Prevalence of preventive behaviors and associated factors during early phase of the H1N1 influenza epidemic

Background: The community plays an important role in controlling influenza A/H1N1. There is a dearth of data investigating adoption of preventive behaviors in the initial phase of the A/H1N1 pandemic. Methods: Three round of random, population-based, anonymous telephone survey were conducted in Hong Kong during the pre-community outbreak phase (May 7 to June 6, 2009) of the influenza A/H1N1 pandemic in Hong Kong (n = 999). Results: Respectively, 46.65%, 88.75%, and 21.5% washed hands more than 10 times/day, wore face masks when having influenza-like illness (ILI), and wore face masks regularly in public areas. Perceptions related to bodily damages, efficacy of frequent handwashing, nonavailability of effective vaccines, high chance of having a large scale local outbreak, and mental distress because of influenza A/H1N1 were associated with frequent handwashing (odds ratio [OR], 1.46 to 2.15). Perceived vaccine availability was associated with face mask use when having ILI (OR, 1.60). Perceived fatality, efficacy of wearing face masks, and mental distress because of influenza A/H1N1 were associated with face mask use in public areas (OR, 1.53 to 2.52). Conclusion: Preventive behaviors were prevalently adopted by the public and were associated with cognitive and affective factors. Prevention efforts should take public perceptions into account, and emerging infectious diseases provide good chances for promoting hygiene.