• Gillian K SteelFisher, Robert J Blendon, Johanna R M Ward, Robyn Rapoport, Emily B Kahn, and Katrin S Kohl.
• Department of Health Policy and Management, Harvard School of Public Health, Boston, MA 02115, USA. gsteel@hsph.harvard.edu.
• Lancet Infect Dis. 2012 Nov 1; 12 (11): 845-50.

BackgroundMany important strategies to reduce the spread of pandemic influenza need public participation. To assess public receptivity to such strategies, we compared adoption of preventive behaviours in response to the 2009 H1N1 influenza pandemic among the public in five countries and examined whether certain non-pharmaceutical behaviours (such as handwashing) were deterrents to vaccination. We also assessed public support for related public health recommendations.MethodsWe used data from simultaneous telephone polls (mobile telephone and landline) in Argentina, Japan, Mexico, the UK, and the USA. In each country, interviews were done in a nationally representative sample of adults, who were selected by the use of random digit dial techniques. The questionnaire asked people whether or not they had adopted each of various preventive behaviours (non-pharmaceutical--such as personal protective and social distancing behaviour--or vaccinations) to protect themselves or their family from H1N1 at any point during the pandemic. Two-tailed t tests were used for statistical analysis.Findings900 people were surveyed in each country except the USA where 911 people were contacted. There were wide differences in the adoption of preventive behaviours between countries, although certain personal protective behaviours (eg, handwashing) were more commonly adopted than social distancing behaviours (eg, avoiding places where many people gather) across countries (53-89%vs 11-69%). These non-pharmaceutical behaviours did not reduce the likelihood of getting vaccinated in any country. There was also support across all countries for government recommendations related to school closure, avoiding places where many people gather, and wearing masks in public.InterpretationThere is a need for country-specific approaches in pandemic policy planning that use both non-pharmaceutical approaches and vaccination.FundingUS Centers for Disease Control and Prevention and the National Public Health Information Coalition.Copyright © 2012 Elsevier Ltd. All rights reserved.

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