Functional Fear Predicts Public Health Compliance in the COVID-19 Pandemic

Changes in Viral Dynamics Following the Legal Relaxation of COVID-19 Mitigation Measures in Japan From Children to Adults: A Single Center Study, 2020-2023

INTRODUCTION

Respiratory infections are an ongoing global health challenge. The COVID-19 pandemic triggered global nonpharmacological measures that reshaped public health. In Japan, the shift from legal to individual discretion in pandemic management started on May 8, 2023. However, it still unknown how the relaxation of measures affects respiratory pathogens across age groups.

METHODS

We collected 16,946 samples from 13,526 patients between February 2020 and September 2023, analyzing the circulating respiratory pathogen dynamics using FilmArray respiratory panel.

RESULTS

Our analysis revealed significant increases in the positivity rates of respiratory pathogens across multiple age groups after relaxation. The pathogens including adenovirus, Bordetella pertussis, parainfluenza 2 and parainfluenza 4 showed increased positivity predominantly in children aged under 10 years. Conversely, some pathogens including human metapneumovirus, rhinovirus/enterovirus, and respiratory virus (RSV) increased in broad range of age groups. SARS-CoV-2 positivity rates decreased in children under 10 years but increased in those aged over 60 years.

DISCUSSION

Age-stratified analysis reveals a dynamic pattern of circulating pathogen in each age group after relaxation measures. This study provides essential epidemiologic data that can guide strategies to protect different age groups and effectively respond to respiratory infections in post-COVID-19 era.

Associated factors for fear of COVID-19 scale in long-term care settings in Spain

OBJECTIVE

To examine the relationship between the Fear of COVID-19 Scale (FCV-19S) score and sociodemographic, health, emotional and behavioural factors, in a cross-sectional observational study in 447 older adults living in long-term care (LTC) settings in Madrid (Spain).

METHODS

The sample was stratified by nursing home ownership, geographical location, and size. Multiple linear regression analysis was used using backward elimination to identify factors that explained associations with fear, and logistic regression models were used to examine its role as a predictor of adherence to preventive measures.

RESULTS

The mean age of the participants was 83.8 years, most were female, had had COVID-19, and were worried about the pandemic. The average score of the FCV-19S was 18.36 (SD: 8.28; range: 7-35), and the variables associated in the multiple linear regression model (explained variance: 34.00%) were being female, lower level of education, satisfaction with life and the residential home, and higher worry about the pandemic. The logistic regression models showed that fear of COVID-19 was a predictor of adherence to preventive measures like wearing facemasks, washing hands, and avoiding physical contact.

CONCLUSIONS

fear of COVID-19 was significantly related with sex and subjective factors as life satisfaction and worry; and it influences older people's preventive behaviour. Interventions aimed at reducing fear and promoting adherence to preventive measures would improve their mental health and well-being.

Understanding the Design of Fear Appeals by Applying the Extended Parallel Process Model: A Qualitative Analysis of COVID-19 Public Service Announcements

PURPOSE

Identify how early COVID-19 public health messages incorporated in the tenets of the extended parallel process model (EPPM).

SETTING

YouTube videos developed by governmental departments, medical institutions, news organizations, and non-profit organizations in the United States were aggregated.

METHOD

This qualitative study conducted a keyword search to identify public service announcements (PSAs). The sample was further refined after searching PSAs that contained fear appeals. A thematic analysis was performed by using the constant comparative method.

SAMPLE

A total of forty-three videos was included in the final analysis.

RESULT

Two themes emerged regarding messages aimed at arousing the perceived severity of threat. These themes include emphasizing the consequences of being infected and utilizing personal narratives. Perceived susceptibility of threat was aroused by emphasizing that some groups have higher risks than others. Two themes emerged around arousing perceived response efficacy: (1) the authority of professionals; and (2) altruism and personal responsibility. One way was identified to arouse perceived self-efficacy, which is informing the protective measures.

CONCLUSION

Multiple strategies were used in PSAs about COVID-19 to arouse fear during the early stages of the pandemic. The utilization of self-efficacy was oversimplified, by not providing details about the rationale for the recommended behavior.

Assessing the perceived effect of non-pharmaceutical interventions on SARS-Cov-2 transmission risk: an experimental study in Europe

We conduct a large (N = 6567) online experiment to measure the features of non-pharmaceutical interventions (NPIs) that citizens of six European countries perceive to lower the risk of transmission of SARS-Cov-2 the most. We collected data in Bulgaria (n = 1069), France (n = 1108), Poland (n = 1104), Italy (n = 1087), Spain (n = 1102) and Sweden (n = 1097). Based on the features of the most widely adopted public health guidelines to reduce SARS-Cov-2 transmission (mask wearing vs not, outdoor vs indoor contact, short vs 90 min meetings, few vs many people present, and physical distancing of 1 or 2 m), we conducted a discrete choice experiment (DCE) to estimate the public's perceived risk of SARS-CoV-2 transmission in scenarios that presented mutually exclusive constellations of these features. Our findings indicate that participants' perception of transmission risk was most influenced by the NPI attributes of mask-wearing and outdoor meetings and the least by NPI attributes that focus on physical distancing, meeting duration, and meeting size. Differentiating by country, gender, age, cognitive style (reflective or intuitive), and perceived freight of COVID-19 moreover allowed us to identify important differences between subgroups. Our findings highlight the importance of improving health policy communication and citizens' health literacy about the design of NPIs and the transmission risk of SARS-Cov-2 and potentially future viruses.

Exploratory study to characterise the individual types of health literacy and beliefs and their associations with infection prevention behaviours amid the COVID-19 pandemic in Japan: a longitudinal study

Background

During a global infectious disease pandemic such as the coronavirus disease 2019 (COVID-19), individuals' infection prevention/risk-taking behaviours are likely to differ depending on their health literacy and beliefs regarding the disease. To effectively promote infection prevention behaviours, it is necessary to enable information dissemination and risk communication that consider individuals' health literacy and beliefs. In this study, we exploratorily characterised segments based on individual health literacy and beliefs regarding COVID-19 among the Japanese during the early stage of the COVID-19 pandemic, and investigated whether infection prevention/risk-taking behaviours and fear of COVID-19 differed among these segments.

Methods

In this study, we conducted two web-based longitudinal surveys in Japan (PHASE 1, 1-30 November 2020, 6,000 participants; PHASE 2, 1-31 December 2020, 3,800 participants). We characterised segments of the target population using cluster analysis on health literacy and beliefs regarding COVID-19 obtained in PHASE 1. We further investigated the associations between the clusters and infection prevention/risk-taking behaviours and fear of COVID-19, obtained from PHASE 2.

Results

Five clusters were identified: 'Calm/hoax denial', 'Hoax affinity/threat denial', 'Minority/indifference', 'Over vigilance', and 'Optimism'. There were significant differences in infection prevention/risk-taking behaviours and fear of COVID-19 among the five clusters. The belief in susceptibility to infection, rather than affinity for hoaxes and conspiracy theories, was coherently associated with infection prevention/risk-taking behaviours and fear of infection across clusters. This study provides foundational knowledge for creating segment-specific public messages and developing interactive risk communication to encourage infection prevention behaviours.

Why Do We Not Wear Masks Anymore during the COVID-19 Wave? Vaccination Precludes the Adoption of Personal Non-Pharmaceutical Interventions: A Quantitative Study of Taiwanese Residents

Background and Objectives: This study examined whether the decline in people's adoption of personal NPIs (e.g., mask wearing) results from the preclusion by vaccination. This study also incorporates the concepts of risk perception and the risk-as-feelings model to elucidate the possible mechanisms behind this preclusion. Materials and Methods: Two cross-sectional surveys (N = 462 in Survey 1 and N = 505 in Survey 2) were administered before and during the first outbreak of COVID-19 in Taiwan. The survey items were designed to measure participants' perceived severity of COVID-19, worry about COVID-19, intention to adopt personal NPIs, and attitudes toward COVID-19 vaccines. Utilizing the risk perception framework, we conducted multigroup SEM (Structural Equation Modeling) to construct the optimal structural model for both samples. Results and Conclusions: The multigroup SEM results showed that worry (i.e., the emotional component of risk perception) fully mediates the influence of the perceived severity of COVID-19 (i.e., the cognitive component of risk perception) on the intention to adopt NPIs in both surveys [z = 4.03, p < 0.001 for Survey 1 and z = 2.49, p < 0.050 for Survey 2]. Before the outbreak (i.e., Survey 1), people's attitudes toward COVID-19 vaccines showed no significant association with their worry about COVID-19 [z = 0.66, p = 0.508]. However, in Survey 2, following the real outbreak of COVID-19, people's attitudes toward COVID-19 vaccines negatively predicts their worry about COVID-19 [z = -4.31, p < 0.001], indirectly resulting in a negative effect on their intention to adopt personal NPIs. This suggests the occurrence of the Peltzman effect. That is, vaccination fosters a sense of safety, subsequently diminishing alertness to COVID-19, and thus reducing the intention to adopt personal NPIs.

