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BMC Public Health
Published in: BMC Public Health 1/2011

Open Access 01-12-2011 | Research article

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

Authors: Marloes Bults, Desirée JMA Beaujean, Onno de Zwart, Gerjo Kok, Pepijn van Empelen, Jim E van Steenbergen, Jan Hendrik Richardus, Hélène ACM Voeten

Published in: BMC Public Health | Issue 1/2011

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Abstract

Background

Research 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.

Methods

Two 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).

Results

Between 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.

Conclusions

Decreasing 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.
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Literature
1.
2.
Rothberg MB, Haessler SD: Complications of seasonal and pandemic influenza. Critical Care Med. 2010, 38: e91-7. 10.1097/CCM.0b013e3181c92eeb.CrossRef
3.
4.
Introduction of a new human Influenza virus in the Netherlands - Operationeel deeldraaiboek 2. National Institute of Public Health and the Environment, Centre for Infectious Diseases Control-RIVM, The Netherlands. 2009, [in Dutch]
5.
Control Influenza pandemic - Operationeel deeldraaiboek 3. National Institute of Public Health and the Environment, Centre for Infectious Diseases Control-RIVM, The Netherlands. 2006, [in Dutch]
6.
Health Council of the Netherlands: Advisory letter Vaccination against pandemic Influenza A (H1N1) target groups and priorisation. The Hague: Health Council of the Netherlands 2009/12E, [http://​www.​gezondheidsraad.​nl/​]
7.
Tang CS, Wong C: Factors influencing the wearing of facemasks to prevent the severe acute respiratory syndrome among adult Chinese in Hong Kong. Preventive Medicine. 2004, 39: 1187-93. 10.1016/j.ypmed.2004.04.032.CrossRefPubMed
8.
Lau JT, Yang X, Tsui H, Pang E, Kim JH: SARS preventive and risk behaviours of Hong Kong air travellers. Epidemiol Infect. 2004, 132: 727-36. 10.1017/S0950268804002225.CrossRefPubMedPubMedCentral
9.
Bosman A, Mulder YM, de Leeuw JRJ, Meijer A, Du Ry van Beest Holle M, Kamst RA, van der Velden PG, Conyn-van Spaendonck MAE, Koopmans MPG, Ruijten MWMM: Avian flu epidemic: public health consequences. Risk factors, health, well-being, health care needs and preventive measures during the H7N7 avian flu outbreak in the Netherlands. 2004, Bilthoven: RIVM/Instituut voor Psychotrauma, Report No.: 630940001/2004, [http://​www.​rivm.​nl/​bibliotheek/​rapporten/​630940001.​html]
10.
Holmes BJ: Communicating about emerging infectious disease: The importance of research. Health, Risk & Society. 2008, 10: 349-60.CrossRef
11.
Vaughan E, Tinker T: Effective risk communication about pandemic influenza for vulnerable populations. Am J Public Health. 2009, 99: S324-32. 10.2105/AJPH.2009.162537.CrossRefPubMedPubMedCentral
12.
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 Management and Health Care Policy. 2009, 2: 9-20. 10.2147/RMHP.S4810.CrossRef
13.
Raude J, Setbon M: Lay perceptions of the pandemic influenza threat. Eur Journal Epidemiology. 2009, 24: 339-42. 10.1007/s10654-009-9351-x.CrossRef
14.
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 Infect Diseases. 2008, 8: 117-10.1186/1471-2334-8-117.CrossRef
15.
Blendon RJ, Koonin LM, Benson JM, Cetron MS, Pollard WE, Mitchell EW, Weldon KJ, Herrmann MJ: Public response to community mitigation measures for pandemic influenza. Emerg Infect Diseases. 2008, 14: 778-86. 10.3201/eid1405.071437.CrossRef
16.
Sadique MZ, Edmunds WJ, Smith RD, Meerding WJ, de Zwart O, Brug J, Beutels P: Precautionary behavior in response to perceived threat of pandemic influenza. Emerg Infect Diseases. 2007, 13: 1307-13.CrossRef
17.
