Effectiveness of Rabies Education for Malaysian Dog Owners: A Randomised Controlled Trial

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Abstract
Background: Rabies remains a nearly invariably fatal zoonosis after clinical onset, requiring prevention-focused strategies. Adult dog owners are critical stakeholders in disrupting dog-mediated transmission. The objective was to evaluate the effectiveness of the Rabies Health Education Module (RaHEM) in improving the knowledge and attitudes toward rabies preventive measures, specified as two co-primary outcomes. Methodology: An open-label randomised controlled trial was conducted among 80 dog owners in Kelantan, Malaysia. Participants were randomised to RaHEM or unrelated educational material. RaHEM comprised 26 expert-led multimedia videos with interactive activities. The two co-primary outcomes were changes in knowledge and attitude scores from baseline to one-month follow-up, analysed using one-way MANOVA. The trial was retrospectively registered with Australian New Zealand Clinical Trial Registry (ACTRN12624000432516). Results: There were no statistically significant differences in sociodemographic, pet dog, or environmental factors between the intervention and control groups at baseline. The study demonstrated significant improvements in the intervention group compared to the control group (Wilks' λ=0.627; F(2,77)=22.921; p-value<0.001; partial η²=0.373). Specifically, participants in the intervention group exhibited greater changes in knowledge scores (F(1,78)=8.70; p-value=0.004; partial η²=0.10) and attitude scores (F(1,78)=46.44; p-value<0.001; partial η²=0.37). Conclusion: RaHEM improved knowledge and attitude scores towards rabies prevention at one-month follow-up among dog owners in Kelantan, Malaysia.