A video-based educational intervention to improve vaccine acceptance for Schistosomiasis japonicum: A pre–post study using the 5C model in rural China

This study evaluated a video intervention to enhance knowledge of <i>Schistosoma japonicum</i> (SK) and general vaccines (GK) and examined how these factors influenced acceptance of a hypothetical <i>Schistosoma japonicum</i> vaccine via the 5C pathways (confidence, complacency, constraints, calculation, and collective responsibility). A single-arm pre - post study was conducted in Eryuan, China (2024). Of 453 baseline participants, 421 completed the one-month post-intervention follow-up. Mean SK knowledge rose from 21.27 ± 6.20 to 29.12 ± 5.01 and GK from 3.17 ± 1.98 to 3.73 ± 1.88 (<i>p </i>< .001). Vaccine acceptance increased from 63.9% to 84.1% (<i>p</i> < .001). Complacency and constraints declined by 2.52 ± 4.27 and 1.79 ± 4.01, while confidence and calculation increased by 0.97 ± 2.96 and 1.42 ± 3.64 (<i>p</i> < .01). Path analysis showed SK and GK were associated with higher confidence (SK standardized beta [stβ] = 0.216; GK = 0.293), greater calculation (SK = 0.204; GK = 0.119), stronger collective responsibility (SK = 0.126; GK = 0.337), and lower constraints (SK = -0.316; GK = -0.140); only SK reduced complacency (stβ = -0.424) (<i>p</i> < .05). Acceptance related positively to confidence (stβ = 0.100), calculation (stβ = 0.099), and collective responsibility (stβ = 0.183), but negatively to complacency (stβ = -0.303) and constraints (stβ = -0.110). Total effects on acceptance were stβ = 0.381 for SK (59.8% indirect via 5C) and stβ = 0.265 for GK (39.2% indirect). The intervention effectively improved knowledge, psychological readiness, and acceptance of a potential <i>Schistosoma japonicum</i> vaccine.