Abstract:
The interface between humans, domestic animals, and wildlife has been implicated in the emergence of infectious
diseases and the persistence of endemic human and animal diseases. For individuals who reside at this
interface, particularly those in low-resource settings, the development of disease risk assessment and mitigation
skills must be prioritized. Using a community engagement-One Health approach, we implemented a training
program aimed at advancing these skills among agro-pastoralists living adjacent to conservation areas in South
Africa. The program included professional development of local facilitators who then conducted workshops with
community members. Workshops used a series of experiential, inquiry-based activities to teach participants the
concepts of pathogen transmission and disease risk assessment and mitigation. The program was implemented
over four weeks with 10 facilitators and 78 workshop participants. We conducted a within-subjects experimental
study using a mixed methods design to evaluate the program in terms of facilitator and participant One Health
knowledge and practices. Quantitative data included pre/post written assessments; qualitative data included
focus group discussions, semi-structured interviews, and pre/post photographs. Mean post-test scores of facilitators
increased by 17% (p=0.0078). For workshop participants, improvements in knowledge were more likely
for females than males (OR =7.315, 95% CI =2.258–23.705, p=0.0009) and participants with a higher
versus lower education level, albeit borderline non-significant (OR =4.781, 95% CI =0.942–24.264,
p =0.0590). Qualitative analysis revealed the implementation of risk mitigation strategies by 98% (60/61) of
workshop participants during the three-month follow-up and included improved personal and domestic hygiene
practices and enhanced animal housing. Although further evaluation is recommended, this program may be
appropriate for consideration as a scalable approach by which to mitigate human and animal infectious disease
risk in high-risk/low-resource communities.
