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

Parents' Level of COVID-19 Fear, Anxiety and Their Attitudes and Behaviors Toward Vaccination of Their Children

The aims of this study were to investigate parents' COVID-19 fear and anxiety levels and determine the relationship between parents' COVID-19 fear and anxiety levels and their attitudes and behaviors toward having themselves and their children vaccinated. This descriptive and cross-sectional type of research was conducted with 950 parents with 12-18 years old children. Having a chronic disease, being vaccinated, intention to vaccinate their children, and the children's age and school year were found to increase parents' COVID-19 fear and anxiety (p < 0.005). A statistically significant correlation was found between the parents' perceived levels of COVID-19 fear and anxiety and their intentions to vaccinate their children (p < 0.005). According to the study's findings, the age of the child, the parents' vaccination, and the parents' intentions to vaccinate their children were predictors of COVID-19 fear and anxiety.

Unpacking Digital Dashboards' Influence on Preventive Health Behavior Among Young Adults

Introduction: The COVID-19 pandemic highlighted the need for digital tools that support public health decision-making and behavior change. Dashboards became a primary method for communicating infectious disease data. However, their influence on preventive health behaviors (PHBs) is not well understood-especially among young adults. This group is less likely to adhere to PHBs, but highly familiar with online tools. Methods: Two experimental studies were conducted with young adult participants (200 in Study 1, 228 in Study 2) who viewed the same COVID-19 data in dashboards with or without actionable components. Participants were randomly assigned to different dashboard conditions to measure, on seven-point Likert scales, their PHB intentions and perceptions of behavioral control, attitudes, norms, and risk. The actionable dashboard interventions, designed using the theory of planned behavior, included dynamic behavioral guidance and risk level visualizations. Results: Actionable dashboards versus basic dashboards significantly increased PHB intentions (B = 0.84, p < 0.001, Study 1). Dynamic behavioral guidance was the key dashboard component influencing PHB intentions (B = 0.61, p = 0.005, Study 2). Parallel mediation analysis testing norms, attitudes, behavioral control, and perceived risk against one another found that only norms explained the link between the dashboard intervention and PHB intentions (Bboot = 0.18 and 0.19). Conclusions: Findings suggest that actionable dashboards can effectively promote PHB by influencing psychosocial beliefs. These dashboards provide context and guidance, making risky situations more manageable and directing individuals to appropriate preventive actions. Public health professionals should consider incorporating behavioral guidance into community health dashboards to improve their effectiveness.

The citizen's perception of a shared responsibility during the COVID-19 management: Insights from a focus group study across four European countries

BACKGROUND

The World Health Organisation emphasises the importance of a whole-of-society approach to the management of health emergencies, which includes a need to involve citizens. Yet, little guidance is found on how this should occur and, more importantly, the citizen's current perspective of their role. Understanding citizens' perceptions is the first step in preparing for citizen engagement during a future pandemic.

METHODS

A qualitative research study of 16 focus groups comprising 89 participants was conducted in Finland, Slovenia, Spain, and the Netherlands. Four age-stratified focus groups in each country were organised online in the country's primary language. Inductive analysis of each focus group transcript was used to identify important themes that captured the participants' perceptions of their role in COVID-19 preparedness, response, and recovery.

RESULTS

Three common themes were found in the cross-country analysis. The first theme was the citizen's personal involvement, with specific references to the citizen's responsibilities and their concrete actions during COVID-19 preparedness, response, and recovery. The second theme was that of the citizen as an information receiver, with specific references to the quantity and quality of the information received. The final theme was the relationship between the citizen and decision-makers, with specific references to the citizen's level of trust in the decision-maker, the decision-maker's communication style as perceived by the citizens, as well as the level of interaction between the citizens and decision-makers as perceived by the citizens.

CONCLUSIONS

Generally, citizens included in this study from Finland, the Netherlands, Slovenia, and Spain felt a shared responsibility in curbing the spread of the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) during the pandemic. However, they emphasised the imperative need to be better informed about the likelihood of, and the developments during a pandemic in their country. Furthermore, the quality of the information provision emerged as an important theme.

[Hypochondriacal fears and corona fears among medical students compared to doctors]

Hypochondriacal fears among medical students were already investigated before the COVID pandemic. Studies on these fears under pandemic conditions and a possible influence of specific fear of illness have not yet been conducted.We asked medical students at two points in time about symptoms of hypochondria and corona anxiety. Doctors served as the comparison group. Hypochondria was assessed using the two MSD scales, corona anxiety using a separate questionnaire.Medical students exhibited significantly more hypochondriacal anxiety at both time points. At the second time point, 35.5% of students and 25.5% of doctors reported fear of contracting the virus.The time of the study did not appear to have any influence on the prevalence of the fears investigated. The influences of the measured anxiety prevalence were shown in the fact that medical students look to their professional careers with concern.

The impact of COVID-19 fear during the later stages of the pandemic on maladaptive eating, psychological distress and body weight: a global cross-sectional study

BACKGROUND

The COVID-19 pandemic significantly impacted global mental health, leading to increased levels of fear, stress, and anxiety [1]. Previous research has suggested associations between functional fear of detrimental mental health outcomes and psychological stressors which may drive maladaptive eating behaviors. This study explored the associations between COVID-19 fear during later stages of the pandemic, psychological distress (anxiety, depression, and stress), maladaptive eating behaviors (emotional, uncontrolled, binge, and nighttime eating), and self-reported body weight.

METHODS

This was a global cross-sectional survey conducted from February 2022 to February 2024, involving 4390 adults (70% female) from 25 countries. The survey collected information on demographics, psychosocial impact, eating behaviors, and COVID-19 related behaviors. General linear models, multinomial logistic regression modes, and structural equation modeling were used to analyze the data.

RESULTS

Higher fear of COVID-19 was significantly associated with increased emotional and uncontrolled eating, even after adjusting for psychological distress and other covariates. Specifically, each unit increase in fear of COVID-19 scores was associated with a corresponding increase in emotional eating (β = 0.018) and uncontrolled eating (β = 0.029) behaviors (p-values < 0.0001). Furthermore, fear of COVID-19 was linked to higher odds of engaging in binge eating (OR = 1.05, 95% CI: 1.03, 1.07, p-value < 0.0001) and nighttime eating behaviors (OR = 1.04, 95% CI: 1.03, 1.06, p-value < 0.0001) in models adjusted for covariates; however, these associations were no longer significant when psychological distress variables were included. Fear of COVID-19 was also associated with body weight (β = 0.18) and BMI (β = 0.08) even with adjustments of covariates and psychological distress variables (p-values < 0.01). Structural equation modeling showed that fear of COVID-19 was related to current body weight through its impact on psychological distress and maladaptive eating behaviors.

CONCLUSIONS

Maladaptive eating behaviors influenced by the psychological distress experienced during the COVID-19 pandemic have persisted into the later stages of the pandemic. These results underscore an interconnectedness between functional fear and its influence on maladaptive eating behaviors and body weight. Understanding this link is crucial and has the potential to inform the development of public health policies.

TRIAL REGISTRATION

Clinical Trials.gov NCT04896060 Date of Registration: May 21, 2021.

The relationship between safety measures, preparedness, and mental health outcomes in New York City during the COVID-19 pandemic

Background

The COVID-19 pandemic necessitated strict safety measures and preparedness, potentially influencing mental well-being worldwide. This study investigated the impact of safety measures and preparedness levels on mental health outcomes during the COVID-19 pandemic in New York City, USA examining how sociodemographic characteristics modified these associations.

Method

A longitudinal study of 1,227 participants from three ongoing cohorts, provided data through telephone interviews across three waves from March 2020 to August 2021. Depression and anxiety were measured using Patient Health Questionnaire 8 (PHQ-8) and Generalized Anxiety Disorder 7 (GAD-7). Logistic regression models were used to investigate associations between safety measures, preparedness, and mental health outcomes over time, adjusting for potential confounders and assessing the modification effect of demographic factors.

Results

At Wave 1, 18% of participants reported moderate to severe depression, while 20% had moderate to severe anxiety. Over time, these rates declined significantly, with depression dropping to 9% and anxiety to 10% by Wave 3. Safety measures practiced at Wave 1 showed a protective effect on depression at Wave 3 (OR=0.45, 95% CI: 0.22, 0.91). Higher preparedness levels were significantly associated with reduced odds of anxiety (aOR=0.72, 95% CI: 0.55, 0.93) in the concurrent wave. Age specific analysis revealed that individuals aged 26-35 experienced stronger protective effects from higher preparedness levels (OR=0.43, 95% CI: 0.2, 0.92) compared to younger age groups.

