Stress, adherence to preventive measures for reducing influenza transmission and influenza-like illness
Identifieur interne : 001F78 ( Istex/Corpus ); précédent : 001F77; suivant : 001F79Stress, adherence to preventive measures for reducing influenza transmission and influenza-like illness
Auteurs : Vanessa Perez ; Monica Uddin ; Sandro Galea ; Arnold S. Monto ; Allison E. AielloSource :
- Journal of Epidemiology and Community Health [ 0143-005X ] ; 2012-07.
English descriptors
- Teeft :
- Academic year, Alcohol consumption, American indian, Arch intern, Average number, Baseline, Baseline gender, Behavioural characteristics, Black asian otherz employment, Clinical assessment, College students, Compliance, Compliance analyses, Continuous measure, Control groups, Covariates, Employment status, Epidemiol, Epidemiol community health, Epidemiological data, Epidemiology, Experimental studies, Face mask, Facemask, Facemask usage, Facemasks, Further studies, Future research, Gender, Gender differences, Gender disparity, Greater risk, Greater stress, Hall correlation, Hand hygiene, Hand hygiene compliance, Hand sanitiser, Hard rate, Health behaviours, Healthy persons, Higher levels, Hygiene, Illness increases, Illness symptoms, Increase susceptibility, Interquartile range, Intervention arms, Intervention period, Life events, Lower levels, Main predictor, Many studies, More drinks, Older adults, Optimal hand, Pandemic, Participant, Past week, Physical activity, Preventive measures, Previous week, Psychological factors, Psychological stress, Psychosocial, Psychosocial factors, Public health, Recent shot, Regression analyses, Residence hall, Residence halls, Respiratory illness, Review board, Sanitiser, Social epidemiology population health, Social support, Stress scores, Stressful life events, Study groups, Study period, Study population, Susceptibility, University residence halls, University students, Vaccination, Vaccination history, Viral transmission, Weekend days, Weekly surveys, Young adults, Yperceived stress.
Abstract
Background Using data from a randomised intervention trial of facemask use and hand hygiene for reducing transmission of seasonal influenza among university students, we examined if levels of perceived stress were negatively associated with adherence to these preventive measures and incidence of influenza-like illness (ILI). Methods Longitudinal analyses using generalised estimating equations were examined. Perceived stress was self-reported at baseline using a validated scale. Compliance with preventive measures was self-reported throughout the study period and reported ILI symptoms were defined as cough and one or more of fever/feverishness, chills and body aches. Results Higher levels of perceived stress were not associated with facemask or hand hygiene compliance. However, perceived stress was significantly associated with a greater ILI incidence (HR1.25, 95% CI 1.07 to 1.45) even after controlling for demographic and behavioural risk factors. Conclusions Among students in the university setting, higher levels of perceived stress affect ILI symptom reporting but not compliance with preventive measures for reducing transmission of influenza. Further studies are needed to examine whether psychological stress is a key mechanism explaining socio-demographic health disparities in confirmed influenza infection among healthy persons in the community setting.
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DOI: 10.1136/jech.2010.117002
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ISTEX:1A6B1CD1C2B1F49CBA12D1328EC9A1C5910BF08FLe document en format XML
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Aiello</name><affiliation><mods:affiliation>Center for Social Epidemiology & Population Health, School of Public Health-University of Michigan, Ann Arbor, Michigan, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Epidemiology, School of Public Health- University of Michigan, Ann Arbor, Michigan, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: aielloa@umich.edu</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Epidemiology and Community Health</title><title level="j" type="abbrev">J Epidemiol Community Health</title><idno type="ISSN">0143-005X</idno><idno type="eISSN">1470-2738</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2012-07">2012-07</date><biblScope unit="volume">66</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="605">605</biblScope></imprint><idno type="ISSN">0143-005X</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0143-005X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="Teeft" xml:lang="en"><term>Academic year</term><term>Alcohol consumption</term><term>American indian</term><term>Arch intern</term><term>Average number</term><term>Baseline</term><term>Baseline gender</term><term>Behavioural characteristics</term><term>Black asian otherz employment</term><term>Clinical assessment</term><term>College students</term><term>Compliance</term><term>Compliance analyses</term><term>Continuous measure</term><term>Control groups</term><term>Covariates</term><term>Employment status</term><term>Epidemiol</term><term>Epidemiol community health</term><term>Epidemiological data</term><term>Epidemiology</term><term>Experimental studies</term><term>Face