Knowledge and attitudes in Puerto Rico concerning dengue prevention.

OBJECTIVE: Dengue has been endemic in Puerto Rico for three decades. Multiple educational and community-based efforts have been developed to inform the population about dengue prevention. We undertook this study to understand the community members' knowledge, attitudes, and practices related to dengue prevention and to elicit their ideas for future prevention campaigns. METHODS: A qualitative study based on grounded theory analysis was conducted between February and May of 2001. The study involved a total of 34 participants in four group interviews who had been identified through the Puerto Rico dengue surveillance system. RESULTS: In general, participants had correct knowledge about dengue prevention, but they did not associate the mosquitoes inside their houses with Aedes aegypti. Participants insisted that "neighbors" needed to control larval habitats, and the participants also asked the Government to fumigate. CONCLUSIONS: The patterns of knowledge and opinion that emerged in the discussions can be arranged along an axis going from high levels of correct knowledge to low levels of correct knowledge about dengue and dengue hemorrhagic fever and related practices. There were few participants at either extreme. Three themes explained these patterns: misconceptions about dengue (based on previously delivered information), the "invisibility" of dengue (as compared to other diseases), and responsibility (individual and Government). Four strategies for preventive behaviors were recommended: developing community groups to identify community priorities on prevention, developing volunteer groups to deliver prevention messages, making house visits to demonstrate specific control measures, and conducting a complementary media campaign to support these strategies.

Knowledge and attitudes in Puerto Rico concerning dengue prevention / Conocimientos y actitudes en Puerto Rico en torno a la prevención del dengue

Objective. Dengue has been endemic in Puerto Rico for three decades. Multiple educational and community-based efforts have been developed to inform the population about dengue prevention. We undertook this study to understand the community members' knowledge, attitudes, and practices related to dengue prevention and to elicit their ideas for future prevention campaigns. Methods. A qualitative study based on grounded theory analysis was conducted between February and May of 2001. The study involved a total of 34 participants in four group interviews who had been identified through the Puerto Rico dengue surveillance system. Results. In general, participants had correct knowledge about dengue prevention, but they did not associate the mosquitoes inside their houses with Aedes aegypti. Participants insisted that "neighbors" needed to control larval habitats, and the participants also asked the Government to fumigate. Conclusions. The patterns of knowledge and opinion that emerged in the discussions can be arranged along an axis going from high levels of correct knowledge to low levels of correct knowledge about dengue and dengue hemorrhagic fever and related practices. There were fewparticipants at either extreme. Three themes explained these patterns: misconceptions about dengue (based on previously delivered information), the "invisibility" of dengue (as compared to other diseases), and responsibility (individual and Government). Four strategies for preventive behaviors were recommended: developing community groups to identify community priorities on prevention, developing volunteer groups to deliver prevention messages, making house visits to demonstrate specific control measures, and conducting a complementary media campaign to support these strategies

Objetivo. El dengue ha sido endémico en Puerto Rico durante tres decenios, y varias iniciativas educativas y comunitarias se han puesto en marcha con objeto de informar a la población sobre la prevención de la enfermedad. Realizamos la presente investigación con el fin de entender los conocimientos, actitudes y prácticas de la comunidad en torno a la prevención del dengue y de recoger sus ideas acerca de futuras campañas de prevención. Métodos. Entre febrero y mayo de 2001 se llevó a cabo un estudio cualitativo basado en el método inductivo conocido por "categorización mediante teoría generada" [grounded theory analysis]. El estudio se efectuó con 34 participantes de cuatro entrevistas en grupo, todos ellos identificados mediante el sistema de vigilancia del dengue de Puerto Rico. Resultados. En términos generales, los participantes tenían conocimientos adecuados acerca de la prevención del dengue, pero no asociaban los mosquitos que había dentro de las viviendas con Aedes aegypti. Repetían con insistencia que "el vecino" tenía que controlar los hábitat larvarios, y también le pidieron al Gobierno que fumigara. Conclusiones. Los conocimientos y opiniones que afloraron en las discusiones mostraron ciertos patrones. Colocados a lo largo de un eje, estos revelaron un espectro desde muchos hasta muy pocos conocimientos que fuesen acertados acerca del dengue, la fiebre hemorrágica del dengue y las prácticas que deben observarse en conexión con estas afecciones. Hubo pocos participantes en un extremo u otro del espectro. Tres temas explicaron los patrones observados: ideas equivocadas en torno al dengue (basadas en información impartida anteriormente), la "invisibilidad" del dengue (por comparación con otras enfermedades), y la responsabilidad (individual y del Gobierno). Se recomendaron cuatro estrategias encaminadas a fomentar conductas de tipo preventivo: crear grupos comunitarios que identificaran las prioridades de la comunidad en materia de prevención; formar grupos de voluntarios que impartieran mensajes con fines preventivos; hacer visitas domiciliarias para demostrar ciertas medidas de control, y llevar a cabo una campaña de publicidad complementaria orientada a reforzar estas estrategias