{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T12:36:35Z","timestamp":1791203795843,"version":"4.2.0"},"reference-count":56,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2020,4,25]],"date-time":"2020-04-25T00:00:00Z","timestamp":1587772800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"publisher","award":["21B20151213037"],"award-info":[{"award-number":["21B20151213037"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Background: The psychological and behavioral responses during the early stage of Coronavirus disease 2019 (COVID-19) in South Korea were investigated to guide the public as full and active participants of public health emergency preparedness (PHEP), which is essential to improving resilience and reducing the population\u2019s fundamental vulnerability. Methods: Data were collected through an online survey four weeks after the Korea Centers for Disease Control and Prevention (KCDC) confirmed the first case in South Korea; 973 subjects were included in the analysis. Results: Respondents\u2019 perceived risk of COVID-19 infection; the majority of respondents reported that their perceived chance of infection was \u201cneither high nor low\u201d (51.3%). The average perceived severity score was higher than perceived susceptibility; 48.6 % reported that the severity would be \u201chigh,\u201d while 19.9% reported \u201cvery high.\u201d Many respondents reported taking precautions, 67.8% reported always practicing hand hygiene, and 63.2% reported always wearing a facial mask when outside. Approximately 50% reported postponing or canceling social events, and 41.5% were avoiding crowded places. Practicing precautionary behaviors associated strongly with perceived risk and response efficacy of the behavior. Conclusions: Our study confirmed the significance of the psychological responses, which associated with behavioral responses and significantly influenced the public\u2019s level of public health emergency preparedness regarding the COVID-19 pandemic. This result has consequences not only for implementing public health strategies for the pandemic but also for understanding future emerging infectious diseases.<\/jats:p>","DOI":"10.3390\/ijerph17092977","type":"journal-article","created":{"date-parts":[[2020,4,28]],"date-time":"2020-04-28T05:05:32Z","timestamp":1588050332000},"page":"2977","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":235,"title":["Psychological and Behavioral Responses in South Korea During the Early Stages of Coronavirus Disease 2019 (COVID-19)"],"prefix":"10.3390","volume":"17","author":[{"given":"Minjung","family":"Lee","sequence":"first","affiliation":[{"name":"Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Myoungsoon","family":"You","sequence":"additional","affiliation":[{"name":"Department of Public Health Sciences, Graduate School of Public Health, Seoul National University, Seoul 08826, Korea"},{"name":"Institute of Health and Environment, Seoul National University, Seoul 08826, Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,4,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1199","DOI":"10.1056\/NEJMoa2001316","article-title":"Early transmission dynamics in Wuhan, China, of novel coronavirus\u2013infected pneumonia","volume":"382","author":"Li","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"727","DOI":"10.1056\/NEJMoa2001017","article-title":"A novel coronavirus from patients with pneumonia in China, 2019","volume":"382","author":"Zhu","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Gralinski, L.E., and Menachery, V.D. (2020). Return of the coronavirus: 2019-nCoV. Viruses, 12.","DOI":"10.3390\/v12020135"},{"key":"ref_4","unstructured":"World Health Organization (2020). Statement on the Second Meeting of the International Health Regulations (2005) Emergency Committee Regarding the Outbreak of Novel Coronavirus (2019-nCoV) 30 January 2020 Statement, World Health Organization."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/S0140-6736(20)30300-7","article-title":"What to do next to control the 2019-nCoV epidemic?","volume":"395","author":"Wang","year":"2020","journal-title":"Lancet"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S9","DOI":"10.2105\/AJPH.2007.114496","article-title":"Conceptualizing and Defining Public Health Emergency Preparedness","volume":"97","author":"Nelson","year":"2007","journal-title":"Am. J. Public Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1486","DOI":"10.3201\/eid1008.040283","article-title":"SARS risk perception, knowledge, precautions, and information sources, the Netherlands","volume":"10","author":"Brug","year":"2004","journal-title":"Emerg. Infect. Dis."