mask</term><term>Facemask</term><term>Facemask usage</term><term>Facemasks</term><term>Further studies</term><term>Future research</term><term>Gender</term><term>Gender differences</term><term>Gender disparity</term><term>Greater risk</term><term>Greater stress</term><term>Hall correlation</term><term>Hand hygiene</term><term>Hand hygiene compliance</term><term>Hand sanitiser</term><term>Hard rate</term><term>Health behaviours</term><term>Healthy persons</term><term>Higher levels</term><term>Hygiene</term><term>Illness increases</term><term>Illness symptoms</term><term>Increase susceptibility</term><term>Interquartile range</term><term>Intervention arms</term><term>Intervention period</term><term>Life events</term><term>Lower levels</term><term>Main predictor</term><term>Many studies</term><term>More drinks</term><term>Older adults</term><term>Optimal hand</term><term>Pandemic</term><term>Participant</term><term>Past week</term><term>Physical activity</term><term>Preventive measures</term><term>Previous week</term><term>Psychological factors</term><term>Psychological stress</term><term>Psychosocial</term><term>Psychosocial factors</term><term>Public health</term><term>Recent shot</term><term>Regression analyses</term><term>Residence hall</term><term>Residence halls</term><term>Respiratory illness</term><term>Review board</term><term>Sanitiser</term><term>Social epidemiology population health</term><term>Social support</term><term>Stress scores</term><term>Stressful life events</term><term>Study groups</term><term>Study period</term><term>Study population</term><term>Susceptibility</term><term>University residence halls</term><term>University students</term><term>Vaccination</term><term>Vaccination history</term><term>Viral transmission</term><term>Weekend days</term><term>Weekly surveys</term><term>Young adults</term><term>Yperceived stress</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Background Using data from a randomised intervention trial of facemask use and hand hygiene for reducing transmission of seasonal influenza among university students, we examined if levels of perceived stress were negatively associated with adherence to these preventive measures and incidence of influenza-like illness (ILI). Methods Longitudinal analyses using generalised estimating equations were examined. Perceived stress was self-reported at baseline using a validated scale. Compliance with preventive measures was self-reported throughout the study period and reported ILI symptoms were defined as cough and one or more of fever/feverishness, chills and body aches. Results Higher levels of perceived stress were not associated with facemask or hand hygiene compliance. However, perceived stress was significantly associated with a greater ILI incidence (HR1.25, 95% CI 1.07 to 1.45) even after controlling for demographic and behavioural risk factors. Conclusions Among students in the university setting, higher levels of perceived stress affect ILI symptom reporting but not compliance with preventive measures for reducing transmission of influenza. 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research</json:string><json:string>psychological factors</json:string><json:string>arch intern</json:string><json:string>older adults</json:string><json:string>vaccination</json:string><json:string>compliance</json:string></teeft></keywords><author><json:item><name>Vanessa Perez</name><affiliations><json:string>Center for Social Epidemiology & Population Health, School of Public Health-University of Michigan, Ann Arbor, Michigan, USA</json:string><json:string>Department of Epidemiology, School of Public Health- University of Michigan, Ann Arbor, Michigan, USA</json:string></affiliations></json:item><json:item><name>Monica Uddin</name><affiliations><json:string>Center for Social Epidemiology & Population Health, School of Public Health-University of Michigan, Ann Arbor, Michigan, USA</json:string><json:string>Department of Epidemiology, School of Public Health- University of Michigan, Ann Arbor, Michigan, USA</json:string></affiliations></json:item><json:item><name>Sandro Galea</name><affiliations><json:string>Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, USA</json:string></affiliations></json:item><json:item><name>Arnold S Monto</name><affiliations><json:string>Department of Epidemiology, School of Public Health- University of Michigan, Ann Arbor, Michigan, USA</json:string></affiliations></json:item><json:item><name>Allison E Aiello</name><affiliations><json:string>Center for Social Epidemiology & Population Health, School of Public Health-University of Michigan, Ann Arbor, Michigan, USA</json:string><json:string>Department of Epidemiology, School of Public Health- University of Michigan, Ann Arbor, Michigan, USA</json:string><json:string>E-mail: aielloa@umich.edu</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Psychological stress</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>influenza</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>behaviour</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>schools</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>young adult</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>health behaviour</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>psychological