Perceived Risk for Dengue Infection Mediates the Relationship between Attitude and Practice for Dengue Prevention: A Study in Seremban, Malaysia

Dengue remains a public health concern due to limited curative treatment and safe vaccine availability. Prevention by individual is utmost necessary but its practice is still lacking. Perceived risk to disease has been reported to exert a good effect on health behaviour change. However, limited evidence showed its relationship towards attitude and practice for dengue prevention. Hence, we aim to measure the mediating effect of dengue risk perception in the relationship between dengue attitude and dengue prevention practice. A cross-sectional study was conducted from April 2021 to November 2021 in a district of Seremban using a pre-validated questionnaire. Informed consent was obtained from the respondents prior to inclusion in the study. The study was approved by the ethical research committee. A total of 347 respondents took part in the survey, but only 341 data points were included in the final analysis. The majority of the respondents were female (63.0%), of Malay ethnicity (86.8%), married (55.4%), and currently employed (71.0%). The pooled confirmatory factor analysis result demonstrated an RMSEA value of 0.038 (<0.08), CFI value of 0.969 (>0.90), TLI value of 0.9565 (>0.90), and ChiSq/df = 1.479 (<3.0). All the hypotheses for direct effect yielded a significant and positive relationship. Bootstrapping analysis to test for mediation revealed a partial mediation effect as both indirect and direct effects are significant. Risk perception is a mediator variable between attitude and dengue prevention practice. Therefore, our recommendation is to increase health awareness activity that helps to improve individual's risk perception through active health promotion and a health educational campaign that inculcates dengue risk messages. Ultimately, this effort can enhance good health prevention behaviour.