The Effect of the COVID-19 Pandemic on Palestinian Patients Attending Selected Governmental Hospitals: An Analysis of Hospital Records

INTRODUCTION

Confronting the COVID-19 epidemic forced the closure or relocation of the majority of health facilities. It is likely that non-COVID-19 patients suffered collateral effects.

METHODS

The clinic and operating room records were analyzed at selected Palestinian government hospitals in the West Bank region.

RESULTS

The reduction in patient clinic visits varied from 49% to 90%, with Ear-Nose-Throat (ENT), urology, and pediatric clinics being the most affected. The reduction in operation numbers in the center (which had independent decision-making) ranged from 7.1% to 23.4%, but in the north and south (which followed centralized choices), the reduction ranged from 19.6% to 91.8%.

CONCLUSIONS

COVID-19 affected outpatient visits. The pandemic affected some services, but West Bank hospitals were able to provide normal obstetric and gynecological treatments and help patients who needed primary or intermediate surgery.

Comparing the language style of heads of state in the US, UK, Germany and Switzerland during COVID-19

The COVID-19 pandemic posed a global threat to nearly every society around the world. Individuals turned to their political leaders to safely guide them through this crisis. The most direct way political leaders communicated with their citizens was through official speeches and press conferences. In this report, we compare psychological language markers of four different heads of state during the early stage of the pandemic. Specifically, we collected all pandemic-related speeches and press conferences delivered by political leaders in the USA (Trump), UK (Johnson), Germany (Merkel), and Switzerland (Swiss Federal Council) between February 27th and August 31st, 2020. We used natural language analysis to examine language markers of expressed positive and negative emotions, references to the community (we-talk), analytical thinking, and authenticity and compare these language markers across the four nations. Level differences in the language markers between the leaders can be detected: Trump's language was characterized by a high expression of positive emotion, Merkel's by a strong communal focus, and Johnson's and the Swiss Federal Council by a high level of analytical thinking. Overall, these findings mirror different strategies used by political leaders to deal with the COVID-19 pandemic.

Unveiling the global nexus: Pandemic fear, government responses, and climate change-an empirical study

This study examined the relationships between pandemic fear, government responses, and climate change using a time-series dataset from January 1, 2020, to December 31, 2020. By employing an auto-regressive distributed lag (ARDL) approach, the results revealed that pandemic fear significantly impacts climate change, while government responses to COVID-19 negatively influence climate change in the long run. Climate change and government responses significantly positively affect pandemic fear in the long run. Moreover, we found a bidirectional causality between government responses and climate change, unidirectional causality from government responses to pandemic fear, and no Granger causality between pandemic fear and climate change. Our findings have some important policy implications. Governments must encourage coordination, enhance crisis responses, and consider revising economic metrics to maintain environmental sustainability. The COVID-19 experience can inform strategies for reducing CO2 emissions and investing in green economies and healthcare to prepare for future challenges.

Mechanism study of social media overload on health self-efficacy and anxiety

Previous studies have found that people's excessive use of social media may have a negative impact on their crisis coping skills. This study focuses on the effects of social media overload (information overload, communication overload and social overload) on anxiety and health self-efficacy during the COVID-19 pandemic. The study used an online questionnaire and partial least squares structural equation modeling (PLS-SEM) to obtain data (816 valid samples), analyze the data and validate the model. The findings revealed that social media overload (information overload, communication overload and social overload) triggers increased social media fatigue, which in turn leads to the development of anxiety and the consequence of diminished health self-efficacy; social media fatigue plays a partially mediating role between social media and health self-efficacy and a fully mediating role between communication overload and health self-efficacy. The results of this study can inform the development of crisis communication strategies during public health emergencies.

Do first responders and populations perceive risks similarly? A comparative study of seven countries

Introduction

Risk perception illustrates the subjective evaluation of individuals concerning the characteristics, severity, and capacity to cope with potential hazards. Risk perception influences attitudes and actions individuals take to protect themselves from future threats. Risk perceptions might change among different stakeholder groups such as society and first responders. Identifying risk perceptions of stakeholders is essential to establish effective protective measures.

Method

This study investigated the commonalities and diversities in risk perception among first responders and the public, within and between seven European and beyond countries. A self-administered questionnaire was used to gather data from both first responders and civilians. They were asked to assess their risk perception level for five categories of risks (Extreme weather-related events, nature-related events, social disruptions, critical services dependencies, and pandemics).

Results

Using Univariate Analysis of Variance showed disparity concerning both the levels of risk perception between the public and first responders, as well as their relative ranking. For example, concerning extreme weather-related and nature-related events, risk perception levels of the first responders is higher than that of the population in six out of the seven studied countries. In contrast, the population's risk perception is higher compared to the first responders in six out of the seven countries, concerning critical infrastructure dependencies and pandemics.

Discussion

The relative gaps between the first responders versus the population, within each country, vary considerably. Norway for example presents significant differences between the two internal populations concerning all risks (except for extreme weather), while in Sweden, no significant gaps were identified, concerning all five risks.

Lessons from COVID-19 for GCR governance: a research agenda

The Lessons from Covid-19 Research Agenda offers a structure to study the COVID-19 pandemic and the pandemic response from a Global Catastrophic Risk (GCR) perspective. The agenda sets out the aims of our study, which is to investigate the key decisions and actions (or failures to decide or to act) that significantly altered the course of the pandemic, with the aim of improving disaster preparedness and response in the future. It also asks how we can transfer these lessons to other areas of (potential) global catastrophic risk management such as extreme climate change, radical loss of biodiversity and the governance of extreme risks posed by new technologies. Our study aims to identify key moments- 'inflection points'- that significantly shaped the catastrophic trajectory of COVID-19. To that end this Research Agenda has identified four broad clusters where such inflection points are likely to exist: pandemic preparedness, early action, vaccines and non-pharmaceutical interventions. The aim is to drill down into each of these clusters to ascertain whether and how the course of the pandemic might have gone differently, both at the national and the global level, using counterfactual analysis. Four aspects are used to assess candidate inflection points within each cluster: 1. the information available at the time; 2. the decision-making processes used; 3. the capacity and ability to implement different courses of action, and 4. the communication of information and decisions to different publics. The Research Agenda identifies crucial questions in each cluster for all four aspects that should enable the identification of the key lessons from COVID-19 and the pandemic response.

The Mediating Role of Fear of COVID-19 in the Association between COVID-19-Related Work Stressors and Subjective Well-being: Path Analysis by Cross-sectional Evidence in the Child Care Sector across Three Samples

OBJECTIVE

COVID-19 has changed work conditions and instilled fear. However, research overlooked the contributing factors to fear of COVID-19 and its impact on well-being. We addressed this research gap and focused on the essential workforce of child care.

METHODS

Three samples of early childhood professionals (ECPs) ( NT1 = 423, NT2 = 142, NT3 = 584) were gathered in Germany between June 2020 and May 2021. We tested via path analysis whether (1) fear of COVID-19 relates to well-being, (2) COVID-19-related work stressors relate to fear of COVID-19, and (3) fear of COVID-19 mediates the relationship of work stressors and well-being.

RESULTS

Findings of N T1 and N T3 lent support, while results of N T2 differed.

CONCLUSIONS

This study underlines the importance of adapting the work conditions during pandemics to reduce the fear of infection and thus preserve ECPs' well-being.

Maternal worry of children contracting COVID-19 predicts vaccine uptake in young children in Vermont

Background

Young children, 6 months to 4 years of age, were the last population for whom the COVID-19 vaccines became available and remain the group with the lowest uptake. Scarce information exists on drivers of vaccine uptake in young children. The relationship between parental perceived risk of infection and child COVID-19 vaccination is unknown.

Objective

Examine the association between perceived risk of infection and early childhood vaccination.

Methods

In June 2020, perinatal women in Vermont were enrolled in a longitudinal survey study assessing life changes during the pandemic. Surveys included worry of infection, Parents Attitude about Childhood Vaccines (PACV), intention to vaccinate children with the COVID-19 vaccine, and masking behaviors. Once vaccines became available, surveys also included child vaccination status. A demographic-adjusted stepwise logistic regression was conducted to assess the relationship of worry of infection and vaccine hesitancy on child vaccination status.

