the mean score of fear after the implementation of the educational intervention indicates the positive relationship between education and the increase of fear and finally, the increase of protective behaviors. The analysis of the results of the present study concludes that raising the level of awareness and the constructs of the PMT through education may have positive effects in improving the preventive behaviors of brucellosis. Conclusions The results of the present study showed the positive and significant effect of the educational intervention on the awareness and improvement of the preventive behaviors of brucellosis among the traditional ranchers in the rural areas of Khodabandeh city. This positive effect included improved perceived self-efficacy, decreased perceived response cost, and significant changes in perceived reward scores, fear construct, perceived sensitivity, and perceived severity. Therefore, the results confirmed that the PMT can be effective in improving the preventive behaviors of brucellosis in ranchers. In addition to the fact that this knowledge can be used in the development of effective interventions to improve preventive behaviors, it can facilitate the process of raising awareness and changing behavior in the rancher’s population. Declarations Acknowledgments We would like to thank the Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences. We would like to thank all the people who assisted the authors in running this research project. Authors’ contributions Hosein Rohani: Design, Idea of research, Article writing Jafar Asanlo: Design, Idea of research Mahdi Moshki: Design of study, critical review Ali Mohammad Mokhtari: Analyze, Article writing Alireza Jafari: Design, Idea of research, Article writing All authors have approved the final manuscript. Funding This study received financial support from the Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences. Availability of data and materials All data generated or analyzed during this study are included in this published article. Ethics approval and consent to participate This study is based on a research project approved by the Ethics Committee of Gonabad University of Medical Sciences with the code of ethics IR.GMU.REC.1402.092. All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable. Written Informed Consent was obtained from all subjects. Consent for publication Not applicable Competing interests The authors declare that they have no competing interests. References Babaei V, Garmaroodi G, Batebi A, Alipour D, Shahbaz M, Babazadeh T: The effectiveness of an educational intervention based on the health belief model in the empowerment of stockbreeders against high-risk behaviors associated with brucellosis . Journal of Education and Community Health 2014, 1 (3):12-19. Taleski V, Zerva L, Kantardjiev T, Cvetnic Z, Erski-Biljic M, Nikolovski B, Bosnjakovski J, Katalinic-Jankovic V, Panteliadou A, Stojkoski S et al : An overview of the epidemiology and epizootology of brucellosis in selected countries of Central and Southeast Europe . 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6468910","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Article","associatedPublications":[],"authors":[{"id":450395064,"identity":"35c5ed0d-1aa3-4955-a56b-8a1a9c458dca","order_by":0,"name":"Hosein Rohani","email":"","orcid":"","institution":"Gonabad University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Hosein","middleName":"","lastName":"Rohani","suffix":""},{"id":450395065,"identity":"5a6c956c-6f26-481f-80bb-49f45e0d594f","order_by":1,"name":"Jafar Osanloo","email":"","orcid":"","institution":"Gonabad University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Jafar","middleName":"","lastName":"Osanloo","suffix":""},{"id":450395066,"identity":"3261f055-894b-4b74-bdc9-81c998075a16","order_by":2,"name":"Mahdi Moshki","email":"","orcid":"","institution":"Gonabad University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Mahdi","middleName":"","lastName":"Moshki","suffix":""},{"id":450395067,"identity":"b804478a-5536-40ae-9ce4-e5ad23f54c7e","order_by":3,"name":"Ali Mohammad Mokhtari","email":"","orcid":"","institution":"Gonabad University of Medical Sciences","correspondingAuthor":false,"prefix":"","firstName":"Ali","middleName":"Mohammad","lastName":"Mokhtari","suffix":""},{"id":450395068,"identity":"603272ea-0f04-4d28-970b-df2a008d5227","order_by":4,"name":"Alireza Jafari","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9ElEQVRIiWNgGAWjYBACxgbGBwwMBkAWe0MikMXAw0dYC7MBRAvPgcdgio2wPSAtICCR+EwCRBPUwtx+mPFzRQGDvPmM5LTKrzl2MmwMzA8f3cDnsJ5kZskzBgyGc848S7stuy0Z6DA2Y+McvH7JPyDZYMDAOIM9J+225DZmoBYeNmm8WvofM/8EarGfwZD/rVhyWz0RWmYks4FsSZzBkZDG+HHbYWK0PGazbDCQSJ7BcyBZmnHbcR42ZgJ+MexPZr7Z8MfGdgYwKj/+3FZtz8/e/PAxXi0NYAocIwzMPGASj3IQkEdx5Q8CqkfBKBgFo2BkAgBmD0MJ4blUoQAAAABJRU5ErkJggg==","orcid":"","institution":"Gonabad University of Medical Sciences","correspondingAuthor":true,"prefix":"","firstName":"Alireza","middleName":"","lastName":"Jafari","suffix":""}],"badges":[],"createdAt":"2025-04-17 07:08:13","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6468910/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6468910/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1038/s41598-025-17974-3","type":"published","date":"2025-09-02T15:57:12+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":90827930,"identity":"7a143b48-b8e3-48cd-9f8f-17d4dad918c0","added_by":"auto","created_at":"2025-09-08 16:03:32","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2240767,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6468910/v1/246a1d51-f6ca-4cd5-87a3-2f74fc2ef1a6.