{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T18:40:07Z","timestamp":1792608007260,"version":"4.5.0"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T00:00:00Z","timestamp":1792540800000},"content-version":"vor","delay-in-days":293,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"publisher","award":["2026JJ82002"],"award-info":[{"award-number":["2026JJ82002"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Transboundary and Emerging Diseases"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:p>\n                    The knowledge\u2013attitude\u2013practice (KAP) model guides rabies health promotion but insufficiently explains the knowledge\u2010practice gap. Existing research largely focuses on individual cognitive factors, lacking integration of multilevel and structural determinants. This study is based on multistage sampling and conducts a cross\u2010sectional survey of rural populations. The multilevel mixed effects model and structural equation model were used to analyze the KAP path of the general population, and a binomial mixed effects model was used to analyze the factors affecting dog vaccination in dog\u2010owning households. A total of 2148 rural residents were included in the study. The KAP analysis revealed a moderate mean knowledge score (68.04\u2009\u00b1\u200922.24) and a high proportion of positive attitudes (88.13%), the active practice rate was low (26.53%). Attitude emerged as a significant mediator, through which knowledge positively influenced (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u20090.12,\n                    <jats:italic>p<\/jats:italic>\n                    &lt; 0.001). The indirect effect accounts for 91.04% of the overall. An analysis of 282 dog\u2010owning households found that the vaccination rate for dogs was 36.17%. The mixed effects model showed that the vaccination rate of purchased dogs was 3.38 times higher than that of home\u2010bred dogs (OR\u2009=\u20093.38, 95% CI: 1.53\u20137.45), and the vaccination rate of leash\u2010restrained dogs was 3.77 times higher than that of free\u2010ranging dogs (OR\u2009=\u20093.77, 95% CI: 1.84\u20137.72). In addition to knowledge and attitude, structural factors such as dog sources and dog management methods significantly affect dog vaccination. Rabies prevention should evolve from education toward comprehensive interventions that include dog management reforms, and the creation of supportive policy and environments that reduce structural barriers.\n                  <\/jats:p>","DOI":"10.1155\/tbed\/4901283","type":"journal-article","created":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T17:59:25Z","timestamp":1792605565000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Beyond Knowledge and Attitude: Structural Drivers Dominate Canine Rabies Vaccination Decisions in Rural China: A Multilevel Modeling Study"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4210-4986","authenticated-orcid":false,"given":"Kun","family":"Sun","sequence":"first","affiliation":[{"name":"Changsha Center for Disease Control and Prevention (Changsha Health Comprehensive Supervision and Law Enforcement Bureau)  509 Wanjiali North Road Changsha Hunan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuilian","family":"Chen","sequence":"additional","affiliation":[{"name":"Changsha Center for Disease Control and Prevention (Changsha Health Comprehensive Supervision and Law Enforcement Bureau)  509 Wanjiali North Road Changsha Hunan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chenlin","family":"Duan","sequence":"additional","affiliation":[{"name":"Changsha Center for Disease Control and Prevention (Changsha Health Comprehensive Supervision and Law Enforcement Bureau)  509 Wanjiali North Road Changsha Hunan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinsong","family":"Qiu","sequence":"additional","affiliation":[{"name":"Changsha Center for Disease Control and Prevention (Changsha Health Comprehensive Supervision and Law Enforcement Bureau)  509 Wanjiali North Road Changsha Hunan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hong","family":"Feng","sequence":"additional","affiliation":[{"name":"Liuyang Center for Disease Control and Prevention  11 Lihua Road Changsha Hunan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Ningxiang Center for Disease Control and Prevention  249 Chuncheng North Road Changsha Hunan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gangdeng","family":"Zheng","sequence":"additional","affiliation":[{"name":"Changsha County Center for Disease Control and Prevention  96 Teli Road Changsha Hunan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7803-4061","authenticated-orcid":false,"given":"Yinzhu","family":"Zhou","sequence":"additional","affiliation":[{"name":"Changsha Center for Disease Control and Prevention (Changsha Health Comprehensive Supervision and Law Enforcement Bureau)  509 Wanjiali North Road Changsha Hunan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-7866-5402","authenticated-orcid":false,"given":"Qiangming","family":"Xie","sequence":"additional","affiliation":[{"name":"Changsha Center for Disease Control and Prevention (Changsha Health Comprehensive Supervision and Law Enforcement Bureau)  509 Wanjiali North Road Changsha Hunan Province China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,10,21]]},"reference":[{"key":"e_1_2_14_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2022.102509"},{"key":"e_1_2_14_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.onehlt.2024.100751"},{"key":"e_1_2_14_3_2","volume-title":"WHO Technical Report Series","author":"World Health Organization","year":"2018"},{"key":"e_1_2_14_4_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003709"},{"key":"e_1_2_14_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/13548506.2025.2486502"},{"key":"e_1_2_14_6_2","doi-asserted-by":"publisher","DOI":"10.36416\/1806-3756\/e20240426"},{"key":"e_1_2_14_7_2","doi-asserted-by":"publisher","DOI":"10.1177\/00469580221087881"},{"key":"e_1_2_14_8_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0012551"},{"key":"e_1_2_14_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s42522-025-00137-9"},{"key":"e_1_2_14_10_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0012064"},{"key":"e_1_2_14_11_2","doi-asserted-by":"crossref","unstructured":"LuR. LinandJ. andZhouY. et al.Rabies Vaccination Adherence and Associated Factors Among Rabies-Exposed Patients in Shenzhen China: A Hospital-Based Cross-Sectional Study Epidemiology and Infection 2024 152.","DOI":"10.1017\/S0950268824000049"},{"key":"e_1_2_14_12_2","doi-asserted-by":"publisher","DOI":"10.4314\/ijbcs.v15i5.9"},{"key":"e_1_2_14_13_2","doi-asserted-by":"crossref","unstructured":"WallaceR. M. UndurragaandE. A. andGibsonA. et al.Estimating the Effectiveness of Vaccine Programs in Dog Populations Epidemiology and Infection 2019 147.","DOI":"10.1017\/S0950268819001158"},{"key":"e_1_2_14_14_2","doi-asserted-by":"publisher","DOI":"10.3390\/vaccines11020352"},{"key":"e_1_2_14_15_2","doi-asserted-by":"publisher","DOI":"10.3389\/fvets.2024.1492418"},{"key":"e_1_2_14_16_2","doi-asserted-by":"crossref","DOI":"10.1093\/acprof:oso\/9780195138382.003.0004","volume-title":"Multilevel Methods for Public Health Research","author":"Subramanian S. V. K. 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