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Abstract 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.

Background: Lyme disease (LD) is the most common tick-borne disease in the United States and in Europe. The aim of this study was to examine knowledge, perceived risk, feelings of anxiety, and behavioral responses of the general public in relation to tick bites and LD in the Netherlands. Methods: From a representative Internet panel a random sample was drawn of 550 panel members aged 18 years and older (8-15 November 2010) who were invited to complete an online questionnaire. Results: Response rate (362/550, 66%). This study demonstrates that knowledge, level of concern, and perceived efficacy are the main determinants of preventive behavior. 35% (n = 125/362) of the respondents reported a good general knowledge of LD. While 95% (n = 344/362) perceived LD as severe or very severe, the minority (n = 130/362, 36%) perceived their risk of LD to be low. Respondents were more likely to check their skin after being outdoors and remove ticks if necessary, than to wear protective clothing and/or use insect repellent skin products. The percentage of respondents taking preventive measures ranged from 6% for using insect repellent skin products, to 37% for wearing protective clothing. History of tick bites, higher levels of knowledge and moderate/high levels of worry were significant predictors of checking the skin. Significant predictors of wearing protective clothing were being unemployed/retired, higher knowledge levels, higher levels of worry about LD and higher levels of perceived efficacy of wearing protective clothing. Conclusions: Prevention programs targeting tick bites and LD should aim at influencing people's perceptions and increasing their knowledge and perceived efficacy of protective behavior. This can be done by strengthening motivators (e.g. knowledge, concern about LD, perceived efficacy of wearing protective clothing) and removing barriers (e.g. low perceived personal risk, not knowing how to recognize a tick). The challenge is to take our study findings and translate them into appropriate prevention strategies. [ABSTRACT FROM AUTHOR]

Objective: To gain insight into how the Dutch general public viewed the risk during the course of the recent pandemic, into how many and which people took precautionary measures, and into the extent to which people trust the information provided by the government., Design: Online survey, cross-sectional (the first two measurements) and follow-up investigations (the last two measurements)., Method: Between 10 and 17 November 2009, 754 people completed the online questionnaire. Earlier survey rounds were held in May (n = 572), June (n = 620) and August (n = 934)., Results: In November 2009, 38% of respondents considered the Mexican flu a serious disease and 36% viewed themselves as vulnerable to this flu. Feelings of anxiety had decreased versus earlier survey rounds. Of the respondents, 73% took precautionary measures against the disease. This concerned mainly hygiene measures, which were most frequently taken by people who were anxious, found hygiene measures effective, paid considerable attention to the media information on flu, and found information from the government reliable and those without children living at home. More than fifty percent (58%) of respondents indicated that they would be willing to have the vaccination if they would be eligible for this. Of the other 315 respondents, 40% indicated that they feared serious side effects, 35% that they doubted the effectiveness of the vaccine and 33% that they considered the vaccine to be insufficiently tested. Almost half of the respondents had read the information leaflet 'Fight the flu', which was sent to every home in the country. One third had seen the television campaign. Governmental institutions, notably the Ministry of Health, Welfare and Sport and the National Institute for Public Health and the Environment, were the most important sources of information and more than half of the respondents trusted this information., Conclusion: During the course of the 2009 influenza A (H1N1) pandemic, anxiety among the Dutch general public decreased progressively, while people increasingly considered themselves more vulnerable to the flu. The public therefore had a realistic view of the situation. Three quarters of the general public had taken precautionary measures against the flu. More than fifty percent would be willing to have the vaccination if they would be eligible for this. The most important reason for not wanting the vaccination was fear of serious side effects and doubts about the effectiveness of the vaccine. This is a point of attention for the development of public information campaigns about vaccinations in the future.

Objective: To determine the reaction of the general public on the information regarding the Mexican flu., Design: Online panel interview., Method: From April 30 to May 4 2009, 572 people filled out an online questionnaire., Results and Conclusion: 88% of the respondents had sufficient general knowledge about the Mexican flu. This information was mostly acquired by watching television (69%). More information was desired regarding the symptoms of the flu and those personal measures that could be taken to avoid infection.