Is participation contagious? Evidence from a household vector control campaign in urban Peru.
OBJECTIVE
High rates of household participation are critical to the success of door-to-door vector control campaigns. We used the Health Belief Model to assess determinants of participation, including neighbour participation as a cue to action, in a Chagas disease vector control campaign in Peru.


METHODS
We evaluated clustering of participation among neighbours; estimated participation as a function of household infestation status, neighbourhood type and number of participating neighbours; and described the reported reasons for refusal to participate in a district of 2911 households.


RESULTS
We observed significant clustering of participation along city blocks (p<0.0001). Participation was significantly higher for households in new versus established neighbourhoods, for infested households, and for households with more participating neighbours. The effect of neighbour participation was greater in new neighbourhoods.


CONCLUSIONS
Results support a 'contagion' model of participation, highlighting the possibility that one or two participating households can tip a block towards full participation. Future campaigns can leverage these findings by making participation more visible, by addressing stigma associated with spraying, and by employing group incentives to spray.
University of Pennsylvania School of Nursing, Family and Community Health, , Philadelphia, Pennsylvania, USA.
Alison M
AM
Buttenheim
Valerie
V
Paz-Soldan
Corentin
C
Barbu
Christine
C
Skovira
Javier
J
Quintanilla Calderón
Lina Margot
LM
Mollesaca Riveros
Juan Oswaldo
JO
Cornejo
Dylan S
DS
Small
Christina
C
Bicchieri
Cesar
C
Naquira
Michael Z
MZ
Levy
D000818:Animals; D014355:Chagas Disease / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D003140:Communicable Disease Control; D003256:Community Participation / Q000379:methods / Q000706:statistics & numerical data*; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D007300:Insect Control / Q000191:economics / Q000379:methods*; D007398:Interpersonal Relations; D016015:Logistic Models; D010568:Peru / Q000453:epidemiology; D011204:Poverty Areas; D045808:Refusal to Participate / Q000706:statistics & numerical data*; D012111:Residence Characteristics / Q000145:classification; D014330:Tropical Medicine; D014349:Trypanosoma cruzi / Q000302:isolation & purification; D014505:Urban Population
Communicable Diseases; Control of DIseases; Developing Countr; Epidemiology; Tropical Health