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International Journal of Behavioral Medicine
Published in: International Journal of Behavioral Medicine 2/2011

Open Access 01-06-2011

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

Authors: Qiuyan Liao, Benjamin J. Cowling, Wendy Wing Tak Lam, Richard Fielding

Published in: International Journal of Behavioral Medicine | Issue 2/2011

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Abstract

Background

Understanding population responses to influenza helps optimize public health interventions. Relevant theoretical frameworks remain nascent.

Purpose

To model associations between trust in information, perceived hygiene effectiveness, knowledge about the causes of influenza, perceived susceptibility and worry, and personal hygiene practices (PHPs) associated with influenza.

Methods

Cross-sectional household telephone surveys on avian influenza A/H5N1 (2006) and pandemic influenza A/H1N1 (2009) gathered comparable data on trust in formal and informal sources of influenza information, influenza-related knowledge, perceived hygiene effectiveness, worry, perceived susceptibility, and PHPs. Exploratory factor analysis confirmed domain content while confirmatory factor analysis was used to evaluate the extracted factors. The hypothesized model, compiled from different theoretical frameworks, was optimized with structural equation modelling using the A/H5N1 data. The optimized model was then tested against the A/H1N1 dataset.

Results

The model was robust across datasets though corresponding path weights differed. Trust in formal information was positively associated with perceived hygiene effectiveness which was positively associated with PHPs in both datasets. Trust in formal information was positively associated with influenza worry in A/H5N1 data, and with knowledge of influenza cause in A/H1N1 data, both variables being positively associated with PHPs. Trust in informal information was positively associated with influenza worry in both datasets. Independent of information trust, perceived influenza susceptibility associated with influenza worry. Worry associated with PHPs in A/H5N1 data only.

