Public’s Response Change During A H1N1Influenza Pandemic Period In Xi’an,2009

ObjectiveThe aim of this study was to investigate the temporal change in knowledge,perceptions and behaviors of general public in response to Influenza A(H1N1) inXi’an2009, to understand the factors associated with public behaviors and provideevidence for policy maker to make prevention and control strategy.MethodsUsing random-digit dialing,6rounds of population-based, anonymous surveywas conducted at different times during and after the2009epidemic of influenza A(H1N1)in Xi’an, and the sampling method was probability proportion to size (PPS).Data was collected and entered into database by Epidata (version3.1). Statisticalanalyses were performed by Statistical Product and Service Solutions13.0(SPSS13.0).Results1. The hygiene protective measures:“cover mouths and noses when coughing”(92.0%),“wash hands”(98.2%) and “wash hands with soap”(97.9%) were stableover the study period. About the preventive behaviors, the trend for “reservepreventive drug” increased significantly all along the study period (from51.4%survey1to66.5%survey6). The level of “avoid crowded places”(65.3%) and“strength indoor ventilation”(89.2%) kept stable during the study period. Percentagesof respondents who have taken up H1N1vaccine all significantly decreased to a lower level from survey1to survey4(11.9%survey1to4.5%survey4), and they increasedin the final phase through the trend was not statistically significant (P>0.05).2. For modes of transmission, most of the respondents believed that H1N1couldbe transmitted via cough or sneeze and face-to-face talk (84.2%and72.1%), and only29.8%believed that the H1N1influenza could be transmitted by indirect hand contact.For the H1N1vaccination, significantly increasing proportion of respondents knewthe vaccination was free of charge（80.2%）. About80%of the respondents knew thestate’s initial vaccination strategy, and the percentage increased in the most recentsurveys (83.5%survey3,85.0%survey4and85.0%survey5, P<0.05).3. Of all respondents,52.5%considered that the H1N1influenza had disturbedtheir daily lives. Fewer respondents of the surveys worried about suffering fromH1N1(31.9%). Most of respondents (95.4%) thought that the state’s initialvaccination strategy was reasonable.63.4%of respondents were afraid of adversereaction caused by H1N1vaccination. All attitudes kept steady trend from survey1tosurvey6.4. There was a linear relationship among knowledge, attitude and behaviors usingpartial correlation analysis. The correlation between knowledge and behavior changewas statistically significant (r=0.173, P<0.001). A linear relationship was also foundbetween attitude and behaviors (r=0.238, P<0.001). H1N1related knowledge was alsocorrelated with respondents attitude(r=0.090, P=0.002).5.Logistic regression analyses results showed that, the factors influencedhygiene protective measures were gende（rOR=0.468,95%CI:0.371~0.590）, whetherdaily life being disturbed by A/H1N1（OR=1.707,95%CI:1.358~2.145）and worryingabout the suffering from H1N1（OR=1.498,95%CI:1.175~1.910）, the factors associatedwith preventive behaviors were age （OR=0.635,95%CI:0.486~0.831）, gender（OR=0.753,95%CI:0.598~0.950）,education leve（lOR=1.289,95%CI:1.007~1.648）,related knowledge（OR=1.557,95%CI:1.164~2.083）, whether daily life beingdisturbed by A/H1N1（OR=1.615,95%CI:1.281~2.035）and worry about suffering from H1N1（OR=1.614,95%CI:1.251~2.084）.ConclusionInfluenza-related knowledge and behaviors showed an increasing trend duringthe peak period of epidemic and after. The change of attitudes kept steady in thewhole period. There were linear relationships among knowledge, attitude andbehaviors. Gender, education level, related knowledge and attitudes were the mainimpact factors on public behaviors. Prevention and control strategy seems to beeffective in controlling the influenza epidemic in Xi’an2009.