Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-22T15:32:23.508Z Has data issue: false hasContentIssue false

The Importance of Developing Rigorous Social Science Methods for Community Engagement and Behavior Change During Outbreak Response

Published online by Cambridge University Press:  09 July 2020

Henry C. Ashworth*
Affiliation:
Harvard Medical School, Boston, MA Vayu Global Health Foundation, Boston, MA
Sara Dada
Affiliation:
Vayu Global Health Foundation, Boston, MA
Conor Buggy
Affiliation:
University College Dublin Centre for Safety and Health at Work, School of Public Health, Physiotherapy and Sports Science, Dublin, Ireland
Shelley Lees
Affiliation:
London School of Hygiene and Tropical Medical, London, UK
*
Correspondence and reprint requests to Mr Henry Ashworth, 25 Shattuck Street, Boston, MA02116 (e-mail: [email protected]).

Abstract

Despite growing international attention, the anthropological and socio-behavioral elements of epidemics continue to be understudied and under resourced and lag behind the traditional outbreak response infrastructure. As seen in the current 2019 coronavirus disease (COVID-19) pandemic, the importance of socio-behavioral elements in understanding transmission and facilitating control of many outbreak-prone pathogens, this is problematic. Beyond the recent strengthening of global outbreak response capacities and global health security measures, a greater focus on the socio-behavioral components of outbreak response is required. We add to the current discussion by briefly highlighting the importance of socio-behavior in the Ebola virus disease (EVD) response, and describe vital areas of future development, including methods for community engagement and validated frameworks for behavioral modeling and change in outbreak settings.

