The Dynamics of Knowledge, Attitude, Practice, and Experience Regarding Infection Control Among Health Quarantine Officials at Points of Entry: A Multicenter Study in Vietnam.

Abstract

Health quarantine officials play a critical role in safeguarding public health and preventing infectious diseases at Vietnam's air, land, and sea points of entry. While previous evidence suggests that knowledge, attitudes, practices, and experiences are interrelated, many interventions in Vietnam have focused solely on improving infection control knowledge. This study aimed to assess the correlations between knowledge, attitudes, practices, and experiences and identify variables associated with higher levels of these domains to inform more effective interventions for strengthening infection control capacity. We conducted a cross-sectional survey of 618 health quarantine officials across 163 points of entry using a self-reported web-based questionnaire. To ensure reliability and validity of the questionnaire, we used Cronbach α, McDonald ω, and confirmatory factor analyses. Path analysis and a generalized linear model with a gamma distribution were used to establish relationships between knowledge, attitude, practice, and experience, and identify associated sociodemographic factors with higher levels of these domains. The final analysis included 378 valid responses, representing 61.2% of Vietnamese health quarantine officials. Our instrument demonstrated good reliability and validity. Path analysis revealed a significant positive effect of attitude on practice (direct coefficient 0.82; 95% CI, 0.64 to 1.01; total coefficient 0.86; 95% CI, 0.68 to 1.04). Attitude also showed a significant positive association with experience (coefficient 0.62; 95% CI, 0.36 to 0.89). A positive attitude emerged as a key factor in enhancing experience and practice of infection control, highlighting the need for targeted interventions that foster positive attitudes while considering certain socioeconomic factors affecting willingness to change.