stress</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>psychosocial influence</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>social epidemiology</value></json:item></subject><articleId><json:string>jech117002</json:string></articleId><arkIstex>ark:/67375/NVC-KKD316NP-J</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>research-article</json:string></originalGenre><abstract>Background Using data from a randomised intervention trial of facemask use and hand hygiene for reducing transmission of seasonal influenza among university students, we examined if levels of perceived stress were negatively associated with adherence to these preventive measures and incidence of influenza-like illness (ILI). Methods Longitudinal analyses using generalised estimating equations were examined. Perceived stress was self-reported at baseline using a validated scale. Compliance with preventive measures was self-reported throughout the study period and reported ILI symptoms were defined as cough and one or more of fever/feverishness, chills and body aches. Results Higher levels of perceived stress were not associated with facemask or hand hygiene compliance. However, perceived stress was significantly associated with a greater ILI incidence (HR1.25, 95% CI 1.07 to 1.45) even after controlling for demographic and behavioural risk factors. Conclusions Among students in the university setting, higher levels of perceived stress affect ILI symptom reporting but not compliance with preventive measures for reducing transmission of influenza. Further studies are needed to examine whether psychological stress is a key mechanism explaining socio-demographic health disparities in confirmed influenza infection among healthy persons in the community setting.</abstract><qualityIndicators><score>9.005</score><pdfWordCount>4749</pdfWordCount><pdfCharCount>32320</pdfCharCount><pdfVersion>1.4</pdfVersion><pdfPageCount>6</pdfPageCount><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractWordCount>188</abstractWordCount><abstractCharCount>1377</abstractCharCount><keywordCount>9</keywordCount></qualityIndicators><title>Stress, adherence to preventive measures for reducing influenza transmission and influenza-like illness</title><pmid><json:string>21224242</json:string></pmid><genre><json:string>research-article</json:string></genre><host><title>Journal of Epidemiology and Community Health</title><language><json:string>unknown</json:string></language><issn><json:string>0143-005X</json:string></issn><eissn><json:string>1470-2738</json:string></eissn><publisherId><json:string>jech</json:string></publisherId><volume>66</volume><issue>7</issue><pages><first>605</first></pages><genre><json:string>journal</json:string></genre></host><namedEntities><unitex><date><json:string>2009</json:string><json:string>2006</json:string><json:string>2011-01-10</json:string></date><geogName></geogName><orgName><json:string>University of Michigan</json:string><json:string>Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, USA The</json:string><json:string>Department of Epidemiology, School of Public</json:string><json:string>University of Michigan-School of Public Health</json:string><json:string>University of Michigan Institutional Review Board</json:string><json:string>INTRODUCTION Center for Social Epidemiology</json:string><json:string>American Indian</json:string></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Of</json:string><json:string>Ann Arbor</json:string><json:string>Sandro Galea</json:string><json:string>Allison</json:string><json:string>Morris Plains</json:string><json:string>Monica Uddin</json:string></persName><placeName><json:string>US</json:string><json:string>MI</json:string></placeName><ref_url><json:string>http://www.cdc.gov.proxy.lib</json:string></ref_url><ref_bibl><json:string>Smolderen et al</json:string><json:string>Mohren et al</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/NVC-KKD316NP-J</json:string></ark><categories><wos><json:string>1 - social science</json:string><json:string>2 - public, environmental & occupational health</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - public health & health services</json:string><json:string>3 - epidemiology</json:string></scienceMetrix><scopus><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Public Health, Environmental and Occupational Health</json:string><json:string>1 - Health Sciences</json:string><json:string>2 - Medicine</json:string><json:string>3 - Epidemiology</json:string></scopus><inist><json:string>1 - sciences appliquees, technologies et medecines</json:string><json:string>2 - sciences biologiques et medicales</json:string><json:string>3 - sciences medicales</json:string></inist></categories><publicationDate>2012</publicationDate><copyrightDate>2011</copyrightDate><doi><json:string>10.1136/jech.2010.117002</json:string></doi><id>1A6B1CD1C2B1F49CBA12D1328EC9A1C5910BF08F</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-KKD316NP-J/fulltext.pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-KKD316NP-J/bundle.zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/ark:/67375/NVC-KKD316NP-J/fulltext.tei"><teiHeader><fileDesc><titleStmt><title level="a">Stress, adherence to preventive measures for reducing influenza