title: Impact of a dengue outbreak experience in the preventive perceptions of the community from a temperate region: Madeira Island, Portugal.
abstract: The ability to effectively modify behaviours is increasingly relevant to attain and maintain a good health status. Current behaviour-change models and theories present two main approaches for (healthier) decision-making: one analytical/logical, and one experiential/emotional/intuitive. Therefore, to achieve an integral and dynamic understanding of the public perceptions both approaches should be considered: community surveys should measure cognitive understanding of health-risk contexts, and also explore how past experiences affect this understanding. In 2011, community perceptions regarding domestic source reduction were assessed in Madeira Island͘. After Madeira's first dengue outbreak (2012) a unique opportunity to compare perceptions before and after the outbreak-experience occurred. This was the aim of this study, which constituted the first report on the effect of an outbreak experience on community perceptions regarding a specific vector-borne disease. A cross-sectional survey was performed within female residents at the most aegypti-infested areas. Perceptions regarding domestic source reduction were assessed according to the Essential Perception (EP)-analysis tool. A matching process paired individuals from studies performed before and after the outbreak, ensuring homogeneity in six determinant variables. After the outbreak, there were more female residents who assimilated the concepts considered to be essential to understand the proposed behaviour. Nevertheless, no significant difference was observed in the number of female residents who achieved the defined 'minimal understanding''. Moreover, most of the population (95.5%) still believed at least in one of the identified myths. After the outbreak some myths disappeared and others appeared. The present study quantified and explored how the experience of an outbreak influenced the perception regarding a dengue-preventive behaviour. The outbreak experience surprisingly led to the appearance of new myths within the population, apart from the expected increase of relevant concepts' assimilation. Monitoring public perceptions is therefore crucial to make preventing dengue campaigns updated and worthy.
authors.affiliation: GABBA Doctoral Program, ICBAS, Abel Salazar Institute for the Biomedical Sciences, University of Porto, Porto, Portugal; Unidade Clínica Tropical, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal; Unidade de Parasitologia Médica, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal.
authors.forename: Teresa
authors.initials: T
authors.lastname: Nazareth
authors.affiliation: Unidade de Parasitologia Médica, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal; Unidade de Parasitologia e Microbiologia Médica, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal.
authors.forename: Carla Alexandra
authors.initials: CA
authors.lastname: Sousa
authors.affiliation: GABBA Doctoral Program, ICBAS, Abel Salazar Institute for the Biomedical Sciences, University of Porto, Porto, Portugal; Basic & Clinical Research on Iron Biology, IBMC, Institute for Molecular and Cellular Biology, Porto, Portugal.
authors.forename: Graça
authors.initials: G
authors.lastname: Porto
authors.affiliation: Unidade de Saúde Pública e Internacional e Bioestatística, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal; Centro de Estatística e Aplicações da Universidade de Lisboa (CEAUL), Lisboa, Portugal.
authors.forename: Luzia
authors.initials: L
authors.lastname: Gonçalves
authors.affiliation: Unidade de Parasitologia Médica, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal.
authors.forename: Gonçalo
authors.initials: G
authors.lastname: Seixas
authors.affiliation: DROTA-Direção de Serviços de Informação Geográfica e Cadastro, Direção Regional de Ordenamento de Território e Ambiente, Funchal, Região Autónoma da Madeira, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Antunes
authors.affiliation: Departamento de Saúde, Planeamento e Administração Geral, Instituto de Administração da Saúde e Assuntos Sociais, Funchal, Região Autónoma da Madeira, Portugal.
authors.forename: Ana Clara
authors.initials: AC
authors.lastname: Silva
authors.affiliation: Unidade Clínica Tropical, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal; Centro de Malária e Doenças Tropicais, Instituto de Higiene e Medicina Tropical, Universidade Nova de Lisboa, Lisboa, Portugal.
authors.forename: Rosa
authors.initials: R
authors.lastname: Teodósio
mesh_terms: D003430:Cross-Sectional Studies; D003625:Data Collection; D003715:Dengue / Q000453:epidemiology / Q000517:prevention & control*; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D010465:Perception; D011174:Portugal / Q000453:epidemiology