03185nas a2200313 4500000000100000008004100001260001600042653003500058653003500093653002800128100001200156700001300168700001400181700001200195700001400207700001100221700001000232700001100242700001100253700001000264700001800274700001100292700001100303245018600314856016700500300001100667520217900678022001402857 2020 d bElsevier BV10aHealth education and awareness10amass drug administration (MDA)10aimplementation research1 aNath TC1 aAdnan MR1 aSultana N1 aHusna A1 aNdossi BA1 aKang Y1 aBia M1 aChoe S1 aPark H1 aLee D1 aEamudomkarn C1 aJeon H1 aEom KS00aIntegration of health education intervention to improve the compliance to mass drug administration for soil-transmitted helminths infection in Bangladesh: An implementation research uhttps://reader.elsevier.com/reader/sd/pii/S2405673120300349?token=23B0112B5D38EBCEB0C792F53032E11735314613290A2F5664020D5464D8DB8982DB8561FA86777D2847A86D6B96B577 ae001653 aIntroduction
In Bangladesh, the prevention and control strategy of soil-transmitted helminthiasis (STHs) is based on the mass drug administration (MDA) program. Despite bi-annual MDA since 2008, the reported compliance is still below the target, and the STH prevalence is high in several areas. This study was done to assess the feasibility and barriers of integrating health education (HE) intervention to achieve the target MDA compliance in the local context of Bangladesh.

Materials and methods
A mixed-method study, utilizing PRISM (Practical Robust Implementation Sustainability Model) framework, was conducted between July 2017 to March 2018 in Dhaka and Sylhet divisions of Bangladesh. A total of 640 school-aged children selected from four different schools were divided into intervention and control groups. Eight focus group discussions (FGDs) and eight in-depth interviews (IDIs) were also conducted among 56 adults, including parents of school-aged children, school teachers, and health officers.

Results
Quantitative findings revealed that HE intervention had a significant role (P < .05) to improve the mean knowledge score in the intervention group (3.35) compared to the control group (0.29). STH preventive behaviours and MDA participating attitudes were also significantly increased in the intervention group (P < .05) compared to the control group. Some of the major barriers associated with HE integration identified in the qualitative study were budget deficiencies, inadequate training of program implementers, and information gaps. In contrast, the school environment and positive community attitudes were observed as supportive factors for the integration of HE.

Conclusion
Increased knowledge score and behaviour changes due to HE intervention demonstrated in this study hint that integration of HE with MDA is feasible and can be promising to promote MDA compliance and to reduce STH prevalence in this setting. However, the allocation of adequate budget, as well as coordination and collaboration with local political context, should be addressed for the sustainability of integration. a2405-6731