ABSTRACT Traumatic brain injury (TBI) is associated with an array of physical, psychological and social changes. Adopting positive coping mechanisms following a TBI is important in maximising recovery outcomes including psychological wellbeing and quality of life. Using grounded theory methodology, this study explored the lived experiences of individuals recovering from severe TBI and the development of coping strategies. The research responds to a recognised gap in survivor-centred literature by prioritising the voices of individuals living with the long-term consequences of TBI. Semi-structured interviews were conducted with eight participants who sustained severe TBIs, capturing rich qualitative data on the psychological, social and cognitive challenges encountered during recovery. Five interrelated factors emerged as critical to the development of coping strategies: Purpose, Management and Acceptance which were found to interact dynamically, with Support and Understanding determining to adoption of Effective TBI Coping. The resulting TBI Model of Coping offers a survivor-informed framework that provides new insights into recovery processes following severe TBI. This research highlights the importance of tailored psychological support and the need for interventions that consider the multifaceted nature of coping. The model has practical implications for neurorehabilitation services and contributes to the advancement of personalised care for TBI survivors.

Brugian filariasis continues to affect marginalized populations in central coastal Kerala, causing chronic disability despite effective disease control. To address this, a vocational rehabilitation initiative under the Morbidity Management and Disability Prevention program was launched in Cherthala taluk to promote economic self-reliance and dignity through microfinancing and livelihood support. The objective of this study was to determine the impact of this initiative on the quality of life (QoL) of disabled filarial lymphoedema patients in Cherthala taluk, South India. A sequential explanatory mixed methods study was conducted among disabled filarial lymphoedema patients across eight different localities of Cherthala taluk. Appropriate statistical tests were used to analyse the quantitative data while a thematic framework approach was used to assess the qualitative data. The study included 40 disabled filarial lymphoedema patients whose mean age was 65.03±7.3y and 52.5% were females. The mean QoL scores showed a significant difference compared with those with moderate-grade lymphoedema in the Lymphatic Filariasis Specific Quality of Life Questionnaire domains of usual activities and disease burden. After rehabilitation, there was a statistically significant increase in the monthly income of the beneficiaries. The main themes that emerged following the qualitative analysis were economic impact, psychological impact and social impact. The vocational rehabilitation initiative significantly enhanced the QoL of filarial lymphoedema patients by fostering economic independence, psychological well-being and social inclusion. These findings highlight the need for holistic, community-based approaches in chronic disease rehabilitation and reintegration efforts.

Purpose: Discussing death with terminally ill patients is a challenging yet essential part of palliative care nursing. This study explored nurses' perceptions and experiences, emphasizing holistic care that addresses patients' physical, emotional, social, cultural, and spiritual needs. Design: A descriptive, exploratory qualitative design was used with content analysis. Methods: Data were collected through in-depth interviews with 16 participants and analyzed using traditional content analysis. MAXQDA software was used for coding and organizing the qualitative data. Results: Four main themes emerged: "Professional Readiness and Communication Competence," "Experiences in Talking About Death," "Factors Shaping Death-Related Communication," and "Internalization of Death and Its Influence on Care." Nurses stated that talking about death was influenced by patient requests, disease progression, family expectations, and the nurse's communication skills. Training and expertise were seen as essential. Some nurses felt this task was more appropriate for physicians or psychosocial teams. Conversations included both positive experiences (e.g., offering hope) and challenges (e.g., emotional strain, patient resistance). Nurses described death as both a fearful and natural experience. Conclusions: Supporting nurses through communication-focused in-service training, with an emphasis on holistic care principles, is recommended to enhance the quality of end-of-life care and better address the multidimensional needs of patients facing death.

ABSTRACT Effective school improvement requires enhancing the capacity to implement change and support development at a collective level. In this context, school self-evaluation processes have emerged as valuable tools for guiding and sustaining improvement efforts. This study investigates the impact of a school self-evaluation process on empowering educators to foster the development of an inclusive school culture as they address emerging challenges. Relying on a case study approach in the action-research framework, the authors examined the effectiveness of such processes in the Cypriot educational system, which is continually challenged in its efforts to implement inclusive education and is currently committed to addressing these obstacles. The main tool in this research was the Index for Inclusion, alongside the Themis Inclusion Tool. Both quantitative and qualitative data revealed significant impact, including enhanced perceptions of the school as a learning community, increased collaboration, contributions to teachers’ professional development and improved levels of self-efficacy and collective efficacy.

