Public health awareness: knowledge, attitude and behaviour of the general public on health risks during the H1N1 influenza pandemic

Background During public health emergencies, public officials are busy in developing communication strategies to protect the population from existing or potential threats. However, a population’s social and individual determinants (i.e. education, income, race/ethnicity) may lead to inequalities in individual or group-specific exposure to public health communication messages, and in the capacity to access, process, and act upon the information received by specific sub-groups- a concept defined as communication inequalities. The aims of this literature review are to: 1) characterize the scientific literature that examined issues related to communication to the public during the H1N1 pandemic, and 2) summarize the knowledge gained in our understanding of social determinants and their association with communication inequalities in the preparedness and response to an influenza pandemic. Methods Articles were searched in eight major communication, social sciences, and health and medical databases of scientific literature and reviewed by two independent reviewers by following the PRISMA guidelines. The selected articles were classified and analyzed in accordance with the Structural Influence Model of Public Health Emergency Preparedness Communications. Results A total of 118 empirical studies were included for final review. Among them, 78% were population-based studies and 22% were articles that employed information environment analyses techniques. Consistent results were reported on the association between social determinants of communication inequalities and emergency preparedness outcomes. Trust in public officials and source of information, worry and levels of knowledge about the disease, and routine media exposure as well as information-seeking behaviors, were related to greater likelihood of adoption of recommended infection prevention practices. When addressed in communication interventions, these factors can increase the effectiveness of the response to pandemics. Conclusions Consistently across studies, a number of potential predictors of behavioral compliance to preventive recommendations during a pandemic were identified. Our findings show the need to include such evidence found in the development of future communication campaigns to ensure the highest rates of compliance with recommended protection measures and reduce communication inequalities during future emergencies.

Background During an infectious disease outbreak, it is critical to learn as much as possible about the concerns, knowledge, attitudes, and behavior of the public. Such information can be crucial to the improvement of communication efforts by public health officials and clinicians. The aim of this study was to identify awareness, attitudes, and practices related to influenza A (H1N1) among the Saudi public. Methods A cross-sectional study of 1,548 adult subjects recruited from various shopping malls in Riyadh and Jeddah was conducted. All of the subjects were interviewed using a questionnaire that tested their knowledge, attitudes, and use of precautionary measures in relation to the H1N1 influenza pandemic. Results More than half (54.3%, 840/1548) of the participants showed high concern, 43.7%(677/1548) showed a low level of knowledge, and 60.8%(941/1548) had taken minimal or no precautionary measures. After adjusting for other variables, education level was the only significant predictor of the level of concern (p < 0.001), while greater precautionary measures were taken by participants who were male (p < 0.001), older (p = 0.047), better educated (p = 0.04), and more knowledgeable (p < 0.001). More than one-third (38.3%) of participants were not convinced that the MOH reports about the disease were true, and only 16.1% of the participants reported receiving information from health providers. Conclusions High concern did not translate into a higher compliance with precautionary recommendations, possibly due to the low level of knowledge about the disease among the public. Frequent communication between physicians and the public is recommended to help dispel myths about the disease and to spread better information about the role that the public can play in limiting the spread of the disease.

The public plays an important role in controlling the spread of a virus by adopting preventive measures. This systematic literature review aimed to gain insight into public perceptions and behavioral responses to the 2009 influenza A (H1N1) pandemic, with a focus on trends over time and regional differences. We screened 5498 articles and identified 70 eligible studies from PubMed, Embase, and PsychINFO. Public misconceptions were apparent regarding modes of transmission and preventive measures. Perceptions and behaviors evolved during the pandemic. In most countries, perceived vulnerability increased, but perceived severity, anxiety, self-efficacy, and vaccination intention decreased. Improved hygienic practices and social distancing were practiced most commonly. However, vaccination acceptance remained low. Marked regional differences were noted. To prevent misconceptions, it is important that health authorities provide up-to-date information about the virus and possible preventive measures during future outbreaks. Health authorities should continuously monitor public perceptions and misconceptions. Because public perceptions and behaviors varied between countries during the pandemic, risk communication should be tailored to the specific circumstances of each country. Finally, the use of health behavior theories in studies of public perceptions and behaviors during outbreaks would greatly facilitate the development of effective public health interventions that counter the effect of an outbreak.