# Development of a Mobile App (MyLepto App) to Improve Knowledge, Attitude, and Practice Regarding Leptospirosis Among Wet Market Workers in Selangor, Malaysia: Protocol for a Quasi-Experimental Study

## TL;DR

This study aims to develop a mobile app to improve knowledge and practices about leptospirosis among wet market workers in Malaysia.

## Contribution

The novel contribution is the development and evaluation of a mobile app based on the Health Belief Model to improve KAP regarding leptospirosis.

## Key findings

- A mobile app will be developed and evaluated for usability and acceptability.
- The intervention will assess changes in knowledge, attitude, and practice before and after using the app.
- The study will focus on wet market workers in Hulu Langat district, an area with high leptospirosis incidence.

## Abstract

Leptospirosis is the most common zoonotic cause of mortality, with most of its burden occurring in tropical regions and low-income countries. It is endemic in Southeast and South Asian nations. Leptospirosis outbreaks occur after natural disasters. In Malaysia, the e-notification system of the Communicable Diseases Control Information System recorded 5217 leptospirosis cases in 2019 with 32 fatalities. The incidence rate was 15.61 per 100,000 people. Male individuals comprised 67% of leptospirosis cases, while people aged 25 to 55 years accounted for 45% of the cases. Information and perception are crucial in influencing positive behavior. Nonetheless, information on urban and rural people’s knowledge, attitude, and practice (KAP) regarding the incidence of leptospirosis is limited.

We aimed to develop a mobile app with information on leptospirosis and measure its effectiveness in improving KAP regarding leptospirosis among wet market workers in Selangor, Malaysia.

A 3-phase study will be conducted and includes development of a mobile app containing information about leptospirosis, analysis of its acceptability, and application of the intervention. Participants will be recruited based on specific inclusion criteria by using purposive sampling. Four wet markets in Hulu Langat district, Selangor, will be selected according to a list provided by local municipal councils. The respondents from each selected wet market will be workers aged 18 years and older. Mobile app development will begin with an idea description, storyboard creation, and content approval through the nominal group technique. The mobile app content will be constructed using the Health Belief Model theory. Subsequently, the usability of the mobile app prototype will be evaluated using the validated Malay version of the System Usability Scale questionnaire for the evaluation of mobile apps. This protocol entails a 12-week intervention stage, in which the baseline assessment is regarded as a pretest evaluation and the follow-up assessment as a posttest evaluation. Participant selection will be based on the inclusion and exclusion criteria. This study will incorporate a set of validated questionnaires created by a group of leptospirosis experts. The validated questionnaire will comprise 9 sections with open-ended questions on sociodemographic data, KAP, and mobile app requirements.

Mobile app development and usability testing were completed between January 2024 and March 2025. Participant recruitment is scheduled in April to May 2025 after submission of this manuscript, with the 12-week intervention and data collection running from May to July 2025. As of manuscript submission, recruitment, data collection, and data analysis have not yet begun. Data analysis is expected to be completed by September 2025, and results are anticipated for publication in late 2025.

Due to the high number of reported leptospirosis cases in the Hulu Langat district, Selangor, this intervention study will be conducted there. The development of the mobile app may contribute to improving wet market workers’ KAP regarding leptospirosis.

PRR1-10.2196/75809