Results

85 women completed baseline and follow up surveys. Participants were highly adherent to adult COVID vaccines with 93 % at least partially vaccinated and only 3 % demonstrated general childhood vaccine hesitancy on the PACV. However, in this highly adherent population, only 61 % of young children are vaccinated. In univariate [OR = 7.35 95 % CI (2.70 to 20.02)] and demographic adjusted [OR = 6.03 95 % CI (1.30 to 27.90)] models, current worry about child infection was associated with higher odds of child vaccination. Previously established predictors, vaccine hesitancy [OR = 0.91 95 % CI (0.84 to 0.99)] and younger maternal age [OR = 1.33 95 % CI (1.07 to 1.65)] were again associated lower odds of child vaccination.

Conclusion

Among vaccine adherent parents, worry of infection was a strong predictor of vaccine uptake. Continued efforts to articulate the potential morbidity of COVID in young children, along with established methods to address general vaccine hesitancy may aid in COVID vaccine uptake in this population.

Fear, Stress, Susceptibility, and Problematic Social Media Use Explain Motivation for COVID-19 Preventive Behaviors Among Patients With Stroke and Their Caregivers

The COVID-19 pandemic presented significant challenges for individuals who experienced stroke and their caregivers. It is essential to understand the factors affecting preventive behavior in these populations. Therefore, the present study examined the factors that influenced COVID-19 preventive behavior and motivation for COVID-19 vaccine uptake among patients with stroke and their caregivers. A cross-sectional study comprising 191 participants (81 patients with stroke and 110 caregivers) was carried out. Participants completed a survey assessing fear of COVID-19, stress, perceived susceptibility, problematic social media use, preventive behaviors, and motivation for vaccine uptake. Statistical analyses included descriptive statistics, Pearson correlations, and multiple linear regressions. Motivation for COVID-19 vaccine uptake was significantly positively correlated with problematic social media use (r = 0.225, P = .002), perceived susceptibility (r = 0.197, P = .008), and fear of COVID-19 (r = 0.179, P = .015), but negatively correlated with stress (r = -0.189, P = .010). Caregivers, compared to patients, showed a lower level of preventive behavior (standardized coefficient = -0.23, P = .017). Furthermore, higher levels of fear were associated with increased preventive behavior (standardized coefficient = 0.22, P = .006), while greater stress correlated with lower preventive behavior (standardized coefficient = -0.38, P < .001). Among patients with stroke and their caregivers, motivation of COVID-19 vaccine uptake and preventive behaviors were influenced by factors such as fear, perceived susceptibility, social media use, and stress. By using strategies such as targeted education, support, and communication campaigns, healthcare providers and policymakers may be able to enhance the well-being of patients with stroke and their caregivers during future pandemics.

When and Why Do People Accept Public-Policy Interventions? An Integrative Public-Policy-Acceptance Framework

The successful introduction of public policies to prompt behavior change hinges on the degree to which citizens endorse the proposed policies. Although there is a large body of research on psychological determinants of public policy acceptance, these determinants have not yet been synthesized into an integrative framework that proposes hypotheses about their interplay. In this article, we develop a review-based, integrative public-policy-acceptance framework that introduces the desire for governmental support as a motivational foundation in public-policy acceptance. The framework traces the route from problem awareness to policy acceptance and, ultimately, policy compliance. We propose this relationship to be mediated by a desire for governmental support. We integrate numerous key variables assumed to qualify the relationship between problem awareness and the desire for governmental support, such as control attributions, trust, and value fit, as well as the relationship between the desire for governmental support and policy acceptance, such as perceived policy effectiveness, intrusiveness, and fairness. We exemplify the use of the proposed framework by applying it to climate policies.

Assessment of Nurses Fear Working in COVID-19 Pandemic Hospitals

Introduction

Nurses play pivotal roles in various facets of managing the COVID-19 epidemic, encompassing tasks such as identifying potential cases with infections, managing suspected patients, conducting patient assessments, and providing critical care to individuals afflicted with COVID-19.

Objective

The objective of this study was to assess the level of COVID-19 fear among nurses who care for infected or suspected COVID-19 patients in pandemic hospitals.

Methods

A cross-sectional study was conducted on 260 nurses employed at COVID-19 hospitals in Palestine. The Fear of COVID-19 Scale (FCV-19S) was employed to measure participants' fear levels. The scale's potential values range from 7 to 35, with higher scores indicating a greater fear of COVID-19. Independent t-tests and ANOVA tests were utilized to evaluate differences between the variables.

Results

The analysis revealed that the mean total fear score of the nurses was 25.22 ± 5.07 (ranging from 7 to 35), indicating a high level of fear. Married nurses exhibited a fear mean score of 27.0 ± 4.9 (p < 0.05). Similarly, nurses with children scored a mean fear level of 29.0 ± 4.6 (p < 0.05). Additionally, nurses engaged in rotating shift work reported a fear mean score of 27.9 ± 4.4 (p < 0.05). Furthermore, nurses who received COVID-19 training exhibited a fear mean score of 24.6 ± 4.8 (p < 0.05). Likewise, nurses who experienced patient loss due to COVID-19 reported a fear mean score of 23.2 ± 4.5 (p < 0.05).

Conclusion

The study confirmed that nurses in Palestine exhibit a significant level of fear concerning COVID-19. Marital status, having children, working schedule, experiencing the loss of a patient due to COVID-19, and receiving training related to COVID-19 were identified as factors associated with the fear of COVID-19 among nurses.

The association of changes in leisure-time physical activity on depressive symptoms during Covid-19 in German adults: A longitudinal study

This longitudinal survey assessed preventive and curative antidepressant effects of at least 75 min/week of leisure-time physical activity (LTPA) at different timepoints of the Covid-19 pandemic. We further investigated if high self-regulation skills were associated with higher odds of initiating or maintaining LTPA during the pandemic. Data was collected online from 4253 participants (age: m = 33.65 years, SD = 0.79; 79 % female) during the first quarantine measures in Germany (T1), as well as 4 weeks (T2), and 8 months (T3) later. We performed linear mixed models with changes (T2-T1, T3-T1) in LTPA and baseline major depressive disorder (MDD) as predictors (main effects and interaction effect) and depressive symptoms (at T2, T3) as the primary outcome. We found significant interaction effects of baseline depression and change in LTPA on depressive symptoms at T2 and T3 (p < 0.001). For probable cases of MDD an increasing LTPA to ≥75 min/week (vs. no change, <75 min/week) was associated with less depressive symptoms at T2 and T3 (p = 0.003, d = 0.28). For absence of depression at baseline, remaining at ≥75 min/week of LTPA was associated with less depressive symptoms at T2 and T3 compared to remaining at <75 min/week (p = 0.006, d = 0.11) or decreasing LTPA to <75 min/week (p = 0.018, d = 0.11). Reporting high self-regulation at T1 was associated with higher odds of performing ≥75 min/week of LTPA at T2/T3 (OR = 1.74, p < 0.001). In general, studies report reduced LTPA during Covid-19. To benefit from the reported preventive and interventional effects, further interventions should focus on improving physical activity related self-regulation to identify and overcome barriers for LTPA.

Fear of COVID-19, Stress and Coping Strategies among Nurses during the COVID-19 Pandemic's Second Wave: A Quasi-Intervention Study

Background

The COVID-19 pandemic and its related consequences caused a higher risk of mental health problems for nurses. Hence, this study aims to reduce the level of fear and stress related to the COVID-19 pandemic and promote active coping among Egyptian nurses.

Methods

This quasi-intervention study was conducted on 125 nurses working at Benha's University hospitals, who were selected by a systematic random sampling technique within the time interval of March 2021 to July 2021. The study was conducted using the fear of COVID-19 scale, the stress scale of depression, anxiety and stress scales, and the Brief (COPE) inventory scale.

Results

The mean ages of the studied nurses were 36.70 ± 9.50. Almost half of the studied nurses were males and married. Before the intervention, 47.2% of nurses had severe stress levels while 82.4% had a high level of fear of COVID-19. Experience years, type of department, and worries about vaccine side effects were the predictors of the fear of COVID-19. A significant difference (p = .000) was found between both mean stress and fear scores pre-intervention (15.27 ± 5.47 and 25.56 ± 6.13) and post-intervention (4.87 ± 2.14 and 11.92 ± 2.43). The most prevalent coping strategies among nurses before the intervention were self-distraction (5.03 ± 1.53), followed by behavioral disengagement and self-blaming. However, after the intervention, religion was found to be the utmost coping mechanism (6.12 ± 1.17), followed by positive reframing and acceptance.

Conclusion

The majority of the nurses in the study reported a significant fear of COVID-19, and around half of the nurses had severe stress as a result. After the intervention, the stress and fear scores were reduced by half or even less. Age, longer work experience, and worries about the vaccine were the predictors of fear of COVID-19. The coping strategies used after the intervention shifted toward active coping strategies. Clinical Trial Registration Number: 10-11-008-701.

