Assessment of public perspectives and barriers towards dengue preventive practices using the Health Belief Model in Puducherry, India: A cross–sectional study

Abstract

Objective: To assess the perspectives and barriers towards dengue preventive practices among the residents of Puducherry, India. Methods: A cross-sectional survey was conducted in 300 households in Puducherry, using a population-proportionate (7:3) distribution from urban and rural areas by grid sampling. One adult interview per household was conducted and the participants were selected using a KISH grid. A semi-structured questionnaire based on the Health Belief Model (HBM) with additional questions on knowledge assessment was used. Knowledge was assessed based on the correctness of answers and the HBM scores were calculated on a 5-point Likert scale. Participants were categorized based on the median score under each domain. Logistic regression was used for adjusted analysis and models were built to predict the performances in each domain. Results: Four percent of the participants lacked basic knowledge regarding dengue transmission. While 208 (69.3%) participants did not consider themselves at risk of contracting dengue within the next year, majority perceived dengue as a disease with low severity. Around 49.3% (148) were skeptical about the benefit of time and money spent on dengue prevention. Inadequate government efforts were stated as the major barrier (47.0%) and frequent reminders (142, 47.3%) as the major cue to action. Age above 50 years (aOR 1.78, 95% CI 1.04-3.06, P=0.037)) and rural locality (aOR 2.68, 95% CI 1.52-4.71, P=0.001) were found to be significantly associated with poor knowledge scores. Urban participants had a significantly higher chance to perceive low susceptibility as compared to the rural counterparts (aOR 1.74, 95% CI 1.05-2.9, P=0.03). Participants with less than a high school education had low perceived benefits (aOR 2.46, 95% CI 1.52-3.96, P<0.001) and low self-efficacy scores (aOR 2.66, 95% CI 1.61-4.39, P<0.001). Conclusions: This study identifies key gaps in dengue prevention, including low perceived susceptibility, mild disease perception, limited knowledge of breeding sites, and overreliance on government efforts. Tailoring interventions to community needs, stratified to factors influencing the community perspectives can significantly improve dengue prevention efforts.

Keywords

• dengue
• public perspectives
• prevention
• barriers
• health belief model