Abstract
BACKGROUND: Pesticide poisoning and unsafe handling among pesticide users, particularly with farmers, pose a significant threat to both public health and the environment. Despite efforts to improve farmers Knowledge, Attitude and Practices, most interventions lack tailored education and sustained follow-up, limiting their effectiveness. This trial assesses the impact of need-based educational intervention with educational documentary, improving safe pesticide practices among farmers in Karnataka, India. METHODS: The study is a multicentric randomized controlled trial, which will be conducted across 4 phases in Udupi, Mysuru, and Shivamogga districts of Karnataka. Phase 1 features a cross-sectional study design of 175 farmers to evaluate their baseline knowledge, attitudes, and practices on usage of pesticides. Phase 2 employs semi-structured interviews with 20–30 farmers and 10–20 key stakeholders, including pesticide dealers, scientists from Farm Science Centers [Krishi Vigyan Kendra (KVK)], and joint directors of agriculture to explore pesticide handling approaches, challenges, and community-specific needs while handling pesticides. The findings from Phases 1 and 2 will help in development and validation of an intervention in the form of educational video in Phase 3 which will be piloted. Phase 4 involves implementing the validated intervention and conducting long-term follow-up to assess the impact and sustainability. Phase 4 will be a two-arm, single-blind, parallel-group randomized controlled trial, with villages randomized 1:1 into intervention and control groups. The intervention group will receive a 15–20-minute educational documentary in the local language, while the control group will receive no intervention. The outcomes will be evaluated based on changes in Knowledge, Attitudes, and Practices (KAP) scores, with assessments conducted immediately post intervention, at 6 months, and at 12 months from the date of intervention. These will be correlated with outcomes including quality of life and laboratory parameters. DISCUSSION: The study aims to provide robust evidence on the role of need-based educational intervention in promoting safe pesticide practices among farmers in rural region. The primary aim of the study is to develop practical strategies to enhance public health and farmer safety by addressing gaps and contextual relevance. It seeks to improve farmers’ knowledge, attitudes, and practices regarding pesticide use, ultimately enhancing their quality of life and promoting better health and safety outcomes. TRIAL REGISTRATION: The trial is registered at Clinical trials Registry India with the trial registration number CTRI/2024/06/069678. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-026-26501-6.