AUTHOR=Ssekkadde Peter , Tomberge Vica Marie Jelena , Brugger Curdin , Atuhaire Aggrey , Dalvie Mohamed Aqiel , Rother Hanna-Andrea , Röösli Martin , Inauen Jennifer , Winkler Mirko S. , Fuhrimann Samuel 

TITLE=Educational Intervention Effects on Pesticide-Related Knowledge, Attitudes, Practices, Exposure, and Health Among Ugandan Smallholder Farmers: A Cluster Randomized Controlled Trial

JOURNAL=International Journal of Public Health

VOLUME=Volume 70 - 2025

YEAR=2025

URL=https://www.ssph-journal.org/journals/international-journal-of-public-health/articles/10.3389/ijph.2025.1608952

DOI=10.3389/ijph.2025.1608952

ISSN=1661-8564

ABSTRACT=ObjectivesThis cluster randomized controlled trial assessed the effect of a two-day in-person pesticide safety training with or without text messages grounded in behavioral change theory on knowledge, attitude, and practice scores, exposure intensity scores (EIS) during application, and self-reported signs and symptoms of pesticide poisoning among 539 Ugandan smallholder farmers.MethodsTwelve subcounties were randomized into three groups: educational (n = 180), educational + text messages (n = 179), or control (n = 180). Intervention effects were estimated with mixed-effects regression models using baseline (2021) and follow-up (2022) data.ResultsKnowledge scores increased by 4.4% (95% CI: 0.9, 7.8) and 6.1% (95% CI: 2.7, 9.6) in the educational and in the education + text messages groups, respectively. Attitudes increased by 6.6% (95% CI: 1.8, 11.4) with text messages. Practice scores showed no significant change. Both interventions reduced pesticide exposure, and text messages reduced signs and symptoms of pesticide poisoning by 1.1% (95% CI: −1.7, −0.3).ConclusionThe limited changes in general practices suggest that generic and content-heavy training programs may hinder implementation. Tailored behavior change approaches, identifying and addressing locally relevant practices and psychosocial drivers, may enhance farmer safety.