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Published in: BMC Infectious Diseases 1/2010

Open Access 01-12-2010 | Research article

Avoidance behaviors and negative psychological responses in the general population in the initial stage of the H1N1 pandemic in Hong Kong

Authors: Joseph TF Lau, Sian Griffiths, Kai Chow Choi, Hi Yi Tsui

Published in: BMC Infectious Diseases | Issue 1/2010

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Abstract

Background

During the SARS pandemic in Hong Kong, panic and worry were prevalent in the community and the general public avoided staying in public areas. Such avoidance behaviors could greatly impact daily routines of the community and the local economy. This study examined the prevalence of the avoidance behaviors (i.e. avoiding going out, visiting crowded places and visiting hospitals) and negative psychological responses of the general population in Hong Kong at the initial stage of the H1N1 epidemic.

Methods

A sample of 999 respondents was recruited in a population-based survey. Using random telephone numbers, respondents completed a structured questionnaire by telephone interviews at the 'pre-community spread phase' of the H1N1 epidemic in Hong Kong.

Results

This study found that 76.5% of the respondents currently avoided going out or visiting crowded places or hospitals, whilst 15% felt much worried about contracting H1N1 and 6% showed signs of emotional distress. Females, older respondents, those having unconfirmed beliefs about modes of transmissions, and those feeling worried and emotionally distressed due to H1N1 outbreak were more likely than others to adopt some avoidance behaviors. Those who perceived high severity and susceptibility of getting H1N1 and doubted the adequacy of governmental preparedness were more likely than others to feel emotionally distressed.

