Preparedness and Preventive Behaviors for a Pandemic Disaster Caused by COVID-19 in Serbia

Effectiveness of Integrated Social and Behavior Change Communication Interventions in Mass Drug Administration Campaigns in Enhancing Knowledge, Perceptions, and Preventive Practices for Neglected Tropical Diseases in Jimma

Background

Despite control efforts, including mass drug administration (MDA), neglected tropical diseases (NTDs) continue to pose a significant public health threat, particularly in rural Ethiopia. Integrating social and behavior change communication (SBCC) into MDA is essential for success. This study aimed to evaluate the effectiveness of tailored SBCC integrated into MDA campaigns to enhance community knowledge, perception, and preventive behaviors regarding targeted NTDs in the Jimma, Ethiopia.

Methods

A community-based study was conducted using a pre-test post-test design. A multistage sampling technique was employed for surveys, while for qualitative insights, purposive sampling was employed. SBCC interventions tailored to local needs were implemented. Changes in knowledge, perception, and practices were evaluated using Cohen's d. Additionally, a score for key outcome variables comparisons were made to examine variations based on socio-demographic factors, employing suitable statistical tests. Qualitative data were analyzed thematically using Atlas.ti 7.1.5.

Results

The prevalence of SBCC exposure was 88.8%. The intervention had a more significant impact on improving knowledge and preventive practices related to Onchocerciasis (OC) compared to Soil-transmitted helminthes (STH). Specifically, most OC outcomes showed moderate to large effect sizes. In contrast, the effect on STH was more limited, with only knowledge of consequences improving moderately and preventive practices showing a small effect size. The mean score for OC preventive practices varied by educational level and sex, while the median score for STH perception varied among educational level and marital status. Additionally, score variation was observed across districts for all key outcome variables.

Conclusion

The majority of the population was exposed to SBCC resulting in improvements in knowledge, perception, and preventive behaviors regarding OC and knowledge of consequences of STH and its prevention behavior. This highlights the importance of incorporating well-designed SBCC activities in to MDA campaigns to optimize the control and eventual elimination of targeted NTDs.

Comprehensive Risk Analysis of Emergency Medical Response Systems in Serbian Healthcare: Assessing Systemic Vulnerabilities in Disaster Preparedness and Response

BACKGROUND/OBJECTIVES

Emergency Medical Response Systems (EMRSs) play a vital role in delivering medical aid during natural and man-made disasters. This quantitative research delves into the analysis of risk and effectiveness within Serbia's Emergency Medical Services (EMS), with a special emphasis on how work organization, resource distribution, and preparedness for mass casualty events contribute to overall disaster preparedness.

METHODS

The study was conducted using a questionnaire consisting of 7 sections and a total of 88 variables, distributed to and collected from 172 healthcare institutions (Public Health Centers and Hospitals). Statistical methods, including Pearson's correlation, multivariate regression analysis, and chi-square tests, were rigorously applied to analyze and interpret the data.

RESULTS

The results from the multivariate regression analysis revealed that the organization of working hours (β = 0.035) and shift work (β = 0.042) were significant predictors of EMS organization, explaining 1.9% of the variance (R2 = 0.019). Furthermore, shift work (β = -0.045) and working hours (β = -0.037) accounted for 2.0% of the variance in the number of EMS points performed (R2 = 0.020). Also, the availability of ambulance vehicles (β = 0.075) and financial resources (β = 0.033) explained 4.1% of the variance in mass casualty preparedness (R2 = 0.041). When it comes to service area coverage, the regression results suggest that none of the predictors were statistically significant. Based on Pearson's correlation results, there is a statistically significant correlation between the EMS organization and several key variables such as the number of EMS doctors (p = 0.000), emergency medicine specialists (p = 0.000), etc. Moreover, the Chi-square test results reveal statistically significant correlations between EMS organization and how EMS activities are conducted (p = 0.001), the number of activity locations (p = 0.005), and the structure of working hours (p = 0.001).

CONCLUSIONS

Additionally, the results underscore the necessity for increased financial support, standardized protocols, and enhanced intersectoral collaboration to strengthen Serbia's EMRS and improve overall disaster response effectiveness. Based on these findings, a clear roadmap is provided for policymakers, healthcare administrators, and EMS personnel to prioritize strategic interventions and build a robust emergency medical response system.

Household preparedness for emergencies during COVID-19 pandemic among the general population of Nepal

The COVID-19 pandemic has negatively impacted the global economy affecting numerous people's livelihoods. Despite preventive behaviors and advancements of vaccination, the risk of infection still exists due to the emergence of new variants of concern and the changing behavior of the SARS CoV-2 virus. Therefore, preparedness measures are crucial for any emergency. In such situations, it is important to understand preparedness behavior at the household level, as it aids in reducing the risk of transmission and the severity of the disease before accessing any external support. Our study aimed to evaluate household preparedness level for emergencies during the COVID-19 pandemic and its relationship with socio-demographic characteristics among the general population of Nepal. Data was collected through a questionnaire survey. Descriptive statistics, a Chi-square test, and logistic regression model were used for analysis. The study demonstrated that 59.2% had a good preparedness level. Good preparedness was observed among the respondents living in urban areas, those who were married, had white-collar occupations, high-education with graduate and above and high-income levels with monthly income >NPR 20,000, and were young-aged. The study findings underscore the need to develop tailored programs on preparedness prioritizing vulnerable population. It further highlights the importance of proper and consistent information flow, resources distribution, capacitating human resources and better health surveillance.

The risk perception of COVID-19 and vaccine uptake among patients with chronic illnesses at a tertiary health facility in Nigeria

Objectives

This study assessed the risk perception of COVID-19 and the uptake of the COVID-19 vaccine among patients with chronic illnesses in a tertiary health facility.

Design

A hospital-based cross-sectional study.

Setting

The outpatient clinics in a tertiary health facility in Ilorin, North-Central Nigeria.

Participants

Patients with chronic diseases attending outpatient clinics in UITH, Ilorin from November- December 2022, excluding patients under 18 years of age, using simple random sampling by balloting for outpatient clinics, proportional allocation for participants from each clinic, and systematic sampling method for eligible respondents.

Main outcome measure

Risk perception of COVID-19 and vaccine uptake among patients with chronic illnesses in Nigeria.

Results

Respondents believed that older people were most at risk of COVID-19. Over two-thirds, 278 (69.5%) of the respondents had received the COVID-19 vaccine. Fear of the unknown (36.0%) and fear of side effects 30 (24.6%) were the most common reasons for not taking the vaccine. Those married were more likely to have received at least one dose of the vaccine (p=0.007).

Conclusion

COVID-19 risk perception and COVID-19 vaccine uptake were relatively above average. Fear of the unknown and side effects were significant reasons for not taking the vaccines.

Funding

None declared.

Effectiveness of a Health Belief Model-Based Education Program on Self-Efficacy and Preparedness for Infectious Disasters in Rural Populations

BACKGROUND

Health education programs can enhance self-efficacy and disaster preparedness. However, research incorporating the Health Belief Model (HBM) in education for infectious disasters is lacking.

AIMS

Examine the effectiveness of an HBM-based education program on self-reported self-efficacy and self-reported preparedness for infectious disasters in rural populations.

METHODS

In total, 109 eligible participants were allocated to two groups: participants who received HBM-based education (n = 55) or regular education (n = 54), presented at in-person meetings, with individual follow-up conducted on WhatsApp. Self-reported self-efficacy and preparedness for infectious disasters in both groups were measured at 4 and 8 weeks.

FINDINGS

Participants showed a significant interaction between groups and in time to increase in self-reported self-efficacy and self-reported preparedness to deal with infectious disasters. After 4 and 8 weeks, the groups had statistically significant differences (p≤.001) in all outcome measures.

CONCLUSION

HBM-based education was associated with increased self-reported self-efficacy and self-reported infectious disaster preparedness among the rural population. Follow-up by nurses is essential to implementing continuing health belief education programs to enhance rural populations' self-efficacy and infectious disaster preparedness.

Implications for long COVID: A systematic review and meta-aggregation of experience of patients diagnosed with COVID-19

AIMS AND OBJECTIVES

This review aims to synthesize the available evidence of what patients experience when infected with COVID-19, both in hospital and post-discharge settings.

DESIGN

This review was conducted using the Joanna Briggs Institute (JBI) methodology for qualitative systematic reviews and evidence synthesis. Reporting of results was presented according to the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) checklist.

BACKGROUND

Coronavirus disease 2019 (COVID-19) continues to be a public health crisis worldwide. Many patients diagnosed with COVID-19 have varied levels of persisting mental disorders. Previous studies have reported the degree, prevalence and outcome of psychological problems. Minimal research explored the experience of patients with long COVID. The real-life experience of patients with COVID-19 from diagnosis to post-discharge can deepen the understanding of nurses, physicians and policymakers.

METHODS

All studies describing the experience of patients were included. Two authors independently appraised the methodological quality of the included studies using the JBI Critical Appraisal Checklist for Qualitative Research 2020.