transmission and influenza-like illness</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher scheme="https://publisher-list.data.istex.fr">BMJ Publishing Group Ltd</publisher><availability><licence><p>© 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</p></licence><p scheme="https://loaded-corpus.data.istex.fr/ark:/67375/XBH-7M42M2QJ-2">bmj</p></availability><date>2011-01-10</date></publicationStmt><notesStmt><note type="research-article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</note><note type="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Stress, adherence to preventive measures for reducing influenza transmission and influenza-like illness</title><author xml:id="author-0000"><persName><forename type="first">Vanessa</forename><surname>Perez</surname></persName><affiliation>Center for Social Epidemiology & Population Health, School of Public Health-University of Michigan, Ann Arbor, Michigan, USA</affiliation><affiliation>Department of Epidemiology, School of Public Health- University of Michigan, Ann Arbor, Michigan, USA</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Monica</forename><surname>Uddin</surname></persName><affiliation>Center for Social Epidemiology & Population Health, School of Public Health-University of Michigan, Ann Arbor, Michigan, USA</affiliation><affiliation>Department of Epidemiology, School of Public Health- University of Michigan, Ann Arbor, Michigan, USA</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Sandro</forename><surname>Galea</surname></persName><affiliation>Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, USA</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Arnold S</forename><surname>Monto</surname></persName><affiliation>Department of Epidemiology, School of Public Health- University of Michigan, Ann Arbor, Michigan, USA</affiliation></author><author xml:id="author-0004" corresp="yes"><persName><forename type="first">Allison E</forename><surname>Aiello</surname></persName><email>aielloa@umich.edu</email><affiliation>Center for Social Epidemiology & Population Health, School of Public Health-University of Michigan, Ann Arbor, Michigan, USA</affiliation><affiliation>Department of Epidemiology, School of Public Health- University of Michigan, Ann Arbor, Michigan, USA</affiliation></author><idno type="istex">1A6B1CD1C2B1F49CBA12D1328EC9A1C5910BF08F</idno><idno type="ark">ark:/67375/NVC-KKD316NP-J</idno><idno type="DOI">10.1136/jech.2010.117002</idno><idno type="href">jech-66-605.pdf</idno><idno type="article-id">jech117002</idno><idno type="PMID">21224242</idno><idno type="local">jech;66/7/605</idno></analytic><monogr><title level="j">Journal of Epidemiology and Community Health</title><title level="j" type="abbrev">J Epidemiol Community Health</title><idno type="pISSN">0143-005X</idno><idno type="eISSN">1470-2738</idno><idno type="publisher-id">jech</idno><idno type="PublisherID-hwp">jech</idno><idno type="PublisherID-nlm-ta">J Epidemiol Community Health</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2012-07"></date><biblScope unit="volume">66</biblScope><biblScope unit="issue">7</biblScope><biblScope unit="page" from="605">605</biblScope></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2011-01-10</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Background Using data from a randomised intervention trial of facemask use and hand hygiene for reducing transmission of seasonal influenza among university students, we examined if levels of perceived stress were negatively associated with adherence to these preventive measures and incidence of influenza-like illness (ILI). Methods Longitudinal analyses using generalised estimating equations were examined. Perceived stress was self-reported at baseline using a validated scale. Compliance with preventive measures was self-reported throughout the study period and reported ILI symptoms were defined as cough and one or more of fever/feverishness, chills and body aches. Results Higher levels of perceived stress were not associated with facemask or hand hygiene compliance. However, perceived stress was significantly associated with a greater ILI incidence (HR1.25, 95% CI 1.07 to 1.45) even after controlling for demographic and behavioural risk factors. Conclusions Among students in the university setting, higher levels of perceived stress affect ILI symptom reporting but not compliance with preventive measures for reducing transmission of influenza. Further studies are needed to examine whether psychological stress is a key mechanism explaining socio-demographic health disparities in confirmed influenza infection among healthy persons in the community setting.