The public's preventive strategies in response to the pandemic influenza A/H1N1 in France: Distribution and determinants

doi:10.1016/j.ypmed.2010.11.010

Preventive Medicine

Volume 52, Issue 2, 1 February 2011, Pages 178-181

https://doi.org/10.1016/j.ypmed.2010.11.010 Get rights and content

Abstract

Objectives

Since the emergence of the pandemic influenza A/H1N1, people were encouraged to adopt a large range of pharmaceutical and non-pharmaceutical measures in order to counter the risk of infection. The aim of this article is to identify and to explain the different types of preventive strategies adopted by the French population.

Methods

The data are based on a phone survey conducted with a representative sample of the French population (N = 1003) in December 2009 (cooperation rate = 45.9%). Logistic regressions were used in order to characterize the different preventive behavioral patterns towards the A/H1N1 influenza.

Results

Four types of behavioral strategies have been identified: 31.5% of the respondents combined vaccination (intention or action, regardless of the nature of the vaccine) with non-pharmaceutical measures, 8.8% wanted to get exclusively vaccinated, 42.0% took non-pharmaceutical steps only and 17.7% didn't protect themselves at all. Significant social and cognitive variables were found to predict membership of each group.

Conclusions

These results indicate that a large majority of that is mainly population adopted a selective strategy rather than a cumulative one as it was recommended, a choice mostly explained by the level of risk perception.

Introduction

The outbreak of the novel A/H1N1 influenza virus in April 2009 and its rapid global spread have raised concerns over a potentially catastrophic influenza pandemic in both scientific and lay communities. Policy for mitigating the epidemiological and socioeconomic consequences of the pandemic constituted at this time a top priority for many public health organizations. In France, the effort to prevent and to control the A/H1N1 pandemic influenza went through different stage, as indicated in Table 1 Broadly speaking, two major phases can be identified. Firstly, in the absence of available vaccine, the public was encouraged to adopt a range of preventive behaviors including hygienic and social distancing measures. Secondly, members of high-priority groups, then the whole population, were recommended to get immunized against the virus (HCSP, 2009). In France, such as in the majority of the western countries, public health authorities failed however to convince a large number of the population to get vaccinated. Nonetheless, the vaccination might be viewed by the public as one possibility among a large variety of pharmaceutical and non-pharmaceutical measures and we don't know the distribution of the health preventive strategies actually adopted, or the social and cognitive factors that determined them (Chapman and Coups, 1999).

Section snippets

The study

The empirical data were collected in France through computer-assisted phone interviews of 1003 adults in December 2009. A proportional random digit dialing was used to select the survey participants across the country. Moreover, a stratified selection procedure based on regions and communes population with quotas on respondents' gender, age, and occupation was carried out to ensure the national representativeness of the sample (cooperation rate = 45.9%). Respondents were informed that the survey

Discussion

In this case of a new public health program, for which a variety of protective measures was both possible and recommended, a majority of individuals had chosen a selective protective strategy rather than a cumulative one. Overall, although more than 80% of the population had declared a protective strategy, it could be assumed that a substitutive effect had gained a large majority; furthermore only the “mixed protection strategy” can be considered as compliant with the public health

Conflict of interest statement

The authors have no conflicts of interest to declare.

References (8)

G.B. Chapman et al.
Predictors of influenza vaccine acceptance among healthy adults
Prev. Med.
(1999)
MaurerJ. et al.
Does receipt of seasonal influenza vaccine predict intention to receive novel H1N1 vaccine: evidence from a nationally representative survey of U.S. adults
Vaccine
(2009)
M. Andrew et al.
Rates of influenza vaccination in older adults and factors associated with vaccine use: a secondary analysis of the Canadian Study of Health and Aging
BMC Public Health
(2004)
N.T. Brewer et al.
Meta-analysis of the relationship between risk perception and health behavior: the example of vaccination
Health Psychol.
(2007)

There are more references available in the full text version of this article.

Cited by (28)