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effectiveness of educational intervention based on the protection motivation theory in promoting brucellosis preventive behaviors in ranchers","fulltext":[{"header":"Introduction","content":"\u003cp\u003eBrucellosis is one of the most common diseases between humans and animals around the world [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. According to the World Health Organization data, there are about 50 human brucellosis reports in the world [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Milk fertilizer is a job disease and is most commonly found in ranchers, farmers, veterinarians and slaughterhouse workers who deal with their contaminated animals or tissues [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. The cause of the disease is brucella, which is one of the forced parasites of animals and humans [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. In humans, and especially in children, it can cause complications such as meningitis, endocarditis, nephritis and pan-cytopenia [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. The disease is more common among men and those who use non -pasteurized dairy products [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe prevalence of the disease varies from country to country and is more prevalent in countries around the Mediterranean (South Europe, North and East Africa), Middle East, India, and Central Asia [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The prevalence of disease in countries such as Australia and Canada is very rare and in developing countries such as Syria and Iran is more [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. The disease is scattered throughout all parts of Iran, and the highest prevalence of the disease is in the Zanjan, Hamedan, Markazi and East Azarbaijan provinces [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe most common way to transmit brucella is through the consumption of raw milk and unpasteurized dairy products, fresh meat, and raw liver. It is also possible to transmit the disease by contact with the placenta and aborted fetus of animals. Since early diagnosis and treatment of the disease does not have much effect on the control of the disease, the importance of prevention and teaching people to control the disease has been highly emphasized [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. Evidence recommended that the prevalence of the disease can be prevented by providing the necessary training to those at risk [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Although the prevalence of disease in humans is reduced by vaccination and reduced disease in ranchers, preventive behaviors are one of the most important factors in protecting human health [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eIn numerous studies, the impact of health education on awareness in various fields, especially healthy behaviors, has been proven. To have effective and scientific evidence-based interventions, it is necessary to plan and implement educational programs based on patterns and theories that have been proven [\u003cspan additionalcitationids=\"CR10 CR11 CR12 CR13\" citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. In this regard, some studies recommended that interventions must have a motivational component [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. A theory used to examine the factors affecting motivation and ultimately one's behavior is the protection motivation theory (PMT). This theory was developed in 1975 by Rogers to explain the effects of fear of health risk on health attitudes and behaviors and whether the arousal of fear has an important effect on choosing behaviors. In this theory, it is assumed that accepting the recommended health behavior against a health risk is a direct act due to one's motivation to protect herself or himself [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Also, given the community's trust in health care providers and their important role in promoting community health, this group can play an important role in promoting preventive behaviors. Accordingly, this study aimed to determine the effectiveness of an educational intervention based on the PMT in promoting brucellosis preventive behaviors in ranchers of Khodabandeh city (Zanjan province, Iran).\u003c/p\u003e"},{"header":"Methods","content":"\u003cp\u003eThis semi-experimental study was designed with the intervention and control groups. The studied persons were selected using the multi-stage sampling method. In this way, in the first stage, 3 centers of 25 Khodabandeh city comprehensive rural health service centers were selected. In the second stage, 2 villages were randomly selected from each center (6 villages in total), and in the third stage, one village was randomly selected as the control group and one village was randomly selected as the intervention group. Finally, the samples of qualified ranchers were selected from each village.\u003c/p\u003e \u003cp\u003eAccording to the results of a similar study (14) and taking into account the confidence interval of 95% and the power of 90%, the sample size was calculated as 59 persons in each group and increased to 64 persons with a 10% chance of attrition. The inclusion criteria were being a rancher, not having brucellosis, and having at least minimal literacy. The study exclusion criteria were absence of more than one session in the educational phase and unwillingness to continue participating in the study. Data were collected before, immediately, and 2 months after the educational intervention in both the intervention and control groups.