A framework for capturing the interactions between laypersons' understanding of disease, information gathering behaviors, and actions taken during an epidemic

Abstract

This paper provides a description of a methodological framework designed to capture the inter-relationships between the lay publics' understanding of health-related processes, information gathering behaviors, and actions taken during an outbreak. We developed and refined our methods during a study involving eight participants living in severe acute respiratory syndrome (SARS)-affected areas (Hong Kong, Taiwan, and Toronto). The framework is an adaptation of narrative analysis, a qualitative method that is used to investigate a phenomenon through interpretation of the stories people tell about their experiences. From our work, several hypotheses emerged that will contribute to future research. For example, our findings showed that many decisions in an epidemic are carefully considered and involve use of significant information gathering. Having a good model of lay actions based on information received and beliefs held will contribute to the development of more effective information support systems in the event of a future epidemic.

Fig. 1

Example of coded interactions.

Fig. 2

Example of the initial phase of coding for a segment of interview text. The themes coded are placed in bolded brackets following the text segment coded. The coded segment of text is underlined. A double underline is used to indicate when multiple codes are assigned to a segment of text.

Fig. 3

Example of coded interactions from the Hong Kong participant: Time period 1 (early weeks of the SARS outbreak).

Fig. 4

Example of coded interactions from the Hong Kong participant: Time period 2 (weeks leading up to awareness of SARS as an epidemic in Hong Kong). The trigger leading to increased concern is shown in italic type.

Fig. 5

Example of coded interactions from the Hong Kong participant: Time period 3 (from an increased awareness of SARS as an epidemic to a decision to leave the region). The trigger leading to increased concern is shown in italic type.