Examining Human Behavior in Dengue Prevention Efforts in Iquitos, Peru

描述(由申请人提供)：本申请是根据项目公告PAR-10-066，“国际研究科学家发展奖(IRSDA)(K01)”提交的。IRSDA的目标是扩大我在病媒传播疾病领域的培训和知识，并为我提供专门的时间进行培训、拨款和指导，以实现发展专门知识并成为预防病媒传播疾病的行为干预领域的独立调查员的目标。我将以我的经验和专业知识为基础，研究预防性生殖健康行为在不同类型的网络中的传播过程，例如不同的战略如何影响这些预防行为的采用，为此，我将获得所需的额外培训，以审查媒介传播疾病预防中的这些过程。这套新的技能和知识将通过一个明确的四年职业发展计划获得，该计划包括定向阅读、短期课程和指导研究。我在社会科学研究方法和技术方面有扎实的基础，在个人和社区层面的行为改变方面有很强的内容知识，自从我的博士学位达到顶峰以来，我一直在稳定地工作，当时我搬回了我的出生地秘鲁，担任研究助理教授，并领导杜兰大学拉丁美洲健康办公室。三年前，作为一名致力于登革热预防的社会科学家，我找到了自己的定位，但我需要这个新领域的培训和指导。因此，课程和阅读材料将主要集中在病媒传播疾病(VBD)、病媒生态学、登革热流行病学和用于预防VBD的行为干预方面，但我还需要在某些社会科学研究技能方面进行额外培训：调查开发和评估、空间数据分析以及定性数据分析软件的使用。除了我的母校杜兰大学的坚实支持外，一群出色而经验丰富的导师和合作者致力于帮助我实现我的目标，并为我提议的导师研究提供指导。这个由多学科导师组成的团队，其中大多数人已经与我密切合作，非常适合指导我解决我在执行研究计划时面临的多个问题，并在我的培训和职业发展计划中提供指导。我们通过Skype、电话会议和定期安排的面对面会议保持着持续的沟通，所有人都同意每年举行一次面对面的会议，以了解我的最新进展。该研究计划的目的都与在三个受资助的登革热研究项目中研究人类行为有关，这些项目都在秘鲁的伊基托斯市进行(或即将进行)，所有登革热血清型都已在那里得到记录。具体目标是：1)验证和修改两项调查，以测量人们的运动模式和“活动空间”，这两项调查将用于斯科特等人的S国立卫生研究院资助的赠款，旨在测试登革热病毒传播的空间维度由秘鲁伊基托斯的人类运动模式定义的假设；2)使用麦克考尔博士(惠康信托资助的)和韦森博士(盖茨基金会资助的)群组随机控制干预试验的数据，评估人类运动在混淆家庭层面干预措施防止登革热传播效果方面的作用；以及3)确定与正确和一致地使用两种不同方法预防登革热有关的个人和家庭一级的社会人口和经济因素：a)经杀虫剂处理的窗帘和b)致命性诱卵器(使用来自目标2的两项干预试验的数据)。所有目标都符合三个现有项目的活动和目标(我是其中一个完整的团队成员)，但都是提交给我的导师的原创想法，受到了很好的欢迎。编制和提交R01赠款提案是这一奖项预计的最终活动：我预计将制定一项提案，与评估人类活动在评估伊基托斯以外的登革热(或其他VBD)干预措施中的作用有关。在个人层面上，完成与IRSDA相关的所有活动将是我成为一名独立调查员的一个坚实的开始，其在VBD预防和控制方面的社会科学专业知识可以开始应用于世界其他地区，以及登革热以外的其他VBD--尽管在登革热研究方面还有很多工作要做。在更大的范围内，拟议的研究计划的影响是实质性的。登革热的发病率和死亡率比任何其他节肢动物传播的病毒都要高，是世界上进展最快的VBD。这项研究的发现将对伊基托斯和整个拉丁美洲的登革热预防和控制计划产生广泛影响。如果该项目的所有拟议目标都能实现，病媒控制战略将得到改进，对新干预措施的评估将更加准确，并将提供一种评估人类活动的新工具--需要适应其他环境--可用于公共卫生和其他领域。此外，了解与使用干预措施有关的个人、社会和经济因素将有助于制定具有成本效益的方法，为成功实施提供最佳机会。 公共卫生相关性：登革热的发病率和死亡率比任何其他节肢动物传播的病毒都要高，是世界上进展最快的媒介传播疾病。这项研究的发现将对伊基托斯和整个拉丁美洲的登革热预防和控制计划产生广泛影响；因此，这项研究与公共卫生高度相关。

DESCRIPTION (provided by applicant): This application is being submitted in response to Program Announcement PAR-10-066, "International Research Scientist Development Award (IRSDA) (K01)." The objectives of this IRSDA are to expand my training and knowledge in the field of vector-borne diseases and provide me with the dedicated time for training, grant-writing and mentorship toward the goal of developing expertise and becoming an independent investigator in the field of behavioral interventions to prevent vector-borne diseases. I will build upon my experience and expertise in studying the diffusion processes of preventive reproductive health behaviors within different types of networks, such as how different strategies influence the adoption of these preventive behaviors, by obtaining the additional training needed to examine these processes in vector-borne disease prevention. This new set of skills and knowledge will be obtained through a well-defined four-year career development plan consisting of directed readings, short courses, and mentored research. I have a solid foundation in social science research methods and techniques, strong content knowledge on behavior change at the individual and community level, and have been producing steadily since the culmination of my PhD, when I moved back to Peru, my country of birth and upbringing, as a research assistant professor and to direct Tulane's Health Office for Latin America. Three years ago I found my niche as a social scientist working on dengue prevention, but I need training and mentorship in this new field to me. Thus, coursework and readings will focus heavily on vector-borne diseases (VBD), vector ecology, dengue epidemiology, and behavioral interventions used in VBD prevention, but I also need additional training in certain social science research skills: survey development and evaluation, spatial data analysis, and use of qualitative data analysis software. In addition to the solid support of my home institution, Tulane University, a superb and experienced group of mentors