A Study Protocol for the X-SIAGA Intervention: A Cluster Randomized Trial to Improve Household Preparedness for Disease X and Outbreaks in Selangor's Indigenous Community

X-SIAGA干预研究方案:一项旨在提高雪兰莪州原住民社区家庭应对X疾病和疫情爆发准备情况的整群随机试验

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Abstract

INTRODUCTION: Proactive preparedness strategies are more effective than reactive responses in minimizing the negative impacts of health emergencies, including outbreaks. Despite their potential to enhance community resilience, household preparedness initiatives are limited in Malaysia. The focus is primarily on flood disasters, often overlooking marginalized communities, such as indigenous groups. In Selangor, these communities live near forest edges and depend on the forest for livelihood, increasing their risk of exposure to zoonotic and novel threats such as Disease X. They also face challenges such as socioeconomic status, poor living conditions, healthcare barriers, and societal marginalization, making them particularly vulnerable to severe impacts from outbreaks. This study aims to evaluate the effectiveness of X-SIAGA, a newly developed intervention package, in improving household preparedness for Disease X and potential outbreaks among indigenous communities in Selangor, Malaysia. METHODS: This study will be a two-arm, parallel, single-blinded, cluster-randomized trial using multistage and simple random sampling to evaluate the effectiveness of X-SIAGA. The primary outcome is Household Outbreak Preparedness scores, with secondary outcomes including Cognitive Preparedness scores and Preparedness Behaviour scores. District and village clusters will be selected using multistage sampling and randomly assigned interventions via computer-generated numbers. Ninety-six households from eight villages are planned for recruitment, split evenly between the intervention and control groups. The intervention group will receive X-SIAGA along with educational brochures, while the control group will receive only the brochures. Outcome measures will assess changes from baseline to immediately after and one- and three-month post-intervention or control. RESULTS: As this is a study protocol, results are not yet available. The study is designed to assess changes in Household Outbreak Preparedness scores (primary outcome), as well as Cognitive Preparedness scores and Preparedness Behaviour scores (secondary outcomes). CONCLUSION: This protocol describes an intervention study that will generate evidence on the effectiveness of X-SIAGA, a novel, culturally tailored, and theory-based intervention designed to improve household preparedness for Disease X and potential outbreaks among indigenous communities in Selangor.

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