Beyond the 'back yard': Lay knowledge about Aedes aegypti in northern Australia and its implications for policy and practice.

Controlling dengue fever in Australia and internationally, relies heavily upon the actions of residents as well as community education and awareness of the risks. Although it has been well established in medical anthropology that the success of health interventions is highly dependent upon a clear grasp of lay knowledge of disease, limited attention has been given to lay understandings of dengue fever and its vectors in the extant literature. We begin addressing this hiatus through an examination of north Queensland residents' knowledge of the breeding habitats of Aedes aegypti mosquitoes. Building on the insights of earlier social research, we use factor analysis to examine the results of a series of randomly selected telephone surveys and compare responses over time and between cities. Our analysis confirms that many people assume that Ae. aegypti is ubiquitous in the landscape, that it lives and breeds not only around the home, but also in a variety of geographical spaces located beyond the suburban 'backyard', and beyond the control of local residents. Lay understandings appear to be placing people at risk from dengue, influencing the mosquito management practices of local residents and acting as a source of resistance to public health messages that focus on individual responsibility. A way forward through the provision of new information that challenges key assumptions is provided in the discussion. We argue that rather than dismissing lay understandings as ignorance, strategies, practices and policy based on a detailed understanding of this knowledge will mean that practitioners are better able to address these assumptions and will likely be more effective at educating the public of the risks posed by dengue.