Understanding health behaviour changes in response to outbreaks: Findings from a longitudinal study of a large epidemic of mosquito-borne disease. (June 2019)

• Record Type: Journal Article
• Authors: Raude, Jocelyn; MCColl, Kathleen; Flamand, Claude; Apostolidis, Themis
• Is Part Of: Social science & medicine. Volume 230(2019)
• Page Start: 184
• Page End: 193
• Publication Date: 2019-06
• Subjects: Behaviour change -- Epidemics -- Risk perception -- Risk habituation -- Elasticity-prevalence -- Mosquito-borne diseases; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2019.04.009
• Languages: English
• ISSNs: 0277-9536

Abstract

Abstract: Rationale: Although greater attention has been recently given to the ecological determinants of health behaviours, we still do not know much about the behavioural changes induced by the spread of infectiousdiseases. Objective: In this study, we took advantage of a large epidemic of chikungunya, an emerging mosquito-borne disease, in French Guiana to examine the dynamic interaction between risk-related perceptions and behaviours that occurs in response to a disease outbreak. In particular, we tested empirically the assumption that both risk perceptions and health behaviours were elastic with respect to prevalence of chikungunya. Methods: A representative sample of French Guianan (N=434) was interviewed in January 2015 just after the peak of the epidemic, and again 2 months later. Participants were asked about their perceptions of the threat, as well as their engagement in a range of protective behaviours promoted by the regional health authorities to control the spread of the disease. Results: The surveys showed that (1) the frequency of some health behaviours - those related to visible control methods - significantly increased with the subjective and objective prevalence of the disease, (2) perceived risk of infection for oneself tended to decrease considerably over time, and (3) the risk reappraisal hypothesis failed to account for this paradoxical trend in the people's response to the risk of contracting the disease. Conclusion: These findings suggest that people may fail to adjust their risk perceptions, and to a lesser extent their health protective behaviours, to the course of an epidemic. Notably, the prevalence elasticity of preventive action found in previous studies of behavioural response to infectious diseases differed substantially according to the type of intervention (personal versus environmental methods). This paradoxical trend may be attributed to risk habituation effects, which seem to vary significantly according to the social visibility of thepreventive actions. Highlights: Personal perceived infection risk decreased as the chikungunya epidemic progressed. Health protective behaviours relatively unchanged as chikungunya epidemic evolves. Only visible protective behaviours increase with subjective and objective prevalence. Risk habituation not risk reappraisal explain paradoxical response to health threat.