This study aims to analyze the management of Christian spiritual programs to improve students’ religious character at SMKS Multistudi High School, Batam. The research used a mixed methods approach with a sequential explanatory design. Quantitative data were obtained through questionnaires completed by 41 students, while qualitative data were collected through interviews with the principal, the vice principal for student affairs, the Christian Religious Education teacher, and the Rohkris advisor, as well as activity documentation. Quantitative analysis used descriptive statistics, while qualitative data were analyzed through data reduction, data display, and conclusion drawing. The research results showed that students’ religious character was in the good to very good category, indicated by increased discipline, responsibility, politeness, and social concern. The findings indicate that the improvement in religious character was influenced by program management, including structured planning, clear task distribution, habit-based implementation, and continuous evaluation. Programs integrated with Christian Religious Education strengthened the internalization of values in school life. Thus, the quality of spiritual program management became the main factor in the success of shaping students’ religious character, not simply the existence of religious activities

The United Kingdom's National Health Service has a workload which is increasingly moving from secondary to primary care. The proportion of Foundation Year 2 (F2) doctor specialty training applicants appointed to General Practitioner (GP) training programmes has historically been in decline. Though recent figures show an increase in applications, the pattern of high competition and many F2s not progressing directly into GP training is ongoing. To explore the features of F2 GP placements that influence career choice DESIGN & SETTING: A retrospective mixed methods study using an on-line survey followed by semi-structured interviews. A survey of 77 F2 doctors from 3 Health Education England regions was completed, of which 20 took part in interviews following their 4-month GP placement. Survey data were analysed using descriptive statistics, and qualitative data using thematic analysis. This study found considerable variation between practice placements in terms of F2s' workload, the quality of supervision and support, whether they encountered inspiring GP role models, the degree of isolation, educational opportunities and the culture of the practice. F2 doctors consider that their GP placements are invaluable for their learning. However, placement experiences were mixed, with F2 doctors being attracted and "put off" a GP career in equal numbers. There is a need to ensure consistently high-quality GP placement experiences for F2 doctors' that can best inform their career choice. F2 doctors made several recommendations following their GP placement which, if implemented, may help to increase the attractiveness of GP as a career.

Abstract Background: Individuals with chronic disease must comprehend their diagnosis (sense) and gain control over the ailment (grip on disease). However, HIV-AIDS is different due to stigma and discrimination. Yet, persons living with HIV, with a robust sense of grip on disease (SoGoD), can lead satisfying lives. This study aimed to assess the SoGoD status and its associates, and then elicit the perspective of the stakeholders. Materials and Methods: This mixed-method study was conducted among People Living with HIVs (PLHIVs) visiting a tertiary care hospital in Kolkata, India, from November 2023 to January 2024. The quantitative strand of the study was conducted among 120 PLHIVs on antiretroviral therapy (ART), and then the qualitative strand was conducted by in-depth interviews (IDIs) with study participants and key informant interviews (KIIs) with healthcare personnel. SPSS software was utilized for quantitative data analysis, and factors associated with the SoGoD were analyzed using logistic regression models. Qualitative data were analyzed thematically. Results: Among the study participants, 34% have a dynamic grip. Illiteracy (adjusted odds ratio [aOR] = 7.22, 95% confidence interval [CI] = 1.94–10.97), current marriage (aOR = 4.44, 95% CI = 1.61–12.27), no history of substance use (aOR = 2.79, 95% CI = 1.99–7.85), and lesser stigma and discrimination (aOR = 5.41, 95% CI = 1.96–7.86) were significantly associated with dynamic grip. Self-care, family and community support, and integrated institutional care were identified as major ways to enhance disease grip. Conclusion: Since HIV is a heavily stigmatized disease, measures such as early family engagement and counseling, and comprehensive and adaptable institutional care should be undertaken to improve their disease grip.

