Effects of message delivery on cross-cultural biosecurity compliance: Insights from experimental simulations.

Background: Effective biosecurity communication of transmission risks and associated protective behaviors can reduce the impacts of infectious diseases in US animal agriculture. Yet, more than 1/5 of animal production workers speak a language other than English at home, and more than 40 percent are less than fluent in English. Communicating with these workers often involves translating into their primary languages. However, communication strategies targeting different cultural groups are not well-understood. Aims: To identify cross-linguistic risk communication strategies to facilitate compliance, we hypothesized that uncertainty avoidance cultures associated with the languages might affect biosecurity compliance contingent upon two additional covariates: (1) the risk of acquiring an infection and (2) the delivery method of the infection risk. Methods: We designed an experimental game simulating a line of separation (LOS) biosecurity tactic in a swine production facility, where participants were tasked with completing tasks inside and outside of the facility. Data were collected using games in the two most spoken languages in the US: English (EN) and Spanish (SP). Participants made binary decisions about whether to use the LOS biosecurity tactic based on the risk information provided. Mixed-effect logistic models were used to test the effects of covariates on using the LOS tactic by different language groups. Results: We found that biosecurity compliance rates of participants who took the experiments in the language associated with high and low uncertainty cultures showed no significant differences. However, there are substantial differences in how risk information is perceived between the two language groups under different infection risks. Specifically, and counterintuitively, SP participants were more risk-averse in gain scenarios but more risk-taking in loss scenarios. These differences are most pronounced in numeric risk messaging, indicating that numbers may not be the best way to communicate risk information regarding biosecurity cross-culturally. Conclusions: When confronted with situational biosecurity decisions, risk perception and preferences vary by language group. Effective biosecurity communication needs to account for these differences and not assume that direct translation of risk messages will result in comparable compliance.

Comparing behavioral risk assessment strategies for quantifying biosecurity compliance to mitigate animal disease spread.

Understanding the impact of human behavior on the spread of disease is critical in mitigating outbreak severity. We designed an experimental game that emulated worker decision-making in a swine facility during an outbreak. In order to combat contamination, the simulation features a line-of-separation biosecurity protocol. Participants are provided disease severity information and can choose whether or not to comply with a shower protocol. Each simulated decision carried the potential for either an economic cost or an opportunity cost, both of which affected their potential real-world earnings. Participants must weigh the risk infection vs. an opportunity cost associated with compliance. Participants then completed a multiple price list (MPL) risk assessment survey. The survey uses a context-free, paired-lottery approach in which one of two options may be selected, with varying probabilities of a high and low risk payouts. We compared game response data to MPL risk assessment. Game risk was calculated using the normalized frequency of biosecurity compliance. Three predominant strategies were identified: risk averse participants who had the highest rate of compliance; risk tolerant participants who had the lowest compliance rate; and opportunists who adapted their strategy depending on disease risk. These findings were compared to the proportion of risk averse choices observed within the MPL and were classified into 3 categories: risk averse, risk tolerant and neutral. We found weak positive correlation between risk measured in our experimental game compared to the MPL. However, risk averse classified participants in the MPL tended to comply with the biosecurity protocol more often than those classified as risk tolerant. We also found that the behavioral risk clusters and categorization via the MPL were significantly, yet weakly associated. Overall, behavioral distributions were skewed toward more risk averse choices in both the MPL and game. However, the MPL risk assessment wasn't a strong predictor for observed game behavior. This may indicate that MPL risk aversion metrics might not be sufficient to capture these simulated, situational risk aversion behaviors. Experimental games have a large potential for expanding upon traditional survey instruments by immersing participants in a complex decision mechanism, and capturing dynamic and evolving behavioral signals.

Connecting livestock disease dynamics to human learning and biosecurity decisions.

The acceleration of animal disease spread worldwide due to increased animal, feed, and human movement has driven a growing body of epidemiological research as well as a deeper interest in human behavioral studies aimed at understanding their interconnectedness. Biosecurity measures can reduce the risk of infection, but human risk tolerance can hinder biosecurity investments and compliance. Humans may learn from hardship and become more risk averse, but sometimes they instead become more risk tolerant because they forget negative experiences happened in the past or because they come to believe they are immune. We represent the complexity of the hog production system with disease threats, human decision making, and human risk attitude using an agent-based model. Our objective is to explore the role of risk tolerant behaviors and the consequences of delayed biosecurity investments. We set up experiment with Monte Carlo simulations of scenarios designed with different risk tolerance amongst the swine producers and we derive distributions and trends of biosecurity and porcine epidemic diarrhea virus (PEDv) incidence emerging in the system. The output data allowed us to examine interactions between modes of risk tolerance and timings of biosecurity response discussing consequences for disease protection in the production system. The results show that hasty and delayed biosecurity responses or slow shifts toward a biosecure culture do not guarantee control of contamination when the disease has already spread in the system. In an effort to support effective disease prevention, our model results can inform policy making to move toward more resilient and healthy production systems. The modeled dynamics of risk attitude have also the potential to improve communication strategies for nudging and establishing risk averse behaviors thereby equipping the production system in case of foreign disease incursions.

Unmet needs and behaviour during the Ebola response in Sierra Leone: a retrospective, mixed-methods analysis of community feedback from the Social Mobilization Action Consortium.

