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Determinants of intentions to prevent triatomine infestation based on the health belief model: An application in rural Southern Ecuador

Abstract:

Introduction Control of triatomine infestation is a key strategy for the prevention of Chagas disease (CD). To promote this strategy, it is important to know which antecedents to behavioral change are the best to emphasize when promoting prevention. Objective The aim of this study was to determine pbkp_redictors for intention to prevent home infestation based on the Health Belief Model (HBM), a commonly used health intervention planning theory. Materials & methods A cross-sectional study was conducted with 112 heads of household in six communities with endemic and high rates of triatomine infestation in Loja province, Ecuador. The data was collected by a questionnaire including perceived severity, susceptibility, benefits to action, barriers to action, and self-efficacy. These data were also used to pbkp_redict actual infestation of homes. Results Community members reported strong intentions to prevent home infestation. HBM constructs pbkp_redicted about 14% of the observed variance in intentions. Perceived susceptibility and severity did not pbkp_redict behavioral intention well; perceived barriers to small-scale action that reduce likelihood of infestation and self-efficacy in participating in surveillance systems did. Self-efficacy and perception of barriers were equally powerful pbkp_redictors. The HBM constructs, however, did not pbkp_redict well actual infestation. Conclusion The findings supported the HBM as a way to pbkp_redict intentions to prevent infestation of the home by triatomine bugs. The findings highlight that messages emphasizing self-efficacy in participating in surveillance systems and overcoming barriers to small-scale action that reduce likelihood of infestation, rather than a focus on risk, should be central messages when designing and implementing educational interventions for CD. The gap between behavioral intention and actual infestation reveals the need to assess home practices and their actual efficacy to fully enact and apply the HBM.