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. 2025 Aug 19;25(1):2850.
doi: 10.1186/s12889-025-23755-4.

Using the Community Perception Tracker (CPT) to inform COVID-19 response in Lebanon and Zimbabwe: a qualitative methods evaluation

Fiona Majorin #  1 , Anika Jain #  2 , Christine Haddad  3 , Eddington Zinyandu  4 , Ghassan Gharzeddine  3 , Mutsawashe Chitando  4 , Aline Maalouf  3 , Ntandoyenkosi Sithole  4 , Rita Doumit  5 , Raissa Azzalini  6 , Thomas Heath  7 , Janet Seeley  8 , Sian White  9
Affiliations

Using the Community Perception Tracker (CPT) to inform COVID-19 response in Lebanon and Zimbabwe: a qualitative methods evaluation

Fiona Majorin et al. BMC Public Health. .

Abstract

Background: Despite the recognized importance of community engagement during disease outbreaks, methods describing how to operationalise engagement are lacking. The Community Perception Tracker (CPT) was designed by Oxfam to systematically record real-time information on disease perceptions and outbreak response actions in order to adapt programmes.

Methods: We conducted a phased, qualitative methods, process evaluation in Zimbabwe and Lebanon to understand whether the CPT approach was a feasible way to incorporate community perceptions into COVID-19 response programming and whether this resulted in more relevant programming. We conducted 3 rounds of interviews with 15 staff using the CPT, analysed programmatic data, and conducted multiple rounds of phone-based interviews with outbreak-affected populations (41 to 50 participants per country each round). Qualitative data were thematically analysed and quantitative data descriptively summarized.

Results: Initially CPT implementing staff struggled to differentiate how the CPT differed from other monitoring tools that they were familiar with and felt that the training did not convey the full process and its value. However, with practise, collaboration and iterative improvements to the recommended CPT steps, staff found the process to be feasible and a significant value-add to their programming. Staff initially focused more on quantitively summarizing perceptions but eventually developed processes for maximizing the qualitative data on perceptions too. Trends emerging from the CPT led to frequent programmatic tweaks to COVID-19 messaging and product distributions. Emergent trends in perceptions also led staff to work cross-sectorally and advocate to other actors on behalf of populations. Outbreak-affected populations exposed to the programmes reported high levels of knowledge about COVID-19 and reported they practiced preventative behaviours, although this waned with time. Most population members also felt the COVID-19 programmes were relevant to their needs and said that non-government organisations were a trusted source of information.

Conclusions: The CPT appears to be a promising approach for ensuring that community engagement is undertaken systematically and that community perspectives are actively incorporated to improve programming. While crisis-affected populations generally found the programmes to be useful and relevant and to have influenced their knowledge and behaviours, it is not possible to attribute this to the CPT approach due to the study design.

Keywords: COVID-19; Community engagement; Lebanon; Perceptions; Process evaluation; Zimbabwe.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Ethical approval was obtained from the London School of Hygiene and Tropical Medicine ethics committee (22586), the Lebanese American University (LAU.SON.RD2.15/Dec/2020) and the Medical Research Council of Zimbabwe (MRCZ/A/2652). All methods were carried out in accordance with relevant guidelines and regulations. Participation in the study was voluntary, and all participants were only enrolled after receiving complete details of the study in their local language and providing informed verbal consent (for phone-based interviews with population members) or informed written consent (for staff interviews). Verbal consent was approved by the ethics committees (LSHTM, LAU and MRCZ) for the phone-based interviews with population members as it was conducted remotely and written consent was not feasible. Verbal consent was recorded on a consent form, filled in by the data collector. Consent for publication: Not Applicable. Competing interests: RA and TH worked within Oxfam and Action Against Hunger respectively and were involved in aspects of the training on the CPT and its implementation. All other authors declare no competing interests.

Figures

Fig. 1
Fig. 1
The Community Engagement Continuum (18)
Fig. 2
Fig. 2
Visualization of the pandemic during the CPT implementation period in Zimbabwe including the epidemic curve [31], national COVID-19 policy milestones and the periods of data collection for this study
Fig. 3
Fig. 3
Visualization of the pandemic in Lebanon during the CPT implementation period including the Epidemic curve [31], national COVID-19 policy milestones and the periods of data collection for this study
Fig. 4
Fig. 4
Hypothesized theory of change used to inform the study design
Fig. 5
Fig. 5
Revised theory of change for the community perception tracker based on findings
See this image and copyright information in PMC

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