Community Resilience and Health Education as Mediators of Epidemic Preparedness in South South Nigeria: A Multilevel Analysis

Epidemic preparedness in South South Nigeria is shaped by community resilience factors and health education exposure, yet the mechanisms through which these variables interact to influence preparedness outcomes remain theoretically underdeveloped. This study examined community resilience and health education as mediators of epidemic preparedness in South South Nigeria through a multilevel analysis. A concurrent mixed methods design was employed, with a structured survey administered to 420 community members from 35 communities across Rivers, Delta, and Bayelsa states. Multilevel mediation analysis with Bayesian estimation was applied to survey data, with 28 in-depth interviews and 6 community focus group discussions providing explanatory depth. Results showed that community resilience (standardised indirect effect 0.28, 95 percent credible interval 0.19 to 0.38) and health education exposure (0.31, 0.22 to 0.41) significantly mediated the relationship between community social capital and epidemic preparedness. Communities with high social cohesion and active health education platforms demonstrated faster epidemic response activation and higher compliance with preventive guidelines during a recent disease outbreak simulation. The study advances an original Community Resilience-Health Education Preparedness Model and recommends its adoption as a guiding framework for epidemic preparedness health education planning in South South Nigeria. Keywords: community resilience, health education, epidemic preparedness, South South Nigeria, multilevel analysis