title: To spray or not to spray? Understanding participation in an indoor residual spray campaign in Arequipa, Peru.
abstract: Current low participation rates in vector control programmes in Arequipa, Peru complicate the control of Chagas disease. Using focus groups (n = 17 participants) and semi-structured interviews (n = 71) conducted in March and May 2013, respectively, we examined barriers to and motivators of household participation in an indoor residual spray (IRS) campaign that had taken place one year prior in Arequipa. The most common reported barriers to participation were inconvenient spray times due to work obligations, not considering the campaign to be necessary, concerns about secondary health impacts (e.g. allergic reactions to insecticides), and difficulties preparing the home for spraying (e.g. moving heavy furniture). There was also a low perception of risk for contracting Chagas disease that might affect participation. The main motivator to participate was to ensure personal health and well-being. Future IRS campaigns should incorporate more flexible hours, including weekends; provide appropriate educational messages to counter concerns about secondary health effects; incorporate peer educators to increase perceived risk to Chagas in community; obtain support from community members and leaders to build community trust and support for the campaign; and assist individuals in preparing their homes. Enhancing community trust in both the need for the campaign and its operations is key.
authors.affiliation: a Department of Global Community Health and Behavioral Sciences , Tulane University School of Public Health and Tropical Medicine , New Orleans , LA , USA.|b Facultad de Salud Pública y Administración , Universidad Peruana Cayetano Heredia , Lima , Perú.
authors.forename: Valerie A
authors.initials: VA
authors.lastname: Paz-Soldán
authors.affiliation: a Department of Global Community Health and Behavioral Sciences , Tulane University School of Public Health and Tropical Medicine , New Orleans , LA , USA.
authors.forename: Karin M
authors.initials: KM
authors.lastname: Bauer
authors.affiliation: c Department of Health, Behavior and Society , Johns Hopkins Bloomberg School of Public Health , Baltimore , MD , USA.
authors.forename: Gabrielle C
authors.initials: GC
authors.lastname: Hunter
authors.affiliation: d Department of Biostatistics and Epidemiology , University of Pennsylvania Perelman School of Medicine , Philadelphia , PA , USA.|e Facultad de Ciencias y Filosofía , Universidad Peruana Cayetano Heredia , Lima , Perú.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Castillo-Neyra
authors.affiliation: f Department of Epidemiology , Tulane University , New Orleans , LA , USA.
authors.forename: Vanessa D
authors.initials: VD
authors.lastname: Arriola
authors.affiliation: d Department of Biostatistics and Epidemiology , University of Pennsylvania Perelman School of Medicine , Philadelphia , PA , USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Rivera-Lanas
authors.affiliation: d Department of Biostatistics and Epidemiology , University of Pennsylvania Perelman School of Medicine , Philadelphia , PA , USA.
authors.forename: Geoffrey H
authors.initials: GH
authors.lastname: Rodriguez
authors.affiliation: f Department of Epidemiology , Tulane University , New Orleans , LA , USA.
authors.forename: Amparo M
authors.initials: AM
authors.lastname: Toledo Vizcarra
authors.affiliation: f Department of Epidemiology , Tulane University , New Orleans , LA , USA.
authors.forename: Lina M
authors.initials: LM
authors.lastname: Mollesaca Riveros
authors.affiliation: d Department of Biostatistics and Epidemiology , University of Pennsylvania Perelman School of Medicine , Philadelphia , PA , USA.|e Facultad de Ciencias y Filosofía , Universidad Peruana Cayetano Heredia , Lima , Perú.
authors.forename: Michael Z
authors.initials: MZ
authors.lastname: Levy
authors.affiliation: g Department of Family and Community Health , University of Pennsylvania School of Nursing , Philadelphia , PA , USA.|h Center for Health Incentives and Behavioral Economics , University of Pennsylvania , Philadelphia , PA , USA.
authors.forename: Alison M
authors.initials: AM
authors.lastname: Buttenheim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014355:Chagas Disease / Q000517:prevention & control*; D003256:Community Participation / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006798:Housing; D006801:Humans; D007306:Insecticides; D008297:Male; D008875:Middle Aged; D009042:Motivation; D010568:Peru; D036301:Qualitative Research; D018570:Risk Assessment; D055815:Young Adult
chemical_list: D007306:Insecticides
keywords: Chagas disease; IRS; community participation; developing country; vector control