Can a low-cost educational intervention result in a change in Chikungunya knowledge and prevention practices? Developing and testing an intervention to prevent Chikungunya in rural Tamil Nadu, India

CHIK is a viral infection transmitted by the Aedes aegypti mosquito which causes an illness with symptoms of severe joint pain, high fever, and rash. The joint pain can continue for months, causing disability and economic strain on families. This study included implementation of a baseline needs assessment, and development, implementation, and evaluation of an experimental community-based educational intervention in rural Tamil Nadu, India. A total of 184 households, across 12 purposively sampled villages (six intervention and six control), participated in the needs assessment between August and December 2010. The experimental community-based educational intervention was implemented between December 2010 and August 2011, in the six intervention villages. A total of 180 households, from the same 12 villages, participated in the post-intervention evaluation. A randomized block design with repetition was used to test whether there was a change in CHIK knowledge scores from baseline to post-intervention in the treatment group. A model including respondent variables, household larval status, household container larval status, recent experience with CHIK, numbers of livestock, socioeconomic position (SEP) variables, and water variables were used to predict CHIK knowledge scores in rural Tamil Nadu. Respondent age, measures of luxury amenities and water source were statistically significant predictors of knowledge in this model. The CHIK knowledge score increased from 9.0 to 9.4 in the intervention group (p=0.6457) and from 8.5 to 9.2 in the control group (p=0.393), showing that the educational intervention did not increase CHIK knowledge in the intervention group. Although this low-cost intervention, utilized in a resource poor area of Tamil Nadu, India did not result in an increase of CHIK knowledge, the process of developing the educational intervention may provide a template for future interventions. Future studies should investigate methods of sustainability in the use of educational messages.