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Public Risk Perceptions and Preventive Behaviors During the 2009 H1N1 Influenza Pandemic

Published online by Cambridge University Press:  17 April 2015

Yushim Kim
Affiliation:
School of Public Affairs, Arizona State University, Phoenix
Wei Zhong*
Affiliation:
School of Public Administration and Policy, Renmin University of China, Beijing, China
Megan Jehn
Affiliation:
School of Human Evolution and Social Change, Arizona State University, Tempe, Arizona
Lauren Walsh
Affiliation:
National Center for Disaster Medicine and Public Health, Uniformed Services University of the Health Sciences, Rockville, Maryland
*
Correspondence and reprint requests to Wei Zhong, PhD, School of Public Administration and Policy, Renmin University of China, Quishi Bldg, Rm 437, No. 59 Zhongguancun St, Beijing, 100872, China (E-mail: wzhong@ruc.edu.cn).

Abstract

Objective

This study examines the public perception of the 2009 H1N1 influenza risk and its association with flu-related knowledge, social contexts, and preventive behaviors during the second wave of the influenza outbreak in Arizona.

Methods

Statistical analyses were conducted on survey data, which were collected from a random-digit telephone survey of the general public in Arizona in October 2009.

Results

The public perceived different levels of risk regarding the likelihood and their concern about contracting the 2009 H1N1 flu. These measures of risk perception were primarily correlated with people of Hispanic ethnicity, having children in the household, and recent seasonal flu experience in the previous year. The perceived likelihood was not strongly associated with preventive behaviors, whereas the perceived concern was significantly associated with precautionary and preparatory behaviors. The association between perceived concern and precautionary behavior persisted after controlling for demographic characteristics.

Conclusions

Pandemic preparedness and response efforts need to incorporate these findings to help develop effective risk communication strategies that properly induce preventive behaviors among the public. (Disaster Med Public Health Preparedness. 2015;9:145-154)

Type
Original Research
Copyright
Copyright © Society for Disaster Medicine and Public Health, Inc. 2015 

