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Anxiety, worry and cognitive risk estimate in relation to protective behaviors during the 2009 influenza A/H1N1 pandemic in Hong Kong: ten cross-sectional surveys.
BMC Infect Dis. 2014 Mar 27; 14:169.BI

Abstract

BACKGROUND

Few studies have investigated associations between psychological and behavioral indices throughout a major epidemic. This study was aimed to compare the strength of associations between different cognitive and affective measures of risk and self-reported protective behaviors in a series of ten cross-sectional surveys conducted throughout the first wave of influenza A/H1N1 pandemic.

METHODS

All surveys were conducted using questionnaire-based telephone interviews, with random digit dialing to recruit adults from the general population. Measures of anxiety and worry (affective) and perceived risk (cognitive) regarding A/H1N1 were made in 10 serial surveys. Multivariate logistic regression models were used to estimate the cognitive/affective-behavioral associations in each survey while multilevel logistic models were conducted to estimate the average effects of each cognitive/affective measure on adoption of protective behaviors throughout the ten surveys.

RESULTS

Excepting state anxiety, other affective measures including "anticipated worry", "experienced worry" and "current worry" specific to A/H1N1 risk were consistently and strongly associated with adoption of protective behaviors across different survey periods. However, the cognitive-behavioral associations were weaker and inconsistent across the ten surveys. Perceived A/H1N1 severity relative to SARS had stronger associations with adoption of protective behaviors in the late epidemic periods than in the early epidemic periods.

CONCLUSION

Risk-specific worries appear to be significantly associated with the adoption of protective behaviors at different epidemic stages, whereas cognitive measures may become more important in understanding people's behavioral responses later in epidemics. Future epidemic-related psycho-behavioral research should include more affective-loaded measures of risk.

Authors+Show Affiliations

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableDivision of Behavioural Sciences, School of Public health, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, Special Administrative Region, China. fielding@hku.hk.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

24674239

Citation

Liao, Qiuyan, et al. "Anxiety, Worry and Cognitive Risk Estimate in Relation to Protective Behaviors During the 2009 Influenza A/H1N1 Pandemic in Hong Kong: Ten Cross-sectional Surveys." BMC Infectious Diseases, vol. 14, 2014, p. 169.
Liao Q, Cowling BJ, Lam WW, et al. Anxiety, worry and cognitive risk estimate in relation to protective behaviors during the 2009 influenza A/H1N1 pandemic in Hong Kong: ten cross-sectional surveys. BMC Infect Dis. 2014;14:169.
Liao, Q., Cowling, B. J., Lam, W. W., Ng, D. M., & Fielding, R. (2014). Anxiety, worry and cognitive risk estimate in relation to protective behaviors during the 2009 influenza A/H1N1 pandemic in Hong Kong: ten cross-sectional surveys. BMC Infectious Diseases, 14, 169. https://doi.org/10.1186/1471-2334-14-169
Liao Q, et al. Anxiety, Worry and Cognitive Risk Estimate in Relation to Protective Behaviors During the 2009 Influenza A/H1N1 Pandemic in Hong Kong: Ten Cross-sectional Surveys. BMC Infect Dis. 2014 Mar 27;14:169. PubMed PMID: 24674239.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Anxiety, worry and cognitive risk estimate in relation to protective behaviors during the 2009 influenza A/H1N1 pandemic in Hong Kong: ten cross-sectional surveys. AU - Liao,Qiuyan, AU - Cowling,Benjamin J, AU - Lam,Wendy W T, AU - Ng,Diane M W, AU - Fielding,Richard, Y1 - 2014/03/27/ PY - 2013/12/19/received PY - 2014/03/19/accepted PY - 2014/3/29/entrez PY - 2014/3/29/pubmed PY - 2015/1/30/medline SP - 169 EP - 169 JF - BMC infectious diseases JO - BMC Infect Dis VL - 14 N2 - BACKGROUND: Few studies have investigated associations between psychological and behavioral indices throughout a major epidemic. This study was aimed to compare the strength of associations between different cognitive and affective measures of risk and self-reported protective behaviors in a series of ten cross-sectional surveys conducted throughout the first wave of influenza A/H1N1 pandemic. METHODS: All surveys were conducted using questionnaire-based telephone interviews, with random digit dialing to recruit adults from the general population. Measures of anxiety and worry (affective) and perceived risk (cognitive) regarding A/H1N1 were made in 10 serial surveys. Multivariate logistic regression models were used to estimate the cognitive/affective-behavioral associations in each survey while multilevel logistic models were conducted to estimate the average effects of each cognitive/affective measure on adoption of protective behaviors throughout the ten surveys. RESULTS: Excepting state anxiety, other affective measures including "anticipated worry", "experienced worry" and "current worry" specific to A/H1N1 risk were consistently and strongly associated with adoption of protective behaviors across different survey periods. However, the cognitive-behavioral associations were weaker and inconsistent across the ten surveys. Perceived A/H1N1 severity relative to SARS had stronger associations with adoption of protective behaviors in the late epidemic periods than in the early epidemic periods. CONCLUSION: Risk-specific worries appear to be significantly associated with the adoption of protective behaviors at different epidemic stages, whereas cognitive measures may become more important in understanding people's behavioral responses later in epidemics. Future epidemic-related psycho-behavioral research should include more affective-loaded measures of risk. SN - 1471-2334 UR - https://www.unboundmedicine.com/medline/citation/24674239/Anxiety_worry_and_cognitive_risk_estimate_in_relation_to_protective_behaviors_during_the_2009_influenza_A/H1N1_pandemic_in_Hong_Kong:_ten_cross_sectional_surveys_ L2 - https://bmcinfectdis.biomedcentral.com/articles/10.1186/1471-2334-14-169 DB - PRIME DP - Unbound Medicine ER -