Situational Awareness and Health Protective Responses to Pandemic Influenza A (H1N1) in Hong Kong: A Cross-Sectional Study

Qiuyan Liao,Man Wai Ng,Richard Fielding,Wing Tak Lam,Benjamin Cowling,Lisa F P Ng

doi:10.1371/journal.pone.0013350

Abstract

BackgroundWhether information sources influence health protective behaviours during influenza pandemics or other emerging infectious disease epidemics is uncertain.MethodologyData from cross-sectional telephone interviews of 1,001 Hong Kong adults in June, 2009 were tested against theory and data-derived hypothesized associations between trust in (formal/informal) information, understanding, self-efficacy, perceived susceptibility and worry, and hand hygiene and social distancing using Structural Equation Modelling with multigroup comparisons.Principal FindingsTrust in formal (government/media) information about influenza was associated with greater reported understanding of A/H1N1 cause (β = 0.36) and A/H1N1 prevention self-efficacy (β = 0.25), which in turn were associated with more hand hygiene (β = 0.19 and β = 0.23, respectively). Trust in informal (interpersonal) information was negatively associated with perceived personal A/H1N1 susceptibility (β = −0.21), which was negatively associated with perceived self-efficacy (β = −0.42) but positively associated with influenza worry (β = 0.44). Trust in informal information was positively associated with influenza worry (β = 0.16) which was in turn associated with greater social distancing (β = 0.36). Multigroup comparisons showed gender differences regarding paths from trust in formal information to understanding of A/H1N1 cause, trust in informal information to understanding of A/H1N1 cause, and understanding of A/H1N1 cause to perceived self-efficacy.Conclusions/SignificanceTrust in government/media information was more strongly associated with greater self-efficacy and handwashing, whereas trust in informal information was strongly associated with perceived health threat and avoidance behaviour. Risk communication should consider the effect of gender differences.

Highlights

Pandemic influenza A/H1N1 has a clinical profile similar to seasonal influenza, despite initially appearing more severe [1]
Both formal and informal information trust were correlated with all situational awareness variables except worry about contracting A/H1N1 (‘‘Worry’’), while formal information trust was independent of perceived personal susceptibility (‘‘Susceptibility’’)
We tested a hypothesized model of associations between trust in information, situational awareness variables and different types of health protective behaviours for influenza protection

Summary

Introduction

Pandemic influenza A/H1N1 has a clinical profile similar to seasonal influenza, despite initially appearing more severe [1]. Respiratory infectious diseases (RIDs) such as influenza are a major public health issue best dealt with by prevention, ideally vaccination. Government health education messages are a major source of information for promoting self-protective practices against RIDs. Government health education messages are a major source of information for promoting self-protective practices against RIDs These preventive messages generally emphasize improved hygiene, face-mask use by infected persons, and social distancing measures, including avoiding crowds during epidemics [5,6,7]. Whether information sources influence health protective behaviours during influenza pandemics or other emerging infectious disease epidemics is uncertain

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Results

Conclusion