Objectives This study examined the social and behavioral factors influencing community leaders’ participation in community-based surveillance (CBS) of infectious diseases. We hypothesized that knowledge, attitudes, and perceptions significantly predict the behavioral likelihood of engaging in CBS activities. Methods: A cross-sectional study was conducted among 470 schoolteachers in Kelantan, Malaysia, from March to June 2024. Participants were selected using multistage sampling, with random selection of schools followed by convenience sampling of teachers. Data were collected using the validated KAP-CBS-ID questionnaire, which was based on the Theory of Reasoned Action and Health Belief Model. Structural equation modeling was used to analyze relationships among the study variables with the maximum likelihood robust estimator. Results: The final model demonstrated good fit (comparative fit index, 0.921; standardized root mean square residual, 0.071; root mean square error of approximation, 0.040 [90% confidence interval, 0.036–0.044]). Ten significant path relationships were identified, explaining 46.1% of the variance in behavioral likelihood. Knowledge of infectious diseases (β=0.419, p<0.001), subjective norms (β=0.235, p=0.038), and negative attitudes (β=–0.432, p<0.001) significantly influenced intention. Behavioral likelihood was directly predicted by intention (β =0.347, p<0.001), perceived susceptibility (β=0.310, p<0.001), perceived benefits (β=0.198, p=0.001), and perceived barriers (β=–0.132, p=0.008). Self-efficacy showed significant indirect effects through perceived benefits (β=0.785, p<0.001) and perceived susceptibility (β=0.765, p<0.001). Conclusion: Knowledge and psychosocial factors significantly inf luence community engagement in CBS of infectious diseases. Public health interventions should address these interconnected determinants to strengthen early disease detection and reporting systems.
Mona Gamal Mohamed, Eman Abdelaziz Ahmed Dabou, Fatma M. Ibrahim, Shaimaa Abdelsamad, Jibin Kunjavara, Kamaruddeen Mannethodi, Moayad Ahmad Wishah, Abdullah Y. Shihab, Khaled Mohammed Al-Sayaghi, Hammad Ali Fadlalmola, Mohammed Musaed Al-Jabri
Osong Public Health Res Perspect 2025;16(4):357-372. Published online June 25, 2025
Objectives This study aimed to (1) assess healthcare workers’ (HCWs) knowledge and attitudes toward mpox across 3 Gulf countries, and (2) examine factors influencing their acceptance of the mpox vaccine using the health belief model (HBM). This model evaluated perceptions related to susceptibility, severity, benefits, barriers, cues to action, and self-efficacy. Additionally, the study explored the impact of prior coronavirus disease 2019 (COVID-19) vaccination history on mpox vaccine acceptance. Methods: A cross-sectional study was conducted among 764 HCWs from the United Arab Emirates (UAE), Saudi Arabia, and Qatar. Data were collected through a structured online questionnaire based on HBM constructs. Logistic regression and structural equation modeling were employed to analyze predictors of vaccine acceptance. Results: Knowledge levels varied across the countries, with the highest proportion of good knowledge reported in the UAE (59%). UAE HCWs also demonstrated higher perceived susceptibility, perceived benefits, and intention to vaccinate compared to those in Saudi Arabia and Qatar (p<0.001). Receiving 4 doses of the COVID-19 vaccine was associated with greater acceptance of the mpox vaccine. Among the HBM constructs, perceived benefits and self-efficacy were identified as the strongest predictors of vaccine acceptance. Perceived barriers, such as fear of side effects and concerns about vaccine safety, were more prominent among HCWs in Saudi Arabia and Qatar. Conclusion: The HBM effectively explains the factors influencing mpox vaccine acceptance among Gulf HCWs. Targeted interventions that improve perceived benefits, reduce barriers, and improve self-efficacy may facilitate greater vaccine uptake and preparedness for emerging infectious diseases.
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