Educational Level Mediates the Relationship Between Knowledge and Preventive Practices in Multidrug-Resistant Tuberculosis Patients.

BACKGROUND

Multidrug-resistant tuberculosis (MDR-TB) prevention presents significant challenges in Peruvian healthcare settings, with substantial gaps in knowledge implementation and preventive practices. However, little is known about how patients' sociodemographic factors influence the translation of knowledge into preventive practices.

METHODS

This cross-sectional study examined the associations between knowledge, preventive practices, and potential mediating roles of occupation, educational level, and sex among MDR-TB patients. We surveyed 280 patients from twelve health centers in the Piura-Castilla Network, Peru, recruited from urban (38.55%), marginal urban (32.06%), and rural (29.39%) areas through nonprobability convenience sampling. Participants represented diverse occupational backgrounds, including housewives (19.85%), workers (20.99%), and unemployed individuals (23.28%).

RESULTS

Measurement instruments were validated through confirmatory factor analysis, demonstrating adequate reliability (McDonald's ω > 0.80) and discriminant validity (HTMT < 0.85). Path analysis using structural equation modeling assessed direct and indirect relationships. Knowledge showed a significant direct association with preventive practices (β = 0.194, p < 0.001). Among the three mediating variables examined, only educational level demonstrated a significant indirect effect (β = 0.073, p < 0.001), while occupation (β = -0.010, p = 0.490) and sex (β = -0.035, p = 0.150) showed no significant indirect associations. The model explained 29.7% of the variance in preventive practices.

CONCLUSIONS

Educational level appears to facilitate the translation of knowledge into preventive practices among MDR-TB patients, though the cross-sectional design precludes causal or directional inferences. Healthcare institutions should develop tailored educational interventions according to patients' educational backgrounds, including literacy-sensitive materials, simplified visual aids, and personalized counseling sessions to enhance MDR-TB prevention effectiveness in clinical settings.