Abstract
<jats:p>Introduction: The Field Epidemiology Training Program (FETP) was established in The Gambia to strengthen disease surveillance capacity among public health officers. Evidence on its impact on surveillance-related knowledge, attitudes, and practices (KAP) in the country remains limited. This study assessed factors associated with KAP among public health officers, with a particular focus on FETP training. Methods: A cross-sectional survey was conducted among 129 public health officers across four health regions in The Gambia, including FETP-trained (n = 32) and non-trained (n = 97) personnel. Data were collected using a structured electronic questionnaire. Composite KAP scores were calculated as percentages. Bivariate analyses compared characteristics between groups. Multivariate linear regression models identified factors associated with knowledge, attitude, and practice scores. Results: FETP-trained officers were significantly more likely to have ≥6 years of experience (p<0.0001) and be ≥35 years old (p=0.023). Distribution varied significantly by region (p=0.018). Overall mean scores were 83.5% (SD=14.5) for knowledge, 91.6% (SD=11.5) for attitude, and 59.2% (SD=15.3) for practice. FETP training was independently associated with significantly higher knowledge (β=8.24, p<0.001), attitude (β=6.78, p<0.001), and practice scores (β=7.89, p<0.001). Higher education (β=5.67, p=0.009) and work experience (β=4.23, p=0.049) were also associated with knowledge. Practice scores were additionally associated with knowledge (β=2.34, p<0.001), attitude (β=1.89, p=0.002), region, use of surveillance tools (β=4.23, p<0.001), and conducting data analysis (β=8.45, p<0.001). Conclusion: FETP training is a strong, independent predictor of higher KAP scores among public health officers in The Gambia. However, the persistent knowledge-practice gap and regional variations highlight the need for concurrent system-level investments</jats:p>