Date of Conferral





Health Services


Hadi Danawi



West Nile virus (WNV) is a major public health problem and the cause of nearly 25% of the world's economic burden of disease. While the risk factors for developing West Nile fever and West Nile disease from WNV infection have been identified, it is not known how knowledge, attitude, behavior (KAB), access to health care (AHC), and comorbidities are associated with prevention practices of WNV infection among ethnic minorities. The aim of this study was to examine the association between KAB, AHC, comorbidities, and prevention practices of WNV infection among ethnic minorities in Texas. KAB, AHC. Comorbidities were used as independent variables and prevention practices were the dependent variables. A cross-sectional quantitative research method within the theoretical framework of the Health belief model was used. Based on sample size computations, 434 for the main study and 20 participants for the pilot study were selected using a convenience sampling method. Linear regression was used for modeling and used a summary index for the dependent variables. The pilot study was used to confirm the feasibility of the main study. Ethnic minorities who speak English and are 18 years and older were surveyed using pre and self-developed survey instruments. Findings of the analyses indicated that there were major associations between knowledge (r=.38, p < .001), attitude (r=.26, p < .001) and behavior (r=.34, p < 001), but not for AHC and comorbidities (p>0.005) The 2 major findings are that AHC and comorbidities are not associated with prevention practices of WNV infection and the current prevention practices are not appropriate for a Texas climate. These findings will allow scientific scholars to design and develop educational materials and create a more acceptable and environmentally adaptable prevention practice. The result of this dissertation may lead to targeted education programs and policy changes, which can lead to positive social change.