+1 Recommend
0 collections
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Situational Awareness and Health Protective Responses to Pandemic Influenza A (H1N1) in Hong Kong: A Cross-Sectional Study


      Read this article at

          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.



          Whether information sources influence health protective behaviours during influenza pandemics or other emerging infectious disease epidemics is uncertain.


          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.

          Principal Findings

          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.


          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.

          Related collections

          Most cited references35

          • Record: found
          • Abstract: found
          • Book: not found

          Self-Efficacy : The Exercise of Control

          1 Theoretical Perspectives The Nature of Human Agency Human Agency in Triadic Reciprocal Causation Determinism and the Exercise of Self-Influence Related Views of Personal Efficacy 2 The Nature and Structure of Self-Efficacy Perceived Self-Efficacy as a Generative Capability Active Producers versus Passive Foretellers of Performances The Self-Efficacy Approach to Personal Causation Multidimensionality of Self-Efficacy Belief Systems Self-Efficacy Causality Sources of Discordance Between Efficacy Judgment and Action 3 Sources of Self-Efficacy Enactive Mastery Experience Vicarious Experience Verbal Persuasion Physiological and Affective States Integration of Efficacy Information 4 Mediating Processes Cognitive Processes Motivational Processes Affective Processes Selection Processes 5 Developmental Analysis of Self-Efficacy Origins of a Sense of Personal Agency Familial Sources of Self-Efficacy Peers and the Broadening and Validation of Self-Efficacy School as an Agency for Cultivating Self-Efficacy Growth of Self-Efficacy through Transitional Experiences of Adolescence Self-Efficacy Concerns of Adulthood Reappraisals of Self-Efficacy with Advancing Age 6 Cognitive Functioning Students' Cognitive Self-Efficacy Teachers' Perceived Efficacy Collective School Efficacy 7 Health Functioning Biological Effects of Perceived Self-Efficacy Perceived Self-Efficacy in Health Promoting Behavior Prognostic Judgments and Perceived Self-Efficacy 8 Clinical Functioning Anxiety and Phobic Dysfunctions Depression Eating Disorders Alcohol and Drug Abuse 9 Athletic Functioning Development of Athletic Skills Self-Regulation of Athletic Performance Collective Team Efficacy Psychobiological Effects of Physical Exercise 10 Organizational Functioning Career Development and Pursuits Mastery of Occupational Roles Self-Efficacy in Organizational Decision Making Self-Efficacy in Enactment of Occupational Roles Collective Organizational Efficacy 11 Collective Efficacy Gauging Collective Efficacy Political Efficacy Enablement by Media Modes of Influence Enablement for Sociocultural Change Underminers of Collective Efficacy References Name and Subject Indexes.
            • Record: found
            • Abstract: found
            • Article: not found

            Pneumonia and respiratory failure from swine-origin influenza A (H1N1) in Mexico.

            In late March 2009, an outbreak of a respiratory illness later proved to be caused by novel swine-origin influenza A (H1N1) virus (S-OIV) was identified in Mexico. We describe the clinical and epidemiologic characteristics of persons hospitalized for pneumonia at the national tertiary hospital for respiratory illnesses in Mexico City who had laboratory-confirmed S-OIV infection, also known as swine flu. We used retrospective medical chart reviews to collect data on the hospitalized patients. S-OIV infection was confirmed in specimens with the use of a real-time reverse-transcriptase-polymerase-chain-reaction assay. From March 24 through April 24, 2009, a total of 18 cases of pneumonia and confirmed S-OIV infection were identified among 98 patients hospitalized for acute respiratory illness at the National Institute of Respiratory Diseases in Mexico City. More than half of the 18 case patients were between 13 and 47 years of age, and only 8 had preexisting medical conditions. For 16 of the 18 patients, this was the first hospitalization for their illness; the other 2 patients were referred from other hospitals. All patients had fever, cough, dyspnea or respiratory distress, increased serum lactate dehydrogenase levels, and bilateral patchy pneumonia. Other common findings were an increased creatine kinase level (in 62% of patients) and lymphopenia (in 61%). Twelve patients required mechanical ventilation, and seven died. Within 7 days after contact with the initial case patients, a mild or moderate influenza-like illness developed in 22 health care workers; they were treated with oseltamivir, and none were hospitalized. S-OIV infection can cause severe illness, the acute respiratory distress syndrome, and death in previously healthy persons who are young to middle-aged. None of the secondary infections among health care workers were severe. 2009 Massachusetts Medical Society
              • Record: found
              • Abstract: found
              • Article: not found

              Facemasks and hand hygiene to prevent influenza transmission in households: a cluster randomized trial.

              Few data are available about the effectiveness of nonpharmaceutical interventions for preventing influenza virus transmission. To investigate whether hand hygiene and use of facemasks prevents household transmission of influenza. Cluster randomized, controlled trial. Randomization was computer generated; allocation was concealed from treating physicians and clinics and implemented by study nurses at the time of the initial household visit. Participants and personnel administering the interventions were not blinded to group assignment. (ClinicalTrials.gov registration number: NCT00425893) Households in Hong Kong. 407 people presenting to outpatient clinics with influenza-like illness who were positive for influenza A or B virus by rapid testing (index patients) and 794 household members (contacts) in 259 households. Lifestyle education (control) (134 households), hand hygiene (136 households), or surgical facemasks plus hand hygiene (137 households) for all household members. Influenza virus infection in contacts, as confirmed by reverse-transcription polymerase chain reaction (RT-PCR) or diagnosed clinically after 7 days. Sixty (8%) contacts in the 259 households had RT-PCR-confirmed influenza virus infection in the 7 days after intervention. Hand hygiene with or without facemasks seemed to reduce influenza transmission, but the differences compared with the control group were not significant. In 154 households in which interventions were implemented within 36 hours of symptom onset in the index patient, transmission of RT-PCR-confirmed infection seemed reduced, an effect attributable to fewer infections among participants using facemasks plus hand hygiene (adjusted odds ratio, 0.33 [95% CI, 0.13 to 0.87]). Adherence to interventions varied. The delay from index patient symptom onset to intervention and variable adherence may have mitigated intervention effectiveness. Hand hygiene and facemasks seemed to prevent household transmission of influenza virus when implemented within 36 hours of index patient symptom onset. These findings suggest that nonpharmaceutical interventions are important for mitigation of pandemic and interpandemic influenza. Centers for Disease Control and Prevention.

                Author and article information

                Role: Editor
                PLoS One
                PLoS ONE
                Public Library of Science (San Francisco, USA )
                12 October 2010
                : 5
                : 10
                : e13350
                [1 ]Health Behaviour Research Group, Department of Community Medicine, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
                [2 ]Infectious Diseases Group, Department of Community Medicine, School of Public Health, The University of Hong Kong, Hong Kong Special Administrative Region, China
                Singapore Immunology Network, Singapore
                Author notes

                Analyzed the data: QL. Wrote the paper: QL. Planned the study: RF, BC. Guided data analysis: RF BC WTL. Interpretation of the data: RF BC WTL. Made critical revisions of the manuscript: RF, BC. Contributed to the design of the survey instrument: RF QL BC WTL MWN. Coordinated the telephone interview: MWN. Managed the dataset: MWN.

                Liao et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                : 7 January 2010
                : 16 September 2010
                Page count
                Pages: 10
                Research Article
                Infectious Diseases/Epidemiology and Control of Infectious Diseases
                Public Health and Epidemiology/Infectious Diseases
                Public Health and Epidemiology/Preventive Medicine
                Public Health and Epidemiology/Social and Behavioral Determinants of Health



                Comment on this article