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

Engagement with regular asymptomatic COVID-19 testing in young people in North West England: a qualitative focus group study

OBJECTIVES

Communities in North West England had some of the highest incidence of COVID-19, particularly in their younger populations. Test kits were provided to young people in Blackburn with Darwen to encourage regular testing and reduce COVID-19 transmission. The aim of this study was to identify barriers and facilitators to engaging in regular asymptomatic testing in young people.

DESIGN

Focus groups.

SETTING

Young people and parents of school-aged children in North West England.

PARTICIPANTS

14 participants aged 12-15 years, 13 participants aged 16-25 years and 9 participants who were parents of school-aged children.

RESULTS

Six focus groups (36 participants) were conducted. Analysis identified young people were not against testing and many wanted to test to protect others; however, they felt their needs were not met when they were seeking information on the importance of testing and accessing tests. Young people also felt they wanted more autonomy to make decisions and access tests themselves, without having to rely on parents. Language barriers and challenges with the testing process, particularly reporting the results, were also identified as barriers for parents and young people. Parents were reluctant to test in the absence of symptoms and also noted that young people were very adaptable and testing became more acceptable to them as the pandemic progressed.

CONCLUSIONS

Tailored messaging for young people would help this group engage in regular testing and feel part of the COVID-19 response. Regular testing is not currently required in England, however, it is important to understand barriers to engaging in testing for young people, as testing may be reintroduced in response to this or future pandemics.

Using machine learning to improve our understanding of COVID-19 infection in children

PURPOSE

Children are at elevated risk for COVID-19 (SARS-CoV-2) infection due to their social behaviors. The purpose of this study was to determine if usage of radiological chest X-rays impressions can help predict whether a young adult has COVID-19 infection or not.

METHODS

A total of 2572 chest impressions from 721 individuals under the age of 18 years were considered for this study. An ensemble learning method, Random Forest Classifier (RFC), was used for classification of patients suffering from infection.

RESULTS

Five RFC models were implemented with incremental features and the best model achieved an F1-score of 0.79 with Area Under the ROC curve as 0.85 using all input features. Hyper parameter tuning and cross validation was performed using grid search cross validation and SHAP model was used to determine feature importance. The radiological features such as pneumonia, small airways disease, and atelectasis (confounded with catheter) were found to be highly associated with predicting the status of COVID-19 infection.

CONCLUSIONS

In this sample, radiological X-ray films can predict the status of COVID-19 infection with good accuracy. The multivariate model including symptoms presented around the time of COVID-19 test yielded good prediction score.

Willingness and uptake of the COVID-19 testing and vaccination in urban China during the low-risk period: a cross-sectional study

BACKGROUND

Regular testing and vaccination are effective measures to mitigate the ongoing COVID-19 pandemic. Evidence on the willingness and uptake of the COVID-19 testing is scarce, and the willingness and uptake of vaccination may change as the pandemic evolves. This study aims to examine willingness and uptake of COVID-19 testing and vaccination during a low-risk period of the COVID-19 pandemic in urban China.

METHODS

A cross-sectional online survey was conducted among 2244 adults in urban China. Descriptive analyses were performed to compare the respondents' willingness and uptake of COVID-19 testing and vaccination. Multivariate logistic regressions were fitted to investigate factors associated with the willingness and uptake of the two measures.

RESULTS

In early 2021, about half (52.45%) of the respondents had received or scheduled a COVID-19 test at least once, and a majority (95.63%) of the respondents were willing to receive testing. About two-thirds (63.28%) of the respondents had received/scheduled or were willing to receive a COVID-19 vaccine. Willingness and uptake of COVID-19 testing were not associated with socio-demographic characteristics, except for occupation. Being of older age, migrants, having higher educational attainment and secure employment were associated with a higher uptake of COVID-19 vaccination among the surveyed respondents, while willingness to vaccinate was consistent across socio-demographic characteristics among those who had not been vaccinated.

CONCLUSIONS

By early 2021, Chinese adults expressed almost universal willingness of COVID-19 testing and over half of adults have been tested, while the willingness and uptake of COVID-19 vaccination were relatively low at the low-risk period of the COVID-19 pandemic. Maintaining willingness of COVID-19 vaccination is critical and necessary, especially when the pandemic evolved into a low-risk period.

Predicting Intention to Take a COVID-19 Vaccine in the United States: Application and Extension of Theory of Planned Behavior

Purpose

This study aims to apply and extend the theory of planned behavior (TPB) to predict intention to take a COVID-19 vaccine.

Design

Cross-sectional.

Setting

Online.

Sample

Adult US residents recruited from Amazon Mechanical Turk (n = 172).

