title: Evaluating public housing residents for knowledge, attitudes, and practices following dengue prevention outreach in Key West, Florida.
abstract: BACKGROUND
  In 2009-2010, 93 cases of dengue were identified in Key West, Florida. This was the first outbreak of autochthonous transmission of dengue in Florida since 1934. In response to this outbreak, a multifaceted public education outreach campaign was launched. The aim of this study is to compare dengue prevention knowledge, attitudes, perceptions, and prevention practices among residents of subsidized public housing to the general population in Key West and to assess whether there were barriers preventing effective outreach from reaching specific vulnerable populations.
  
  
  METHODS
  A randomized population-based evaluation of knowledge, attitudes, and behaviors toward dengue prevention consisting of 521 separate household interviews was undertaken in July of 2011. A subset analysis was performed on interviews collected from 28 public housing units within four subsidized public housing complexes. Analysis was performed to determine whether knowledge, attitudes, and behaviors exhibited by public housing residents differed from the non-public housing study population.
  
  
  RESULTS
  Public housing residents recalled fewer outreach materials (p=0.01) and were 3.4 times (95% confidence interval [CI] 1.4-8.3) more likely not to recall any outreach materials. Public housing residents were less likely to correctly identify how dengue transmission occurs (61% vs. 89%), where mosquitoes lay their eggs (54% vs. 85%), or to identify any signs or symptoms related to dengue (36% vs. 64%). Public housing residents were less likely to perform dengue prevention practices such as removing standing water or always using air conditioning.
  
  
  CONCLUSIONS
  Examination of public housing residents identified an at-risk population that recalled less exposure to outreach materials and had less knowledge about dengue infection and prevention than the randomized study population. This provides public health systems the opportunity to target or modify future health messages and interventions to this group. Differences identified in the demographics of this population suggest that alternative methods or non-English materials may be required to reach desired outcomes.
authors.affiliation: 1 Florida Department of Health , Tallahassee, Florida.
authors.forename: James
authors.initials: J
authors.lastname: Matthias
authors.forename: Emily C
authors.initials: EC
authors.lastname: Zielinski-Gutierrez
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Tisch
authors.forename: Danielle
authors.initials: D
authors.lastname: Stanek
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Blanton
authors.forename: Michael S
authors.initials: MS
authors.lastname: Doyle
authors.forename: Robert B
authors.initials: RB
authors.lastname: Eadie
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Gazdick
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Leal
authors.forename: Kimberly J
authors.initials: KJ
authors.lastname: Pattison
authors.forename: Carmen L
authors.initials: CL
authors.lastname: Perez-Guerra
authors.forename: Christopher J
authors.initials: CJ
authors.lastname: Tittel
authors.forename: Jooi
authors.initials: J
authors.lastname: Vyas
authors.forename: Todd
authors.initials: T
authors.lastname: Wagner
authors.forename: Carina G M
authors.initials: CG
authors.lastname: Blackmore
mesh_terms: D003710:Demography; D003715:Dengue / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D004196:Disease Outbreaks; D005260:Female; D005431:Florida / Q000453:epidemiology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D011638:Public Housing; D011795:Surveys and Questionnaires
keywords: Dengue; Health education; Key West; Outreach; Public housing