Knowledge and attitudes towards pandemic influenza at the University of Alberta Rob Lake; Olive Yonge; Tom Marrie; Tracey Bailey; Rhonda Rosychuk; Ben

Knowledge and attitudes towards pandemic influenza at the University

of Alberta

Rob Lake; Olive Yonge; Tom Marrie; Tracey Bailey; Rhonda

Rosychuk; Ben Herman

Background

• Pandemics in 1918, 1957 and 1968

• H5N1 latest concern– 271 cases and 165 deaths (60% mortality)– Continues to mutate– Currently in WHO Phase 3

• Could cost up to $4.4 trillion U.S.

Pandemic versus BC Planning

• Not the same as business continuity planning

• Everyone’s problem

• Expect up to 40% staff absenteeism

• Longer duration, multiple waves

• Some advance notice

PHRC Background

• PHRC formed by request of Dean’s Council January 2006

• Mandate to prepare U of A for a pandemic

• Decision made to broaden the scope to public health

Evidence-Based Decision Making

• Decision was made to design a web- based survey for all students and staff to assess knowledge and attitudes towards a pandemic in the following areas: current health status, sources of information, general knowledge, volunteering, resource allocations, closure of the university

Significance

• Information needed for planning for allocation of resources, closure

• Programs need to be developed

• Minimal research background and thus decisions will have to be paid in the current context

• Lessons learned from SARS

Methods

• Questionnaire designed42 questions; Likert type scale; 2 free text

• Sep 12 – Oct 31 06 administered via web• Ethics and FOIPP approvals• Email list managed by others• UGME; UNP students letters

Overall Response Rates

• 5225/40,086 13.03%

• 3657/23,044 15.87% females

• 1521/17,029 8.93% male

5178/5225 answered question on gender13/40,086 could not determine gender from database records

Response rate by category

020

4060

8010

0

Response Rates

Subgroup

Per

cent

(%

) 60%

32%

12% 14% 17%

SMS NS OS F SS(n=250) (n=1512) (n=30498) (n=2233) (n=3434)

Study Population Descriptors

SMS NS OS F SS

N 151 484 3652 318 575

Female% 71.5 95.0 68.0 52.0 76.0

Age 24.8 24.7 22.0 47.0 40.6

Children% 6.0 11.0 5.6 69.0 56.0

Poor H % 0 0.8 2.2 1.6 2.5

Subgroup

020

4060

8010

0P

erce

nt (

%)

72%

95%

68%

52%

76%


Female

02

04

06

08

01

00

Single Marital Status

Subgroup

Pe

rce

nt (

%)

73% 73%79%

19%

33%


02

04

06

08

01

00Have Children

Subgroup

Pe

rce

nt (

%)

6%11%

6%

69%

56%


0.0

0.5

1.0

1.5

2.0

2.5

3.0

Poor / Very Poor Health Status

Subgroup

Pe

rce

nt (

%)

0%

0.8%

2.2%

1.6%

2.5%


Previous volunteer activities

• Sports/recreation 38.0 – 43.7%

• Hosp/ health care 16.7 – 78.8%

• School 39.3 – 68.9%

• Religious Institutions 21.6 – 31.0%

• Social Services 16.7 – 37.7%

• Other 22.5 – 30.6%

02

04

06

08

01

00

Subgroup

SMS(n=151)

NS(n=484)

OS(n=3652)

F(n=318)

SS(n=575)

Past VolunteerismP

erc

en

t (%

)

Sports

Hospital

School

Religious

Social

Other

020

4060

8010

0

Subgroup

SMS(n=151)

NS(n=484)

OS(n=3652)

F(n=318)

SS(n=575)

Health Information SourcesHigh Reliance

Per

cent

(%

)

TV

Internet

Newspaper

Friends

Courses

MDs

RNs

PHO

UHC

Subgroup

(n=151) (n=484) (n=3652) (n=318) (n=575)

020

4060

8010

0

SMS NS OS F SS

Per

cent

(%

)

TV

Internet

Newspaper

Friends

Courses

MDs

RNs

PHO

UHC

Health Information SourcesConfidence

02

04

06

08

01

00

Subgroup

SMS(n=151)

NS(n=484)

OS(n=3652)

F(n=318)

SS(n=575)

Spread of Influenza KnowledgeP

erc

en

t (%

)

Close contact

Blood transfusion

Doorknobs, etc

Infected birds

020

4060

8010

0

Medical Student Group

Junior(n=224)

Senior(n=130)

Influenza KnowledgeSpread

Per

cent

(%

)

Contact

Blood

Sexual

Cough

Touching

Birds

Knowledge about how influenza can be prevented

020

4060

8010

0

Subgroup

SMS(n=151)

NS(n=484)

OS(n=3652)

F(n=318)

SS(n=575)

Prevention of Influenza KnowledgeP

erce

nt (

%)

Nothing

Hand washing

Vaccination

Quarantine

Antibiotics

Antivirals

Knowledge of treatment of influenza

020

4060

8010

0

Subgroup

SMS(n=151)

NS(n=484)

OS(n=3652)

F(n=318)

SS(n=575)

Treatment of Influenza KnowledgeP

erce

nt (

%)

Nothing

Antibiotics

Antivirals

Bedrest

Comp. med.

