The impact of communications about swine flu (influenza A H1N1v) on public responses to the outbreak: results from 36 national telephone surveys in the UK
The impact of communications about swine flu (influenza A H1N1v) on public responses to the outbreak: results from 36 national telephone surveys in the UK
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DOI：
10.3310/hta14340-03
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发表时间：
2010-07-01
影响因子：
3.6
通讯作者：
Michie, S.
中科院分区：
文献类型：
--
作者：
Rubin, G. J.;Potts, H. W. W.;Michie, S.
目的：评估对感染猪流感可能性的担忧程度与媒体报道数量之间的关系；心理因素在预测可能感染猪流感疫苗方面的作用；以及媒体报道和广告在预测其他猪流感相关行为方面的作用。设计：分析来自一系列随机数字拨号电话调查的数据。一项时间序列分析测试了担忧程度与每次调查开始当天媒体报道数量之间的关联。横断面回归分析评估了可能的疫苗接种或行为与预测变量之间的关系。背景：从2009年5月1日到2010年1月10日，英国各地平均每周进行36次调查。使用了五项调查(在8月14日至9月13日期间进行)来评估可能的疫苗接种情况。五项调查(5月1日至17日)提供了与其他行为有关的数据。参与者：每项调查都有1047至1173名16岁或以上的人参与：5175名参与者提供了他们可能接种猪流感疫苗的数据；5419名参与者提供了与其他行为相关的数据。主要结果指标：所有参与者都被要求说明他们对个人感染猪流感的可能性有多担心。他们被问及如果提供猪流感疫苗接种的可能性有多大，以及他们最近是否随身携带纸巾、购买洗手液、避免使用公共交通工具或因流感相关原因去看过全科医生、去过医院或致电NHS Direct。结果：“非常”或“相当”担心的参与者的比例在9.6%至32.9%之间波动。这一数字与媒体报道的数量有关，即使在根据疫情严重程度的变化进行调整后也是如此[chi(2)(1)=6.6，p=0.010，对数转换数据系数=2.6]。然而，这种影响只发生在英国夏季的第一波猪流感期间。总体而言，56.1%的受访者非常或相当可能接受甲流疫苗。最强的预测因素是非常担心自己[调整后的优势比(AOR)4.7，95%可信区间(CI)3.2~7.0]或自己的孩子(AOR 8.0，95%CI 4.6~13.9)感染猪流感的可能性。总体而言，33.1%的参与者报告随身携带纸巾，9.5%的人购买了消毒凝胶，2.0%的人避免乘坐公共交通工具，1.6%的人寻求医疗建议。2009年5月初，接触到有关猪流感的媒体报道或广告后，携带或购买消毒手胶的纸巾增加，避免乘坐公共交通工具或咨询医疗服务的情况减少。路径分析表明，媒体报道和广告具有不同的效果，因为它们提高了卫生行为的感知有效性，但降低了回避行为的感知有效性。结论：在猪流感暴发期间，保护性行为的接受率和疫苗接种的可能接受率较低。这其中一个原因可能部分是因为公众对感染猪流感的可能性的担忧程度较低。当担忧程度普遍较低时，采取行动增加大众媒体和广告的覆盖量可能会增加推荐行为的感知效果，这反过来可能会增加它们的接受度。
Objectives: To assess the association between levels of worry about the possibility of catching swine flu and the volume of media reporting about it; the role of psychological factors in predicting likely uptake of the swine flu vaccine; and the role of media coverage and advertising in predicting other swine flu-related behaviours.Design: Data from a series of random-digit-dial telephone surveys were analysed. A time series analysis tested the association between levels of worry and the volume of media reporting on the start day of each survey. Cross-sectional regression analyses assessed the relationships between likely vaccine uptake or behaviour and predictor variables.Setting: Thirty-six surveys were run at, on average, weekly intervals across the UK between I May 2009 and 10 January 2010. Five surveys (run between 14 August and 13 September) were used to assess likely vaccine uptake. Five surveys (1-17 May) provided data relating to other behaviours.Participants: Between 1047 and 1173 people aged 16 years or over took part in each survey: 5175 participants provided data about their likely uptake of the swine flu vaccine; 5419 participants provided data relating to other behaviours.Main outcome measures: All participants were asked to state how worried they were about the possibility of personally catching swine flu. Subsets were asked how likely they were to take up a swine flu vaccination if offered it and whether they had recently carried tissues with them, bought sanitising hand gel, avoided using public transport or had been to see a general practitioner, visited a hospital or called NHS Direct for a flu-related reason.Results: The percentage of 'very' or 'fairly' worried participants fluctuated between 9.6% and 32.9%. This figure was associated with the volume of media reporting, even after adjusting for the changing severity of the outbreak [chi(2)(1)=6.6, p = 0.010, coefficient for log-transformed data = 2.6]. However, this effect only occurred during the UK's first summer wave of swine flu. In total, 56.1% of respondents were very or fairly likely to accept the swine flu vaccine. The strongest predictors were being very worried about the possibility of oneself [adjusted odds ratio (aOR) 4.7, 95% confidence interval (CI) 3.2 to 7.0] or one's child (aOR 8.0, 95% CI 4.6 to 13.9) catching swine flu. Overall, 33.1% of participants reporting carrying tissues with them, 9.5% had bought sanitising gel, 2.0% had avoided public transport and 1.6% had sought medical advice. Exposure to media coverage or advertising about swine flu increased tissue carrying or buying of sanitising hand gel, and reduced avoidance of public transport or consultation with health services during early May 2009. Path analyses showed that media coverage and advertising had these differential effects because they raised the perceived efficacy of hygiene behaviours but decreased the perceived efficacy of avoidance behaviours.Conclusions: During the swine flu outbreak, uptake rates for protective behaviours and likely acceptance rates for vaccination were low. One reason for this may in part be explained by was the low level of public worry about the possibility of catching swine flu. When levels of worry are generally low, acting to increase the volume of mass media and advertising coverage is likely to increase the perceived efficacy of recommended behaviours, which, in turn, is likely to increase their uptake.