\u003c/p\u003e \u003cp\u003eIn order to collect data, the validated questionnaire of the PMT was used [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e]. The first part of the questionnaire was the demographic variables. The second part included questions related to knowledge, which consists of 5 questions related to the knowledge of the general causes and symptoms of the brucellosis, 8 questions about the knowledge of the brucellosis transmission, and 7 questions about the ways of prevention and treatment of brucellosis (each correct answer scored 2 points, don't knowing the answer also negative answer scored 1 and 0 point respectively). The maximum score in this section was 20 and 0 points is considered the minimum). The third part of the questionnaire included; 66 items to measure 9 constructs of PMT. Which contained the perceived sensitivity construct with 6 items, perceived intensity 6 items, self-efficacy 7 items, response efficiency 7 items, perceived reward 7 items, fear construct 5 items, protection motivation 10 items, perceived response 9 items. The questions related to the constructs were measured using a five-point Likert scale from completely agree (score 5) to completely disagree (score 1). Also, 9 questions related to the construct of preventive behavior were measured with a four-choice scale: always (score 4) most of the time (score 3) Sometimes (score 2) and never (score 1). The maximum and the minimum score of this section were 321 and 66 score, respectively. The validity of this questionnaire was determined by the content validity ratio of the questionnaire (0.62) and the content validity index 0.79. To determine the reliability of the questionnaire, the test-retest method and Cronbach's alpha were used. For this purpose, the questionnaire was completed by 15 members of the target population at a time interval of 10 days, and the results showed a correlation of over 70%. Also, the internal reliability of the questionnaire showed that all the constructs Cronbach's alpha are more than 0.70.\u003c/p\u003e \u003cp\u003eThe educational content of the study was prepared based on the constructs of the PMT. Educational intervention was provided to ranchers through health care providers whose oriented by the research team. The educational intervention program was implemented in 7 sessions that took 45 minutes for 5 weeks. Lectures, brainstorming and forum method were used in the educational sessions. Also 6 educational videos were made based on PMT in the local language and in accordance with the cultural customs of the region. A summary of the educational activity is presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. In order to comply with ethical points, after ending the study, the educational intervention was implemented for the control group. Data analysis was done using SPSS 22 software using independent sample t-test, Mann\u0026ndash;Whitney and Friedman test.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eEducational intervention contents\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eContent\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSession\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e- Creating\u003c/p\u003e \u003cp\u003e- Explanation about the aims of the study and group rules\u003c/p\u003e \u003cp\u003e- Presenting the statistics of brucellosis and conducting the pre-test\u003c/p\u003e \u003cp\u003e- Obtaining consent and grouping the participants\u003c/p\u003e \u003cp\u003e- Review the educational content and determine the time and topic of the next session.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eConstructs\u003c/b\u003e: Perceived sensitivity and severity\u003c/p\u003e \u003cp\u003e\u003cb\u003eEducational method\u003c/b\u003e: Forum, lectures, pamphlets reading, watching educational videos, and educational booklets\u003c/p\u003e \u003cp\u003e- \u003cb\u003eEducational content\u003c/b\u003e: Explaining common diseases between humans and animals, geographical spread of Brucellosis and how animals get infected also the ways of transmission of brucellosis\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eConstructs\u003c/b\u003e: Preventive behaviors, self-efficacy, and motivation\u003c/p\u003e \u003cp\u003e\u003cb\u003eEducational method\u003c/b\u003e: Educational video, speech, and brainstorming\u003c/p\u003e \u003cp\u003e\u003cb\u003eEducational content\u003c/b\u003e: Teaching how to properly boil milk and how to practically prepare salt water through an educational video\u003c/p\u003e \u003cp\u003e- teaching how to properly wash hand video\u003c/p\u003e \u003cp\u003e- Explain the importance of animal vaccination and emphasize that vaccination is free.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eConstructs\u003c/b\u003e: preventive behaviors, cost of response and efficiency of response\u003c/p\u003e \u003cp\u003e\u003cb\u003eEducational method\u003c/b\u003e: speech, educational video\u003c/p\u003e \u003cp\u003e\u003cb\u003eEducational content\u003c/b\u003e: ways to prevent brucellosis, how to treat brucellosis, and the importance of correct behaviors\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eConstructs\u003c/b\u003e: Fear and self-efficacy\u003c/p\u003e \u003cp\u003e\u003cb\u003eEducational method\u003c/b\u003e: Lectures, forum, brainstorming, pamphlets and educational slides.\u003c/p\u003e \u003cp\u003e\u003cb\u003eEducational content\u003c/b\u003e: Ways to prevent brucellosis, the importance of prevention and the fear of the disease\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cb\u003eConstructs\u003c/b\u003e: Motivation and perceived rewards based on lectures, question and answer.\u003c/p\u003e \u003cp\u003e\u003cb\u003eEducational method\u003c/b\u003e: Brainstorming, educational videos, handouts and educational slides.\u003c/p\u003e \u003cp\u003e\u003cb\u003eEducational content\u003c/b\u003e: rewards for correct behaviors and appropriate alternatives for incorrect behaviors.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e- Reviewing and summarizing the contents of the previous sessions, presenting the points of view of the participants in the group discussions and completing the questionnaires.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eIn this quasi -experimental study, 126 ranchers were present, and the mean (\u0026plusmn;\u0026thinsp;standard deviation) age in the intervention and control groups was 44.74 (\u0026plusmn;\u0026thinsp;12.01) and 42.45 (\u0026plusmn;\u0026thinsp;13.28), respectively, and the two groups were homogeneous in terms of age (p\u0026thinsp;=\u0026thinsp;0.313). Also, the type of ranchers in 32.54% of the participants was sheep and goats (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eFrequency of the examined ranchers based on demographic characteristics\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003econtrol group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003eintervention group\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMarriage\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSingle\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e11.