Motivating social distancing during the COVID-19 pandemic: An online experiment

The Roles of General Health and COVID-19 Proximity in Contact Tracing App Usage: Cross-sectional Survey Study

Background

Contact tracing apps are considered useful means to monitor SARS-CoV-2 infections during the off-peak stages of the COVID-19 pandemic. Their effectiveness is, however, dependent on the uptake of such COVID-19 apps.

Objective

We examined the role of individuals’ general health status in their willingness to use a COVID-19 tracing app as well as the roles of socioeconomic characteristics and COVID-19 proximity.

Methods

We drew data from the WageIndicator Foundation Living and Working in Coronavirus Times survey. The survey collected data on labor market status as well as the potential confounders of the relationship between general health and COVID-19 tracing app usage, such as sociodemographics and regular smartphone usage data. The survey also contained information that allowed us to examine the role of COVID-19 proximity, such as whether an individual has contracted SARS-CoV-2, whether an individual has family members and colleagues with COVID-19, and whether an individual exhibits COVID-19 pandemic–induced depressive and anxiety symptoms. We selected data that were collected in Spain, Italy, Germany, and the Netherlands from individuals aged between 18 and 70 years (N=4504). Logistic regressions were used to measure individuals’ willingness to use a COVID-19 tracing app.

Results

We found that the influence that socioeconomic factors have on COVID-19 tracing app usage varied dramatically between the four countries, although individuals experiencing forms of not being employed (ie, recent job loss and inactivity) consistently had a lower willingness to use a contact tracing app (effect size: 24.6%) compared to that of employees (effect size: 33.4%; P<.001). Among the selected COVID-19 proximity indicators, having a close family member with SARS-CoV-2 infection was associated with higher contact tracing app usage (effect size: 36.3% vs 27.1%; P<.001). After accounting for these proximity factors and the country-based variations therein, we found that having a poorer general health status was significantly associated with a much higher likelihood of contact tracing app usage; compared to a self-reported “very good” health status (estimated probability of contact tracing app use: 29.6%), the “good” (estimated probability: +4.6%; 95% CI 1.2%-8.1%) and “fair or bad” (estimated probability: +6.3%; 95% CI 2.3%-10.3%) health statuses were associated with a markedly higher willingness to use a COVID-19 tracing app.

Conclusions

Current public health policies aim to promote the use of smartphone-based contact tracing apps during the off-peak periods of the COVID-19 pandemic. Campaigns that emphasize the health benefits of COVID-19 tracing apps may contribute the most to the uptake of such apps. Public health campaigns that rely on digital platforms would also benefit from seriously considering the country-specific distribution of privacy concerns.

Compassionate goals predict COVID-19 health behaviors during the SARS-CoV-2 pandemic

We predicted that people with compassionate goals to support others and not harm them practiced more COVID-19 health behaviors during the SARS-CoV-2 pandemic to protect both themselves and others from infection. Three studies (N = 1,143 American adults) supported these predictions and ruled out several alternative explanations. Compassionate goals unrelated to the health context predicted COVID-19 health behaviors better than the general motivation to be healthy (Studies 2 and 3). In contrast, general health motivation predicted general health behaviors better than did compassionate goals. Compassionate goals and political ideology each explained unique variance in COVID-19 health behaviors (Studies 1-3). Compassionate goals predict unique variance in COVID-19 health behaviors beyond empathic concern, communal orientation, and relational self-construal (Study 3), supporting the unique contribution of compassionate goals to understanding health behaviors. Our results suggest that ecosystem motivation is an important predictor of health behaviors, particularly in the context of a highly contagious disease.

