Beyond resistance: social factors in the general public response to pandemic influenza
Beyond resistance: social factors in the general public response to pandemic influenza
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DOI：
10.1186/s12889-015-1756-8
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发表时间：
2015-04-29
影响因子：
4.5
通讯作者：
Flowers, Paul
中科院分区：
文献类型：
--
作者：
Davis, Mark D. M.;Stephenson, Niamh;Flowers, Paul
背景：影响公众对大流行病的反应是一项公共卫生优先事项。然而，普遍的看法是，一般公众对关于大流行性流感的宣传有抵触情绪，对2009/10年H1N1大流行的行为反应不够充分。本文采用定性方法，调查了公众如何应对大流行性流感以及公共卫生部门提出的卫生、社会隔离和其他措施。超越了普遍部署的概念，即公众抵制公共卫生传播，本文探讨了健康个人主义，性别和现实世界的制约因素如何促进和限制个人行动。方法：对墨尔本、悉尼和格拉斯哥的社区样本进行深度访谈（n = 57）和焦点小组（10个焦点小组，59人）。根据最大变异抽样，采用有目的的标准选择参与者，包括：1)2009/2010年怀孕；2)慢性病；（三）70岁及以上；4)没有公开的健康问题。逐字抄本进行归纳和专题分析。结果：受访者没有对公共卫生传播表示抵制，但对他们如何解释和实施指导意见提出了见解。应对大流行风险的个人主义方法占主导地位。卫生、社会隔离和疫苗战略的采用受到限制，因为他们认为自己“有风险”，但对他人没有“风险”。性别规范影响公众如何制定卫生和社会隔离政策。其他挑战涉及过度依赖认为远离风险、期望从感染中恢复以及接种疫苗方面的实际限制。结论：总体而言，答复者参与了有关大流行性流感的公共卫生咨询，这表明公众耐药性的概念解释力有限。公共传播得到认可，但挑战依然存在。面对大流行风险的个人主义做法阻碍了为他人利益采取行动，并可能加深社区根据健康状况的分歧。关于大流行病的公共传播以性别规范为媒介，这可能使妇女负担过重，限制男子的行动。关于公众应对大流行病的社会研究需要把重点放在影响个人行动的社会结构、现实世界环境和关系上。
Background: Influencing the general public response to pandemics is a public health priority. There is a prevailing view, however, that the general public is resistant to communications on pandemic influenza and that behavioural responses to the 2009/10 H1N1 pandemic were not sufficient. Using qualitative methods, this paper investigates how members of the general public respond to pandemic influenza and the hygiene, social isolation and other measures proposed by public health. Going beyond the commonly deployed notion that the general public is resistant to public health communications, this paper examines how health individualism, gender and real world constraints enable and limit individual action.Methods: In-depth interviews (n = 57) and focus groups (ten focus groups; 59 individuals) were conducted with community samples in Melbourne, Sydney and Glasgow. Participants were selected according to maximum variation sampling using purposive criteria, including: 1) pregnancy in 2009/2010; 2) chronic illness; 3) aged 70 years and over; 4) no disclosed health problems. Verbatim transcripts were subjected to inductive, thematic analysis.Results: Respondents did not express resistance to public health communications, but gave insight into how they interpreted and implemented guidance. An individualistic approach to pandemic risk predominated. The uptake of hygiene, social isolation and vaccine strategies was constrained by seeing oneself 'at risk' but not 'a risk' to others. Gender norms shape how members of the general public enact hygiene and social isolation. Other challenges pertained to over-reliance on perceived remoteness from risk, expectation of recovery from infection and practical constraints on the uptake of vaccination.Conclusions: Overall, respondents were engaged with public health advice regarding pandemic influenza, indicating that the idea of public resistance has limited explanatory power. Public communications are endorsed, but challenges persist. Individualistic approaches to pandemic risk inhibit acting for the benefit of others and may deepen divisions in the community according to health status. Public communications on pandemics are mediated by gender norms that may overburden women and limit the action of men. Social research on the public response to pandemics needs to focus on the social structures and real world settings and relationships that shape the action of individuals.