Trust in government moderates the association between fear of COVID-19 as well as empathic concern and preventive behaviour

With the COVID-19 pandemic, behavioural scientists aimed to illuminate reasons why people comply with (or not) large-scale cooperative activities. Here we investigated the motives that underlie support for COVID-19 preventive behaviours in a sample of 12,758 individuals from 34 countries. We hypothesized that the associations of empathic prosocial concern and fear of disease with support towards preventive COVID-19 behaviours would be moderated by trust in the government. Results suggest that the association between fear of disease and support for COVID-19 preventive behaviours was strongest when trust in the government was weak (both at individual- and country-level). Conversely, the association with empathic prosocial concern was strongest when trust in the government was high, but this moderation was only found at individual-level scores of governmental trust. We discuss how motivations may be shaped by socio-cultural context, and outline how findings may contribute to a better understanding of collective action during global crises.

Mapping the association between mental health and people's perceived and actual ability to practice hygiene-related behaviours in humanitarian and pandemic crises: A scoping review

Humanitarian crises such as disease outbreaks, conflict and displacement and natural disasters affect millions of people primarily in low- and middle-income countries. Here, they often reside in areas with poor environmental health conditions leading to an increased burden of infectious diseases such as gastrointestinal and respiratory infections. Water, sanitation, and hygiene behaviours are critical to prevent such infections and deaths. A scoping review was conducted to map out what is known about the association between three mental health disorders and people's perceived and actual ability to practice hygiene-related behaviours, particularly handwashing, in humanitarian and pandemic crises. Published and grey literature was identified through database searches, humanitarian-relevant portals, and consultations with key stakeholders in the humanitarian sector. 25 publications were included, 21 were peer-reviewed published articles and four were grey literature publications. Most of the studies were conducted in mainland China (n = 12) and most were conducted in an outbreak setting (n = 20). Six studies found a positive correlation between handwashing and anxiety where participants with higher rates of anxiety were more likely to practice handwashing with soap. Four studies found an inverse relationship where those with higher rates of anxiety were less likely to wash their hands with soap. The review found mixed results for the association between handwashing and depression, with four of the seven studies reporting those with higher rates of depression were less likely to wash their hands, while the remaining studies found that higher depression scores resulted in more handwashing. Mixed results were also found between post-traumatic stress disorder (PTSD) and handwashing. Two studies found that lower scores of PTSD were associated with better hygiene practices, including handwashing with soap. The contradictory patterns suggest that researchers and practitioners need to explore this association further, in a wider range of crises, and need to standardize tools to do so.

Fear of COVID-19 when experiencing pregnancy or childbirth in the pandemic: what are the associated factors?

OBJECTIVE

to identify factors associated with fear of COVID-19 among women who experienced pregnancy or childbirth during the pandemic.

METHODS

a cross-sectional study, nested within a prospective cohort, using an online survey, from August 2021 to February 2022, based on descriptive data analysis.

RESULTS

of the 431 participants, 52.8% were postpartum women and 20.1% were pregnant women. With regard to fear of COVID-19, a mean score of 20.46 was obtained (moderate fear). The highest fear scores were present in women whose newborns were admitted to hospital in neonatal critical units (p=0.032), and the lowest among those covered by supplementary health (insurance) (p=0.016).

CONCLUSION

among pregnant and postpartum women, high fear of COVID-19 translated into the possibility of having newborns admitted to hospital in a critical unit. The importance of supporting actions to support pregnant/postpartum women's mental health in relation to COVID-19 or other threats that may influence the neonatal outcome stands out.

Partying during a pandemic: role of descriptive partying norms, residence, college alcohol beliefs, and political ideology in COVID-19 party behavior

OBJECTIVE

Non-adherence to COVID-19 guidelines is a major public health issue. This study explored factors that explain college student party behavior (PB; defined as attending a college party wherein COVID-19 guidelines, including masks and social distancing were ignored) during the pandemic.

METHOD

Freshmen students at a northeastern university (N = 207; 72% women) responded to an online Fall 2020 semester survey.

RESULTS

The percentage of students who participated in on-campus partying during past month was 11.6%, with 20.3% participating in off-campus partying. Living on campus and higher perceived norms for partying were associated with higher levels of on-campus PB, whereas higher perceived norms for partying, stronger college alcohol beliefs, and a more conservative political ideology accounted for significant variance in off-campus PB.

CONCLUSIONS

Efforts to reduce party behavior should target misperception of party behavior norms as well as college alcohol beliefs, and take into account students' residence and political ideology.

Assessment of implicit COVID-19 attitudes using affective priming for pro-vaccine and vaccine-hesitant individuals

The COVID-19 pandemic has resulted in the introduction of pharmaceutical and non-pharmaceutical interventions such as precautionary behaviours. The current study used affective priming to evaluate COVID-19 attitudes in vaccine-hesitant and pro-vaccine participants. Explicitly, both groups rated their overall perception of risk associated with contracting COVID-19 significantly lower compared to their perception of necessary precautions and overall adherence to public health measures. Pro-vaccine participants rated their perception of necessary precautions higher compared to vaccine-hesitant participants. During baseline measures, both groups classified COVID-19 affiliated words as unpleasant. Affective priming was observed for congruent prime-target pleasant and unpleasant word pairs but was not observed for COVID-19 related word pairs. Differences between groups in the perception of necessary public health precautions points to different underlying pathways for reduced perceived risk and lack of affective priming. These results refine previous findings indicating that implicit attitudes towards COVID-19 can be measured using the affective priming paradigm.

Exploring the perceptions and lived experiences of family members living with people diagnosed with COVID-19 in South Africa: a descriptive phenomenological study

BACKGROUND

The incidence and prevalence of COVID-19 continues to escalate globally, with the consequence to quality of life, the economies of nations and various sectors of society. While there is substantial research on the impact and experiences of the COVID-19 pandemic, little remains known about the perceptions and lived experiences of families living with people diagnosed with COVID-19, particularly within the South African context.

PURPOSE

To explore the perceptions and lived experiences of family members  living with people diagnosed with COVID-19 in South Africa.

METHODS

A descriptive phenomenological design was used. Data were collected from 15 participants who were family members of people diagnosed with COVID-19 in South Africa. Purposive snowball sampling was used to identify and recruit participants, and data were collected at community level in KwaZulu-Natal, Western Cape and Gauteng, South Africa. Individual in-depth interviews were used to collect the data, and an audio tape was used to record all interviews. Data were transcribed verbatim and analysed using a phenomenological data analysis processes. Ethical approval to conduct the study was obtained from the University of KwaZulu-Natal Research Ethics Committee-reference number: BREC00003228/2021.

RESULTS

Four super-ordinate themes emerged in relation to the perceptions and lived experiences of family members  living with people diagnosed with COVID-19 in South Africa. The superordinate themes were: (1) sources of information about COVID-19, (2) pandemic  perceptions and experiences, (3) impact of diagnosis and related burden and (4) aftermath of living with a family member diagnosed with COVID-19.

DISCUSSION AND CONCLUSION

Family members' perceptions and lived experiences of COVID-19 are largely influenced by media, moreover, the impact of diagnosis has consequences for the physical, mental and emotional well-being of family members. Diagnosis disrupts family dynamics by depleting financial resources due to  the caregiver burden experienced. The findings thus imply that provision of psychosocial support is imperative for families living with persons diagnosed with COVID-19.

Attitudes toward COVID-19 restrictions and COVID-19-related stress and fear among college students across three waves

Background and Aims

The COVID-19 pandemic has significantly impacted the mental health of college students, leading to increased psychological distress. This study explored potenital predictors to better understand the factors that influence and mitigate student COVID-19 stress in the evolving landscape of residential colleges. Specifically, we investigated the roles of COVID-19 fear, loneliness, and attitudes toward COVID-19 restrictions.

Methods

Employing a longitudinal online survey design, we collected data over the fall 2020 semester from 122 first-year college students enrolled in a small mid-west liberal arts college. Participants completed the same survey three times: Wave 1 in August, Wave 2 in October, and Wave 3 in November.

Results

Fear of COVID-19 (Time 1) was a significant predictor of increased COVID-19 related stress at both Time 2 and Time 3. Interestingly, loneliness (Time 1) moderated the effect of fear of COVID-19 (Time 1) on attitudes toward COVID-19 restrictions at Time 2. Moreover, students' negative attitudes toward COVID-19 restrictions and feelings of loneliness increased over the course of the semester.

