How Public Perceptions Are Guiding Development of Messages for Use After An Anthrax Attack

Theoretical Background and research questions/hypothesis:  The use of anthrax spores as a weapon is considered a very real threat in the United States. The Centers for Disease Control and Prevention’s Anthrax Management Team has developed public health messages that aim to increase people’s chances for survival following an anthrax attack. To inform the development of these messages, we analyzed data from a survey of public knowledge, attitudes, and intended behaviors. Our main objective was to identify factors that might block or motivate people to comply with public health directives during an anthrax crisis. Theoretical constructs that guided the development of survey questions and messages included perceived susceptibility, perceived severity, perceived benefits, perceived barriers, and self-efficacy.

Methods:  We analyzed responses from Porter Novelli’s 2011 FallStyles survey to better understand the public’s knowledge and attitudes about inhalation anthrax, intended behaviors should an anthrax attack occur, and factors that might motivate or block people from complying with public health directives during an anthrax crisis. FallStyles is a web-based survey that included a final sample of 3,696 U.S. adults aged 18 years and older.  Thirteen FallStyles items focused on anthrax. We used SPSS version 9.2 to conduct basic frequencies and cross-tabs analyses.

Results:  More than half of respondents said they did not know or were not sure if inhalation anthrax was a life-threatening disease. Only 37% of respondents indicated they knew that you cannot “catch” anthrax from someone who has it; about half said they were unsure, and 14% said they thought you could catch it from others. Nearly 84% agreed that if a doctor told them to take antibiotics for 60 days to prevent inhalation anthrax, they would comply. Only 27% of respondents indicated they would “stay in a community contaminated by anthrax” if officials told them to stay there.  

Conclusions:  Public health messages are needed to increase the public’s awareness that inhalation anthrax is a serious, potentially deadly illness, but not contagious. Although most people surveyed said that during an anthrax crisis, they would take antibiotics for 60 days if a doctor advised them to, messages would be needed to encourage people to keep taking their medicines for the full course. Because most people indicated they would not be willing to stay in a community contaminated by anthrax, messages would be needed for people both within and outside the areas where anthrax was released.

Implications for research and/or practice:  Understanding people’s perceptions about health risks and their intended behaviors during an anthrax crisis can improve public health messages that would be used following an anthrax attack.