Sociodemographic Predictors of Health Risk Perception, Attitude and Behavior Practices Associated with Health-Emergency Disaster Risk Management for Biological Hazards: The Case of COVID-19 Pandemic in Hong Kong, SAR China
The Situation in Hong Kong and Past Experiences of Similar Pandemics
2. Materials and Methods
2.1. Study Design and Study Population
2.2. Data Collection
2.3. Study Instrument
- Sociodemographic information was collected for age, gender, district of residence, household income, household size, marital status, education, size of housing, occupation and employment status.
- Knowledge about COVID-19, including the transmission route, and the comparison between COVID-19 and other respiratory diseases.
- Risk perception of Health-EDRM behavior associated with COVID-19, including the perceived impacts (e.g., physical, mental, social, financial and the whole impact), perceived sufficient knowledge to manage COVID-19, perceived severity and infectivity. Five-point Likert scales were used to measure the level of agreement or disagreement for the questions (from 1 to 5, 1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree). The 6-item short form of the State-Trait Anxiety Inventory (STAI) was used for measuring their current anxiety level concerning the outbreak . A binary question of whether the respondent was worried about getting infected with COVID-19 was asked.
- Self-reported perceived usefulness and actual Health-EDRM behavioral practice of nine personal or household health emergency disaster risks management related behaviors and practices of COVID-19 prevention behavior. These include: (1) washing hands before meals and after toileting, (2) washing hands with soaps, (3) avoiding dining or gathering together, (4) using serving utensils, (5) ordering takeaways more often, (6) bringing one’s own utensil when dining out, (7) wearing a mask when going out, (8) avoiding going to public places or using public transport, and (9) avoiding going to COVID-19-confirmed regions outside Hong Kong. The four-point Likert scale was used to ascertain the level of the practices (from 1 to 4, 1 = always, 2 = usually, 3 = sometimes, 4 = never).
- Current and preferred channels of information acquisition, the information they were interested in and the awareness of COVID-19.
- Questions about home quarantine and caregiving to non-suspected family members during the COVID-19 outbreak were also asked.
2.4. Statistical Analysis
3.1. Perception of Various Health and Economic Impacts of COVID-19
3.2. Knowledge and Risk Perception of COVID-19
3.3. Attitude and Uptake of Health-EDRM Behavior Practice towards COVID-19
3.4. Sociodemographic Factors Affecting Anxiety around Getting COVID-19
3.5. Other Related Behavioral Experiences: Home Quarantine and Caregiving to Non-Infected Family Members during COVID-19
3.6. Information Channel and Type of Information of Health Information Seeking for COVID-19
Conflicts of Interest
|Large Impact on Mental Health||Large Impact on Social Health||Large Impact on Financial Status||Large Impact on Hong Kong||Can be Prevented at Government Level||Can Be Spread by Insect||Can Be Spread by Asymptomatic Patient|