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e14.52\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMarried\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e112\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e88.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e92.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e85.48\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eElementary\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e39.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e34.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e45.16\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eGuidance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e35.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e40.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e30.65\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDiploma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e15.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8.06\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUniversity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e9.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e19.36\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eMonthly income\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eless than enough\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e60.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e64.52\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEnough to live\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e46\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e36.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e39.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e33.87\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMore than enough\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.61\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"4\" rowspan=\"5\"\u003e \u003cp\u003eType of ranchers\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e22.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e29.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e14.52\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eThe sheep\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e27.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSheep and cow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e6.45\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSheep and goats\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e32.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e34.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e30.64\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSheep, cows and goats\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e19.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e17.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e20.97\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eAccording to the Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, there was no significant difference between the two groups before the intervention (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05) in all constructs of the PMT, but immediately after the intervention and 2 months later, the score difference between the two groups was significant. (P\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eComparison of the score of PMT constructs in three periods before, immediately, and 2 months after the intervention\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"9\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" morerows=\"1\" nameend=\"c2\" namest=\"c1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003eBefore the intervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003eImmediately after the intervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003eTwo months after the intervention\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-Value (within groups)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIQR\u003csup\u003e\u003cb\u003e*\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003eIQR\u003csup\u003e\u003cb\u003e*\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMedian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003eIQR\u003csup\u003e\u003cb\u003e*\u003c/b\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eGeneral Knowledge of brucellosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.012\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.007\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eP-Value (Between groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.553\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eKnowledge of ways of transmission\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eP-Value (Between groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.078\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eKnowledge of the prevention methods\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e12.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eP-Value (Between groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.042\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePerceived sensitivity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.011\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eP-Value (Between groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.464\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePerceived intensity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e5.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e28.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eP-Value (Between groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.034\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePerceived self-efficacy\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eP-Value (Between groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.858\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eResponse efficiency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.013\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eP-Value (Between groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.077\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePerceived reward\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e10.