The pandemic and the problem of compliance with safety measures: The case of Egypt

Analysing data from a nationally representative sample of 3442 interviews conducted in Egypt in 2020, this study examines the influence of four sets of factors in predicting compliance with the advice of healthcare professionals to combat the spread of COVID-19: demographics, knowledge and values, fear of the disease and denial, and the pandemic as a foreign invasion. The findings show that a higher likelihood of compliance is linked to socioeconomic status, awareness of the pandemic, reliance on a plurality of information sources, adherence to liberal values, and fear of the disease, but being male, young, employed, religious, fatalistic, and in denial of the severity of the pandemic lower this likelihood - all consistent with the results reported in the literature. In addition, this study highlights the link between compliance and such attributes of nationalism as national identity, national pride, the perception of the pandemic as a national event, and the willingness to sacrifice one's human right to combat the spread of the disease. Drawing on these factors, this paper suggests building societal consensus around the theme of national unity against the microparasitic invasion is the key to an effective strategy to combat the spread of the virus.

Reimagining the peer-review system for translational health science journals

Retractions of coronavirus disease 2019 (COVID-19) papers in high impact journals, such as The Lancet and the New England Journal of Medicine, have been panned as major scientific fraud in public media. The initial reaction to this news was to seek out scapegoats and blame individual authors, peer-reviewers, editors, and journals for wrong doing. This paper suggests that scapegoating a few individuals for faulty science is a myopic approach to the more profound problem with peer-review. Peer-review in its current limited form cannot be expected to adequately address the scope and complexity of large interdisciplinary science research collaboration, which is central in translational research. In addition, empirical studies on the effectiveness of traditional peer-review reveal its very real potential for bias and groupthink; as such, expectations regarding the capacity and effectiveness of the current peer review process are unrealistic. This paper proposes a new vision of peer-review in translational science that, on the one hand, would allow for early release of a manuscript to ensure expediency, whereas also creating a forum or a collective of various experts to actively comment, scrutinize, and even build on the research under review. The aim would be to not only generate open discussion and oversight respecting the quality and limitations of the research, but also to assess the extent and the means for that knowledge to translate into social benefit.

Fatalism in the Early Days of the COVID-19 Pandemic: Implications for Mitigation and Mental Health

This research assessed fatalism toward COVID-19 and its role in behavioral intentions to support mitigation efforts (e. g., social distancing) and mental well-being. A COVID-19 fatalism measure was developed, and a messaging manipulation (fatalistic vs. optimistic vs. no message) was created to examine causal links between fatalism scores. Support for mitigation efforts and negative affect (anxiety, fear, depression, and insecurity) were measured to examine the consequences of fatalism toward COVID-19. Results showed that the fatalistic messaging condition increased fatalism whereas the optimistic message reduced it. The effects of the messaging manipulation were also apparent in the downstream measures of support for mitigation and negative affect through the mediator of fatalism toward COVID-19. Specifically, fatalism negatively predicted intentions to support mitigation. Regarding mental health, fatalism was positively associated with depression but negatively associated with fear and insecurity. Implications for COVID-19 mitigation efforts and mental health in the face of the coronavirus pandemic are discussed.

COVID-19 related stigma and health-protective behaviours among adolescents in the Netherlands: An explorative study

The COVID-19 pandemic has forced many governments to impose social distancing measures upon its citizens, including in the Netherlands. Motivating adolescents to adhere to measures such as social distancing can be challenging, since adolescents are relatively more affected by them, while experiencing virtually no personal health benefit. In addition, the COVID-19 pandemic seems to impact the social environment of adolescents in schools, as some media sources have reported bullying and stigmatisation of students with an Asian appearance. This study aims to explore the experiences of adolescents regarding their Health-Protective Behaviour (HPB), as well as the prevalence and expression of stigma towards ethnic minorities within the context of the first wave of COVID-19 pandemic. We performed a cross-sectional mixed-methods study, including two independent online questionnaires. An adapted version of the "HPB" questionnaire (n = 528) and the "Measure of Disease-Related Stigma (MDRS)" questionnaire (n = 380), were administered to Dutch adolescents of 10-16 years old, attending primary or secondary school. Furthermore, 15 interviews were held with eight male and seven female adolescents. All data collection took place between March 17 and April 20, 2020. Results show that adolescents perceive COVID-19 as a threat to other peoples' health, rather than their own, and report adherence to public health measures in the interest of older and more vulnerable members of their community. We found no convincing evidence for widespread misinformation or stigmatising of certain ethnic groups among adolescents related to COVID-19 during this study. Participants acknowledged such behaviour happened in the early stages of the pandemic, before this study was initiated. Adolescents are a vital group for public health researchers to engage with during a pandemic, even when reaching them can be challenging.