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"De Zwart, O., Veldhuijzen, I.K., Richardus, J.H., and Brug, J. (2010). Monitoring of risk perceptions and correlates of precautionary behaviour related to human avian influenza during 2006-2007 in the Netherlands: Results of seven consecutive surveys. BMC Infect. Dis., 10.","DOI":"10.1186\/1471-2334-10-114"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1016\/j.amepre.2010.07.011","article-title":"Knowledge and adoption of community mitigation efforts in Mexico during the 2009 H1N1 pandemic","volume":"39","author":"Aburto","year":"2010","journal-title":"Am. J. Prev. Med."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1177\/00333549141296S408","article-title":"Media use and communication inequalities in a public health emergency: A case study of 2009\u20132010 pandemic influenza a virus subtype H1N1","volume":"129","author":"Lin","year":"2014","journal-title":"Public Health Rep."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Lee, M., Ju, Y., and You, M. (2019). The effects of social determinants on public health emergency preparedness mediated by health communication: The 2015 MERS outbreak in South Korea. Health Commun., 1\u201311.","DOI":"10.1080\/10410236.2019.1636342"},{"key":"ref_12","first-page":"349","article-title":"Communicating about emerging infectious disease: The importance of research","volume":"10","author":"Holmes","year":"2008","journal-title":"HealthRisk Soc."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"677","DOI":"10.3201\/eid1105.041225","article-title":"Avian influenza risk perception, Hong Kong","volume":"11","author":"Fielding","year":"2005","journal-title":"Emerg. Infect. Dis."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1307","DOI":"10.3201\/eid1309.070372","article-title":"Precautionary behavior in response to perceived threat of pandemic influenza","volume":"13","author":"Sadique","year":"2007","journal-title":"Emerg. Infect. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.3201\/eid2008.131821","article-title":"Human exposure to live poultry and psychological and behavioral responses to influenza A (H7N9), China","volume":"20","author":"Wang","year":"2014","journal-title":"Emerg. Infect. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Wang, C., Pan, R., Wan, X., Tan, Y., Xu, L., Ho, C.S., and Ho, R.C. (2020). Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17051729"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Zhang, Y., and Ma, Z. (2020). Impact of the COVID-19 pandemic on mental health and quality of life among local residents in Liaoning Province, China: A cross-sectional study. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17072381"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Bo, H.X., Li, W., Yang, Y., Wang, Y., Zhang, Q., Cheung, T., and Xiang, Y. (2020). Posttraumatic stress symptoms and attitude toward crisis mental health services among clinically stable patients with COVID-19 in China. Psychol. Med., 1\u20137.","DOI":"10.1017\/S0033291720000999"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1126\/science.3563507","article-title":"Perception of risk","volume":"236","author":"Slovic","year":"1987","journal-title":"Science"},{"key":"ref_20","first-page":"370","article-title":"Perceived risk and efficacy beliefs as motivators of change","volume":"29","author":"Rimal","year":"2003","journal-title":"Hum. Commun. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1080\/03637759209376276","article-title":"Putting the fear back into fear appeals: The extended parallel process model","volume":"59","author":"Witte","year":"1992","journal-title":"Commun. Monogr."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1080\/00223980.1975.9915803","article-title":"A protection motivation theory of fear appeals and attitude change","volume":"91","author":"Rogers","year":"1975","journal-title":"J. Psychol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1177\/109019818401100101","article-title":"The health belief model: A decade later","volume":"11","author":"Janz","year":"1984","journal-title":"Health Educ. Q."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1111\/j.1559-1816.2009.00574.x","article-title":"Use of the risk perception attitude framework for promoting breast cancer prevention","volume":"40","author":"Rimal","year":"2010","journal-title":"J. Appl. Soc. Psychol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1080\/10410236.2014.940670","article-title":"Men\u2019s intentions to engage in behaviors to protect against human papillomavirus (HPV): Testing the risk perception attitude framework","volume":"31","author":"Pask","year":"2016","journal-title":"Health Commun."