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eP-Value (Between groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.133\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eFear\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eP-Value (Between groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eProtection motivation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e0.002\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eP-Value (Between groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.333\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003ePreventive behavior\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e27.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eP-Value (Between groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.845\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eResponse costs\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eControl group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e6.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eIntervention group\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eP-Value (Between groups)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e \u003cp\u003e0.888\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c9\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"9\"\u003e* Interquartile range\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eIn the intervention group, the results obtained from the Friedman test showed a significant difference in the scores of the constructs of the PMT (except for two constructs) during the three periods before, immediately and 2 months after the intervention, and the score in this group compared to before the intervention had increased (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05). The score of perceived cost-response constructs and perceived reward in this group had decreased compared to before the intervention (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e \u003cp\u003eIn the control group, the score of the constructs of the PMT, immediately after of the intervention and 2 months later had significantly decreased compared to before the intervention (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05), except the score of the constructs Perceived cost-response and perceived reward increased compared to before the intervention (P\u0026thinsp;\u0026lt;\u0026thinsp;0.05).\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eBecause brucellosis is known as one of the common diseases between humans and animals, it is essential to investigate the factors related to the transmission of this disease and provide solutions for its prevention. These measures can help reduce the spread of disease and maintain the health of animals and humans. This study was conducted to determine the effect of education based on the theory of protected motivation on the promotion of preventive behaviors against brucellosis in Khodabandeh city ranchers using health care providers.\u003c/p\u003e \u003cp\u003eThe results of the present study showed that after the implementation of the educational intervention, there was a significant difference in the knowledge about the general aspects of human brucellosis between the two groups. Also, after the implementation of the educational program, the awareness of ranchers about the ways of brucellosis transmission increased, and this difference was also significant. The results of Jahani et al.'s study [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] showed that educational programs could significantly increase the level of awareness about Malaria disease in the intervention group compared to the control group. which is consistent with the results of the present study. The results of the semi-experimental study by Alah Verdipour [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e] and colleagues showed that the educational program was able to significantly improve the level of awareness about brucellosis in the intervention group, compared to the control group, which is in line with the results of this study. Therefore, it can be claimed that the implementation of the educational program can lead to an increase in people's awareness of brucellosis and the importance of knowledge and prevention in disease control will be revealed.\u003c/p\u003e \u003cp\u003eIt was observed that after the implementation of the educational intervention, there was a significant difference in the perceived sensitivity score between the two Intervention and control groups. Also, study results showed that the sensitivity constructs perceived in the intervention group increased significantly immediately and 2 months after the intervention [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. The study of Khosravi et al., [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] and Khazaian study et al., [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e] showed that an increase in perceived susceptibility can lead ranchers to imagine the fact that they are at risk of contracting brucellosis and then adopt preventive behaviors.\u003c/p\u003e \u003cp\u003eThere was a significant difference in the perceived severity scores between the intervention and control groups at different phases of data collection. Then, using the PMT can be effective for increasing the perceived severity of the brucellosis. The study of Farzadmehr et al., also showed that after the implementation of the educational intervention, the mean scores of perceived severity in the intervention group increased significantly compared to the control group [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. Also, results a study showed that implementation of the educational intervention increased the perceived severity between the intervention and the control group [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. In general, education can increase the severity perceived by ranchers and improve understanding of the risk of brucellosis, leading to the reduction of risky behaviors.