The Association of Beliefs About Heredity with Preventive and Interpersonal Behaviors in Communities Affected by Podoconiosis in Rural Ethiopia

Desta Ayode College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia; Brighton and Sussex Medical School, Falmer, Brighton, United Kingdom

Search for other papers by Desta Ayode in
Current site
Google Scholar
PubMed
Close
,
Colleen M. McBride College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia; Brighton and Sussex Medical School, Falmer, Brighton, United Kingdom

Search for other papers by Colleen M. McBride in
Current site
Google Scholar
PubMed
Close
,
Hendrik de Heer College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia; Brighton and Sussex Medical School, Falmer, Brighton, United Kingdom

Search for other papers by Hendrik de Heer in
Current site
Google Scholar
PubMed
Close
,
Emi Watanabe College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia; Brighton and Sussex Medical School, Falmer, Brighton, United Kingdom

Search for other papers by Emi Watanabe in
Current site
Google Scholar
PubMed
Close
,
Tsega Gebreyesus College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia; Brighton and Sussex Medical School, Falmer, Brighton, United Kingdom

Search for other papers by Tsega Gebreyesus in
Current site
Google Scholar
PubMed
Close
,
Getnet Tadele College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia; Brighton and Sussex Medical School, Falmer, Brighton, United Kingdom

Search for other papers by Getnet Tadele in
Current site
Google Scholar
PubMed
Close
,
Abebayehu Tora College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia; Brighton and Sussex Medical School, Falmer, Brighton, United Kingdom

Search for other papers by Abebayehu Tora in
Current site
Google Scholar
PubMed
Close
, and
Gail Davey College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia; Social and Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland; Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia; Brighton and Sussex Medical School, Falmer, Brighton, United Kingdom

Search for other papers by Gail Davey in
Current site
Google Scholar
PubMed
Close
Restricted access

Little is known about how beliefs about heredity as a cause of health conditions might influence preventive and interpersonal behaviors among those individuals with low genetic and health literacy. We explored causal beliefs about podoconiosis, a neglected tropical disease (NTD) endemic in Ethiopia. Podoconiosis clusters in families but can be prevented if individuals at genetically high risk wear shoes consistently. Adults (N = 242) from four rural Ethiopian communities participated in qualitative assessments of beliefs about the causes of podoconiosis. Heredity was commonly mentioned, with heredity being perceived as (1) the sole cause of podoconiosis, (2) not a causal factor, or (3) one of multiple causes. These beliefs influenced the perceived controllability of podoconiosis and in turn, whether individuals endorsed preventive and interpersonal stigmatizing behaviors. Culturally informed education programs that increase the perceived controllability of stigmatized hereditary health conditions like podoconiosis have promise for increasing preventive behaviors and reducing interpersonal stigma.

Author Notes

* Address correspondence to Colleen M. McBride, Social and Behavioral Research Branch, National Human Genome Research Institute, Building 31, MSC 2073, 31 Center Drive, Room B1B54, Bethesda, MD 20892. E-mail: cmcbride@mail.nih.gov

Financial support: This project was supported by the Intramural Research Program of the Social & Behavioral Science Branch (SBRB). The SBRB is supported by the National Human Genome Research Institutes, National Institutes of Health.

Authors' addresses: Desta Ayode and Getnet Tadele, College of Social Sciences, Addis Ababa University, Addis Ababa, Ethiopia, E-mails: destaayode@yahoo.com and getnett2001@yahoo.com. Colleen M. McBride and Emi Watanabe, Social & Behavioral Research Branch, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, E-mails: cmcbride@mail.nih.gov and watanabee@mail.nih.gov. Hendrik de Heer, Department of Physical Therapy and Athletic Training, College of Health and Human Services, Northern Arizona University, Flagstaff, AZ, E-mail: hendrik.deheer@nau.edu. Tsega Gebreyesus, Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, E-mail: tgebreye@jhsph.edu. Abebayehu Tora, Department of Sociology, Wolaita Sodo University, Sodo, Ethiopia, E-mail: abezed@yahoo.com. Gail Davey, Brighton and Sussex Medical School, Falmer, Brighton, United Kingdom, E-mail: G.Davey@bsms.ac.uk.

  • 1.