Conclusions

The prevalence of avoidance behaviors was very high. Cognitions, including unconfirmed beliefs about modes of transmission, perceived severity and susceptibility were associated with some of the avoidance behaviors and emotional distress variables. Public health education should therefore provide clear messages to rectify relevant perceptions.
Literature
2.
go back to reference Fraser C, Donnelly C, Cauchemez S, Hanage W, Van Kerkhove M, Hollingsworth T, Griffin J, Baggaley RF, Jenkins HE, Lyons EJ, Jombart T, Hinsley WR, Grassly NC, Balloux F, Ghani AC, Ferguson NM, Rambaut A, Pybus OG, Lopez-Gatell H, Alpuche-Aranda CM, Chapela IB, Zavala EP, Guevara DM, Checchi F, Garcia E, Hugonnet S, Roth C, WHO Rapid Pandemic Assessment Collaboration: Pandemic potential of a strain of Influenza A (H1N1): Early findings. Science. 2009, 324: 1557-1561. 10.1126/science.1176062.CrossRefPubMedPubMedCentral Fraser C, Donnelly C, Cauchemez S, Hanage W, Van Kerkhove M, Hollingsworth T, Griffin J, Baggaley RF, Jenkins HE, Lyons EJ, Jombart T, Hinsley WR, Grassly NC, Balloux F, Ghani AC, Ferguson NM, Rambaut A, Pybus OG, Lopez-Gatell H, Alpuche-Aranda CM, Chapela IB, Zavala EP, Guevara DM, Checchi F, Garcia E, Hugonnet S, Roth C, WHO Rapid Pandemic Assessment Collaboration: Pandemic potential of a strain of Influenza A (H1N1): Early findings. Science. 2009, 324: 1557-1561. 10.1126/science.1176062.CrossRefPubMedPubMedCentral
4.
go back to reference Lau JTF, Yang X, Tsui H, Kim JH: Monitoring community responses to the SARS epidemic in Hong Kong: from day 10 to day 62. Journal of Epidemiology and Community Health. 2003, 57: 864-870. 10.1136/jech.57.11.864.CrossRefPubMedPubMedCentral Lau JTF, Yang X, Tsui H, Kim JH: Monitoring community responses to the SARS epidemic in Hong Kong: from day 10 to day 62. Journal of Epidemiology and Community Health. 2003, 57: 864-870. 10.1136/jech.57.11.864.CrossRefPubMedPubMedCentral
5.
go back to reference Leung GM, Quah S, Ho LM, Ho SY, Hedley AJ, Lee HP, Lam TH: A tale of two cities: Community psychobehavioral surveillance and related impact on outbreak control in Hong Kong and Singapore during the severe acute respiratory syndrome epidemic. Infection Control and Hospital Epidemiology. 2004, 25: 1033-1041. 10.1086/502340.CrossRefPubMed Leung GM, Quah S, Ho LM, Ho SY, Hedley AJ, Lee HP, Lam TH: A tale of two cities: Community psychobehavioral surveillance and related impact on outbreak control in Hong Kong and Singapore during the severe acute respiratory syndrome epidemic. Infection Control and Hospital Epidemiology. 2004, 25: 1033-1041. 10.1086/502340.CrossRefPubMed
6.
go back to reference Leung GM, Lam TH, Ho LM, Ho SY, Chan BHY, Wong IOL, Hedley AJ: The impact of community psychological responses on outbreak control for severe acute respiratory syndrome in Hong Kong. Journal of Epidemiology and Community Health. 2003, 57: 857-863. 10.1136/jech.57.11.857.CrossRefPubMedPubMedCentral Leung GM, Lam TH, Ho LM, Ho SY, Chan BHY, Wong IOL, Hedley AJ: The impact of community psychological responses on outbreak control for severe acute respiratory syndrome in Hong Kong. Journal of Epidemiology and Community Health. 2003, 57: 857-863. 10.1136/jech.57.11.857.CrossRefPubMedPubMedCentral
7.
go back to reference Tang CSK, Wong CY: Factors influencing the wearing of facemasks to prevent the severe acute respiratory syndrome among adult Chinese in Hong Kong. Preventive Medicine. 2004, 39: 1187-1193. 10.1016/j.ypmed.2004.04.032.CrossRefPubMed Tang CSK, Wong CY: Factors influencing the wearing of facemasks to prevent the severe acute respiratory syndrome among adult Chinese in Hong Kong. Preventive Medicine. 2004, 39: 1187-1193. 10.1016/j.ypmed.2004.04.032.CrossRefPubMed
8.
go back to reference Leung GM, Ho LM, Chan SKK, Ho SY, Bacon-Shone J, Choy RYL, Hedley AJ, Lam TH, Fielding R: Longitudinal assessment of community psychobehavioral responses during and after the 2003 outbreak of severe acute respiratory syndrome in Hong Kong. Clinical Infectious Diseases. 2005, 40: 1713-1720. 10.1086/429923.CrossRefPubMed Leung GM, Ho LM, Chan SKK, Ho SY, Bacon-Shone J, Choy RYL, Hedley AJ, Lam TH, Fielding R: Longitudinal assessment of community psychobehavioral responses during and after the 2003 outbreak of severe acute respiratory syndrome in Hong Kong. Clinical Infectious Diseases. 2005, 40: 1713-1720. 10.1086/429923.CrossRefPubMed
10.
go back to reference Siu A, Wong Y: Economic Impact of SARS: The Case of Hong Kong. Asian Economic Papers. 2004, 3: 62-83. 10.1162/1535351041747996.CrossRef Siu A, Wong Y: Economic Impact of SARS: The Case of Hong Kong. Asian Economic Papers. 2004, 3: 62-83. 10.1162/1535351041747996.CrossRef
11.