\u003c/p\u003e \u003cp\u003eIt was observed that there was no significant difference in self-efficacy between the two groups before the intervention, but after the intervention and 2 months later, the difference between the two groups was significant. Self-efficacy is one of the most important constructs of PMT, which was investigated based on this study. The results of this research showed that emphasizing self-efficacy can have a positive effect on a person's final behavior, and increasing confidence in people's ability to use protective behaviors increases the likelihood of their compliance. In addition, other studies have shown that educational programs based on self-efficacy can improve people's confidence in their abilities and increase disease prevention behavior[\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThere was no significant difference in the response efficiency scores between the two groups before the intervention, but after the implementation of the intervention and 2 months later, a significant difference was observed between the two groups. Response efficacy refers to a person\u0026rsquo;s expectation that adaptive responses and protective behaviors against a health hazard can eliminate the hazard. According to the research findings of Matlabi et al., after an educational intervention based on response efficiency, performing preventive behaviors against Corona significantly increased [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. This finding is in agreement with the results of other studies that show that the response efficiency increased after the intervention. However, some studies have shown that there was no statistical difference in the mean response efficiency scores between the intervention and control groups, which may be due to the short duration of the intervention to change the attitude [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. In general, education increases the adoption of protective behaviors by ranchers and increases the effectiveness of the response.\u003c/p\u003e \u003cp\u003eAccording to the findings, it was observed that there was no significant difference in the preventive behavior scores between the two groups before the intervention, but after the intervention and 2 months later, a significant difference was observed between the two groups. The results show that using the PMT can be effective for increasing preventive behaviors. Studies have shown that education as an effective factor can be effective in reducing diseases. This study also shows that the implementation of educational programs has increased preventive behaviors by ranchers.\u003c/p\u003e \u003cp\u003eAccording to the findings, it was observed that there was no significant difference in protection motivation between the two groups before the intervention, but after the implementation of the intervention and 2 months later, a significant difference between the two groups was clearly observed. According to the findings of Matlabi et al., the protection motivation scores increased after the implementation of the educational program in the intervention group. This may be due to the educational programs provided [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. On the other hand, the results from Magai et al.'s research showed that after the educational intervention based on this model, protection motivation in women increased significantly [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e], which is consistent with the findings of the present study and shows that education may have a positive effect on the motivation of ranchers.\u003c/p\u003e \u003cp\u003eBefore the intervention, there was no significant difference in the perceived response cost between the two groups. However, after the intervention and after 2 months of follow-up, a significant difference was observed between the two groups. Based on studies, the higher the perceived response efficacy and self-efficacy and the lower the perceived costs, the more likely the protective behaviors. In agreement with the findings of a study, the educational program significantly decreased the perceived response cost in the intervention group compared to the control group[\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Helmes\u0026rsquo; research also found that lower perceived costs can increase the motivation to undergo genetic testing. These findings recommended that if people rationalize the costs associated with prevention behaviors, they are likely to perform these behaviors [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003e According to the information, it was observed that there was no significant difference in the perceived reward between the two groups before the intervention, but after the implementation of the intervention and 2 months follow-up, a significant difference was observed between the two groups. As the study of Matlabi et al., this study showed, after the implementation of the educational program, the perceived reward decreased in the intervention group [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. The lower the internal and external rewards of maladaptive behavior (lack of self-protection), can cause more likely to protective behaviors.\u003c/p\u003e \u003cp\u003eRegarding the construct of fear, it was observed that there was no significant difference in the scores of this construct between the two groups before the intervention, but after the implementation of the intervention and 2 months follow-up, a significant difference was observed between the groups. Fear acts through protection motivation and can influence health behaviors. The conformity of the results of this research with the reports of other studies [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] shows that the increase in the mean score of fear after the implementation of the educational intervention indicates the positive relationship between education and the increase of fear and finally, the increase of protective behaviors. The analysis of the results of the present study concludes that raising the level of awareness and the constructs of the PMT through education may have positive effects in improving the preventive behaviors of brucellosis.