In science we (should) trust: Expectations and compliance across nine countries during the COVID-19 pandemic

The magnitude and nature of the COVID-19 pandemic prevents public health policies from relying on coercive enforcement. Practicing social distancing, wearing masks and staying at home becomes voluntary and conditional on the behavior of others. We present the results of a large-scale survey experiment in nine countries with representative samples of the population. We find that both empirical expectations (what others do) and normative expectations (what others approve of) play a significant role in compliance, beyond the effect of any other individual or group characteristic. In our vignette experiment, respondents evaluate the likelihood of compliance with social distancing and staying at home of someone similar to them in a hypothetical scenario. When empirical and normative expectations of individuals are high, respondents' evaluation of the vignette's character's compliance likelihood goes up by 55% (relative to the low expectations condition). Similar results are obtained when looking at self-reported compliance among those with high expectations. Our results are moderated by individuals' trust in government and trust in science. Holding expectations high, the effect of trusting science is substantial and significant in our vignette experiment (22% increase in compliance likelihood), and even larger in self-reported compliance (76% and 127% increase before and after the lockdown). By contrast, trusting the government only generates modest effects. At the aggregate level, the country-level trust in science, and not in government, becomes a strong predictor of compliance.

Trust in science increases conservative support for social distancing

The COVID-19 pandemic necessitates adherence to scientifically supported prevention strategies, such as social distancing. Although most Americans support social distancing, a subset of conservatives reject the scientific consensus on this matter. We explored why some conservatives reject social distancing, focusing on how trust in science contributes to ideological differences in social distancing intentions. In two studies, we replicated recent research demonstrating that conservatives report lower support for social distancing compared to liberals. However, in Study 1 we found support for a moderating role of trust in science, such that conservatives reported stronger intentions to socially distance when they had high trust in science. In Study 2, we enhanced trust in messaging about social distancing – and in turn, social distancing intentions among conservatives – by having the messages come from a Republican (vs. unidentified) government official. These studies provide insight into how we can increase adherence to public health recommendations regarding COVID-19.

Reactions of older Swiss adults to the COVID-19 pandemic: A longitudinal survey on the acceptance of and adherence to public health measures

RATIONALE

An important public health strategy during the COVID-19 pandemic was the protection of people at risk of severe progressions of an infection; namely, older people and people with pre-existing conditions.

OBJECTIVE

To improve public health communication, it is vital to understand, which sociodemographic and psychological factors drive older people's acceptance of and compliance with public health measures.

METHOD

This goal was pursued in this three-wave longitudinal online study with older adults, collected between March and June during the COVID-19 pandemic in 2020 (N = 327; first and second wave during the national lockdown; third wave: after the lifting of most lockdown measures).

RESULTS

The results show that overall acceptance of and adherence to the public health measures were high among older adults and even more so for people with pre-existing conditions (e.g., cancer, type II diabetes). However, some infringements of the measures were observed, and the longitudinal analyses suggest that increases in social trust positively influenced acceptance of measures over time, while trivialising beliefs and health fears impacted older adults' compliance with protective measures over time.

CONCLUSIONS

This study offers insights into the behavioural responses of older adults to an ongoing threat and the associated uncertainty that is part of public communication about the pandemic and protective measures.