Conclusions

These findings suggest that college students' wellbeing in the context of COVID-19 stress is influenced by a complex interplay of perceptions of COVID-19 (stress, fear, attitudes) and feelings of social isolation (loneliness). Further research in this area is crucial to provide targeted support and interventions to promote students' mental health.

Investigating the factors related to protective behaviors against COVID-19 in healthcare workers: Application of extended parallel process model

Background and Aims

Preventive behaviors against coronavirus disease 2019 (COVID-19) are important, and messages that create a sense of danger are necessary to create these behaviors. One of the widely used models for designing risk messages is the Extended Parallel Process Model (EPPM). The present study was conducted to investigate the factors related to protective behaviors against COVID-19 in the personnel of the health department based on EPPM.

Methods

In this cross-sectional study, 699 personnel of the deputy health department of Chaharmahal and Bakhtiari province were included in the study by census method. Data were collected online using valid questionnaires, including demographic questions and history of contracting COVID-19 and the questionnaire of EPPM constructs. Data were analyzed in SPSS24 software, using descriptive and analytical statistics.

Results

The results showed that there were positive correlations between the protective behaviors and the constructs of perceived severity (p < 0.001, r = 0.542), perceived susceptibility (p < 0.001, r = 0.260), self-efficacy (p < 0.001, r = 0.594), response efficiency (p > 0.001, r = 0.522), and risk control (p > 0.001, r = 0.501). There was a negative correlation between protective behaviors and fear control (p < 0.001, r = 0.329). The results of multiple linear regression showed that these six constructs explained 49.8% of protective behaviors against COVID-19, among which the role of the perceived severity construct was stronger than other constructs.

Conclusion

Regarding the results, it is suggested that the results of this research be used in the development of training programs to improve protective behaviors in high-traffic offices, and by focusing on fear and risk control.

Relationship Between Fear of Monkeypox and Intention to be Vaccinated Against Monkeypox in a Peruvian Sample. The Mediating Role of Conspiracy Beliefs About Monkeypox

The present study evaluated the predictive capacity of fear of Monkeypox (MPX) on the intention to be vaccinated against MPX and the influence of conspiracy beliefs as a mediating variable in this relationship in 516 Peruvian sample with an average age of 27.10 years participated. Monkeypox Fear Scale, MPX Conspiracy Beliefs Scale and a single item of intention to be vaccinated against MPX were used. Statistical analyses have included estimation of descriptive statistics for all variables in the model tested and Structural Equation Modeling to predict intention to be vaccinated against monkeypox. It has been found that fear has a positive impact on conspiracy beliefs about MPX and intention to be vaccinated against MPX. Finally, conspiracy beliefs are negatively related to intention to be vaccinated. As for indirect effects, both are statistically significant. The model explains 11.4% of the variance in beliefs and 19.1% in intention to be vaccinated. It is concluded that fear of MPX played an important role, both directly and indirectly, in the intention to be vaccinated against MPX, having conspiratorial beliefs about MPX as a mediating variable. The results have important implications for public health practices aimed at combating doubts about MPX vaccination.

COVID-19 in Baghdad, Iraq: adaptive and emotional findings in a household cluster survey

Purpose

The objective of this study was to assess the impact of COVID-19 infection on households in Baghdad, Iraq.

Methods

A cross-sectional household survey was conducted in early 2022; 41 clusters were selected proportional to population size from the districts of the Baghdad governorate. Households were randomly selected for inclusion. The head of household or senior female member present was interviewed to obtain a listing of COVID-19 infections, deaths, and vaccinations among members of the household and to understand if social and economic changes occurred during the pandemic. All analyses incorporated the complex survey design and sample weights for clustering.

Findings

The findings revealed that there were 1,464 cases of COVID-19 (37.1%) and 34 reported fatalities among the 927 households enrolled in this study. One or more COVID-19 immunizations were received by 50.9% of household members. Preventive measures against COVID-19 were widely reported to be being practiced but were not more commonly reported in households having reported a clinical case of infection. While some households where infections had occurred stated that their household expenses were increased, overall, infections were not associated with significantly increased household costs. In households where COVID-19 had occurred, senior members reported a substantial increase in emotional and psychological problems compared with uninfected households.

Implications

COVID-19 deaths were rare, though infections were common, suggesting an effect of vaccination and other efforts. The household economic implications were minimal in houses with and without COVID-19-infected members. COVID-19 had mental health consequences on affected and unaffected populations alike. It is conceivable that the fear and uncertainty generated by the pandemic had an effect on senior household members which was out of keeping with the other effects in the households sampled. This suggests that there may be a persisting need for mental health services for a protracted period to manage the consequences of mental health needs arising from the pandemic.

Relationship between Fear of COVID-19, Intolerance of Uncertainty, and Coping Strategies on University Students' Mental Health

BACKGROUND

the mental health of students was particularly affected by the COVID-19 pandemic. The present study therefore examined the relationships between anxiety and depressive symptoms, eating-related problems, coping, fear of COVID-19, and intolerance of uncertainty.

METHODS

2139 French students of 54 universities were recruited in the different regions of France during a French lockdown (between 21 April and 3 May 2021). Six variables were measured: fear of COVID-19, intolerance of uncertainty, coping, anxiety and depressive symptoms, and eating-related problems. To explore the directions of the relationships between our variables of interest, we calculated a directed acyclic graph.

RESULTS

our data highlighted the central roles of intolerance of uncertainty in students' anxiety and depressive symptoms, and the direct role of prospective intolerance of uncertainty on eating-related problems.

CONCLUSIONS

these findings indicate that intolerance of uncertainty should be targeted by interventions designed to help students with high levels of anxiety, depressive symptoms, and/or eating-related problems.

Relationship between spiritual intelligence and intolerance of uncertainty, anxiety and fear of Corona in the elderly

INTRODUCTION

The COVID-19 pandemic has caused physical and psychological health problems in the elderly. Spiritual intelligence has an effect on health and healing. The aim of this study determining the relationship between spiritual intelligence and intolerance of uncertainty, anxiety, and fear of corona in the elderly.

METHODOLOGY

A cross-sectional study was done on 207 elderly people who referred to comprehensive health service centers in Mashhad in 2022. The samples were selected based on the inclusion criteria using multistage and cluster sampling. To collect data, various questionnaires were used, including demographic characteristics (age, gender, marital status …), King's Spiritual Intelligence Questionnaire, Freestone's Intolerance of Uncertainty Questionnaire, Corona Anxiety Scale, and Coronavirus Fear Scale. Statistical analysis of variables was done using descriptive and analytical (independent t-test, Mann-Whitney, analysis of variance, linear regression) tests by means of STATA version 14.

RESULTS

The average level of spiritual intelligence was 54.1. Participants reported a high level of intolerance of uncertainty (M = 79.2) and fear of corona (M = 14.09). Education, economic status, and marital status were the predictors of spiritual intelligence of the studied subjects (r = 0.24, P < .05). Spiritual intelligence and gender were also related to uncertainty intolerance (r = 0.12, P < .05). Another finding of the study was the superiority of variables of spiritual intelligence and gender in predicting the level of anxiety of corona compared to other variables (r = 0.17, P < .05).

CONCLUSION

There was a relationship between spiritual intelligence, education, and gender with the level of fear and anxiety of corona. Therefore, planning and implementing educational projects based on increasing spiritual intelligence for the elderly with priority for elderly women and with a low level of literacy and income is recommended.

Impact of Easing COVID-19 Restrictions on Fear of COVID-19 and Social Support Among Chinese Students: A Longitudinal Analysis

Introduction

This longitudinal study aims to investigate the relationship between fear of COVID-19, support-seeking behaviors, and perceived social support among Chinese college students during two distinct periods of the COVID-19 pandemic: the period of strict control (time 1) and the period following a relaxation of restrictions (time 2).

Methods

A total of 408 Chinese college students participated in this study. Data collection included demographic information, measures of fear of COVID-19, support-seeking behaviors, and perceived social support.

Results

Fear of COVID-19 at time 1 showed a significant positive association with fear of COVID-19 at time 2. The relationship between support-seeking behavior at time 1 and fear of COVID-19 at time 2 was significantly mediated through a chain mediation effect of support-seeking behavior at time 1 and perceived social support at time 2.

Discussion

This study contributes to the growing body of evidence on the psychological impacts of the COVID-19 pandemic and underscores the significance of social support in mitigating fear of COVID-19. It calls for a re-evaluation of public health policies considering their potential psychological effects and introduces new opportunities for developing psychosocial interventions.

Social and psychological resources and COVID-19 related fear, threat and worry

OBJECTIVES

The current study examines the relationship between social/psychological resources and COVID-related fear, threat, and worry.

