02823nas a2200241   4500000000100000008004100001260001200042100002300054700001200077700001200089700001200101700001400113700001400127700001700141700001800158700001400176245010700190856009900297300001300396490000700409520215100416022001402567       2021                            d  c08/20211 avan 't Noordende A1 aLisam S1 aSingh V1 aSadiq A1 aAgarwal A1 aHinders D1 aRichardus JH1 avan Brakel WH1 aKorfage I00aChanging perception and improving knowledge of leprosy: An intervention study in Uttar Pradesh, India.  uhttps://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0009654&type=printable  ae00096540 v153 a<p><b>INTRODUCTION: </b>Since ancient times leprosy has had a negative perception, resulting in stigmatization. To improve the lives of persons affected by leprosy, these negative perceptions need to change. The aim of this study is to evaluate interventions to change perceptions and improve knowledge of leprosy.</p><p><b>METHODOLOGY/PRINCIPAL FINDINGS: </b>We conducted a pre-post intervention study in Fatehpur and Chandauli districts, Uttar Pradesh, India. Based on six steps of quality intervention development (6SQuID) two interventions were designed: (1) posters that provided information about leprosy and challenged misconceptions, and (2) meetings with persons affected by leprosy, community members and influential people in the community. The effect of the interventions was evaluated in a mixed-methods design; in-depth interviews, focus group discussions, and questionnaires containing a knowledge measure (KAP), two perception measures (EMIC-CSS, SDS) and an intervention evaluation tool. 1067 participants were included in Survey 1 and 843 in Survey 2. The interventions were effective in increasing knowledge of all participant groups, and in changing community and personal attitudes of close contacts and community members (changes of 19%, 24% and 13% on the maximum KAP, EMIC-CSS and SDS scores respectively, p<0.05). In Survey 1, 13% of participants had adequate knowledge of leprosy versus 53% in Survey 2. Responses showed stigmatizing community attitudes in 86% (Survey 1) and 61% (Survey 2) of participants and negative personal attitudes in 37% (Survey 1) and 19% (Survey 2). The number of posters seen was associated with KAP, EMIC-CSS and SDS scores in Survey 2 (p<0.001). In addition, during eight post-intervention focus group discussions and 48 interviews many participants indicated that the perception of leprosy in the community had changed.</p><p><b>CONCLUSIONS/SIGNIFICANCE: </b>Contextualized posters and community meetings were effective in changing the perception of leprosy and in increasing leprosy-related knowledge. We recommend studying the long-term effect of the interventions, also on behavior.</p>  a1935-2735