Health awareness videos are integral in disseminating knowledge about respiratory infectious diseases (RIDs). The aim of this study is to produce and evaluate an evidence-based health awareness video on precautionary measures against respiratory infectious diseases among public transportation drivers in Lebanon. You will be asked to watch a newly produced health-awareness video, then we will test your knowledge about respiratory infectious diseases , health-risk perceptions, attitude towards vaccination, and cognitive dissonance. Public transportation drivers are eligible to enroll if they operate within the Lebanese public transportation system, regardless of their gender. A proportionate sample of drivers will be invited to enroll from various Lebanese regions. The experimental group (n=80) will watch a health-awareness video, whereas the control group (n=80) will watch a neutral video on traffic signs. Participants' knowledge about RID, health-risk perceptions, attitude towards vaccination, and cognitive dissonance will be evaluated. The trial study will be conducted in community settings where public transportation drivers are naturally present (transportation stations, parking lots). A written informed consent will be sought. Data will be electronically recorded. Data will remain anonymous during data entry/analyses. An incentive will be provided.

Background: Health awareness videos are integral in disseminating knowledge about respiratory infectious diseases (RIDs), elevating health-risk perceptions, and enhancing attitudes towards precautionary measures, as per the Health Belief Model (HBM) and Cognitive Dissonance Theory (CDT).

Aim: The aim of this study is to produce and evaluate an evidence-based health awareness video on precautionary measures against RID among public transportation drivers in Lebanon.

Methods: This project will be conducted over three stages and executed over two fiscal years (start date March 2026).

Stage one: Drafting the script of the video is inspired by seven published / unpublished evidence-based studies on public transportation drivers in Lebanon and fourteen studies from international literature. This ensures the video content is evidence-based, culturally oriented, socially acceptable and tailored towards the target viewers.

Stage two: Using a Delphi technique, the script will be revised by a panel of eight experts in public health, infection control, psychology, filmmaking, and public transportation using two validated assessment tools, the Patient Education Materials Assessment Tool (PEMAT) and DISCERN. A purposive sampling method will be followed. Once consensus is reached, the video will be produced.

Stage three: Non-blinded, randomized, two-arm controlled trial will be conducted by a group of senior nursing students (minimal risk study). Public transportation drivers are eligible to enroll if they operate within the Lebanese public transportation system, regardless of their gender. A proportionate sample of drivers will be invited to enroll from various Lebanese regions. Simple randomization technique will be performed. The experimental group (n=80) will watch the health-awareness video, whereas the control group (n=80) will watch a neutral video on traffic signs. Participants' knowledge about RID, health-risk perceptions, attitude towards vaccination, and cognitive dissonance will be evaluated. The trial study will be conducted in community settings where public transportation drivers are naturally present (transportation stations, parking lots). A written informed consent will be sought. Data will be electronically recorded. Data will remain anonymous during data entry/analyses. An incentive will be provided.

Data analysis: Data will be analyzed using SPSS; IBM (version 30). Knowledge statements will be scored and converted to percentage mean score. Risk perceptions, attitude and dissonance will be scored and converted to mean scores. Between group analyses of mean differences will be tested using student t-test and one way analysis of variance (ANOVA) with post hoc analysis (for normally distributed data) and Kruskall Wallis test with post hoc analysis (for skewed data). Forward stepwise linear regression analyses will be executed. Statistical significance will be at P<0.05 (two sided). Interim analysis will be performed at n=40.

Expected outcomes: Public transportation drivers and users might be unknowingly exposed to RID, so promoting their safety is a priority. When public transportation drivers are exposed to a video on RID, they will gain knowledge about it and demonstrate a positive attitude towards precautionary measures. This video contributes to higher service satisfaction and subsequently higher utilization of the transportation system. Utilizing the public transportation systems reduces street congestions, controls pollution, saves money for users and generates profits for stakeholders. Promoting a safe public transportation system reflects positively on public health, aligns with the CDC mission to control the global spread of diseases and lessens disease burden. Last but not least, health awareness videos are cost effective and they can reach a wider audience.

Ethical considerations: This study will not pose any risk or harm to participants. The video will not contain any material that might offend, insult, degrade, or discriminate against study participants in any way possible. Medical jargon and complex terms will be avoided. The video will be concluded with contact information in case participants decided to consult with experts in the future. Data collectors will be trained on how to remedy their concerns through cognitive behavioral therapy techniques to resolve negative thoughts, guide them on sources of knowledge and places to obtain facemasks, hand sanitizers and vaccines. Last but not least, participants will not be asked for any ID. The decision to participate or not will have no impact on drivers.

Inclusion Criteria:

• Public transportation drivers who operate within the Lebanese public transportation system, regardless of their nationality or gender.

Exclusion Criteria:

• Commercial drivers (trucks) or others who are not in a daily contact with commuters.
• Drivers who are unwilling to enroll in the study or unable to comprehend written/verbal Arabic language will be excluded.

Sharing of IPD will follow local policies and regulations.