An Investigation on the Public's Acceptance of Prevention and Control Measures for COVID-19 in China

Background: China has basically succeeded in controlling the COVID-19 epidemic, which is due to the cooperation and acceptance of epidemic prevention measures by the public. However, few studies have examined the measures China has taken to combat COVID-19 in order to reect on its success in curbing the the spread of epidemic. Methods: In this study, the public acceptance questionnaire was designed based on the epidemic prevention measures adopted in China, to investigate the difference of public acceptance of epidemic prevention measures. The survey data was collected from 2,062 samples with different demographic characteristics from March 8, 2020 to April 9, 2020. And SPSS was used to analyze the data collected in the questionnaire, such as one-way variance, so as to draw conclusions. Results: The results show that age and educational level have a signicant inuence on public acceptance. In contrast gender and occupation eld has no signicant impact on it. The acceptance of the emergency prevention and control measures taken by the government during the epidemic period is generally high. With the development of the epidemic, the acceptability is increasing. And the public acceptance of trac measures was highest. Conclusions: Rapid deployment of epidemic prevention measures and appropriate methods in transportation, economy and education are the key to China's effective containment of the epidemic. Measures such as shutting down cities and encouraging the wearing of masks deserve to be copied by other countries.This study summed up China's scientic experience in the ght against COVID-19 and differences in public acceptance. It can provide a positive reference for the development of epidemic prevention measures in other countries.


Introduction
The Coronavirus (COVID-19) pandemic is disrupting the world as we knew it, with a heavy toll on human lives and economic activities. The World Health Organization (WHO) has been listed as a "public health emergency of a global pandemic". China has successfully stopped the spread of the epidemic as the world's largest developing country, and the daily life of the public is gradually getting on the right track. At the same time, European countries had discussions in the early stages of the epidemic but did not consider crucial measures such as lockdown of entire cities, regions or countries [1]. Also, in some countries which are severely affected by the epidemic, some people and o cials have different attitudes o cials on epidemic prevention measures such as wearing masks and keeping a safe social distance, so that public even refuses to accept some epidemic prevention measures. Thus it can be seen, the public acceptance of epidemic prevention measures has become one of the most signi cant factors for the effective control of the epidemic. However, there is little research or literature on public acceptance of the measures taken to prevent and control the epidemic. The effectiveness of the prevention and control measures taken by the government affects the development trend of the epidemic, and the public's acceptance of the measures is the most direct indicator of the effectiveness of the measures.
Acceptance refers to the degree of subjective recognition of a product, measure or regulation by its intended audience, which often re ects the usefulness of the product, measure or regulation from the side. Most of the acceptance studies are in the form of questionnaires to explore public attitude towards products or measures, which can be used to study people's views on emergency prevention and control policies during the epidemic period. Previous acceptance studies have used model validation and questionnaires as the most common forms of research in education, medicine, socioeconomic, science and technology applications, and new energy development. For example, in the social economy, the scholars investigated the relationship among personality traits, knowledge and attitude of GM agriculture use, and avoiding willingness to pay (WTP) for GM food by analyzing the relationship between personality characteristics and consumer behavior [2]. Abdulrahman, Duha and Victor's [3] research on the residents' acceptance determinants of smart city technologies is one of the rst batches of empirical studies to determine the most in uential factors of residents and civil servants' acceptance of smart city services; In the aspect of science and technology, previous scholars have studied the relationship between college students' acceptance of campus bikes and the in uence of the built environment and shared bikes themselves [4], as well as that of the information contained in the tasting environment on the acceptance of arti cially bred meat by participants of different ages and genders [5] in the form of questionnaires. Also, there were a large number of studies on the acceptance of new energy sources. Ziya, Can and Berrin [6] conducted a continuous explanatory survey to preliminarily assess the public acceptance of geothermal energy applications in the Canakkale region of Turkey. Tan, Gabrielle and Xu [7] conducted a study on public acceptance of shale gas application and development from different dimensions of public psychology. Caroline, Claudia and John [8] used the interview data of direct drinking water reuse project in ve inland communities to analyze the factors affecting its acceptance. Susana [9] investigated the public acceptance of renewable energy technologies and related infrastructure and identi ed and discussed approaches for some future research. In general, most studies take perceived usefulness and perceived ease of use as study variables, and there are few COVID-19 related acceptance surveys at present.
Generally, there is a lack of research on the public acceptance of emergency prevention and control measures of COVID-19, and few articles have applied the acceptance research to the public's attitude towards the prevention and control of public health incidents. In terms of the development process of the epidemic, there are great differences in the acceptance of some emergency prevention and control measures in some countries with a severe epidemic. Therefore, public acceptance for the government and epidemic prevention policy is especially important. Based on above reasons, this article will start from acceptance, design and distribute the questionnaire according to COVID-19 epidemic prevention and control measures adopted in China, analysis of different types of COVID-19 emergency prevention and control measures to the acceptance of differences, explore how to develop rationally deal with public health emergencies prevention and control measures, to gain the experience, to deal with public health emergencies of public health emergency response to similar constructive signi cance.

