{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T22:25:10Z","timestamp":1783722310141,"version":"3.55.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0012723","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000}}],"reference-count":64,"publisher":"Public Library of Science (PLoS)","issue":"5","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec018\">\n<jats:title>Background<\/jats:title>\n<jats:p>Dengue remains a significant public health challenge in Taiwan, particularly in the southern region where <jats:italic>Aedes aegypti<\/jats:italic> and <jats:italic>Aedes albopictus<\/jats:italic> mosquitoes thrive. Despite nationwide dengue prevention campaigns, message fatigue\u2014where individuals become disengaged due to repetitive messaging\u2014may reduce the effectiveness of public health communication. This study analyses trends and associations between key predictors\u2014such as age, sex, education, job, and perceived risks (optimistic bias, perceived prevalence, and perceived severity)\u2014and message fatigue across different dengue-risk areas in Taiwan.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec019\">\n<jats:title>Methodology\/principal findings<\/jats:title>\n<jats:p>A cross-sectional online survey was conducted from October 25 to November 13, 2023, among 814 adults across Taiwan. Participants were classified into high-risk (southern Taiwan) and low-risk (other regions) groups. Message fatigue was assessed using the message environment (ME) and audience response (AR) dimensions. Perceived risks (perceived prevalence, severity, and optimistic bias) and demographic variables (sex, age, education, job experience, and residency) were analyzed using Poisson and Negative Binomial regression models.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec020\">\n<jats:title>Findings<\/jats:title>\n<jats:p>The findings revealed that message fatigue varied by region and demographic factors. In high-risk areas, individuals with lower education levels exhibited higher AR fatigue (boredom and disengagement) (p\u2009=\u20090.04). In low-risk areas, males (p\u2009=\u20090.02), individuals with lower education (p\u2009=\u20090.01), and those with optimistic bias (p\u2009=\u20090.02) reported significantly higher ME fatigue (perceived overexposure). Despite uniform nationwide messaging, participants in high-risk regions exhibited greater message fatigue, possibly due to habituation.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec021\">\n<jats:title>Conclusions\/significance<\/jats:title>\n<jats:p>Message fatigue is associated with regional dengue risk, demographic factors, and perceived risk. A uniform health communication approach may not be effective across different populations. In high-risk regions, message fatigue is more pronounced. Repetitive warnings may contribute to disengagement, suggesting a need for communication strategies that reduce redundancy and emphasize localized, actionable information. In low-risk areas, messages should focus on engagement, particularly for men, who exhibited higher fatigue in this study. Simplified messaging can reduce cognitive overload for lower-educated populations. Addressing message fatigue can enhance the effectiveness of dengue prevention campaigns and sustain public engagement in long-term health communication efforts.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0012723","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T17:56:31Z","timestamp":1748627791000},"page":"e0012723","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Tailoring dengue health communication: Survey-based strategies to reduce message fatigue across risk areas"],"prefix":"10.1371","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8325-648X","authenticated-orcid":true,"given":"Chia-Hsien","family":"Lin","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yen-Jung","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hung-Yi","family":"Lu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,5,30]]},"reference":[{"key":"pntd.0012723.ref001","volume-title":"Guidelines for Dengue\/ Chikungunya Control 2024 [Chinese]","author":"Centers for Disease Control ROCT.","year":"2024"},{"key":"pntd.0012723.ref002","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.ijid.2016.11.008","article-title":"Trend and geographic analysis of the prevalence of dengue in Taiwan, 2010-2015","volume":"54","author":"JC Hsu","year":"2017","journal-title":"Int J Infect Dis"},{"issue":"1","key":"pntd.0012723.ref003","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1186\/s12879-021-05809-1","article-title":"Retrospective Seroepidemiology study of dengue virus infection in Taiwan","volume":"21","author":"Y-H Lee","year":"2021","journal-title":"BMC Infect Dis"},{"issue":"5","key":"pntd.0012723.ref004","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1016\/j.bj.2018.06.002","article-title":"Dengue outbreaks and the geographic distribution of dengue vectors in Taiwan: A 20-year epidemiological analysis","volume":"41","author":"W-J Chen","year":"2018","journal-title":"Biomed J"},{"issue":"3","key":"pntd.0012723.ref005","first-page":"307","article-title":"Investigations on the distribution and breeding habitats of dengue vectors in Liuchiu, Pingtung","volume":"14","author":"JS Hwang","year":"1994","journal-title":"Formosan Entomologist"},{"issue":"3","key":"pntd.0012723.ref006","first-page":"155","article-title":"The distribrtion of dengue vectors and its possible explanation in the coastal area of Chiayi County","volume":"16","author":"H Teng","year":"1996","journal-title":"Formosan Entomologist"},{"issue":"2","key":"pntd.0012723.ref007","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1603\/ME11263","article-title":"A dengue vector surveillance by human population-stratified ovitrap survey for Aedes (Diptera: Culicidae) adult and egg collections in high dengue-risk areas of Taiwan","volume":"50","author":"H-H Wu","year":"2013","journal-title":"J Med Entomol"},{"issue":"4","key":"pntd.0012723.ref008","doi-asserted-by":"crossref","first-page":"241","DOI":"10.7601\/mez.60.241","article-title":"Recent distribution of vector mosquitoes and epidemiology of the diseases they transmitted in Taiwan","volume":"60","author":"J-W WU","year":"2009","journal-title":"Med Entomol Zool"},{"issue":"4","key":"pntd.0012723.ref009","doi-asserted-by":"crossref","first-page":"468","DOI":"10.1093\/jmedent\/36.4.468","article-title":"Mosquito fauna in water-holding containers with emphasis on dengue vectors (Diptera: Culicidae) in Chungho, Taipei County, Taiwan","volume":"36","author":"HJ Teng","year":"1999","journal-title":"J Med Entomol"},{"issue":"5","key":"pntd.0012723.ref010","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1177\/01655515221118047","article-title":"How do information overload and message fatigue reduce information processing in the era of COVID-19? 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