The risk of occupational anaphylaxis in beekeepers: an educational public health intervention

Beekeepers are at increased risk for anaphylaxis due to frequent honeybee stings. This study developed an educational program for anaphylaxis prevention and an assessment tool to evaluate the knowledge and attitudes of Slovenian beekeepers.

The educational program was developed using the Delphi method with 13 healthcare professionals (9 allergists and 4 registered nurses specialized in allergology). The Beekeepers Anaphylaxis Awareness and Learning Questionnaire (BAALQ) consisted of two distinct components, developed by 12 experts. Content validity for the Recognition and Anaphylaxis Action Scale (RAAS) was confirmed by 59 healthcare professionals. Criterion and construct validity were assessed with 143 beekeepers without a history of anaphylaxis, using a nominal scale for measuring knowledge and a 5-point Likert scale for evaluating Socio-Cultural Learning Attitudes Scale (SCLAS). Knowledge differences among beekeepers before and after the educational intervention were evaluated using the Wilcoxon test. Cronbach's Alpha coefficient was used to assess internal consistency of the instrument.

The RAAS included 26 statements. Kendall's W was 0.799 (95% CI: 0.718-0.866, x ² = 359, p < 0.001), indicating strong expert agreement, while Cronbach's alpha was 0.798 (95% CI: 0.756-0.840). To further assess internal consistency, the Split-half method showed a Pearson correlation of 0.733, with a Spearman-Brown correction value of 0.846, confirming the instrument's good reliability. The Wilcoxon test showed a significant increase in knowledge (Z = -10.078; p < 0.001), with Mdn scores rising from 18 to 25. The SCLAS included 15 statements. Kendall's W was 0.714 (95% CI: 0.600-0.814, x ² = 289, p < 0.001). Confirmatory Factor Analysis confirmed three factors: "Self-confidence," "Importance of knowledge and education," and "Influence of gender and age." The model fit well (RMSEA = 0.0618, CFI = 0.925, TLI = 0.911), with Cronbach's alpha of 0.717 (95% CI: 0.683-0.751).

The developed educational program is effective in improving beekeepers' knowledge of recognizing and responding to anaphylaxis. The assessment tool shows strong validity and reliability and supports its use in future educational and research contexts.