The total burden of brucellosis remains widespread [7]. This infection has been eradicated in developed countries, but due to the endemic nature of this disease in Iran, the need for educational programs to adopt preventive behaviors is felt. Considering more animal husbandry in the village and the prevalence of Malt fever, this intervention study was adopted .The results of this study showed that the mean scores of knowledge, outcome expectations, outcome value, self-efficacy, self-efficacy in overcoming obstacles, self-regulation, emotional adjustment, measuring behavior increased significantly after the intervention for the participants in the intervention group compared to before the intervention, but the changes the mentioned variables were not significant for the control group.
The results this study indicated that the mean score of knowledge after the training intervention in the intervention group increased significantly compared to the control group. These findings were in line with the results of previous [4, 8, 9]. If people do not have the knowledge and information about behaviors that affect their health, they will not know the reasons for their behavior change and it will be difficult for them to adapt to the new behavior. Knowledge of risks and benefits associated with health-related behaviors is a prerequisite for behavior change. Therefore, the most important way to prevent brucellosis is to increase people's knowledge and awareness, which can be done through the development of educational programs using mass media such as radio, television, and also the personnel of health centers.
Outcome expectations are one of the constructs of the social cognitive theory that was examined in this study. The results showed that outcome expectations were not significantly different between the two groups before the intervention. However, outcome expectations increased significantly for the participants in the intervention group after the intervention. These findings confirmed the effect of the intervention on change in the belief of rural residents in achieving the possible consequences of adopting preventive behavior of brucellosis. The results in the present study showed that the more positive the predictions of individuals about the possible consequences of performing brucellosis prevention behaviors, the more likely they are to perform those behaviors as indicated by previous studies [10–12].
The present study also showed that the mean score of outcome value after the training intervention increased significantly for the participants in the intervention group compared to the control group, confirming the effectiveness of the intervention in the participants’ valuation of brucellosis preventive behaviors because people tend to engage in behaviors that are satisfying and valuable to them [13, 14]. Emphasis on health aspects seems to enhance the value of the outcome. Outcome expectation variables and outcome value in Bashirian [15] et al.'s study related to students' fruit and vegetable consumption and Aqdasi [16] et al.'s study on nutritional behaviors in children's weight change after educational intervention had a significant increase, which was in line with the findings of our study.
The results of the present study indicated that situational awareness of the participants in the intervention group did not increase after the training intervention compared to the control group. This confirms that the training intervention did not have a positive effect on improving the understanding of environmental and social conditions of rural residents and their engagement in brucellosis prevention behavior in the intervention group. It seems that this construct is less effective in contributing to the prevention of brucellosis [17–19].
The findings of this study indicated that environmental perception after the training intervention did not increase significantly in the intervention group compared to the control group because the construct of the environmental assessment does not seem to be effective in preventing brucellosis as indicated by Ghasemi Ghale et al. [4]. This finding was not in line with the results reported [20, 21].
Self-efficacy is one of the constructs of the social cognitive theory that can play an important role in changing behavior. In the present study, the mean score of self-efficacy increased significantly after the training intervention for the participants in the intervention group compared to the control group as suggested by the previous studies in the literature 12, 22–24. Another construct of the social cognitive theory that was examined in this study is self-efficacy in overcoming obstacles. The findings of this study indicated that after the training intervention, the participants in the intervention group reported higher levels of self-efficacy in overcoming obstacles compared to the control group. This finding highlights the effect of training in removing barriers that prevent the improvement of self-efficacy in overcoming barriers and ultimately the adoption and continuation of brucellosis prevention behaviors. The evidence from the literature also supports this finding [23, 24]. Self-efficacy for overcoming obstacles is a person's belief in overcoming obstacles while performing a behavior. If there is no obstacle to overcome in performing the behavior, personal change it will be easy. Some of the personal barriers prevent behavior and form an integral part of self-efficacy evaluations. Self-efficacy beliefs can be measured against existing challenges in successful action.
The findings of this study confirmed that the level of self-regulation improved significantly after the training intervention in the intervention group compared to the control group as confirmed by other studies [16, 25, 26]. In fact, self-regulation is a technique that can be used to identify and overcome obstacles that may prevent a person from performing a behavior. In this case, the person gets motivation to continue the program by seeing the result of the change and the fact that he was responsible for the change.
The evaluation of the mean scores of emotional adjustment in this study showed that the mean score of emotional adjustment improved significantly after the training intervention for the participants in the intervention group compared to the control group [15, 25, 27]. Holding educational programs has reduced people's stress.
The main focus of this study was on empowering people to prevent brucellosis using a training program developed based on social cognitive theory. This training program induced a significant difference in brucellosis prevention behaviors by increasing knowledge, self-efficacy, self-efficacy in overcoming obstacles, and self-regulation. These findings were in line with the results reported in the literature [3, 14, 28, 29]. It is necessary to have intervention training programs to correct behaviors undesirable design and implementation.
Following the findings of the present study, it can be argued that despite the negative effects of using online social networks such as reducing book reading and eliminating face-to-face conversations, these networks can be used as a platform for teaching and learning. Furthermore, the capabilities of health ambassadors can be used in health education as an effective step in promoting community health.
Limitations
The present study was conducted at the time of the COVID-19 pandemic in Iran. Thus, there were restrictions on holding face-to-face training sessions. Besides, the COVID-19 outbreak made people afraid and unwilling to participate in the research project.