METHODS

This work is based on data collected in March 23, 2020 from a national sample of 10,368 adults (ages 18 or older) living in the United States. The final sample of 10,368 was post-stratification weighted across gender, age, race, income, and geography (state) to ensure representativeness of the overall population of the United States.

RESULTS

Findings suggest some social and psychological resources are related to COVID-specific distress (fear/threat/worry), but depending on the resource, relationships vary in both direction and significance. On the one hand, strength of social ties and mastery of fate play a protective role in perceived distress (fear/threat/worry) related to COVID. On the other hand, community connectedness is significantly related to higher levels of COVID-specific fear, threat, and worry.

CONCLUSIONS

The analyses provide some evidence of the nature of the relationships between social and psychological resources and perceived COVID-19 distress that vary by race and ethnicity. These and other relationships are explored and discussed in the context of improving ones well-being with mediating social and psychological resources.

Prevalence of COVID-19 fear and its association with quality of life and network structure among Chinese mental health professionals after ending China's dynamic zero-COVID policy: a national survey

Background

China recorded a massive COVID-19 pandemic wave after ending its Dynamic Zero-COVID Policy on January 8, 2023. As a result, mental health professionals (MHPs) experienced negative mental health consequences, including an increased level of fear related to COVID-19. This study aimed to explore the prevalence and correlates of COVID-19 fear among MHPs following the end of the Policy, and its association with quality of life (QoL) from a network analysis perspective.

Methods

A cross-sectional national study was conducted across China. The correlates of COVID-19 fear were examined using both univariate and multivariate analyses. An analysis of covariance (ANCOVA) was conducted to determine the relationship between fear of COVID-19 and QoL. Central symptoms were identified using network analysis through the "Expected Influence" of the network model while specific symptoms directly correlated with QoL were identified through the "flow function."

Results

A total of 10,647 Chinese MHPs were included. The overall prevalence of COVID-19 fear (FCV-19S total score ≥ 16) was 60.8% (95% CI = 59.9-61.8%). The binary logistic regression analysis found that MHPs with fear of COVID-19 were more likely to be married (OR = 1.198; p < 0.001) and having COVID-19 infection (OR = 1.235; p = 0.005) and quarantine experience (OR = 1.189; p < 0.001). Having better economic status (good vs. poor: OR = 0.479; p < 0.001; fair vs. poor: OR = 0.646; p < 0.001) and health status (good vs. poor: OR = 0.410; p < 0.001; fair vs. poor: OR = 0.617; p < 0.001) were significantly associated with a lower risk of COVID-19 fear. The ANCOVA showed that MHPs with fear of COVID-19 had lower QoL [F = 228.0, p < 0.001]. "Palpitation when thinking about COVID-19" was the most central symptom in the COVID-19 fear network model, while "Uncomfortable thinking about COVID-19" had the strongest negative association with QoL (average edge weight = -0.048).

Conclusion

This study found a high prevalence of COVID-19 fear among Chinese MHPs following the end of China's Dynamic Zero-COVID Policy. Developing effective prevention and intervention measures that target the central symptoms as well as symptoms correlated with QoL in our network structure would be important to address COVID-19 fear and improve QoL.

Fear of COVID-19: the mediation role between the COVID-19 diagnosis and KAP in Spanish university students

BACKGROUND

Although health public services recommend prevention strategies for COVID-19 some of these recommendations have not been taken seriously by young people. Understanding why some people comply with these recommendations and others do not seem to be crucial in helping public health services to predict behavior and compliance with rules, especially for young people. Previous studies suggest that knowledge, attitudes, and practices (KAP) are useful to assess compliance with the preventive measures and public health policies. Being afraid has also been found to correlate with more engagement with preventive measures. This study aims to assess the KAP and fear of COVID-19 of Spanish university students and to understand the relation between diagnosis, KAP and the level of fear.

METHOD

Participants of this cross-sectional study were 598 college students (69.4% women) from different Spanish Universities. Data were collected for a month using an online questionnaire through Sphinx iQ2.

RESULTS

Levels of KAP among Spanish students were satisfactory and results suggest the presence of fear among them. More importantly, fear of COVID-19 mediated the impact of the diagnosis on the KAP.

CONCLUSIONS

Feeling fear seems to be the mechanism underlying the relationship between diagnosis and KAP. Diagnosis is associated with KAP when the diagnosis it is accompanied by measures of fear. KAP, diagnosis, or perceived fear of COVID must be taken together in consideration for health interventions and public health campaigns design.

Symptoms of anxiety and depression in Denmark during the first year of the COVID-19 pandemic: A two-wave matched-control study

Subsequent to the restriction measures taken to curb the COVID-19 infection rate, researchers theorized these would have detrimental mental health consequences. This two-wave matched-control study investigates depression and anxiety symptoms during the first 12 months of the pandemic (March 2020-March 2021) in Denmark with data from the I-SHARE and Project SEXUS studies. The I-SHARE study includes 1,302 (Time period 1 only n = 914, Time period 2 only n = 304, both time periods 1 and2 n = 84) Danish participants, and the sex and birth year-matched control participants from the Project SEXUS study comprise 9,980 Danes. During the first year of the pandemic, the study populations' anxiety and depression symptom mean levels did not significantly differ from pre-pandemic matched controls. Younger age, female gender, fewer children in the same household (depression only), lower education level, and not being in a relationship (depression only) were associated with increased anxiety and depression symptom scores. The key COVID-19-related variable linked with significantly higher anxiety and depression symptom scores was COVID-19-related loss of income. Contrary to initial concerns, we did not find a significant effect of the pandemic on anxiety and depression symptom scores. However, the results underscore the importance of structural resources to prevent income loss to safeguard mental health during crises such as a pandemic.

Associations of Mental Health and Experience of the COVID-19 Pandemic with United States Adults' Intentions to Be Vaccinated

COVID-19 vaccine uptake in the United States has proved challenging. A deeper characterization extending beyond demographics and political ideologies of those hesitating or resisting is needed to guide ongoing conversations. This study examined associations between US adults' vaccination intentions and mental health history, experience of the COVID-19 pandemic, and mental health outcomes. An online population-based cross-sectional survey was administered nationwide during January 4-7, 2021. Participants were questioned about past and current mental health, and completed the Patient Health Questionnaire 8 (PHQ-8), Generalized Anxiety Disorder 7-item (GAD-7), and Posttraumatic Diagnostic Scale (PDS)-5 (to capture symptoms of depression, anxiety, and traumatic stress, respectively). Experience of the pandemic included cumulative county-level COVID case and death rates, self-reported COVID-19 testing/exposure/diagnosis, and self-reported impact on routines, resources, and relationships. Of 936 respondents, 66% intended to be vaccinated, 14.7% responded "maybe," and 19.6% "no." Past diagnosis of obsessive compulsive disorder, less impact on routines or social supports, not having been screened or tested for COVID-19, not knowing someone who tested positive, and not self-isolating were associated with less intention to vaccinate. After controlling for demographic and pandemic experience factors, symptoms of traumatic stress, but not other mental health outcomes, were associated with less intention to vaccinate. The apparent contradiction between less negative impact of the pandemic and symptoms of traumatic stress being associated with less intention to be vaccinated indicates the complex nature of barriers to vaccine uptake. Results from this study contribute to the evidence base needed to improve ongoing and future communications about, and strategies to increase uptake of, vaccination.

Mass behaviour change amid COVID-19: How public health information and social norms explain the transformation

COVID-19 is a severe and ongoing threat globally, with the spread disrupting lives and society. Despite the developments of vaccines, the key measure to reduce the transmission of variants has stemmed from mass changes to personal behaviours. COVID-19 pandemic offers a unique context, where the protection behaviours enacted by an individual are necessary to keep the community safe. A social psychological perspective can be used to understand the reasons for adherence to policies and determine what other factors can shape preventive behaviours. To resolve this, in partnership with health consumers we use an online survey, with the findings substantiating preventive behaviours are positively related to COVID-19 information access and descriptive norms. Additionally, findings demonstrate the mediating role of injunctive norms on preventive behaviour suggesting that policy makers can influence decision-making by promoting health information that provides guidance on acceptable behaviours, but also demonstrates subsequent success. The integrity of the model is substantiated by partial least squares (PLS) testing.

Are Fear Campaigns Effective for Increasing Adherence to COVID-Related Mitigation Measures?

BACKGROUND

Using fear to increase the uptake of preventative health behaviours is a longstanding practice, which could be useful in mitigating the spread of COVID-19. However, the impact of fear campaigns beyond behavioural outcomes has rarely been considered. It is possible that these threatening health messages could heighten health-related anxiety by inducing a tendency to interpret ambiguous stimuli in a threatening manner. This research aimed to evaluate the effects of fear-based articles about COVID-19, on intentions to adhere to mitigation measures and interpretation bias-a core maintenance factor in health anxiety.