|Primary||1.10 (0.51–2.38)||0.15 (0.04–0.51) *||2.89 (1.35–6.18) *||0.45 (0.21–0.96) *|
|Secondary||1.81 (1.22–2.69) *||0.51 (0.21–1.23)||1.40 (0.87–2.26)||0.50 (0.32–0.78) *|
|Female||1.41 (1.02–1.95) *||1.60 (1.10–2.33) *|
|18–24||2.00 (0.77–5.18)||6.12 (1.78–21.54) *||7.93 (2.76–22.76) *||3.06 (0.88–10.61)|
|25–44||2.21 (1.19–4.12) *||4.03 (1.99–8.15) *||7.05 (3.35–14.81) *||2.12 (1.10–40.9) *|
|45–64||1.26 (0.73–2.19)||2.98 (1.60–5.55) *||4.32 (2.22–8.42) *||0.96 (0.55–1.69)|
|8000–19,999||0.43 (0.20–0.92) *|
|20,000–39,999||0.33 (0.16–0.72) *|
|40,000 or more||0.25 (0.12–0.54) *|
|Blue collar||1.70 (0.99–2.93)|
|Unemployment or retired||3.41 (1.72–6.76) *|
|Demographics||Wash Hands with Soaps||Avoid Dining or Gathering Together||Use Serving Utensil||Avoid Going to Public Place or Using Public Transport|
|Primary||0.31 (0.12–0.84) *||0.15 (0.04-0.51) *|
|Secondary||0.68 (0.33–1.42)||0.51 (0.21–1.23)|
|Female||2.27 (1.17–4.43) *||1.82 (1.21–2.74) *|
|18–24||2.15 (0.39–11.97)||2.48 (0.93–6.65)|
|25–44||4.62 (1.47–14.52) *||2.08 (1.09–3.98) *|
|45–64||2.83 (1.15–6.95) *||1.37 (0.77–2.44)|
|40,000 or more|
|Blue collar||0.70 (0.44–1.23)|
|Housewife||3.47 (1.87–6.42) *|
|Unemployment or retired||2.29 (1.28–4.07) *|
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|Demographics||2016 Population Census||Study Sample||p-Value d|
|65 or older||1,163,153||18.40%||143||18.70%|
|Marital status||0.962 e|
|Residential district a,b||0.334|
|Hong Kong Island||1,120,143||17.2%||147||19.20|
|Primary level or below||1,673,431||25.7%||61||8.00%|
|Household Income c||<0.001|
|40000 or more||782,383||31.2||360||50.2|
|Control Measures that Can Protect from COVID-19 Infections||Thought It Was Useful for Prevention||Always or Usually Practicing Currently||Attitude vs. Practice a|
|Wash hands before meals and after toilet||749||97.9||749||97.9||0.555 b|
|Wash hands with soaps||740||96.7||706||92.3||<0.001|
|Wear mask when going out||753||98.4||745||97.4||<0.001 b|
|Use serving utensil||708||92.5||568||74.2||0.174|
|Bring own utensils when dining out †||542||81.9||52||7.9||0.199|
|Order takeaway more often||474||62.0||262||34.4||<0.001|
|Avoid dining or gathering together||742||97.0||616||85.0||0.178|
|Avoid going to public place or using public transport||713||93.4||408||53.5||0.002|
|Avoid going to COVID-19 confirmed regions outside Hong Kong||714||93.3||628||88.0||<0.001|
|Characteristics||Not Worry or Don’t Know † (n = 252)||Worry (n = 505)||p-Value||AOR (95% CI)||p-Value|
|Age||18–24||15 (6.0%)||55 (10.9%)||0.037||1|
|25–44||77 (30.6%)||169 (33.5%)||0.567 (0.294–1.095)||0.091|
|45–64||103 (40.9%)||198 (39.2%)||0.606 (0.318–1.153)||0.127|
|65 or more||57 (22.6%)||83 (16.4%)||0.493 (0.244–0.995)||0.048|
|Gender||Male||132 (52.4%)||220 (43.6%)||0.022||1|
|Female||120 (47.6%)||285 (56.4%)||1.323 (0.956–1.831)||0.092|
|Chronic disease||No||206 (81.7%)||412 (81.6%)||0.957|
|Yes||46 (18.3%)||93 (18.3%)|
|Education level||Primary level or below||25 (10.0%)||33 (6.6%)||0.249|
|Secondary level||108 (43.0%)||220 (43.7%)|
|Tertiary level||118 (47.0%)||250 (49.7%)|
|Marital status||Non-married||99 (39.4%)||201 (39.9%)||0.908|
|Married||152 (60.2%)||303 (60.1%)|
