Department of Global Public Health, Karolinska Institutet, Tomtebodavägen 18A, 17717, Stockholm, Sweden.
Centers for Disease Control and Prevention, Atlanta, GA, USA.
BMC Public Health. 2020 Oct 12;20(1):1539. doi: 10.1186/s12889-020-09648-8.
Perceived susceptibility to a disease threat (risk perception) can influence protective behaviour. This study aims to determine how exposure to information sources, knowledge and behaviours potentially influenced risk perceptions during the 2014-2015 Ebola Virus Disease outbreak in Sierra Leone.
The study is based on three cross-sectional, national surveys (August 2014, n = 1413; October 2014, n = 2086; December 2014, n = 3540) that measured Ebola-related knowledge, attitudes, and practices in Sierra Leone. Data were pooled and composite variables were created for knowledge, misconceptions and three Ebola-specific behaviours. Risk perception was measured using a Likert-item and dichotomised into 'no risk perception' and 'some risk perception'. Exposure to five information sources was dichotomised into a binary variable for exposed and unexposed. Multilevel logistic regression models were fitted to examine various associations.
Exposure to new media (e.g. internet) and community-level information sources (e.g. religious leaders) were positively associated with expressing risk perception. Ebola-specific knowledge and hand washing were positively associated with expressing risk perception (Adjusted OR [AOR] 1.4, 95% Confidence Interval [CI] 1.2-1.8 and AOR 1.4, 95% CI 1.1-1.7 respectively), whereas misconceptions and avoiding burials were negatively associated with risk perception, (AOR 0.7, 95% CI 0.6-0.8 and AOR 0.8, 95% CI 06-1.0, respectively).
Our results illustrate the complexity of how individuals perceived their Ebola acquisition risk based on the way they received information, what they knew about Ebola, and actions they took to protect themselves. Community-level information sources may help to align the public's perceived risk with their actual epidemiological risk. As part of global health security efforts, increased investments are needed for community-level engagements that allow for two-way communication during health emergencies.
对疾病威胁的感知（风险感知）可以影响保护行为。本研究旨在确定在塞拉利昂 2014-2015 年埃博拉病毒病疫情期间，接触信息来源、知识和行为如何潜在地影响风险感知。
该研究基于三项全国性的横断面调查（2014 年 8 月，n=1413；2014 年 10 月，n=2086；2014 年 12 月，n=3540），这些调查测量了塞拉利昂的埃博拉相关知识、态度和实践。数据汇总后，为知识、误解和三个埃博拉特定行为创建了综合变量。风险感知通过李克特项目进行测量，并分为“无风险感知”和“有风险感知”。接触五种信息来源被分为暴露和未暴露的二进制变量。使用多水平逻辑回归模型来检查各种关联。
接触新媒体（如互联网）和社区级信息来源（如宗教领袖）与表达风险感知呈正相关。埃博拉特定知识和洗手与表达风险感知呈正相关（调整后的比值比 [OR] 1.4，95%置信区间 [CI] 1.2-1.8 和 OR 1.4，95% CI 1.1-1.7），而误解和避免埋葬与风险感知呈负相关（OR 0.7，95% CI 0.6-0.8 和 OR 0.8，95% CI 0.6-1.0）。
我们的结果说明了个体如何根据他们接收信息的方式、他们对埃博拉的了解以及他们采取的保护自己的行动来感知自己感染埃博拉的风险的复杂性。社区级信息来源可能有助于使公众对风险的感知与他们的实际流行病学风险保持一致。作为全球卫生安全努力的一部分，需要增加对社区级接触的投资，以便在卫生紧急情况下进行双向沟通。
