The cognition, behaviours and social environment related to Clonorchis sinensis infection in China: a qualitative study.

Background: Cognition, behaviours and social environment are associated with Clonorchis sinensis infection, a prevalent liver fluke disease in China. This study aimed to use social cognitive theory (SCT) to investigate these three aspects and their interaction in an endemic area.

Methods: We conducted three semi-structured focus group discussions in Da'ao town, Jiangmen city, Guangdong Province, China. Thematic analysis was used to extract themes.

Results: Twenty-four people were interviewed. The participants exhibited inadequate knowledge about C. sinensis infection and were unaware of the health risks. Although some have reduced their consumption of raw fish, some continue to consume it frequently. Compared with stopping eating raw fish, receiving tests and taking medicines were easier behaviours to adopt. Guided by the SCT, we considered the reciprocal determinism between people and the social environment as the basis of the persistent raw fish consumption behaviour. While the social environment could influence the cognition and behaviours of people, people also can reshape the social environment. Based on the reciprocal determinism, we proposed an integrated intervention framework.

Conclusions: Our study unveiled a reciprocal determinism between the cognition, behaviours and social environment related to C. sinensis infection in high-endemic areas of China, providing insights for establishing control strategies.