Perceived risk, anxiety, and behavioural responses of the general public during the early phase of the Influenza A (H1N1) pandemic in the Netherlands: results of three consecutive online surveys

Abstract

BackgroundResearch into risk perception and behavioural responses in case of emerging infectious diseases is still relatively new. The aim of this study was to examine perceptions and behaviours of the general public during the early phase of the Influenza A (H1N1) pandemic in the Netherlands.MethodsTwo cross-sectional and one follow-up online survey (survey 1, 30 April-4 May; survey 2, 15-19 June; survey 3, 11-20 August 2009). Adults aged 18 years and above participating in a representative Internet panel were invited (survey 1, n = 456; survey 2, n = 478; follow-up survey 3, n = 934). Main outcome measures were 1) time trends in risk perception, feelings of anxiety, and behavioural responses (survey 1-3) and 2) factors associated with taking preventive measures and strong intention to comply with government-advised preventive measures in the future (survey 3).ResultsBetween May and August 2009, the level of knowledge regarding Influenza A (H1N1) increased, while perceived severity of the new flu, perceived self-efficacy, and intention to comply with preventive measures decreased. The perceived reliability of information from the government decreased from May to August (62% versus 45%). Feelings of anxiety decreased from May to June, and remained stable afterwards. From June to August 2009, perceived vulnerability increased and more respondents took preventive measures (14% versus 38%). Taking preventive measures was associated with no children in the household, high anxiety, high self-efficacy, more agreement with statements on avoidance, and paying much attention to media information regarding Influenza A (H1N1). Having a strong intention to comply with government-advised preventive measures in the future was associated with higher age, high perceived severity, high anxiety, high perceived efficacy of measures, high self-efficacy, and finding governmental information to be reliable.ConclusionsDecreasing trends over time in perceived severity and anxiety are consistent with the reality: the clinical picture of influenza turned out to be mild in course of time. Although (inter)national health authorities initially overestimated the case fatality rate, the public stayed calm and remained to have a relatively high intention to comply with preventive measures.

Willingness to Receive the Influenza A(H1N1) Vaccine and its Determinants among University Students during the 2009 Outbreak in Turkey

“…The low level of knowledge towards H1N1 of the health group students who shall be a reliable source of knowledge for the public derives a necessity of education and training. The willingness to receive the Influenza A(H1N1) vaccine was quite low in our study like other studies in Turkey, although lower than studies in other countries, especially for the health group compared to international health proffesionals [3,5,10,[14][15][16]. Additionally, a considerable proportion of the study group was undecided.…”

“…Most of the students knew the infectious agent was a virus like similar ones [9,10]. Breathing was known as the most familiar way of transmission of H1N1, although the term 'droplet' was also almost unknown for the health group.…”

Anxiety and Work Avoidance among Intensive Care Workers during an Influenza A/H1N1 Outbreak

“…Similarly, good staff perception of the infection control measures in their unit was associated with less rescheduling of shifts. This seems to be in accordance with the health belief model, which states that reactions to the threat of a viral infection depend on the level of appraisal of the threat; therefore, high perception of risk is directly related to avoidance behavior [12][13][14][15].…”

Ten lessons for the next influenza pandemic—an English perspective

“…This behavioral change though based on a strongly biased sample (age, gender, perseverance of recording) is to be expected, given the opportunity for the public to learn from their family and community experience of the pandemic as it unfolds. 19 A favorable review of the newspaper response to the pandemic was reported by Hilton and Hunt. 20 The regional governments (England, Scotland, Wales, Northern Ireland) agreed a coordinated communication strategy which was delivered by The Chief Medical Officer for England.…”

“…There have been several studies investigating public reaction to the pandemic mostly based on telephone or internet surveys and focus group discussions in small and highly selected populations. [17][18][19] Brookes-Pollock et al conducted an internet based enquiry in a volunteer panel of 5,700 persons recruited from July 16 onwards to provide weekly reports on their respiratory health. 18 More than half the recruits provided only one report and a further 10% only two, perhaps reflecting waning interest in what seemed a mild illness.…”