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Impact of a behaviour change intervention on long-lasting insecticidal net care and repair behaviour and net condition in Nasarawa State, Nigeria.

Koenker H, Kilian A, Hunter G, Acosta A, Scandurra L, Fagbemi B, Onyefunafoa EO, Fotheringham M, Lynch M - Malar. J. (2015)

Bottom Line: All campaign nets were 100-denier polyester, long-lasting insecticidal nets (LLIN).Estimated median net lifespan was approximately one full year longer for nets in households with a positive compared to a negative attitude.It is possible for BCC interventions to change both attitudes and behaviours, and to have an important effect on overall median net lifespan.

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins Bloomberg School of Public Health Center for Communication Programs, Baltimore, MD, USA. hkoenker@jhu.edu.

ABSTRACT

Background: While some data on net durability have been accumulating in recent years, including formative qualitative research on attitudes towards net care and repair, no data are available on how the durability of a net is influenced by behaviour of net maintenance, care and repair, and whether behavioural change interventions (BCC) could substantially impact on the average useful life of the net.

Methods: The study used an intervention-control design with before-after assessment through repeated cross-sectional household surveys with two-stage cluster sampling following Nasarawa State's December 2010 mass campaign. All campaign nets were 100-denier polyester, long-lasting insecticidal nets (LLIN). Baseline, midline, and endline surveys occurred at one-year intervals, in March 2012, March 2013, and April 2014, respectively. Outcome measures were the proportion of confirmed campaign nets with observed repairs, and the proportion in serviceable condition, measured with proportionate hole index (pHI) and according to WHO guidelines.

Results: For all respondents, exposure to BCC messages was strongly correlated with increased positive attitude towards care and repair, and increases in attitude were positively correlated with observed net repairs, and with the proportion of nets in serviceable condition. In a multivariate regression model, positive care and repair attitude (OR 6.17 p = 0.001) and level of exposure (1 source: OR 4.00 p = 0.000; 3 sources: OR 9.34 p = 0.000) remained the most significant predictors of net condition, controlling for background and environmental factors. Nets that were tied up had 2.70 higher odds of being in serviceable condition (p = 0.001), while repairs made to nets were not sufficient to improve their pHI category. Estimated median net lifespan was approximately one full year longer for nets in households with a positive compared to a negative attitude.

Conclusion: Exposure to multiple channels of a comprehensive BCC intervention was associated with improved attitude scores, and with improved net condition at endline. It is possible for BCC interventions to change both attitudes and behaviours, and to have an important effect on overall median net lifespan. Care and repair messages are easily incorporated into existing malaria BCC platforms, and will help contribute to improved net condition, providing, in principle, more protection from malaria.

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Related in: MedlinePlus

Sources of messages in each study site (endline only).
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Fig3: Sources of messages in each study site (endline only).

Mentions: The BCC intervention was targeted only in Kokona LGA, where there was significant recall of care and repair messages, with 72.7% of respondents reporting hearing any care and repair message in the last six months. However, exposure to messages was also relatively high in the control LGA (Toto), at 46.8% (Table 4). Figure 3 shows the sources of messages in each LGA. As expected, radio, community health worker (CHW), community event and health workers were the main sources of exposure in the intervention area. In the control area, radio (29.1%) and health workers (15.5%) were the primary sources of exposure, indicating that indeed the boost in signal strength of NBS resulted in care and repair messages reaching the control LGA. Health workers in the control LGA were not trained in care and repair messages, but may have advised patients on this spontaneously, or possibly because they had been exposed to the campaign themselves. Community leaders and faith leaders were the least cited sources of care and repair information, and family members were a small but equally prevalent source in both areas.Table 4


Impact of a behaviour change intervention on long-lasting insecticidal net care and repair behaviour and net condition in Nasarawa State, Nigeria.

Koenker H, Kilian A, Hunter G, Acosta A, Scandurra L, Fagbemi B, Onyefunafoa EO, Fotheringham M, Lynch M - Malar. J. (2015)

Sources of messages in each study site (endline only).
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4308907&req=5

Fig3: Sources of messages in each study site (endline only).
Mentions: The BCC intervention was targeted only in Kokona LGA, where there was significant recall of care and repair messages, with 72.7% of respondents reporting hearing any care and repair message in the last six months. However, exposure to messages was also relatively high in the control LGA (Toto), at 46.8% (Table 4). Figure 3 shows the sources of messages in each LGA. As expected, radio, community health worker (CHW), community event and health workers were the main sources of exposure in the intervention area. In the control area, radio (29.1%) and health workers (15.5%) were the primary sources of exposure, indicating that indeed the boost in signal strength of NBS resulted in care and repair messages reaching the control LGA. Health workers in the control LGA were not trained in care and repair messages, but may have advised patients on this spontaneously, or possibly because they had been exposed to the campaign themselves. Community leaders and faith leaders were the least cited sources of care and repair information, and family members were a small but equally prevalent source in both areas.Table 4

Bottom Line: All campaign nets were 100-denier polyester, long-lasting insecticidal nets (LLIN).Estimated median net lifespan was approximately one full year longer for nets in households with a positive compared to a negative attitude.It is possible for BCC interventions to change both attitudes and behaviours, and to have an important effect on overall median net lifespan.

View Article: PubMed Central - PubMed

Affiliation: Johns Hopkins Bloomberg School of Public Health Center for Communication Programs, Baltimore, MD, USA. hkoenker@jhu.edu.

ABSTRACT

Background: While some data on net durability have been accumulating in recent years, including formative qualitative research on attitudes towards net care and repair, no data are available on how the durability of a net is influenced by behaviour of net maintenance, care and repair, and whether behavioural change interventions (BCC) could substantially impact on the average useful life of the net.

Methods: The study used an intervention-control design with before-after assessment through repeated cross-sectional household surveys with two-stage cluster sampling following Nasarawa State's December 2010 mass campaign. All campaign nets were 100-denier polyester, long-lasting insecticidal nets (LLIN). Baseline, midline, and endline surveys occurred at one-year intervals, in March 2012, March 2013, and April 2014, respectively. Outcome measures were the proportion of confirmed campaign nets with observed repairs, and the proportion in serviceable condition, measured with proportionate hole index (pHI) and according to WHO guidelines.

Results: For all respondents, exposure to BCC messages was strongly correlated with increased positive attitude towards care and repair, and increases in attitude were positively correlated with observed net repairs, and with the proportion of nets in serviceable condition. In a multivariate regression model, positive care and repair attitude (OR 6.17 p = 0.001) and level of exposure (1 source: OR 4.00 p = 0.000; 3 sources: OR 9.34 p = 0.000) remained the most significant predictors of net condition, controlling for background and environmental factors. Nets that were tied up had 2.70 higher odds of being in serviceable condition (p = 0.001), while repairs made to nets were not sufficient to improve their pHI category. Estimated median net lifespan was approximately one full year longer for nets in households with a positive compared to a negative attitude.

Conclusion: Exposure to multiple channels of a comprehensive BCC intervention was associated with improved attitude scores, and with improved net condition at endline. It is possible for BCC interventions to change both attitudes and behaviours, and to have an important effect on overall median net lifespan. Care and repair messages are easily incorporated into existing malaria BCC platforms, and will help contribute to improved net condition, providing, in principle, more protection from malaria.

Show MeSH
Related in: MedlinePlus