Perceived effectiveness of public health measures and positive attitudes during a pandemic: a large cross-sectional study in Shanghai, China

OBJECTIVES: Building individuals’ positive attitudes during a pandemic is essential for facilitating psychological resilience. However, little is known about how public health measures may improve people’s positive attitudes during a pandemic. We investigated the potential mechanism underlying the association between individuals’ perceived effectiveness of public health measures and positive attitudes towards the success of pandemic control during the COVID-19 pandemic, by examining the parallel mediating effects of three types of threat appraisals: concerns about contracting the virus, perceived impact of the pandemic on life and estimated duration of the pandemic. DESIGN, SETTING AND PARTICIPANTS: In February 2020 when the COVID-19 infection was spreading rapidly in China, a large cross-sectional survey was conducted among 132 054 adults from the 16 districts in Shanghai, China. OUTCOME MEASURES: Perceived effectiveness of the public health measures, positive attitudes towards the success of pandemic control and threat appraisals. RESULTS: Results of structural equation modelling supported the hypothesised mediation model: perceived effectiveness of public health measures was associated with lower levels of concerns about contracting the virus (β=−0.20), perceived impact of the pandemic (β=−0.13) and perceived duration of the pandemic (β=−0.20), which were then associated with higher levels of positive attitudes towards the success of pandemic control (βs=−0.12 to −0.25). CONCLUSIONS: The findings suggest that threat appraisals may be important pathways through which individuals’ evaluations of prevention strategies may influence their attitudes towards the success of pandemic control. The health authorities should consider reducing people’s inappropriate threat appraisals when designing public health policies to facilitate people’s positive attitudes during a pandemic.