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"866","DOI":"10.1177\/1090198108326164","article-title":"Nutrition-related cancer prevention cognitions and behavioral intentions: Testing the risk perception attitude framework","volume":"35","author":"Sullivan","year":"2008","journal-title":"Health Educ. Behav."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1080\/10410236.2018.1431024","article-title":"A test of the risk perception attitude framework as a message tailoring strategy to promote diabetes screening","volume":"34","author":"Rains","year":"2019","journal-title":"Health Commun."},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Simonds, V.W., Omidpanah, A., and Buchwald, D. (2017). Diabetes prevention among American Indians: The role of self-efficacy, risk perception, numeracy and cultural identity. BMC Public Health, 17.","DOI":"10.1186\/s12889-017-4766-x"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1123\/jpah.2015-0358","article-title":"The influence of risk perceptions and efficacy beliefs on leisure-time physical activity during pregnancy","volume":"13","author":"Connolly","year":"2016","journal-title":"J. Phys. Act. Health"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1080\/08824096.2015.1016144","article-title":"Testing the risk perception attitude framework in the context of texting while driving","volume":"32","author":"Dillow","year":"2015","journal-title":"Commun. Res. Rep."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Lee, M., and You, M. (2020). Safety Behaviors to reduce risk of using chemical household products: An application of the risk perception attitude framework. Int. J. Environ. Res. Public Health, 17.","DOI":"10.3390\/ijerph17051528"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Aledort, J.E., Lurie, N., Wasserman, J., and Bozzette, S.A. (2007). Non-pharmaceutical public health interventions for pandemic influenza: An evaluation of the evidence base. BMC Public Health, 7.","DOI":"10.1186\/1471-2458-7-208"},{"key":"ref_33","doi-asserted-by":"crossref","unstructured":"Group (2006). Nonpharmaceutical interventions for pandemic influenza, national and community measures. Emerg. Infect. Dis., 12, 88.","DOI":"10.3201\/eid1201.051371"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"b2651","DOI":"10.1136\/bmj.b2651","article-title":"Public perceptions, anxiety, and behaviour change in relation to the swine flu outbreak: Cross sectional telephone survey","volume":"339","author":"Rubin","year":"2009","journal-title":"BMJ"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Lin, L., Savoia, E., Agboola, F., and Viswanath, K. (2014). What have we learned about communication inequalities during the H1N1 pandemic: A systematic review of the literature. BMC Public Health, 14.","DOI":"10.1186\/1471-2458-14-484"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"4639","DOI":"10.1073\/pnas.0706849105","article-title":"Modeling targeted layered containment of an influenza pandemic in the United States","volume":"105","author":"Halloran","year":"2008","journal-title":"Proc. Natl. Acad. Sci. USA"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"233","DOI":"10.3201\/eid1502.081166","article-title":"Face mask use and control of respiratory virus transmission in households","volume":"15","author":"MacIntyre","year":"2009","journal-title":"Emerg. Infect. Dis."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.ijid.2013.12.001","article-title":"Mass gathering-related mask use during 2009 pandemic influenza A (H1N1) and Middle East Respiratory Syndrome coronavirus","volume":"20","author":"Elachola","year":"2014","journal-title":"Int. J. Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"864","DOI":"10.1136\/jech.57.11.864","article-title":"Monitoring community responses to the SARS epidemic in Hong Kong: From day 10 to day 62","volume":"57","author":"Lau","year":"2003","journal-title":"J. Epidemiol. Community Health"},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Lau, J.T., Griffiths, S., Choi, K.C., and Tsui, H.Y.J.B.I.D. (2010). Avoidance behaviors and negative psychological responses in the general population in the initial stage of the H1N1 pandemic in Hong Kong. BMC Infect. Dis., 10.","DOI":"10.1186\/1471-2334-10-139"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Greer, A. (2013). Can informal social distancing interventions minimize demand for antiviral treatment during a severe pandemic?. BMC Public Health, 13.","DOI":"10.1186\/1471-2458-13-669"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Brahmbhatt, M., and Dutta, A. (2008). On SARS Type Economic Effects during Infectious Disease Outbreaks, The World Bank.","DOI":"10.1596\/1813-9450-4466"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"244","DOI":"10.1080\/10410236.2011.578332","article-title":"Seeking and processing influenza vaccine information: A study of health care workers at a large urban hospital","volume":"27","author":"Clarke","year":"2012","journal-title":"Health Commun."