Online Program

Motivators and barriers concerning Chagas disease indoor residual spraying campaigns in Arequipa, Peru

Tuesday, November 3, 2015 : 4:30 p.m. - 4:45 p.m.

Alison M. Buttenheim, PhD, MBA, Center for Health Incentives and Behavioral Economics, Leonard Davis Institute, University of Pennsylvania, Philadelphia, PA
Valerie Paz-Soldan, PhD, Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, Lima, Peru
Michael Z. Levy, PhD, Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA
Molly McGuire, MPH, Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA
Simple household hygiene coupled with periodic indoor residual spray campaigns (IRS) can decrease transmission and prevalence of Chagas disease in endemic areas. In recent years, a government-run Chagas disease vector control campaign in Arequipa, Peru has been threatened by declining rates of IRS participation among urban and peri-urban communities. In order to develop strategies to increase participation, a qualitative study was conducted to identify factors related to decreased participation in IRS campaigns. Two focus group discussions (FGD) and 71 semi-structured interviews (SSI) were conducted with individuals who had participated in a first round of IRS, but had declined to participate in a second IRS round. Both FGD and SSI results reveal that most individuals feel that IRS is effective (80.3% in SSI). The most common reported barriers were logistical, such as limited hours of spraying (those who work are not available during spray times), difficulty in moving furniture to allow for effective spraying, campaign staff who arrive later than scheduled, or not being able to open all rooms of the house for the spray if renters have locked their doors. Other barriers included the perception that IRS was not necessary because the house was “clean” or not infested; concerns about health impacts of insecticide on young or elderly households members or those with respiratory conditions; and lack of trust of the campaign personnel. Interventions to improve participation based on these behavioral and attitudinal diagnoses have been designed and are currently being trialed in a pragmatic community-based cluster randomized trial.

Learning Areas:

Assessment of individual and community needs for health education
Planning of health education strategies, interventions, and programs

Learning Objectives:
Describe barriers to households' decisions to participate in indoor residual spray (IRS) campaigns for Chagas disease prevention.

Keyword(s): International Health, Behavioral Research

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: No financial ties exist between myself and the present research. I have consulted on several prior investigations and impact evaluation studies focusing on midwives and micro-finance programs in Indonesia, school feeding schemes in Laos, household sanitation in Bangladesh, and post-disaster relief and recovery programs. My scientific interests also lie in the domestic sphere, having compiled evidence-based evaluation for the Centers for Disease Control Global Tobacco Control Branch on global tobacco surveillance strategies.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.