The role of institutional trust in preventive practices and treatment-seeking intention during the coronavirus disease 2019 outbreak among residents in Hubei, China

  1. Li Ping Wong
  2. Qunhong Wu
  3. Yanhua Hao
  4. Xi Chen
  5. Zhuo Chen
  6. Haridah Alias
  7. Mingwang Shen
  8. Jingcen Hu
  9. Shiwei Duan
  10. Jinjie Zhang
  11. Liyuan Han

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Abstract

Background

We aimed to investigate the association between institution trust and public responses to the coronavirus disease 2019 (COVID-19) outbreak.

Methods

An Internet-based, cross-sectional survey was administered on 29 January 2020. A total of 4393 adults ≥18 y of age and residing or working in the province of Hubei, central China were included in the study.

Results

The majority of the participants expressed a great degree of trust in the information and preventive instructions provided by the central government compared with the local government. Being under quarantine (adjusted odds ratio [OR] 2.35 [95% confidence interval {CI} 1.80 to 3.08]) and having a high institutional trust score (OR 2.23 [95% CI 1.96 to 2.53]) were both strong and significant determinants of higher preventive practices scores. The majority of study participants (n=3640 [85.7%]) reported that they would seek hospital treatment if they suspected themselves to have been infected with COVID-19. Few of the participants from Wuhan (n=475 [16.6%]) and those participants who were under quarantine (n=550 [13.8%]) expressed an unwillingness to seek hospital treatment.

Conclusions

Institutional trust is an important factor influencing adequate preventive behaviour and seeking formal medical care during an outbreak.

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  1. Version published to 10.1093/inthealth/ihab023
  2. ScreenIT

    SciScore for 10.1101/2020.02.15.20023333: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: Ethics Approval: This survey was part of a continuing public health outbreak investigation and thus considered exempt from institutional review board approval.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    10 All statistical analyses were performed using the Statistical Package for the Social Sciences, version 20.0 (IBM Corp., Armonk, NY, USA).
    Statistical Package for the Social Sciences
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This current study has several limitations that should be considered. The first pertains to the cross-sectional nature of the study. Thus, it cannot be used to infer causality. Second, the responses were based on self-report and may be subject to self-reporting bias and a tendency to report socially desirable responses. Therefore, the results should be interpreted with caution. Third, the snowballing method used in this study can lead to selection bias. Nevertheless, the demographic distributions of our study population resembles of the general population in Hubei province. Despite these limitations, the study data contributes tremendously to understanding of public responses, especially now that the epidemic is growing exponentially. In conclusion, bridging the trust gaps between the public and local authorities in the epicentres is crucial. It is of utmost urgency to carry out public health interventions to reach out to individuals with poor adherence to preventive measures and who are reluctant to seek conventional medical care. Considering the extremely contagious nature of the 2019-nCoV, a slight incompliance by even a small portion of the population may have grave consequences and contribute to the continued exponential increase of the outbreak cases.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.02.15.20023333v1 on medRxiv