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Is participation contagious? Evidence from a household vector control campaign in urban Peru
  1. Alison M Buttenheim1,
  2. Valerie Paz-Soldan2,
  3. Corentin Barbu3,
  4. Christine Skovira3,
  5. Javier Quintanilla Calderón4,
  6. Lina Margot Mollesaca Riveros4,
  7. Juan Oswaldo Cornejo4,
  8. Dylan S Small5,
  9. Christina Bicchieri6,
  10. Cesar Naquira7,
  11. Michael Z Levy3
  1. 1University of Pennsylvania School of Nursing, Family and Community Health, Philadelphia, Pennsylvania, USA
  2. 2Department of Global Health Systems and Development, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
  3. 3Department of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  4. 4Universidad Peruana Cayetano Heredia, Arequipa, Peru
  5. 5Department of Statistics, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  6. 6Department of Philosophy, The Wharton School, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  7. 7Universidad Peruana Cayetano Heredia, Lima, Peru
  1. Correspondence to Dr Alison M Buttenheim, University of Pennsylvania School of Nursing, Family and Community Health 235L Fagin Hall, 418 Curie Boulevard, Philadelphia, PA 19104, USA; abutt{at}


Objectives High rates of household participation are critical to the success of door-to-door vector control campaigns. We used the Health Belief Model to assess determinants of participation, including neighbour participation as a cue to action, in a Chagas disease vector control campaign in Peru.

Methods We evaluated clustering of participation among neighbours; estimated participation as a function of household infestation status, neighbourhood type and number of participating neighbours; and described the reported reasons for refusal to participate in a district of 2911 households.

Results We observed significant clustering of participation along city blocks (p<0.0001). Participation was significantly higher for households in new versus established neighbourhoods, for infested households, and for households with more participating neighbours. The effect of neighbour participation was greater in new neighbourhoods.

Conclusions Results support a ‘contagion’ model of participation, highlighting the possibility that one or two participating households can tip a block towards full participation. Future campaigns can leverage these findings by making participation more visible, by addressing stigma associated with spraying, and by employing group incentives to spray.

  • Communicable Diseases
  • Control of DIseases
  • Tropical Health
  • Developing Countr
  • Epidemiology

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