</p></abstract><textClass><keywords scheme="keyword"><list><head>keywords</head><item><term>Psychological stress</term></item><item><term>influenza</term></item><item><term>behaviour</term></item><item><term>schools</term></item><item><term>young adult</term></item><item><term>health behaviour</term></item><item><term>psychological stress</term></item><item><term>psychosocial influence</term></item><item><term>social epidemiology</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2011-01-10">Created</change><change when="2012-07">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/ark:/67375/NVC-KKD316NP-J/fulltext.txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">jech</journal-id><journal-id journal-id-type="nlm-ta">J Epidemiol Community Health</journal-id><journal-id journal-id-type="publisher-id">jech</journal-id><journal-title>Journal of Epidemiology and Community Health</journal-title><abbrev-journal-title abbrev-type="publisher">J Epidemiol Community Health</abbrev-journal-title><abbrev-journal-title>J Epidemiol Community Health</abbrev-journal-title><issn pub-type="ppub">0143-005X</issn><issn pub-type="epub">1470-2738</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">jech117002</article-id><article-id pub-id-type="doi">10.1136/jech.2010.117002</article-id><article-id pub-id-type="other">jech;66/7/605</article-id><article-id pub-id-type="other">jech;jech.2010.117002</article-id><article-id pub-id-type="pmid">21224242</article-id><article-id pub-id-type="other">605</article-id><article-id pub-id-type="other">jech.2010.117002</article-id><article-categories><subj-group subj-group-type="heading"><subject>Social and psychosocial factors and health</subject></subj-group></article-categories><title-group><article-title>Stress, adherence to preventive measures for reducing influenza transmission and influenza-like illness</article-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Perez</surname><given-names>Vanessa</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Uddin</surname><given-names>Monica</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Galea</surname><given-names>Sandro</given-names></name><xref ref-type="aff" rid="aff3">3</xref></contrib><contrib contrib-type="author"><name><surname>Monto</surname><given-names>Arnold S</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author" corresp="yes"><name><surname>Aiello</surname><given-names>Allison E</given-names></name><xref ref-type="aff" rid="aff1">1</xref><xref ref-type="aff" rid="aff2">2</xref></contrib></contrib-group><aff id="aff1"><label>1</label>Center for Social Epidemiology & Population Health, School of Public Health-University of Michigan, Ann Arbor, Michigan, USA</aff><aff id="aff2"><label>2</label>Department of Epidemiology, School of Public Health- University of Michigan, Ann Arbor, Michigan, USA</aff><aff id="aff3"><label>3</label>Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, USA</aff><author-notes><corresp><label>Correspondence to</label> Dr Allison E Aiello, Associate Professor of Epidemiology, Department of Epidemiology, Center for Social Epidemiology & Population Health, University of Michigan-School of Public Health, SPH Tower 109 Observatory, Ann Arbor, MI 48109-2029, USA; <email>aielloa@umich.edu</email></corresp></author-notes><pub-date pub-type="epub-original"><day>10</day><month>1</month><year>2011</year></pub-date><pub-date pub-type="ppub"><month>7</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>10</day><month>1</month><year>2011</year></pub-date><volume>66</volume><volume-id pub-id-type="other">66</volume-id><volume-id pub-id-type="other">66</volume-id><issue>7</issue><issue-id pub-id-type="other">jech;66/7</issue-id><issue-id pub-id-type="other">7</issue-id><issue-id pub-id-type="other">66/7</issue-id><fpage>605</fpage><history><date date-type="accepted"><day>13</day><month>12</month><year>2010</year></date></history><permissions><copyright-statement>© 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</copyright-statement><copyright-year>2012</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jech-66-605.pdf"></self-uri><abstract><sec><title>Background</title><p>Using data from a randomised intervention trial of facemask use and hand hygiene for reducing transmission of seasonal influenza among university students, we examined if levels of perceived stress were negatively associated with adherence to these preventive measures and incidence of influenza-like illness (ILI).</p></sec><sec><title>Methods</title><p>Longitudinal analyses using generalised estimating equations were examined. Perceived stress was self-reported at baseline using a validated scale. Compliance with preventive measures was self-reported throughout the study period and reported ILI symptoms were defined as cough and one or more of fever/feverishness, chills and body aches.</p></sec><sec><title>Results</title><p>Higher levels of perceived stress were not associated with facemask or hand hygiene compliance. However, perceived stress was significantly associated with a greater ILI incidence (HR1.25, 95% CI 1.07 to 1.45) even after controlling for demographic and behavioural risk factors.</p></sec><sec><title>Conclusions</title><p>Among students in the university setting, higher levels of perceived stress affect ILI symptom reporting but not compliance with preventive measures for reducing transmission of influenza. Further studies are needed to examine whether psychological stress is a key mechanism explaining socio-demographic health disparities in confirmed influenza infection among healthy persons in the community setting.