Since its discovery in 1947 in Uganda, ZIKV has spread to 61 countries with a total of 229,238 confirmed human cases worldwide. Specifically, Ecuador has recorded 3,058 confirmed cases and 7 confirmed cases of congenital syndrome associated with ZIKV. Using the Health Belief Model (HBM), this pilot study was conducted to assess Zika virus-related knowledge and attitudes among adults in Ecuador. The survey data were collected in public places in rural and urban areas of Ecuador in May 2016. Seven items measured ZIKV knowledge and 23 items measured attitudes toward ZIKV. A total of 181 Ecuadorians participated in this study. The average age of the sample was 33.4. With respect to ZIKV knowledge, the majority of the participants had heard of ZIKV (n = 162, 89.5%). More males reported first hearing of ZIKV on the internet (p = 0.02), more rural individuals reported knowing someone diagnosed with ZIKV (p = 0.02), more primary school educated individuals reported hearing about ZIKV first from their doctor/nurse (p = 0.03), and more high school graduates correctly identified that ZIKV could be transmitted from mother to child (p = 0.03). As for the HBM constructs, there was a statistically significant difference between gender and cues to action (p = 0.04), with males having a statistically significant lower mean on the cues to action items compared to females. There were also statistically significant differences between those categorized as having “adequate” knowledge compared to “low” knowledge on the benefits construct (p = 0.04) and the perceived severity construct (p = 0.03). There is a clear need for education about the transmission and prevention of ZIKV. High levels of self-efficacy for prevention behaviors for ZIKV combined with low perceived barriers in this community set the stage for effective educational interventions or health promotion campaigns that can ameliorate the knowledge deficits surrounding transmission and prevention.

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Context: There is strong evidence that social support-particularly perceived social supportfunctions as a protective factor for health. Few studies have investigated how medical students perceive the types of social support they experience. Objective: To determine how osteopathic medical students perceive social support, understand the factors that influence their perceptions, and explore how group participation in a cocurricular, academic program could affect student perceptions. Methods: In this cross-sectional study of 983 medical students at a multicampus osteopathic medical school in the Midwest, potential respondents were invited by email in March 2018 to participate in a self-reported evaluation of their perceived social support using a 40-question Interpersonal Support Evaluation List (ISEL). The demographic variables included gender, race, age, current phase in medical school, Hispanic heritage, campus assignment, and hometown population type. A total score for each type of social support and a summative score for overall perceived social support were calculated. Descriptive statistics were applied to provide a summary of the distribution of study variables. Bivariate analyses were conducted using student t test and analysis of variance (ANOVA) statistic to determine distribution of 4 social support constructs and overall social support by all the study variables; α < .05 was considered statistically significant. Linear regression analysis was performed to determine the association between all study variables and 4 social support constructs. Pairwise interactions were calculated to determine whether the association differed by any of the study variables. Results: Self-esteem support was the lowest type of perceived social support overall in the total sample (mean [SD], 23.5[2.0]). Hispanic students reported lower overall mean perceived social support than those who did not identify as Hispanic (100 vs 104; P=.04). Older study participants had higher mean tangible support compared with their younger counterparts (26.25 vs. 25.60, P=.018; t [264]=1.18). Older study participants also had higher mean appraisal support compared with their younger counterparts (26.57 vs. 25.92, P=.06; t [266]=1.27). Female medical students reported lower levels of belonging support overall (mean [SD] 26.79, [2.10]). Students from rural hometowns reported a higher sense of belonging support than any other group. Female students from suburban and urban hometowns reported lower levels of belonging support compared with women from rural hometowns (Adj. β=−0.96, P=.01). Students who participated in the rural and urban underserved program had higher self esteem support compared with those who did not participate in the rural and urban underserved program (Adj. β=−1.30, P=.05). Students in the clinical phase of medical education reported lower levels of belonging support than students in the preclinical phase (26.14 vs. 26.69, P=.05; t[256]=1.07). Conclusions: It is critical to understand the ways medical students experience social s...

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