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References

1. Centers for Disease Control and Prevention. 2009 H1N1 flu (“swine flu”) and you. Centers for Disease Control and Prevention website. http://www.cdc.gov/h1n1flu/qa.htm. Accessed February 5, 2014.Google Scholar
2. Das, T, Savachkin, A, Zhu, Y. A large scale simulation model of pandemic influenza outbreaks for development of dynamic mitigation strategies. IIE Transactions. 2008; 40(9):893-905.Google Scholar
3. Ferguson, NM, Cummings, DA, Cauchemez, S, et al. Strategies for containing an emerging influenza pandemic in Southeast Asia. Nature. 2005; 437(8):209-214.Google Scholar
4. Gladwin, H, Lazo, JK, Morrow, BH, et al. Social science research needs for the hurricane forecast and warning system. Natural Hazards Rev. 2007; 8(3):87-95.Google Scholar
5. Lau, JT, Griffiths, S, Choi, KC, et al. Avoidance behaviors and negative psychological responses in the general population in the initial stage of the H1N1 pandemic in Hong Kong [published online May 28, 2010]. BMC Infec Dis. doi:10.1186/1471-2334-10-139.Google Scholar
6. Trainor, JE, McNeil, S. A Brief Summary of Social Science Warning and Response Literature: A Report to COT Netherlands. Newark, Deleware: University of Delaware, Disaster Research Center; 2008.Google Scholar
7. Ferguson, NM, Cummings, DA, Fraser, C, Cajka, JC, Cooley, PC, Burke, DS. Strategies for mitigating an influenza pandemic. Nature. 2006; 442(27):448-452.Google Scholar
8. Low, DE. Pandemic planning: non-pharmaceutical interventions. Respirology. 2008; 13(suppl 1):S44-S48.Google Scholar
9. de Zwart, O, Veldhuijzen, IK, Elam, G, et al. Perceived threat, risk perception, and efficacy beliefs related to SARS and other (emerging) infectious diseases: results of an international survey. Int J Behav Med. 2009; 16(1):30-40.Google Scholar
10. Ibuka, Y, Chapman, GB, Meyers, LA, Li, M, Galvani, AP. The dynamics of risk perceptions and precautionary behavior in response to 2009 (H1N1) pandemic influenza [published online October 14, 2010]. BMC Infect Dis. doi:10.1186/1471-2334-10-296.Google Scholar
11. Liao, Q, Cowling, BJ, Lam, WW, Fielding, R. The influence of social-cognitive factors on personal hygiene practices to protect against influenzas: using modelling to compare avian A/H5N1 and 2009 pandemic A/H1N1 influenzas in Hong Kong. Int J Behav Med. 2011; 18(2):93-104.Google Scholar
12. Jones, JH, Salathé, M. Early assessment of anxiety and behavioral response to novel swine-origin influenza A (H1N1) [published online December 3, 2009]. PLoS One. doi:10.1371/journal.pone.0008032.Google Scholar
13. Raude, J, Setbon, M. Lay perceptions of the pandemic influenza threat. Eur J of Epidemiol. 2009; 24:339-342.Google Scholar
14. Jiang, X, Elam, G, Yuen, C, et al. The perceived threat of SARS and its impact on precautionary actions and adverse consequences: a qualitative study among Chinese communities in the United Kingdom and the Netherlands. Int J Behav Med. 2009; 16(1):58-67.Google Scholar
15. Rubin, GJ, Amlôt, R, Page, L, Wessely, S. Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: cross sectional telephone survey [published online July 2, 2009]. BMJ. doi:http://dx.doi.org/10.1136/bmj.b2651.Google Scholar
16. Leppin, A, Aro, AR. Risk perceptions related to SARS and avian influenza: theoretical foundations of current empirical research. Int J Behav Med. 2009; 16(1):7-20.CrossRefGoogle ScholarPubMed
17. Eastwood, K, Durrheim, DN, Jones, A, Butler, M. Acceptance of pandemic (H1N1) 2009 influenza vaccination by the Australian public. Med J Aust.. 2010; 192(1):33-36.Google Scholar
18. Lau, JT, Yeung, NC, Choi, KC, Cheng, MY, Tsui, HY, Griffiths, S. Acceptability of A/H1N1 vaccination during pandemic phase of influenza A/H1N1 in Hong Kong: population based cross sectional survey [published online October 27, 2009]. BMJ. doi:http://dx.doi.org/10.1136/bmj.b4164.Google Scholar
19. Liao, Q, Cowling, B, Lam, WT, Ng, MW, Fielding, R. Situational awareness and health protective responses to pandemic influenza A (H1N1) in Hong Kong: a cross-sectional study [published online October 12, 2010]. PLoS One. doi:10.1371/journal.pone.0013350.Google Scholar
20. Jacobs, J, Taylor, M, Agho, K, Stevens, G, Barr, M, Raphael, B. Factors associated with increased risk perception of pandemic influenza in Australia [published online June 15, 2010]. Influenza Res Treat. doi:10.1155/2010/947906.Google Scholar