RESULTS

This systematic review aggregated patients' experience of being diagnosed with COVID-19 in both hospitalized and post-discharge settings. Finally, 17 studies met inclusion criteria and quality appraisal guidelines. The selected studies in the meta-synthesis resulted in 12 categories, and further were concluded as five synthesized findings: physical symptoms caused by the virus, positive and negative emotional responses to the virus, positive coping strategies as facilitators of epidemic prevention and control, negative coping strategies as obstacles of epidemic prevention and control, and unmet needs for medical resource.

CONCLUSIONS

The psychological burden of patients diagnosed with COVID-19 is heavy and persistent. Social support is essential in the control and prevention of the epidemic. Nurses and other staff should pay more attention to the mental health of the infected patients both in and after hospitalization.

RELEVANCE TO CLINICAL PRACTICE

Nurses should care about the persistent mental trauma of COVID-19 survivors and provide appropriate psychological interventions to mitigate the negative psychological consequences of them. Besides, nurses, as healthcare professionals who may have the most touch with patients, should evaluate the level of social support and deploy it for them. It is also needed for nurses to listen to patient's needs and treat them with carefulness and adequate patience in order to decrease the unmet needs of patients.

Knowledge and behaviors of prevention of COVID-19 and the related factors in the rural population referred to the health centers: a cross-sectional study

BACKGROUND AND OBJECTIVE

Observance of preventive behaviors is one of the main ways to break the coronavirus disease 2019 (COVID-19) chain of transmission. Therefore, the present study was conducted to determine the knowledge and behaviors of prevention of COVID-19 and the related factors in the rural population of Rasht city.

METHODS

In this cross-sectional study, 344 people of the population referred to health centers in Rasht city were included through multi-stage cluster random sampling. The data were collected using a three-part researcher-made questionnaire including individual-social factors, knowledge about the prevention of COVID-19, and the preventive behaviors against COVID-19. Data analysis was performed using the Kolmogorov-Smirnov and Shapiro-Wilk tests, Spearman's correlation coefficient, and multiple logistic regression analysis, by SPSS software version 16 at a significance level < 0.05.

RESULTS

The mean total score of knowledge about COVID-19 was at a moderate level, and the preventive behaviors of COVID-19 were at a good level. There was no significant relationship between the scores of awareness and preventive behaviors of COVID-19 (rs=0.001, P = 0.998). Awareness of COVID-19 was higher in university-educated individuals and women. Also, women, individuals who had access to the Internet, those trained by health centers, and those who were visited by health workers at home had more preventive behaviors.

CONCLUSION

Despite the lack of connection between knowledge and preventive behaviors, the villagers living in the suburbs of Rasht had a moderate level of knowledge and a good level of preventive behaviors of COVID-19. Appropriate educational interventions should be carried out to increase the awareness and performance of the rural residents.

Prevalence and factors associated with healthcare avoidance during the COVID-19 pandemic among the Sámi in Sweden: the SámiHET study

The aim of this population-based cross-sectional study was to assess the prevalence of healthcare avoidance during the COVID-19 pandemic and its associated factors among the Sámi population in Sweden. Data from the "Sámi Health on Equal Terms" (SámiHET) survey conducted in 2021 were used. Overall, 3,658 individuals constituted the analytical sample. Analysis was framed using the social determinants of health framework. The association between healthcare avoidance and several sociodemographic, material, and cultural factors was explored through log-binomial regression analyses. Sampling weights were applied in all analyses. Thirty percent of the Sámi in Sweden avoided healthcare during the COVID-19 pandemic. Sámi women (PR: 1.52, 95% CI: 1.36-1.70), young adults (PR: 1.22, 95% CI:1.05-1.47), Sámi living outside Sápmi (PR: 1.17, 95% CI: 1.03-1.34), and those having low income (PR: 1.42, 95% CI:1.19-1.68) and experiencing economic stress (PR: 1.48, 95% CI: 1.31-1.67) had a higher prevalence of healthcare avoidance. The pattern shown in this study can be useful for planning future pandemic responses, which should address healthcare avoidance, particularly among the identified vulnerable groups, including the active participation of the Sámi themselves.

[Factors associated with adherence to COVID-19 preventive behaviors in ELSA-Brasil participants]

The aim of the study is to assess the adherence to recommended prevention measures during the COVID-19 pandemic and to investigate the factors associated with this adherence in the adult population. This study has a cross-sectional design and used data from the complementary study Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) - COVID, conducted from 2020 to 2021. Data were analyzed using the chi-square test and multinomial logistic regression. The sample consisted of 5,440 participants. The preventive measure with the highest adherence was the use of a face mask (95.5%). There was greater adherence by females and lower chance of adherence by white people, by those who consume alcoholic beverages, people who were retired, as well as for those who live alone or who have family members who did not follow the recommendations to stay at home. Greater adherence to preventive behaviors was observed in only one third of the participating population, which demonstrates that there was a need for greater awareness of the risks in specific populations. The findings contribute to improving our understanding about health promotion and COVID-19 prevention.

Using the Health Belief Model to assess COVID-19 perceptions and behaviours among a group of Egyptian adults: a cross-sectional study

BACKGROUND

It is crucial to study the public's perceptions and behaviour during a pandemic as this will be the driving force for practicing recommended precautions. The current study aimed to identify perceptions of a group of Egyptian adults to COVID-19 using the Health Belief Model (HBM), to measure self-reported practice of preventive behaviours and to identify influencing factors.

METHODS

Cross sectional study was used, including Egyptian adults aged 18 + years. A structured anonymous online questionnaire was used including: a demographic section, the modified MERS- CoV Health Belief Model scale after addition of questions related to COVID-19 and questions on preventive behaviours to COVID-19.

RESULTS

Of the 532 study participants, 28.6% were males, age ranges (18 to 74 years). There was a statistically significant positive correlation between total practice score and all COVID-19 Health Belief Model constructs total scores except for perceived barriers score showing negative correlation (P value < 0.05). Linear regression analysis showed that older age, male gender and living inside Cairo were associated with lower practice score (P value < 0.01).

CONCLUSIONS

Increased perceived susceptibility, perceived benefits, cues to action and perceived self-efficacy scores were associated with higher practice score in the current study. Additionally, results revealed that social media and websites can play an important role in shaping risk perception in the community. Stressing risk perception and efficacy beliefs prevention message can drive people to practice preventive behaviors.

Poor air passenger knowledge of COVID-19 symptoms and behaviour undermines strategies aimed at preventing the import of SARS-CoV-2 into the UK

Air travel mediates transboundary movement of SARS-CoV-2. To prepare for future pandemics, we sought to understand air passenger behaviour and perceived risk during the COVID-19 pandemic. This study of UK adults (n = 2103) quantified knowledge of COVID-19 symptoms, perceived health risk of contracting COVID-19, likelihood of returning to the UK with COVID-19 symptoms, likelihood to obey self-quarantining guidelines, how safe air travellers felt when flying during the pandemic (n = 305), and perceptions towards face covering effectiveness.Overall knowledge of COVID-19 symptoms was poor. Men and younger age groups (18-44) were less informed than women and older age groups (44 +). A significant proportion (21%) of the population would likely travel back to the UK whilst displaying COVID-19 symptoms with many expressing that they would not fully comply with self-isolation guidelines. Overall, males and younger age groups had a reduced perceived personal risk from contracting COVID-19, posing a higher risk of transporting SARS-CoV-2 back to the UK. Poor passenger knowledge and behaviour undermines government guidelines and policies aimed at preventing SARS-CoV-2 entry into the UK. This supports the need for stricter, clearer and more targeted guidelines with point-of-departure viral testing and stricter quarantining upon arrival.

Natural multi-hazard risk perception and educational insights among Geography and Tourism students and graduates amid the Covid-19 pandemic

Multi-hazard risk perception is an emerging research topic that has been gaining more and more interest since the beginning of the Covid-19 pandemic, due to the unprecedented interactions between the management practices of the pandemic and of other co-occurring natural hazards, and to the compounded impact of these multi-hazards. This paper aims to investigate the specialization and study level-dependent differences concerning multi-hazard risk perception and hazard-related education insights of future potential specialists in natural hazard-induced risk management and tourism reconstruction. These differences were explored by applying a multi-layer questionnaire on 547 Geography and Tourism students and graduates from two universities in Iași City (Romania) and Novi Sad (Serbia), and performing descriptive and differential statistical analyses. The statistically significant differences that emerged refer to estimations of the impact level of the Covid-19 pandemic and of other natural hazards at different spatial scales and on different socio-economic activities, on the training/career of the respondents, and to the hazard-related education improvements. Up to date, none of the papers in the existing literature integrate both the Covid-19 pandemic and the co-occurrent natural hazards as objects of students' perception, which makes the present study a starting point for such research endeavours.

The Determinants of Adherence to Public Health and Social Measures Against COVID-19 Among the General Population in South Korea: National Survey Study

BACKGROUND

The COVID-19 pandemic has created devastating health, social, economic, and political effects that will have long-lasting impacts. Public health efforts to reduce the spread of COVID-19 are the priority of national policies for responding to the pandemic globally. Public health and social measures (PHSMs) have been shown to be effective when used alone or in combination with other measures, reducing the risk of spreading COVID-19. However, there is insufficient evidence on the status of compliance with PHSMs in the general population for the prevention of COVID-19 in public areas, including Korea.

