Understanding individual adaptation to arboviral diseases risk: a systematic review of behavioral determinants of prevention and meta-analysis for non-tropical countries.

OBJECTIVES

The global spread of Aedes albopictus, a vector of dengue, chikungunya, and Zika, has caused rising autochthonous cases in non-tropical regions. This review synthesizes evidence on psychological and social determinants of individual preventive behaviors in non-endemic settings.

METHOD: Following PRISMA 2020 guidelines, PubMed and Web of Science were searched for peer-reviewed quantitative studies published up to January 6, 2026. Eligible studies reported associations between individual-level psychosocial factors (e.g., risk perception) and preventive behaviors in adults. Effect sizes from multivariate analyses were converted to correlation coefficients (r) and pooled using random-effects meta-analysis. Moderator analyses examined zone type (subtropical vs temperate) and world region (Asia-Pacific, Europe, United States).

RESULTS

Of 8531 unique records screened, 226 studies were included, with 62 in non-tropical settings. Thirteen variables across 39 studies met criteria for meta-analysis. Preventive behaviors were strongly influenced by perceived barriers, perception scores, risk perception, perceived severity, and knowledge about MBDs. The effect of knowledge was stronger in subtropical countries and Asia-Pacific countries compared to temperate countries and the United States.

CONCLUSION

Tailored communication strategies in non-endemic regions are essential to support individual adaptation as Aedes albopictus expands. Campaigns should enhance public knowledge of MBDs as well as awareness of individual and collective health risks and highlight simple, effective preventive measures.