title: Bird harvesting practices and knowledge, risk perceptions, and attitudes regarding avian influenza among Canadian First Nations subsistence hunters: implications for influenza pandemic plans.
abstract: BACKGROUND
  There is concern of avian influenza virus (AIV) infections in humans. Subsistence hunters may be a potential risk group for AIV infections as they frequently come into close contact with wild birds and the aquatic habitats of birds while harvesting. This study aimed to examine if knowledge and risk perception of avian influenza influenced the use of protective measures and attitudes about hunting influenza-infected birds among subsistence hunters.
  
  
  METHODS
  Using a community-based participatory research approach, a cross-sectional survey was conducted with current subsistence hunters (n = 106) residing in a remote and isolated First Nations community in northern Ontario, Canada from November 10-25, 2013. Simple descriptive statistics, cross-tabulations, and analysis of variance (ANOVA) were used to examine the distributions and relationships between variables. Written responses were deductively analyzed.
  
  
  RESULTS
  ANOVA showed that males hunted significantly more birds per year than did females (F1,96 = 12.1; p = 0.001) and that those who hunted significantly more days per year did not perceive a risk of AIV infection (F1,94 = 4.4; p = 0.040). Hunters engaged in bird harvesting practices that could expose them to AIVs, namely by cleaning, plucking, and gutting birds and having direct contact with water. It was reported that 18 (17.0%) hunters wore gloves and 2 (1.9%) hunters wore goggles while processing birds. The majority of hunters washed their hands (n = 105; 99.1%) and sanitized their equipment (n = 69; 65.1%) after processing birds. More than half of the participants reported being aware of avian influenza, while almost one third perceived a risk of AIV infection while harvesting birds. Participants aware of avian influenza were more likely to perceive a risk of AIV infection while harvesting birds. Our results suggest that knowledge positively influenced the use of a recommended protective measure. Regarding attitudes, the frequency of participants who would cease harvesting birds was highest if avian influenza was detected in regional birds (n = 55; 51.9%).
  
  
  CONCLUSIONS
  Our study indicated a need for more education about avian influenza and precautionary behaviours that are culturally-appropriate. First Nations subsistence hunters should be considered an avian influenza risk group and have associated special considerations included in future influenza pandemic plans.
authors.affiliation: Department of Environment and Resource Studies, University of Waterloo, 200 University Avenue West, N2L 3G1 Waterloo, Ontario, Canada. ncharani@uwaterloo.ca.
authors.forename: Nadia A
authors.initials: NA
authors.lastname: Charania
authors.forename: Ian D
authors.initials: ID
authors.lastname: Martin
authors.forename: Eric N
authors.initials: EN
authors.lastname: Liberda
authors.forename: Richard
authors.initials: R
authors.lastname: Meldrum
authors.forename: Leonard J S
authors.initials: LJ
authors.lastname: Tsuji
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D001717:Birds; D055812:Community-Based Participatory Research; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D009980:Influenza A virus / Q000302:isolation & purification; D005585:Influenza in Birds / Q000517:prevention & control*; D004930:Inuit; D008297:Male; D008875:Middle Aged; D009864:Ontario; D058873:Pandemics / Q000517:prevention & control; D015047:Zoonoses / Q000517:prevention & control