Exploring barriers and facilitators of physical distancing in the context of the COVID-19 pandemic: a qualitative interview study

Background: Physical distancing measures (e.g., keeping a distance of two metres from others, avoiding crowded areas, and reducing the number of close physical contacts) continue to be among the most important preventative measures used to reduce the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID -19). Therefore, it is important to understand barriers and facilitators of physical distancing to help inform future public health campaigns. Methods: The current study aimed to qualitatively explore barriers and facilitators of physical distancing in the context of the COVID-19 pandemic using a qualitative interpretative design. Semi-structured one-to-one phone interviews were conducted with 25 participants aged 18+ years and living in the Republic of Ireland between September and October 2020. A purposive sampling strategy was used to maximise diversity in terms of age, gender, and socioeconomic status. Interviews were transcribed verbatim and analysed using inductive thematic analysis. Results: Analysis resulted in the development of six main themes related to barriers and facilitators of physical distancing: (1) Maintaining and negotiating close relationships; (2) Public environments support or discourage physical distancing; (3) Habituation to threat; (4) Taking risks to maintain well-being; (5) Personal responsibility to control the “controllables”; and (6) Confusion and uncertainty around government guidelines. Conclusions: Our study found that physical distancing measures are judged to be more or less difficult based on a number of internal and external psychosocial factors, including maintaining and negotiating close relationships, habituation to threat, risk compensation, structure of public environments, personal responsibility, and confusion or uncertainty around government guidelines. Given the diversity in our sample, it is clear that the identified barriers and facilitators vary depending on context and life stage. Messaging that targets sub-groups of the population may benefit from considering the identified themes in this analysis.

Affective empathy predicts self-isolation behaviour acceptance during coronavirus risk exposure

Health risk exposure during the global COVID-19 pandemic has required people to adopt self-isolation. Public authorities have therefore had the difficult task of sustaining such protective but stressful behaviour. Evidence shows that besides egoistic drives, the motivation for self-isolation behaviour could be altruistic. However, the type and role of prosocial motivation in the current pandemic is underestimated and its interaction with risk exposure and psychological distress is largely unknown. Here we show that affective empathy for the most vulnerable predicts acceptance of lockdown measures. In two retrospective studies, one with a general population and one with COVID-19 positive patients, we found that (1) along with health risk exposure, affective empathy is a predictor of acceptance of lockdown measures (2) social covariates and psychological distress have no significant impact. Our results support the need to focus on altruistic behaviours while informing the public instead of on fear-inducing messages.

Self-Interested Framed and Prosocially Framed Messaging Can Equally Promote COVID-19 Prevention Intention: A Replication and Extension of Jordan et al.'s Study (2020) in the Japanese Context

How can we effectively promote the public's prevention of coronavirus disease 2019 (COVID-19) infection? Jordan et al. (2020) found with United States samples that emphasizing either self-interest or collective-interest of prevention behaviors could promote the public's prevention intention. Moreover, prosocially framed messaging was more effective in motivating prevention intention than self-interested messaging. A dual consideration of both cultural psychology and the literature on personalized matching suggests the findings of Jordan et al. (2020) are counterintuitive, because persuasion is most effective when the frame of the message delivered and the recipient of the message are culturally congruent. In order to better understand the potential influence of culture, the current research aimed to replicate and extend Jordan et al. (2020) findings in the Japanese context. Specifically, we examined the question (1) whether the relative effectiveness of the prosocial appeal is culturally universal and robust, (2) which types of 'others' especially promote prevention intention, and (3) which psychological mechanisms can explain the impact of messaging on prevention intention. In Study 1 (N = 1,583), we confirmed that self-interested framed, prosocially framed, and the combination of both types of messaging were equally effective in motivating prevention intention. In Study 2 (N = 1,686), we found that family-framed messaging also had a promoting effect similar to that from self-interested and prosocial appeals. However, the relative advantage of prosocial appeals was not observed. Further, a psychological propensity relevant to sensitivity to social rejection did not moderate the impact of messaging on prevention intention in both studies. These results suggest that since engaging in the infection control itself was regarded as critical by citizens after public awareness of COVID-19 prevention has been sufficiently heightened, for whom we should act might not have mattered. Further, concerns for social rejection might have had less impact on the prevention intentions under these circumstances. These results suggest that the relative advantage of a prosocial appeal might not be either culturally universal or prominent in a collectivistic culture. Instead, they suggest that the advantages of such an appeal depends on the more dynamic influence of COVID-19 infection.