BACKGROUND: The west African Ebola epidemic (2014-15) necessitated behaviour change in settings with prevalent and pre-existing unmet needs as well as extensive mechanisms for local community action. We aimed to assess spatial and temporal trends in community-reported needs and associations with behaviour change, community engagement, and the overall outbreak situation in Sierra Leone. METHODS: We did a retrospective, mixed-methods study. Post-hoc analyses of data from 12 096 mobiliser visits as part of the Social Mobilization Action Consortium were used to describe the evolution of satisfied and unsatisfied needs (basic, security, autonomy, respect, and social support) between Nov 12, 2014, and Dec 18, 2015, and across 14 districts. Via Bayesian hierarchical regression modelling, we investigated associations between needs categories and behaviours (numbers of individuals referred to treatment within 24 h of symptom onset or deaths responded to with safe and dignified burials) and the role of community engagement programme status (initial vs follow-up visit) in the association between satisfied versus unsatisfied needs and behaviours. FINDINGS: In general, significant associations were observed between unsatisfied needs categories and both prompt referrals to treatment and safe burials. Most notably, communities expressing unsatisfied capacity needs reported fewer safe burials (relative risk [RR] 0·86, 95% credible interval [CrI] 0·82-0·91) and fewer prompt referrals to treatment (RR 0·76, 0·70-0·83) than did those without unsatisfied capacity needs. The exception was expression of unsatisfied basic needs, which was associated with significantly fewer prompt referrals only (RR 0·86, 95% CrI 0·79-0·93). Compared with triggering visits by community mobilisers, follow-up visits were associated with higher numbers of prompt referrals (RR 1·40, 95% CrI 1·30-1·50) and safe burials (RR 1·08, 1·02-1·14). INTERPRETATION: Community-based development of locally feasible, locally owned action plans, with the support of community mobilisers, has potential to address unmet needs for more sustained behaviour change in outbreak settings. FUNDING: Bill & Melinda Gates, Bill & Melinda Gates Foundation, and National Institutes of Health.

Using experimental gaming simulations to elicit risk mitigation behavioral strategies for agricultural disease management.

Failing to mitigate propagation of disease spread can result in dire economic consequences for agricultural networks. Pathogens like Porcine Epidemic Diarrhea virus, can quickly spread among producers. Biosecurity is designed to prevent infection transmission. When considering biosecurity investments, management must balance the cost of protection versus the consequences of contracting an infection. Thus, an examination of the decision making processes associated with investment in biosecurity is important for enhancing system wide biosecurity. Data gathered from experimental gaming simulations can provide insights into behavioral strategies and inform the development of decision support systems. We created an online digital experiment to simulate outbreak scenarios among swine production supply chains, where participants were tasked with making biosecurity investment decisions. In Experiment One, we quantified the risk associated with each participant's decisions and delineated three dominant categories of risk attitudes: risk averse, risk tolerant, and opportunistic. Each risk class exhibited unique approaches in reaction to risk and disease information. We also tested how information uncertainty affects risk aversion, by varying the amount of visibility of the infection as well as the amount of biosecurity implemented across the system. We found evidence that more visibility in the number of infected sites increases risk averse behaviors, while more visibility in the amount of neighboring biosecurity increased risk taking behaviors. In Experiment Two, we were surprised to find no evidence for differences in behavior of livestock specialists compared to Amazon Mechanical Turk participants. Our findings provide support for using experimental gaming simulations to study how risk communication affects behavior, which can provide insights towards more effective messaging strategies.

Emulating Agricultural Disease Management: Comparing Risk Preferences Between Industry Professionals and Online Participants Using Experimental Gaming Simulations and Paired Lottery Choice Surveys.

Mitigating the spread of disease is crucial for the well-being of agricultural production systems. Implementing biosecurity disease prevention measures can be expensive, so producers must balance the costs of biosecurity investments with the expected benefits of reducing the risk of infections. To investigate the risk associated with this decision making process, we developed an online experimental game that simulates biosecurity investment allocation of a pork production facility during an outbreak. Participants are presented with several scenarios that vary the visibility of the disease status and biosecurity protection implemented at neighboring facilities. Certain rounds allowed participants to spend resources to reduce uncertainty and reveal neighboring biosecurity and/or disease status. We then test how this uncertainty affects the decisions to spend simulation dollars to increase biosecurity and reduce risk. We recruited 50 attendees from the 2018 World Pork Expo to participate in our simulation. We compared their performance to an opportunity sample of 50 online participants from the survey crowdsourcing tool, Amazon Mechanical Turk (MTurk). With respect to biosecurity investment, we did not find a significant difference between the risk behaviors of industry professionals and those of MTurk participants for each set of experimental scenarios. Notably, we found that our sample of industry professionals opted to pay to reveal disease and biosecurity information more often than MTurk participants. However, the biosecurity investment decisions were not significantly different during rounds in which additional information could be purchased. To further validate these findings, we compared the risk associated with each group's responses using a well-established risk assessment survey implementing paired lottery choices. Interestingly, we did not find a correlation in risk quantified with simulated biosecurity investment in comparison to the paired lottery choice survey. This may be evidence that general economic risk preferences may not always translate into simulated behavioral risk, perhaps due to the contextual immersion provided by experimental gaming simulations. Online recruitment tools can provide cost effective research quality data that can be rapidly assembled in comparison to industry professionals, who may be more challenging to sample at scale. Using a convenience sample of industry professionals for validation can also provide additional insights into the decision making process. These findings lend support to using online experimental simulations for interpreting risk associated with a complex decision mechanism.