Amanda E. Sorensen
Rebecca C. Jordan
Shannon LaDeau
Publication Date
November 21, 2017

Rutgers University (Sorensen, Jordan); Cary Institute of Ecosystem Studies (LaDeau)

"To address the issue of controlling invasive disease vector mosquitoes, it is clear that we need new methods and strategies that emphasize the efficacy of collective action by local communities."

Given the need to control mosquitoes as a potential transmitter of ZIKV (Zika virus), this research study explored whether community action to prevent the spread can be motivated through specialised framing around ZIKV communication to increase public compliance and preventative behaviours. The idea behind the research is that how science is communicated - in particular, which elements of the science are emphasised (known as framing) - to community members can impact how they respond to the implications of this science. In the context of invasive, disease-carrying mosquitoes, cooperation and action on the part of scientists and community members are needed to mitigate the impacts of these mosquitoes. This study found that shifting the emphasis of a scientific message from protecting yourself from mosquitoes as an individual choice to highlighting the impact individual action has on a commonly-held value (e.g., protecting unborn babies) leads to a higher proportion of individuals willing to take action against mosquitoes.

The researchers explain that, in the public health domain, misinformation campaigns (much like climate change denial) have distorted individual decision-making. As an example, there have been long-lasting negative impacts on vaccination rates and public health communication efforts around vaccinations due to falsified science published decades ago. Despite this research being retracted, misinformation campaigns persist that reduce trust in vaccines and reduce individual vaccination rates. Scientists in the field have worked to address this problem by employing framing research to influence vaccination behaviour. For example, researchers have found that the willingness to get a vaccine is greater if the framing focuses on positive health outcomes versus the risk of negative outcomes without a vaccine. Given these successes in the public health literature in employing framing, the researchers argue these methods could be applied to ecological issues as well.

The invasive Aedes spp. (aegypti or albopictus) mosquitoes and ZIKV were used here as a case study of the efficacy of framing ecological issues influencing public behaviour. A. albopictus is referred to as an urban mosquito because urban areas provide a plethora of container-breeding habitats, thus enabling high population densities. Many of these habitats are on private property, making them inaccessible to mosquito control workers. A. albopictus is also commonly associated with low socioeconomic areas, because juveniles readily develop in unmanaged containers that are more likely to accumulate in disadvantaged neighbourhoods. A feedback loop can exist between two socioeconomic areas, whereby the breeding habitats in lower socioeconomic areas are eliminated or reduced, but high socioeconomic areas harbour pools of mosquitoes that lead to recolonisation. Thus, it is important to have compliance at the household level across neighbourhoods. The investigation was carried out in West Baltimore, Maryland, United States (US) because it is characterised by a relationship of closely intertwined high/low socioeconomic areas, making the residents an intended audience for ZIKV communication interventions.

The researchers used a multiple step approach to investigate how framing impacts resident behaviour in West Baltimore. (1) They performed an initial frame analysis of the current ZIKV communication efforts in West Baltimore to identify common frame elements. (2) They conducted semi-structured interviews (n=60) with residents to understand community perceptions of ZIKV risk and severity and to investigate the efficacy of current communication materials. Using results from these first two steps, they developed an alternative frame for communication about ZIKV. (3) They present findings from a second round of interviews (n=26) that reveal perceptions of the alternative frame in addition to results from a pre/post questionnaire addressing resident behaviour toward ZIKV and mosquitos.

For the current frame, to investigate how science-based organisations are communicating about ZIKV, during spring 2016, the researchers collected flyers and informational pamphlets published by the US Centers for Disease Control and Prevention (CDC) and the DHMH (Maryland Department of Health and Mental Hygiene) that were being distributed in this community by various organisations. The analysis identified a single dominant frame valance of "personal safety" or "individual action" in these communication materials. In this frame, the emphasis for protecting against ZIKV is to prevent the individual from getting the virus.

Opportunistically sampling of the population of residents in four local parks found that: 73% of individuals did not know why ZIKV poses serious risks. When asked about their likelihood of infection, 80% identified the risk as being minimal and thought they could avoid infection. Only slightly more than half intended to protect themselves from ZIKV and, of those who did, very few were using effective strategies that would have an impact on their likelihood of being bitten by mosquitoes. In addition, no participants were able to describe typical symptoms of ZIKV infection.

To study the new, alternate frame the researchers developed, in the pre-survey, participants were asked if they had experienced recent communication efforts or messaging about ZIKV recently and whether they currently take action to prevent mosquito bites and ZIKV in response to those materials (2 binary survey items). The researchers then asked participants to read a brief narrative created with the "collective action" frame valance. In this narrative, preventing ZIKV was discussed as a collective action with an emphasis on breaking the transmission cycle. In the post-intervention interview, individuals were asked if they would now take action to prevent themselves from getting ZIKV (1 binary survey item); a free-response interview question sought to seek connections between their actions and helping pregnant women and unborn babies.

Post framing intervention, the researchers found a significant increase (n = 26, p < 0.001) in individuals willing to take preventative action against mosquitoes. Nineteen of the 23 who previously were not protecting themselves from mosquitoes reported they were going to take action. Of the 26 respondents, 12 referenced some aspect of their individual behaviour benefiting others. These findings lead the researchers to conclude that, in explicitly connecting two ideological congruent ideas (i.e., protecting self-protecting others, breaking the transmission cycle) for individuals, there was increased willingness to comply with mosquito prevention.

In the study, even though not all participants were able to explicitly connect their behaviour to protection of vulnerable populations, they still reported being willing to take action after the framing intervention. The researchers call for further investigation to decipher whether it is necessary for the broader public to understand the mechanisms behind how their actions will help protect vulnerable persons. In addition, considering that social networks also play an important role in how information, as well as misinformation, is spread, research into the intersection of framing, social networks, and behaviour could be fruitful. If minor changes in how mosquito control issues are communicated can influence how people behave, this type of cross-disciplinary research may have implications for how scientists should develop their communication strategies.

Reflecting on the findings, the researchers suggest that, by methodically investigating best communication practices, this study and others can help practitioners mobilise communities to address large-scale ecological problems. Furthermore, they assert, the principles outlined here may be transferrable to other communication efforts about ecological issues outside of ZIKV and mosquitoes.