A Nominal Group Technique Consolidated Consensus for Developing Mobile Application Content on Leptospirosis

The nominal group technique (NGT) was used to identify and prioritise the constructs and items for developing mobile application content to improve wet market workers' knowledge, attitudes and practices regarding leptospirosis.A hybrid-platform 3-hour NGT session was conducted, where seven experts (epidemiology, health informatics, environmental health) prioritised 18 constructs and 50 items to develop the content.The hybrid session involved five experts who participated in person, while two experts participated remotely via the Google Meet platform.The NGT consisted of four structured steps: (i) the experts independently and silently documented their responses to a stimulus question; (ii) each expert contributed an idea when asked a question, and the response was recorded; (iii) the experts discussed each idea to clarify its meaning and identified the most critical ideas; and (iv) the experts ranked their preferences (optional), voted on the ideas, and discussed the voting pattern.The experts' recommendations identified four key constructs and 10 essential items which aligned with health belief model (HBM) components.Construct 1 is essential to establish fundamental information and awareness regarding leptospirosis and addresses the perceived severity and susceptibility HBM components.Construct 2 aligns with perceived risk and self-efficacy and focuses on the direct and indirect transmission routes and fosters awareness of how routine behaviors may increase infection risk.Construct 3 emphasises the importance of using personal protective equipment when handling potentially contaminated materials.Construct 4 lists public and private health facilities and addresses perceived barriers by simplifying the medical care-seeking process.This study identified and prioritised mobile application content for leptospirosis prevention based on experts' opinions to ensure comprehensive, relevant and user-appropriate information.Keywords: Leptospirosis; mobile application content; nominal group technique that leptospirosis affects more than 500,000 people annually worldwide.Leptospirosis spreads rapidly, especially after a heavy rainy season or flooding.Most North and South American countries have recorded cases, where leptospirosis outbreaks were reported in Brazil, Guyana, Nicaragua and other Latin American countries.Severe symptoms and high mortality exceeding 10% have been observed in most complex cases.The exact number of human cases is unknown due to underdiagnosis or misdiagnosis, and flare-ups may be associated with tropical cyclones and floods [Pan American Health Organisation (PAHO) n.d.].Malaysia is prone to leptospirosis endemicity given its geographic proximity to the equator and the significant rainfall in the region, especially during the monsoon season.Local data has stated that there were 30.2 leptospirosis cases per 100,000 people in 2015, a significant increase from 1.03 cases per 100,000 people in 2004.Furthermore, the age-standardised incidence rate