METHOD

Two pilot studies were conducted with the aim of validating our novel COVID-related measures and assessing engagement with the threat manipulation. Following this, 375 community members were recruited through social media for the main study. Participants were then randomly allocated to read an article about COVID which was manipulated on both threat and efficacy. After reading the article, participants then completed measures of interpretation bias and intentions to engage in COVID-19 mitigation measures.

RESULTS

Although the threatening articles consistently produced greater COVID-related threat, they only generated a stronger interpretation bias in the first pilot study. Importantly, threat-based communications failed to enhance intentions to perform mitigation measures in any of the studies. Likewise, reading an article which bolstered self-efficacy did not increase intentions, compared to reading a low efficacy article.

CONCLUSION

This research suggests that fear appeals are unlikely to increase intentions to perform COVID-related mitigation measures.

The mediating role of sleep quality in the relationship between orthorexia nervosa and fear of COVID-19

The COVID-19 (SARS-CoV-2) pandemic has jeopardized humanity worldwide and has considerably altered the healthy lifestyle behaviors of societies. This study examined the possible mediating role of sleep quality in the relationship between orthorexia nervosa and fear of COVID-19 among Turkish adults. This study used an observational and descriptive design. It was carried out online with 1,130 participants across Turkey between April and August 2021. The data were collected using a questionnaire, the Fear of COVID-19 Scale (FC-19S), the Pittsburgh Sleep Quality Index (PSQI), and Orthorexia Nervosa-R (ON-R). The participants had an ON-R mean score of 3.08 ± 0.90 and a mean PSQI score of 8.03 ± 2.80. Likewise, their mean FC-19S score was 18.24 ± 6.55. There was a significant positive correlation between the FC-19S and the PSQI (r = 0.208; p = 0.000) as well as a significant negative correlation between the ON-R and the PSQI (r = - 0.145; p = 0.000). In addition, the results of the process model analysis supported our hypotheses that the PSQI was a predictor of ON-R and that its direct and indirect effects were moderated by FC19S and the PSQI. A one-unit increase in FC-19S scores causes an average 1% increase on the ON-R scale, while it generates an 8% increase on the PSQI. It was determined that the PSQI total score caused an average of 6% increase in the ON-R scale score. The findings of this study showed that sleep quality has a mediating role in the relationship between orthorexia nervosa and fear of COVID-19 experienced by Turkish adults during the pandemic. For this reason, governments need to take the necessary precautions concerning this subject when creating action plans for possible global crisis situations that may adversely affect public health in the future.

"Feeling Trapped in Prison" Due to the COVID-19 Pandemic: Perceptions and Practices among Healthcare Workers and Prison Staff from a Brazilian Maximum Security Unit

The COVID-19 pandemic had several repercussions on prison staff, but the currently available evidence has mainly ignored these effects. This qualitative study aimed to understand the impact of COVID-19 on the prison system through the narratives of health and security professionals, using the methodological framework of the constructivist grounded theory proposed by Charmaz. The sample included 10 healthcare workers and 10 security professionals. Data collection took place between October and November 2022 through individual in-depth interviews. The data were analyzed using the MaxQDA software. Three categories of interrelated data emerged: (1) "Confrontation and disruption" caused by the COVID-19 pandemic in the prison system; (2) "Between disinfodemic and solicitude" referring to the tension between information management and the practice of care centered on the needs of inmates; and, finally, (3) "Reorganization and mitigation strategies during the fight against COVID-19". Continuous education and the development of specific skills are essential to enable professionals to face the challenges and complex demands that arise in prison contexts. The daily routines professionals had previously taken for granted were disrupted by COVID-19. Thus, investing in adequate training and emotional support programs is crucial to promote the resilience and well-being of these professionals, ensuring an efficient and quality response to critical events.

Self-reported interoception, worries and protective behaviors during the COVID-19 pandemic: a longitudinal study

BACKGROUND

Protective behaviors were essential for minimizing the spread of the virus during the coronavirus disease 2019 (COVID-19) pandemic. It is often assumed that awareness of bodily sensations (interoception) can improve decision-making and facilitate adaptive behavior.

OBJECTIVE

This paper investigates cross-sectional and longitudinal relationships between different aspects of self-reported interoception, trait anxiety, COVID-related worry, and health protective behaviors.

METHODS

The study was conducted on a community sample of 265 adults. The two data collection phases took place online, before (baseline) and during the second wave of the COVID-19 pandemic in Hungary.

RESULTS

Contrary to our expectations, neither cross-sectional nor longitudinal associations were found between protective behaviors and indicators of self-reported interoception. However, worry at baseline predicted protective behaviors during the second wave, even after controlling for socio-economical characteristics and protective behaviors at baseline.

CONCLUSION

Our results highlight the adaptivity of health-related worry when behavioral steps to avoid threats are known and available. Also, higher level of perceived interoception did not appear to be health protective under these circumstances.

Determinants of COVID-19 vaccination worldwide: WORLDCOV, a retrospective observational study

Introduction

The COVID-19 pandemic has resulted in numerous deaths, great suffering, and significant changes in people's lives worldwide. The introduction of the vaccines was a light in the darkness, but after 18 months, a great disparity in vaccination coverage between countries has been observed. As disparities in vaccination coverage have become a global public health issue, this study aimed to analyze several variables to identify possible determinants of COVID-19 vaccination.

Methods

An ecological study was conducted using pooled secondary data sourced from institutional sites. A total of 205 countries and territories worldwide were included. A total of 16 variables from different fields were considered to establish possible determinants of COVID-19 vaccination: sociodemographic, cultural, infrastructural, economic and political variables, and health system performance indicators. The percentage of the population vaccinated with at least one dose and the total doses administered per 100 residents on 15 June 2022 were identified as indicators of vaccine coverage and outcomes. Raw and adjusted values for delivered vaccine doses in the multivariate GLM were determined using R. The tested hypothesis (i.e., variables as determinants of COVID-19 vaccination) was formulated before data collection. The study protocol was registered with the grant number NCT05471635.

Results

GDP per capita [odds = 1.401 (1.299-1.511) CI 95%], access to electricity [odds = 1.625 (1.559-1.694) CI 95%], political stability, absence of violence/terrorism [odds = 1.334 (1.284-1.387) CI 95%], and civil liberties [odds = 0.888 (0.863-0.914) CI 95%] were strong determinants of COVID-19 vaccination. Several other variables displayed a statistically significant association with outcomes, although the associations were stronger for total doses administered per 100 residents. There was a substantial overlap between raw outcomes and their adjusted counterparts.

Discussion

This pioneering study is the first to analyze the association between several different categories of indicators and COVID-19 vaccination coverage in a wide complex setting, identifying strong determinants of vaccination coverage. Political decision-makers should consider these findings when organizing mass vaccination campaigns in a pandemic context to reduce inequalities between nations and to achieve a common good from a public health perspective.

Will the Relaxation of COVID-19 Control Measures Have an Impact on the Chinese Internet-Using Public? Social Media-Based Topic and Sentiment Analysis

Objective: In December 2022, the Chinese government announced the further optimization of the implementation of the prevention and control measures of COVID-19. We aimed to assess internet-using public expression and sentiment toward COVID-19 in the relaxation of control measures in China. Methods: We used a user-simulation-like web crawler to collect raw data from Sina-Weibo and then processed the raw data, including the removal of punctuation, stop words, and text segmentation. After performing the above processes, we analyzed the data in two aspects. Firstly, we used the Latent Dirichlet Allocation (LDA) model to analyze the text data and extract the theme. After that, we used sentiment analysis to reveal the sentiment trend and the geographical spatial sentiment distribution. Results: A total of five topics were extracted according to the LDA model, namely, Complete liberalization, Resource supply, Symptom, Knowledge, and Emotional Outlet. Furthermore, sentiment analysis indicates that while the percentages of positive and negative microblogs fluctuate over time, the overall quantity of positive microblogs exceeds that of negative ones. Meanwhile, the geographical dispersion of public sentiment on internet usage exhibits significant regional variations and is subject to multifarious factors such as economic conditions and demographic characteristics. Conclusion: In the face of the relaxation of COVID-19 control measures, although concerns arise among people, they continue to encourage and support each other.

The Relationship between Socio-Demographic Factors, Preventive Health Behaviors and Acceptance of COVID-19 Vaccine among Israeli Pregnant Women during the Coronavirus Pandemic

BACKGROUND

The outbreak of the Coronavirus disease led the World Health Organization to publish recommendations regarding preventive health behaviors (PHB). Pregnant women are at a higher risk of severe COVID-19 infection and adherence to these recommendations is critical. There are little data regarding PHB among pregnant women. The current study aims to evaluate the contribution of socio-demographic factors and COVID-19 vaccinations in predicting PHB among pregnant women.

