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      The impacts of knowledge, risk perception, emotion and information on citizens’ protective behaviors during the outbreak of COVID-19: a cross-sectional study in China

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          Abstract

          Background

          Individual protective behaviors play an important role in the control of the spread of infectious diseases. This study aimed to investigate the adoption of protective behaviors by Chinese citizens amid the COVID-19 outbreak and its associated factors.

          Methods

          An online cross-sectional survey was conducted from 22 January to 14 February 2020 through Wenjuanxing platform, measuring their knowledge, risk perception, negative emotion, response to official communication, and protective behaviors in relation to COVID-19. A total of 3008 people completed the questionnaire, of which 2845 were valid questionnaires.

          Results

          On average, 71% of respondents embraced protective behaviors. Those who made no error in the knowledge test (AOR = 1.77, p < 0.001) perceived the high severity of the epidemic (AOR = 1.90, p < 0.001), had high negative emotion (AOR = 1.36, p = 0.005), reported good health (AOR = 1.94, p < 0.001), paid high attention to the governmental media (AOR = 4.16, p < 0.001) and trusted the governmental media (AOR = 1.97, p < 0.001) were more likely to embrace protective behaviors after adjustments for variations in potential confounding factors. Women and older people were also more likely to embrace protective behaviors. No regional or educational differences were found in the adoption of protective behaviors.

          Conclusion

          The majority of Chinese citizens embraced protective behaviors. Higher levels of protective behaviors are associated with higher knowledge, perceived severity, negative emotion, and attention to and trust in the official governmental media. Official governmental communication is the largest single predictor of protective behaviors.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12889-020-09892-y.

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          Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China

          Cuiyan Wang, Riyu Pan, Xiaoyang Wan … (2020)
          Background: The 2019 coronavirus disease (COVID-19) epidemic is a public health emergency of international concern and poses a challenge to psychological resilience. Research data are needed to develop evidence-driven strategies to reduce adverse psychological impacts and psychiatric symptoms during the epidemic. The aim of this study was to survey the general public in China to better understand their levels of psychological impact, anxiety, depression, and stress during the initial stage of the COVID-19 outbreak. The data will be used for future reference. Methods: From 31 January to 2 February 2020, we conducted an online survey using snowball sampling techniques. The online survey collected information on demographic data, physical symptoms in the past 14 days, contact history with COVID-19, knowledge and concerns about COVID-19, precautionary measures against COVID-19, and additional information required with respect to COVID-19. Psychological impact was assessed by the Impact of Event Scale-Revised (IES-R), and mental health status was assessed by the Depression, Anxiety and Stress Scale (DASS-21). Results: This study included 1210 respondents from 194 cities in China. In total, 53.8% of respondents rated the psychological impact of the outbreak as moderate or severe; 16.5% reported moderate to severe depressive symptoms; 28.8% reported moderate to severe anxiety symptoms; and 8.1% reported moderate to severe stress levels. Most respondents spent 20–24 h per day at home (84.7%); were worried about their family members contracting COVID-19 (75.2%); and were satisfied with the amount of health information available (75.1%). Female gender, student status, specific physical symptoms (e.g., myalgia, dizziness, coryza), and poor self-rated health status were significantly associated with a greater psychological impact of the outbreak and higher levels of stress, anxiety, and depression (p < 0.05). Specific up-to-date and accurate health information (e.g., treatment, local outbreak situation) and particular precautionary measures (e.g., hand hygiene, wearing a mask) were associated with a lower psychological impact of the outbreak and lower levels of stress, anxiety, and depression (p < 0.05). Conclusions: During the initial phase of the COVID-19 outbreak in China, more than half of the respondents rated the psychological impact as moderate-to-severe, and about one-third reported moderate-to-severe anxiety. Our findings identify factors associated with a lower level of psychological impact and better mental health status that can be used to formulate psychological interventions to improve the mental health of vulnerable groups during the COVID-19 epidemic.
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            The Fear of COVID-19 Scale: Development and Initial Validation