020

4060

8010

0

Medical Student Group

Junior(n=224)

Senior(n=130)

Influenza KnowledgeTreatment

Per

cent

(%

)

Nothing

Antibiotics

Antivirals

Vaccination

Bed rest

Fluids

Comp. med.

Soup

Canadian Pandemic Influenza Plan for the Health Sector

• 70% of pop will be infected but only 15 – 35% will be clinically ill.

• Mild – Mod disease 50.0% outpatient care 1.0% hospitalized 0.4% fatal

• Severe disease10% hospitalized; 2% fatal

Likelihood of being infected if pandemic influenza hits Edmonton

020

4060

8010

0

Subgroup

4%

49%

4%

35%

6%

26%

4%

33%

5%

28%

SMS(n=151)

NS(n=484)

OS(n=3652)

F(n=318)

SS(n=575)

Pandemic Flu in EdmontonP

erce

nt (

%)

Very unlikely

Likely / Very likely

Likelihood ( L or VL) of the following outcomes if you develop influenza

020

4060

8010

0

Subgroup

SMS(n=151)

NS(n=484)

OS(n=3652)

F(n=318)

SS(n=575)

Pandemic Influenza OutcomesP

erce

nt (

%)

Will not miss

Miss some

Hospitalized

Death

Volunteering during pandemic influenza

020

4060

8010

0

Subgroup

SMS(n=151)

NS(n=484)

OS(n=3652)

F(n=318)

SS(n=575)

Pandemic Influenza Volunteerism AttitudesP

erce

nt (

%)

Enc. HC Stud.

Enc. Retired HC

Obl. of HC Stud.

Required justified

Penalize HC Stud.

Volunteerism

• Six motivations (Clary & Snyder):1. Values

2. Understanding

3. Enhancement

4. Career

5. Social

6. Protective

020

4060

8010

0

Willingness to VolunteerP

erce

nt (

%)

49.2% 50.8%

Likely Unlikely(n=2444) (n=2523)

05

1015

2025

AgriArts

Augustana

Business

Educatio

n

Engineering

Extensio

n

GraduateLaw

Med / Dent

Native

Nursing

Open

Pharmacy

Phys Ed

Pub. Health

Rehab med

Saint-Jean

Science

FacultyP

erce

nt (

%)

Likely Unlikely

020

4060

8010

0

Likely(n=2410-2431)

Unlikely(n=2497-2506)

Pandemic Influenza Volunteerism AttitudesP

erce

nt (

%)

Enc. HC Stud.

Enc. Retired HC

Obl. of HC Stud.

Required justified

Penalize HC Stud.

Penalize HC Staff

020

4060

8010

0

76%79% 78%

54%

40%35% 33%

17%

Likely(n=2401-2419)


Community Volunteer ActivitiesP

erce

nt (

%)

Phone lines

Check neighbours

Groceries

Transportation

020

4060

8010

0

76%

40%

79%

35%

78%

33%

54%

17%

Phone lines

Check neighbour

Grocerie

s

Transporta

tion

Per

cent

(%

)

Likely Unlikely

Community Volunteer Activities

020

4060

8010

0

61%

76%79%

74%

11%

34% 35%

17%

Likely(n=2343-2417)


Per

cent

(%

)

Feed patients

Clerical

Staff refreshments

Wherever

Hospital Volunteer Activities

What penalty should Univ/Govt be able to impose for refusal to provide aid, if required

020

4060

8010

0

Subgroup

SMS(n=151)

NS(n=484)

OS(n=3652)

F(n=318)

SS(n=575)

Penalty for Refusing to Provide AidP

erce

nt (

%)

Expulsion

Jail

Fine

None listed

High or very high priority for scarce resources

020

4060

8010

0

Subgroup

SMS(n=151)

NS(n=484)

OS(n=3652)

F(n=318)

SS(n=575)

Scarce Resource AllocationP

erce

nt (

%)

Newborn - 2yr

65+

HC workers

Emerg. workers

Politicians

Conclusions

• 1. Study may be biased by low response rate and dominance of female responders

Conclusions

• 2. Health care professionals trusted as a source of information during a pandemic.

• 3. Gaps exist in knowledge about all aspects of influenza – spread, prevention, treatment

Conclusions

• 4. Volunteerism – sort of alive; needs further study.

• 5. Penalties for failing to volunteer – frightening.

• 6. Allocation of scarce resources – not sure public is ready for prioritization.

Acknowledgements

• U of A Public Health Response Committee

• Provost’s Office

• Participants

Documents

Knowledge and attitudes towards pandemic influenza at the University of Alberta Rob Lake; Olive Yonge; Tom Marrie; Tracey Bailey; Rhonda Rosychuk; Ben