Division of Behavioural Sciences, School of Public health, The University of Hong Kong, 21 Sassoon Road, Pokfulam, Hong Kong, Special Administrative Region, China.
BMC Infect Dis. 2014 Mar 27;14:169. doi: 10.1186/1471-2334-14-169.
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.
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.
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.
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.
鲜有研究调查过大流行期间心理和行为指标之间的关联。本研究旨在比较在甲型 H1N1 流感大流行的第一个波次期间进行的十项横断面调查中，不同认知和情感风险指标与自我报告的保护行为之间关联的强度。
所有调查均采用基于问卷的电话访谈，通过随机数字拨号招募来自一般人群的成年人。在 10 项连续调查中对甲型 H1N1 的焦虑和担忧（情感）和感知风险（认知）进行了测量。使用多变量逻辑回归模型估计每个调查中的认知/情感-行为关联，而使用多层次逻辑模型则估计每个认知/情感测量对整个 10 项调查期间保护行为采用的平均影响。
除了状态焦虑外，其他情感指标，包括针对甲型 H1N1 风险的“预期担忧”、“经历的担忧”和“当前的担忧”，在不同的调查期间与保护行为的采用一直保持着强烈的关联。然而，认知-行为关联则较为薄弱，并且在十项调查中不一致。与 SARS 相比，感知到的甲型 H1N1 严重程度与保护行为的采用在大流行后期比在早期阶段具有更强的关联。
针对特定风险的担忧似乎与不同流行阶段的保护行为的采用密切相关，而认知措施在理解大流行后期人们的行为反应时可能变得更为重要。未来与流行相关的心理-行为研究应包括更多包含风险的情感测量。
