Original Article

Predictors of Dengue Preventive Practices Based on Precaution Adoption Process Model among Health Care Professionals in Northwest of Iran


Background: Dengue fever as a mosquito-borne disease, has rapidly spread due to climate change, globalization, and human behavior. Iran is prone to dengue fever, as its vector recently has been found in the country. This study aimed to assess predictors of dengue preventive practices based on Precaution Adoption Process Model (PAPM) factors in West Azerbaijan province, northwest of Iran.

Methods: This cross-sectional study conducted on 405 health professionals of communicable disease sector who were interested in study participation. Data-gathering instrument was an online researcher-made questionnaire consisting of demographic characteristics (11 items), questions based on PAPM, and dengue preventive practices (85 items). Content validity and reliability of the instrument, content validity ratio, content validity index, and Cronbach α were utilized, respectively. Descriptive, analytical, and regression analysis using SPSS and STATA were examined.     

Results: Regression analysis revealed that awareness of appropriate actions for dengue prevention was a stronger pre­dictor of preventive practice in borderline and appropriate categories (β= 4.09, p< 0.001) and (β= 4.42, p< 0.001), re­spectively. Among factors of PAPM, beliefs about precaution effectiveness and difficulty in borderline (β= 1.04, p= 0.04) and appropriate (β= 1.12, p= 0.03) groups had direct and significant relation with dengue preventive practice.

Conclusion: The highest mean score of beliefs about hazard likelihood and severity factor was related to dengue pre­vention. Therefore, theory-based interventions that address beliefs about precaution effectiveness and difficulty can lead to assistance in acting. To improve dengue preventive practices, a well-designed promotive intervention that addresses associated factors in a context-specific manner is essential.

