School of Social Work, Boston College, Chestnut Hill, MA, USA.
Sustainable Health Systems, Freetown, Sierra Leone.
J Community Health. 2024 Feb;49(1):108-116. doi: 10.1007/s10900-023-01265-x. Epub 2023 Aug 2.
The 2014-2016 West Africa Ebola outbreak was the largest in history, resulting in approximately 11,000 deaths. Despite the outbreak's eventual end, national and international health sensitization and containment efforts were subject to criticism. This study investigates disease-related knowledge and beliefs, as well as trusted sources of health information among EVD-survivors and their family members, highlighting the importance of community-informed public health responses. Participants (n = 134) were adults who were either EVD-infected, affected families/caregivers, or community leaders. In-depth interviews and focus groups explored EVD-related experiences, including health effects, stigma, and community relationships. Using a grounded theory and thematic content analysis approach, transcripts were coded for evidence of health sensitization, as well as compliance with mitigation measures and trusted sources of information. Participants displayed a high level of knowledge around EVD and reported compliance with mandated and personal prevention measures. Levels of health sensitization and subsequent reintegration of survivors were reported to be largely the products of community-based efforts, rather than the top-down, national public health response. Primary sources of trusted information included EVD survivors acting as peer educators; local leaders; and EVD sensitization by community health workers. This study highlights the importance of a community-based response for increasing the effectiveness of public health campaigns. Participants expressed that relying on the experiences of trusted cultural insiders led to a deeper understanding of Ebola compared to top-down public health campaigns, and helped infected and affected community members reintegrate. Future public health efforts should incorporate community-based participatory approaches to address infectious disease outbreaks.
2014-2016 年西非埃博拉疫情是历史上最大的一次，导致约 11000 人死亡。尽管疫情最终结束，但国家和国际卫生宣传和遏制努力仍受到批评。本研究调查了埃博拉幸存者及其家属的疾病相关知识和信念，以及他们信任的健康信息来源，强调了社区知情的公共卫生应对措施的重要性。参与者（n=134）为成年人，他们或是埃博拉病毒感染者、受影响的家庭/照顾者，或是社区领袖。深入访谈和焦点小组探讨了埃博拉相关的经历，包括健康影响、污名和社区关系。使用扎根理论和主题内容分析方法，对转录本进行编码，以寻找卫生宣传的证据，以及遵守缓解措施和信任的信息来源的证据。参与者对埃博拉病毒有很高的认识水平，并报告说遵守了强制和个人预防措施。幸存者的健康意识水平和随后的重新融入被报告在很大程度上是社区为基础的努力的产物，而不是自上而下的国家公共卫生应对措施的产物。值得信赖的信息的主要来源包括埃博拉幸存者充当同伴教育者；地方领导人；以及社区卫生工作者的埃博拉宣传。本研究强调了社区为基础的应对措施对于提高公共卫生运动的有效性的重要性。参与者表示，与自上而下的公共卫生运动相比，依赖值得信赖的文化内部人士的经验，使他们对埃博拉有了更深入的了解，并帮助受感染和受影响的社区成员重新融入社会。未来的公共卫生工作应该纳入社区参与式方法，以应对传染病的爆发。