Kristiansen IS, Halvorsen PA, Gyrd-Hansen D: Influenza pandemic: perception of risk and individual precautions in a general population. Cross sectional study. BMC Public Health. 2007, 7: 48-10.1186/1471-2458-7-48.CrossRefPubMedPubMedCentral
18.
Kok G, Jonkers R, Gelissen R, Meertens R, Schaalma H, de Zwart O: Behavioral intentions in response to an influenza pandemic. BMC Public Health. 2010, 10: 174-10.1186/1471-2458-10-174.CrossRefPubMedPubMedCentral
19.
Gelissen R, Vrolings E, Jonkers R: Expected behavioural responses in case of pandemic influenza. Results of a literature review and empirical research among the general public in the Netherland. 2008, Rescon, research & consultancy, in Dutch
20.
Jones JH, Salanthé M: Early Assessment of Anxiety and Behavioral Response to Novel Swine-Origin Influenza A(H1N1). PLoS ONE. 2009, 4: e8032-10.1371/journal.pone.0008032.CrossRefPubMedPubMedCentral
21.
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. BMJ. 2009, 339: b2651-10.1136/bmj.b2651.CrossRefPubMedPubMedCentral
22.
Seale H, Heywood AE, Mc Laws ML, Ward KF, Lowbridge CP, Van D, MacIntyre CR: Why do I need it? I am not at risk! Public perceptions towards the pandemic (H1N1) 2009 vaccine. BMC Infect Dis. 2010, 10: 99-10.1186/1471-2334-10-99.CrossRefPubMedPubMedCentral
23.
24.
25.
26.
27.
28.
29.
30.
Brug J, Aro AR, Oenema A, de Zwart O, Richardus JH, Bischop GD: SARS risk perception, knowledge, precautions, and information sources, the Netherlands. Emerg Infect Dis. 2004, 10: 1486-9.CrossRefPubMedPubMedCentral
31.
de Zwart O, Veldhuijzen IK, Elam G, Aro AR, Abraham T, Bishop GD, Richardus JH, Brug J: Avian influenza risk perception, Europe and Asia. Emerg Infect Dis. 2007, 13: 290-3. 10.3201/eid1302.060303.CrossRefPubMedPubMedCentral
32.
Norman P, Boer H, Seydel ER: Protection Motivation Theory. Predicting health behaviour. Edited by: Conner M, Norman P. 2005, Berkshire, UK: Open University Press, 81-126.
33.
Champion VL, Skinner CS: The Health Belief Model. Health behaviour and health education; theory, research, and practice. Edited by: Glanz K, Rimer BK, Viswanath K. 2008, San Francisco, CA: Jossey Bass, 45-65.
34.
Chapman GB, Coups EJ: Emotions and preventive health behavior: worry, regret, and influenza vaccination. Health psychology. 2006, 25: 82-90. 10.1037/0278-6133.25.1.82.CrossRefPubMed
35.
Brewer NT, Weinstein ND, Cuite CL: Risk perception and their relation to risk behavior. Ann of behavioral medicine. 2004, 27: 125-30. 10.1207/s15324796abm2702_7.CrossRef
36.
Fraser C, Donnelly CA, Cauchemez S, Hanage WP, van Kerkhove MD, Hollingsworth TD, Griffin J, Baggaley RF, Jenkins HE, Lyons EJ, Jombart T, Hinsley WR, Grassly NC: Pandemic potential of a strain of Influenza A (H1N1): Early findings. Science. 2009, 324: 1557-61. 10.1126/science.1176062.CrossRefPubMedPubMedCentral
37.
Hahné S, Donker T, Meijer A, Timen A, van Steenbergen J, Osterhaus A, van der Sande M, Koopmans M, Wallinga J, Coutinho R, the Dutch New Influenza A(H1N1)v Investigation Team: Epidemiology and control of influenza A(H1N1)v in the Netherlands: the first 115 cases. Euro Surveillance. 2009, 14: 19267-PubMed
38.
39.
Lau JTF, Yang X, Tsui H, Kim JH: Monitoring community responses to the SARS epidemic in Hong Kong: from day 10 to day 62. J Epidemiol Community Health. 2003, 57: 864-70. 10.1136/jech.57.11.864.CrossRefPubMedPubMedCentral
40.
Leung GM, Ho LM, Chen SK, Ho SY, Bacon-Shone J, Choy RY, 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. Clin Infect Dis. 2005, 40: 1713-20. 10.1086/429923.CrossRefPubMed
Metadata
Title
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
Authors
Marloes Bults
Desirée JMA Beaujean
Onno de Zwart
Gerjo Kok
Pepijn van Empelen
Jim E van Steenbergen
Jan Hendrik Richardus
Hélène ACM Voeten
Publication date
01-12-2011
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2011
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/1471-2458-11-2

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