go back to reference Lau J, Griffiths S, Chan P, Tsui HY: SARS and avian flu: A serial of 6 surveillance surveys of anticipated behavioral and psychological responses to avian influenza pandemic in humans among the Hong Kong general public (SF-04). Oral presentation at the 40th APACPH Annual Conference, November 7 - 9, 2008, Kuala Lumpur, Malaysia. 2008 Lau J, Griffiths S, Chan P, Tsui HY: SARS and avian flu: A serial of 6 surveillance surveys of anticipated behavioral and psychological responses to avian influenza pandemic in humans among the Hong Kong general public (SF-04). Oral presentation at the 40th APACPH Annual Conference, November 7 - 9, 2008, Kuala Lumpur, Malaysia. 2008
12.
go back to reference Lau JTF, Tsui H, Kim JH, Griffiths S: Perceptions about status and modes of H5N1 transmission and associations with immediate behavioral responses in the Hong Kong general population. Preventive Medicine. 2006, 43: 406-410. 10.1016/j.ypmed.2006.06.007.CrossRefPubMed Lau JTF, Tsui H, Kim JH, Griffiths S: Perceptions about status and modes of H5N1 transmission and associations with immediate behavioral responses in the Hong Kong general population. Preventive Medicine. 2006, 43: 406-410. 10.1016/j.ypmed.2006.06.007.CrossRefPubMed
13.
go back to reference Lau J, Kim J, Tsui H, Griffiths S: Anticipated and current preventive behaviors in response to an anticipated human-to-human H5N1 epidemic in the Hong Kong Chinese general population. BMC Infectious Diseases. 2007, 7: 18-10.1186/1471-2334-7-18.CrossRefPubMedPubMedCentral Lau J, Kim J, Tsui H, Griffiths S: Anticipated and current preventive behaviors in response to an anticipated human-to-human H5N1 epidemic in the Hong Kong Chinese general population. BMC Infectious Diseases. 2007, 7: 18-10.1186/1471-2334-7-18.CrossRefPubMedPubMedCentral
14.
go back to reference Lau JTF, Kim JH, Tsui H, Griffiths S: Perceptions related to human avian influenza and their associations with anticipated psychological and behavioral responses at the onset of outbreak in the Hong Kong Chinese general population. American Journal of Infection Control. 2007, 35: 38-49. 10.1016/j.ajic.2006.07.010.CrossRefPubMed Lau JTF, Kim JH, Tsui H, Griffiths S: Perceptions related to human avian influenza and their associations with anticipated psychological and behavioral responses at the onset of outbreak in the Hong Kong Chinese general population. American Journal of Infection Control. 2007, 35: 38-49. 10.1016/j.ajic.2006.07.010.CrossRefPubMed
15.
go back to reference Peltz R, Avisar-Shohat G, Bar-Dayan Y: Differences in public emotions, interest, sense of knowledge and compliance between the affected area and the nationwide general population during the first phase of a bird flu outbreak in Israel. British Infection Society. 2007, 55: 545-550. 10.1016/j.jinf.2007.07.014.CrossRef Peltz R, Avisar-Shohat G, Bar-Dayan Y: Differences in public emotions, interest, sense of knowledge and compliance between the affected area and the nationwide general population during the first phase of a bird flu outbreak in Israel. British Infection Society. 2007, 55: 545-550. 10.1016/j.jinf.2007.07.014.CrossRef
17.
go back to reference Lau JTF, Griffiths S, Choi KC, Tsui HY: Widespread public misconception in the early phase of the H1N1 influenza epidemic. Journal of Infection. 2009, 59: 122-127. 10.1016/j.jinf.2009.06.004.CrossRefPubMed Lau JTF, Griffiths S, Choi KC, Tsui HY: Widespread public misconception in the early phase of the H1N1 influenza epidemic. Journal of Infection. 2009, 59: 122-127. 10.1016/j.jinf.2009.06.004.CrossRefPubMed
18.
go back to reference Rubin GJ, Amlot R, Page L, Wessely S: Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: cross sectional telephone survey. British Medical Journal. 2009, 339- Rubin GJ, Amlot R, Page L, Wessely S: Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: cross sectional telephone survey. British Medical Journal. 2009, 339-
19.
go back to reference Seale H, McLaws ML, Heywood AE, Ward KF, Lowbridge CP, Van D, Gralton J, MacIntyre CR: The community's attitude towards swine flu and pandemic influenza. Medical Journal of Australia. 2009, 191: 267-269.PubMed Seale H, McLaws ML, Heywood AE, Ward KF, Lowbridge CP, Van D, Gralton J, MacIntyre CR: The community's attitude towards swine flu and pandemic influenza. Medical Journal of Australia. 2009, 191: 267-269.PubMed
20.
go back to reference Goodwin R, Haque S, Neto F, Myers LB: Initial psychological responses to Influenza A, H1N1 ("Swine flu"). Bmc Infectious Diseases. 2009, 9: 10.1186/1471-2334-9-166. Goodwin R, Haque S, Neto F, Myers LB: Initial psychological responses to Influenza A, H1N1 ("Swine flu"). Bmc Infectious Diseases. 2009, 9: 10.1186/1471-2334-9-166.
21.
go back to reference Raude J, Setbon M: Lay perceptions of the pandemic influenza threat. European Journal of Epidemiology. 2009, 24: 339-342. 10.1007/s10654-009-9351-x.CrossRefPubMed Raude J, Setbon M: Lay perceptions of the pandemic influenza threat. European Journal of Epidemiology. 2009, 24: 339-342. 10.1007/s10654-009-9351-x.CrossRefPubMed