Conclusions

Knowledge of influenza cause and perceived PHP effectiveness were associated with PHPs. Improving trust in formal information should increase PHPs. Worry was significantly associated with PHPs in A/H5N1.
Appendix
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Literature
1.
World Health Organization Writing Group. Nonpharmaceutical interventions for pandemic influenza, national and community measures. Emerg Infect Dis. 2006;12:88–94.
2.
Mounts AW, Kwong H, Izurieta HS, Ho Y, Au T, Lee M, et al. Case-control study of risk factors for avian influenza A (H5N1) disease, Hong Kong, 1997. J Infect Dis. 1999;180:505–8.PubMedCrossRef
3.
Zhou L, Liao Q, Dong L, Huai Y, Bai T, Xiang N, et al. Risk factors for human illness with avian influenza A (H5N1) virus infection in China. J Infect Dis. 2009;199:1726–34.PubMedCrossRef
4.
Peiris JS, Poon LL, Guan Y. Emergence of a novel swine-origin influenza a virus (S-OIV) H1N1 virus in humans. J Clin Virol. 2009;45:169–73.PubMedCrossRef
5.
Grayson ML, Melvani S, Druce J, Barr IG, Ballard SA, Johnson PD, et al. Efficacy of soap and water and alcohol-based hand-rub preparations against live H1N1 influenza virus on the hands of human volunteers. Clin Infect Dis. 2009;48:285–91.PubMedCrossRef
6.
Jefferson T, Del Mar C, Dooley L, Ferroni E, Al-Ansary LA, Bawazeer GA, et al. Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review. BMJ. 2009;339:b3675.PubMedCrossRef
7.
Cowling BJ, Chan KH, Fang VJ, Cheng CK, Fung RO, Wai W, et al. Facemasks and hand hygiene to prevent influenza transmission in households: a cluster randomized trial. Ann Intern Med. 2009;151:437–46.PubMed
8.
Syed Q, Sopwith W, Regan M, Bellis MA. Behind the mask. Journey through an epidemic: some observations of contrasting public health responses to SARS. J Epidemiol Community Health. 2003;57:855–6.PubMedCrossRef
9.
Wong TW, Tam WS. Handwashing practice and the use of personal protective equipment among medical students after the SARS epidemic in Hong Kong. Am J Infect Control. 2005;33:580–6.PubMedCrossRef
10.
Leppin A, Aro AR. Risk perceptions related to SARS and avian influenza: theoretical foundations of current empirical research. Int J Behav Med. 2009;16:7–29.PubMedCrossRef
11.
12.
Slovic P. Trust, emotion, sex, politics, and science: surveying the risk-assessment battlefield. Risk Anal. 1999;19:689–701.PubMed
13.
Vaughan E, Tinker T. Effective health risk communication about pandemic influenza for vulnerable populations. Am J Public Health. 2009;99 Suppl 2:S324–32.PubMedCrossRef
14.
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. BMJ. 2009;339:b2651.PubMedCrossRef
15.
Tang CS, Wong CY. Psychosocial factors influencing the practice of preventive behaviors against the severe acute respiratory syndrome among older Chinese in Hong Kong. J Aging Health. 2005;17:490–506.PubMedCrossRef
16.
Ajzen I. Attitudes, personality and behavior. Chicago: Dorsey; 1988.
17.
Ajzen I. The theory of planned behaivor. Organ Behav Hum Decis Process. 1991;50:179–211.CrossRef
18.
Fishbein M, Ajzen I. Attitudes towards objects as predictors of single multiple behavioral criteria. Psychol Rev. 1974;81:59–74.CrossRef
19.
Ajzen I, Fishbein M. Understanding attitudes, and predicting social behavior. Englewood Cliffs: Prentice Hall; 1980.
20.
Becker MH. The health belief model and personal health behaviour. Thorofare: Slack; 1974.
21.
Becker MH, Haefner DP, Maiman LA. The health belief model in the prediction of dietary compliance: a field experiment. J Health Soc Behav. 1977;18:348–66.PubMedCrossRef
22.
Rogers RW. A protection motivation theory of fear appeals and attitude change. J Psychol. 1975;91:93–114.CrossRef
23.
Quinn SC, Kumar S, Freimuth VS, Kidwell K, Musa D. Public willingness to take a vaccine or drug under emergency use authorization during the 2009 H1N1 pandemic. Biosecur Bioterror. 2009;7:275–90.PubMedCrossRef
24.
Tang CS, Wong CY. An outbreak of the severe acute respiratory syndrome: predictors of health behaviors and effect of community prevention measures in Hong Kong, China. Am J Public Health. 2003;93:1887–8.PubMedCrossRef
25.
Bandura A. Social learning theory. New Jersey: Prentice Hall; 1977.
26.
De Wandel D, Maes L, Labeau S, Vereecken C, Blot S. Behavioral determinants of hand hygiene compliance in intensive care units. Am J Crit Care. 2010;19:230–9.PubMedCrossRef
27.
28.
Rosen NO, Knauper B. A little uncertainty goes a long way: state and trait differences in uncertainty interact to increase information seeking but also increase worry. Health Commun. 2009;24:228–38.PubMedCrossRef
29.
Bandura A. Social foundations of thought and action: a social cognitive theory. Englewood Cliffs: Prentice Hall; 1986.
30.
Voeten HA, de Zwart O, Veldhuijzen IK, Yuen C, Jiang X, Elam G, et al. Sources of information and health beliefs related to SARS and avian influenza among Chinese communities in the United Kingdom and The Netherlands, compared to the general population in these countries. Int J Behav Med. 2009;16:49–57.PubMedCrossRef
31.
Leventhal H, Safer MA, Paganis D. The impact of communications on health beliefs, decisions, and behaviours. Health Educ Q. 1983;10:1–29.
32.
Petty R, Cacioppo J. In: Berkowitz L, editor. The elaboration likelihood model of persuasion. Orlando: Academic; 1986.
33.
Slaughter L, Keselman A, Kushniruk A, Patel VL. A framework for capturing the interactions between laypersons’ understanding of disease, information gathering behaviors, and actions taken during an epidemic. J Biomed Inform. 2005;2005:298–313.CrossRef
34.