Research Methods
At present, the existing literature has widely used questionnaire survey, literature review and other methods to investigate the public acceptance. Generally, a questionnaire survey is conducted to investigate the public acceptance of products or policies through random sampling. Therefore, this study summarized and optimized the scales of previous acceptance studies through literature review, and then designed a questionnaire on public acceptance of COVID-19 epidemic prevention measures in combination with the emergency prevention and control measures taken in various places during the outbreak of the epidemic in China from January to March 2020. The empirical data obtained in the form of a questionnaire survey, and then SPSS software was used to conduct descriptive statistical analysis and multiple comparative analysis to study the differences in acceptability between groups with different demographic characteristics.

Major Measure
Since the outbreak of COVID-19 in Wuhan China, relevant government departments have issued hundreds of relevant policy documents, including but not limited to measures and regulations on social isolation, tra c control, screening and testing, dynamic monitoring, diagnosis and treatment, resource allocation, material support and other aspects. China has adopted a unique anti-epidemic mode of complete isolation, combining its national nature and its political and social model. This paper extracts the various measures mentioned in each document and summarizes them as follows: Resolutely closing cities, villages, schools and factories, and isolating people from each other through complete isolation at the peak of the epidemic, thus fundamentally interrupting the transmission chain of the virus.
Fully mobilizing the medical and health system to treat and cure the patients, and nally, achieve "full collection from receivables". Deploying the strongest Chinese and Western medical resources and experts to combine Chinese and Western medicine to minimize the number of deaths.
Strengthening the guarantee of medical treatment costs for patients and ensuring that patients receive timely treatment.
Quarantining close contacts, suspected cases and travellers in affected areas through various means, including hospital isolation, central isolation point isolation and home isolation.
The government coordinated and mobilized medical resources, including the rapid construction of specialized hospitals and makeshift hospitals, and the organization of provincial and municipal medical and health systems to provide corresponding support to areas hit hard by the epidemic.
Strengthening supervision of farmers' markets and control of wildlife, preventing internal proliferation and external export, urging the public to disperse rather than gather, minimizing public gathering activities, and avoiding the occurrence of clustered epidemics. Taking the strictest screening measures for febrile diseases and putting them under medical observation to prevent further spread of the epidemic.
Citizens are advised to wash their hands regularly, maintain social distance, isolate infected people and ensure hospital capacity.
Citizens are advised to avoid unnecessary travel activities. Citizens are advised to wear masks on public transportation and to enter and exit public places. People in public places should be equipped with temperature checkers and travel registration.
Compulsory closure of kindergartens, primary schools, middle schools, universities, etc., all schools adopt online teaching mode. Enterprises and institutions adopt online o ce mode.
During the epidemic period, the phenomenon of driving up prices, deceiving consumers and disturbing social and market order was severely punished. It is strictly prohibited to fabricate or disseminate false information about the development of the epidemic situation or emergency response.
China's satellite TV stations have stepped up coverage of the epidemic and appropriately reduced entertainment programs.
Since March 10, 2020, all provinces have gradually promoted the resumption of work, production and schooling to restore the order of production and life.
Also, corresponding countermeasures have also been taken against the negative impact of the epidemic: Implement economic stimulus policies and provide necessary social relief measures to prevent largescale secondary disasters caused by unemployment, poverty and business closures.
In the worst-affected areas, the necessary economic activities for the basic operation of society should be maintained as much as possible, while in the worst-affected areas, the normalization of economy and society should be taken into account as much as possible.
So far, these measures have played a positive role in China's ght against COVID-19. However, it is di cult to assess the hazard of COVID-19 in the early stage of the epidemic. So not all measures can be understood and coordinated by the public. Therefore, it is necessary to investigate the public acceptance of epidemic prevention measures.

