Stakeholders' attitudes to outdoor residual spraying technique for dengue control in Malaysia: A PLS-SEM approach

Author summary The ups and downs of dengue cases require the Outdoor Residual Spraying (ORS) technique as an alternative method to control dengue in Malaysia. However, the introduction of ORS depends on stakeholders' acceptance. Here, the purpose of this study was to determine the factors that predict attitude to ORS and the role of religiosity as a moderator. The results indicate positive responses for implementing the ORS as a suitable technique to control dengue in Malaysia. Perceived benefit emerged as the most significant direct predictor of attitude towards the ORS (beta = 0.618, p<0.001), which they viewed this technique as less risky. Trust in key players had a significant positive relationship with attitudes towards the ORS that makes this factor the second most important direct predictor (beta = 0.151, p<0.001). Interestingly, the religiosity factor significantly moderated the relationship between perceived benefit and risk with attitudes towards the ORS. This study also showed the role played by both perceived benefit and risk as mediating factors. Outdoor Residual Spraying (ORS) technique is a complementary preventive measure for dengue. The alarming number of dengue cases in Malaysia requires an alternative method to control dengue besides the traditional method such as fogging. However, the introduction of new technologies depends on social acceptance. Therefore, this study was important to determine the factors that influence stakeholders' attitudes towards the ORS and the moderating factor. A validated instrument was used to randomly interview 399 respondents representing two stakeholder groups which consist of scientists, and the public in Klang Valley, Malaysia. The findings revealed that the stakeholders claimed to have a high degree of religiosity, a high level of trust in the key players, perceived ORS as having high benefits, and displayed highly positive attitudes towards the ORS. The attitudes model towards the ORS model was developed using the SmartPLS software version. The perceived benefit was endorsed as the most important direct predictor of attitudes towards the ORS (ss = 0.618, P<0.001), followed by trust in the key players (ss = 0.151, P<0.001). It is also interesting to note that religiosity served as a moderator for the association between perceived benefit (ss = 0.075, P = 0.024) and perceived risk (ss = 0.114, P = 0.006) with attitudes towards the ORS. The identified predictor factors of stakeholders' attitudes toward the ORS and the moderating factor can serve as indicators for social acceptance of ORS in developing countries. These indicators can help the policymakers in decision making to implement this technique.