Open Access Highly Accessed Research article

Perceptions of and willingness to engage in public health precautions to prevent 2009 H1N1 influenza transmission

Marc T Kiviniemi*, Pavani K Ram, Lynn T Kozlowski and Kaitlin M Smith

Author Affiliations

School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA

For all author emails, please log on.

BMC Public Health 2011, 11:152  doi:10.1186/1471-2458-11-152

Published: 8 March 2011



Recommendations about precautionary behaviors are a key part of public health responses to infectious disease threats such as the 2009 H1N1 pandemic. Individuals' interpretation of recommendations, willingness to comply, and factors predicting willingness were examined.


A telephone survey of adult residents of New York State was conducted (N = 807). Respondents reported how they interpreted recommendations, willingness to engage in recommended actions, risk perceptions for H1N1 infection, and perceived efficacy of recommendations. Demographic characteristics were used to calculate sampling weights to obtain population-representative estimates.


There was substantial variability in interpretation of preventive actions. Willingness to engage in preventive actions also varied substantially; vaccination willingness was substantially lower than other preventive actions. No pattern of demographic characteristics consistently predicted willingness. Perceived efficacy was associated with willingness for all recommendations, and perceived severity was associated with willingness for some recommendations.


Results suggest that individual interpretation of actions differ widely. The results suggest that current recommendations are not clear to laypeople and are open to different interpretations. These varying interpretations should be considered in crafting public health messages about precautionary behaviors.