Questionnaire Design
In this survey, based on the existing acceptance studies, combined with the characteristics of public health emergencies and the development of the epidemic, and according to the main epidemic prevention measures summarized in the previous section, the following variables are used to measure the public acceptance, which is speci cally de ned as follows: Epidemic awareness level: the degree of public understanding of the basic information of the epidemic situation, including the characteristics of the virus, the spread of the epidemic situation and other epidemic information.
Measures acceptance: the public's understanding of the epidemic prevention and control decisions and the frequency of participation, as well as the public's subjective satisfaction with the decision after understanding the epidemic prevention and control decisions.
Demographic characteristics: basic personal information such as gender, age, educational level, number of family members, etc. This study adopts the method of a questionnaire survey to conduct an empirical investigation. The questionnaire includes three parts: questionnaire description, basic personal information and the measurement of public acceptance of COVID-19 emergency prevention and control measures. This questionnaire selected major epidemic prevention and control measures to measure each variable according to Notice on strict prevention of novel Coronavirus infection by vehicle and Notice on strengthening the prevention and control work of novel Coronavirus infected community released by the State Council and other epidemic prevention and control documents.
In the design of the questionnaire, the basic information of the individual (BI) was a general multiple choices question, a total of 6 questions, marked as Bi-1, Bi-2... and so on. The public's acceptance of the novel Coronavirus emergency prevention and control measures was measured by Likert's ve-point method (SC), namely, respectively in 1-5 represents "strongly inconsistent", "not quite consistent", "consistent", "quite consistent", "strongly consistent", a total of 6 questions, marked as Sc-1, Sc-2... and so on. See the appendix for a detailed overview of the items in the questionnaire.

Questionnaire Distribution
This study adopts the method of random sampling to conduct the survey. The survey is conducted in the form of an online questionnaire survey. All questionnaires are distributed and collected through the webpage version provided by The Questionnaire Star(https://www.wjx.cn). The questionnaire stated the purpose of the study and ensured the anonymity of the respondents. 2,101 questionnaires were recovered during March 8, 2020, to April 9, 2020, and 39 questionnaires were excluded as they did not meet the requirements. The number of valid questionnaires was 2,062, with an effective recovery rate of about 98.14%. Among the respondents, 48.74% were male ,and 51.25% were female. The age ranged between 16 and 60 years old, with 0.53% of adolescents under 18, 29.39% of young people between 18 and 25, 28.23% of young people between 26 and 30, 24.68% of middle-aged people between 31 and 40, 11.06% of middle-aged people between 41 and 50, 4.95% of middle-aged people between 51 and 60, and 1.16% of older adults over 60 years old. In terms of educational level, 2.91% have received junior high school education, 12.51% have received senior high school education, 26.24% have received junior college education, 50.53% have bachelor's degree, and 7.81% have master's degree or above.
In addition, the number of respondents from all regions of the country was relatively average, including a large number of people from the worst-hit areas, with 5.09% from Hubei province and 5.00% from Beijing. As for the occupations of the respondents, 21.58% are undergraduates or postgraduates, and 6.55% are engaged in nance and insurance.
In terms of gender, age, region, occupation and other dimensions, the sample has good randomness.

Data Analysis Method
In this study, SPSS 22.0 (IBM, the United States), was used as a statistical analysis tool to process and analyze data. The proposed data analysis methods are mainly as follows:

Descriptive statistical analysis
The descriptive statistical analysis mainly refers to the data obtained through the survey, which are grouped according to different regions, different times and different population characteristics, describing the distribution of various aspects of the population characteristics, and then making comparison on this basis. It includes the distribution of basic demographic characteristics, the distribution of public awareness of the epidemic and the distribution of public attitudes towards decision-making.

One-way analysis of variance (ANOVA)
In the analysis of variance, certain characteristics of the object to be examined are called test indicators, and the conditions affecting the test indicators are called factors. Each factor has several states to choose from, and each state of the factors to choose from is called the level of the factor. If only one factor is changing during an experiment, it is called a single-factor experiment. This study analyzed the differences in attitudes of groups with different demographic characteristics (including gender, age, education level, number of family members, and occupation) towards all emergency prevention and control measures taken to respond to the development of COVID-19.

Multiple comparative analysis
Multiple comparison is a method of comparing the mean of a population with equal variance. If the overall difference reaches a signi cant level in a certain factor, the multiple comparison method is used to test which groups have signi cant differences.