Malaria is a major public health problem in Ethiopia, and long-lasting insecticide-treated nets (LLINs) are one of the primary preventive strategies used to control it. Gondar Zuria District, Central Gondar Zone's highest malaria-reporting district, reached 100% LLIN coverage in 2023. However, malaria cases remain high, suggesting gaps in LLIN utilization. Therefore, this study aimed to assess LLIN usage and determinants in Gondar Zuria District. Community-based mixed-methods study was conducted from February 1 to 28, 2025 among 700 participants selected through multistage sampling. Quantitative data was collected via interviewer-administered questionnaires and entered into EpiData version 4.6.0.2 and exported to SPSS version 25 for analysis. A binary logistic regression model was fitted, and statistical significance was determined using 95% confidence intervals (CI) and a p-value ≤ 0.05. Qualitative data were collected through purposively sampled interviews (n = 7) and key informant interviews (n = 3) and analyzed thematically. The prevalence of ITN utilization was 55.6% (95% CI: 51.9%-59.3%) and was significantly associated with perceived severity (AOR = 1.74; 95% CI: 1.27-2.39), LLINs-to-family size ratio (AOR = 2.09; 95% CI: 1.51-2.91), and occupation specifically, being a government employee (AOR = 3.45; 95% CI: 1.57-7.58). The mixed methods design therefore provided a more comprehensive understanding by revealing behavioral and contextual factors that were not captured through quantitative data alone. Qualitative findings complemented the quantitative results by explaining why LLIN utilization remained low, highlighting misconceptions about net safety, doubts about effectiveness, discomfort due to heat, and structural barriers such as lack of space for hanging nets. LLIN utilization in Gondar Zuria District fell below the national target (100%). Misconceptions and misinformation contribute to irregular use and reduced trust. Beyond distribution and health education, community-based behavior changes strategies such as household follow-ups by health workers and integrating LLIN promotion into local forums alongside routine net condition monitoring are essential to improve consistent use and advance malaria elimination efforts.

This study investigates the persistent gap between technology acceptance and actual technology adoption among internal auditors in Thai public universities. While digital technologies are widely promoted as essential to contemporary audit practice, favorable perceptions do not consistently translate into meaningful integration. Drawing on qualitative data from ten in-depth interviews, this study explores how auditors interpret and negotiate digital technology within high-accountability professional environments. The findings reveal that adoption is shaped not only by perceived usefulness but also by professional identity preservation, perceived redistribution of authority, accountability-driven anxiety, cognitive demands, and constrained self-efficacy. Digital tools are not encountered as neutral instruments; rather, they are evaluated in relation to professional legitimacy, risk exposure, and confidence under scrutiny. The study argues that prevailing technology acceptance models overemphasize cognitive determinants while underestimating identity-mediated and emotion-mediated mechanisms. By analytically distinguishing acceptance from adoption, this research advances a more critical and context-sensitive understanding of digital transformation in expert professions. Sustainable adoption requires not only technical readiness but alignment with professional identity, authority structures, and psychological safety.

In Italy, rural tourism has become an increasingly important form of sustainable development, capable of combining economic, environmental, social, and cultural objectives. This study examines the principles of agroecology applied to rural tourism, analysing the generated public value. Specifically, the case of Masseria Casacapanna, a multifunctional agritourism farm, is analysed through qualitative and quantitative data obtained through a structured questionnaire administered to the managers. The results show that the agro-ecological practices significantly contribute to the creation of Public Value by generating equitable and sustainable well-being in the region: they create local employment, support local economic networks, preserve traditions, and reduce environmental impactthrough innovative agro-economic practices. In conclusion, we emphasize the need to integrate the assessment of these impacts into territorial planning decision-making processes and rural development strategies, in line with the national objectives of Equitable and Sustainable Well-being.

Abstract This paper discusses Manx as it is spoken in the twenty-first century. Like many minoritized languages, Manx underwent linguistic obsolescence in the nineteenth and twentieth centuries. More recently, Manx has undergone revitalization, which has increased speaker numbers. The revitalized Manx speaker community is here analysed as new speakers, who acquired the language through means other than transmission in the home. New speakers of minority languages often differ from other speaker profiles in various ways, including the beliefs they hold about language. This paper aims to explore such beliefs in the context of Revitalized Manx. To do so, I will present both qualitative and quantitative data from new speakers of Revitalized Manx, collected by means of sociolinguistic interviews and ethnographic observation. The paper addresses the following research questions: 1) How do Manx new speakers understand “good language use” in Manx? 2) What language ideologies underlie the judgements speakers make about their own and others’ language practices. This paper will shed light on the beliefs around “good language use” present in the current Manx revival community. It will also explore the relationship between these beliefs and linguistic structure in Manx, namely the valuing of varying morphosyntactic constructions in a revitalized language community.

