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Background <p>Non-communicable diseases (NCDs) are a major public health challenge in Sri Lanka, driven by behavioural risk factors. Healthcare Assistants (HCAs) play a key role in NCD prevention, but limited health literacy (HL) reduces their effectiveness. Strengthening HL among HCAs can reduce their own NCD risk, enhance their role as health promoters, and improve patient education and hospital-based health initiatives.</p> Objectives <p>This study aimed to assess the effectiveness of a behaviour change intervention package (BCIP) to improve HL on behavioural risk factors of NCDs among HCAs in Colombo district.</p> Methods <p>A cluster Randomized Controlled Trial (cRCT) was conducted with 240 HCAs from 20 hospitals in the Colombo district, 10 hospitals each for the control and intervention arms. The 16 sessions of the BCIP were conducted over eight weeks. The HL-NCD tool and STEPS questionnaire were administered two weeks before and after the intervention. HL score was analyzed as a continuous variable, while HL level was categorized as inadequate or adequate based on predefined HL score cutoffs. Analyses included unadjusted, cluster-level, and Generalized Estimating Equations (GEE) models to account for clustering effects.</p> Results <p>The intervention group showed significant improvements in HL score (unadjusted <i>p</i> &lt; 0.001; cluster <i>p</i> = 0.005; GEE OR = 7.80, 95% CI: 7.38–8.22, <i>p</i> &lt; 0.001) and HL level (unadjusted <i>p</i> = 0.003; cluster <i>p</i> = 0.011; GEE OR = 3.80, 95% CI: 1.59–9.11, <i>p</i> = 0.003). Age &lt; 35 years was a significant positive predictor of HL score and educated only up to O/Ls was a significant negative predictor of HL level. The GEE analysis revealed significant improvement in behaviour change related to diet, physical activity, avoiding smokeless tobacco, and non-exposure to secondhand smoking except avoiding smoking tobacco and alcohol intake.</p> Conclusions <p>The BCIP was effective in improving HL and reducing behavioural risk factors of NCDs among HCAs, highlighting its potential for broader implementation.</p> Clinical trial number <p>SLCTR/2023/023, <a href="https://slctr.lk/trials/slctr-2023-023">https://slctr.lk/trials/slctr-2023-023</a>, 11th December 2023, Sri Lanka Clinical Trial Registry.</p>

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Effectiveness of a behaviour change intervention on health literacy for behavioural risk factors of non-communicable diseases among health care assistants of government hospitals in Colombo District: a cluster-randomized controlled trial

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  • 发表日期：

    2026年1月2日

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  • Irshad Mashood,
  • Dulani Samaranayake,
  • Vindya Kumarapeli

摘要

Background

Non-communicable diseases (NCDs) are a major public health challenge in Sri Lanka, driven by behavioural risk factors. Healthcare Assistants (HCAs) play a key role in NCD prevention, but limited health literacy (HL) reduces their effectiveness. Strengthening HL among HCAs can reduce their own NCD risk, enhance their role as health promoters, and improve patient education and hospital-based health initiatives.

Objectives

This study aimed to assess the effectiveness of a behaviour change intervention package (BCIP) to improve HL on behavioural risk factors of NCDs among HCAs in Colombo district.

Methods

A cluster Randomized Controlled Trial (cRCT) was conducted with 240 HCAs from 20 hospitals in the Colombo district, 10 hospitals each for the control and intervention arms. The 16 sessions of the BCIP were conducted over eight weeks. The HL-NCD tool and STEPS questionnaire were administered two weeks before and after the intervention. HL score was analyzed as a continuous variable, while HL level was categorized as inadequate or adequate based on predefined HL score cutoffs. Analyses included unadjusted, cluster-level, and Generalized Estimating Equations (GEE) models to account for clustering effects.

Results

The intervention group showed significant improvements in HL score (unadjusted p < 0.001; cluster p = 0.005; GEE OR = 7.80, 95% CI: 7.38–8.22, p < 0.001) and HL level (unadjusted p = 0.003; cluster p = 0.011; GEE OR = 3.80, 95% CI: 1.59–9.11, p = 0.003). Age < 35 years was a significant positive predictor of HL score and educated only up to O/Ls was a significant negative predictor of HL level. The GEE analysis revealed significant improvement in behaviour change related to diet, physical activity, avoiding smokeless tobacco, and non-exposure to secondhand smoking except avoiding smoking tobacco and alcohol intake.

Conclusions

The BCIP was effective in improving HL and reducing behavioural risk factors of NCDs among HCAs, highlighting its potential for broader implementation.

Clinical trial number

SLCTR/2023/023, https://slctr.lk/trials/slctr-2023-023, 11th December 2023, Sri Lanka Clinical Trial Registry.