{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T08:56:05Z","timestamp":1776416165913,"version":"3.51.2"},"reference-count":20,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T00:00:00Z","timestamp":1776384000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: Rabies is almost invariably fatal once clinical symptoms develop, yet it is preventable through canine vaccination and timely post-exposure prophylaxis (PEP). In rural Thailand, preventive behaviors likely depend on health literacy and contextual conditions that enable and reinforce protective action, but structural pathways remain unclear. Methods: We conducted a cross-sectional study among 750 adults in rabies-risk areas of Si Sa Ket Province, Thailand. A socio-ecological, One Health-informed structural equation model (SEM) examined associations among rabies-related health literacy skills (HLskill), service\/system enabling conditions (ENAB), reinforcing community mechanisms (COMM), and rabies-prevention behaviors (BEHAV). Results: Model fit was acceptable (CFI = 0.948; TLI = 0.918; SRMR = 0.047; scaled RMSEA = 0.090). HLskill and COMM showed direct associations with BEHAV (\u03b2 = 0.352 and 0.371, respectively), while ENAB was strongly associated with COMM (\u03b2 = 0.939), indicating an indirect pathway through community reinforcement (\u03b2 = 0.348; 95% CI [0.273, 0.424]). Conclusions: Rabies-prevention behaviors were associated with health literacy skills and reinforcing community mechanisms; service readiness operated primarily through community reinforcement. Rabies control should combine health literacy strengthening with community communication, coordinated dog vaccination, bite management, and timely PEP uptake.<\/jats:p>","DOI":"10.3390\/ijerph23040515","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T07:48:12Z","timestamp":1776412092000},"page":"515","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Health Literacy, Service Readiness, and Community Reinforcement of Rabies-Prevention Behaviors in Rural Thailand"],"prefix":"10.3390","volume":"23","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8041-5090","authenticated-orcid":false,"given":"Jinda","family":"Khumkaew","sequence":"first","affiliation":[{"name":"College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani 34190, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6491-6067","authenticated-orcid":false,"given":"Aree","family":"Butsorn","sequence":"additional","affiliation":[{"name":"College of Medicine and Public Health, Ubon Ratchathani University, Ubon Ratchathani 34190, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2267-5776","authenticated-orcid":false,"given":"Putthikrai","family":"Pramual","sequence":"additional","affiliation":[{"name":"Si Sa Ket Provincial Public Health Office, Si Sa Ket 33000, Thailand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Hampson, K., Coudeville, L., Lembo, T., Sambo, M., Kieffer, A., Attlan, M., Barrat, J., Blanton, J.D., Briggs, D.J., and Cleaveland, S. 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