OBJECTIVE

The aim of this study was to assess levels of compliance with the recommended PHSMs against SARS-CoV-2 infection and their predictors among the general population by using national data.

METHODS

This study was a secondary data analysis of the National Survey of Infectious Disease Preventive Behaviors in Community, which was conducted by the Korea Centers for Disease Control and Prevention Agency (KDCA) between October 12 and October 30, 2020. The primary study was cross-sectional, using stratified sampling via an adjusted proportional allocation method to select representative samples and ensure the stability of samples. The data were collected through phone interviews conducted by trained enumerators using a structured questionnaire. PHSM adherence was measured using a 10-item comprehensive infectious disease prevention behavior (CIDPB) scale, and each sociocognitive factor, including perceived susceptibility to SARS-CoV-2 infection, perceived severity of SARS-CoV-2 infection, perceived confidence in performing preventive behaviors related to COVID-19, information comprehension ability, and trust in information from the KDCA, was measured. A total of 4003 participants were included in the final analysis. Tobit regression and a decision tree analysis were performed to identify the predictors of preventive measures and the target groups for intervention.

RESULTS

We discovered that women scored 1.34 points higher on the CIDPB scale than men (P<.001). Compared to the group aged 19 to 29 years, those aged 50 to 59 years and those older than 60 years scored 1.89 and 2.48 points higher on the CIDPB scale (P<.001), respectively. The perceived severity of infection, confidence in preventive behaviors, information comprehension ability, and trust in information from the KDCA were significant positive determinants of CIDPBs (P<.001). The perceived susceptibility to infection showed a significant negative relationship with CIDPBs (P<.001).

CONCLUSIONS

Female sex, older age, lower income, and sociocognitive factors were found to be significant determinants of adhering to PHSMs. The findings suggest the need for tailored interventions for target groups; specifically, the age group that was the most active at work indicated the highest potential to spread infection. Adequate public health education and health communication for promoting adherence to PHSMs should be emphasized, and behavior change strategies for those with low perceived confidence in performing PHSMs should be prioritized.

Multiple Concurrent Causal Relationships and Multiple Governance Pathways for Non-Pharmaceutical Intervention Policies in Pandemics: A Fuzzy Set Qualitative Comparative Analysis Based on 102 Countries and Regions

The global outbreak of COVID-19 has been wreaking havoc on all aspects of human societies. In addition to pharmaceutical interventions, non-pharmaceutical intervention policies have been proven to be crucial in slowing down the spread of the virus and reducing the impact of the outbreak on economic development, daily life, and social stability. However, no studies have focused on which non-pharmaceutical intervention policies are more effective; this is the focus of our study. We used data samples from 102 countries and regions around the world and selected seven categories of related policies, including work and school suspensions, assembly restrictions, movement restrictions, home isolation, international population movement restrictions, income subsidies, and testing and screening as the condition variables. A susceptible-exposed-infected-quarantined-recovered (SEIQR) model considering non-pharmaceutical intervention policies and latency with infectiousness was constructed to calculate the epidemic transmission rate as the outcome variable, and a fuzzy set qualitative comparative analysis (fsQCA) method was applied to explore the multiple concurrent causal relationships and multiple governance paths of non-pharmaceutical intervention policies for epidemics from the configuration perspective. We found a total of four non-pharmaceutical intervention policy pathways. Among them, L1 was highly suppressive, L2 was moderately suppressive, and L3 was externally suppressive. The results also showed that individual non-pharmaceutical intervention policy could not effectively suppress the spread of the pandemic. Moreover, three specific non-pharmaceutical intervention policies, including work stoppage and school closure, testing and screening, and economic subsidies, had a universal effect in the policies grouping for effective control of the pandemic transmission.

Impact of Personal Experience of COVID-19 Disease on Recreational Anglers' Attitudes and Behaviors

BACKGROUND

Anglers are a large social group with access to a "relatively safe" form of recreation, that allows the opportunity to relieve stress. An important question, however, is how they did so, and to what extent their perceived COVID-19 transition status influenced decisions both in life and at the fishing site.

AIM

Our study aimed to determine the dynamics of anglers' attitudes and behaviors during the COVID-19 pandemic as a result of the different statuses of their exposure to the SARS-CoV-2 virus. We assumed that the behavior of anglers who have not experienced the disease (were not ill and not sure if ill) will be similar and, on the other hand, different from the behavior of those who have experienced COVID-19.

METHODS

The web-assisted interviews survey was used among 586 anglers with different COVID-19 disease experience statuses. Their pandemic behavior and activities by four age groups were studied using non-metric multidimensional scaling. Redundancy analysis has been used to identify the relationship between anglers' life attitudes and socioeconomic and demographic factors, taking into account their preferences and involvement in fishing.

RESULTS

We have demonstrated that the behavior of anglers who have not experienced COVID-19 disease and do not present a reckless attitude toward pandemic threats, do not show significant differences from the life attitudes of the group experienced by the SARS-CoV-2 virus. These two groups comprise more than 70% of anglers. However, the rest show a lack of interest in an aware diagnosis of their health and a low level of acceptance of self-restraint in the area of direct social contact.

CONCLUSIONS

Unawareness, combined with ignorance, could be a potential factor in the transmission of the virus while fishing. The behaviors of almost 30% of anglers are particularly risky when combined with a strong need to fish in the company of friends and familiar people. Anglers' social identity should be tapped by fishery managers. Targeted educational campaigns should be aimed at groups around specific fishing spots. The need for self-limitation under the pandemic should be promoted for the benefit of the general public and to maintain the reputation of angling as a safe recreational activity.

Four Waves of the COVID-19 Pandemic: Comparison of Clinical and Pregnancy Outcomes

During the last two and a half years, clinical manifestations, disease severity, and pregnancy outcomes have differed among pregnant patients with SARS-CoV-2 infection. These changes were preceded by the presence of new variants of SARS-CoV-2, known in the literature as variants of concern. The aim of this study is to describe the differences between maternal clinical characteristics and perinatal outcomes among pregnant women with COVID-19 during four waves of the COVID-19 epidemic in Serbia. This retrospective study included a series of 192 pregnant patients who were hospitalized due to the severity of their clinical status of SARS-CoV-2 infection. During four outbreaks of COVID-19 infection in Serbia, we compared and analyzed three sets of variables, including signs, symptoms, and characteristics of COVID-19 infection, clinical endpoints, and maternal and newborn parameters. During the dominance of the Delta variant, the duration of hospitalization was the longest (10.67 ± 1.42 days), the frequency of stillbirths was the highest (17.4%), as well as the frequency of progression of COVID infection (28.9%) and the requirement for non-invasive oxygen support (37%). The dominance of the Delta variant was associated with the highest number of prescribed antibiotics (2.35 ± 0.28), the most common presence of nosocomial infections (21.7%), and the highest frequency of corticosteroid therapy use (34.8%). The observed differences during the dominance of four variants of concern are potential pathways for risk stratification and the establishment of timely and proper treatments for pregnant patients. Early identification of the Delta variant, and possibly some new variants with similar features in the future, should be a priority and, perhaps, even an opportunity to introduce more accurate and predictive clinical algorithms for pregnant patients.

Factors affecting worriedness: A study of the COVID-19 pandemic in Japan

The global effect of COVID-19 is no longer simply a public health issue; it is causing an economic crisis that has a significant impact on the job market and people's lives. The disease has led to 43% of businesses temporarily closing, and almost all these closures are due to COVID-19. Organizations that have temporarily suspended their activities have pointed mainly to a decline in demand and employee health issues as the reasons for closure. In emergency and disaster management, perception often helps shape personality and how people act in certain situations. This study aims to examine personal risk perception of COVID-19 from many viewpoints and whether it affects motivation with regard to improving personal preparedness. We collected data from three major Japanese cities through a questionnaire survey and analyzed the results of the survey through factor analysis and multiple regression analysis by using the Partial Least Square Structural Equation Modeling (PLS-SEM). The three study areas include (1) the most damaged regions from the 2011 Great East Japan earthquake and tsunami, (2) the capital city and surrounding areas of Tokyo, and (3) Kumamoto, which has recently experienced an earthquake. The findings show a correlation between the nature of the information received during COVID-19 and worriedness and the necessity for adequate information. The expected benefit of this study is to provide guidelines for the government or organizations to make a suitable emergency management plan based on pertinent factors for future pandemics.

