Promoting Adoption of Preventive Actions towards Coronavirus in Addis Ababa, Ethiopia: A social-ecological model

The overall objective of the study is identifying optimal ways of promoting adoption of preventive actions towards Coronavirus (COVID-19) in Addis Ababa Ethiopia. Since the first case of coronavirus was reported on December 31, 2019 in Wuhan town, Hubei province, China, the virus has spread fast and wide to other countries, and the world is still in turmoil. Globally, the number of casualties is showing rapid growth. Ethiopia reported its first Coronavirus case on March 13, 2020 and the number of confirmed cases has reached 3345 with 57 deaths by June 14, 2020. In response to this global pandemic, the Ethiopian government is taking a number of actions to reduce the transmission of the disease. However, the public is still seen engaged in risky behaviors. Public health experts appear to be confused and the media is propagating sometimes unclear and conflicting messages. The fight against the virus is likely to require large investment and extended efforts. Among this, there is a need at the moment to alter people's health behavior. Yet, little has been known how to effectively promote healthy behavior against COVID-19 such as keeping physical/social distance, avoiding large gatherings and practicing personal hygiene. It appears that state actors and the media are of the opinion that disseminating information about the virus alone goes a long way to bring about behavioral changes among the populace. We postulate that individuals may lack accurate understanding about transmission/ preventive methods or do not take the disease seriously enough. Another likely hypothesis is individuals take COVID-19 seriously, but they have an optimism bias, they think they won't catch it. Another possible scenario could be individuals have awareness about transmission and preventive methods, perceive the disease to be severe, worry that they could catch it but are materially limited to take preventive actions. Thus, we propose to employee social-ecological model in order to identify the major individual and structural factors that hinder and facilitate adoption of preventive actions. Our team has been conducting an array of research activities on preventive health knowledge and behavior. Our previous experience suggested that interventions that aim at changing the health behavior of individuals should take multilevel enabling factors and barriers into account. In view of this, we propose conducting a mixed methods research to develop effective and context-based intervention strategies to promote adoption of preventive actions. The findings can be used for health promotion interventions to improve the self-efficacy of the public and creating conducive environment for adoption of preventive actions. This could ultimately contribute to prevention and control of Coronavirus. Expected Outputs Expected Knowledge output and outcomes Outputs At the end of the research period, we will develop theory-driven effective interventions to promote adoption of preventive practices towards COVID-19 in Addis Ababa, Ethiopia. The intervention will indicate effective strategies to address individual, interpersonal, community and other barriers to adopt preventive actions that can also be implemented in other similar settings. Furthermore, contextual and technological and sector-specific factors which can support adoption to the recommended preventive actions will be identified. The outputs will be made accessible in the following ways: First, a series of research papers/reports that present scientific findings of multilayered factors that account for adoption of preventive actions and the viable ways of promoting preventive actions will be published. Second, a communication strategy manual, outlining techniques of effective communication, key messages, and effective avenues of communication targeting media professionals, government organizations, and other health message providers will be developed. Third, a policy brief which presents key interventions at the individual, community, and national levels, as well as sector-specific intervention will be drafted. Outcome This project aspires to inform the scientific community, health communicators, and policy makers. The outputs of the project will help community actors, NGOs and policy makers design and implement effective intervention strategies to modify individual's health behavior to minimize the risk of contracting COVID-19. This could be achieved through supporting people with tailored interventions to overcome their major barriers at individual and interpersonal level, and taking measures that will make public places, service centers, and work-places COVID-19-resistant. This could help us see informed and confident citizens who are able to take preventive actions consistently. Expected potential impact of knowledge outputs This research project has been designed to have a long-term effect on the society. Coronavirus causes morbidity that threatens the lives and wellbeing of the affected individual. Moreover, it is associated with adverse psychological and social consequences. With a careful implementation of the project output, the effects of COVID19 can be minimized and public safety maximized. Additionally, identified intervention strategies could produce lasting changes in preparing citizens and health systems to effectively deal with epidemics and pandemics.