|Residential district||Hong Kong Island||52 (21.0%)||93 (18.4%)||0.207|
|Kowloon||83 (32.9%)||145 (28.7%)|
|New Territories||116 (46.0%)||267 (52.9%)|
|Families members with chronic disease||No or don’t know||209 (82.9%)||393 (77.8%)||0.100|
|Yes||43 (17.1%)||112 (22.2%)|
|Household floor area||350 ft or below||53 (21.6%)||100 (21.1%)||0.964|
|351 ft to 800 ft||157 (64.1%)||304 (64.0%)|
|801 ft or above||35 (14.3%)||71 (14.9%)|
|Household income||<2000–7999||29 (12.1%)||36 (7.6%)||0.147|
|8000–19,999||36 (15.0%)||65 (13.8%)|
|20,000–39,999||66 (27.5%)||123 (26.1%)|
|40,000 or more||109 (45.4%)||248 (52.5%)|
|Believing COVID-19 had large effect on their physical health||No||158 (62.9%)||206 (40.9%)||<0.001||1|
|Yes||93 (37.1%)||298 (59.1%)||1.583 (1.111–2.256)||0.011|
|Believing COVID-19 had large effect on their mental health||No||183 (72.6%)||219 (43.4%)||<0.001||1|
|Yes||69 (27.4%)||286 (56.6%)||2.490 (1.719–3.608)||<0.001|
|Believing COVID-19 had large effect on their financial status||No||181 (71.8%)||324 (64.2%)||0.035||1|
|Yes||71 (28.2%)||181 (35.8%)||0.927 (0.644–1.336)||0.685|
|Believing COVID-19 had large effect on their social life||No||104 (41.3%)||108 (21.4%)||<0.001||1|
|Yes||148 (58.7%)||397 (78.6%)||1.657 (1.138–2.413)||0.008|
|Believing COVID-19 had large effect on whole Hong Kong society||No||22 (8.7%)||20 (4.0%)||0.007||1|
|Yes||230 (91.3%)||485 (96.0%)||1.205 (0.608–2.385)||0.593|
|Perceived sufficient knowledge to manage COVID-19||No||127 (50.4%)||269 (53.3%)||0.456|
|Yes||125 (49.6%)||236 (43.7%)|
|Perceived COVID-19 infectivity||Very low to medium or don’t know||16 (6.3%)||17 (3.4%)||0.058||1|
|High or very high||236 (93.7%)||488 (96.6%)||1.290 (0.610–2.728)||0.505|
|Perceived COVID-19 severity||Very low to medium or don’t know||58 (23.0%)||63 (19.0%)||0.197|
|High or very high||194 (77.0%)||409 (81.0%)|
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Chan, E.Y.Y.; Huang, Z.; Lo, E.S.K.; Hung, K.K.C.; Wong, E.L.Y.; Wong, S.Y.S. Sociodemographic Predictors of Health Risk Perception, Attitude and Behavior Practices Associated with Health-Emergency Disaster Risk Management for Biological Hazards: The Case of COVID-19 Pandemic in Hong Kong, SAR China. Int. J. Environ. Res. Public Health 2020, 17, 3869. https://doi.org/10.3390/ijerph17113869
Chan EYY, Huang Z, Lo ESK, Hung KKC, Wong ELY, Wong SYS. Sociodemographic Predictors of Health Risk Perception, Attitude and Behavior Practices Associated with Health-Emergency Disaster Risk Management for Biological Hazards: The Case of COVID-19 Pandemic in Hong Kong, SAR China. International Journal of Environmental Research and Public Health. 2020; 17(11):3869. https://doi.org/10.3390/ijerph17113869Chicago/Turabian Style
Chan, Emily Ying Yang, Zhe Huang, Eugene Siu Kai Lo, Kevin Kei Ching Hung, Eliza Lai Yi Wong, and Samuel Yeung Shan Wong. 2020. "Sociodemographic Predictors of Health Risk Perception, Attitude and Behavior Practices Associated with Health-Emergency Disaster Risk Management for Biological Hazards: The Case of COVID-19 Pandemic in Hong Kong, SAR China" International Journal of Environmental Research and Public Health 17, no. 11: 3869. https://doi.org/10.3390/ijerph17113869