Conclusion

This study highlights the importance of safety measures and preparedness in mitigating mental health challenges during crises. Addressing age specific factors and preparedness levels can guide the public health strategies to better support diverse populations.

Effect of the coronavirus disease 2019 pandemic on beliefs and practices regarding hand hygiene among intensive care nurses: A repeated cross-sectional study

Hand hygiene is an important factor in the prevention of healthcare-associated infections. Studies show healthcare professionals' hand hygiene practices vary and are not at sufficient levels. This study aimed to examine the effect of the COVID-19 pandemic on the beliefs and practices of nurses working in intensive care units (ICU) towards hand hygiene. This was longitudinal, repeated, and cross-sectional study. The study was conducted in 2 phases between January 2,2020 and March 10,2021 in the intensive care unit of a university hospital in northern Turkey. No sampling method was used. The objective was to reach the entire population. The first phase of this study was completed with 119 (76% of the population) ICU nurses and the second phase with 85 (70% of the population) ICU nurses. The data were collected with the personal information form, hand hygiene belief scale (HHBS), hand hygiene practices inventory (HHPI) and the views of the intensive care nurses related to COVID-19. Descriptive statistics such as mean and standard deviations, frequency, and percentages and analytical statistics such as t-test, Mann-Whitney U test, Kruskal-Wallis test were used for data analysis at the significance level of P < .05. The majority of the nurses who participated in the study were female (75.6%; 69.4%), with a mean age of 30.82 ± 5.51 and 30.58 ± 5.51 years, respectively. There was a significant difference (P < .05) between the median HHBS (P = .002) and HHPI (P = .001) scores before and after COVID-19. All nurses (100%) reported that the pandemic was effective in hand hygiene practices. In this study, it was determined that the hand hygiene beliefs and practices of nurses were high, and the scores of nurses' hand hygiene beliefs and practices after COVID-19 increased significantly. Healthcare professionals must always adhere to stringent standards of hand hygiene, rather than merely during periods of heightened challenges. To ensure the sustainability of optimal hand hygiene practices, it is recommended that motivational interventions that strengthen beliefs and practices related to hand hygiene should be implemented and that studies should be conducted to evaluate their effectiveness.

Does self-compassion buffer the impact of fear of COVID-19 on health-related quality of life for people living with HIV?

Extant literature has consistently documented the adverse impact of fear of COVID-19 on the health-related quality of life (HRQoL) of people living with HIV (PLWHIV), as they are more prone to being infected with this deadly disease than the normal population. However, studies on the mechanism that could mitigate this adverse impact are lacking. We investigated whether self-compassion could buffer the negative impact of fear of COVID-19 on HRQoL among PLWHIV. Utilizing a cross-sectional design, 241 outpatients (41.5% male, 58.5% female) from two Nigerian healthcare facilities were conveniently sampled. Results showed that heightened fear of COVID-19 was associated with poorer HRQoL across four domains. Unexpectedly, self-compassion neither predicted HRQoL nor buffered the impact of fear of COVID-19 on HRQoL. Practical interventions should prioritize reducing fear of COVID-19 and addressing broader psycho-social factors to enhance HRQoL in this vulnerable population.

From information to action: modelling social and cognitive factors in health decisions

BACKGROUND

This study examines the social and cognitive factors influencing health decisions to adopt protective behaviors in a U.S.

SAMPLE

A theoretical framework was developed, incorporating key variables such as perceived severity, perceived vulnerability, use of formal and informal health information, conspiracy beliefs, and political ideology. The protective behaviors studied included mask-wearing and vaccination intentions.

METHODS

This study employed a cross-sectional design to explore how cognitive appraisals and socio-political factors influence health decisions. Data were collected from 742 U.S.-based participants via Amazon Mechanical Turk (MTurk) between January 28-30, 2023.

RESULTS

Perceived vulnerability and perceived severity had distinct effects on information source preferences. Reliance on formal sources positively correlated with compliance behaviors such as mask-wearing and vaccination, while perceived severity strongly predicted mask adherence. In contrast, perceived vulnerability was associated with conspiracy beliefs and informal information use. Notably, fear of COVID-19 did not significantly influence health behaviors. Instead, political ideology and conspiracy beliefs played a more dominant role, emphasizing the importance of integrating socio-political factors into traditional health behavior models.

CONCLUSIONS

Understanding the complex interplay of cognitive and socio-political factors is crucial for developing effective public health strategies to enhance compliance with health guidelines during the COVID-19 pandemic and future crises.

Fear of COVID-19, traumatic growth, and traumatic stress symptoms: the mediating role of basic psychological needs

Although COVID-19 brought many negative psychological consequences, many people also experienced psychological growth. The present study investigated why this happened and hypothesized that self-determination theory's (SDT's) basic psychological needs (BPNs) may play a role in this explanation. Based on SDT, this cross-sectional study hypothesized that both the satisfaction and frustration of BPNs mediated the associations between fear of COVID-19, post-traumatic growth (PTG), and post-traumatic stress (PTS) symptoms. A sample of 391 Peruvian adults (70.6% women; Mage  = 35.04, age range between 18 and 84) responded to several valid and reliable questionnaires: Fear of COVID-19 Scale (FCV.19S); Basic Psychological Needs Satisfaction and Frustration Scale (BPNSFS); Impact Event Scale-Revised (IES-R); Post-Traumatic Growth Inventory (PTGI). The results showed that need satisfaction mediated the negative association between fear of COVID-19 and PTG, and need frustration mediated the positive association between fear of COVID-19 and PTG. In addition, a direct effect was found from fear of COVID-19 toward PTS symptoms. The results showed the importance of considering SDT's BPNs in explaining PTG and PTS after experiencing fear of COVID-19.

Citizen Worry and Adherence in Response to Government Restrictions in Switzerland During the COVID-19 Pandemic: Repeated Cross-Sectional Online Surveys

BACKGROUND

Good communication between health authorities and citizens is crucial for adherence to preventive measures during a pandemic. Crisis communication often appeals to worries about negative consequences for oneself or others. While worry can motivate protective behavior, it can also be overwhelming and lead to irrational choices or become a mental health problem. Also, the levels and consequences of worry can differ between different groups of citizens. Little is known about the evolution of worries during the pandemic and adherence to measures in distinct groups.

OBJECTIVE

This study aimed to evaluate worries in the Swiss population as well as associations between worry levels and citizens' adherence to government restrictions during different phases of the COVID-19 pandemic.

METHODS

We carried out an observational study with 4 cross-sectional online surveys of adults in the Canton of Vaud, Switzerland. Questionnaires were distributed through social media and websites during 4 periods: survey 1: April 17 to May 14, 2020; survey 2: May 15 to June 22, 2020; survey 3: October 30 to December 12, 2020; and survey 4: June 18 to December 30, 2021. On visual analog scales from 0 to 100, participants reported worry, self-adherence to pandemic restrictions, and their perceived adherence to others. We used multivariable linear regression, adjusting for age, gender, health literacy, and education to assess associations between self-reported worry, adherence, and study periods.

RESULTS

We collected 7106 responses. After excluding 2377 questionnaires (incomplete, age <18 years, residence outside Vaud), 4729 (66.55%) were analyzed (mean age 47, SD 15.6 years, 63.96% women). Mean worry across the 4 periods was 42/100, significantly higher in women (44.25/100, vs 37.98/100; P<.001) and young people (43.77/100 in those aged 18-39 years, vs 41.69/100; P=.005; in those aged 40-64 years and 39.16/100; P=.002; in those aged >64 years). Worries were higher during survey 1 and survey 3 (52.41/100 and 56.32/100 vs 38.93/100, P<.001; and 35.71/100, P<.001) than during survey 2 and survey 4, respectively. This corresponds to pandemic peaks during which federal restrictions were better followed with self-reported adherence of 84.80/100 and 89.59/100 in survey 1 and survey 3 versus 78.69/100 (P<.001) and 78.64/100 (P<.001) in survey 2 and survey 4. A 2.9-point increase in worry score, adjusted for the pandemic period, gender, age, education, and health literacy, was associated with a 10-point increase in personal adherence score (95% CI 2.5-3.2; P<.001).

