title: Association Between Causal Beliefs and Shoe Wearing to Prevent Podoconiosis: A Baseline Study.
abstract: Podoconiosis is a neglected tropical disease caused by long-term barefoot exposure to volcanic clay soil. Our previous qualitative research identified various domains of beliefs about the causes of podoconiosis held by members of the community. This cross-sectional survey, conducted in southern Ethiopia, aimed to quantitatively evaluate the prevalence of these beliefs and to assess their association with observed shoe-wearing behavior. A total of 1,800 adult respondents (600 from affected families and 1,200 from unaffected families of an index child aged between 3 and 6 years) took part in the survey. Two standardized versions of an enumerator-administered survey were created, with "all day, everyday" shoe-wearing status of the index child assessed in parallel for the affected and unaffected household respondents. Associations between measures were assessed using logistic regression. Accuracy of understanding about podoconiosis was significantly lower among respondents from unaffected than affected households (P < 0.001). Among affected respondents, beliefs about heredity were negatively associated with reported shoe wearing of the index child (odds ratio = 0.67, 95% confidence interval = 0.55-0.83). In both groups, associations of causal beliefs with shoe wearing were moderated by risk perceptions. Interventions aimed at preventing podoconiosis and improving shoe wearing should consider family-oriented education on hereditary susceptibility that targets affected and unaffected families in resource-limited settings.
authors.affiliation: College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia; People Designs Inc., Durham, North Carolina; Brighton and Sussex Medical School, Falmer, Brighton, East Sussex, United Kingdom; Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Desta
authors.initials: D
authors.lastname: Ayode
authors.affiliation: College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia; People Designs Inc., Durham, North Carolina; Brighton and Sussex Medical School, Falmer, Brighton, East Sussex, United Kingdom; Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Abebayehu
authors.initials: A
authors.lastname: Tora
authors.affiliation: College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia; People Designs Inc., Durham, North Carolina; Brighton and Sussex Medical School, Falmer, Brighton, East Sussex, United Kingdom; Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: David
authors.initials: D
authors.lastname: Farrell
authors.affiliation: College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia; People Designs Inc., Durham, North Carolina; Brighton and Sussex Medical School, Falmer, Brighton, East Sussex, United Kingdom; Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Getnet
authors.initials: G
authors.lastname: Tadele
authors.affiliation: College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia; People Designs Inc., Durham, North Carolina; Brighton and Sussex Medical School, Falmer, Brighton, East Sussex, United Kingdom; Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia.
authors.forename: Gail
authors.initials: G
authors.lastname: Davey
authors.affiliation: College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia; People Designs Inc., Durham, North Carolina; Brighton and Sussex Medical School, Falmer, Brighton, East Sussex, United Kingdom; Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia cmmcbri@emory.edu.
authors.forename: Colleen M
authors.initials: CM
authors.lastname: McBride
mesh_terms: D000328:Adult; D015984:Causality; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D004604:Elephantiasis / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D005002:Ethiopia / Q000453:epidemiology; D005260:Female; D005534:Foot Diseases / Q000453:epidemiology / Q000209:etiology* / Q000517:prevention & control*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D012775:Shoes