Determinants of intended prevention behaviour against mosquitoes and mosquito-borne viruses in the Netherlands and Spain using the MosquitoWise survey: cross-sectional study

Abstract

Background: Recently, Europe has seen an emergence of mosquito-borne viruses (MBVs). Understanding citizens' perceptions of and behaviours towards mosquitoes and MBVs is crucial to reduce disease risk. We investigated and compared perceptions, knowledge, and determinants of citizens' behavioural intentions related to mosquitoes and MBVs in the Netherlands and Spain, to help improve public health interventions.

Methods: Using the validated MosquitoWise survey, data was collected through participant panels in Spain (N = 475) and the Netherlands (N = 438). Health Belief Model scores measuring behavioural intent, knowledge, and information scores were calculated. Confidence Interval-Based Estimation of Relevance was used, together with potential for change indexes, to identify promising determinants for improving prevention measure use.

Results: Spanish participants' responses showed slightly higher intent to use prevention measures compared to those of Dutch participants (29.1 and 28.2, respectively, p 0.03). Most participants in Spain (92.2%) and the Netherlands (91.8%) indicated they used at least one prevention measure, but differences were observed in which types they used. More Spanish participants indicated to have received information on mosquitoes and MBVs compared to Dutch participants. Spanish participants preferred health professional information sources, while Dutch participants favoured government websites. Determinants for intent to use prevention measures included "Knowledge", "Reminders to Use Prevention Measures", and "Information" in the Netherlands and Spain. Determinants for repellent use included "Perceived Benefits" and "Cues to Action", with "Perceived Benefits" having a high potential for behavioural change in both countries. "Self-Efficacy" and "Knowledge" were determinants in both countries for breeding site removal.

Conclusion: This study found differences in knowledge between the Netherlands and Spain but similarities in determinants for intent to use prevention measures, intent to use repellents and intent to remove mosquito breeding sites. Identified determinants can be the focus for future public health interventions to reduce MBV risks.

Keywords: Confidence Interval Based Estimation of Relevance Analysis; Health Belief Model; Knowledge; Mosquito-borne viruses; Prevention and control; Social Determinants of Health; Surveys and Questionnaires; Vector-Borne Diseases.

Fig. 1

CIBER plots of the determinants for intent to use prevention measures (HBM scores) for A participants in the Netherlands and B those in Spain. In the leftmost panels, red diamonds indicate low means, green diamonds show high means, and blue diamonds illustrate middle means. The dots surrounding the diamonds in the left panel show participants’ response distribution with jitter to avoid overplotting. In the rightmost panels, the diamond’s colour demonstrates the strength and direction of association. Greener diamonds imply strong positive associations with intent to use interventions redder diamonds show strong negative associations, and greyer diamonds display weak associations. HBM Score Health Belief Model score. CIs Confidence Intervals. R² Confidence interval of explained variance

Fig. 2

binaryCIBER plots of determinants for repellent use in A the Netherlands and B Spain. The leftmost panels have two diamonds: The teal diamonds are for participants that reported “yes” for using a specific prevention measure, and the purple diamonds are for those who said “no”. In the rightmost panels, the diamond’s colour demonstrates the strength and direction of association. Greener diamonds imply strong positive associations, redder diamonds show strong negative associations, and greyer diamonds display weak associations. CIs Confidence Intervals. R² Cox-Snell | Nagelkerke

Fig. 3

binaryCIBER plots of determinants for removing mosquito breeding sites in A the Netherlands and B Spain. The left panel has two diamonds: The teal diamonds are for participants that reported “yes” for using a specific prevention measure, and the purple diamonds are for those who said “no”. In the right panel, the diamond’s colour demonstrates the strength and direction of association. Greener diamonds imply strong positive associations, redder diamonds show strong negative associations, and greyer diamonds display weak associations. CIs Confidence Intervals. R² Cox-Snell | Nagelkerke