Preparing the Frontline: Profiling Knowledge, Attitudes, and Practice Gaps in Healthcare-Associated Infection Prevention Among Future Health Professionals in Belize.

BACKGROUND: Healthcare-associated infections (HAIs) pose a significant threat to patient safety in Belize, with prevalence rates far exceeding global averages. Allied health students represent the future frontline in infection prevention, yet their preparedness in high-burden, resource-limited settings like Belize-where HAI prevalence approaches 40%-remains unassessed. This study aimed to conduct the first multidimensional analysis of the knowledge, attitudes, and preventive practices (KAP) regarding HAIs among allied health students at the University of Belize (UB).

METHODS: A descriptive cross-sectional study was conducted among 210 randomly selected nursing, pharmacy, and medical laboratory science students, yielding an 85% response rate. Data were collected via a structured, self-administered electronic questionnaire. Analysis included descriptive statistics, inferential tests (chi-square, t-tests, and ANOVA), multivariable regression, and latent class analysis to identify distinct student profiles.

RESULTS: The mean knowledge score was 3.84 out of 7 (54.9%), indicating moderate overall understanding. While students demonstrated strength in general transmission routes (81.9% correct) and basic prevention, critical deficits were identified. Only 24.3% recognized mechanical ventilation as a risk factor for ventilator-associated pneumonia (a common HAI), and just 56.7% correctly identified common bacterial agents. A significant knowledge-practice gap was observed; while knowledge did not differ by academic program, practice scores varied significantly (p < 0.001). In-service training was strongly associated with better practice scores (p < 0.001) but not with knowledge. Latent class analysis revealed three distinct profiles: "High Performers" (60.2%), "Motivated Learners" (36.1%) with good practice but lower knowledge, and a "Disengaged" group (3.7%) with poor scores across all domains.

CONCLUSION: UB allied health students possess foundational HAI knowledge but appear critically underprepared in key clinical areas, with a clear disconnect between theory and practice. This evidence suggests an urgent need to consider a shift from uniform curricula to tailored, competency-based education integrating robust theory with mandatory simulation and clinical practice. Such a reform could contribute to mitigating Belize's high HAI burden.