1. Ebi KL, Nealon J (2016) Dengue in a chang¬ing climate. Environ Res. 151: 115–123.
2. Wesolowski A, Qureshi T, Boni MF, Sundsøy PR, Johansson MA, Rasheed SB, Engø-Monsen K, Buckee CO (2015) Impact of human mobility on the emergence of dengue epidemics in Pakistan. Proc Natl Acad Sci USA. 112(38): 11887–1192.
3. Guzman MG, Gubler DJ, Izquierdo A, Martinez E, Halstead SB (2016) Dengue infection. Nat Rev Dis Primers. 2(1): 1–25.
4. Rasheed SB, Butlin RK, Boots M (2013) A review of dengue as an emerging di-sease in Pakistan. Public Health. 127: 11–17.
5. Tahir U, Khan UH, Zubair MS (2015) Wolbachia pipientis: A potential candi-date for combating and eradicating den-gue epidemics in Pakistan. Asian Pac J Trop Med. 12: 989–998.
6. Thai KTD, Nishiura H, Hoang PL, Tran NTT, Phan GT, Le HQ, Tran BQ, Nguyen NV, de Vries PJ (2011) Age-Specificity of Clinical Dengue during Primary and Secondary Infections. PLoS Negl Trop Dis. 5(6): e1180.
7. Khetarpal N, Khanna I (2016) Dengue fever: causes, complications, and vaccine strategies. J Immunol Res. 2016: 1–14.
8. Dehghani R, Kassiri H (2021) A review on epidemiology of dengue viral infection as an emerging disease. Research J. Pharm. and Tech. 14(4): 2296–2301.
9. Guzman M, Alvarez M, Halstead SB, Artsob H, Buchy P, Farrar J, Gubler DJ, Hunsperger E, Kroeger A, Margolis HS, Martínez E, Nathan MB, Pelegrino JS, Simmons C, Yoksan S, Peeling RW (2010) Dengue: a continuing global threat. Nat Rev Microbiol. 8(12 Suppl): S7–S16.
10. Nanaware N, Banerjee A, Mullick Bagchi S, Bagchi P, Mukherjee A (2021) Den-gue virus infection: a tale of viral ex-ploitations and host responses. Viruses. 13(10): 1–20.
11. Jayawickreme K, Jayaweera D, Weerasinghe S, Warapitiya D, Subasinghe S (2021) A study on knowledge, attitudes and prac-tices regarding dengue fever, its preven-tion and management among dengue pa-tients presenting to a tertiary care hos-pital in Sri Lanka. BMC Infect Dis. 21 (1): 1–14.
12. DiClemente RJ, Crosby R, Kegler MC (2009) Emerging theories in health pro-motion practice and research. John Wiley and Sons. New Jersey.
13. Porche DJ (2004) Public and community health nursing practice: A population-based approach. SAGE Publications, CA.
14. Glanz K, Rimer BK, Viswanath K (2008) Health behavior and health education: theory, research, and practice:4th Edition John Wiley and Sons, San Francisco, CA.
15. Wiyono L, Rocha ICN, Cedeño TDD, Mi-randa AV, Lucero-Prisno III DE (2021) Dengue and COVID-19 infections in the ASEAN region: a concurrent out-break of viral diseases. Epidemiol Health. 43: 1–5.
16. Tsheten T, Clements AC, Gray DJ, Gyeltshen K, Wangdi K (2021) Medical practitioner’s knowledge on dengue management and clinical practices in Bhutan. PLoS One. 16(7): 1–15.
17. Lawshe CH (1975) A quantitative approach to content validity. J Pers Psychol. 28 (4): 563–575.
18. George D, Mallery P (2019) IBM SPSS statistics 26 step by step: A simple guide and reference: 16th Edition, Routledge, New York.
19. Khoobdel M, Jonaidi Jafari N (2016) Dengue fever, an old arboviral disease threatening the Persian Gulf region and southern Iran. J Mil Med. 18(2): 181–183.
20. Wong LP, Shakir SMM, Atefi N, Abu-Bakar S (2015) Factors affecting dengue prevention practices: nationwide survey of the Malaysian public. PLoS One. 10 (4): 1–16.
21. Chanyasanha C, Guruge GR, Sujirarat D (2015) Factors influencing preventive be-haviors for dengue infection among house-wives in Colombo, Sri Lanka. Asia Pac J Public Health. 27(1): 96–104.
22. Guad RM, Mangantig E, Low WY, Tay-lor-Robinson AW, Azzani M, Sekaran SD, Sim MS, Azizan N (2021) Develop-ment and validation of a structured sur-vey questionnaire on knowledge, attitude, preventive practice, and treatment-seek-ing behaviour regarding dengue among the resident population of Sabah, Malay-sia: an exploratory factor analysis. BMC Infect Dis. 21(1): 1–11.
23. Elsinga J, Schmidt M, Lizarazo EF, Vin-centi-Gonzalez MF, Velasco-Salas ZI, Arias L, Burgerhof JGM, Tami A (2018) Knowledge, attitudes, and preventive practices regarding dengue in Maracay, Venezuela. Am J Trop Med Hyg. 99(1): 195–203.
24. Sarfraz MS, Tripathi NK, Tipdecho T, Thongbu T, Kerdthong P, Souris M (2012) Analyzing the spatio-temporal relation-ship between dengue vector larval den-sity and land-use using factor analysis and spatial ring mapping. BMC Public Health. 12: 1–19.
25. Panagos A, Lacy ER, Gubler DJ, Mac-pherson CN (2005) Dengue in Grenada. Revista panamericana de salud pública. 17(4): 225–229.
26. Shuaib F, Todd D, Campbell-Stennett D, Ehiri J, Jolly PE (2010) Knowledge, attitudes and practices regarding dengue infection in Westmoreland, Jamaica. West Indian Med J. 59(2): 139–146.
27. Siddiqui TR, Ghazal S, Bibi S, Ahmed W, Sajjad SF (2016) Use of the health belief model for the assessment of public knowledge and household preventive practices in Karachi, Pakistan, a dengue-endemic city. PLoS Negl Trop Dis. 10 (11): 1–15.
IssueVol 16 No 4 (2022) QRcode
SectionOriginal Article
Preventive practices Dengue fever Precaution Adoption Process Model (PAPM) Health Professionals

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How to Cite
Firooziyan S, Sedaghat MM, Sabouri M, Tol A, Sadeghi R, Rikhtrgar E, Fathi B. Predictors of Dengue Preventive Practices Based on Precaution Adoption Process Model among Health Care Professionals in Northwest of Iran. J Arthropod Borne Dis. 2023;16(4):340–349.