The Effect of Persuasive Messages in Promoting Home-Based Physical Activity During COVID-19 Pandemic

We tested the plausibility of a persuasion model to understand the effects of messages framed in terms of gain, non-loss, loss, and non-gain, and related to the physical, mental and social consequences of doing physical activity at home during the lockdown restrictions. 272 Italian participants responded to a questionnaire on their attitude and intention at Time 1, frequency of past behavior, and self-efficacy related to exercising at home. Then, participants were randomly assigned to four different message conditions: (a) gain messages focused on the positive outcomes associated with doing physical activity at home; (b) non-loss messages focused on the avoided negative outcomes associated with doing physical activity at home; (d) loss messages focused on the negative outcomes associated with not doing physical activity at home; (c) non-gain messages focused on the missed positive outcomes associated with not doing physical activity at home. After reading the messages, participants answered a series of questions regarding their perception of threat and fear, their evaluation of the messages, and their attitude and intention toward exercising at home at Time 2. Using multigroup structural equation modeling, we compared message conditions, and tested whether the effects of the messages on attitude and intention at Time 2 were mediated by message-induced threat, message-induced fear, and message evaluation. Results showed that the perception of the messages as not threatening was the key point to activate a positive evaluation of the recommendation. The highest persuasive effect was observed in the case of the non-loss frame, which did not threaten the receivers, triggered a moderated fear and, in turn, activated a positive evaluation of the recommendation, as well as higher attitude and intention to do home-based physical activity at Time 2. Overall, these results advance our comprehension of the effects of message framing on receivers' attitudes and intentions toward home-based physical activity.

Behavioral Changes After the COVID-19 Lockdown in Italy

This study aims at identifying the tools necessary for COVID-19 health emergency management, with particular reference to the period following the first lockdown, a crucial phase in which it was important to favor the maintenance of protective behaviors. It also aims at identifying the messages and sources that were most effective in managing communication correctly in such a crucial phase that is likely characterized by a fall in perceived health risk (due to the flattening of the epidemic curve) and a simultaneous rise in perceived economic and social risks (due to the enduring calamity). Knowing what source will be most effective to convey a specific message is fundamental in enabling individuals to focus on and comply with the rules. At the same time, it is necessary to understand how the message should be presented, and the relationships between messages, sources and targets. To meet these goals, data were collected through a self-administered online questionnaire submitted to a sample of undergraduate students from a University in Lombardy-the region most affected by the pandemic in the first wave- (Study 1), and to a national sample composed of Italian citizens (Study 2). Through our first manipulation which explored the effectiveness of social norms in relation to different sources, we found that, in the national sample, the injunctive norm conveyed by the government was the most effective in promoting behavioral intentions. By contrast, among the students, results showed that for the critical group with a lower risk perception (less inclined to adopt prevention behavior) descriptive norms, which implicitly convey the risk perception of peers, were as effective as the government injunctive norm. Our second manipulation, identical in Study 1 and 2, compared four types of communication (emotional, exponential growth, both of them, or neutral). The neutral condition was the most memorable, but no condition was more effective than the others. Across all message types there was a high intention to adopt protective behaviors. The results indicate possible applicative implications of the adopted communicative tools.