Abstract This study investigates the impact of generative artificial intelligence (GenAI) on creative workflow in digital textile design. Thirty-four undergraduate students completed matched pattern design tasks using both conventional vector-based tools and GenAI-supported workflows within Adobe Illustrator. A within-subject experimental design was used to compare the two approaches. Paired comparisons showed that GenAI significantly reduced perceived task difficulty and total workload and increased procedural efficiency. However, these gains accompanied by lower editability and weaker articulation of personal style, along with lower ratings of creativity, aesthetic value, satisfaction, and goal fulfillment. Idea generation felt easier with GenAI, but the breadth of distinct ideas did not increase, suggesting stylistic convergence rather than divergent exploration. Qualitative data revealed a redistribution of cognitive effort, as automation eased technical operations but shifted focus to prompt formulation, weakening expressive control. This reflects GenAI’s dual effect of enhancing procedural fluency while diminishing authorship. For effective integration into education, this study proposes structuring AI-integrated design into an exploration, refinement, and reflection phase, accompanied by assessment that documents prompt, decision histories, and human re-authoring of AI results.

Telehealth has become an integral component of mental health care delivery worldwide. Understanding provider perceptions is essential to guiding its continued implementation. This international study used quantitative and qualitative methodologies to examine and broaden our understanding of the benefits and concerns related to telehealth for mental health care. An internet-based survey was conducted during the COVID-19 pandemic between November 11 and December 18, 2020, among mental health professionals, primarily psychiatrists and psychologists, registered with the World Health Organization's Global Clinical Practice Network. Clinicians completed the survey in 1 of 6 languages (Chinese, English, French, Japanese, Russian, or Spanish). Descriptive statistics and logistic regressions were used to analyze quantitative survey data on concerns and implementation of telehealth. Responses to an open-ended question about providers' perspectives on the benefits of telehealth were analyzed qualitatively. In total, 847 participants completed the telehealth section of the survey, and 496 provided a response to the open-ended question. Quantitative data on telehealth use and concerns revealed that clinicians' primary concerns focused on technical issues and clinical effectiveness relative to in-person services, specifically, loss of clinical information (eg, nonverbal behavior) and challenges with establishing a therapeutic alliance. Findings varied by profession, World Health Organization region, and telehealth training and experience. Qualitative data examining benefits fell into 3 major areas: accessibility and reach of mental health services, efficiency and flexibility for clinicians, and enhancement of clinical processes and outcomes. Taken together, findings revealed a trade-off between telehealth benefits and disadvantages. From the perspective of mental health professionals, telehealth practice comes with key challenges and valuable benefits. Findings offer important considerations for the implementation of telehealth systems, including the importance of training and education and balancing trade-offs to optimize care.

This study examines how remittances contribute to household food availability, accessibility, and stability outcomes in protracted crisis settings. A mixed explanatory research design was employed, collecting data from 193 randomly selected households, ten purposively selected key informants, and six heterogeneous focus group sessions. Quantitative data were analysed using descriptive statistics, cross-tabulations, and mean comparisons to assess remittance utilisation, categorised into four levels: none, minimal, moderate, and higher. Qualitative data were analysed thematically to explore usage patterns, coping strategies, and barriers. Findings show that 85.5% of households relied heavily on remittances to ensure food security, 6.7% used them moderately, 2.6% minimally, and 5.2% did not receive remittances. Qualitative results corroborated these patterns, revealing that remittances, typically received weekly or monthly, enhanced purchasing power, food access, and social cohesion, while also supporting social obligations such as idir, weddings, and funerals. Participants emphasised that remittances helped households prevent hunger and cope with rising living costs during crises. The study concludes that remittances are a vital lifeline that strengthens household resilience and food security. To maximise their impact, policies and programs should facilitate secure, timely, and cost-effective remittance transfers, promote financial literacy among recipients, and integrate remittance-based support into broader food security and social protection initiatives, enhancing food availability, access, and stability within recipient households