METHOD

202 pregnant Israeli women (mean age = 30.8 years) participated in an online survey in 2021.

RESULTS

88% of the women were vaccinated and few had been infected. Of the women, 75.2% reported wearing face masks in closed spaces, while 12.4% reported wearing masks outdoors; 63.9% of the women did not travel abroad for fear of infection by the virus and 51% avoided crowded events. A simultaneous regression analysis to predict PHB indicated that pregnancy week and Coronavirus vaccination significantly and positively predicted PHB, but religious status was a negative predictor. Age, number of children, and level of education were not associated with PHB.

CONCLUSIONS

These findings can be helpful as a preliminary evidence base for policy-making at present and for future epidemics regarding guidelines on PHB adjusted for pregnant women.

Risk perception in the era of COVID-19 and related factors among nurses: A cross-sectional study

AIM

Our study aimed at investigating the risk perception of nurses and related factors in the era of COVID-19 period.

DESIGN

Cross-sectional study.

METHODS

Four hundred and forty-two participants completed an online questionnaire relating to their risk perception on public health emergencies. Data were collected between 25 November 2020 and 1 December 2020. Kruskal-Wallis test, Mann-Whitney U test and Ordinal logistic regression analysis were used to examine factors impacting on risk perception.

RESULTS

65.2% of nurses' risk perception of COVID-19 was the moderate level even below the moderate level in the postperiod of COVID-19. Kruskal-Wallis test results indicated significant differences in gender, age, education status, working years, professional title, postlevel, COVID-19 contact experience, marital status and health status (p < 0.05). Ordinal logistic regression showed that gender, education status, professional title, work department, COVID-19 contact experience, character, health status and nursing work environment are associated with risk perception (p < 0.05). No Patient or Public Contribution.

The Role of Hyperarousal and Aberrant Salience in the Acceptance of Anti-COVID-19 Vaccination

Background and Objectives: This present study was aimed at exploring hyperarousal and aberrant salience in a sample of the Italian general population to understand their possible role in the acceptance of anti-COVID-19 vaccination. Materials and Methods: Sociodemographic data questions, the "Acceptance of Vaccination" measure, the Hyperarousal Scale (H-Scale), and the Aberrant Salience Inventory (ASI) were sent as an unpaid online survey to the general population (age range 18-80 years) within the Italian territory. Results: The enrolled subjects were divided into two subgroups: "Pro-vax" (n = 806; 87.4%) and "No-vax" (n = 116; 12.6%). Statistical analysis showed significant differences between groups in the "Education Level" (p = 0.001) category, higher in the "Pro-vax" group, and in the ASI "Senses Sharpening" (p = 0.007), "Heightened Emotionality" (p = 0.008), and "Heightened Cognition" (p = 0.002) subscales with the "Total Score" (p = 0.015), all higher in "No-vax" subjects. Furthermore, a linear regression model evidenced that only "Education Level" (β = 0.143; p < 0.0001) and "Senses Sharpening" (β = -0.150; p = 0.006) were, respectively, direct and inverse predictors of "Acceptance of Vaccination". Conclusions: Our results show that several subthreshold conditions, such as somatosensory amplification, anxiety traits, and panic experiences, should be taken into account by authoritative sources involved in health education, communication, and policy to alleviate public concerns about vaccine safety, for the present and also future pandemics, and to provide more inclusive, informed, and accurate public health preventive and treatment programs.

Predictors of fear control related to COVID-19 among older population: an investigation on COVID-19 risk perception and health related quality of life during the pandemic

BACKGROUND

The aim of this study was to examine the role of demographic characteristics, general health and health related quality of life on the fear control. Also, the aim of study was to explore how older people percept the COVID-19 pandemic by using the component of the expanded parallel process model (EPPM), and how the possible perception may contribute to probable behavior responses to prevention and control of COVID-19.

METHODS

The present study is a cross-sectional study that was conducted in Tabriz, a city in north of Iran from February to April 2021, the period that correspond with the fourth wave of COVID-19. To collect information, the Covid-19 risk perception questionnaire (based on EPPM model including efficacy, defensive responses, and perceived threat) and health related quality of life (HQOL) Short Form-36 questionnaire were used. Discriminate value was calculated to estimate fear control and danger control. Univariate and multivariable logistic regression were calculated to examine the effect of demographic characteristics, general health and health-related quality of life on the fear control.

RESULTS

The mean age of the 350 participants was 67.9 (6.4) years. A total of 83.1% of participants were engaged in danger control processes and 16.9% in fear control processes. According to the multivariable results, significant predictors for fear control were: gender 1.57 (95% CI 1.05-2.34, 0.025), education 7.38 (1.42-38.35, p = 0.017), economic status 1.31 (0.4-0.63, p = 0.029), and significant protective factors for fear control were: body pain 0.97 (0.94-0.99, p = 0.041), general health 0.96 (0.93-0.98, p = 0.032), physical health 0.94 (0.90-0.98) and total quality of life 0.024 (0.89-0.98).

CONCLUSIONS

Strong associations of fear control were found with being female, being illiterate, and having a good economic status and also body pain, general health, physical health and total HQOL were significantly associated with danger control. Since, most of elderly populations have adequately higher perceptions of efficacy to counteract their threat perceptions to continue motivating these older people to engage in COVID-19 self-protective behaviors, it is necessary to emphasis on the susceptibility of target population and the severity of the COVID-19 threats.

Precarious Young Adults' Mental Health during the Pandemic: The Major Impact of Food Insecurity Independently of COVID-19 Diagnosis

The COVID-19 pandemic had a major impact on mental health across populations, especially young and precarious people. Furthermore, COVID-19 diagnosis itself has been associated with psychiatric symptoms. However, only a few studies have assessed the mental health of precarious youth, and examined a possible association with food insecurity, while including COVID-19 diagnosis in their analyses. We aimed to determine the prevalence of poor mental health in precarious youth during the COVID-19 pandemic, and to investigate its possible association with food insecurity, independently of COVID-19 diagnosis. In a cross-sectional study conducted in the context of an employment program for precarious youth (18-25 years) living in Paris, France, 823 individuals were assessed for depression, anxiety, subjective distress and food insecurity during the second lockdown of 2020. A directed acyclic graph (DAG)-based approach was used to identify confounders for inclusion in a multivariate regression model. Of the 823 precarious youth, 45.93% reported significant symptoms of depression, 36.69% anxiety, 39% distress and 25.39% suicidal ideation. In the multivariate analysis based on DAG, food insecurity (less than one meal per day) was associated with depression (OR = 2.30; CI%: 1.19-4.51), anxiety (OR = 2.51; CI%: 1.29-4.88), distress (OR = 2.36; CI%: 1.23-4.57) and suicidal ideation (OR = 4.81; CI%: 2.46-9.44), independently of age, gender, education, COVID-19 contact and COVID-19 diagnosis. This study highlights the importance of food insecurity on mental health among young precarious people during the COVID-19 pandemic. Reducing food insecurity is essential to help reduce psychological distress.

Predicting COVID-19 exposure risk perception using machine learning

BACKGROUND

Self-perceived exposure risk determines the likelihood of COVID-19 preventive measure compliance to a large extent and is among the most important predictors of mental health problems. Therefore, there is a need to systematically identify important predictors of such risks. This study aims to provide insight into forecasting and understanding risk perceptions and help to adjust interventions that target various social groups in different pandemic phases.

METHODS

This study was based on survey data collected from 5001 Norwegians in 2020 and 2021. Interpretable machine learning algorithms were used to predict perceived exposure risks. To detect the most important predictors, the models with best performance were chosen based on predictive errors and explained variances. Shapley additive values were used to examine individual heterogeneities, interpret feature impact and check interactions between the key predictors.

RESULTS

Gradient boosting machine exhibited the best model performance in this study (2020: RMSE=.93, MAE=.74, RSQ=.22; 2021: RMSE=.99, MAE=.77, RSQ=.12). The most influential predictors of perceived exposure risk were compliance with interventions, work-life conflict, age and gender. In 2020, work and occupation played a dominant role in predicting perceived risks whereas, in 2021, living and behavioural factors were among the most important predictors. Findings show large individual heterogeneities in feature importance based on people's sociodemographic backgrounds, work and living situations.

CONCLUSION

The findings provide insight into forecasting risk groups and contribute to the early detection of vulnerable people during the pandemic. This is useful for policymakers and stakeholders in developing timely interventions targeting different social groups. Future policies and interventions should be adapted to the needs of people with various life situations.