Let's (not) get together! The role of social norms on social distancing during COVID-19

While effective preventive measures against COVID-19 are now widely known, many individuals fail to adopt them. This article provides experimental evidence about one potentially important driver of compliance with social distancing: social norms. We asked each of 23,000 survey respondents in Mexico to predict how a fictional person would behave when faced with the choice about whether or not to attend a friend's birthday gathering. Every respondent was randomly assigned to one of four social norms conditions. Expecting that other people would attend the gathering and/or believing that other people approved of attending the gathering both increased the predicted probability that the fictional character would attend the gathering by 25%, in comparison with a scenario where other people were not expected to attend nor to approve of attending. Our results speak to the potential effects of communication campaigns and media coverage of compliance with, and normative views about, COVID-19 preventive measures. They also suggest that policies aimed at modifying social norms or making existing ones salient could impact compliance.

Young Adults' COVID-19 Testing Intentions: The Role of Health Beliefs and Anticipated Regret

PURPOSE

Young adults are at high risk for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and transmission due to their social behaviors. The purpose of this study was to determine their attitudes toward coronavirus disease 2019 (COVID-19) testing, an important approach for minimizing infection and transmission.

METHODS

One hundred seventy eight US individuals aged 19-25 years completed an online survey measuring COVID-19 health beliefs and testing intentions. Multivariable logistic regression evaluated the association of heath belief measures (perceived COVID-19 susceptibility, COVID-19 severity, barriers and benefits to testing, and social concerns) with testing intentions.

RESULTS

Most respondents (86.0%) intended to accept a COVID-19 test if recommended by a health professional. High social concern and low perceived obstacles were associated with intent to get tested.

CONCLUSIONS

In this sample, most young adults intended to accept COVID-19 testing. Health beliefs predicted testing intention and point to possible intervention approaches to increase willingness to accept COVID-19 testing.

Coronavirus risk perception and compliance with social distancing measures in a sample of young adults: Evidence from Switzerland

The health risk of the coronavirus pandemic is age-specific. The symptoms of a COVID-19 infection are usually mild in the healthy population below the age of 65; however, the measures laid down to prevent the spread of the virus apply typically to the whole population. Hence, those who have a low risk of severe symptoms face a social dilemma in cooperating and complying with the safety measures: Cooperating in preventing the spread of the disease is good for society but comes with individual costs. These costs provide an incentive not to cooperate with the safety measures. In this paper we analyze via structural equation modelling a sample of young adults (N = 510) who were surveyed right after the end of the first lockdown period in Switzerland. We investigate why and to what extent they cooperated in preventing the epidemic by following the recommendation to stay at home as much as possible. We hypothesize that those respondents who perceive themselves to be personally at risk, or who have relatives belonging to the risk group, complied more often with the safety measures as compared to those without severe risks. Cooperating should also be linked to individuals' pro-social orientation. Furthermore, we hypothesize that those who believe that the virus is dangerous for society or who have a personal interest in protection show higher support for the general safety measures. Our empirical results show that compliance with the coronavirus social distancing measures was generally very high during the first lockdown. Although young adults perceived themselves to be at low personal risk, they still believed that the virus is dangerous for society. Those who had a personal interest in staying at home because they had relatives belonging to the risk group complied more often with the safety measures. Overall, the results suggest that the support of the preventive measures is the most important promoter of cooperation to prevent the spread of COVID-19.

The Psychological Consequences of COVID-19 Fear and the Moderator Effects of Individuals' Underlying Illness and Witnessing Infected Friends and Family

The COVID-19 virus has become a fearful epidemic for people all over the world. In Turkey, long quarantine periods and curfews have increased both physical and psychological problems. Due to the rapid spread and substantial impact of the COVID-19 virus, different psychological effects were observed among different segments of society, such as among young people, elderly people, and active workers. Because of fear caused by the COVID-19 virus, it is thought that depression, stress, and anxiety levels have increased. It is estimated that there are more psychological issues for people with poor health and others whose friends or family became ill or have died because of COVID-19. To explore and test the situation mentioned above, we conducted a cross-sectional study in Turkey with 3287 participants above 16 years old. We measured COVID-19 fear, along with anxiety, stress, and depression levels (DASS21) and demographics. Firstly, we tested whether COVID-19 fear predicts stress, anxiety, and depression. Secondly, we investigated if the effect of COVID-19 fear is stronger for those who have underlying illness and for those whose friends or family became ill or have died because of COVID-19. The results showed that women and 16-25 years old youths have higher COVID-19-related fear, anxiety, depression, and stress. Furthermore, we found a significant relationship between COVID-19 fear and stress, anxiety, and depression, as well as significant moderation effects of having an underlying illness and having friends or family who were infected or have died. These results show the importance of implementing specific implementations, particularly for vulnerable groups, to minimize the psychological problems that may arise with the pandemic.