An empirical study of the effect of a flooding event caused by extreme rainfall on preventive behaviors against COVID-19

Since the outbreak of COVID-19, wearing masks, vaccinations, and maintaining a safe distance has become social behaviors advocated by the government and widely adopted by the public. At the same time, unpredictable natural disaster risks brought by extreme climate change compound difficulties during epidemics and cause systemic risks that influence the existing pattern of epidemic prevention. Therefore, it is necessary to explore the effect of natural disaster risk caused by climate change on the response to outbreaks in the context of the COVID-19 epidemic. This study will focus on individual-level epidemic prevention behaviors, taking as an example the significant risk of severe destructive flooding caused by heavy rains in Henan, China, on July 20, 2021, which claimed 398 lives, to explore the effect of floods on the preventive behaviors of residents in the hardest hit areas against COVID-19. Through the multi-stage stratified random sampling of the affected residents in Zhengzhou, Xinxiang, Hebi, Luoyang, Anyang, and other cities in Henan Province, 2,744 affected people were surveyed via questionnaires. Through the linear regression model and moderating effect analysis, the study found that after floods, the individual's flood risk perception and response behaviors significantly correlated with the individual's prevention behaviors against COVID-19. Specifically, both flood risk perception and response behaviors strengthened the individual's prevention behaviors. Furthermore, the study also found that community risk preparation behavior and social capital can moderate the above relationship to a certain extent. The research can guide risk communication under the compound risk scenario and prevent risky public behavior under the consistent presence of COVID-19 in the community.

Medical students' perceptions and performance in an online regional anatomy course during the Covid-19 pandemic

The present study evaluated the students' psychological well-being, experiences, performance, and perception of learning regional anatomy remotely. A regional anatomy remote learning curriculum was designed and learning materials were delivered virtually to 120 undergraduate medical students at Jinan University, China. All the students consented and voluntarily participated in this study by completing self-administered online questionnaires including the Zung's Self-Rating Anxiety and Depression Scales at the beginning and end of the learning session. A subset participated in focus group discussions. Most of the students (90.0%) positively evaluated the current distance learning model. More than 80% were satisfied with the content arrangement and coverage. Many students preferred virtual lectures (68.2%) and videos showing dissections (70.6%) during the distance learning sessions. However, writing laboratory reports and case-based learning were the least preferred modes of learning as they were only preferred by 23.2% and 14.1% of the students, respectively. There was no significant lockdown-related anxiety or depression reported by students using depression and anxiety scales as well as feedback from focus group discussions. The surveyed students' confidence scores in distance learning were significantly higher after 5 weeks than at the beginning of the session (3.05 ± 0.83 vs. 3.70 ± 0.71, P < 0.05). Furthermore, the present results showed no significant differences between the current group's academic performance in the unit tests as well as the final overall evaluation for different parts of the course compared to that of the previous year's cohort. The findings above were congruent with focus group discussion data that the use of the online teaching platform for regional anatomy significantly improved the students' confidence in virtual and self-directed learning and did not negatively affect their academic performance.

Using a national level cross-sectional study to develop a Hospital Preparedness Index (HOSPI) for Covid-19 management: A case study from India

Background

We developed a composite index–hospital preparedness index (HOSPI)–to gauge preparedness of hospitals in India to deal with COVID-19 pandemic.

Methods

We developed and validated a comprehensive survey questionnaire containing 63 questions, out of which 16 critical items were identified and classified under 5 domains: staff preparedness, effects of COVID-19, protective gears, infrastructure, and future planning. Hospitals empaneled under Ayushman Bharat Yojana (ABY) were invited to the survey. The responses were analyzed using weighted negative log likelihood scores for the options. The preparedness of hospitals was ranked after averaging the scores state-wise and district-wise in select states. HOSPI scores for states were classified using K-means clustering.

Findings

Out of 20,202 hospitals empaneled in ABY included in the study, a total of 954 hospitals responded to the questionnaire by July 2020. Domains 1, 2, and 4 contributed the most to the index. The overall preparedness was identified as the best in Goa, and 12 states/ UTs had scores above the national average score. Among the states which experienced high COVID-19 cases during the first pandemic wave, we identified a cluster of states with high HOSPI scores indicating better preparedness (Maharashtra, Tamil Nadu, Karnataka, Uttar Pradesh and Andhra Pradesh), and a cluster with low HOSPI scores indicating poor preparedness (Chhattisgarh, Delhi, Uttarakhand).

Interpretation

Using this index, it is possible to identify areas for targeted improvement of hospital and staff preparedness to deal with the COVID-19 crisis.

Geographically weighted regression model for physical, social, and economic factors affecting the COVID-19 pandemic spreading

This study aims to analyze the spatial distribution of the epidemic spread and the role of the physical, social, and economic characteristics in this spreading. A geographically weighted regression (GWR) model was built within a GIS environment using infection data monitored by the Iraqi Ministry of Health records for 10 months from March to December 2020. The factors adopted in this model are the size of urban interaction areas and human gatherings, movement level and accessibility, and the volume of public services and facilities that attract people. The results show that it would be possible to deal with each administrative unit in proportion to its circumstances in light of the factors that appear in it. So, there will not be a single treatment for all areas with different urban characteristics, which sometimes helps not to stop social and economic life due to the imposition of a comprehensive ban on movement and activities. Therefore, there will be other supportive policies other than the ban, depending on the urban indicators for each region, such as reducing external movement from it or relying on preventing public activities only.

Knowledge, attitudes and practices of Iranian people about food safety and hygiene during covid-19 pandemic

AIM

The objective of this study was to develop a cultural adopted questionnaire for evaluation of knowledge (K), attitude (A) and practice (P) of Iranian population toward food safety during Covid-19.

METHODS

The study is based on an online questionnaire that filled by 712 Iranians over 16 years old. Exploratory factor analysis (EFA), confirmatory factor analysis (CFA) and reliability assessment were performed. The construct validity of A and P determined by EFA and confirmed by CFA. Difficulty index was used for K.

RESULTS

The reliability score of questionnaire was satisfactory. The three items of K-A-P questionnaire were significantly associated with the total score of questionnaire. The KAP questionnaire regarding food safety in covid-19 consisted of 27 items multidimensional scale with strong psychometric features. The respondent showed a satisfactory level of KAP during covid-19 pandemics.

CONCLUSION

The KAP questionnaire regarding food safety in covid-19 is a valid and reliable tool for measurement of knowledge, attitude and practice of people regarding food safety in covid-19.

Determinants of adherence to personal preventive behaviours based on the health belief model: a cross-sectional study in South Korea during the initial stage of the COVID-19 pandemic

BACKGROUND

Along with the rapid transmission of COVID-19, adherence to preventive behaviours plays a crucial role with respect to the control of COVID-19. However, different individuals' psychological characteristics and risk perception result in various forms of response to preventive behaviours. Based on the Health Belief Model, this study identifies the factors associated with preventive behaviours towards COVID-19 in South Korea during the initial stage of the COVID-19 pandemic.

METHODS

A cross-sectional study was conducted in April 2020 through an anonymous online survey. A total of 1207 people in the age bracket of 20-59 years participated in the survey. Single and multiple linear regression analyses were conducted to identify the determinants of preventive behaviours against COVID-19.

RESULTS

The following factors were associated with preventive behaviours towards COVID-19: female gender (β = .124, p < 0.001), has a master's degree or above (β = 0.065, p = 0.010), perceived susceptibility (β = .197, p < 0.001), self-efficacy (β = .404, p < 0.001), trust in radio (β = -.080, p = .006), trust in official government website (β = .057, p = .045), trust in social networks (β = .054, p = .033), and trust in family and friends (β = .068, p = .009), with an explanatory power of 41.5% (R2 = 0.415).

CONCLUSIONS

To flatten the epidemic curve, it is important to understand the public's risk perception and the motivation behind behavioural responses that aim to promote preventive behaviours among the public. Thus, this study calls for the provision of accessible and credible information sources and demonstrates a public health campaign that encourages the public's engagement in preventive behaviours towards COVID-19.

A Look at COVID-19 Global Health Situation, 1-Year Post Declaration of the Pandemic

The new coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic on 11 March 2020 by the World Health Organization (WHO). The impacts of COVID-19 have changed over the past year globally. There were 116 million confirmed cases of COVID-19 in more than 220 countries, including 2.5 million deaths, as reported at the end of the first week of March 2021. Throughout this time, different variants of SARS-CoV-2 have emerged. In early March, the United States of America (USA) led in both confirmed cases and casualties, while India followed in the number of confirmed cases and Brazil in the number of deaths. Vaccines are available in the USA and worldwide to help combat COVID-19. The level of preparedness among multisectoral communities played a role in transmission rates; therefore, lessons learned from past outbreaks, alongside this pandemic, are crucial in establishing policies and regulations to reduce and/or prevent the spread. This narrative literature review provides an update on the global spread of the COVID-19 outbreak, and the current impact of the pandemic 1-year after the declaration, preparedness, and mitigation efforts since the outbreak.

From warning messages to preparedness behavior: The role of risk perception and information interaction in the Covid-19 pandemic

During infectious disease outbreaks, early warning is crucial to prevent and control the further spread of the disease. While the different waves of the Covid-19 pandemic have demonstrated the need for continued compliance, little is known about the impact of warning messages and risk perception on individual behavior in public health emergencies. To address this gap, this paper uses data from the second wave of Covid-19 in China to analyse how warning information influences preventive behavior through four categories risk perception and information interaction. Drawing on the protective action decision model (PADM) and the social amplification of risk framework (SARF), risk warning information (content, channel, and type), risk perception (threat perception, hazard- and resource-related preparedness behavior perception and stakeholder perception), information interaction, and preparedness behavior intention are integrated into a comprehensive model. To test our model, we run a survey with 724 residents in Northern China. The results show that hazard-related preparedness behavior perception and stakeholder perception act as mediators between warning and preventive action. Stakeholder perception had much stronger mediating effects than the hazard-related attributes. In addition, information interaction is effective in increasing all categories risk perception, stimulating public response, while functioning as a mediator for warning. The risk warning information content, channel, and type are identified as key drivers of risk perception. The research found that information channel was more related to different risk perception than other characteristics. Overall, these associations in our model explain core mechanisms behind compliance and allow policy-makers to gain new insights into preventive risk communication in public health emergencies.

