A Longitudinal Intervention Study to Improve Public Knowledge, Behavior, and Practices for Sustainable Pharmaceutical Waste Management

Improper disposal of household pharmaceutical waste poses significant environmental and public health risks. This longitudinal intervention study aimed to (1) assess public knowledge, behavioral intentions, and self-reported practices (KBP) regarding pharmaceutical waste management in Northern Cyprus, and (2) evaluate the short-term and longer-term retention effects of a structured educational intervention. A total of 530 adults completed a validated KBP questionnaire at baseline. Based on baseline composite scores (Mean = 3.09 ± 0.51 out of 4.00, with scores ≥ 3.50 considered ‘optimal’), a purposively selected sub-sample of 30 participants with the lowest scores (Mean = 2.33 ± 0.32) received an eight-session intervention. KBP outcomes were assessed at baseline for all participants, and at baseline (immediately before the intervention), one-month post-intervention, and three-month follow-up for the intervention subgroup (n = 30). Changes were analyzed using repeated-measures Analysis of Variance (ANOVA). Baseline findings indicated a high prevalence of improper disposal practices. A significant improvement in composite KBP scores was observed at one-month post-intervention (p < 0.001, partial eta squared (effect size) (η2p) = 0.318), with the most pronounced gains in knowledge. Although three-month follow-up scores remained significantly higher than baseline, partial attenuation was detected, indicating that behavioral improvements were not fully maintained over time. Structured educational interventions were associated with significant enhancements in public knowledge and short-term disposal behaviors. However, achieving lasting behavioral change likely requires integrating continuous public awareness strategies with accessible medicine take-back infrastructure and clear regulatory frameworks. These findings provide actionable evidence for policymakers in Northern Cyprus and comparable transitional contexts.