Effect of Digital Mobile of Information-Motivation-Bahavioural Skills Dengue Intervention Module (IMODE) in Improving Dengue Preventive Practices Among Military Families: Cluster Randomised Control Trial (Preprint)
Authors: Shamsudin Nur Hidayah , Ahmad Norliza , Md Said Salmiah , Azman Ahmad Zaid Fattah , Hamedon Titi Rahmawati 
Published: June 2023

BACKGROUND

Dengue cases were reported at approximately 400 million cases worldwide, with 70% of the burden in Asia. It is a significant public health concern due to its increasing prevalence and severe complications. Situated in a dengue high-burden area, a few military camps have become dengue hotspots, exposing the personnel and its member to dengue infection, and putting the military forces’ strength at risk due to the need to be hospitalised and long absences.

OBJECTIVE

To analyse the effect of digital IMODE in improving the knowledge, motivation, behavioural skills and dengue preventive practice among heads of households in military quarters in a camp in Kuala Lumpur.

METHODS

This was a two-arm, single-blinded, cluster randomised control trial intervention conducted from October 2022 until March 2023 in one of the army camps in Kuala Lumpur, Malaysia. Four clusters for each parallel arm of the intervention and control groups with a ratio of 1:1. There were 234 participants recruited, with 117 for each intervention and control group. The intervention has 2 phases; the first phase is the main intervention given in 2 weeks, followed by the second phase of reminder in the subsequent 3 months. The intervention was conducted in digital information using a series of videos and infographics, and field activities. Data were collected at baseline, immediate and 3 months post-intervention using a validated electronic questionnaire. Multiple imputations were conducted for missing data as missing data were categorised as missing data at random (MCAR). Final data were analysed with intention-to-treat analysis. The effect of the intervention was analysed using a generalised estimating equation (GEE) adjusted for household income, rank and number of children. A significant level was set at p < 0.05.

RESULTS

A total of 203 participants completed the study, with 99 participants in the control group and 104 participants in the intervention group, giving an attrition rate of 13.2% (31/234). At 3 months post-intervention, the intervention group showed significantly improved knowledge compared to the control group (OR 18.38, 95% CI 23.56, 48.37; p < 0.001) and significantly increased motivation compared to the control group (OR 10.33, 95% CI 7.27, 13.39, p < 0.001). The intervention also significantly improved dengue preventive behavioural skills compared to the control group (OR 8.58, 95% CI 3.32, 13.83, p = 0.001). The intervention, however, was not significant in improving dengue preventive practices (OR 4.4, 95% CI -0.6, 9.48, p = 0.08)

CONCLUSIONS

IMODE effectively improves the participants’ knowledge, motivation and dengue preventive behavioural skills. IMODE, however, was not effective in improving dengue preventive practices. The ineffectiveness may be due to time constraint, therefore it is recommended to prolong the intervention duration and improve the module for better outcome. The involvement of the stakeholder is also recommended.

CLINICALTRIAL

TCTR 20211021004