title: The perceived threat of SARS and its impact on precautionary actions and adverse consequences: a qualitative study among Chinese communities in the United Kingdom and the Netherlands.
abstract: BACKGROUND
  Although the SARS outbreak involved few probable cases of infection in Europe, swift international spread of infections raised the possibility of outbreaks. In particular, SARS presented a sociopsychological and economic threat to European Chinese communities because of their close links with the outbreak's origins.
  
  
  METHODS
  A qualitative study was conducted among Chinese residents in the United Kingdom and the Netherlands to identify the origins of SARS risk perceptions and their impact on precautionary actions and adverse consequences from the perspective of vulnerable communities living in unaffected regions. Analysis was informed by protection motivation theory.
  
  
  RESULTS
  Results revealed that information from affected Asia influenced risk perceptions and protective behavior among the Chinese in Europe when more relevant local information was absent. When high risk perceptions were combined with low efficacy regarding precautionary measures, avoidance-based precautionary action appeared to dominate responses to SARS. These actions may have contributed to the adverse impacts of SARS on the communities.
  
  
  CONCLUSIONS
  Experiences of European Chinese communities suggest that practical and timely information, and consistent implementation of protective measures from central governments are essential to protect vulnerable populations in unaffected regions from unnecessary alarm and harm during outbreaks of emerging infections.
authors.affiliation: Health Protection Agency - Centre for Infections, London, UK. x.y.jiang@dundee.ac.uk
authors.forename: Xinyi
authors.initials: X
authors.lastname: Jiang
authors.forename: Gillian
authors.initials: G
authors.lastname: Elam
authors.forename: Cicely
authors.initials: C
authors.lastname: Yuen
authors.forename: Helene
authors.initials: H
authors.lastname: Voeten
authors.forename: Onno
authors.initials: O
authors.lastname: de Zwart
authors.forename: Irene
authors.initials: I
authors.lastname: Veldhuijzen
authors.forename: Johannes
authors.initials: J
authors.lastname: Brug
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000208:ethnology; D003469:Culture; D004196:Disease Outbreaks / Q000517:prevention & control*; D054242:Emigrants and Immigrants / Q000193:education* / Q000523:psychology*; D005260:Female; D017144:Focus Groups; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006723:Hong Kong / Q000208:ethnology; D006801:Humans; D033181:Information Dissemination; D008297:Male; D008875:Middle Aged; D008913:Minority Groups / Q000193:education* / Q000523:psychology*; D009426:Netherlands; D018570:Risk Assessment; D045169:Severe Acute Respiratory Syndrome / Q000208:ethnology* / Q000517:prevention & control / Q000523:psychology* / Q000635:transmission; D012846:Singapore / Q000208:ethnology; D011795:Surveys and Questionnaires; D006113:United Kingdom; D055815:Young Adult