Identifying psychosocial factors to explain Ebola preventive behaviours in Guinea-Bissau

Abstract

Background: The Ebola virus disease is a severe illness with a mortality rate of up to 90%. Human-to-human transmission occurs via several pathways, e.g. touching infected persons. This study aimed at identifying the psychosocial factors of the RANAS model (risks, attitudes, norms, abilities, and self-regulation) to explain intentions to perform Ebola preventive behaviours in Guinea-Bissau. Methods: A quantitative survey with 1369 households was conducted by structured face-to-face interviews. The questionnaire assessed Ebola preventive behaviours (not touching affected people, reporting suspected cases to the Ebola hotline), and the RANAS model factors. Data were analysed by multiple linear regression. Findings: For the intention not to touch infected persons, the most important predictors were risk perception (β = .210; p ≤ .001), health knowledge (β = .132; p ≤ .001), and self-efficacy (β = .132; p ≤ .001). The most important predictors for the intention to call the Ebola hotline were personal norm (β = .204; p ≤ .001), injunctive norm (β = .137; p ≤ .001), response belief (β = .137; p ≤ .001), and commitment (β = .137; p ≤ .001). Discussion: Interventions to increase the intention not to touch infected persons should focus on increasing knowledge by presenting scenarios about the possibilities of contracting Ebola and on increasing risk perception by informing people about personal risk. Calling the Ebola hotline might be increase by normative behaviour change techniques, e.g. by an influential local celebrity. This research is relevant to other disease outbreaks (e.g. Zika), and public health interventions during emergencies.