Avian influenza A/H7N9 risk perception, information trust and adoption of protective behaviours among poultry farmers in Jiangsu Province, China

Background: Poultry farmers are at high-risk from avian influenza A/H7N9 infection due to sustained occupational exposures to live poultry. This study examined factors associated with poultry farmers' adoption of personal protective behaviours (PPBs) based on Protection Motivation Theory (PMT). Methods: Totally, 297 poultry farmers in three cities of Jiangsu Province, China were interviewed during November 2013-January 2014. Data on PMT constructs, perceived trustworthiness of A/H7N9 information from mass media (formal sources), friends and family (informal sources), intention to adopt and actual adoption of PPBs and respondents' demographics were collected. Structural equation modeling (SEM) identified associations between demographic factors and PMT constructs associated with A/H7N9-oriented PPB intention. Moderated mediation analysis examined how demographics moderated the effects of information trust on PPB intention via risk perceptions of A/H7N9. Results: Respondents generally perceived low vulnerability to A/H7N9 infection. The SEM found that male respondents perceived lower severity of (beta = -0.23), and lower vulnerability to (beta = -0.15) A/H7N9 infection; age was positively associated with both perceived personal vulnerability to (beta = 0.21) and perceived self-efficacy (beta = 0.24) in controlling A/H7N9; education was positively associated with perceived response efficacy (beta = 0.40). Furthermore, perceived vulnerability (beta = 0.16), perceived self-efficacy (beta = 0.21) and response efficacy (beta = 0.67) were positively associated with intention to adopt PPBs against A/H7N9. More trust in informal information (TII) was only significantly associated with greater PPB intention through its positive association with perceived response efficacy. Age significantly moderated the associations of TII with perceived Self-efficacy and perceived response efficacy, with younger farmers who had greater TII perceiving lower self-efficacy but higher response efficacy. Conclusion: Poultry farmers perceive A/H7N9 as a personally-irrelevant risk. Interventions designed to enhance perceived response efficacy, particularly among lower educated respondents may effectively motivate adoption of PPBs. Informal information may be an important resource for enhancing response efficacy.