The dynamics of risk perceptions and precautionary behavior in response to 2009 (H1N1) pandemic influenza

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Ibuka, Yoko
Chapman, Gretchen B.
Meyers, Lauren A.
Li, Meng
Galvani, Alison P.

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BMC Infectious Diseases


Background: The trajectory of an infectious disease outbreak is affected by the behavior of individuals, and the behavior is often related to individuals' risk perception. We assessed temporal changes and geographical differences in risk perceptions and precautionary behaviors in response to H1N1 influenza. Methods: 1,290 US adults completed an online survey on risk perceptions, interests in pharmaceutical interventions (preventive intervention and curative intervention), and engagement in precautionary activities (information seeking activities and taking quarantine measures) in response to H1N1 influenza between April 28 and May 27 2009. Associations of risk perceptions and precautionary behaviors with respondents' sex, age, and household size were analyzed. Linear and quadratic time trends were assessed by regression analyses. Geographic differences in risk perception and precautionary behaviors were evaluated. Predictors of willingness to take pharmaceutical intervention were analyzed. Results; Respondents from larger households reported stronger interest in taking medications and engaged in more precautionary activities, as would be normatively predicted. Perceived risk increased over time, whereas interest in pharmaceutical preventive interventions and the engagement in some precautionary activities decreased over time. Respondents who live in states with higher H1N1 incidence per population perceived a higher likelihood of influenza infection, but did not express greater interests in pharmaceutical interventions, nor did they engage in a higher degree of precautionary activities. Perceived likelihood of influenza infection, willingness to take medications and engagement in information seeking activities were higher for women than men. Conclusions: Perceived risk of infection and precautionary behavior can be dynamic in time, and differ by demographic characteristics and geographical locations. These patterns will likely influence the effectiveness of disease control measures.


Yoko Ibuka and Alison P. Galvani are with the Department of Epidemiology and Public Health, Yale School of Medicine, 60 College Street, New Haven, CT 06520, USA -- Gretchen B. Chapman and Meng Li are with the Department of Psychology, Rutgers University, 152 Frelinghuysen Road, Piscataway, NJ 08854, USA -- Lauren A. Meyers is with the Section of Integrative Biology, The University of Texas at Austin, Austin, TX 78712, USA and the Santa Fe Institute, 1399 Hyde Park Road, Santa Fe, NM 87501, USA

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Ibuka, Yoko, Gretchen B. Chapman, Lauren A. Meyers, Meng Li, and Alison P. Galvani. “The Dynamics of Risk Perceptions and Precautionary Behavior in Response to 2009 (H1N1) Pandemic Influenza.” BMC Infectious Diseases 10, no. 1 (October 14, 2010): 296. doi:10.1186/1471-2334-10-296.