Technology can deliver culturally and linguistically appropriate resources to support ethnically diverse family carers (hereafter referred to as carers) of people living with dementia. However, carers' involvement in research on the development and evaluation of such digital health interventions is limited. This study aims to user-test the co-designed Draw-Care multilingual, web-based dementia resource with and for carers. We evaluated the web-based resource through observation sessions to collect carer feedback, using a mixed methods approach. This comprised the online, validated eHealth Literacy Scale and survey questions assessing the perceived usefulness and importance of the internet for health-related decision-making and access to health resources. In addition, "think-aloud" website navigation sessions were conducted, and Hotjar analytics were used to capture participants' behavior on the website. Quantitative and analytics data were analyzed descriptively, and qualitative data were analyzed using instant data analysis, followed by thematic analysis. Between March and April 2023, a total of 30 carers participated in the user-testing sessions (women, n=20, 67%; mean age 61, SD 13.5 years). The mean eHealth Literacy Scale score was 30 (SD 6.1). Overall, 18 (60%) participants perceived the internet as useful, and laptops and tablets were the most commonly used devices for accessing resources, each used by 9 (30%) participants. Vietnamese (n=5, 17%), Mandarin (n=5, 17%), and English (n=5, 17%) were the top 3 languages the resource was accessed in. A total of 28 (93%) participants could navigate and log in to the website with little to no support. Qualitative results showed that overall, the Draw-Care web-based resource was acceptable, culturally responsive, engaging, and usable. However, navigation was more complicated for those using smaller screens (eg, smartphones and tablets). There were linguistic discrepancies arising from translation issues in Vietnamese and Mandarin, and 14 (46%) participants found it difficult to identify and use the chatbot (ie, virtual helper interface). Issues identified with the prototype Draw-Care website and the proposed improvements included eliminating the virtual helper, simplifying the rating scale from a 5-point smiling emoticon scale to a 3-star rating scale, improving the visibility of the feedback button, and ensuring translation accuracy. To our knowledge, this is the first study to evaluate a bespoke multilingual website delivering a novel, co-designed, and culturally adapted digital intervention in 10 languages for ethnically diverse family carers of people living with dementia. Findings from this user-testing study undertaken with carers uncovered usability issues requiring remediation and emphasized the importance of inclusive, accessible, culturally sensitive, engaging, and beneficial content and design. Key revisions were implemented before the randomized controlled trial commenced. RR2-10.1177/20552076231205733.

This study aims to empirically and comprehensively assess security vulnerabilitiesin military Wi-Fi networks at the XYZ defense educational institution, encompassing technicalaspects (penetration testing with Aircrack-ng, WPA2 encryption analysis) and human factors(social engineering, personnel security awareness). A convergent mixed-methods approachwas used to integrate quantitative and qualitative data. Penetration testing conducted at fourstrategic locations revealed that 75 percent of the network could be breached in less than 130minutes due to weak passwords with low entropy (less than 60 bits) and default configurations.Meanwhile, a survey of 50 personnel showed that 80 percent were unable to accurately identifyphishing attacks before training, and 65 percent were vulnerable to pretexting scenarios.Vulnerability analysis using the CIA Triad framework revealed violations of Confidentiality (40percent of traffic could be intercepted within 30m), Integrity (20 percent of the network wasvulnerable to Man-in-the-Middle), and Availability (DoS through deauthentication closed 80percent of active sessions). hese findings indicate that the human factor is the biggestvulnerability (95 percent of global cyber breaches originate from human error or manipulation).Therefore, mitigation recommendations are integrative and multi-layered, encompassingtechnical interventions (migration to WPA3 with SAE, implementation of RADIUS and SnortIDS), behavioral interventions (regular awareness training and monthly phishing simulations),and organizational interventions (establishment of a 24/7 CSOC). This integrated frameworkis estimated to reduce attack success by 70 percent, which is crucial for creating military cyberresilience in accordance with the spirit of Sishankamrata and Permenhan No. 82/2014concerning Cyber Defense.