and collaborators have committed themselves to helping me achieve my goal and provide guidance for my proposed Mentored Research. This multidisciplinary team of mentors, most of whom I am already working closely with, is ideal for guiding me through the multiple issues I face in carrying out the research plan, as well as providing guidance in my training and career development plans. We are in constant communication via Skype, conference calls and regularly scheduled face-to-face meetings, and all have agreed on an annual face-to-face meeting for updates on my progress. The aims of the research plan are all linked to studying human behavior within three funded dengue research projects all being conducted (or soon to be) in the city of Iquitos, Peru, where all dengue serotypes have been documented. The specific aims are: 1) to validate and modify two surveys to measure people's movement patterns and "activity space," which will be used for Dr. Scott et al.'s NIH-funded grant designed to test the hypothesis that spatial dimensions of dengue virus transmission are defined by daily patterns of human movement in Iquitos, Peru; 2) to assess the role of human movement in confounding the effect of household- level interventions to prevent dengue transmission, using data from Dr. McCall (Wellcome Trust-funded) and Dr. Wesson (Gates Foundation funded) cluster-randomized controlled intervention trials; and 3) to determine the individual and household-level socio-demographic and economic factors associated with the correct and consistent use of two different approaches to dengue prevention: a) insecticide-treated curtains and b) lethal ovitraps (using data from the two intervention trials in Aim 2). All aims fit within the activities and goals of the three existing projects (of which I am an integral team member), but are all original ideas presented to my mentors that have been very well received. Preparation and submission of an R01 grant proposal is the expected culminating activity for this award: I foresee development of a proposal associated to the assessing the role of human movement in evaluation of dengue (or other VBD) interventions in settings outside of Iquitos. On a personal level, accomplishment of all activities associated to this IRSDA would be a solid start to my becoming an independent investigator whose social science expertise in VBD prevention and control could start being applied in other regions of the world, as well as to other VBD beyond dengue - although there is plenty of more work to be done in dengue research. On a larger scale, the impact of the proposed research plan is substantive. Dengue has a higher morbidity and mortality rate than any other arthropod-borne virus and is the most rapidly advancing VBD in the world. The findings from this study will have a wide impact on dengue prevention and control programs in Iquitos and throughout Latin America. If all proposed aims for this project are achieved, vector control strategies could be improved, evaluation of new interventions would be more accurate, and a new tool for assessing human movement - which would need to be adapted for other settings - would be available for use in public health, as well as other fields. In addition, understanding the individual, social and economic factors associated with use of interventions will be helpful in the development of cost-effective methodologies with optimal opportunity for successful implementation. PUBLIC HEALTH RELEVANCE: Dengue has a higher morbidity and mortality rate than any other arthropod-borne virus and is the most rapidly advancing vector-borne disease in the world. The findings from this study will have a wide impact on dengue prevention and control programs in Iquitos and throughout Latin America; thus this research is highly relevant to public health.