CONCLUSIONS

Worries were higher in women, young people, and during the peak of the COVID-19 pandemic. Higher worry levels were associated with increased self-reported adherence to federal restrictions. Authorities should consider population worry levels and population subgroups in the planning and design of pandemic communication.

Extending and Testing Protection Motivation Theory in the Context of COVID-19 Contact-Tracing Technology: A Comparison of South Korea and the United States

This study applies protection motivation theory (PMT) to the COVID-19 contact-tracing context by including privacy concerns, collective efficacy, and a mediator (fear of COVID-19) and tests it in the US and South Korea. The study uses a structural equation modeling (SEM) approach and a sample of 418 Americans and 444 South Koreans. According to the results, fear was positively associated with adoption intentions in the US sample but not in the Korean sample. Coping appraisals positively affected adoption intentions in both samples. However, while all types of coping appraisals were significant in the Korean sample, response efficacy was the only significant predictor among US participants. Privacy concerns were negatively associated with adoption intentions in the US sample, but not in the Korean sample. The results indicate that differences exist in the mediating role of fear connecting threat appraisals and adoption intentions in both countries. These findings hold important implications for future studies in AI-based health communication, especially in the areas of privacy management, protection motivation, and diverse cultural contexts.

The Effect of Information Exposure on Stigma Toward the COVID-19 Patient Mediated by Perceived Risk, Attribution of Blame and Protection Norm Conformity

This study employed the model of stigma communication (MSC) to analyze how exposure to COVID-19-related information affected stigma-related information sharing about people who contracted COVID-19 during the pandemic and examined the cognitive process of the MSC in a collectivist culture. Based on a survey of 526 social media users during the COVID-19 pandemic in China, the study found that exposure to contact tracing information and pandemic control information had different impact on stigma-related information sharing through a series of cognitive variables. A dual-path model showed that perceived personal risk influenced stigma-related information sharing through attribution of blame toward the infected (the personal path), while perceived social risk influenced stigma-related information sharing through protection norm conformity (the social path). Compared to the personal path, the social path is more salient in shaping stigmatized attitudes and behaviors. The findings and discussions added to our understanding of the intricate stigma communication process in a collectivist culture.

Evaluating the relationship of empathic concern to college students' responses to the COVID-19 pandemic

Objective: Empathic concern (EC) for others may be related to COVID-19 pandemic responses. Participants and methods: The purpose of this survey study was to examine differences in pandemic responses in 1,778 college students rated as low (LE) versus high (HE) on the EC subscale of the Interpersonal Reactivity Index. Results: HE participants reported greater concerns in numerous pandemic-related domains, including acquiring COVID-19; access to COVID-19 treatment; number of COVID-19 cases, hospitalizations, and deaths reported; staying employed; and being isolated for long periods of time. Generalized anxiety symptoms, depressive symptoms, and perceived stress scores were significantly higher for individuals in the HE group compared to the LE group. The HE group reported being significantly more adherent to health and safety recommendations than the LE group. Conclusions: Empathic concern for others is important for promoting college student prosocial behavior but is associated with anxiety and depression symptomatology during times of traumatic stress.

Changes in complacency to adherence to COVID-19 preventive behavioral measures and mental health after COVID-19 vaccination among medical and dental healthcare professionals

Medical and dental professionals should continue to adhere to preventive measures after COVID-19 vaccination due to their increased risk of exposure to the virus, particularly as new variants emerge that may heighten their risk perception and susceptibility. Therefore, this study aimed to explore the effects of COVID-19 vaccination on complacency to adherence to COVID-19 preventive behavioral measures and mental health among medical and dental professionals. In this cross-sectional study 410 medical and dental professionals were recruited from different medical and dental hospitals in Islamabad, Pakistan. The data was collected using a valid and reliable questionnaire comprising of three sections (socio-demographic, information of preventive behaviors performance against COVID-19 after vaccination, mental health status). A chi-square test and ordinal logistic regression were used for analysis. Post COVID-19 vaccination there was decrease in the frequency of use of hand washing, sanitizers (70.2%), and social distancing (60.5%), however greeting with a handshake (58.8%) and use of public transport (45.9%) seen upward trend among participants. Only face mask usage post-vaccination was statistically significant (p < .05) in association with age, marital status, and years of working Experience. The greatest decrease in the usage of masks after COVID-19 vaccination was seen in age group of 10-30 (41.7%) and working experience group of 0-5 years (39.7%). All the preventive behaviors are statistically significant (p < .05) associated with the mental status of the participants except online shopping and use of public transport. These results indicate the presence of vaccination-induced complacency in adherence to COVID-19 preventive behavioral measures among healthcare professionals.

Exploring the relationship between personal and cohabiting family members' COVID-19 infection experiences and fear of COVID-19: a longitudinal study based on the Japan COVID-19 and Society Internet Survey (JACSIS)

OBJECTIVES

This study aims to explore the relationship between the combined experiences of COVID-19 infection in individuals and their family members and the resulting fear of COVID-19, with a focus on the severity of symptoms and various sociodemographic factors.

DESIGN

Longitudinal survey study.

SETTING

The Japan COVID-19 and Society Internet Survey (JACSIS), a large-scale web panel survey administered in Japan.

PARTICIPANTS

Analysis was based on responses from 15 542 individuals who participated in all three waves of JACSIS conducted between 2020 and 2022.

MAIN OUTCOME MEASURES

The primary measure was the fear of COVID-19, assessed using the Fear of COVID-19 Scale. The study employed a two-way analysis of variance without repetition, Games-Howell post hoc tests and ordinary least-squares linear regression analysis, with time points treated as fixed effects.

RESULTS

The study revealed significant differences in fear levels based on the combined COVID-19 infection experiences of respondents and their family members, with variations observed across different time points. Mild symptoms in either the respondents or their family members correlated with reduced fear (β=-0.584, SE=0.181, p=0.001), while severe symptoms were associated with increased fear (β=1.244, SE=0.217, p<0.001). Gender, age, marital status and a history of respiratory disease or mental illness were also significant factors. For instance, females reported higher fear levels compared with males (β=0.707, SE=0.049, p<0.001), and those with a history of respiratory diseases showed increased fear (β=1.632, SE=0.286, p<0.001). Over time, the general fear of COVID-19 decreased, with the sharpest decline observed at T3 compared with T1 (β=-1.399, SE=0.061, p<0.001).

CONCLUSION

The study highlights the significant influence of the combined COVID-19 infection experiences of individuals and their family members (the severity of symptoms, in particular) on the fear of COVID-19. These results underscore the need for tailored mental health interventions that consider both personal and familial infection experiences, as well as other sociodemographic factors. The findings also reflect the evolving public response to the changing dynamics of the pandemic.

The relationship between COVID-19 anxiety and self-efficacy among adolescent students: A cross-sectional study

BACKGROUND

The spread of the COVID-19 epidemic, as well as its high contagiousness, increased students' anxiety and stress. Anxiety may affect individuals' functioning and undermine their self-efficacy. Therefore, the present study aimed to determine the relationship between COVID-19 anxiety and self-efficacy among adolescent students.

METHOD

This cross-sectional descriptive correlational study was conducted on 306 adolescent students in southern Iran. The research tools were the Corona Disease Anxiety Scale consisting of physical and psychological dimensions of anxiety and the Self-Efficacy Scale composed of three subscales: academic, social, and emotional self-efficacy. Data were analyzed using SPSS 25. Pearson correlation was used to investigate the relationship between COVID-19 anxiety and self-efficacy using the total score of both scales and their dimensions as well. T-Test and one-way ANOVA were used to see whether sociodemographic variables of participants significantly varied in self-efficacy and COVID-19 anxiety.

RESULTS

The mean score of COVID-19 anxiety was 11.70 ± 9.25, representing mild anxiety, and the mean score of the psychological dimension was higher than that of the physical dimension. The mean self-efficacy score was 81.29 ± 12.98 indicating high level of self-efficacy. In addition, the mean score of academic self-efficacy was higher than that of social and emotional self-efficacy. There was an inverse, significant, and mild to moderate relationship between COVID-19 anxiety and the total score of self-efficacy (r = -.28, p < .001) and all its dimensions (r = -. 18, p = .002 for social and academic self-efficacy; r = -.32, p <. 001 for emotional self-efficacy). While the physical dimension of COVID-19 anxiety correlated significantly and negatively with self-efficacy total and subscale scores, the mental subscale of COVID-19 anxiety only correlated with the self-efficacy total score (r = -.20, p < .001) and emotional self-efficacy (r = -.28, p < .001).