Exploring perceived risk for COVID-19 and its role in protective behavior and COVID-19 vaccine hesitancy: a qualitative study after the first wave

Background

The novel coronavirus pandemic (COVID-19) has had severe impacts on morbidity and mortality globally.

Methods

This study was set in rural central Kentucky and included participants recruited from public spaces. Fifteen qualitative interviews about personal experiences during the COVID-19 pandemic were conducted by phone from July 3 to July 24, 2020. Interviews were recorded, transcribed, and coded using a grounded theory approach.

Results

Participants who perceived COVID-19 to be a severe risk tended to have personal health concerns and therefore reported taking protective measures for themselves. A slightly smaller proportion of participants reported taking measures to protect others (particularly family). A minority of participants had an ambivalent attitude towards the risk and only took measures if required. COVID-19 vaccine acceptability was low with most participants expressing concerns regarding their need for a vaccine, safety of this vaccine, the value of personal rights, or future vaccine supply.

Conclusions

Most participants perceived some risk of COVID-19 and took steps to prevent infections in themselves and others. Mandates for mask use in certain locations were additionally useful for those who had an ambivalent attitude towards the risk of illness. There was surprisingly little connection between perceiving COVID-19 risk and a desire for the COVID-19 vaccine. In this setting, vaccine acceptability was low, with vaccine concerns outweighing perceived potential benefits. In conclusion, because the risk was often constructed in terms of worries for themselves and others, the framing of health education materials for protective behaviors in these terms may be effective. Furthermore, future COVID-19 vaccine education should address vaccine knowledge and concerns, such as the need for a vaccine and its safety, and emphasize how a vaccination would reduce their chances of severe disease if they were to get sick.

A Predictive Model of Pandemic Disaster Fear Caused by Coronavirus (COVID-19): Implications for Decision-Makers

This paper presents quantitative research results regarding a predictive model of pandemic disaster fear caused by the coronavirus disease (COVİD-19). The aim of this paper was to establish the level and impact of certain demographic and socioeconomic characteristics on pandemic disaster fear caused by the coronavirus (COVID-19). The research was conducted using a questionnaire that was provided and then collected online for 1226 respondents during May 2021. A closed, five-point Likert scale was used to create the structured questionnaire. The first section of the questionnaire included research questions about the participants' socioeconomic and demographic characteristics, while the second section included issue questions about fear caused by COVID-19. The results of multivariate regression analyses showed the most important predictor for fear of COVID-19 to be gender, followed by age and education level. Furthermore, the results of t-tests showed statistically significant differences between men and women in terms of different aspects of pandemic disaster fear caused by the coronavirus disease. Our results have several significant public health implications. Women who were more educated and knowledgeable, married, and older, reported a greater fear of the outbreak at various levels. Decision-makers can use these findings to identify better strategic opportunities for pandemic disaster risk management.

Precautionary behaviours of individuals with multimorbidity during the COVID-19 pandemic

Studies show that older individuals with multimorbidity are more susceptible to develop a more severe case of COVID-19 when infected by the virus. These individuals are more likely to be admitted to Intensive Care Units and to die from COVID-19-related conditions than younger individuals or those without multimorbidity. This research aimed to assess whether there are differences in terms of precautionary behaviours between individuals aged 50 + with multimorbidity and their counterparts without multimorbidity residing in 25 European countries plus Israel. We used data from the SHARE-COVID19 questionnaire on the socio-demographic and economic characteristics, multimorbidity, and precautionary behaviours of individuals. SHARE wave 8 and 7 databases were also used to fully identify individuals with multimorbidity. Our results showed that individuals with multimorbidity were more likely to exhibit precautionary behaviours than their counterparts without multimorbidity when gender, age, education, financial distress and countries were included as controls. Additionally, we found that women, more educated individuals and those experiencing more financial distress adopt more protective behaviours than their counterparts. Our results also indicate that the prevalence of precautionary behaviours is higher in Spain and Italy and lower in Denmark, Finland and Sweden. To guarantee the adoption of preventive actions against COVID-19, public health messaging and actions must continue to be disseminated among middle and older aged persons with multimorbidity, and more awareness campaigns should be targeted at men and less educated individuals but also at persons experiencing less financial distress, particularly in countries where people engaged in fewer precautionary behaviours.

Factors associated with preventive behaviors for COVID-19 among adolescents in South Korea

PURPOSE

COVID-19's infection rate among adolescents is increasing; hence, it is important to prevent it as it can spread in the community through transmission in schools. It is crucial to determine the extent to which adolescents follow COVID-19 preventive measures and identify factors relating to such behaviors to implement more effective health education. This study aimed to understand factors related to COVID-19 preventive behaviors using the theory of planned behavior (TPB) and the health belief model (HBM) among adolescents in South Korea.

DESIGN AND METHODS

A cross-sectional face-to-face questionnaire survey was conducted among 272 adolescents in South Korea. Structural equation modeling was used to examine the relationships between perceived susceptibility, perceived severity, attitude, subjective norms, perceived behavioral control, intention, and COVID-19 preventive behaviors.

RESULTS

Among adolescents' COVID-19 preventive behavior scores, wearing masks was the highest and distancing was the lowest. Adolescents' adherence to COVID-19 preventive behaviors was directly or indirectly associated with their perceived susceptibility, perceived severity, subjective norms, perceived behavioral control, and intention.

CONCLUSIONS

Attention to mitigate social isolation is important to improve compliance with COVID-19 preventive behaviors. Perceived susceptibility, perceived severity, subjective norms, perceived behavioral control, and intention explained 61.3% of adolescents' COVID-19 preventive behaviors, there is a need for education to promote relevant factors.

PRACTICE IMPLICATIONS

To increase adolescent awareness of COVID-19 and increase attitudes, subjective norms, and perceived behavior control, nurses need to provide education including the evidence for COVID-19 preventive behavior to increase adolescents' understanding and active implementation of those behaviors.

The mechanism of governments' and individuals' influence on protective behaviours during the second wave of COVID-19: a multiple mediation model

Background: The SARS-CoV-2 virus continues to spread and resurge globally with signs of a second wave, despite actions by governments to curb the COVID-19 pandemic. However, evidence-based strategies to combat COVID-19 recurrence are poorly documented. Objective: To reveal how governments and individuals should act to effectively cope with future waves, this study proposed a preventive model of COVID-19 resurgence. Method: A questionnaire survey was conducted among 1,137 residents of Beijing, where the epidemic reoccurred. Structural equation model was used to explore the mechanism among government intervention, perceived efficacy, positive emotions, posttraumatic growth (PTG) and protective behaviours. Results: Data analysis revealed that during COVID-19 resurgence, government intervention could directly and indirectly influence protective behaviours through individual factors (i.e. perceived efficacy, positive emotions), and PTG could mediate the indirect pathway to protective behaviours. Conclusions: These findings implied that government intervention needs to be integrated with individual factors to effectively control repeated COVID-19 outbreaks.

Risk Perceptions, Knowledge and Behaviors of General and High-Risk Adult Populations Towards COVID-19: A Systematic Scoping Review

Objectives: The COVID-19 pandemic represents a major crisis for governments and populations. The public’s risk perceptions, knowledge, and behaviors are key factors that play a vital role in the transmission of infectious diseases. Our scoping review aims to map the early evidence on risk perceptions, knowledge, and behaviors of general and high-risk adult populations towards COVID-19.

Methods: A systematic scoping review was conducted of peer-reviewed articles in five databases on studies conducted during the early stages of COVID-19. Thirty-one studies meeting the inclusion criteria were appraised and analyzed.

Results: The levels of risk perceptions, knowledge, and behaviors towards COVID-19 were moderate to high in both general and high-risk adult populations. Adults were knowledgeable about preventive behaviors. Our review identified hand-washing and avoiding crowded places as dominant preventive behaviors. Being a female, older, more educated, and living in urban areas was associated with better knowledge of COVID-19 and appropriate preventive behaviors.

Conclusion: This review offers a first understanding of risk perceptions, knowledge and behaviors of adult populations during the early stages of the COVID-19 pandemic.

