Effects of a Health Belief Model–Based Intervention on Tuberculosis Prevention Behaviors and Screening Attendance of Household Contacts

Abstract

            Tuberculosis (TB) remains a major public health problem in Thailand. Household contacts are at high risk of infection, but the rate of screening attendance is low. This research aimed to study the effect of a health belief promotion program based on the Health Belief Model (HBM) on preventive behaviors and TB screening attendance among household contacts. A two-group quasi-experimental design with pre-test and post-test was conducted. The sample consisted of 108 household contacts of new pulmonary TB patients at Khon Kaen Hospital, randomized by simple random sampling into an experimental group (n=54) and a control group (n=54). The experimental group received the program for 4 weeks, while the control group received standard care. Data were analyzed using Independent t-test, Paired t-test, Chi-square test, Risk Ratio (RR), Odds Ratio (OR), Absolute Risk Reduction (ARR), Number Needed to Treat (NNT), and Multiple linear regression.

            The experimental group had a significantly higher overall health belief score after the experiment compared to the control group (Mean diff.=0.27; 95% CI: 0.16, 0.37; Cohen's D=0.97). Preventive behaviors were also significantly better in the experimental group (Mean diff.=0.36; 95% CI: 0.26, 0.46; Cohen's D=1.34). The rate of screening attendance of household contacts to 92.6%. The experimental group was 2.27 times more likely to attend screening. Multiple linear regression analysis revealed that perceived susceptibility was the most important predictor of behavior. The four dimensions of the health belief model collectively explained 50.6% of the variance.

            The health belief promotion program was highly effective in increasing health beliefs, preventive behaviors, and TB screening attendance. Perceived susceptibility was the most important predictor. Therefore, the program should emphasize building perceived susceptibility along with enhancing perceived benefits and self-efficacy.