Predictors of preventive practices towards hand-foot-and-mouth disease among mothers of preschool children using socioecological model in Klang district

Background: The epidemics of Hand-foot-and-mouth Disease (HFMD) has recurred globally, causing significant morbidity and mortality. During which Klang District, Selangor was among 3 governance districts with the most cases of HFMD in Malaysia by August 2016, update on local assessment of Socioecological Model predictors of preventive practices towards HFMD is fundamental. Objectives: To determine the socioecological predictors of preventive practices towards HFMD among mothers of preschool children in Klang district. Methods: A cross-sectional study was conducted to assess preventive practices towards HFMD among 353 mothers of Community Development Department (KEMAS) preschool children in Klang District. Sampling method used application of probability proportional to size and pretested self-administered questionnaire was distributed. Using IBM version 22.0, descriptive analysis was computed for all variables. Pearson‘s correlation and simple linear regression were computed for bivariate analysis and hierarchical multiple regression was computed to determine the predictors. Result: A total of 353 mothers of KEMAS preschool children participated in the study with response rate of 80.2%. The median preventive practice score was high, which was 57.00 (IQR=7.00). With exemption on knowledge, perceived severity and perceived barrier which showed low mean score of 13.61(SD=4.04), 8.30(SD=1.36) and 7.80(SD=2.14) respectively, other variables demonstrated on high median score. Other prominent findings were incorrectly perceived severity and correct handwashing technique as the most perceived as barrier towards preventive practices. From simple linear regression, knowledge, all health belief subscales, relationship factors, community factors and societal factors had significant linear relationship with preventive practices. The predictors of preventive practice practices towards HFMD were knowledge, perceived severity, perceived barrier, social support and community factor with entire group of variables were significantly predicting the preventive practices towards HFMD (F [9, 343] =8.934, p-value<0.001, adjusted R2=0.169). Conclusion: This study provides an understanding that preventive practices is not solely influenced by individual factor, but is contributed too by relationship factors and community factors.

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