Type
Commentary
Copyright
Copyright © 2020 Society for Disaster Medicine and Public Health, Inc.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bempong, N-E, Ruiz De Castañeda, R, Schütte, S, et al. Precision global health – the case of Ebola: a scoping review. J Glob Health. 2019;9(1). doi: 10.7189/jogh.09.010404.CrossRefGoogle ScholarPubMed
Wells, CR, Pandey, A, Ndeffo Mbah, ML, et al. The exacerbation of Ebola outbreaks by conflict in the Democratic Republic of the Congo. Proceed Nat Acad Sci. 2019;116(48):24366.CrossRefGoogle ScholarPubMed
World Health Organization. Social science research projects for the Ebola response in the DRC and neighbouring countries. 2019. https://www.who.int/risk-communication/social-science-research-for-ebola/en/. Accessed January 19, 2020.Google Scholar
Roca, A, Afolabi, MO, Saidu, Y, Kampmann, B. Ebola: a holistic approach is required to achieve effective management and control. J Allergy Clin Immunol. 2015;135(4):856867.CrossRefGoogle ScholarPubMed
Abramowitz, SA, Hipgrave, DB, Witchard, A, Heymann, DL. Lessons from the West Africa Ebola epidemic: a systematic review of epidemiological and social and behavioral science research priorities. J Infect Dis. 2018;218(11):17301738.Google ScholarPubMed
Wilkinson, A, Parker, M, Martineau, F, Leach, M. Engaging “communities”: anthropological insights from the West African Ebola epidemic. Philos Trans R Soc Lond B Biol Sci. 2017;372(1721). doi:10.1098/rstb.2016.0305.CrossRefGoogle ScholarPubMed
Moon, S, Sridhar, D, Pate, MA, et al. Will Ebola change the game? Ten essential reforms before the next pandemic. The report of the Harvard-LSHTM Independent Panel on the Global Response to Ebola. Lancet. 2015;386(10009):22042221.CrossRefGoogle ScholarPubMed
Mohatt, NV, Thompson, AB, Thai, ND, Tebes, JK. Historical trauma as public narrative: a conceptual review of how history impacts present-day health. Soc Sci Med (1982). 2014;106:128136.CrossRefGoogle ScholarPubMed
Laverack, G, Manoncourt, E. Key experiences of community engagement and social mobilization in the Ebola response. Glob Health Promot. 2016;23(1):7982.CrossRefGoogle ScholarPubMed
Enria, L, Lees, S, Smout, E, et al. Power, fairness and trust: understanding and engaging with vaccine trial participants and communities in the setting up the EBOVAC-Salone vaccine trial in Sierra Leone. BMC Public Health. 2016;16(1):1140.CrossRefGoogle ScholarPubMed
Bedson, J, Jalloh, MF, Pedi, D, et al. Community engagement during outbreak response: standards, approaches, and lessons from the 2014–2016 Ebola outbreak in Sierra Leone. bioRxiv. 2019;epub:661959.Google Scholar
Durojaye, ET, Mirugi-Mukundi, G. The Ebola virus and human rights concerns in Africa. Afr J Reprod Health. 2015;19(3):1826.Google ScholarPubMed
Chan, M. Ebola virus disease in West Africa – no early end to the outbreak. N Engl J Med. 2014;371(13):11831185.CrossRefGoogle ScholarPubMed
Vinck, P, Pham, PN, Bindu, KK, et al. Institutional trust and misinformation in the response to the 2018–19 Ebola outbreak in North Kivu, DR Congo: a population-based survey. Lancet Infect Dis. 2019;19(5):529536.CrossRefGoogle Scholar
Jacobsen, KH, Aguirre, AA, Bailey, CL, et al. Lessons from the Ebola outbreak: action items for emerging infectious disease preparedness and response. Ecohealth. 2016;13(1):200212.CrossRefGoogle ScholarPubMed
Dada, S, McKay, G, Mateus, A, Lees, S. Lessons learned from engaging communities for Ebola vaccine trials in Sierra Leone: reciprocity, relatability, relationships and respect (the four R’s). BMC Public Health. 2019;19(1):1665.CrossRefGoogle Scholar
World Health Organization. Key messages for social mobilization and community engagement in intense transmission areas. September 2014. https://www.who.int/csr/resources/publications/ebola/social-mobilization-guidance/en/. Accessed January 19, 2020Google Scholar
Joint workshop: community engagement in and for ethical research in outbreaks of infectious diseases and other humanitarian crises. Dakar, Senegal: 2019. https://www.nuffieldbioethics.org/assets/pdfs/Research-in-global-health-emergencies-Dakar-Workshop.pdf. Accessed January 19, 2020.Google Scholar
Thiam, S, Delamou, A, Camara, S, et al. Challenges in controlling the Ebola outbreak in two prefectures in Guinea: why did communities continue to resist? Pan Afr Med J. 2015;22 (Suppl 1):2222.Google Scholar
Tengbeh, AF, Enria, L, Smout, E, et al. “We are the heroes because we are ready to die for this country”: Participants’ decision-making and grounded ethics in an Ebola vaccine clinical trial. Soc Sci Med (1982). 2018;203:3542.CrossRefGoogle Scholar
Verelst, F, Willem, L, Beutels, P. Behavioural change models for infectious disease transmission: a systematic review (2010-2015). J Royal Soc Interface. 2016;13(125):20160820.CrossRefGoogle Scholar
Sharareh, N, Sabounchi, N, Sayama, H, MacDonald, R. The Ebola crisis and the corresponding public behavior: a system dynamics approach. PLoS Curr. 2016;8. doi: 10.1371/currents.outbreaks.23badd9821870a002fa86bef6893c01d.Google ScholarPubMed
Wilken, JA, Pordell, P, Goode, B, et al. Knowledge, attitudes, and practices among members of households actively monitored or quarantined to prevent transmission of Ebola virus disease – Margibi County, Liberia: February–March 2015. Prehosp Disaster Med. 2017;32(6):673678.CrossRefGoogle ScholarPubMed
Tenkorang, EY. Ebola-related stigma in Ghana: individual and community level determinants. Soc Sci Med. 2017;182:142149.CrossRefGoogle ScholarPubMed
Keeling, AW. Ebola: how a people’s science helped end an epidemic. Nurs Hist Rev. 2019;27(1):165166.CrossRefGoogle ScholarPubMed
Blanchet, K, Ramesh, A, Frison, S, et al. Evidence on public health interventions in humanitarian crises. Lancet. 2017;390(10109):22872296.CrossRefGoogle ScholarPubMed
Spengler, JR, Ervin, ED, Towner, JS, et al. Perspectives on West Africa Ebola virus disease outbreak, 2013–2016. Emerg Infect Dis. 2016;22(6):956963.CrossRefGoogle Scholar
Svoronos, T, Mate, KS. Evaluating large-scale health programmes at a district level in resource-limited countries. Bull World Health Organ. 2011;89(11):831837.CrossRefGoogle Scholar
Linsley, P, Howard, D, Owen, S. The construction of context-mechanisms-outcomes in realistic evaluation. Nurse Res. 2015;22(3):2834.CrossRefGoogle ScholarPubMed
Gilmore, B, Adams, BJ, Bartoloni, A, et al. Improving the performance of community health workers in humanitarian emergencies: a realist evaluation protocol for the PIECES programme. BMJ Open. 2016;6(8):e011753.CrossRefGoogle ScholarPubMed
Van Belle, SB, Marchal, B, Dubourg, D, Kegels, G. How to develop a theory-driven evaluation design. Lessons learned from an adolescent sexual and reproductive health programme in West Africa. BMC Public Health. 2010;10:741.CrossRefGoogle ScholarPubMed
Stellmach, D, Beshar, I, Bedford, J, et al. Anthropology in public health emergencies: what is anthropology good for? BMJ Glob Health. 2018;3(2):e000534.CrossRefGoogle Scholar