    Acharya T, Daar A, Thorsteinsdottir H, Dowdeswell E, Singer P, 2004. Strengthening the role of genomics in global health. PLoS Med 1: e40.

  • 2.

    Williams T, 2010. Genomics offers new possibilities for global health through international collaboration. Dis Model Mech 3: 131133.

  • 3.

    Smith RD, Thorsteinsdottir H, Daar AS, Gold ER, Singers PA, 2004. Genomics knowledge and equity: a global public goods perspective of the patent system. Bull World Health Organ 82: 385389.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Daar AS, Thorsteinsdottir H, Martin DK, Smith AC, Nast S, Singer PA, 2002. Top ten biotechnologies for improving health in developing countries. Nat Genet 32: 229232.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 5.

    Seib KL, Dougan G, Rappuoli R, 2009. The key role of genomics in modern vaccine and drug design for emerging infectious diseases. PLoS Genet 5: 26.

  • 6.

    Khoury MJ, Gwinn M, Bowen MS, Dotson WD, 2012. Beyond base pairs to bedside: a population perspective on how genomics can improve health. Am J Public Health 102: 3437.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    Condit CM, Shen L, 2011. Public understanding of risks from gene-environment interaction in common diseases: implications for public communications. Public Health Genomics 14: 115124.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 8.

    Leventhal H, Breland JY, Mora PA, Leventhal EA, 2010. Lay representations of illness and treatment. Steptoe A, Freeland K, Jennings R, Llabre M, Manuck S, Susman E, eds. Handbook of Behavioral Medicine: Methods and Applications. New York, NY: Springer.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 9.

    Bandura A, 1977. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 84: 191215.

  • 10.

    Janz NK, Becker MH, 1984. The Health Belief Model: a decade later. Health Educ Q 11: 147.

  • 11.

    Landrine H, Klonoff EA, 1992. Culture and health-related schemas: a review and proposal for interdisciplinary integration. Health Psychol 11: 267276.

  • 12.

    Decruyenaere M, Evers-Kiebooms G, Welkenhuysen M, Denayer L, Claes E, 2000. Cognitive representations of breast cancer, emotional distress and preventive health behaviour: a theoretical perspective. Psychooncology 9: 528536.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 13.

    Abraham C, Sheeran P, Johnston M, 1998. From health beliefs to self-regulation: theoretical advances in the psychology of action control. Psychol Health 13: 569591.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Shiloh S, Rashuk-Rosenthal D, Benyamini Y, 2002. Illness causal attributions: an exploratory study of their structure and associations with other illness cognitions and perceptions of control. J Behav Med 25: 373394.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Marteau TM, Weinman J, 2006. Self-regulation and the behavioural response to DNA risk information: a theoretical analysis and framework for future research. Soc Sci Med 62: 13601368.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Klonoff EA, Landrine H, 1994. Culture and gender diversity in commonsense beliefs about the causes of six illnesses. J Behav Med 17: 407418.

  • 17.

    Marteau TM, Senior V, 1997. Illness representations after the human genome project: the perceived role of genes in causing illness. Petrie KJ, Weinman JA, eds. Perceptions of Illness and Treatment: Current Psychological Research and Implications. Amsterdam, The Netherlands: Harwood Academic, 241266.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 18.

    van Oostrom I, Meijers-Heijboer H, Duivenvoorden HJ, Brocker-Vriends AH, van Asperen CJ, Sijmons RH, Seynaeve C, Van Gool AR, Klijn JG, Tibben A, 2007. The common sense model of self-regulation and psychological adjustment to predictive genetic testing: a prospective study. Psychooncology 16: 11211129.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 19.

    Marteau TM, French DP, Griffin SJ, Prevost AT, Sutton S, Watkinson C, Attwood S, Hollands GJ, 2010. Effects of communicating DNA-based disease risk estimates on risk-reducing behaviours. Cochrane Database Syst Rev 10: CD007275.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 20.

    McBride CM, Koehly LM, Sanderson SC, Kaphingst KA, 2010. The behavioral response to personalized genetic information: will genetic risk profiles motivate individuals and families to choose more healthful behaviors? Annu Rev Public Health 31: 89103.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 21.

    Angermeyer MC, Holzinger A, Carta MG, Schomerus G, 2011. Biogenetic explanations and public acceptance of mental illness: systematic review of population studies. Br J Psychiatry 199: 367372.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 22.