Scientometric Analysis of Disaster Risk Perception: 2000-2020

This paper used 1526 works from the literature on disaster risk perception from 2000 to 2020 in the Web of Science core collection database as the research subject. The CiteSpace knowledge graph analysis tool was used to visual analyze the country, author, institution, discipline distribution, keywords, and keyword clustering mapping. The paper drew the following conclusions. Firstly, disaster risk perception research has experienced three stages of steady development, undulating growth, and rapid growth. Secondly, the field of disaster risk perception was mainly concentrated in the disciplines of engineering, natural science, and management science. Thirdly, meteorological disasters, earthquakes, nuclear radiation, and epidemics were the main disasters in the field of disaster risk perception. Residents and adolescents were the main subjects of research in the field of disaster risk perception. Fourthly, research on human risk behavior and risk psychology and research on disaster risk control and emergency management were two major research hotspots in the field of disaster risk perception. Finally, the research field of disaster risk perception is constantly expanding. There is a trend from theory to application and multi-perspective combination, and future research on disaster risk perception will be presented more systematically. The conclusion can provide a reference for disaster risk perception research, as well as directions for future research.

Social determinants of adherence to COVID-19 preventive guidelines: a comprehensive review

Adherence to coronavirus disease 2019 (COVID-19) preventive guidelines (ACPG) is an important strategy to control the COVID-19 pandemic effectively. The present study aimed to identify and summarize the social determinants of ACPG among the general population. A comprehensive review was performed from December 2019 to February 2021 through searching electronic databases. Two independent reviewers assessed and selected relevant studies. Next, the characteristics and main findings of the included studies were summarized. Finally, the World Health Organization's conceptual framework of social determinants of health was used to synthesize the identified social determinants of ACPG. Forty-one of 453 retrieved articles met the inclusion criteria. The study results showed different patterns of ACPG among various communities. Furthermore, 84 social determinants were identified and categorized into structural and intermediary determinants. ACPG is a set of complex behaviors associated with different individual sociodemographic and behavioral characteristics; living and working conditions; COVID-19 knowledge, attitudes, and risk perceptions; exposure to sources and information level; leisure activities; social support; trust; social norms; psychosocial well-being; socio-economic position; and the socio-economic and political context. Interventions to promote ACPG among the general population should consider the identified social determinants of ACPG.

Risk Culture and COVID-19 Protective Behaviors: A Cross-Sectional Survey of Residents in China

The COVID-19 outbreak caused by the Severe Acute Respiratory Syndrome CoronaVirus type 2 (SARS-CoV-2) has spread across the world. However, our understanding of the public responses, in particular in adopting protective behaviors, has been limited. The current study aimed to determine the level of protective behaviors adopted by the residents in China and its association with their cultural attributes. A national cross-sectional online survey was conducted in mainland China from 4^th to 13^th August 2020. Protective behaviors were assessed as a summed score (ranging from 0 to 40) measured by ten items. The self-report tendency of study participants toward the four cultural attributes (individualism, egalitarianism, fatalism, hierarchy) was rated on a seven-point Likert scale. A total of 17651 respondents returned a valid questionnaire, representing 47.9% of those who accessed the online survey. Most (89.8%) respondents aged between 18 and 45 years in the age range of and 47.7% were male. High levels of protective behaviors (34.04 ± 5.78) were reported. The respondents had high scores in the cultural attributes of hierarchy (Median = 5) and egalitarianism (Median = 5), compared with low scores in individualism (Median = 1) and fatalism (Median = 1). High levels of protective behaviors were associated a higher tendency toward egalitarianism (AOR = 2.90, 95% CI 2.67–3.15) and hierarchy (AOR = 1.66, 95% CI 1.53–1.81) and a low tendency toward fatalism (AOR = 1.79, 95% CI 1.63–1.97) and individualism (AOR = 2.62, 95% CI 2.41–2.85). The cultural attributes explained 17.3% of the variations in the protective behavioral scores. In conclusion, the adoption of protective behaviors is associated a risk culture characterized by high levels of hierarchy and egalitarianism and low levels of individualism and fatalism. Government actions and communication strategies need to adapt to the cultural characteristics of their target audience.

The role of knowledge, attitudes, and health workers’ behavior in COVID19 pandemic preparedness at Aceh Pidie Jaya District, Indonesia

Introduction

Health workers are at high risk of contracting the disease because they are at the forefront of assisting COVID19 patients. Globally, Indonesia has the worst death toll of health workers. Many previous studies have shown the differences in knowledge, attitudes, and behavior of health workers in handling with the COVID19 pandemic. This study aims to asses the role of knowledge, attitudes, and health workers' preparedness during the COVID-19 pandemic in Aceh Pidie Jaya District.

Methods

A cross-sectional study and the data were collected by distributing online questionnaires about knowledge, attitudes, behavior, and preparedness related to the COVID-19 at 12 Pidie Jaya District health centers. The knowledge, behavior, and preparedness parameters used Guttman and Likert scales to measure the workers' attitudes. Chi-square test was used to evaluate the relationship between knowledge, attitudes, behavior, and preparedness.

Results

In this study, 377 health workers were selected, the majority of respondents' education level was diploma, level 3 (257, 76.3%), and one-third of the respondents did not attend training. There are 197 (58.5%) respondents who had good knowledge, 177 (52.5%) positive attitudes, 283 (84%) good behavior, and 173 (51, 3%) well prepared. Furthermore, good knowledge, positive attitude, and good behavior had a significant correlation statistically with well prepared during the pandemic (p < 0.05).

Discussion

Most of the health workers in Aceh Pidie Jaya have good knowledge, positive attitudes, and good behavior that create adequate preparedness. Even though training is still very limited, educational attainment would remain the cornerstone for preparedness to encounter COVID-19.

Emotional Reactivity and Emotion Regulation Among Young Adults During COVID-19 Lockdown: The Moderating Role of Gender and Engagement in Sports

The effects of the COVID-19 pandemic on mental health have not been fully inspected among the young adults' population. The objectives of the present study were: (1) to examine differences in emotional reactivity and emotion regulation between, both gender and sports engagement level during the first 2 weeks of the lockdown; and (2) to examine the possible impact of emotion regulation on emotional reactivity, and possible significant roles of gender and sports engagement level as moderators. This cross-sectional study included 315 Serbian young adults (aged 18-26 years old) during COVID-19 lockdown. Respondents answered socio-demographic questions and the Serbian version of the Multidimensional Emotion Questionnaire (MEQ). The results of confirmatory factor analysis indicated good fit for both positive and negative reactivity scales (SRMR = 0.037; CFI = 0.984, RMSEA = 0.046, and SRMR = 0.055; CFI = 0.964, RMSEA = 0.064, respectively). Gender differences were found in both positive (p = 0.039; d = 0.28) and negative emotional reactivity scales (p < 0.001; d = 0.60), with females reported lower and higher values, respectively. Professional athletes presented higher scores in positive reactivity scale in comparison to non-athletes (p < 0.001; d = 0.78) and recreational athletes (p = 0.034; d = 0.34) during 2 weeks of COVID-19 lockdown. Conversely, professional athletes scored lower in negative emotional reactivity scale in comparison to non-athletes (p < 0.001; d = 0.85) and recreational athletes (p = 0.006; d = 0.42). Both gender and sports engagement level differences were found for negative, but not for positive emotion regulation scale. Furthermore, results showed that engagement in sports level plays a significant role as moderator in relationship between negative regulation and negative reactivity, where professional athletes presented significant interaction effect and predicted lower negative reactivity scores compared to non-athletes and recreational athletes. However, gender does not moderate the influence of emotion regulation on emotional reactivity either positive or negative. Engagement in sports as a lifestyle may contribute to better emotional harmony especially in the crisis situation as COVID-19 lockdown.

Psychological distance towards COVID-19: Geographical and hypothetical distance predict attitudes and mediate knowledge

While different antecedents have been examined to explain peoples’ reactions towards COVID-19, there is only scarce understanding about the role of the subjective closeness and distance to the pandemic. Within the current study, we applied the concept of psychological distance to understand the distance towards COVID-19 and investigated its (1) connection with preventive attitudes and proactive behaviors, (2) context-specific antecedents, and its (3) mediating effect of knowledge on attitudes. Using an online sample from a German quantitative cross-sectional study (N = 395, M = 32.2 years, SD = 13.9 years, 64.3% female) in July 2020, a time with a general low incidence of people infected with Sars-CoV2, we measured relevant socio-psychological constructs addressing COVID-19 and included further information from external sources. Based on a path model, we found geographical distance as a significant predictor of cognitive attitudes towards COVID-19. Furthermore, hypothetical distance (i.e., feeling to be likely affected by COVID-19) predicted not only participants’ affective, cognitive, and behavioral attitudes, but also the installation of a corona warning-app. While several variables affected the different dimensions of psychological distance, hypothetical and geographical distance mediated the effect of knowledge on attitudes. These results underline the role of geographical and hypothetical distance for health-related behaviors and education. For example, people will only comply with preventive measures if they feel geographically concerned by the disease, which is particularly challenging for fast-spreading global diseases such as COVID-19. Therefore, there is a need to clearly communicate the personal risks of diseases and address peoples’ hypothetical distance.

