Preventive factors related to brucellosis among rural population using the PRECEDE model: an application of path analysis.

ABSTRACT

The purpose of this model-based study was to identify behavioral and environmental prevention factors for brucellosis and to determine the causal linkage among these factors in a rural area with high prevalence of the disease. A multi-stage random sampling method was used to select villages in Ahar County, located in East Azerbaijan Province, Iran. Participants (n = 400) were recruited from these villages. Data was collected in accordance with the PRECEDE model established in March 2016. This model consists of four phases intended to assess each participant's health and quality of life. Standardized, structured questionnaires exploring different aspects of brucellosis prevention (predisposing, reinforcing, enabling, environmental, and behavioral factors) were used. Path analysis was applied to assess the pathway structure of the PRECEDE model. Overall, the model fitted the data well (χ2/df = 1.10; RMSEA = .016 (CI 95% 0.00-0.07), SRMR = .02, CFI = .99). Significant positive associations were found among predisposing, reinforcing, and enabling factors on the one hand, and behavior, on the other hand. The predisposing factors showed significant positive associations with general health, and the reinforcing factors and general health showed significant positive associations with health-related quality of life (HRQOL). The results of this study support the use of the PRECEDE model for brucellosis prevention, and suggest that a high level of general health, in combination with reinforcing factors can increase HRQOL in an area with a high prevalence of brucellosis.