            Daniel Ahorsu, Chung-Ying Lin, Vida Imani … (2020)
            Background The emergence of the COVID-19 and its consequences has led to fears, worries, and anxiety among individuals worldwide. The present study developed the Fear of COVID-19 Scale (FCV-19S) to complement the clinical efforts in preventing the spread and treating of COVID-19 cases. Methods The sample comprised 717 Iranian participants. The items of the FCV-19S were constructed based on extensive review of existing scales on fears, expert evaluations, and participant interviews. Several psychometric tests were conducted to ascertain its reliability and validity properties. Results After panel review and corrected item-total correlation testing, seven items with acceptable corrected item-total correlation (0.47 to 0.56) were retained and further confirmed by significant and strong factor loadings (0.66 to 0.74). Also, other properties evaluated using both classical test theory and Rasch model were satisfactory on the seven-item scale. More specifically, reliability values such as internal consistency (α = .82) and test–retest reliability (ICC = .72) were acceptable. Concurrent validity was supported by the Hospital Anxiety and Depression Scale (with depression, r = 0.425 and anxiety, r = 0.511) and the Perceived Vulnerability to Disease Scale (with perceived infectability, r = 0.483 and germ aversion, r = 0.459). Conclusion The Fear of COVID-19 Scale, a seven-item scale, has robust psychometric properties. It is reliable and valid in assessing fear of COVID-19 among the general population and will also be useful in allaying COVID-19 fears among individuals.
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              A Longitudinal Study on the Mental Health of General Population during the COVID-19 Epidemic in China

              Cuiyan Wang, Riyu Pan, Xiaoyang Wan … (2020)
              Highlights • A significant reduction in psychological impact 4 weeks after COVID outbreak. • The mean scores of respondents in both surveys were above PTSD cut-offs. • Female gender, physical symptoms associated with a higher psychological impact. • Hand hygiene, mask-wearing & confidence in doctors reduced psychological impact. • Online trauma-focused psychotherapy may be helpful to public during COVID-19.
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                Author and article information

                Contributors
                Yanhua Hao:
                ORCID: http://orcid.org/0000-0002-0841-2291
                hyhyjw@126.com
                Lijun Gao: gg73@163.com
                Journal
                Journal ID (nlm-ta): BMC Public Health
                Journal ID (iso-abbrev): BMC Public Health
                Title: BMC Public Health
                Publisher: BioMed Central (London )
                ISSN (Electronic): 1471-2458
                Publication date (Electronic): 23 November 2020
                Publication date PMC-release: 23 November 2020
                Publication date Collection: 2020
                Volume: 20
                Electronic Location Identifier: 1751
                Affiliations
                [1 ]GRID grid.410736.7, ISNI 0000 0001 2204 9268, School of Health Management, , Harbin Medical University, ; Harbin, China
                [2 ]Harbin Center for Disease Control and Prevention, Harbin, China
                [3 ]GRID grid.411991.5, ISNI 0000 0001 0494 7769, School of Education Science, , Harbin Normal University, ; Harbin, China
                [4 ]GRID grid.1018.8, ISNI 0000 0001 2342 0938, School of Psychology and Public Health, , La Trobe University, ; Melbourne, VIC 3086 Australia
                Author information
                http://orcid.org/0000-0002-0841-2291
                Article
                Publisher ID: 9892
                DOI: 10.1186/s12889-020-09892-y
                PMC ID: 7681179
                PubMed ID: 33225934
                SO-VID: 4416ddea-fcec-4cff-b934-3a0848e9802c
                Copyright © © The Author(s) 2020
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 28 July 2020
                Date accepted : 15 November 2020
                Funding
                Funded by: National Natural Scientific Fund of China
                Award ID: 71673072
                Award ID: 72042001
                Award Recipient :
                Categories
                Subject: Research Article
                Custom metadata
                issue-copyright-statement © The Author(s) 2020

                ScienceOpen disciplines: Public health
                Keywords: covid-19,china,behavior,public health,perception
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: covid-19, china, behavior, public health, perception

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