Background/Objectives: Empirical evidence on intergenerational commensality in institutional care settings remains scarce. This pilot and feasibility study evaluated the preliminary impact of an innovative intergenerational mealtime model on older adults’ subjective well-being, self-esteem, perceived health, and food consumption in an adult day care setting. Methods: A 16-week wait-list randomised controlled pilot trial with a sequential explanatory mixed-methods design was conducted in an intergenerational centre in southern Spain. Twenty-two older adults who reside in a community living setting and attend a day care service were randomly assigned to two intergenerational dining intervention/waiting-list groups or a control group. Participants in the intervention/waiting-list groups had lunch four times per week with children 2–3 years of age, following a structured protocol. The quantitative outcomes examined included subjective well-being (WHO-5 Well-Being Index), self-esteem (Rosenberg scale), perceived health (EuroQol EQ-5D), and objective assessment of plate leftovers using photographic records and the Comstock visual estimation method. Qualitative data were collected through semi-structured interviews and ethnographic observation. The trial was registered at ClinicalTrials.gov (NCT06996418). Results: Across the study period, intervention, waiting-list, and control groups showed preliminary improvements in subjective well-being and self-esteem, but with no significant group-by-time interaction. In contrast, mixed-effects models revealed an encouraging significant reduction in plate leftovers among older adults during intergenerational meals, particularly in second courses. The reduction was consolidated during the post-intervention follow-up. Qualitative findings showed perceived improvements in emotional well-being, motivation, and appetite, thus highlighting potential relational and affective mechanisms underlying changes in eating behaviour. Conclusions: This pilot study shows promise for intergenerational commensality in adult day care settings and provides preliminary evidence of its potential to promote well-being and self-esteem and reduce food waste among older adults. Larger, multi-centre, appropriately powered trials are warranted to validate these findings.

The study presented is the result of an action research process led by the authors since April 2024, with the objective of determining whether the process evaluation has strengthened continuous improvement in the institutional management of the Instituto Superior Tecnológico Loja; this, as a strategy of self-reflection and commitment among its members. Given the nature of the activities, the method applied was a mixed one based on the collection of quantitative and qualitative data, which made it possible to reach results and conclusions of the same nature. In its diagnostic part, as a product of action research, there is a set of criteria on the problems detected of institutional pedagogical management, then a description of the main advances attained; and finally the results achieved by November 30, 2025, which show the improvements achieved as a result of management accompanied by process evaluation, where two hypotheses structured by 23 academic-pedagogical variables are tested: one referring to the achievement of management in planning and the other in the execution of actions. Concluding that: The implementation of the process evaluation has significantly strengthened the pedagogical planning and execution of the Instituto Superior Tecnológico Loja. This is done through the Student t-test calculated at 95% significance and with 22 degrees of freedom. This information is presented in tables and graphs that allow for easy reading.

This study examines how Internet of Things (IoT) technologies are supporting global education. It notes that IoT is improving assessment methods, increasing student engagement, enabling personalized learning, and strengthening educational connections across countries. It also highlights issues related to privacy and cybersecurity. Using a mixed research methodology, data were collected from 210 students and 158 teachers through questionnaires. Interviews were also conducted with 58 teachers. Quantitative data were performed using Multivariate Analysis of Variance (MANOVA) and Partial Least Squares Structural Equation Modelling (PLS-SEM) methods; qualitative data were performed using NVivo. Results indicated that IoT-based assessments enhance fairness and accuracy in grading and increase student participation. However, data security and privacy challenges remain. Therefore, secure digital systems need to be developed, digital skills of teachers and students need to be improved, and IoT tools need to be used in a way that is compatible with teaching methods.

Introduction Mass dog vaccination is the most effective approach for interrupting canine rabies transmission. However, current vaccination strategies are typically centralized and conducted annually, leaving some communities excluded and with few opportunities to vaccinate their dogs. A community-based continuous mass dog vaccination strategy was piloted in the Mara region of Tanzania. We investigate factors that influenced the delivery of this approach and how the processes were sustained over two years. Methods We employed mixed methods to explore what influenced vaccination delivery. We conducted in-depth interviews ( n = 24) and focus group discussions ( n = 12) with implementers and community members, and non-participant observation of vaccinations ( n = 172 h). We documented time spent by dog owners attending campaigns ( n = 610) and how dogs were handled ( n = 696), and audited how components of the community-based continuous approach were delivered (n= 47). Qualitative data was analyzed thematically, and regression and descriptive statistics used to assess factors affecting delivery. Main findings Factors that facilitated participation in the campaigns included delivering vaccination free of charge, more frequent availability of vaccinations, and co-implementation with communities. Limiting factors were distance to vaccination points, difficulties in handling dogs and vaccination schedules conflicting with local socioeconomic activities. Sub-village level campaigns were more accessible and required less time from dog owners. Interpretation Involving community-based persons facilitated planning and advertising of campaigns. Mass dog vaccination campaigns can achieve and maintain herd immunity if organized at least twice a year and at subvillage levels. Educating vaccinators and communities on dog behavior and handling could improve participation in campaigns.