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Intentions to perform non-pharmaceutical protective behaviors during influenza outbreaks in Sweden: a cross-sectional study following a mass vaccination campaign
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Health and Developmental Care, Center for Public Health.ORCID iD: 0000-0001-6049-5402
Linköping University, Department of Medical and Health Sciences, Division of Community Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Center for Health and Developmental Care, Center for Public Health.
National Strategies Support Directorate, ANSER/Analytic Services Inc, Arlington, Virginia, USA.
Linköping University, Department of Computer and Information Science, Statistics. Linköping University, Faculty of Arts and Sciences.
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2014 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 9, no 3, e91060- p.Article in journal (Refereed) Published
Abstract [en]

Failure to incorporate the beliefs and attitudes of the public into theoretical models of preparedness has been identified as a weakness in strategies to mitigate infectious disease outbreaks. We administered a cross-sectional telephone survey to a representative sample (n = 443) of the Swedish adult population to examine whether self-reported intentions to improve personal hygiene and increase social distancing during influenza outbreaks could be explained by trust in official information, self-reported health (SF-8), sociodemographic factors, and determinants postulated in protection motivation theory, namely threat appraisal and coping appraisal. The interviewees were asked to make their appraisals for two scenarios: a) an influenza with low case fatality and mild lifestyle impact; b) severe influenza with high case fatality and serious disturbances of societal functions. Every second respondent (50.0%) reported high trust in official information about influenza. The proportion that reported intentions to take deliberate actions to improve personal hygiene during outbreaks ranged between 45–85%, while less than 25% said that they intended to increase social distancing. Multiple logistic regression models with coping appraisal as the explanatory factor most frequently contributing to the explanation of the variance in intentions showed strong discriminatory performance for staying home while not ill (mild outbreaks: Area under the curve [AUC] 0.85 (95% confidence interval 0.82;0.89), severe outbreaks AUC 0.82 (95% CI 0.77;0.85)) and acceptable performance with regard to avoiding public transportation (AUC 0.78 (0.74;0.82), AUC 0.77 (0.72;0.82)), using handwash products (AUC 0.70 (0.65;0.75), AUC 0.76 (0.71;0.80)), and frequently washing hands (AUC 0.71 (0.66;0.76), AUC 0.75 (0.71;0.80)). We conclude that coping appraisal was the explanatory factor most frequently included in statistical models explaining self-reported intentions to carry out non-pharmaceutical health actions in the Swedish outlined context, and that variations in threat appraisal played a smaller role in these models despite scientific uncertainties surrounding a recent mass vaccination campaign.

Place, publisher, year, edition, pages
Public Library of Science , 2014. Vol. 9, no 3, e91060- p.
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Health Sciences
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URN: urn:nbn:se:liu:diva-105029DOI: 10.1371/journal.pone.0091060ISI: 000332485800091OAI: oai:DiVA.org:liu-105029DiVA: diva2:703313
Available from: 2014-03-06 Created: 2014-03-06 Last updated: 2017-12-05Bibliographically approved

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Timpka, ToomasSpreco, ArminEriksson, OlleDahlström, ÖrjanEkberg, JoakimPilemalm, SofieKarlsson, DavidHinkula, Jorma

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Division of Community MedicineFaculty of Health SciencesCenter for Public HealthStatisticsFaculty of Arts and SciencesThe Swedish Institute for Disability ResearchDisability ResearchInformation SystemsHuman-Centered systemsThe Institute of TechnologyDivision of Microbiology and Molecular Medicine
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