MOTIVATING CONCERN ABOUT PANDEMIC INFLUENZA: EFFECTS OF GRAPHICS AND DISEASE TERMS IN A 11-COUNTRY STUDY

Purpose: With infectious diseases increasingly in the headlines (e.g., Ebola, Zika), it is important to identify methods to communicate disease risks that influence perceived risk and vaccination intentions. Currently, emotional reactions are often not concordant with the actual risk. For example, worry is often either greater than the actual risk (e.g., Ebola) or less than the actual risk (e.g., influenza). As part of a larger, multi-country study, we evaluated the effects of different risk graphics and disease terms on people’s reactions to an infectious disease.

Method: Using Internet panels in 11 countries (United States, United Kingdom, Germany, Netherlands, Hungary, Poland, Finland, Sweden, Norway, Italy, Spain; N=16,037) we tested two factors on participants’ knowledge, risk perceptions, and intended behavior in an influenza scenario: 1) graphical communication of prevalence and death via either a heat map, dot map, or trendline and 2) different terms used to describe a hypothetical type of influenza (H11N3 Influenza, Horse Flu, Yarraman Flu). Materials were translated to each country’s language.

Result: The heat map display produced the highest vaccination intentions (F=4.67, p=0.01), highest perceived likelihood of contracting influenza (F=7.47, p<0.001), and the greatest interest in seeking more information about the outbreak (F=4.04, p=0.02). It was also most preferred (F=248.81, p<0.001). Using Yarraman Flu or H11N3 Influenza produced greater perception of likelihood of contracting the disease (F=5.95, p=0.003) and greater interest in vaccination (F=5.23, p=0.005). Yarraman Flu and Horse Flu resulted in a greater interest in seeking more information (F=16.13, p<0.001).

Cross country comparisons revealed few differences in the risk graphic used. However, cross-country differences were observed in response to the disease term manipulation: Knowledge was highest when the flu was called H11N3 influenza among subjects in Germany, Hungary, and Italy, but lowest among subjects in Finland, Spain, and Sweden. The flu label seemed to have little impact on knowledge among subjects in the Netherlands, Poland, the UK, and the US.

Conclusion: When communicating to the public about infectious diseases, both heat map displays and use of either a scientific term (H11N3 Influenza) or an exotic sounding term (Yarraman flu) to label the disease increased risk perceptions and interest in vaccinations. Using these methods in future pandemics could improve the public’s interest in reading information about novel diseases and getting necessary vaccinations.