Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

Abstract

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development's (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security.

Keywords: Behavioral risk; Multi-disciplinary surveillance; One health; Social science research.

Fig. 1

PREDICT behavioral risk investigations. Twenty-seven out of PREDICT’s 28 participating countries implemented questionnaires for quantitative analysis; the exception was Mongolia, which focused exclusively on Influenza A surveillance in wild birds. 13 countries conducted qualitative behavioral risk investigations

Fig. 2

Implementation of questionnaires, ethnographic interviews, and focus group discussions (FGDs)

Fig. 3

Supporting the Creation of a Global Behavioral Risk Cadre. Bringing together a transdisciplinary team of scientists and practitioners was central to the human behavioral risk surveillance arm of PREDICT. Representing myriad disciplines, local behavioral risk teams were provided with trainings specifically centered on the foundations needed to successfully conduct behavioral risk investigations

Fig. 4

Bat-specific interfaces investigated by One Health surveillance teams. Several bat-specific interfaces were investigated by PREDICT’s One Health surveillance teams and explored in-depth through our human behavioral risk investigations. Large market value chains were a principal area of interest in relation to all wildlife taxa.

Fig. 5

While human-bat interactions were unique by country and context, key themes ranging from bat hunting to bat-community interfaces were commonly shared among the countries conducting qualitative research. This figure presents cross-country examples of how interviewee’s describe local interaction with wildlife, particularly bats

Fig. 6

Implementation of the Living Safely with Bats resource in West Africa, which provided scripted talking points for moderators. These talking points covered themes such as basic ways to live safely with bats, disposal of dead bats, what to do with them when contact is unavoidable, and managing bats living in and around the home

Fig. 7

Community Engagement in DRC: Sharing Living Safely with Bats with partner communities: Talking points included themes such as bats as essential agents in the local ecosystem