Understanding of the epidemic situation and attitude towards decision-making
To ensure the accuracy and effectiveness of the research data, the questionnaire collected the respondents' understanding of the epidemic situation and the prevention and control measures, to ensure that the respondents could correctly understand the effective degree of the epidemic prevention measures during the epidemic. Figure 1 shows the sample's understanding of the epidemic and attitude towards decision-making.
The following data indicate that most of the respondents in this study have a certain understanding of the nature of COVID-19 itself, a certain understanding of the severity of the virus and the epidemic, and have a certain concern and tracking of the development process of the epidemic, and are also aware of the severity of the epidemic and the difference among stages of its development.
Also, on the attitude to decision-making, The respondents differed in their judgment of the local government's disclosure of information on the speci c situation of the epidemic and whether the emergency measures adopted were timely, effective and accurate, emergency prevention and control measures in different areas of the strength and ageing are different, which is widely distributed and diverse, so the population distribution of the sample is in line with the research needs.

The relationship between demographic characteristics and acceptance
In this part, some basic demographic characteristics such as gender, age, educational level and occupation eld will be taken as independent variables, and public's acceptance of measures will be taken as dependent variables to verify the difference of measures with different characteristics through one-way ANOVA. The speci c results are as follows:   Note:* p < 0.05 ** p < 0.01 As can be seen from the above table, variance analysis was used to study the difference between educational level and public acceptance of measures and samples of different education level presented signi cant differences for SC-6 and SC-7 (P < 0.05), indicating that samples of different educational level had differences in acceptance of measures. The speci c analysis shows that respondents with a bachelor's degree or above are less receptive to the measures than respondents of other age groups.

Analysis of the changing trend of public acceptance
In this study, 2,062 valid questionnaires were collected from March 8, 2020 to April 9, 2020. Presently The questionnaire data of 1148 questionnaires and 914 questionnaires collected in two time periods of solstice from March 8, 2020, to March 23, 2020, and solstice from March 23 to April 9, 2020, are respectively extracted for statistical analysis. Figure 2 and Fig. 3 respectively show the data distribution of sample data collected in Sc-6 and Sc-7 in the rst half period. Namely the initial phase of the outbreak (later referred to as the early phase) and the second half period, namely the stable phase of the outbreak (later referred to as the late phase).
The data showed that the average scores of the two questions in the early phase were 3.92 and 3.95, respectively, which meant that the public had a high acceptance of the epidemic prevention and control measures. The average scores of the two questions in the late phase were 4.07 and 4.17, respectively, indicating that the public has a very high acceptance of various measures for epidemic prevention and control. During the epidemic, in general, the public has a high acceptance of social isolation, tra c control, screening and testing, dynamic monitoring, diagnosis and treatment, resource allocation, material support and other prevention and control measures. With the development of the epidemic, the trend of the epidemic has been gradually brought under control. China has become more pro cient in the epidemic control, and the public's acceptance of the prevention and control measures has increased signi cantly.

Analysis of acceptance of different epidemic prevention measures
Various measures adopted by China have high public acceptance. The following is a case-by-case analysis of the public acceptance of some types of measures.

Acceptance analysis of tra c measures
This paper analyzes the acceptance of tra c measures by the public, and the data is shown in the table below. Tra c measures, as a unique anti-epidemic mode adopted by China in combination with its national nature and political and social mode, can best re ect the measures of complete isolation and isolation, which have higher public acceptance than other types of measures. This also shows that China can control the epidemic faster and more effectively than other countries with severe epidemics and the fully closed tra c control plays the most important role. The urban blockade of Wuhan, Hubei province, suppressed the spread of the epidemic in the rst place.
With the development of the epidemic, and according to the epidemic situation of other western countries, measures such as tra c control are one of the most effective measures to curb the spread of COVID-19

Acceptance analysis of real economy measures
This paper analyzes the acceptance of real economy measures by the public, and the data is shown in the table below. The epidemic has had a huge negative impact on the country's economic development. Measures of the real economy are also necessary to minimize the damage and ensure the daily life of the public as much as possible. At the public level, to ensure the daily life of the public during the epidemic; At the national level, restore the national economy as soon as possible. As it is directly related to the daily life of the public, the public acceptance of this part of measures is also very high.The epidemic has dealt a huge blow to the real economy. As the epidemic has gradually cooled down, China has successively introduced policies and regulations to save the real economy.

