Abstract
BackgroundMosquito net use is an essential part of malaria prevention. Although previous research has shown that many people sleep under a mosquito net in endemic areas, it is unknown whether people underestimate how common it is to sleep under a net every night. Furthermore, perceived social norms about whether most others sleep under a mosquito net every night may contribute to personally sleeping under a net, given decades of research showing that people often mimic others’ behaviours.MethodsPopulation-based data were collected from 1669 adults across eight villages in one rural parish in southwestern Uganda. Individuals’ perception about whether most adults in their community sleep under a mosquito net every night was compared with whether daily mosquito net use was the actual norm in their community to identify the extent of norm misperception. The association between whether an individual perceived daily mosquito net use to be the norm and personal mosquito net use was assessed while adjusting for the ratio of nets:people in the household and other factors.ResultsAlthough the majority (65%) of participants reported sleeping under a mosquito net every night (and 75% did so among the 86% of people with at least one net), one-quarter of participants thought that most adults in their community did not sleep under a mosquito net every night. Another 8% were unsure how many nights per week most adults in their community sleep under a mosquito net. Participants who perceived that daily mosquito net use was the norm were 2.94 times more likely to report personally sleeping under a mosquito net every night (95% CI 2.09–4.14, p < 0.001) compared to participants who thought doing so was not normative, adjusting for other factors.ConclusionsResults suggest an opportunity for anti-malarial interventions to reduce misperceptions about mosquito net use norms and emphasize the commonness of daily mosquito net use in malaria-endemic regions. If people correctly perceive most others to sleep under a net every night, then they may personally do so when possible and support others to do so too.
Highlights
Mosquito net use is an essential part of malaria prevention
Despite evidence that nets are effective in preventing malaria transmission and that most people have a net under which to sleep, some individuals still do not sleep under a mosquito net [2, 3]
In this study, 23% of adults in a malaria-endemic region misperceived sleeping under a mosquito net every night as rarely occurring among most adults in their community even though most adults personally reported sleeping under a mosquito net every night
Summary
Mosquito net use is an essential part of malaria prevention. previous research has shown that many people sleep under a mosquito net in endemic areas, it is unknown whether people underestimate how common it is to sleep under a net every night. Perceived social norms about whether most others sleep under a mosquito net every night may contribute to personally sleeping under a net, given decades of research showing that people often mimic others’ behaviours. Despite evidence that nets are effective in preventing malaria transmission and that most people have a net under which to sleep, some individuals still do not sleep under a mosquito net [2, 3]. Past research on protective behaviours and attitudes has found that many people underestimate the prevalence of a protective behaviour or attitude in a reference group and believe it to rarely occur or be held (i.e., they perceive a minority to do it or hold that belief ) even when the protective behaviour or attitude is present among a majority in that reference group [4,5,6,7,8,9]. That is, perceived descriptive norms, which are the behaviours an individual believes to be the most common within a reference group [22], may not be actual descriptive norms ( known as collective norms), which are the behaviours engaged in by a majority of the reference group [23,24,25,26]
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