CONCLUSION

The study results revealed that the higher the COVID-19 anxiety, the lower the self-efficacy among adolescents. It is important to prioritize the enhancement of self-efficacy among adolescents to ensure their success across various life domains including managing stressors brought about by pandemics like COVID-19. This requires a collaborative effort from parents and teachers as they are a primary source of reassurance and information. Parents and teachers can also serve as role models in showcasing resilience and positive coping with the pandemic and allow adolescent students to master adaptive coping and provide positive reinforcement for effective behaviors.

Assessing the Fear of Covid-19 in Psychiatric Patients: Results from an Italian Multicentric Study

Objective

Even though the COVID-19 emergency has concluded, its consequences are still relevant. Recent evidence suggests that a significant proportion of individuals experience persistent symptoms long after the initial infection has resolved, classified as "Long COVID" condition. Fear of COVID-19 increases anxiety and stress levels in healthy individuals and exacerbates the symptoms of those with pre-existing psychiatric disorders; therefore understanding the impact of the pandemic on psychiatric disorders remains of utmost importance. The present study aimed at assessing the prevalence and predictive factors of fear of COVID-19 in a sample of patients with different psychiatric conditions.

Method

A sample of 269 psychiatric patients were recruited from two different tertiary clinics in Italy and assessed with the Fear of COVID-19 Scale (FCV-19S). In order to compare patients with a significant fear of COVID-19 or without (Fear+ vs. Fear-) and to identify the main features in terms of clinical dimension, exploratory and predictive analysis were performed.

Results

Female gender, age at illness onset, and insight levels emerged as positive predictors of FCV-19S. Conversely, current substance abuse emerged as a negative predictor of fear levels. Moreover, significantly lower FCV-19S scores were observed in patients with a diagnosis of schizophrenia spectrum disorders.

Conclusions

Specific sociodemographic and clinical factors predicted higher levels of fear of COVID-19 in psychiatric patients. Further studies are warranted to determine the potential long-term consequences of the COVID-19 impact on mental health.

Effective health communication depends on the interaction of message source and content: two experiments on adherence to COVID-19 measures in Türkiye

OBJECTIVE

Following the COVID-19 outbreak, authorities recommended preventive measures to reduce infection rates. However, adherence to calls varied between individuals and across cultures. To determine the characteristics of effective health communication, we investigated three key features: message source, content, and audience.

METHODS

Using a pre-test and two experiments, we tested how message content (emphasizing personal or social benefit), audience (individual differences), message source (scientists or state officials), and their interaction influence adherence to preventive measures. Using fliers advocating preventive measures, Experiment 1 investigated the effects of message content and examined the moderator role of individual differences. Experiment 2 presented the messages using news articles and manipulated sources.

RESULTS

Study 1 found decreasing adherence over time, with no significant impact from message content or individual differences. Study 2 found messages emphasizing 'protect yourself' and 'protect your country' to increase intentions for adherence to preventive measures. It also revealed an interaction between message source and content whereby messages emphasizing personal benefit were more effective when they came from healthcare professionals than from state officials. However, message source and content did not affect vaccination intentions or donations for vaccine research.

CONCLUSION

Effective health communication requires simultaneous consideration of message source and content.

Online Media Consumption, Fear, Mental Wellbeing, and Behavioral Compliance During the COVID-19 Pandemic: A Longitudinal Study

This study explored how online media consumption, fear, mental wellbeing, and behavioral compliance with COVID-19 measures were related to one another during the COVID-19 pandemic. Employing a four-wave longitudinal survey research design (n = 1,092), this study found positive relationships between online media consumption and fear of COVID-19, between fear of COVID-19 and behavioral compliance, and between behavioral compliance and mental wellbeing in the general Dutch population. Results showed a negative relationship between fear of COVID-19 and mental wellbeing. Repeated measures ANOVAs indicated that participants' online media consumption, fear of COVID-19, and behavioral compliance with COVID-19 measures all gradually decreased as the pandemic progressed, while mental wellbeing gradually recovered as the pandemic progressed. Recognizing the negative relationship between fear of COVID-19 and mental wellbeing, policymakers may be encouraged to focus on implementing interventions and communication strategies to support mental health during pandemics. Using other types of appeals (e.g. hope appeals) in addition to the commonly used fear appeals when developing online public health messages could ensure behavioral compliance during pandemics without triggering high levels of fear. This can contribute to maintaining people's mental wellbeing when they have to cope with life-threatening public health crises while still promoting behavioral compliance with necessary public health measures.

Fear and Impact of COVID-19 Among Post-Infected Adults: Types and Associations with Quality of Life and Post-Traumatic Stress Symptoms

Survivors of COVID-19 are susceptible to diminished health-related quality of life (HRQoL) and adverse psychological health, which may be exacerbated by their experiences of fear and the impact of the pandemic itself. This study aims to identify distinct fear and impact patterns related to the COVID-19 pandemic among survivors through latent profile analysis (LPA) and examine the associations of fear and impact patterns with post-traumatic stress symptoms (PTSS) and HRQoL. A total of 5,890 Vietnamese COVID-19 survivors completed the COVID-19 Impact Battery- Disability Scale (CIB-D), the Fear of COVID-19 Scale (FCoV-19 S), the Impact of Event Scale-Revised for PTSS, and the 36-Item Short Form Survey (SF-36) for HRQoL. Four distinct groups of fear and impact were identified: "Fearful and highly impacted" (26.8%), "moderately impacted yet not fearful" (22.9%), "less impacted and less fearful" (18.6%), and "mildly impacted and neutral" (31.7%). Survivors who were "less impacted and less fearful" exhibited significantly higher HRQoL scores (regression coefficient, B: 10.9; 95% confidence interval (CI): 10.0 - 11.7), both in terms of physical (B: 12.0; 95%CI: 11.1 - 12.9) and mental health (B: 19.4; 95%CI: 9.6 - 11.1), and lower PTSS levels (B: -24.5; 95%CI: -25.8 - -23.3) compared to those who were "highly impacted and fearful". It is imperative to acknowledge the intricate association between fear, impact, and mental health to comprehensively address the diverse needs of this distinct population post-COVID-19. These findings provide insights for designing interventions and support mechanisms for COVID-19 survivors.

The effects of mass media messages, perceived susceptibility and self-rated health on public attitude towards COVID-19 in South Africa

OBJECTIVES

South Africa was the worst affected country in Africa by the COVID-19 pandemic and it is important to interrogate the attitude of the populace towards the pandemic for future interventions. Therefore, this study examined effects of mass media messages, susceptibility to COVID-19 and self-rated health on the attitudes of South Africans towards the COVID-19 pandemic.

METHODS

Data was from the National Income Dynamics Study - Coronavirus Rapid Mobile Survey (NIDS-CRAM) of 2021 which is a nationally representative panel survey of about 7,000 South African individuals in all the nine provinces. Analyses of data were through descriptive statistics, chi square test and logistic regression models.

RESULTS

The results showed that 61.28% of the resondents did not take COVID-19 test while 91.09% of them engaged in behavioral changes such as social distancing and wearing of face masks. In addition, 74.27% of the respondents had access to mass media information, 70.44% believed they have good physical health while 32.43% felt they were not susceptible to COVID-19. The chi-square results of attitude towards COVID-19 showed significant differences in access to mass media messages on COVID-19, race, and province of residence. Furthermore, respondents who had access to mass media information on COVID-19 (OR = 1.469; p = 0.001) and respondents who believed that they were susceptible to COVID-19 infection (OR = 1.443; p = 0.001) were significantly associated with increased likelihood of engagement in behavioral changes to avoid the COVID-19.

CONCLUSION

These findings therefore emphasize the need for increased awareness and sensitization of the people about the susceptibility and adverse effects of diseases to ensure that they adopt the appropriate attitudes that will safeguard them from such diseases outbreak.

Implications of the health information pollution for society, health professionals, and science

In the era of ultra-connectivity, the proliferation of speculative notions driven by personal emotions eclipses the credibility of scientific evidence. This trend has led to an alarming surge in information pollution, particularly by the pervasive influence of social media platforms. Consequently, this overflow of falsehoods poses a significant threat to public health and overall societal well-being. In this sense, this critical review aims to present the harmful impacts of the health information pollution on society, health professionals, and health science, as well as strategies for their mitigation. The management of information pollution requires coordinated efforts to develop and implement multiple effective preventive and debunking strategies, such as the regulation of big tech companies' actions and algorithm data transparency, the education of health professionals on responsible social media use, and the establishment of a novel academic culture, shifting from the valorization of productivism to socially relevant scientific production. By acknowledging the complexities of this contemporary issue and drawing insights from distinct perspectives, it is possible to safeguard the integrity of information dissemination and foster a more informed and resilient community.