</p></sec></abstract><kwd-group><kwd>Psychological stress</kwd><kwd>influenza</kwd><kwd>behaviour</kwd><kwd>schools</kwd><kwd>young adult</kwd><kwd>health behaviour</kwd><kwd>psychological stress</kwd><kwd>psychosocial influence</kwd><kwd>social epidemiology</kwd></kwd-group></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><title>Stress, adherence to preventive measures for reducing influenza transmission and influenza-like illness</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><title>Stress, adherence to preventive measures for reducing influenza transmission and influenza-like illness</title></titleInfo><name type="personal"><namePart type="given">Vanessa</namePart><namePart type="family">Perez</namePart><affiliation>Center for Social Epidemiology & Population Health, School of Public Health-University of Michigan, Ann Arbor, Michigan, USA</affiliation><affiliation>Department of Epidemiology, School of Public Health- University of Michigan, Ann Arbor, Michigan, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Monica</namePart><namePart type="family">Uddin</namePart><affiliation>Center for Social Epidemiology & Population Health, School of Public Health-University of Michigan, Ann Arbor, Michigan, USA</affiliation><affiliation>Department of Epidemiology, School of Public Health- University of Michigan, Ann Arbor, Michigan, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sandro</namePart><namePart type="family">Galea</namePart><affiliation>Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Arnold S</namePart><namePart type="family">Monto</namePart><affiliation>Department of Epidemiology, School of Public Health- University of Michigan, Ann Arbor, Michigan, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal" displayLabel="corresp"><namePart type="given">Allison E</namePart><namePart type="family">Aiello</namePart><affiliation>Center for Social Epidemiology & Population Health, School of Public Health-University of Michigan, Ann Arbor, Michigan, USA</affiliation><affiliation>Department of Epidemiology, School of Public Health- University of Michigan, Ann Arbor, Michigan, USA</affiliation><affiliation>E-mail: aielloa@umich.edu</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-1JC4F85T-7">research-article</genre><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2012-07</dateIssued><dateCreated encoding="w3cdtf">2011-01-10</dateCreated><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><abstract>Background Using data from a randomised intervention trial of facemask use and hand hygiene for reducing transmission of seasonal influenza among university students, we examined if levels of perceived stress were negatively associated with adherence to these preventive measures and incidence of influenza-like illness (ILI). Methods Longitudinal analyses using generalised estimating equations were examined. Perceived stress was self-reported at baseline using a validated scale. Compliance with preventive measures was self-reported throughout the study period and reported ILI symptoms were defined as cough and one or more of fever/feverishness, chills and body aches. Results Higher levels of perceived stress were not associated with facemask or hand hygiene compliance. However, perceived stress was significantly associated with a greater ILI incidence (HR1.25, 95% CI 1.07 to 1.45) even after controlling for demographic and behavioural risk factors. Conclusions Among students in the university setting, higher levels of perceived stress affect ILI symptom reporting but not compliance with preventive measures for reducing transmission of influenza. Further studies are needed to examine whether psychological stress is a key mechanism explaining socio-demographic health disparities in confirmed influenza infection among healthy persons in the community setting.</abstract><subject><genre>keywords</genre><topic>Psychological stress</topic><topic>influenza</topic><topic>behaviour</topic><topic>schools</topic><topic>young adult</topic><topic>health behaviour</topic><topic>psychological stress</topic><topic>psychosocial influence</topic><topic>social epidemiology</topic></subject><relatedItem type="host"><titleInfo><title>Journal of Epidemiology and Community Health</title></titleInfo><titleInfo type="abbreviated"><title>J Epidemiol Community Health</title></titleInfo><genre type="journal" authority="ISTEX" authorityURI="https://publication-type.data.istex.fr" valueURI="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</genre><identifier type="ISSN">0143-005X</identifier><identifier type="eISSN">1470-2738</identifier><identifier type="PublisherID">jech</identifier><identifier type="PublisherID-hwp">jech</identifier><identifier type="PublisherID-nlm-ta">J Epidemiol Community Health</identifier><part><date>2012</date><detail type="volume"><caption>vol.</caption><number>66</number></detail><detail type="issue"><caption>no.</caption><number>7</number></detail><extent unit="pages"><start>605</start></extent></part></relatedItem><identifier type="istex">1A6B1CD1C2B1F49CBA12D1328EC9A1C5910BF08F</identifier><identifier type="ark">ark:/67375/NVC-KKD316NP-J</identifier><identifier type="DOI">10.1136/jech.2010.117002</identifier><identifier type="href">jech-66-605.pdf</identifier><identifier type="ArticleID">jech117002</identifier><identifier type="PMID">21224242</identifier><identifier type="local">jech;66/7/605</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2012, Published by the BMJ Publishing Group Limited. 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