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"S230","DOI":"10.1006\/enrs.1998.3940","article-title":"Proposed model of the relationship of risk information seeking and processing to the development of preventive behaviors","volume":"80","author":"Griffin","year":"1999","journal-title":"Environ. Res."},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Jung, S.-M., Akhmetzhanov, A.R., Hayashi, K., Linton, N.M., Yang, Y., Yuan, B., Kobayashi, T., Kinoshita, R., and Nishiura, H. (2020). Real-time estimation of the risk of death from novel coronavirus (covid-19) infection: Inference using exported cases. J. Clin. Med., 9.","DOI":"10.1101\/2020.01.29.20019547"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1002\/jmv.25678","article-title":"Outbreak of pneumonia of unknown etiology in Wuhan China: The mystery and the miracle","volume":"92","author":"Lu","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Song, Z., Xu, Y., Bao, L., Zhang, L., Yu, P., Qu, Y., Zhu, H., Zhao, W., Han, Y., and Qin, C. (2019). From SARS to MERS, thrusting coronaviruses into the spotlight. Viruses, 11.","DOI":"10.3390\/v11010059"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Kwok, K.O., Li, K.K., Chan, H.H., Yi, Y.Y., Tang, A., Wei, W.I., and Wong, Y.S. (2020). Community responses during the early phase of the COVID-19 epidemic in Hong Kong: Risk perception, information exposure and preventive measures. medRxiv, published online (preprint).","DOI":"10.1101\/2020.02.26.20028217"},{"key":"ref_49","doi-asserted-by":"crossref","unstructured":"Qian, M., Wu, Q., Wu, P., Hou, Z., Liang, Y., Cowling, B.J., and Yu, H.J. (2020). Psychological responses, behavioral changes and public perceptions during the early phase of the COVID-19 outbreak in China: A population based cross-sectional survey. medRxiv, published online (preprint).","DOI":"10.1101\/2020.02.18.20024448"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"D3","DOI":"10.1016\/j.vaccine.2010.08.024","article-title":"The 2009\u20132010 influenza pandemic: Effects on pandemic and seasonal vaccine uptake and lessons learned for seasonal vaccination campaigns","volume":"28","author":"Poland","year":"2010","journal-title":"Vaccine"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1348\/135910710X485826","article-title":"Demographic and attitudinal determinants of protective behaviours during a pandemic: A review","volume":"15","author":"Bish","year":"2010","journal-title":"Br. J. Health Psychol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Drake, J.M., Chew, S.K., and Ma, S. (2006). Societal learning in epidemics: Intervention effectiveness during the 2003 SARS outbreak in Singapore. PLoS ONE, 1.","DOI":"10.1371\/journal.pone.0000020"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"e2015033","DOI":"10.4178\/epih\/e2015033","article-title":"2015 MERS outbreak in Korea: Hospital-to-hospital transmission","volume":"37","author":"Ki","year":"2015","journal-title":"Epidemiol. Health"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.giq.2013.06.002","article-title":"ICT, public values and transformative government: A framework and programme for research","volume":"31","author":"Bannister","year":"2014","journal-title":"Gov. Inf. Q."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s12529-010-9123-8","article-title":"The influence of social-cognitive factors on personal hygiene practices to protect against influenzas: Using modelling to compare avian A\/H5N1 and 2009 pandemic A\/H1N1 influenzas in Hong Kong","volume":"18","author":"Liao","year":"2011","journal-title":"Int. J. Behav. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"855","DOI":"10.1136\/jech.57.11.855","article-title":"Behind the mask. Journey through an epidemic: Some observations of contrasting public health responses to SARS","volume":"57","author":"Syed","year":"2003","journal-title":"J. Epidemiol. Community Health"}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/9\/2977\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:23:43Z","timestamp":1760361823000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/17\/9\/2977"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,25]]},"references-count":56,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2020,5]]}},"alternative-id":["ijerph17092977"],"URL":"https:\/\/doi.org\/10.3390\/ijerph17092977","relation":{},"ISSN":["1660-4601"],"issn-type":[{"value":"1660-4601","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,4,25]]}}}