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThe results of the present study showed the positive and significant effect of the educational intervention on the awareness and improvement of the preventive behaviors of brucellosis among the traditional ranchers in the rural areas of Khodabandeh city. This positive effect included improved perceived self-efficacy, decreased perceived response cost, and significant changes in perceived reward scores, fear construct, perceived sensitivity, and perceived severity. Therefore, the results confirmed that the PMT can be effective in improving the preventive behaviors of brucellosis in ranchers. In addition to the fact that this knowledge can be used in the development of effective interventions to improve preventive behaviors, it can facilitate the process of raising awareness and changing behavior in the rancher\u0026rsquo;s population.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAcknowledgments\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe would like to thank the Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences. We would like to thank all the people who assisted the authors in running this research project.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eHosein Rohani: Design, Idea of research, Article writing\u003c/p\u003e\n\u003cp\u003eJafar Asanlo: Design, Idea of research\u003c/p\u003e\n\u003cp\u003eMahdi Moshki: Design of study, critical review\u003c/p\u003e\n\u003cp\u003eAli Mohammad Mokhtari: Analyze, Article writing\u003c/p\u003e\n\u003cp\u003eAlireza Jafari: Design, Idea of research, Article writing\u003c/p\u003e\n\u003cp\u003eAll authors have approved the final manuscript.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003cbr\u003e\u003c/strong\u003eThis study received financial support from the Social Development and Health Promotion Research Center, Gonabad University of Medical Sciences.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll data generated or analyzed during this study are included in this published article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study is based on a research project approved by the Ethics Committee of Gonabad University of Medical Sciences with the code of ethics IR.GMU.REC.1402.092. All procedures performed in this study were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable. Written Informed Consent was obtained from all subjects.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eBabaei V, Garmaroodi G, Batebi A, Alipour D, Shahbaz M, Babazadeh T: \u003cstrong\u003eThe effectiveness of an educational intervention based on the health belief model in the empowerment of stockbreeders against high-risk behaviors associated with brucellosis\u003c/strong\u003e. \u003cem\u003eJournal of Education and Community Health \u003c/em\u003e2014, \u003cstrong\u003e1\u003c/strong\u003e(3):12-19.\u003c/li\u003e\n\u003cli\u003eTaleski V, Zerva L, Kantardjiev T, Cvetnic Z, Erski-Biljic M, Nikolovski B, Bosnjakovski J, Katalinic-Jankovic V, Panteliadou A, Stojkoski S\u003cem\u003e et al\u003c/em\u003e: \u003cstrong\u003eAn overview of the epidemiology and epizootology of brucellosis in selected countries of Central and Southeast Europe\u003c/strong\u003e. \u003cem\u003eVeterinary Microbiology \u003c/em\u003e2002, \u003cstrong\u003e90\u003c/strong\u003e(1):147-155.\u003c/li\u003e\n\u003cli\u003eEskandari Z, Bashirian S, Barati M, Soltanian AR, Hazavehi SMM: \u003cstrong\u003eThe Effect of Educational Program Based on the Health Belief Model on Brucellosis Preventive Behaviors among Traditional Ranchers in Rural Areas of Hamadan Province\u003c/strong\u003e. \u003cem\u003eJ Educ Community Health \u003c/em\u003e2017, \u003cstrong\u003e3\u003c/strong\u003e(4):16-23.\u003c/li\u003e\n\u003cli\u003eRamezankhani A, Jahani H, Hatami H, Sharifzadeh GH, Hosseini SH: \u003cstrong\u003eDetermine the effect of intervention on the adoption of preventive behaviours of the brucellosis was based on the health belief model\u003c/strong\u003e. \u003cem\u003enkums-journal \u003c/em\u003e2016, \u003cstrong\u003e8\u003c/strong\u003e(1):33-45.\u003c/li\u003e\n\u003cli\u003eShahnavazi M, Gholamreza M, Ansari-Moghadam A, Raeisy D, Varnamkhasti Khashei F: \u003cstrong\u003ePreventive Behaviors of Brucellosis in Khash City Ranchers Based on Health Belief Model\u003c/strong\u003e. \u003cem\u003eIran-J-Health-Educ-Health-Promot \u003c/em\u003e2017, \u003cstrong\u003e4\u003c/strong\u003e(4):281-288.\u003c/li\u003e\n\u003cli\u003eRoushan MRH, Baiani M, Asnafi N, Saedi F: \u003cstrong\u003eOutcomes of 19 pregnant women with brucellosis in Babol, northern Iran\u003c/strong\u003e. \u003cem\u003eTransactions of the Royal Society of Tropical Medicine and Hygiene \u003c/em\u003e2011, \u003cstrong\u003e105\u003c/strong\u003e(9):540-542.\u003c/li\u003e\n\u003cli\u003ePappas G, Papadimitriou P, Akritidis N, Christou L, Tsianos EV: \u003cstrong\u003eThe new global map of human brucellosis\u003c/strong\u003e. \u003cem\u003eThe Lancet infectious diseases \u003c/em\u003e2006, \u003cstrong\u003e6\u003c/strong\u003e(2):91-99.\u003c/li\u003e\n\u003cli\u003ePetkova AS, Zhelyazkov CB, Kitov BD: \u003cstrong\u003eSpontaneous Spondylodiscitis - Epidemiology, Clinical Features, Diagnosis and Treatment\u003c/strong\u003e. \u003cem\u003eFolia Med (Plovdiv) \u003c/em\u003e2017, \u003cstrong\u003e59\u003c/strong\u003e(3):254-260.\u003c/li\u003e\n\u003cli\u003eKhunti K, Millar-Jones D: \u003cstrong\u003eClinical inertia to insulin initiation and intensification in the UK: a focused literature review\u003c/strong\u003e. \u003cem\u003ePrimary care diabetes \u003c/em\u003e2017, \u003cstrong\u003e11\u003c/strong\u003e(1):3-12.