Acceptance analysis of educational measures
This paper analyzes the acceptance of educational measures by the public, and the data is shown in the table below. The

Discussion of Results
Since the beginning of the COVID-19 pandemic, public health decision-makers have been called on to identify responses that are appropriate in intensity, duration, and scope [10], and the corresponding emergency prevention and control measures taken by the Chinese government have played a great role. Compared with the response to public health emergencies in the past, emergency prevention has always been the key link to prevent the epidemic from worsening and reduce the loss of the epidemic. By comparing the cost of treatment during a large outbreak of hepatitis A with that of prevention and control and prevention in advance, it was found that the cost of the latter was much lower than the former [11]. It should be noted that the results of this study showed that since the questionnaire was issued at the peak of the epidemic in China, the public had a poor risk perception on novel Coronavirus in the early stage of the epidemic and had negative emotions on the prevention and control of the epidemic at the early stage, so the public generally did not accept the government measures at the early stage of the epidemic.
Moreover, theoretical prevention and control measures are prone to deviation when they are implemented in reality. Ajay and Bhargavi [12] believe that although in theory the advance prevention before the occurrence of an emergency is more bene cial, due to the impact of regional social concepts, cultural traditions and other factors, the advance prevention is di cult to implement in practice, resulting in the ine ciency of prevention. However, with the development of the epidemic, public acceptance has gradually increased, which proves that the prevention and control measures taken by China are indeed positive and effective.
To contain COVID-19, full cooperation between the government and the public is essential. China has made comprehensive prevention and control measures from the perspectives of social isolation, tra c control, screening and testing, dynamic monitoring, diagnosis and treatment, resource allocation and material support. This study examines the effectiveness of these measures from the perspective of the public. This study, according to the construction of specialized hospital strengthen population medical treatment work measures such as public acceptance, diagnosis and treatment are one of the most important aspects of dealing with emergent public health events, Shwiff Katie and Aaron [13] showed that treating infectious diseases population can bring a broader economic bene ts to the nation. Also The main purpose of this study is to design a questionnaire on public acceptance of government emergency prevention and control measures for COVID-19 that can be used to investigate public health emergencies, to investigate whether the emergency prevention and control measures taken by local governments of COVID-19 are timely, effective, and accepted and adopted by the public. The results of data analysis were used to explore whether there were signi cant differences in the acceptance of different groups to various aspects of government measures. This research data shows that, with the development of the outbreak, the public new crown outbreak risk perception is increased. The blockaded city, closed community management, extension work extension of school and take clear implementation of network teachings such as policy, our country's resistance to disease progress and orderly, increased acceptance of public emergency prevention and control measures to the government rate increases

Research contributions
As an investigation and study during the COVID-19 epidemic, this study pays close attention to the development of the epidemic and analyzes the implementation of epidemic prevention and control measures from the perspective of the public, which is of profound signi cance to the prevention and control of the epidemic.
This study focus on one of the most important factors affecting the effective control of the epidemic: the public acceptance to the epidemic prevention measures, design the questionnaire from acceptance directions, explore the differences in the public's acceptance of the epidemic prevention measures adopted in China by different demographic characteristics, to further explore how to reasonably deal with public health emergencies prevention and control measures.

Lack of research
Due to some limitations, this study still has some limitations in terms of research methods and research contents. This part will summarize and provide a reference for future researchers.
1) The questionnaire content of this study only considers common demographic characteristics such as gender, age and educational level. It ignores other demographic characteristics, such as whether they have experienced (participated in emergency protection) other public health events, etc. In the future, these factors can be added, so that speci c measures can be better proposed for the government to issue recommendations, the results will be more accurate and detailed.
2) The questionnaire data obtained in this study are concentrated in different regions, so in future studies, the sample size can be increased to improve the diversity of samples and the proportion of average sample distribution.

Conclusion
After investigating the COVID-19 control work report issued by various provinces and cities of China, this study summarized and collated the corresponding measures taken since the discovery of the epidemic, designed and distributed questionnaires, the following conclusions were drawn: 1) There was no signi cant difference in the cognition of measures between different gender and occupation groups; Respondents aged between 40 and 60 were more receptive to the measures than respondents of other age groups. Respondents with a bachelor degree or above were more receptive to the measures than respondents of other age groups.
2) The public has a high acceptance of emergency prevention and control measures on the whole. With the development of the epidemic, the acceptance has increased signi cantly under the comparison between the government and relevant media and other countries with the severe epidemic.

Consent for publication
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Availability of data and materials
Not applicable.

Competing interests
The authors declare that they have no competing interests.

Authors' Contributions
ZA conducted the research, wrote the paper, collected and analyzed the basic data; WX conceived the key ideas and the system architecture; GJQ checked and polished the language; ZYB reviewed the process.