Lazarus RS, Folkman S. Stress, appraisal, and coping. New York: Springer; 1984.
35.
Smith CA, Lazarus RS. Appraisal components, core relational themes, and the emotions. Cogn Emot. 1993;7:233–69.CrossRef
36.
Spector PE, Zapf D, Chen PY, Frese M. Why negative affectivity should not be controlled in job stress research: don’t throw the baby out with the bath water. J Organ Behav. 2000;21:79–95.CrossRef
37.
38.
Endsley MR. Toward a theory of situation awareness in dynamic systems. Hum Factors. 1997;37:32–64.CrossRef
39.
Fielding R, Bich TH, Quang LN, Lam WW, Leung GM, Tien TQ, et al. Live poultry exposures, Hong Kong and Hanoi, 2006. Emerg Infect Dis. 2007;13:1065–7.PubMed
40.
Cowling BJ, Ng MW, Ip KM, Liao Q, Lam WT, Wu JT, et al. Community psychological and behavioral responses through the first wave of 2009 pandemic (H1N1) in Hong Kong. J Infect Dis. 2010;202:867–76.PubMedCrossRef
41.
Perez-Padilla R, de la Rosa-Zamboni D, Ponce de Leon S, Hernandez M, Quinones-Falconi F, Bautista E, et al. Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico. N Engl J Med. 2009;361:680–9.PubMedCrossRef
42.
Wong CY, Tang CS. Practice of habitual and volitional health behaviors to prevent severe acute respiratory syndrome among Chinese adolescents in Hong Kong. J Adolesc Health. 2005;36:193–200.PubMedCrossRef
43.
Cohen J. Statistical power analysis for the behavioral sciences. 2nd ed. Hillsdale: Erlbaum; 1988.
44.
Byrne BM. Structural equation modeling with EQS: basic concepts, applications, and programming. 2nd ed. New Jersey: Lawrence Erlbaum Associates, Inc.; 2006.
45.
King G, Honaker J, Joseph A, Scheve K. Analyzing incomplete political science data: an alternative algorithm for multiple imputation. Am Polit Sci Rev. 2001;95:49–69.
46.
Little RJA, Rubin DB. Statistical analysis with missing data. Hoboken: Wiley; 2002.
47.
Kline RB. Principles and practice of structural equation modeling. New York: Guiford; 1998.
48.
49.
Munro BH. Statistical methods for health care research. 5th ed. Philadelphia: Lippincott Williams & Wilkins; 2005.
50.
Bentler PM, Wu EJC. EQS 6 for Windows user’s guide. Encino, CA: Multivariate Software, Inc.; 2002.
51.
52.
Chapman GB, Coups EJ. Emotions and preventive health behavior: worry, regret, and influenza vaccination. Health Psychol. 2006;25:82–90.PubMedCrossRef
53.
Weinstein ND, Kwitel A, McCaul KD, Magnan RE, Gerrard M, Gibbons FX. Risk perceptions: assessment and relationship to influenza vaccination. Health Psychol. 2007;26:146–51.PubMedCrossRef
54.
Baron RM, Kenny DA. The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986;51:1173–82.PubMedCrossRef
55.
56.
Liao Q, Lam WW, Jiang CQ, Ho EY, Liu YM, Zhang WS, et al. Avian influenza risk perception and live poultry purchase in Guangzhou, China, 2006. Risk Anal. 2009;29:416–24.PubMedCrossRef
57.
Liao QY, Lam WWT, Dang VT, Jiang CQ, Udomprasertgul V, Fielding R. What causes H5N1 avian influenza? Lay perceptions of H5N1 etiology in South East and East Asia. J Pub Health. 2009;31:573–81.CrossRef
58.
Lau JT, Kim JH, Tsui HY, Griffiths S. Anticipated and current preventive behaviours in response to an anticipated human-to-human H5N1 epidemic in the Hong Kong Chinese general population. BMC Infect Dis. 2007;7:18–29.PubMedCrossRef
59.
Hong S, Collins A. Societal responses to familiar versus unfamiliar risk: comparisons of influenza and SARS in Korea. Risk Anal. 2006;26:1247–57.PubMedCrossRef
60.
61.
Lagrange RL, Ferraro KF. Assessing age and gender differences in perceived risk and fear of crime. Criminol. 2006;27:697–720.CrossRef
62.
Elvik R, Bjornskau T. How accurately does the public perceive differences in transport risks?: an exploratory analysis of scales representing perceived risk. Accident Anal Prev. 2005;37:2005–11.
63.
Robb KA, Miles A, Wardle J. Demographic and psychosocial factors associated with perceived risk for colorectal cancer. Cancer Epidemiol Biomark Prev. 2004;13:366–72.
64.
Murray R, Chandler C, Clarkson Y, Wilson N, Baker M, Cunningham R. Sub-optimal hand sanitiser usage in a hospital entrance during an influenza pandemic, New Zealand, August 2009. Euro Surveill. 2009;14(pii):19331.PubMed
65.
Finucane NL, Slovic P, Mertz CK, Flynn KJ, Satterfield GA. Gender, race, and perceived risk: the ‘white male’ effect. Health Risk Soc. 2000;2:159–72.CrossRef
66.
Fatiregun AA, Saani MM. Knowledge, attitudes and compliance of poultry workers with preventive measures for avian influenza in Lagelu, Oyo State, Nigeria. J Infect Dev Ctries. 2008;2:130–4.PubMedCrossRef
67.
Leung GM, Ho LM, Chan SK, Ho SY, Bacon-Shone J, Choy RY, et al. Longitudinal assessment of community psychobehavioral responses during and after the 2003 outbreak of severe acute respiratory syndrome in Hong Kong. Clin Infect Dis. 2005;40:1713–20.PubMedCrossRef
68.
Abraham T. Risk and outbreak communication: lessons from alternative paradigms. Bull World Health Organ. 2009;87:604–7.PubMedCrossRef
69.
70.
71.
Berry TR, Wharf-Higgins J, Naylor PJ. SARS wars: an examination of the quantity and construction of health information in the news media. Health Commun. 2007;21:35–44.PubMed
72.
Leventhal H, Meyer D, Nerenz D. The Common sense model of illness danger. New York: Pergamon; 1980.
Metadata
Title
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
Authors
Qiuyan Liao
Benjamin J. Cowling
Wendy Wing Tak Lam
Richard Fielding
Publication date
01-06-2011
Publisher
Springer US
Published in
International Journal of Behavioral Medicine / Issue 2/2011
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-010-9123-8

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