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UBC Theses and Dissertations

Public health responses to West Nile virus : the role of risk perceptions and behavioral uncertainty in risk communication and policy Elmieh, Negar


Emerging and re-emerging infectious diseases provide a challenge to public health in that the frequency, location, duration, and severity of the disease and outbreak are not always readily identifiable. In the absence of such information, the need to understand what drives risk perceptions, risk trade-offs, and heterogeneity in population behaviors becomes important in designing effective and appropriate risk communications, public health messages, and interventions. In this thesis, four studies are described that examine risk perceptions, risk trade-offs, and behavioral uncertainties as they relate to West Nile virus (WNV) prevention and control strategies. In Chapter 2, the health belief model was used to examine the influence of health beliefs and demographics on health behaviors recommended to reduce the risk of WNV. Results showed that health beliefs and subsequent behaviors varied based on the perceived risk and disease context. Respondents were more likely to engage in recommended health behaviors if they received timely information, understood the benefits of a particular behavior, and lived in areas exposed to WNV. Chapter 3 explored behavioral and demographic risk factors associated with risk perceptions of WNV and WNV interventions. Unique associations were found which merit further study to understand the extent of their relationships. In Chapter 4, risk trade-offs of WNV interventions were examined between laypeople and health experts using multi-criteria decision analyses. Laypeople perceived some WNV interventions to be more effective than health experts reported them to be. Health experts were most concerned about the effectiveness of such interventions. This showed that laypeople were more willing to make risk trade-offs given the scenario. In Chapter 5, probabilistic modeling techniques were used to characterize variability and uncertainty in population, environmental, pesticide, and exposure characteristics. By modeling a realistic mosquito abatement campaign, we found that children under 6 are potentially at risk of exposure to malathion levels that exceed standards set by Canadian and US regulatory agencies. Together, these studies highlight the importance of targeted programs and risk communications to specific sub-populations bridging knowledge gaps. Though the findings are specific to WNV, their implications are far-reaching and useful in preparing for other emerging and re-emerging diseases.

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