The role of personality traits and emotional intelligence in the evaluation of the benefits and costs of social distancing during a pandemic outbreak

The analysis of the benefits and costs of social distancing is a crucial aspect for understanding how individual and community actions can mitigate and manage the costs of a pandemic. In this study, we aimed to investigate the extent to which personality factors and emotional intelligence (EI) contributed to the subjective assessment of the benefits and costs of social distancing behaviors during the COVID-19 pandemic. We also aimed at determining whether EI served as a mediator in the relationship between personality traits and the evaluation of social distancing consequences. Data was collected via online surveys from a sample of 223 Italian-speaking participants (age: 30.78 ± 9.97; 86.1% females) between March and April 2021. Findings indicate that the tendency to prioritize the benefits of social distancing over personal costs was positively associated with emotional stability and emotion regulation, but negatively associated with extroversion. The following mediational analyses revealed that the emotion regulation facet of EI mediated the associations between personality dimensions (emotional stability and extroversion) and the evaluation of the costs and benefits of social distancing. These findings provide useful indications and implications for developing appropriate communication strategies aimed at reaching the general population and suggest that, during health-related crises, emphasis should be placed on offering courses and programs to improve and develop individuals' EI.

The Shield of Self-Esteem: Buffering against the Impact of Traumatic Experiences, Fear, Anxiety, and Depression

BACKGROUND

Adverse life occurrences (e.g., severe accidents, violence/abuse, organic disorders such as COVID-19) can elicit traumatic responses that heighten fear, anxiety, and depression. However, scientific research has shown that certain variables, such as self-esteem, based on theories like terror management theory (TMT) and the anxiety-buffering hypothesis (ABH), can mitigate the negative effects of trauma. This study aimed to test the ABH by assessing the buffering role of self-esteem in the relationships among the impact of traumatic experiences, fear, anxiety, and depression.

METHOD

An observational research design was used. This study involved 321 participants who experienced COVID-19 as a traumatic experience. A sequential multiple-mediation model with observed variables (path analysis) was used to test the impact of the traumatic experience on fear, anxiety, and depression, examining the protective role of self-esteem.

RESULTS

A path analysis revealed that fear and anxiety mediated the relationship between the impact of the traumatic experience of COVID-19 and depression. Additionally, in line with the ABH, self-esteem was found to mediate the relationship between the predictors and their adverse psychological consequences. This suggests that self-esteem played a buffering role, mitigating the negative impact of traumatic experiences on mental health outcomes.

CONCLUSIONS

These findings underscore the central mediating role of self-esteem, as well as fear and anxiety, in the pathway from trauma-related factors to depression. These insights advocate for evidence-based interventions aimed at alleviating the psychological suffering associated with traumatic experiences, fostering adaptation, and supporting psychological health.

Analysis of the relationship between fear of coronavirus and hand hygiene beliefs and practices of surgical nurses: A descriptive and cross-sectional study

AIM

This study aimed to analyse the relationship between fear of COVID-19 and hand hygiene beliefs and practices of surgical nurses.

METHOD

This article is a descriptive correlational study. It was conducted between February and May 2021 with 306 surgical nurses working at public and private hospitals in Northern Cyprus. A personal information form, Fear of COVID-19 Scale, Hand Hygiene Belief Scale and Hand Hygiene Practices Inventory were used for data collection.

RESULTS

Of the participants in the study, 25.41% were 29 years old or younger and 85.15% were female. The mean scores obtained from the Fear of COVID-19 Scale, Hand Hygiene Belief Scale and the Hand Hygiene Practices Inventory were 23.12 ± 8.03, 81.33 ± 7.67 and 69.15 ± 1.94, respectively. The Fear of COVID-19 Scale scores were negatively correlated with the Hand Hygiene Belief Scale scores and positively correlated with the Hand Hygiene Practices Inventory scores.

CONCLUSION

Hand hygiene practices were better for nurses with higher level of COVID-19 fear. Therefore, a high level of seriousness and awareness of nurses about hand hygiene, which was achieved during the COVID-19 pandemic, should be sustained to maintain proper hand hygiene practices.

Don't say it's over: The perceived epidemic stage and COVID preventive behaviour

Little is known about the perceptions of the COVID-19 pandemic's dynamic and its effect on self-protective behaviour. Using survey data from 1343 university students we explored how the perceived temporal distance to the COVID pandemic peak associates with risk perception and the adherence of preventive behaviours. Results show that individuals differ in their perception of the pandemic stage despite being in the same environment. The belief that the COVID peak is in the past was associated with less perceived risk and decreased self-protection. A high COVID-19 media involvement and trust in the authorities were associated with higher perceived risk and preventive behaviour implementation. Overall, the perception that the pandemic wave is in its final stages could be an independent predictor of more risky behaviour. Thus, the communication of the pandemic dynamic should be provided by policy makers with caution to avoid the possibility of discounting the risk.

Surviving the storm: Wave-wise comparison of the pandemic's impact on mental health dynamics, sleep patterns, and preventive behaviors among coronavirus patients in Northern India

Background

Different clinical manifestations were revealed by the distinct waves of the coronavirus. The pandemic had a multifaceted impact on mental health, sleep patterns, and associated fear.

Materials and Methods

It was an observational online survey using by using Google Forms in the city of Chandigarh between April 2020 and April 2021 across three waves of the coronavirus outbreak (first wave from March 2020 to May 2020, second wave from June 2020 to January 2021, and third wave from February 2021 to April 2021). Fear of coronavirus disease (COVID), preventive behaviors, insomnia-related problems, and impact of the event were assessed by using standardized scales.

Results

The participants who were infected during the first phase exhibited significantly higher levels of distress, loss of control over their reactions, increased fear of coronavirus and sleep problems, and also greater adherence to preventive behaviors compared to those who were infected during the second and third waves. A tendency to emerge post-traumatic stress disorder (PTSD) was seen in 68 (58.1%) of the participants (Peritraumatic Distress Inventory (PDI) score >14) and 34 (29.1%) of all the participants (PDI score >23). Overall, 66 (56.4%) participants reported having insomnia. About 24 people (20.5%) had clinical concerns about PTSD, 20 people (17.1%) had probable PTSD diagnoses, and 16 people (13.7%) experienced a severe coronavirus disease 2019 (COVID-19) pandemic impact on their lives.

Conclusion

The first wave of COVID-19 had a greater psychological impact than subsequent waves. Further research must fill important gaps in our knowledge of the clinical range and long-term effects.

Fear of COVID-19 predicts increases in anxiety, depressive symptoms, health anxiety, psychosocial distress, and loneliness: Findings from a prospective two-year follow-up study

The role of fear of COVID-19 in prospectively predicting changes in psychopathological symptoms during the COVID-19 pandemic remains unclear. The present data were obtained from a longitudinal non-probability sample in Germany, initially assessed at the beginning of the COVID-19 pandemic in Germany (April-May 2020) and reassessed after two years (n = 846; 83% female; mean age: 44.59 years, SD = 12.32; response rate: 19.5%). Multiple linear regressions were used to examine associations of fear of COVID-19 at baseline with depressive symptoms, anxiety, health anxiety, psychosocial distress, and loneliness controlling for (a) the respective symptom measure, and (b) all psychopathological symptoms at baseline. The data were weighted to minimize attrition and representativeness biases. Overall, loneliness decreased from the beginning of the COVID-19 pandemic until the two-year follow-up, whereas all other symptoms did not change. Fear of COVID-19 at the beginning of the pandemic predicted an increase in anxiety symptoms, health anxiety, psychosocial distress, and loneliness two years later. In addition, fear of COVID-19 predicted higher health anxiety, depressive symptoms, psychosocial distress, and loneliness, but not anxiety symptoms when controlling for all baseline symptom measures at once. Fear of COVID-19 seems to play a central role in predicting negative mental health outcomes, emphasizing the necessity of indicated prevention and intervention to decrease worry and manage anxiety, thereby reducing the negative impact on mental health caused by fear during future pandemics.

