Perceived risk, anxiety, and behavioural responses of the general public during the early phase of the Influenza A (H1N1) pandemic in The Netherlands: Results of three consecutive online surveys
Open accessAbstract
BACKGROUND: Research into risk perception and behavioural responses in case of emerging infectious diseases is still relatively new. The aim of this study was to examine perceptions and behaviours of the general public during the early phase of the Influenza A (H1N1) pandemic in the Netherlands. METHODS: Two cross-sectional and one follow-up online survey (survey 1, 30 April-4 May; survey 2, 15-19 June; survey 3, 11-20 August 2009). Adults aged 18 years and above participating in a representative Internet panel were invited (survey 1, n = 456; survey 2, n = 478; follow-up survey 3, n = 934). Main outcome measures were 1) time trends in risk perception, feelings of anxiety, and behavioural responses (survey 1-3) and 2) factors associated with taking preventive measures and strong intention to comply with government-advised preventive measures in the future (survey 3). RESULTS: Between May and August 2009, the level of knowledge regarding Influenza A (H1N1) increased, while perceived severity of the new flu, perceived self-efficacy, and intention to comply with preventive measures decreased. The perceived reliability of information from the government decreased from May to August (62% versus 45%). Feelings of anxiety decreased from May to June, and remained stable afterwards. From June to August 2009, perceived vulnerability increased and more respondents took preventive measures (14% versus 38%). Taking preventive measures was associated with no children in the household, high anxiety, high self-efficacy, more agreement with statements on avoidance, and paying much attention to media information regarding Influenza A (H1N1). Having a strong intention to comply with government-advised preventive measures in the future was associated with higher age, high perceived severity, high anxiety, high perceived efficacy of measures, high self-efficacy, and finding governmental information to be reliable. CONCLUSIONS: Decreasing trends over time in perceived severity and anxiety are consistent with the reality: the clinical picture of influenza turned out to be mild in course of time. Although (inter)national health authorities initially overestimated the case fatality rate, the public stayed calm and remained to have a relatively high intention to comply with preventive measures.
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Previous research found that more than half of individuals exhibit anxiety during virus-induced epidemics or pandemics.
“Previous research has found that more than half of individuals exhibit anxiety during virus-induced epidemics or pandemics (Bults et al., 2011; Goulia et al., 2010).”
From Understanding terror states of online users in the context of COVID-19: An application of Terror Management Theory (2021) · cites this paper as Bults et al., 2011
The Results section (Time-trends in perceived risk, feelings of anxiety, and behavioural responses; no page number available) reports a high anxiety summary score for 61% of Dutch respondents in the first H1N1 survey. That supports the claim for one early-pandemic survey, but the proportion fell below half in subsequent surveys (40%, 39%, and 36%); the paper does not establish that more than half of individuals generally experience anxiety during epidemics or pandemics. (LLM, conf=0.86)
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Retracted
- Authors
- Bults, M., Beaujean, D. J., de Zwart, O., Kok, G., van Empelen, P., van Steenbergen, J. E., Richardus, J. H., & Voeten, H. A.
- Affiliations
- GGD Rotterdam-Rijnmond (NL)
- National Institute for Public Health and the Environment (NL)
- Maastricht University (NL)
- Erasmus MC (NL)
- Corresponding author
- Bults, Marloes
- Venue
- BMC Public Health
- Published
- 2011-01-03
- Volume
- 11
- Issue
- 1
- Pages
- 2-2
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC3091536
- OpenAlex
- W2160326461
- Cited by
- 508
- References
- 29
- Citations by year
- 2026: 9 · 2025: 19 · 2024: 30 · 2023: 35 · 2022: 87 · 2021: 125 · 2020: 108 · 2019: 14 · 2018: 9 · 2017: 9 · 2016: 13 · 2015: 10 · 2014: 10 · 2013: 13 · 2012: 14
- FWCI
- 42.86
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Research Publications (Maastricht University) (publishedVersion, cc-by)
- EUR Research Repository (Erasmus University Rotterdam) (submittedVersion, other-oa)
- RePub (Erasmus University Rotterdam) (submittedVersion, other-oa)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- RePub (Erasmus University Rotterdam) (submittedVersion)
- Rivm Repository (Netherlands National Institute for Public Health and the Environment) (submittedVersion)
- Research Publications (Maastricht University) (submittedVersion, other-oa)
- Funders
- ZonMw
- Nederlandse Organisatie voor Wetenschappelijk Onderzoek
- Topics
- Social Sciences › Sociology and Political Science › Risk Perception and Management
- Health Sciences › Medicine › Epidemiology › Influenza Virus Research Studies
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- influenza A (H1N1) pandemic, risk perception, anxiety, preventive behavior, self-efficacy, perceived severity, perceived susceptibility, media attention, compliance with preventive measures, emerging infectious diseases, public health communication, temporal trends
- MeSH terms
- Adult, Aged, Aged, 80 and over, Anxiety, Female, Follow-Up Studies, Humans, Influenza, Human, Health Knowledge, Attitudes, Practice, Male, Middle Aged, Netherlands, Surveys and Questionnaires, Risk, Socioeconomic Factors, Health Behavior, Multivariate Analysis, Logistic Models, Internet, Influenza A Virus, H1N1 Subtype, Pandemics
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
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