Coronavirus in Ireland: one behavioural scientist’s view

This paper offers the perspective of a behavioural scientist advising and providing evidence for Ireland's government during the coronavirus pandemic. It describes how behavioural research informed the public response in the early months of the crisis, but lost influence as political conflict increased. It proposes some broader lessons for managing public health crises, one of which is to recognise the potential wisdom of crowds.

Telling people to "rely on their reasoning" increases intentions to wear a face covering to slow down COVID-19 transmission

Finding messaging to promote the use of face masks is fundamental during a pandemic. Study 1 (N = 399) shows that telling people to “rely on their reasoning” increases intentions to wear a face mask, compared with telling them to “rely on their emotions.” In Study 2 (N = 591) we add a baseline. However, the results show only a non‐significant trend. Study 3 reports a well‐powered replication of Study 2 (N = 930). In line with Study 1, this study shows that telling people to “rely on their reasoning” increases intentions to wear a face mask, compared to telling them to “rely on their emotions.” Two internal meta‐analyses show that telling people to “rely on their reasoning” increases intentions to wear a face mask compared (1) to telling them to “rely on their emotions” and (2) to the baseline. These findings suggest interventions to promote intentions to wear a face mask.

Framing Messages to Deal With the COVID-19 Crisis: The Role of Loss/Gain Frames and Content

The goal of this study was to test the role of message framing for effective communication of self-care behaviors in the context of the COVID-19 pandemic, contrasting health and economic-focused messages. We presented 319 participants with an unforced choice task where they had to select the message that they believed was more effective to increase intentions toward self-care behaviors, motivate self-care behaviors in others, increase perceived risk and enhance perceived message strength. Results showed that gain-frame health messages increased intention to adopt self-care behaviors and were judged to be stronger. Loss-framed health messages increased risk perception. When judging effectiveness for others, participants believed other people would be more sensitive to messages with an economic focus. These results can be used by governments to guide communication for the prevention of COVID-19 contagion in the media and social networks, where time and space for communicating information are limited.

Follow or not follow?: The relationship between psychological entitlement and compliance with preventive measures to the COVID-19

Some recent evidence has shown that individuals with a higher sense of psychological entitlement were more likely to ignore instructions than individuals with a lower sense of psychological entitlement. Building on these findings, the current research investigated the relationship between psychological entitlement and breaching coronavirus restrictions during the COVID-19 pandemic. Using self-reported adherence to various infection prevention measures, Study 1 revealed that psychological entitlement positively predicted a lower likelihood of complying with distancing instructions in Chinese university students. Study 2 fully replicated these findings in a new sample of Chinese working adults. Moving beyond self-assessment of public health-compliance behaviors, Study 3 further assessed the relationship behaviorally and recapitulated the reported effects. Consistently, Studies 1 through 3 provided supporting evidence that fairness perceptions mediate the negative link between psychological entitlement and observance of preventive measures. Overall, our findings suggest that individual differences in psychological entitlement are associated with people's virus-mitigating behaviors in the fight against COVID-19.