Non-adherence to COVID-19 lockdown: who are they? A cross-sectional study in Portugal
2022, Public Health
Citation Excerpt :
Independent variables were divided into five dimensions: demographic, social, labour, health and perceptions (see Supplementary Table S1). These variables were selected based on the literature review on adherence to preventive measures during a pandemic.23,34–37 Variables were described using absolute and relative frequencies, and multicollinearity was checked using the variance inflation factor.
The SARS-CoV-2 virus has spread worldwide, leading governments to implement mitigation measures. Understanding the reluctance to adhere to non-pharmacological interventions might help promote adherence to these measures. This study aimed to identify factors associated with non-adherence to the first lockdown in Portugal.
Cross-sectional study.
This study used data from a Portuguese community-based survey entitled ‘COVID-19 Barometer: Social Opinion’. Data were collected on risk perception, health status and social experiences using a snowball sampling technique. The event of interest corresponded to participants who reported not staying home during the lockdown period, serving as a proxy for non-adherence to lockdown. Logistic regression was used to identify factors associated with non-adherence to the first lockdown.
Responses from 133,601 individual questionnaires that were completed during the first week of the first lockdown in 2020 were analysed. A minority of participants (5.6%) reported non-adherence to lockdown (i.e. leaving home for reasons other than essential situations). Working in the workplace was the factor with the strongest association of non-adherence to the lockdown. Several other factors were also associated with non-adherence to the first lockdown; namely, being a man, being a student, having a low level of education, having a low income, living alone or with a high-infection-risk professional (e.g. doctor, nurse, pharmaceutical, health technician, firefighter, police officer, military, essential services worker), perceiving the risk of getting COVID-19 to be high, not having social support in case of infection, feeling agitated, sad or anxious every day, and considering the preventive measures to be unimportant or inadequate.
Non-adherence to lockdown was associated with socio-economic, trust and perception factors. Future research should investigate the mechanisms underlying these associations to help identify the population groups who are most at risk of non-adherence.
Non-compliance with COVID-19-related public health measures among young adults in Switzerland: Insights from a longitudinal cohort study
2021, Social Science and Medicine
Citation Excerpt :
Non-compliance research with this and previous pandemics has typically focused on proximal, concurrent correlates in explaining non-compliance with preventive measures (see Bults et al., 2015; Clark et al., 2020; Webster et al., 2020). For example, individuals who perceive a high risk of contracting or being harmed by the virus, who seek out more information, have trust in the government, and feel a moral obligation to comply are more likely to adopt preventive measures (Bults et al., 2015; Cho and Lee, 2015; Clark et al., 2020; Harper et al., 2020; Lammers et al., 2020; Prati et al., 2011a, 2011b; Rubin et al., 2009; Setbon et al., 2011; Shao and Hao, 2020; Van der Weerd et al., 2011; Webster et al., 2020). Certain sociodemographic characteristics, such as sex (i.e., female) and higher education, have also been associated with greater compliance (Bish and Michie, 2010; Brouard et al., 2020), whereas individuals from other demographic backgrounds may lack the practical capacity to comply due to their occupation or economic concerns (Bodas and Peleg, 2020; Kuiper et al., 2020; Webster et al., 2020).
Adolescents and young adults were identified internationally as a group with potentially low compliance rates with public health measures aimed at curbing the spread of coronavirus disease 2019 (COVID-19). Although non-compliance research during pandemics has typically focused on concurrent correlates, less is known about how prior social and psychological risk factors are associated with non-compliance during pandemics.
This paper leverages a prospective-longitudinal cohort study with data before and during the pandemic to describe patterns of non-compliance with COVID- 19 related public health measures in young adults and to identify which characteristics increase the risk of non-compliance.
Data came from an ongoing cohort study in Zurich, Switzerland (n=737). Non-compliance with public health measures and concurrent correlates were measured at age 22. Antecedent sociodemographic, social, and psychological factors were measured at ages 15-20. Young adults generally complied with COVID-19 public health measures, although non-compliance with some measures (e.g., cleaning/disinfecting mobile phones, standing 1.5-2 meters apart) was relatively higher.
Non-compliance, especially with hygiene-related measures, was more prevalent in males, and in individuals with higher education, higher SES, and a nonmigrant background. Non-compliance was higher in young adults who had previously scored high on indicators of “antisocial potential,” including low acceptance of moral rules, pre-pandemic legal cynicism, low shame/guilt, low self-control, engagement in delinquent behaviors, and association with delinquent peers. Young adults with low trust, including in the government’s measures for fighting the virus, also complied less.
In order to increase voluntary compliance with COVID-19 measures, public health campaigns should implement strategies that foster moral obligation and trust in authorities, or leverage trustworthy individuals in the community to disseminate information. For young adults with low self-control, self-monitoring, environmental restructuring, or nudging may increase compliance. Long-term investments into integrating youth with antisocial potential into society may decrease rule-breaking behaviors, including during pandemics when compliance saves lives.
Taking control amidst the chaos: Emotion regulation during the COVID-19 pandemic
2020, Journal of Vocational Behavior