Investigating the Possibility of Nurse Prescribing Training Development in Nursing Education System in Iran

PURPOSE

Adequate medical knowledge and skills are fundamentals for nurse prescribing authority development. This study will explore the potential for developing nurse prescribing training in Iran, where nurses currently lack prescribing authority despite their strong academic nursing education.

METHODS

This is a study with two phases. At first, in a conventional qualitative content analysis method, with purposive and snowball sampling, from June 2021 to March 2023, 20 participants, including 16 nurses in different clinical, managerial, educational, and policy-making settings, three physicians, and one clinical pharmacist were interviewed. Unstructured interviews were conducted face-to-face or virtually as the situation required during the pandemic period due to Coronavirus disease, 2019 (COVID-19). Qualitative content analysis as developed by Elo and Kyngäs in 2008 was used for data analysis. In the second comparative analysis phase, four masters of science and one doctor of nursing curricula analyzed in the existence of the nurse prescribing prerequisite courses and these five curricula and two potential masters of science in community health and critical care nursing curricula were compared with John Hopkins University curricula.

RESULTS

In the qualitative phase, two themes emerged: nursing education challenges and the potential for nurse prescribing training development. These were further broken down into four subthemes: inadequate nurses' knowledge in prerequisite nurse prescribing courses, unprepared educational infrastructure, treatment sector potentials, and educational potentials, with a total of 12 concepts identified. During the comparative phase, it was found that none of the nursing curricula had adequate prerequisite courses for nurse prescribing. However, the Community Health and Critical Care nursing curricula showed potential for developing nurse prescribing training.

CONCLUSIONS

In the nursing education system, there are some challenges and potentials for prescribing training, and the community health and critical care nursing curricula have the potential capacity to prepare the graduated nurses to prescribe. It needs educational and managerial policies. More developmental research and pilot studies are recommended.

Death Obsession, COVID-19-Related Fear and Religiosity in People Living with Type 2 Diabetes

Patients diagnosed with type 2 diabetes were included among high-risk groups for more severe manifestations in case of COVID-19 infection and higher risk of mortality. The current study aims to (1) examine the relationship between death obsession, religiosity, and fear of COVID-19 among type 2 diabetes patients, and (2) assess if religiosity moderates the relationship between death obsession and fear of COVID-19. This cross-sectional online survey involved 306 type 2 diabetes patients. We found that 35.6 % of the participants were overweight and 14.6 % were suffering from obesity. Results showed that death obsession was positively associated with fear of COVID-19 and more religious individuals experience higher levels of fear. The overall level of religiosity did not moderate the relationship between death obsession and fear of COVID-19 but only the preoccupation with God dimension of the religiosity scale. The practical implications of these findings are discussed.

Workplace Deceptions During the Pandemic: Differences in Conspiracy Beliefs, Psychological Functioning, and Covid-19 Experiences

The global pandemic has disrupted virtually all countries on health, psychological functioning, and economies, to name a few. Accurate information has also fallen victim to the pandemic, which has been rife with misinformation and conspiracy theories. The current study investigated Covid-19 deceptions related to employment. With complete anonymity via MTurk, 389 participants from the United States rated their likelihood of deception regarding hypothetical four workplace scenarios. The first set of analyses examined differences between high and low risk of deceptions for each scenario based on participants' self-appraisals. The largest differences were found for general conspiracy beliefs and affective disorders, specifically major depression and generalized anxiety. The second set of analyses focused across the workplace scenarios on two operationalized groups with Likely-Deceptive (n = 189) vastly outnumbering Likely-Genuine (n = 55). Personal experiences with Covid-19 dramatically increased deceptions. Testing positive for Covid-19 increased the odds of being in the Likely-Deceptive by twelve-fold. Two discriminant models examined cognitive misbeliefs and psychological functioning. When both were combined, depression and Covid-19 misinformation produced the strongest structure coefficients followed closely by general conspiracy beliefs and generalized anxiety. The far-ranging implications of these findings are discussed.

Factors Influencing COVID-19 Vaccine Hesitancy in Pregnant and Breastfeeding/Puerperium Women: A Cross-Sectional Study

Vaccination among pregnant and breastfeeding women is critical for protecting this vulnerable population and their children. COVID-19 vaccination is recommended both during pregnancy and breastfeeding; however, we still do not fully understand the determinants that influence hesitancy towards COVID-19 vaccination. This study aimed to identify the determinants of vaccine hesitancy in pregnant and breastfeeding, puerperium women. A multicenter, cross-sectional study, involving 435 pregnant and breastfeeding women, was conducted. Vaccination hesitancy was evaluated by administering the Vaccination Attitudes (VAX) Scale and the Zung Anxiety Self-Assessment Scale (SAS) was adopted to measure anxiety levels. Overall, 14% of the participants reported that they did not receive the COVID-19 vaccine, and 78.3% received their first dose during pregnancy or while breastfeeding. The descriptive statistics for the VAX scale showed a total mean score of 3.35 (±1.6), and 75% of participants reported an anxiety index equal to or lower than the threshold. Vaccine hesitancy increased as "adverse events after vaccination" increased (p < 0.01), while SAS levels positively correlated with the participants' mean age (p < 0.05). Investigating the factors influencing vaccine hesitancy enables the development of targeted health policies and SARS-CoV-2 vaccination programs.

Individual Differences in Females' Adherence to Public Health Measures and Psychopathology Symptoms During a Global Health Crisis: the Role of Triarchic Psychopathic Traits

The two broad aims of this study were to (a) investigate how the three traits of the triarchic model-boldness, meanness, and disinhibition-relate to compliance with public health measures, as well as to internalizing and externalizing psychopathology, during a public health crisis, and (b) test for associations between psychopathology and compliance with public health measures. Participants were 947 Brazilian adult females aged 18-75 years who completed measures of the triarchic traits, internalizing and externalizing symptoms/problems, and a COVID-19 behaviors and beliefs questionnaire. Multiple regression and path analyses showed meanness to be the only triarchic trait significantly predictive of compliance with public health measures, in a negative direction, when controlling for the other traits. Results also demonstrated that compliance with public health measures was associated with levels of distress (negatively), obsessions/fear (positively), and positive mood (negatively). Overall, the results demonstrate the contributions of the triarchic traits to understanding complex phenomena, highlighting meanness as the most essential triarchic trait predictor of adherence to public health measures among females.

Managing Fear During Pandemics: Risks and Opportunities

Fear is an emotion triggered by the perception of danger and motivates safety behaviors. Within the context of the COVID-19 pandemic, there were ample danger cues (e.g., images of patients on ventilators) and a high need for people to use appropriate safety behaviors (e.g., social distancing). Given this central role of fear within the context of a pandemic, it is important to review some of the emerging findings and lessons learned during the COVID-19 pandemic and their implications for managing fear. We highlight factors that determine fear (i.e., proximity, predictability, and controllability) and review several adaptive and maladaptive consequences of fear of COVID-19 (e.g., following governmental health policies and panic buying). Finally, we provide directions for future research and make policy recommendations that can promote adequate health behaviors and limit the negative consequences of fear during pandemics.

Mental health and the overall tendency to follow official recommendations against COVID-19: A U-shaped relationship?

This paper investigates the association between several mental health indicators (depression, anxiety, stress, and loneliness) and the overall tendency to follow official recommendations regarding self-protection against COVID-19 (i.e., overall compliance). We employ panel data from the COME-HERE survey, collected over four waves, on 7,766 individuals (22,878 observations) from France, Germany, Italy, Spain, and Sweden. Employing a flexible specification that allows the association to be non-monotonic, we find a U-shaped relationship, in which transitions to low and high levels of mental health are associated with higher overall compliance, while transitions to medium levels of mental health are associated with less overall compliance. Moreover, anxiety, stress, and loneliness levels at baseline (i.e., at wave 1) also have a U-shaped effect on overall compliance later (i.e., recommendations are followed best by those with lowest and highest levels of anxiety, stress, and loneliness at baseline, while following the recommendations is lowest for those with moderate levels of these variables). These U shapes, which are robust to several specifications, may explain some of the ambiguous results reported in the previous literature. Additionally, we observe a U-shaped association between the mental health indicators and a number of specific health behaviours (including washing hands and mask wearing). Importantly, most of these specific behaviours play a role in overall compliance. Finally, we uncover the role of gender composition effects in some of the results. While variations in depression and stress are negatively associated with variations in overall compliance for men, the association is positive for women. The U-shaped relation in the full sample (composed of males and females) will reflect first the negative slope for males and then the positive slope for females.

