Across pastoralist groups, dairy products often fulfill major nutritional, economic, and socio-cultural functions. These contributions are jeopardized by poor milk quality with studies among pastoralist groups showing dairy products can harbour a long list of pathogens. These potential risks underscore the need for more effective dairy hygiene interventions. Here, we determine how health messages advocating the “novel” method of pasteurization versus boiling, and administered in narrative versus technical formats, can have an impact on hygiene practices and milk quality in Maasai pastoralists. Four Maasai villages in northern Tanzania were purposively selected to receive intervention strategies that varied in message format (narrative or technical) and heat treatment advocated (boiling or pasteurization). Census lists were used to randomly select 30–35 households in each village (N = 125). Across three visits, milk hygiene knowledge and attitudes were monitored, hygiene practices were directly measured by smart thermometers that recorded heat treatment, and milk quality was determined by calculating total bacterial counts (TBCs) (N = 1007). Compared to initial levels, TBCs in the pasteurization-narrative village (N = 33) exhibited a 73.4% decrease (OR 0.148–0.480) after 7 days and a 59.1% decrease (OR 0.216–0.734) after 14 days. The boiling-narrative (N = 28) exhibited a significant decrease at 7 days (− 68.8%, OR 0.161–0.606), but this decrease was not significant after 14 days (− 35.5%, OR 0.322–1.253). There were no significant decreases for the pasteurization-technical (N = 29) or boiling-technical (N = 31) villages after 7 or 14 days. In addition, narrative health formats led to significantly greater retention of health messages and peer-to-peer sharing. Interventions to improve milk quality in pastoralist and other livestock-dependent communities may benefit from enabling the “novel” method of pasteurization. More broadly, our results suggest that the use of narrative messages can promote healthy behaviours when cultural norms are contrary to best health practices as well as enhance the sustainability and scalability of interventions targeted at hard-to-reach populations, including most pastoralist communities.

中文翻译：

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叙事性风险信息增加了难以到达人群的卫生干预措施的吸收和共享：一项旨在促进坦桑尼亚马赛牧民牛奶安全的试点研究

在各种牧民群体中，乳制品通常履行主要的营养，经济和社会文化功能。牛奶质量差会危害这些贡献，牧民群体的研究表明，乳制品可能含有大量病原体。这些潜在风险突显了对更有效的乳制品卫生干预措施的需求。在这里，我们确定倡导巴氏灭菌与煮沸的“新颖”方法，以叙述形式与技术形式进行管理的健康信息如何对马赛牧民的卫生习惯和牛奶质量产生影响。有目的地选择了坦桑尼亚北部的四个马赛村，以接受干预策略，干预策略的信息格式（叙述性或技术性）各异，倡导热处理（沸腾或巴氏灭菌）。人口普查清单用于在每个村庄中随机选择30-35个家庭（N = 125）。在三次访问中，监测了牛奶的卫生知识和态度，通过记录热处理的智能温度计直接测量了卫生习惯，并通过计算总细菌数（TBC）确定了牛奶质量（N = 1007）。与初始水平相比，巴氏灭菌叙述村（N = 33）中的TBC在7天后下降了73.4％（OR 0.148-0.480），在14天后下降了59.1％（OR 0.216-0.734）。沸腾叙事（N = 28）在第7天显着下降（-68.8％，或0.161-0.606），但在14天后下降不明显（-35.5％，或0.322-1.253）。巴氏杀菌技术村（N = 29）或沸腾技术村（N = 31）在7天或14天后没有显着下降。此外，叙述性健康格式大大提高了健康消息的保留率和对等共享。启用“新型”巴氏灭菌法可以提高牧民和其他以牲畜为生的社区的牛奶质量干预措施。从更广泛的角度来看，我们的结果表明，当文化规范与最佳健康做法背道而驰时，使用叙事信息可以促进健康行为，并可以针对包括大多数牧民在内的难以到达的人群提高干预措施的可持续性和可扩展性。启用“新型”巴氏灭菌法可以提高牧民和其他畜牧社区的牛奶质量的干预措施。从更广泛的角度来看，我们的结果表明，当文化规范与最佳健康做法背道而驰时，使用叙事信息可以促进健康行为，并可以针对包括大多数牧民在内的难以到达的人群提高干预措施的可持续性和可扩展性。启用“新型”巴氏灭菌法可以提高牧民和其他畜牧社区的牛奶质量的干预措施。从更广泛的角度来看，我们的结果表明，当文化规范与最佳健康做法背道而驰时，使用叙事信息可以促进健康行为，并可以针对包括大多数牧民在内的难以到达的人群提高干预措施的可持续性和可扩展性。