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Application of propensity score matching method in the analysis of knowledge, attitude and practice in health education of schistosomiasis control
Received date: 2020-01-01
Online published: 2020-09-09
Supported by
NIH-Pilot Study of Schistosomiasis Behavior Change Communication Intervention Model(1R01AI134673-01A1);Chinese Center for Disease Control and Prevention-Summary, Refinement and Dissemination of Experience in Controlling Malaria and Schistosomiasis in China-Applicable to Low-and Middle-Income Countries(GHSP-CS-OP1-01)
To explore application of the propensity score matching (PSM) method in knowledge, attitude and practice(KAP) analysis of health education on schistosomiasis control. Baseline questionnaire survey of the schistosomiasis intervention pilot project behavior change communication (BCC) was performed among villagers aged 16 and above in April 2018 in two villages in Xide County, Liangshan Prefecture, Sichuan province (Taoyuan Village of Hongmo Town served as the intervention village and Luonaige Village of Plums township as the control village). The survey results were analyzed using the PSM method to score the matching of age, gender, educational background and knowledge, attitude and practice of the surveyed villages in the two selected villages. Statistical analysis was performed using SPSS 25.0 software. The composition ratio was compared between the groups by chi-square test, and the scores were analyzed by t-test. Person correlation analysis and linear regression analysis were used to analyze the correlations between knowledge, attitude and practice. A total of 619 valid questionnaires were collected during the baseline survey. There were 319 valid questionnaires in the intervention village, including 202 males and 117 females, with the majority villagers at age 40-59 (145, 45.5%) and in illiteracy (129, 40.4%). There were 300 valid questionnaires in the control village, including 159 males and 141 females, with the majority villagers at age 40-59 (139, 46.3%) and having primary school education (168, 56%). The 120 valid questionnaires selected from the intervention village were successfully matched with 102 subjects from the control village by the PSM method, and the number of subjects was close to that of the control villages. There were significant differences in gender, age and educational background between the intervention and the control villages before matching (P < 0.01); however, these differences became insignificant after matching (P > 0.05). The scores of knowledge, attitudes and practices in the intervention village before matching were 6.5 ± 2.0, 3.4 ± 0.9 and 11.7 ± 0.9, respectively, while those in the control village were 8.1 ± 2.9, 3.2 ± 0.7 and 10.0 ± 2.3, respectively, being statistically significant between the scores of two villages (P < 0.05). After matching, the scores of knowledge, attitude and practice in the intervention village were 7.0 ± 1.5, 3.3 ± 0.9 and 11.3 ± 0.9, respectively, and those in the control village were 7.8 ± 2.4, 3.4 ± 0.7 and 11.4 ± 1.4, respectively. There were no significant differences in scores of attitude and practice between the intervention village and the control village after matching (P > 0.05). Although the difference in knowledge score between the intervention and the control villages after matching remained statistically significant(P < 0.01), the difference in the knowledge scores decreased from 1.6 before matching to 0.8 after matching. Results of Person correlation analysis showed that the three variables knowledge, attitude and practice were all positively correlated(r > 0). Regression analysis showed that knowledge had a positive impact on attitude, and practices, while attitudes also positively impacted practices. The knowledge-attitude-practice path has mediating effects. When active intervention is being conducted in schistosomiasis endemic areas based on the KAP approach, proper statistical methods may be integrated to analyze the control results, and thereby to pertinently formulate intervention strategy.
Yu ZHANG , Ding LU , Chen PU , Lin CHEN , Yong MAO , Liang XU , Yang LIU . Application of propensity score matching method in the analysis of knowledge, attitude and practice in health education of schistosomiasis control[J]. CHINESE JOURNAL OF PARASITOLOGY AND PARASITIC DISEASES, 2020 , 38(4) : 513 -517 . DOI: 10.12140/j.issn.1000-7423.2020.04.020
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