22.
go back to reference Shigemura J, Nakamoto K, Ursano R: Responses to the outbreak of novel influenza A (H1N1) in Japan: risk communication and shimaguni konjo. American Journal of Disaster Medicine. 2009, 4: 133-134.PubMed Shigemura J, Nakamoto K, Ursano R: Responses to the outbreak of novel influenza A (H1N1) in Japan: risk communication and shimaguni konjo. American Journal of Disaster Medicine. 2009, 4: 133-134.PubMed
23.
go back to reference Lee S, Tsang A: A Population-based Study of Depression and Three Kinds of Frequent Pain Conditions and Depression in Hong Kong. Pain Medicine. 2009, 10: 155-163. 10.1111/j.1526-4637.2008.00541.x.CrossRefPubMed Lee S, Tsang A: A Population-based Study of Depression and Three Kinds of Frequent Pain Conditions and Depression in Hong Kong. Pain Medicine. 2009, 10: 155-163. 10.1111/j.1526-4637.2008.00541.x.CrossRefPubMed
24.
go back to reference Lau JTF, Yang X, Tsui HY, Kim JH: Impacts of SARS on health-seeking behaviors in general population in Hong Kong. Preventive Medicine. 2005, 41: 454-462. 10.1016/j.ypmed.2004.11.023.CrossRefPubMed Lau JTF, Yang X, Tsui HY, Kim JH: Impacts of SARS on health-seeking behaviors in general population in Hong Kong. Preventive Medicine. 2005, 41: 454-462. 10.1016/j.ypmed.2004.11.023.CrossRefPubMed
25.
go back to reference Lau JTF, Kim JH, Tsui HY: Prevalence and factors of sexual problems in Chinese males and females having sex with the same-sex partner in Hong Kong: a population-based study. International Journal of Impotence Research. 2006, 18: 130-140. 10.1038/sj.ijir.3901368.CrossRefPubMed Lau JTF, Kim JH, Tsui HY: Prevalence and factors of sexual problems in Chinese males and females having sex with the same-sex partner in Hong Kong: a population-based study. International Journal of Impotence Research. 2006, 18: 130-140. 10.1038/sj.ijir.3901368.CrossRefPubMed
26.
go back to reference Smith BW, Kay VS, Hoyt TV, Bernard ML: Predicting the anticipated emotional and behavioral responses to an avian flu outbreak. American Journal of Infection Control. 2009, 37: 371-380. 10.1016/j.ajic.2008.08.007.CrossRefPubMed Smith BW, Kay VS, Hoyt TV, Bernard ML: Predicting the anticipated emotional and behavioral responses to an avian flu outbreak. American Journal of Infection Control. 2009, 37: 371-380. 10.1016/j.ajic.2008.08.007.CrossRefPubMed
27.
go back to reference Barr M, Raphael B, Taylor M, Stevens G, Jorm L, Giffin M, Lujic S: Pandemic influenza in Australia: Using telephone surveys to measure perceptions of threat and willingness to comply. BMC Infectious Disease. 2008, 8: 1-14. 10.1186/1471-2334-8-1.CrossRef Barr M, Raphael B, Taylor M, Stevens G, Jorm L, Giffin M, Lujic S: Pandemic influenza in Australia: Using telephone surveys to measure perceptions of threat and willingness to comply. BMC Infectious Disease. 2008, 8: 1-14. 10.1186/1471-2334-8-1.CrossRef
28.
go back to reference Hilleman M: Realities and enigmas of human viral influenza: pathogenesis, epidemiology and control. Vaccine. 2002, 20: 3068-3087. 10.1016/S0264-410X(02)00254-2.CrossRefPubMed Hilleman M: Realities and enigmas of human viral influenza: pathogenesis, epidemiology and control. Vaccine. 2002, 20: 3068-3087. 10.1016/S0264-410X(02)00254-2.CrossRefPubMed
29.
go back to reference Lau JTF, Yang XL, Tsui HY, Pang E, Kim JH: SARS preventive and risk behaviours of Hong Kong air travellers. Epidemiology and Infection. 2004, 132: 727-736. 10.1017/S0950268804002225.CrossRefPubMedPubMedCentral Lau JTF, Yang XL, Tsui HY, Pang E, Kim JH: SARS preventive and risk behaviours of Hong Kong air travellers. Epidemiology and Infection. 2004, 132: 727-736. 10.1017/S0950268804002225.CrossRefPubMedPubMedCentral
30.
go back to reference Tang CSK, Wong CY: An outbreak of the severe acute respiratory syndrome: Predictors of health behaviors and effect of community prevention measures in Hong Kong, China. American Journal of Public Health. 2003, 93: 1887-1888. 10.2105/AJPH.93.11.1887.CrossRefPubMedPubMedCentral Tang CSK, Wong CY: An outbreak of the severe acute respiratory syndrome: Predictors of health behaviors and effect of community prevention measures in Hong Kong, China. American Journal of Public Health. 2003, 93: 1887-1888. 10.2105/AJPH.93.11.1887.CrossRefPubMedPubMedCentral
Metadata
Title
Avoidance behaviors and negative psychological responses in the general population in the initial stage of the H1N1 pandemic in Hong Kong
Authors
Joseph TF Lau
Sian Griffiths
Kai Chow Choi
Hi Yi Tsui
Publication date
01-12-2010
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2010
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-10-139

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