    Sobel SK, Cowan DB, 2000. Impact of genetic testing for Huntington disease on the family system. Am J Med Genet 90: 4959.

  • 23.

    Chao S, Roberts JS, Marteau TM, Silliman R, Cupples LA, Green RC, 2008. Health behavior changes after genetic risk assessment for Alzheimer disease: the REVEAL Study. Alzheimer Dis Assoc Disord 22: 9497.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 24.

    Wade CH, Wilfond BS, McBride CM, 2010. Effects of genetic risk information on children's psychosocial wellbeing: a systematic review of the literature. Genet Med 12: 317326.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 25.

    Pang T, 2009. Germs, genomics and global public health: how can advances in genomic sciences be integrated into public health in the developing world to deal with infectious diseases? Hugo J 3: 59.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 26.

    Price EW, 1988. Non-filarial elephantiasis—confirmed as a geochemical disease, and renamed podoconiosis. Ethiop Med J 26: 151153.

  • 27.

    Davey G, Gebrehanna E, Adeyemo A, Rotimi C, Newport M, Desta K, 2007. Podoconiosis: a tropical model for gene-environment interactions? Trans R Soc Trop Med Hyg 101: 9196.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 28.

    Davey G, Tekola F, Newport MJ, 2007. Podoconiosis: non-infectious geochemical elephantiasis. Trans R Soc Trop Med Hyg 101: 11751180.

  • 29.

    Yakob B, Deribe K, Davey G, 2008. High levels of misconceptions and stigma in a community highly endemic for podoconiosis in southern Ethiopia. Trans R Soc Trop Med Hyg 102: 439444.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 30.

    Tadesse G, 2005. The prevalence of intestinal helminthic infections and associated risk factors among school children in Babile town, eastern Ethiopia. Ethiop J Health Dev 19: 140147.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 31.

    Tekola F, Bull S, Farsides B, Newport MJ, Adeyemo A, Rotimi CN, Davey G, 2009. Impact of social stigma on the process of obtaining informed consent for genetic research on podoconiosis: a qualitative study. BMC Med Ethics 10: 13.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 32.

    Tora A, Davey G, Tadele G, 2011. A qualitative study on stigma and coping strategies of patients with podoconiosis in Wolaita zone, Southern Ethiopia. In Health 3: 176181.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 33.

    International Human Development Indicators. Ethiopia Country Profile: Human Development Indicators. Available at: http://hdrstats.undp.org/en/countries/profiles/ETH.html. Accessed March 26, 2012.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 34.

    Ethiopia World Bank Data. Available at: http://www.tradingeconomics.com/ethiopia/indicators. Accessed June 19, 2012.

    • PubMed
    • Export Citation
  • 35.

    Central Statistical Agency of Ethiopia. Available at: http://www.csa.gov.et/. Accessed March 26, 2012.

    • PubMed
    • Export Citation
  • 36.

    Destas K, Ashine M, Davey G, 2003. Prevalence of podoconiosis (endemic non-filarial elephantiasis) in Wolaitta, Southern Ethiopia. Trop Doct 33: 217220.

  • 37.

    Davey G, Burridge E, 2009. Community-based control of a neglected tropical disease: the mossy foot treatment and prevention association. PLoS Negl Trop Dis 3: e424.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 38.

    Sikorski C, Ashine M, Zeleke Z, Davey G, 2010. Effectiveness of a simple lymphoedema treatment regimen in podoconiosis management in southern ethiopia: one year follow-up. PLoS Negl Trop Dis 4: e902.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 39.

    Peay HL, Austin JC, 2011. How to Talk with Families About Genetics and Psychiatric Illness. W. W. Norton & Company, 87.

  • 40.

    Gyapong M, Gyapong JO, Adjei S, Vlassoff C, Weiss M, 1996. Filariasis in northern Ghana: some cultural beliefs and practices and their implications for disease control. Soc Sci Med 43: 235242.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • 41.

    Tekola Ayele F, Adeyemo A, Finan C, Hailu E, Sinnott P, Burlinson ND, Aseffa A, Rotimi CN, Newport MJ, Davey G, 2012. HLA class II locus and susceptibility to podoconiosis. N Engl J Med 366: 12001208.

    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 212 209 18
Full Text Views 416 6 0
PDF Downloads 68 1 0
 
 
 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save