Preventive factors related to brucellosis among rural population using the PRECEDE model: an application of path analysis
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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.
KeywordsBrucellosis Path analysis PRECEDE Prevention
quality of Life
PRECEDE model-based scales for brucellosis prevention
structural equation modeling
asymptotically distribution-free method
goodness of fit index
adjusted goodness of fit index
comparative fit index
normed fit index
relative fit index
root mean-square error of approximation
We acknowledge the contributions of Tabriz University of Medical Sciences, Tabriz, Iran for providing facilities to the study. Also, we express our deep appreciation and sincere thanks to Prof. Lawrence W. Green for his comments and suggestions on how to proceed with the study framework.
LJ was the study’s supervisor and contributed to all aspects of the study and provided the manuscript. BM collected the data. PS conducted the analysis, MKH have helped and consulted us in data gathering process. KP contributed substantially to the data interpretation and critically revised the final article for important intellectual content. All authors read and approved the paper.
Compliance with ethical standards
Informed consent was obtained from all participants. The study received ethical approval from the Ethics Committee of Tabriz University of Medical Sciences (NO: IR. TBZMED. REC. 1394. 596).
Consent for publication
The authors have agreed on the content of the manuscript.
Conflict of interest
The authors declare that they have no conflicts of interest.
- Brown, T. Confirmatory factor analysis for applied research. New York: Guilford. (2006).Google Scholar
- Corbel, M. (2006) Brucellosis in Humans and Animals: FAO, OIE, WHO. Available: http://www.who.int/csr/resources/publications/Brucellosis.pdf. Accessed 2017 May 10.
- El Idrissia, A. FAO works to curb the burden of brucellosis in endemic countries. 2014. Avalable at: http://www.fao.org/3/a-i3916e.pdf.
- Finney, S.J, DiStefano, C. 2006. Non-normal and categorical data in structural equation modeling. Structural equation modeling. A second course, 269–314.Google Scholar
- Glantz K, Rimer BK, Viswanath K (2008) The scope of health behavior and health education. In: Glanz K, Rimer BK, Viswanath K (eds) Health behavior and health education: theory, research, and practice, 4th edn. Jossey-Bass, San Francisco, p 3–22Google Scholar
- Glaser, L., Carstensen, M., Shaw, S., Robbe-Austerman, S., Wunschmann, A., Grear, D., & Thomsen, B. (2016). Descriptive epidemiology and whole genome sequencing analysis for an outbreak of bovine tuberculosis in beef cattle and white-tailed deer in northwestern Minnesota. PloS One,11(1), e0145735.CrossRefPubMedPubMedCentralGoogle Scholar
- Green, L.W., Kreuter, M.W. 2005. Health program planning: An educational and ecological approach. McGraw-Hill Companies.Google Scholar
- Hox J. Multilevel analysis: techniques and applications. Mahwah, NJ: Lawrence Erlbaum Associates; 2002.Google Scholar
- Jahangiry, L., Nadrian, H., Mahdavi, B., Allahverdipour, H., Kousha, A. 2017. Primary Development and Psychometric Properties of PRECEDE Model-based Scales for Brucellosis Prevention among an Iranian Rural Population. Infect Dis. ; 12(3):e62957.Google Scholar
- Kansiime, C., Rutebemberwa, E., Mugisha, A., Mugisha, S., Asiimwe, B.B., Rwego, I.B. and Kiwanuka, S.N., 2014. Determinants of Patients’ choice of provider in accessing brucellosis care among pastoral communities adjacent to Lake Mburo National Park in Kiruhura District, Uganda. PloS One, 9(8), e105276.CrossRefPubMedPubMedCentralGoogle Scholar
- Ragan, V., Vroegindewey, G., Babcock S. 2013. International standards for brucellosis prevention and management. Revue scientifique et technique (International Office of Epizootics). 32(1):189–98.Google Scholar
- Shang D. Progress in the study of prevention and control of Brucellosis in China in last 50 years. Zhonghua liu xing bing xue za zhi 2000;21(1):55-7Google Scholar
- Smits, H.L. 2013.Brucellosis in pastoral and confined livestock: prevention and vaccination. Revue scientifique et technique (International Office of Epizootics). 32(1):219–28Google Scholar
- World Health Organisation. 1997. World Health Organisation. Fact Sheet: N173.Google Scholar