Relationships among COVID-19 Prevention Practices, Risk Perception and Individual Characteristics: A Temporal Analysis

The effectiveness of public health measures in containing an infectious disease largely depends on how the general public is taking the prevention practices in daily lives. Previous studies have shown that different risk perceptions and sociodemographic characteristics may lead to vastly different prevention behaviors. This paper applies a temporal perspective in examining the changing patterns of prevention practices over time and their dynamic relationships with the perceived risk towards COVID-19 and its individual characteristics. Three key timelines (February, April, and June of 2020) were identified to represent the early, lockdown, and reopening stages of the first wave. Data were drawn from an online survey conducted in the Greater Toronto Area (GTA) of Canada (n = 470). Chi-square tests and logistic regression models revealed important temporal patterns in practicing different hygienic and mobility-related prevention measures and the respondents' risk perceptions during the three timelines. The factors predicting the level of prevention practices vary across the three timelines, based on the specific type of prevention, and within the changing public health contexts. This study contributes to the literature on COVID-19 by incorporating a temporal perspective in conceptualizing prevention predictors. It provides crucial insights for developing timely public health strategies to improve infectious disease prevention at different stages and for individuals with varying backgrounds.

Public Awareness on Prevention Behavior of Coronavirus Disease-19 at North Sulawesi Indonesia

BACKGROUND: The coronavirus diseases (COVID)-19 outbreak around the world has prompted the government to urge its citizens to take precautionary measures to minimize the incidence of COVID-19, which has been continued to attack the world, including Indonesia. The pandemic has led to a massive global public health campaign to slow the spread of the virus by increasing hand washing, reducing face touching, wearing masks in public, and physical distancing. AIM: This study aims to analyze the sociodemographic relationship of knowledge, attitudes, and practices of preventing COVID-19. METHOD: This study was an analytic survey with a cross-sectional study design, conducted for 3 months with number of samples 356 people spared across four districts and cities in North Sulawesi Province. There are two types of data collection those are through Google forms and face to face questions. The studied variables are sociodemography as independent variables and knowledge, attitude, and behavior of COVID-19 prevention. Data were analyzed with Chi-square test. RESULTS: The result of study, only gender has a relationship toward people’s attitudes toward COVID-19 prevention with p = 0.046; while most of the variables, namely, age (0.333), education (0.085), occupation (0.152), and income (0.966), did not have a significant relationship with attitudes toward the prevention of COVID-19. Gender has a relationship toward people’s attitudes toward COVID-19 prevention with p = 0.046; while most of the variables, namely, age (0.333), education (0.085), occupation (0.152), and income (0.966), did not have a significant relationship with attitudes toward the prevention of COVID-19. Most of the variables had a significant relationship with prevention measures, including age (0.008), education (0.009), and occupation (0.038); and only the gender variable (0.895) and monthly income (0.077) had no statistical relationship. CONCLUSION: It is important for the government and society to take a role by becoming more concerned about the COVID-19 pandemic through wise steps to prevent and protect public health using all available resources.

Capacity Development of Local Self-Governments for Disaster Risk Management

The objective of this research was to examine the capacity development of local self-governments in the field of disaster risk management (DRM). This quantitative research examines the degree of implementation of strategic, legislative, and institutional frameworks, as well as the capacity of local authorities to apply related policies through five analytical scopes: (1) degree of preparedness and legal framework; (2) financial framework; (3) policy aspects; (4) cooperation and partnership; (5) communication. The ability of municipalities and towns to respond to disasters was also analyzed and compared. In this paper, our initial hypothesis was that the effective implementation of the concept of DRM policy in towns of Serbia requires the continual strategic, tactical, and operational transformation of the public administration and public management system in order to strengthen the capacity of local self-governments for disaster prevention, preparation, response, and recovery. This multimethod research was conducted over the period of 2014-2017 and included the following two target groups: (a) heads of disaster sectors in local self-government units (mayor) and (b) employees of the DRM sector in local self-government units. The results of this research will enable decision makers to successfully respond to challenges and help to improve the capacity of local self-governments and public local administrations within the scope of DRM in the Republic of Serbia, based on the principles of prevention and proactive action, coordination, cooperation, partnership, and responsibility.

Mental images of nurses regarding COVID-19: A metaphor study

AIM

The purpose of this study is to understand the thoughts and perceptions of nurses caring for patients with COVID-19 diagnosis about the COVID-19 pandemic.

BACKGROUND

The nursing profession, with the basic duty of caring for people, is among the professional groups most affected by COVID-19. The high rate of transmission of COVID-19, inadequate numbers of nurses for the increasing case numbers, inadequate personal protective equipment and increases in numbers of deaths negatively affected nurses, as they affected all health professionals.

METHODS

This research is phenomenological research. A parallel mixed design including quantitative and qualitative research methods was used in the research. A sociodemographic data form and metaphor perception related to the COVID-19 pandemic form were used for data collection. Responses of nurses to the open-ended metaphor questions were evaluated with descriptive analysis and content analysis using the document investigation method.

RESULTS

The research was completed with 227 nurses. Most of the nurses were employed in COVID-19 wards (68.3%), were not diagnosed with COVID-19 (65.2%) and had not lost any relatives to COVID-19 (59.0%). It was determined that the answers given by the nurses comprised 151 metaphors collected in eight categories in total.

CONCLUSION

The results show that the metaphors mentioned by nurses involve hopelessness.

IMPLICATIONS FOR NURSING MANAGEMENT

This study reflects the ideas of nurses who are working with all their might during the COVID-19 pandemic and reveals the psychological status of the nurses.

Assessment of pandemic (COVID-19) preparedness in a teaching hospital in northern India using available (CDC-Atlanta) checklist

Background:

Hospitals are at the forefront of dealing infectious public health emergencies. Recently, COVID-19 has been declared as pandemic by the World Health Organization. Dealing with COVID-19 pandemic requires high intensity of administrative activity.

Objective:

We conducted this study to assess and compare, objectively, hospital preparedness with available Centre of Disease Control and Prevention (CDC) standards.

Methods:

CDC has issued checklist for the assessment of hospital preparedness for COVID-19 pandemic, globally. This list contains 10 elements with sub-sections. We objectified the same and scored the hospital preparations accordingly. Various financial efforts made by the hospital to procure COVID19-specified items was also recorded.

Results:

As per the CDC checklist, the hospital scored 197 points (72.06%) out of 270 points with highest points in element two and eight. Element two is for the development for written COVID-19 plan. Element eight consists of addressing the occupational health of healthcare workers. Lowest scoring was in the element seven represented visitor access and movement within facility. During the study period, the hospital procured items of approximately 55 lakhs. In the study period, doctors, nursing staff, housekeeping staff, and security staff were channelized for doing COVID-19 duties.

Conclusions:

We obtained a score above 70% (good) which is quite encouraging, and we concluded that pandemic preparations in hospitals are necessary and it can be assessed objectively against prevailing standards. It is important in poor countries like India where spending on healthcare is minimal compared to other countries. Additionally, this assessment can be used to guide us further changes in policies and identifying the gaps in pandemic preparedness in hospitals which require special attention.

Factors influencing protective behavior in the post-COVID-19 period in China: a cross-sectional study

BACKGROUND

The study aimed to explore the factors influencing protective behavior and its association with factors during the post-COVID-19 period in China based on the risk perception emotion model and the protective action decision model (PADM).

METHODS

A total of 2830 valid questionnaires were collected as data for empirical analysis via network sampling in China. Structural equation modeling (SEM) was performed to explore the relationships between the latent variables.

RESULTS

SEM indicated that social emotion significantly positively affected protective behavior and intention. Protective behavioral intention had significant direct effects on protective behavior, and the direct effects were also the largest. Government trust did not have a significant effect on protective behavior but did have a significant indirect effect. Moreover, it was found that government trust had the greatest direct effect on social emotion. In addition, we found that excessive risk perception level may directly reduce people's intention and frequency of engaging in protective behavior, which was not conducive to positive, protective behavior.

CONCLUSION

In the post-COVID-19 period, theoretical framework constructed in this study can be used to evaluate people's protective behavior. The government should strengthen its information-sharing and interaction with the public, enhance people's trust in the government, create a positive social mood, appropriately regulate people's risk perception, and, finally, maintain a positive attitude and intent of protection.

The importance of non-pharmaceutical interventions during the COVID-19 vaccine rollout

The promise of efficacious vaccines against SARS-CoV-2 is fulfilled and vaccination campaigns have started worldwide. However, the fight against the pandemic is far from over. Here, we propose an age-structured compartmental model to study the interplay of disease transmission, vaccines rollout, and behavioural dynamics. We investigate, via in-silico simulations, individual and societal behavioural changes, possibly induced by the start of the vaccination campaigns, and manifested as a relaxation in the adoption of non-pharmaceutical interventions. We explore different vaccination rollout speeds, prioritization strategies, vaccine efficacy, as well as multiple behavioural responses. We apply our model to six countries worldwide (Egypt, Peru, Serbia, Ukraine, Canada, and Italy), selected to sample diverse socio-demographic and socio-economic contexts. To isolate the effects of age-structures and contacts patterns from the particular pandemic history of each location, we first study the model considering the same hypothetical initial epidemic scenario in all countries. We then calibrate the model using real epidemiological and mobility data for the different countries. Our findings suggest that early relaxation of safe behaviours can jeopardize the benefits brought by the vaccine in the short term: a fast vaccine distribution and policies aimed at keeping high compliance of individual safe behaviours are key to mitigate disease resurgence.