21. Sadique, MZ, Edmunds, WJ, Smith, RD, et al. Precautionary behavior in response to perceived threat of pandemic influenza. Emerg Infect Dis. 2007; 13(9):1307-1313.Google Scholar
22. Taylor, M, Raphael, B, Barr, M, Agho, K, Stevens, G, Jorm, L. Public health measures during an anticipated influenza pandemic: factors influencing willingness to comply. Risk Manag Healthc Policy. 2009; 2:9-20.Google Scholar
23. Yap, J, Lee, VJ, Yau, TY, Ng, TP, Tor, PC. Knowledge, attitudes and practices towards pandemic influenza among cases, close contacts, and healthcare workers in tropical Singapore: a cross-sectional survey [published online July 28, 2010]. BMC Public Health. doi:10.1186/1471-2458-10-442.Google Scholar
24. Rubin, GJ, Potts, HWW, Michie, S. The impact of communications about swine flu (influenza A H1N1v) on public responses to the outbreak: results from 36 national telephone surveys in the UK. Health Technol Assess. 2010; 14(34):183-266.Google Scholar
25. Eurobarometer. Avian influenza. European Commission website. http://ec.europa.eu/public_opinion/archives/ebs/ebs_257_en.pdf. Accessed February 11, 2013.Google Scholar
26. Hsu, JL, Liu, KE, Huang, MH, Lee, HJ. Consumer knowledge and risk perceptions of avian influenza. Poult Sci. 2008; 87:1526-1534.Google Scholar
27. Jehn, M, Kim, Y, Bradley, B, Lant, T. Community knowledge, risk perception and preparedness for the 2009 influenza A/H1N1 pandemic. J Public Health Manag Pract. 2011; 17(5):431-438.Google Scholar
28. Brug, J, Aro, AR, Oenema, A, de Zwart, O, Richardus, JH, Bishop, GD. SARS risk perception, knowledge, precautions, and information sources, the Netherlands. Emerg Infect Dis. 2004; 10(8):1486-1489.Google Scholar
29. Brewer, NT, Hallman, WK. Subjective and objective risk as predictors of influenza vaccination during the vaccine shortage of 2004-2005. Clin Infect Dis. 2006; 43(11):1379-1386.Google Scholar
30. Donner, WR. An Integrated Model of Risk Perception and Protective Action: Public Response to Tornado Warnings. Newark, Deleware: University of Delaware; 2007.Google Scholar
31. Perloff, LS, Fetzer, BK. Self-other judgments and perceived vulnerability to victimization. J Pers Soc Psychol. 1986; 1986(50):502-510.Google Scholar
32. Weinstein, ND. Unrealistic optimism about susceptibility to health problems: conclusions from a community-wide sample. Int J Behav Med. 1987; 10(5):481-500.Google Scholar
33. Chowell, G, Ayala, A, Berisha, V, Viboud, C, Schumaker, M. Risk factors for mortality among 2009 A/H1N1 influenza hospitalizations in Maricopa County, Arizona, April 2009 to March 2010 [published online May 28, 2012]. Comput Math Methods Med. doi:10.1155/2012/914196.Google Scholar
34. Shanks, J. Arizona swine flu: Maricopa County gets first case. The National Ledger website. April 29, 2009. http://www.nationalledger.com/cgi-bin/artman/exec/view.cgi?archive=36&num=25842. Accessed February 3, 2011.Google Scholar
35. Fischhoff, B. Risk perception and communication unplugged: twenty years of process. Risk Anal. 1995; 15(2):137-145.CrossRefGoogle ScholarPubMed
36. Prati, G, Pietrantoni, L, Zani, B. A social-cognitive model of pandemic influenza H1N1 risk perception and recommended behaviors in Italy. Risk Anal. 2011; 31(4):645-656.Google Scholar
37. Balkhy, HH, Abolfotouh, MA, Al-Hathlool, RH, Al-Jumah, MA. Awareness, attitudes, and practices related to the swine influenza pandemic among the Saudi public [published online February 28, 2010]. BMC Infect Dis. doi:10.1186/1471-2334-10-42.Google Scholar
38. Prati, G, Pietrantoni, L, Zani, B. Compliance with recommendations for pandemic influenza H1N1 2009: the role of trust and personal beliefs. Health Educ Res. 2011; 26(5):761-769.Google Scholar
39. Blumberg, SJ, Luke, JV. Wireless substitution: early release of estimates from the National Health Interview Survey, July-December 2008. Centers for Disease Control and Prevention website; April 22, 2010. http://www.cdc.gov/NCHS/data/nhis/earlyrelease/wireless200905.htm. Accessed February 11, 2013.Google Scholar
40. Blumberg, SJ, Luke, JV, Davidson, G, Davern, ME, Yu, TC, Soderberg, K. Wireless substitution: state-level estimates from the National Health Interview Survey, January-December 2007. Natl Health Stat Report. 2009; 14(1-13):16.Google Scholar