Attitude
The reception given to the video by the participants was unanimously positive. They experienced a sense of satisfaction and even elation after viewing it. The video was appreciated for the learning it provided. Not only did it meet a need for information, but it also standardized the front-line medical approach. The video transmitted specific and concise information that increased their knowledge and understanding of dengue fever.
“I can say the video is short and specific; the key points are made briefly, so it can be viewed without losing too much time, and without becoming impatient and abandoning it.” (Midwife)
The positive assessment of the video was also based on the relevance of the message, which was considered essential given the dengue fever outbreaks. It was greatly appreciated that the video was in French and clarified the terminology in current use.
“We ourselves, the health workers, tended to say ‘palu-dingue’ [malaria-dengue]. So it was really useful for changing that, and now I, too, correct anyone who says palu-dingue.” (Midwife)
Respondents’ attitudes were also strongly influenced by the epidemic context. Health workers had been worried since the 2013 dengue epidemic. The video could serve as a tool for raising awareness or alerting the medical community. Some reported having witnessed fatal cases of dengue fever, which made the epidemic all the more tangible and the desire to fight it more personal.
“The video was welcome. I received the video when dengue fever was at a very high level at the CMA [satellite medical centre] in Nouna. There were cases every day.” (Nurse)
The lessons learned, the summary format, the relevance of the message, as well as the epidemic context thus appeared to make respondents receptive to integrating the video’s content into their practice.
Subjective norms
Subjective norms suggest the social environment can influence the individual’s behaviour and intention to act. Respondents expressed a strong sense of belonging to the health professional community by systematically sharing the video they had viewed through social networks, to encourage others to integrate this knowledge as well.
“Dengue fever is a disease of global concern. It was important for everyone to learn what this disease is, and if there are ways [to cope with it], for everyone to adopt them for protection. It was with this in mind that I received the link and wanted to share it with my colleagues so everyone could become aware.” (Pharmacist)
The respondents did not view the reactions of their colleagues and superiors as hindering the use of the knowledge, as they were confident those reactions would be positive.
Perception of control over one’s behaviour
Health workers’ perceptions of how much control they had over their behaviour influenced their intention to act. Respondents working in clinics all emphasized the healthcare provider’s autonomy. In their view, there was no restriction on applying scientific data, as long as those data were considered credible, which was the case here.
“The staff member is quite autonomous; he doesn’t need third-party authorization to be able to diagnose, because he’s the one in charge, so there’s nothing to worry about.” (District medical officer)
It should be noted that half the respondents indicated that the information in the video was in line with Ministry of Health guidelines, which reinforced its integration into their practice. However, only three of those respondents treated patients directly. The rest were in management positions, and it was to be expected that they would be more aware of national guidelines. The other half of respondents deplored the lack of information on dengue fever and its treatment. The video was likely to change practices:
“If things go well with the Ministry of Health, there’s no problem putting this into practice. But this year, we’re not really informed about dengue fever. That’s what’s making it difficult to manage dengue.” (Midwife)
“I think what’s in the video doesn’t contradict the directives we were given. It just reinforces what was issued by the Department of Diseases, so in my view, there shouldn’t be any problem as long as it complies with the national directives.” (Manager, evaluation follow-up)
The healthcare providers thus had the autonomy required to integrate new knowledge into their practice and affirmed that they had full control over what they did in consultations.