Situational awareness and health protective responses to pandemic influenza A (H1N1) in Hong Kong: a cross-sectional study.
BACKGROUND
Whether information sources influence health protective behaviours during influenza pandemics or other emerging infectious disease epidemics is uncertain.


METHODS
Data 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.


RESULTS
Trust 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
Trust 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.
Liao
Qiuyan
Q
Health Behaviour Research Group, Department of Community Medicine, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China.
Cowling
Benjamin
B
Lam
Wing Tak
WT
Ng
Man Wai
MW
Fielding
Richard
R
D000293:Adolescent; D000328:Adult; D001364:Awareness; D001521:Behavior Therapy; D003430:Cross-Sectional Studies; D005260:Female; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D053118:Influenza A Virus, H1N1 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000453:epidemiology* / Q000517:prevention & control / Q000821:virology; D008297:Male; D008875:Middle Aged; D055815:Young Adult