\u003c/li\u003e\n\u003cli\u003eEshete A, Mohammed S, Deresse T, Kifleyohans T, Assefa Y: \u003cstrong\u003eAssociation of stress management behavior and diabetic self-care practice among diabetes type II patients in North Shoa Zone: a cross-sectional study\u003c/strong\u003e. \u003cem\u003eBMC Health Services Research \u003c/em\u003e2023, \u003cstrong\u003e23\u003c/strong\u003e(1):767.\u003c/li\u003e\n\u003cli\u003ePaudel G, Vandelanotte C, Dahal PK, Biswas T, Yadav UN, Sugishita T, Rawal L: \u003cstrong\u003eSelf-care behaviours among people with type 2 diabetes mellitus in South Asia: A systematic review and meta-analysis\u003c/strong\u003e. \u003cem\u003eJournal of global health \u003c/em\u003e2022, \u003cstrong\u003e12\u003c/strong\u003e.\u003c/li\u003e\n\u003cli\u003eKontoangelos K, Raptis A, Lambadiari V, Economou M, Tsiori S, Katsi V, Papageorgiou C, Martinaki S, Dimitriadis G, Papageorgiou C: \u003cstrong\u003eBurnout related to diabetes mellitus: a critical analysis\u003c/strong\u003e. \u003cem\u003eClinical practice and epidemiology in mental health: CP \u0026amp; 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2015.\u003c/li\u003e\n\u003cli\u003eKunkel EJ, Meyer B, Daskalakis C, Cocroft J, Jennings-Dozier K, Myers RE: \u003cstrong\u003eBehaviors used by men to protect themselves against prostate cancer\u003c/strong\u003e. \u003cem\u003eCancer Epidemiology Biomarkers \u0026amp; Prevention \u003c/em\u003e2004, \u003cstrong\u003e13\u003c/strong\u003e(1):78-86.\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Brucellosis, Models, Educational, Health behavior, Ranchers","lastPublishedDoi":"10.21203/rs.3.rs-6468910/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6468910/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground and objectives\u003c/strong\u003e: In this regard, the main goal of the current research was to determine the effect of educational intervention based on the protection motivation theory on the promotion of preventive behaviors against brucellosis among ranchers of Khodabandeh city through health care providers.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e This quasi -experimental study was conducted in two groups of intervention and control in the before, immediately and 2 months after intervention. A total of 126 ranchers were investigated with the multi-stage sampling method and were included in two control groups (n=64) and the test (n=62). The standard motivational theory questionnaire was used to collect data. The data collected in SPSS-22 software was analyzed using the independent sample t-test, Mann–Whitney and Friedman test.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The results in the test group showed a significant difference in the general knowledge score during the three stages before, immediately, and 2 months after the intervention (P = 0.007). The results in the test group showed a significant difference in perceived sensitivity, perceived intensity of self-efficacy, response efficiency, perceived reward, fear, protection motivation, and preventive behavior showed a perceived response cost during the three stages before, immediately, and 2 months after the intervention (P \u0026lt; 0.001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions:\u003c/strong\u003e The results indicate the high impact of education by the area and the importance of paying attention to the culture and customs of the areas in education. Also, given the stability of the effects in most cases, it can be of interest to experts.\u003c/p\u003e","manuscriptTitle":"Effectiveness of educational intervention based on the protection motivation theory in promoting brucellosis preventive behaviors in ranchers","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-02 10:49:05","doi":"10.21203/rs.3.rs-6468910/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-07-15T16:01:35+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-07-14T19:19:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"10861610242663707607799955899664447090","date":"2025-06-23T16:52:57+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-06-18T21:07:18+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"50252825178106892572693883746661664326","date":"2025-06-10T12:49:26+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-04-29T19:53:40+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"211596575531371535416163124471249889166","date":"2025-04-29T18:41:38+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-04-28T09:28:36+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-04-25T09:57:12+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-04-24T09:28:26+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-04-23T08:23:21+00:00","index":"","fulltext":""},{"type":"submitted","content":"Scientific Reports","date":"2025-04-23T08:22:16+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"scientific-reports","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"scirep","sideBox":"Learn more about [Scientific Reports](http://www.nature.com/srep/)","snPcode":"","submissionUrl":"","title":"Scientific Reports","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Scientific Reports","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7bfb2299-d746-479e-a463-59edc4dc8789","owner":[],"postedDate":"May 2nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[{"id":47929415,"name":"Health sciences/Diseases/Infectious diseases"},{"id":47929416,"name":"Health sciences/Health care/Patient education"}],"tags":[],"updatedAt":"2025-09-08T15:59:20+00:00","versionOfRecord":{"articleIdentity":"rs-6468910","link":"https://doi.org/10.1038/s41598-025-17974-3","journal":{"identity":"scientific-reports","isVorOnly":false,"title":"Scientific Reports"},"publishedOn":"2025-09-02 15:57:12","publishedOnDateReadable":"September 2nd, 2025"},"versionCreatedAt":"2025-05-02 10:49:05","video":"","vorDoi":"10.1038/s41598-025-17974-3","vorDoiUrl":"https://doi.org/10.1038/s41598-025-17974-3","workflowStages":[]},"version":"v1","identity":"rs-6468910","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6468910","identity":"rs-6468910","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}