The COVID-19 pandemic represents a major global health crisis that continues to threaten public health and safety. Although the pandemic is still unfolding, measures to reduce the spread of the virus have spawned significant challenges to people's current work as well as their careers more generally. In this commentary, we discuss the implications of COVID-19 for maintaining one's psychological well-being and employment security, and also managing family and work responsibilities. We also bring forth evidence from the emotion regulation literature to help mitigate the downstream negative consequences of COVID-19 on people's work lives. Finally, we offer several suggestions for future scholarly investigation into how this pandemic impacts vocational behavior.
Predictors of IV behaviors during and after the 2009 influenza pandemic in France
2014, Vaccine
Citation Excerpt :
As individuals aged 65 years and over are especially targeted by French IV campaigns and have a particular IV behavior across time (with higher IVCs) [28], regression analyses were stratified on age (under or equal and over 65 years). The differences on vaccine uptake between two consecutive seasons were assessed using McNemar's test. [35] Statistical analysis was performed using IBM SPSS statistics version 20.
Controversies about the 2009 H1N1 pandemic influenza vaccination might have impacted the motivational processes that underlie individual immunization against seasonal influenza. The purpose of this article is to investigate correlates of vaccine uptake during and after the pandemic.
Data from the 1174 subjects of the CoPanFlu France cohort aged 15 and over were used. We used logistic regression models to identify social and behavioral predictors of getting vaccinated against seasonal influenza in 2009–2010 and in 2010–2011 and against H1N1 influenza in 2009–2010.
This study points out that correlates of vaccination behaviors varied according to the vaccine. Respondents under 65 years who adopted the seasonal influenza vaccine were, as usual, more likely to belong to a target group and have a lower education, contrary to subjects who chose the pandemic vaccine. Exceptionally during the pandemic, a higher socioeconomic status also led to adoption of either vaccine. Motivational processes differed by vaccine. Uptaking the “new” pandemic vaccine was the result of a deliberative decision-making process, influenced by cognitive factors related to the pandemic context (such as perceived severity of the H1N1 flu strain and trust in public health authorities). In contrast, respondents got the seasonal flu vaccine without relying on explicit justifications, but instead through habit of performing this behavior in the past.
Target groups for seasonal influenza but not those for pandemic influenza were more likely to adopt the pandemic vaccine, which is a cause for great concern. This may be due to large extent to the automatic and habitual nature of influenza vaccination decisions. Public health authorities, should pay more attention to situational than informational cues to facilitate vaccine uptake among priority groups, especially in case of mild pandemic influenza.
Public response to the 2009 influenza A H1N1 pandemic: A polling study in five countries
2012, The Lancet Infectious Diseases
Citation Excerpt :
The reasons for cross-country differences are plausibly related to a wide array of factors that affect behaviour adoption, including the prevalence of the illness, government responses, availability and cost of interventions, and the media's portrayal of these factors. Research suggests that ultimately public perceptions of these factors also play a part, and these perceptions are grounded in each country's culture, values, and practices.15–19 Thus, public perceptions should be taken into account to best tailor and communicate policy approaches that need public support in each country.
Many important strategies to reduce the spread of pandemic influenza need public participation. To assess public receptivity to such strategies, we compared adoption of preventive behaviours in response to the 2009 H1N1 influenza pandemic among the public in five countries and examined whether certain non-pharmaceutical behaviours (such as handwashing) were deterrents to vaccination. We also assessed public support for related public health recommendations.
We used data from simultaneous telephone polls (mobile telephone and landline) in Argentina, Japan, Mexico, the UK, and the USA. In each country, interviews were done in a nationally representative sample of adults, who were selected by the use of random digit dial techniques. The questionnaire asked people whether or not they had adopted each of various preventive behaviours (non-pharmaceutical—such as personal protective and social distancing behaviour—or vaccinations) to protect themselves or their family from H1N1 at any point during the pandemic. Two-tailed t tests were used for statistical analysis.
900 people were surveyed in each country except the USA where 911 people were contacted. There were wide differences in the adoption of preventive behaviours between countries, although certain personal protective behaviours (eg, handwashing) were more commonly adopted than social distancing behaviours (eg, avoiding places where many people gather) across countries (53–89% vs 11–69%). These non-pharmaceutical behaviours did not reduce the likelihood of getting vaccinated in any country. There was also support across all countries for government recommendations related to school closure, avoiding places where many people gather, and wearing masks in public.
There is a need for country-specific approaches in pandemic policy planning that use both non-pharmaceutical approaches and vaccination.
US Centers for Disease Control and Prevention and the National Public Health Information Coalition.
Handwashing against hospitalization for influenza: Time for PHIR?
2012, Preventive Medicine

View all citing articles on Scopus

View full text

The public's preventive strategies in response to the pandemic influenza A/H1N1 in France: Distribution and determinants

Abstract

Objectives

Methods

Results

Conclusions

Introduction

Section snippets

The study

Discussion

Conflict of interest statement

Prev. Med.

Vaccine

Rates of influenza vaccination in older adults and factors associated with vaccine use: a secondary analysis of the Canadian Study of Health and Aging

BMC Public Health

Meta-analysis of the relationship between risk perception and health behavior: the example of vaccination

Health Psychol.