Technology intervention for preventing COVID-19 outbreak

Purpose

The purpose for writing this article is derived from the misery and chaos prevalent in the world due to the coronavirus pandemic – since late 2019 and still continuing as of December 2020.

Design/methodology/approach

A blockchain-based solution to verify the country visit trail and disease and treatment history of the passengers who arrive at the immigration counters located at various national borders and entry points is proposed. A fuzzy inference based suspect identifier system is also presented in this article that could be utilized to make further decisions based on the degree of suspicion observed on a particular passenger.

Findings

This paper attempted to put forth a blockchain-based system which consumes the healthcare and visit trail summary of a passenger (appearing for an interview before an immigration officer) and forwards it to a fuzzy inference system to reach to a conclusion that the passenger should be advised to self-quarantine, detained, or should be allowed to enter. Such a system would help to make correct decisions at the immigration counters to check pandemic diseases, like COVID-19, right at the entry points.

Research limitations/implications

The implications of this work are manifold. First, the proposed framework works independent of the type of pandemic and is a readymade tool to check the spread of disease through infected human carriers. Second, the proposed framework will keep the mortality rates under check, which would give ample time for the authorities to save the lives of the people with co-morbidities and age vulnerabilities (Vichitvanichphong et al., 2018). Third, it is a general phenomenon to restrict the flights from the country where the first few cases of infection are discovered; however, the infected person, at the same time, might travel through alternative routes. The blockchain-enabled proposed framework ensures the detection of such cases at no other cost. Finally, the solution may appear costly in the first place, but it has the potential to hold back the revenue of the countries that would otherwise be spent on reactive measures.

Originality/value

As of now no other study or research article provides the solution to the biggest problem persists in the world in this way. The contribution is original and worth applying.

Community risk perception and health-seeking behavior in the era of COVID-19 among adult residents of Harari regional state, eastern Ethiopia

BACKGROUND

COVID-19 brought significant challenges to public health. It changed the view of global health and safety, trust in the healthcare system, and clients' willingness to seek healthcare. To contain the course of the COVID-19 pandemic and its detrimental effects, understanding peoples' health behavior, especially healthcare-seeking, and determining the community risk perception is very important. Thus, this study aimed to determine the health-seeking behavior, community's risk perception to COVID-19 pandemics, and factors influencing the community risk perception in Harari regional state, Ethiopia.

METHODS

Community-based cross-sectional study was conducted from 5 to 30 February 2021. A total of 1320 adult (>18 years) participants were selected using systematic random sampling. The data were collected using an online kobo collect toolbox and analyzed using descriptive statistical tests. Chi-square test and multiple binary logistic regression were applied to examine the difference between variables. A p-value < 0.05 was considered to be of statistical significance.

RESULTS

The study included 1296 respondents >18 years old. The overall prevalence of willingness to seek healthcare in the study area was 35.6% (95% CI: 33%-38.3.0%). The mean cumulative score of risk perception was 30.5 (SD ± 7.25) with the minimum and maximum score of 13 and 63, respectively. A total of 656 (50.6%) of the participants had low-risk perceptions concerning COVID-19. The study found a statistically significant association between risk perception and sociodemographic characteristics (age, educational status, and income), and knowledge of the respondents.

CONCLUSION

The overall prevalence of willingness to seek healthcare was 35.6%. Healthcare intervention aimed to contain the COVID-19 pandemic should consider the factors associated with the study area. Similarly, the study found a low-risk perception among the community that needs critical action to manage the COVID-19 pandemic and to protect the community as a whole. Thus, it is necessary to improve community risk perception through health education.

The Study on Public-Interest Short Message Service (SMS) in China during the COVID-19 Pandemic: Mobile User Survey and Content Analysis

The outbreak of coronavirus disease 2019 (COVID-19) has greatly threatened the global health system and triggered the public health emergency. In order to manage the COVID-19 pandemic, healthcare and prevention information have been delivered through omni-media channels (e.g., television, radio, social platform, etc.). As a traditional outlet, the short message service (SMS) can timely provide abundant anti-epidemic alerts to mobile users. In this paper, we aim to investigate mobile users' attitudes toward COVID-19 public-interest SMS sent from government authorities and then explore the insight from messaging texts collected between January and April 2020 in China. In general, respondents show a positive attitude towards content and the necessity of public-interest SMS during the pandemic. However, we find that gender and age differences not only affect content evaluation, but also influence reading and forwarding behaviors. For the necessity of SMS, it shows significant difference between the 18-25-year-old and over 40-year-old group, with the middle and elder group showing serious attitudes and giving higher remarks than the youth due to the habits of media usage. However no significant difference is presented between females and males. In terms of content, the category of topics and releasing institutions are analyzed, respectively. Due to the centralized responses and coordination of prevention and control in China, the messages from COVID-19 disposal organizations (e.g., municipal steering group and provincial CDC) account for more than 70% among four cities.

Role of Threat and Coping Appraisal in Protection Motivation for Adoption of Preventive Behavior During COVID-19 Pandemic

With more than 100 million cases and over 2 million deaths globally, the COVID-19 pandemic continues to remain a major threat. Identifying the behavioral factors influencing preventive behaviors for COVID-19 are crucial in devising public health policies to promote essential strategies to combat the pandemic in an efficient manner. The current study was therefore conducted to estimate the prevalence of COVID-19 preventive behaviors and measure their association with behavioral constructs like threat perception, response efficacy, and self-efficacy, as per socio-demographic background. A region-stratified online survey focusing on the constructs of protection motivation theory, for example, threat and coping appraisal for preventive health practices against COVID-19, was carried out among adult users of social media in India. Generalized linear models with cluster-adjusted-robust standard errors were used to analyze the responses and model the preventive practices among the study population. Analysis of a total 2,646 responses revealed that proper perceptions regarding cause, symptoms, and transmission of COVID-19 were prevalent in the majority of the respondents. The majority of the participants reported frequent use of face masks (93.20%), followed by frequent washing of hands with soap and water (84.90%). The majority of the respondents affirmed that, though not frequently but sometimes, they avoid touching the face with unclean hands. Frequently covering mouth with the crook of the elbow while sneezing and coughing, and maintaining physical distance when outside was noted among 74.14 and 83.84%, respectively. The proportion of participants frequently using sanitizers to clean hands and those infrequently practicing the same were comparable. Self-efficacy for preventive practices and threat-appraisal of COVID-19 illness were identified as important determinants of the selected COVID-19 preventive behaviors, independently. The analysis confirmed that practices of the behaviors were mostly synergistic to each other. Current findings highlight that formulation of precise risk communication strategies to improve perceptions regarding threat appraisal and self-efficacy could facilitate desirable practices, which are also effective in the prevention of airborne infections and, hence, may contribute toward broader policy directions. The evidence urges the implementation of precision-driven risk communication and diffusion of these practices to attain behavioral herd immunity.

Factors Related to COVID-19 Preventive Behaviors: A Structural Equation Model

Background: While COVID-19 has rapidly spread around the world, and vaccines are not widely available to the general population, the World Health Organization outlines preventive behavior as the most effective way to limit the rapid spread of the virus. Preventive behavior is associated with a number of factors that both encourage and discourage prevention. Aim: The aim of this research was to study COVID-19 threat appraisal, fear of COVID-19, trust in COVID-19 information sources, COVID-19 conspiracy beliefs and the relationship of socio-demographic variables (gender, age, level of education, place of residence, and employment status) to COVID-19 preventive behavior. Methods: The data originate from a national cross-sectional online survey (N = 2,608) undertaken in July 2020. The data were analyzed using structural equation modeling. Results: COVID-19 threat appraisal, trust in COVID-19 information sources, and fear of COVID-19 are all significant predictors of COVID-19 preventive behaviors. Together they explain 26.7% of the variance of this variable. COVID-19 conspiracy beliefs significantly negatively predict COVID-19 threat appraisal (R 2 = 0.206) and trust in COVID-19 information sources (R 2 = 0.190). COVID-19 threat appraisal contributes significantly and directly to the explanation of the fear of COVID-19 (R 2 = 0.134). Directly, as well as mediated by COVID-19 conspiracy beliefs, threat appraisal predicts trust in COVID-19 information sources (R 2 = 0.190). The relationship between COVID-19 threat appraisal and COVID-19 preventive behaviors is partially mediated by fear of COVID-19 (indirect effect 28.6%) and trust in information sources (15.8%). Socio-demographic variables add very little in prediction of COVID-19 preventive behavior. Conclusions: The study results demonstrate that COVID-19 threat appraisal is the most important factor associated with COVID-19 preventive behavior. Those Latvian residents with higher COVID-19 threat appraisal, experienced higher levels of fear of COVID-19, had more trust in COVID-19 information sources, and were more actively involved in following COVID-19 preventive behaviors. COVID-19 conspiracy beliefs negatively predict COVID-19 threat appraisal and trust in COVID-19 information sources, but not the COVID-19 preventive behaviors. Socio-demographic factors do not play an important role here.