Exploring the relationship between older adults' online health information seeking, negative emotions and prevention behaviors in the pandemic context: a two-wave longitudinal study

Introduction

During the COVID-19 pandemic, older adults were facing more mental health issues that may cause complex impacts on pandemic prevention, and turning to the internet for health information is a double-edged sword for them. This study aimed to investigate the reciprocal relationship between negative emotions and prevention behaviors in older adults, as well as the direct and moderating effects of online health information seeking (OHIS) on negative emotions and prevention behaviors.

Methods

Based on the common-sense model of self-regulation (CSM) and a sample of more than 20,000 participants from the Survey of Health, Aging and Retirement in Europe (SHARE), this study first used an autoregressive cross-lagged panel model (CLPM) to analyze the longitudinal effect of negative emotions on prevention behaviors. Second, the study used ordinary least squares (OLS) regression to explore the influence of OHIS usage frequency changes on negative emotions and prevention behaviors. Third, the study used multigroup analysis to examine the moderating effect of OHIS usage frequency changes on the CLPM.

Results

The findings indicate a significant longitudinal association where initial negative emotions predicted later prevention behaviors (β = 0.038, p < 0.001), and increased OHIS frequency was linked to positive changes in prevention behavior (β = 0.109, p < 0.001). Multigroup analysis revealed that the connection between negative emotions or increased negative emotions and prevention behaviors remained significant for those with no change or an increase in OHIS frequency but not for those with a decrease.

Conclusion

This study suggested that negative emotions may drive older adults to engage more in prevention behaviors and that OHIS can augment this effect. These results underscore the importance of addressing mental health and providing reliable online health information to support older adults in managing infectious disease risks.

Motivating Protective Behavior against COVID-19: Fear Versus Hope

OBJECTIVES

Based on protection motivation theory, we investigate how indicators of threat perception (perceived severity, perceived vulnerability, and fear arousal) and coping appraisal (hope) are associated with older people's motivation to engage in protective behavior after the outbreak of COVID-19.

METHODS

We use multivariate regression analyses with a sample of 40,282 individuals from 26 countries participating in the SHARE Corona Survey.

RESULTS

We find that 15% of all respondents stayed home completely-mainly the oldest and vulnerable people with prior health risk conditions. On average, older Europeans responded strongly to the recommended protective behavior measures (6 out of 7 measures adopted). Among the threat perception indicators, fear arousal is the main motivator for protective behavior, whereas the coping appraisal indicator hope shows an equally strong association.

DISCUSSION

Given the negative health effects of fear, our findings may help evaluate and revise governmental policy responses and communication strategies.

The Impact of Caregivers on COVID-19 Fears, Behaviors, and Perceived Impact in a Majority Black American Sample of Children

Introduction

Caregivers may play an essential role in buffering and/or exacerbating COVID-19 fears and behaviors in youth. However, few studies have examined these associations in children from racial and ethnic minority groups, who have been historically marginalized and may be disproportionately susceptible to psychological consequences. Here, we examined the associations among caregivers and children for COVID-19-related fears, behaviors, and impact in a majority Black sample (71.9%) of children.

Methods

Children (N = 64, 24 females, ages 7-10 years) were recruited from three Detroit, Michigan-area schools during the 2019-2020 school year. Following school shutdowns in March 2020, children and their caregivers were invited to complete remote surveys in May and August 2020. We examined the associations among child and caregiver COVID-19-related fears, preventive behaviors, and perceived impact. We also examined whether aspects of the caregiver-child relationship (i.e., closeness, conflicts) moderated these associations.

Results

Caregiver-child fears about social distancing, preventive behaviors, and perceived impact of COVID-19 were positively correlated. The positive correlation between caregiver-child preventive behaviors strengthened over time and was moderated by caregiver-child closeness.

Conclusion

These findings suggest that caregivers may impact fear as well as preventive behaviors and perceived impact of the pandemic in marginalized youth.

Covid-19 pandemic, social normative compliance, and sustainable consumption: Evidence from experiments

This research aims to investigate the causal effects of consumers' Covid-19 pandemic experiences on their preferences for sustainable consumption. Drawing on social identity theory, we argue that pandemic experiences heighten consumers' awareness of the importance of adhering to collective social norms, subsequently motivating them to adopt sustainable consumption practices that promote collective interests. Through three preregistered experiments, we demonstrate that: (i) Covid-19 pandemic experiences increase consumers' preferences for sustainable consumption; (ii) this effect is more pronounced for individuals with severer pandemic experiences and females; (iii) pandemic experiences influence sustainable consumption preferences by enhancing consumers' social normative compliance. This study contributes to the understanding of Covid-19's consequences from a micro-level perspective of consumer behavior and offers insights into the factors driving consumers' sustainable consumption preferences.

Closing the Gap: How Psychological Distance Influences Willingness to Engage in Risky COVID Behavior

Pandemics, and other risk-related contexts, require dynamic changes in behavior as situations develop. Human behavior is influenced by both explicit (cognitive) and implicit (intuitive) factors. In this study, we used psychological distance as a lens to understand what influences our decision-making with regard to risk in the context of COVID-19. This study was based on the rationale that our relational needs are more concrete to us than the risk of the virus. First, we explored the impact of social-psychological distance on participants' risk perceptions and behavioral willingness. As hypothesized, we found that close social relationships of agents promoted willingness to engage in risky behavior. In the second phase, we tested an intervention designed to increase the concreteness of information about virus transmission as a mechanism to mitigate the bias of social influence. We found that the concreteness intervention resulted in significantly reduced willingness to engage in risky behavior. As such, communications aimed at changing the behavior of citizens during times of increased risk or danger should consider conceptually concrete messaging when communicating complex risk, and hence may provide a valuable tool in promoting health-related behavior.

Vaccine communication strategies among healthcare workers as a reflection of the Israeli Ministry of Health's communication strategies before and after the COVID-19 pandemic

Background

Healthcare workers play a central role in communicating information to the public regarding vaccines. Most of the literature has focused on healthcare workers' hesitancy and doubts about getting the flu vaccine themselves. However, few studies have dealt with how they perceive their role in communicating information regarding vaccines, especially following the COVID-19 pandemic.

Objectives

(1) To identify the communication strategies used by the Israeli Ministry of Health regarding vaccines during epidemic crises (before and after the COVID-19 pandemic); (2) To identify the communication strategies used by healthcare workers regarding vaccines before and after the COVID-19 pandemic.

Methods

A qualitative study based on in-depth interviews was conducted among healthcare workers and used a semi-structured protocol as a research tool. A total of 18 healthcare workers were sampled using purposeful and snowball sampling.

Results

Despite healthcare workers' perception that there has been a decrease in trust in the Israeli Ministry of Health among the public following the COVID-19 outbreak, they still rely on the Israeli Ministry of Health as their primary source of information and use the same communication strategies (such as fear appeals and correcting information) as of the Israeli Ministry of Health to communicate with the public, healthcare providers, and other relevant stakeholders.

Conclusion

Healthcare workers have been shaped by the professional socialization processes within the health system, leading to a predominant reliance on established communication strategies and informational channels. This reliance underscores the importance of evolving these methods to better engage with the public. To address this, there is a compelling need to innovate and adopt new communication techniques that emphasize effective dialogue and transparent interactions. By doing so, healthcare professionals can ensure that their outreach is not only informative but also responsive to the diverse needs and preferences of the community.

The use of fear appeals for pandemic compliance: A systematic review of empirical measurement, fear appeal strategies and effectiveness

Interventions to pandemic outbreaks are often associated with the use of fear-appeal to trigger behavioral change, especially in public health issues. However, no systematic review exists in the literature on the effectiveness of fear appeal strategies in the context of pandemic compliance. This paper aims at providing systematic literature review that answers the following thought-provoking research questions: (1) What is the standard measurement of fear in relation to pandemics in the existing literature? (2) What are the fear appeal strategies used in the empirical literature? (3) How effective are fear appeal strategies in changing behavior toward adopting pandemic preventive measures? A total of 22 studies were selected from 455 potential studies, following a comprehensive literature search and assessment in accordance with the PRISMA guidelines. The findings show that nearly all the available studies on fear measurement used the Likert scale (as the standard approach) with different points of degree and fear appeal strategies such as fear triggers in media channels, print advertisements, and verbal descriptions. Furthermore, most studies conclude that fear appeal is effective in making participants adopt pandemic preventive measures; hence, it is effective for positive behavioral change (the degree of effectiveness depends on gender, population group, etc.), especially when combined with self-efficacy and socio-cultural considerations. Very few studies, however, find an insignificant association, arguably due to the kind and intensity of the fear appeal messages and strategies used.

