Form 0920-18ANU KAP Adult

Communities Organized to Prevent Arboviruses: Assessment of Knowledge, Attitudes, and Vector Control Practices and Sero-Prevalence and Incidence of Arborviral Infection in Ponce, Puerto Rico (COPA)

6. EN Paper Questionnaire - KAP Adult

Knowledge, Attitudes, and Practices Individual Questionnaire

OMB: 0920-1254

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K AP: Adults and Adolescents

1. If you could change or improve three things in your community, what would they be?

Do not read the options; it is okay if they only provide 1-2 answers.

Standing water

Environmental/Pollution

Stray animals

Crime/Gangs/Safety

Potable water distribution

Drugs

Electricity

Teen pregnancy

Sexually transmitted diseases/HIV

Diseases transmitted by mosquitoes

(dengue, Zika, chikungunya)

Debris

Lack of sewage system

Children’s health

Maintenance of green spaces

Flies, no-see-ums, other insects

Mosquitoes

Homelessness

Trash removal

Messy or dirty neighborhood

None

Other: _______________________



2. In the last 12 months, since this month of the past year, which of the following sources have you used to obtain health information?

Probe if necessary. Select all that apply.

School

Brochures

Internet

Children

Newspapers/magazines

Official spokespeople

Health professionals

Radio

Social networks

(Facebook,

Twitter, Instagram)

Community

meetings

TV

Neighbors

WhatsApp



3. Do you think that mosquitoes transmit diseases?

Yes | No

4 . In the next 12 months, how much risk do you think there is in this house of becoming sick with:

a. Dengue


 High | Low | None

 None because I have had it

b. Zika

 High | Low | None

 None because I have had it

c. Chikungunya

 High | Low | None

 None because I have had it

5. Would you go to the doctor if you thought you had chikungunya, dengue, o Zika?

 Yes | No | Only if the symptoms were severe

11. Do you think controlling mosquito-breeding sites is a good strategy to prevent mosquito-borne diseases?

Yes | No

12. In the last 12 months, have you spoken with any of the following people about how to control mosquitoes?

a. Your family Yes | No

b. Your neighbors Yes | No

c. Your community Yes | No

13. Do you think that your community should do more to control mosquitoes?

 Yes | No

14. Who do you think is responsible for controlling mosquitoes?

a. The government and/or the Department of Health?


 Yes | No

b. You?

 Yes | No

15. Do you think it is worth it to invest time and money each month to control mosquitoes inside and outside the house?

Yes | No





KAP: Adults and Adolescents

6. Do you think that diseases transmitted by mosquitos such as dengue, Zika and chikungunya are a problem in your community?

 Yes | No

7. Have you used mosquito repellent in the last 30 days?

Shape1 Yes | No

7a. What type of repellant have you used to prevent mosquito bites?

Citronella

Store-bought spray (Off)

Cream

Towelettes

Natural/Artisanal/

Homemade

repellants

Other: _____________

8. In the last 12 months, how often have you used a mosquito net?

Daily

One time per week

One time per month

Rarely

Never

9. Where do mosquitoes bite you most frequently?

Read the options. Select all that apply.

Around the house outside

Inside the house

Work

School

Community sports field

Somewhere else in the community

Somewhere else outside of the community

Mosquitoes do not bite me

A mosquito-breeding site is anything that retains water that enables mosquitoes to reproduce. Mosquitoes can even reproduce in an area as small as a bottle cap.

10. Currently, what are the most common mosquito breeding sites in this community?

Select all that apply, do not read the options.

Hollow trees

Abandoned houses

Neighbors’ houses

Garbage containers

Drains

Debris from hurricane

Tires

Other containers

Pools in abandoned houses

Untreated pools

Septic tanks

Soil

Rooves

There are no breeding sites

Other: _______________________


16. Did you know that we would be here in your community?

 Yes | No

16a. How did you find out that we would be in your community?

Through the community leader

 Informational flyer

Through someone else

Who? _____________________________

Facebook

 Which page? .

Loud speaker

 Where? _ .

Radio

 Which station? _ .

Street banner

Newspaper

 Which one? .

Other: .










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Participant Laboratory Data



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**Project flag:** Fever in last 7 days

No: COPA

Yes: COPA_SYM




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AuthorLittle, Emma (CDC/OID/NCEZID)
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