Health Perceptions and Misconceptions Regarding COVID-19 in China: Online Survey Study

Abstract

Background Great efforts have been made to prevent the spread of COVID-19, including national initiatives to promote the change of personal behaviors. The lessons learned from the 2003 SARS outbreak indicate that knowledge and attitudes about infectious diseases are related to panic among the population, which may further complicate efforts to prevent the spread of infectious diseases. Misunderstandings may result in behaviors such as underestimation, panic, and taking ineffective measures to avoid infection; these behaviors are likely to cause the epidemic to spread further. Objective The purpose of this study is to assess public health perceptions and misunderstandings about COVID-19 in China, and to propose targeted response measures based on the findings to control the development of the epidemic. Methods The study was conducted in April 2020 through an online survey, with participants in 8 provinces in Eastern, Central, and Western China. We designed a questionnaire with a health knowledge section consisting of 5 questions (4 conventional questions and 1 misleading question) on clinical features of and preventive measures against COVID-19. Descriptive statistics, chi-square analysis, binary logistic regression, and Mantel-Haenszel hierarchical analysis were used for statistical analysis. Results In total, 4788 participants completed the survey and the mean knowledge score was 4.63 (SD 0.67), gained mainly through experts (76.1%), television (60.0%), newspapers (57.9%), and opinions (46.6%) and videos (42.9%) from social media. Compared to those who obtained information from only 1 or 2 channels, people who obtained information from >3 channels had increased health perception and a better ability to identify misleading information. Suggestions from experts were the most positive information source (χ2=41.61), while information on social media was the most misleading. Those aged >60 years (OR 1.52, 95% CI 1.10-2.11), those with a lower or middle income (OR 1.36, 95% CI 1.00-1.83), those not working and not able to work (OR 1.83, 95% CI 1.04-3.21), those with a household income <100,000 RMB (<US $14,954; OR 1.34, 95% CI 1.08-1.67), and those with >2 suspected symptoms (OR 2.95, 95% CI 1.50-5.80) were more likely to be misled by videos on social media, but the error correction effect of expert advice was limited in these groups. Conclusions Multiple information channels can improve public health perception and the identification of misleading information during the COVID-19 pandemic. Videos on social media increased the risk of rumor propagation among vulnerable groups. We suggest the government should strengthen social media regulation and increase experts’ influence on the targeted vulnerable populations to reduce the risk of rumors spreading.

Perceived psychosocial health and its sociodemographic correlates in times of the COVID-19 pandemic: a community-based online study in China

“…In light of the above, it is important to provide the necessary mental health support [44]. We recommend the active and ongoing participation of mental health professionals in policy task forces during this critical period [45].To meet the needs of the general population during this pandemic, it is necessary to consider online or smartphone-based psychosocial education to promote mental health and psychological interventions [46,47], such as cognitive behavioral therapy (CBT) and mindfulness-based cognitive therapy (MBCT). MBCT focuses on the use of various mindfulness meditation exercises to develop a sense of right and wrong judgment and is particularly helpful in relieving stress in people with poor physical conditions.…”

Preventive behaviours and family inequalities during the COVID-19 pandemic: a cross-sectional study in China

“…To date, research on preventive behaviours has been primarily conducted at the individual level. Existing studies include investigations of residents' disease perceptions, beliefs, and preventive behaviours [ 11 – 13 ], the impact of misinformation [ 14 , 15 ], mental health during the COVID-19 pandemic [ 16 , 17 ], and disparities in prevention practices among people of various socioeconomic statuses [ 18 ]. Aggregate transmission within the home can be a hidden danger for epidemic control.…”

Systematic evaluation of COVID-19 related Internet health rumors during the breaking out period of COVID-19 in China

“…14 This may also be one of the reasons why this rumor was generated and spread. Zhou et al 15 designed a questionnaire to assess the health perceptions and misunderstanding about COVID-19 in different groups of people, indicating that the increase of information channels can improve the public’s health perceptions and help them identify rumors and other misleading information. Therefore, the government should strengthen the supervision of social media and improve the influence of expert opinions to reduce the risk of rumor spread.…”