Exploring the impact of pandemic fear on visitation to park attractions in urban city: A case study in Seoul, South Korea

This research explores changes in perceptions and utilization of parks during the COVID-19 pandemic in Seoul, South Korea. It investigates the relationship between fear of the pandemic and individuals' opinions about open spaces and their visiting decisions. The study surveyed 600 adults from February 22-23, 2022, and used structural equation modeling to analyze the data. The findings revealed that increased fear of the pandemic led to more positive park sentiments, resulting in higher park visits and fewer visits to other public spaces. The research highlights the significance of parks during the COVID-19 pandemic and how people's perceptions were influenced by their pandemic-related fear.

Protective behaviors against COVID-19 and their association with psychological factors in China and South Korea during the Omicron wave: a comparative study

OBJECTIVES

We aimed to explore the level of protective behaviors against COVID-19 and its association with psychological factors in China and South Korea during the Omicron wave.

STUDY DESIGN

Cross-sectional study.

METHODS

We conducted a population-based cross-sectional survey from March 15 to 30, 2023 in China and South Korea. Demographic characteristics, health status, protective behaviors, and psychological factors (including perceived risks, efficacy belief, attribution of disease, fear of COVID-19, trust and evaluation, fatalism, resilience, and pandemic fatigue) were investigated. After adjusting for sociodemographic and health-related factors, multivariable regression models were constructed to explore the psychological influencing factors of protective behavior.

RESULTS

A total of 3000 participants from China and 1000 participants from Korea were included in the final analysis. The mean performance score for protective behaviors among all respondents was 2.885 in China and 3.139 in Korea, with scores ranging from 1 to 4. In China, performance scores were higher in those who were female, aged 30-39, employed, married, living in urban areas, having the highest income level, having the best subjective health status, and having a history of chronic disease (P-value <0.05). In Korea, performance scores were higher for individuals who were female, over 50 years old, educated to high school or below, unemployed, married, had a history of chronic disease, and had never been infected with SARS-CoV-2 (P-value <0.05). In the multivariable regression model, perceived severity (β = 0.067), attribution of disease (β = 0.121), fear of COVID-19 (β = 0.128), trust and evaluation (β = 0.097), psychological resilience (β = 0.068), and efficacy belief (β = 0.216) were positively associated with the performance scores, pandemic fatigue (β = -0.089) was negatively associated with performance scores in China (P-value <0.05). However, in Korea, perceived susceptibility (β = 0.075), fear of COVID-19 (β = 0.107), and efficacy belief (β = 0.357) were positively associated with protective behaviors (P-value <0.05), trust and evaluation (β = -0.078) and pandemic fatigue (β = -0.063) were negatively associated with performance scores (P-value <0.05).

CONCLUSIONS

Populations in both China and Korea demonstrated great compliance with protective behaviors during the Omicron wave. Because of the sociocultural, economic, and political differences, there were differences in the association between psychological factors and protective behaviors in the two countries. This study, from the perspective of psychological factors in different cultural contexts, would provide references for increasing adherence to protective guidelines in future outbreaks of emerging infectious diseases.

Effects of working from home on lifestyle behaviors and mental health during the COVID-19 pandemic: A survey study

The COVID-19 outbreak has led to relevant changes in everyday life worldwide. One of these changes has been a rapid transition to and an increasing implementation of working from home (WH) modality. This study aimed to evaluate the impact of mandatory WH during the COVID-19 pandemic on lifestyle behaviors, Mediterranean diet adherence, body weight, and depression. An online cross-sectional survey was conducted in the early 2022 at the National Research Council of Italy using ad hoc questions and validated scales collecting information on physical activity, sedentary behavior, hobbies/pastimes, dietary habits including adherence to the Mediterranean diet, body weight, and depression during WH compared with before WH. 748 respondents were included in the study. An increased sedentary lifetime was reported by 48% of respondents; however, the subsample of workers who previously performed moderate physical activity intensified this activity. Body weight gain during WH was self-reported in 39.9% of respondents. Mediterranean diet adherence increased (p≪0.001) during WH compared with before WH. The average level of mental health did not record an overall variation; however, the proportion of subjects with mild and moderate depression increased (p = 0.006), while workers who reported values indicative of depression before the transition declared an improvement. These findings highlight health-related impact of WH during the COVID-19 pandemic that may inform future strategies and policies to improve employees' health and well-being.

Anticipatory worry and returning to campus during the COVID-19 pandemic

BACKGROUND

Assessing the psychological needs of students and employees as they return to campus is crucial to resuming University life in a safe and secure way. The current research aimed to explore how safety concerns, anticipatory worry, and mitigation efforts affected the well-being of individuals within a campus community.

METHODS

A five-part survey was distributed via student & employee listservs in the Fall 2020 at a midsize private university in the Mid-Atlantic Mid-Atlantic United States. Participants were surveyed about sources of worry regarding Covid-19, levels of anticipatory worry, amenability to various mitigation strategies and whether intended implementation of safety mitigation measures impacted worry levels.

RESULTS

Data collected from 559 students and employees indicated a relationship between source of worry and level of distress, with the greatest source of worry being fear of getting sick. Anticipatory worry after thinking about safety mechanisms was significantly lower than anticipated worry before thinking about safety mechanisms. No differences were found between students and employee experiences of worry, and there was no moderating effect of role on the difference between anticipated worry after, as compared to before, thinking about the mechanisms.

CONCLUSION

Findings highlight how different sources of concern related to Covid-19 are associated with varying levels of distress, the significant impact that the presence of mitigation strategies can have on reducing overall levels of anticipatory worry, and the universality of distress associated with Covid-19.

Anxiety Levels among Healthcare Workers during the COVID-19 Pandemic and Attitudes towards COVID-19 Vaccines

Background: The pandemic has proven to be a particular challenge for healthcare workers, not only in the professional but also individual sense. The COVID-19 pandemic negatively influenced their well-being and caused psychological distress. Undoubtedly, direct contact with sick patients, the fight against the pandemic, and observing the epidemiological situation influenced the attitudes of this group towards COVID-19 and vaccinations. The aim of the study was to analyse the level of anxiety among healthcare workers during the COVID-19 pandemic and to assess attitudes towards vaccinations against COVID-19. Methods: The cross-sectional study followed the recommendations of STROBE (Strengthening the Reporting of Observational Studies in Epidemiology). A convenience purposive sampling method was used and the study was led among nurses and doctors employed in healthcare facilities. The study used a survey and the Trait Anxiety Scale SL-C. Results: The study included 385 participants, with an average age of 48.41 ± 6.76 years. The nurses constituted 55% of the study group and the doctors 45%. A total of 70% of healthcare workers had over 10 years of work experience. Over half of the subjects (57%) became infected with COVID-19. A total of 85% of respondents have received vaccination. A total of 71% of respondents believe vaccinations are harmless. Frequently, the participants assessed their level of anxiety as moderate. Conclusions: Almost all surveyed doctors chose to be vaccinated, while the percentage of vaccinated nurses was significantly lower. As a result, it is possible to conclude that the employment position has a significant influence on the decision to get vaccinated against COVID-19. In self-assessment during the COVID-19 pandemic, most healthcare professionals experienced a moderate level of anxiety. Receiving the COVID-19 vaccination reduced the level of anxiety.

Risk Perceptions Regarding COVID-19 and Compliance with Protective Measures of Midwifery and Nursing Senior Students

OBJECTIVE

This study aims to examine the risk perceptions of midwifery and nursing senior students regarding COVID-19 and compliance with vaccination and protective measures.

METHOD

This cross-sectional study was conducted in two academic years on senior midwifery and nursing students (n = 358). In the present study, the descriptive characteristics of the students and the COVID-19 risk perception scale were used.

RESULTS

The students' COVID-19 Risk Perception Scale scores were at a moderate level and a similar level in both years of this study. More than 80% of the students were fully vaccinated, and the family history of COVID-19 was positive in approximately half of them. In the second year of the pandemic, they paid less attention to social distance and avoidance of being indoors.

CONCLUSION

Although the COVID-19 risk perceptions of future health professional students remained at a similar level during the examined period, it was found that in the second year of the pandemic, they started to get used to the process and paid less attention to social protective measures.