Vaccines are not yet a silver bullet: The imperative of continued communication about the importance of COVID-19 safety measures

COVID-19 vaccines are by no means a silver bullet. With more COVID-19 vaccines expecting approval in the coming months, it is necessary to note that vaccine availability does not equate to vaccine accessibility, nor vaccine efficacy. Some research suggests that approximately 9 out of 10 individuals living in lower-income countries will not have access to COVID-19 vaccines until 2023 or later. For higher-income countries, such as the United States, the prevalence of vaccine hesitancy may further compound the situation. These insights combined, in turn, emphasize the fact that even though COVID-19 vaccines are becoming more available, safety measures (e.g., face masks, personal hygiene, and social distancing) are still of pivotal importance in protecting personal and public health against COVID-19. Furthermore, this paper argues for the continued imperative for health experts and government officials to communicate and emphasize the importance of COVID-19 safety measures with the public, to make sure people are protected against COVID-19 till the pandemic ceases to pose a threat to personal or public health.

Influence of Empathy Disposition and Risk Perception on the Psychological Impact of Lockdown During the Coronavirus Disease Pandemic Outbreak

During the current COVID-19 pandemic, and especially in the absence of availability of an effective treatment or a vaccine, the main health measure is neither chemical nor biological, but behavioral. To reduce the exponential growth of infections due to the new coronavirus (SARS-CoV-2) and the resulting overburdening of the healthcare system, many European Countries, parts of the US and Switzerland gradually implemented measures of quarantine and isolation defined as lockdown. This consideration leads to the need to understand how individuals are motivated to protect themselves and others. Recent research suggested that prosocial mental dispositions, such as empathy, might promote adherence to social norms of distancing. Other research conducted during the COVID-19 outbreak indicates, however, that empathy levels might fluctuate according to anxiety linked to the risk of death, and this negatively predicted prosocial willingness. The present protocol proposes a study on whether people's empathic dispositions, interacting with the levels of risk, influence the psychological impact of lockdown. The rationale is that emphatic dispositions, encouraging the acceptance of the lockdown, determine a better psychological adaptation and less distress. One retrospective study will be developed in Switzerland and, if the pandemic conditions force a new wave of lockdown on the population, one prospective study as well. A total of 120 participants will be involved, distinguished by their level of objective risk: (1) high objective risk (COVID-19 positive patients, hospitalized in isolation in post-acute phase); (2) moderate objective risk (COVID-19 positive patients, isolated at home); (3) minimum objective risk (non-positive adults, in lockdown). Measures of perceived risk of being contagious for third parties, empathic dispositions and acceptance of lockdown will be collected. The expected results provide important answers related to the immediate impact of empathic dispositions, effective risk and risk perception on the psychological impact of lockdown during a pandemic outbreak. Data gathered from this study could inform policy makers and public health managers about the best communication strategies that will take into account the various stages of health risk and, in particular, to modulate messages to the population aimed at inducing self-isolation behaviors.

Effective but fragile? Responses to repeated nudge-based messages for preventing the spread of COVID-19 infection

Nudge-based messages have been employed in various countries to encourage voluntary contact-avoidance and infection-prevention behaviors to control the spread of COVID-19. People have been repeatedly exposed to such messages; however, whether the messages keep exerting a significant impact over time remains unclear. From April to August 2020, we conducted a four-wave online survey experiment to examine how five types of nudge-based messages influence Japanese people's self-reported preventive behaviors. In particular, we investigate how their behaviors are affected by repeated displays over time. The analysis with 4241 participants finds that only a gain-framed altruistic message, emphasizing their behavioral adherence would protect the lives of people close to them, reduces their frequency of going out and contacting others. We do not find similar behavioral changes in messages that contain an altruistic element but emphasize it in a loss-frame or describe their behavioral adherence as protecting both one's own and others' lives. Furthermore, the behavioral change effect of the gain-framed altruistic message disappears in the third and fourth waves, although its impact of reinforcing intentions remains. This message has even an adverse effect of worsening the compliance level of infection-prevention behaviors for the subgroup who went out less frequently before the experiment. The study's results imply that when using nudge-based messages as a countermeasure for COVID-19, policymakers and practitioners need to carefully scrutinize the message elements and wording and examine to whom and how the messages should be delivered while considering their potential adverse and side effects.