Abstract
BACKGROUND: Community engagement (CE) is essential for public health interventions. This is particularly important when introducing novel technologies, such as the Sterile Insect Technique (SIT), that require strong community understanding and acceptance. Against this background, arts-based CE strategies, including music, drama, and radio short stories, were developed and piloted, but their effectiveness remained unevaluated. This study assessed whether exposure to arts-based CE approaches influenced community knowledge, attitudes, and acceptance of the SIT in uMkhanyakude District, KwaZulu-Natal, South Africa. METHODS: A cross-sectional survey to understand the influence of arts-based CE approaches was conducted in the Jozini municipality, uMkhanyakude District, after community exposure to these CE productions. Structured interviews were conducted with randomly sampled community members. Data were collected on CE exposure and SIT-related knowledge, attitudes, and acceptance. A chi-square test and a stepwise ordinal logistic regression were used to analyse the data after adjusting for sociodemographic factors. RESULTS: Among 614 participants, only 26.2% (n = 161) were exposed to arts-based CE approaches. Those exposed were more likely to correctly identify that female mosquitoes feed on blood as compared to the unexposed (95.0% vs. 85.8%, p = 0.008), and to express support for SIT (e.g., 98.1% vs. 89.4% agreed with upcoming releases, p = 0.003). Exposure remained a significant predictor of SIT acceptance in multivariate models (OR 0.65, 95% CI 0.45-0.94). Positive attitudes and accurate knowledge also independently predicted greater acceptance. CONCLUSION: Arts-based CE tools were effective in supporting the introduction of SIT by improving knowledge and acceptance. However, limited exposure suggests the need for more sustained and widely accessible engagement strategies to maximize reach and long-term impact. These findings suggest that artistic productions, especially when delivered through culturally relevant, multimodal formats, play a meaningful role in shaping community receptiveness to novel vector control methods like the SIT.