Measures

Intention to take a COVID-19 vaccine (outcome variable), demographic variables (predictors), standard TPB variables (perceived behavioral control, attitude, and subjective norm; predictors), and non-TPB variables (anticipated regret, health locus of control, and perceived community benefit; predictors).

Analysis

Hierarchical linear regression predicting intention to take a COVID-19 vaccine, with demographic, standard TPB, and non-TPB variables entered in regression models 1, 2, and 3, respectively.

Results

The extended TPB model accounted for 72.5% of the variance in vaccination intention (p < .001), with perceived behavioral control (β = .29, p < .001), attitude (β = .23, p = .043), and perceived community benefit (β = .23, p = .020) being significant unique predictors.

Conclusion

Despite the relatively small and non-representative sample, this study, conducted after COVID-19 vaccines were widely available in the USA, demonstrated that perceived behavioral control was the most robust predictor of intention to take a COVID-19 vaccine, suggesting that the TPB is a useful theoretical framework that can inform effective strategies to promote vaccine acceptance.

COVID-19 Help-Seeking Behaviors: Application of the Theory of Planned Behavior

The novel coronavirus disease (COVID-19) is highly contagious. More than 247 million cases have been confirmed by the end of October 2021. Seeking help earlier may slow the spread of COVID-19 because it may help in early detection of infected cases, and it facilitate tracing those who were with close contact with infected cases. The purpose of this study is to identify participants’ intentions toward COVID-19 seeking help and the factors affecting their decision. This is a cross-sectional study. An online survey using Google Forms was used for data collection. Hierarchical multiple regression analysis was used to explain intentions to seek help for COVID-19. The concepts included in the Theory of Planned Behavior and COVID-19 knowledge were used as predictors. The sample included 780 participants, with an average age of 28.60±9.86 years old. Most of the sample were female (67.4%) and having a bachelor’s degree (72.7%). Participants showed high level of knowledge regarding COVID-19, 73% of the sample had a total knowledge score equal to or higher than 85%. Also, participants had high positive attitudes and high intentions to seek help for COVID-19. The four predictors: Attitudes towards COVID-19, subjective norm, perceived behavioral control, and COVID-19 knowledge significantly explained intentions to seek help. Participants had high intentions to seek help for COVID-19, which was related to having positive attitudes toward seeking help, high social approval, high perceived controllability, and high COVID-19 knowledge levels. Regular awareness campaigns during early stages of pandemics should be performed to improve attitudes and knowledge level, which may improve prevention measures, and promote help seeking behaviors. Consequently, this may facilitate early detection of cases, and slow the spread of pandemics.

Fatigue during the COVID-19 pandemic: Evidence of social distancing adherence from a panel study of young adults in Switzerland

In this paper we analyze panel data (N = 400) to investigate the change in attitudes towards the Covid-19 measures and the change in compliance behavior between the first and second lockdowns in a sample of young adults from the University of Bern, Switzerland. We find considerable fatigue. While respondents expressed high acceptance of and compliance with the Covid-19 measures during the first lockdown, both acceptance and compliance behavior decreased substantially during the second lockdown. Moreover, we show via a structural equation model that respondents' compliance behavior is largely driven by the perception of how others behave and by the acceptance of the Covid-19 measures. All other effects scrutinized e.g., individual and social risk perception, trust in politics, and pro-social orientations affect compliance behavior via the acceptance of Covid-19 measures. We also conduct two tests of causality of the estimated relation between attitudes towards the measures and social distancing behavior. The first test incorporates the effect of compliance behavior reported during the first lockdown on attitudes during the second lockdown. The second test involves estimating a first difference panel regression model of attitudes on compliance behavior. The results of both tests suggest that the effect of Covid-19 attitudes on social distancing behavior can be interpreted causally.

Behavioral Correlates of COVID-19 Worry: Stigma, Knowledge, and News Source

Non-adherence to COVID-19 guidelines may be attributable to low levels of worry. This study assessed whether endorsing COVID-19-stigmatizing restrictions, COVID-19 knowledge, and preferred news source were associated with being 'very worried' versus 'not at all' or 'somewhat' worried about contracting COVID-19. Survey data were collected in July-August 2020 from N = 547 New York State (NYS) and N = 504 national Amazon MTurk workers. Respondents who endorsed COVID-19 stigmatizing restrictions (NYS OR 1.96; 95% CI 1.31, 2.92; national OR 1.80; 95% CI 1.06, 3.08) and consumed commercial news (NYS OR 1.89; 95% CI 1.21, 2.96; national OR 1.93; 95% CI 1.24, 3.00) were more likely to be very worried. National respondents who consumed The New York Times (OR 1.52; 95% CI 1.00, 2.29) were more likely to be very worried, while those with little knowledge (OR 0.24; 95% CI 0.13, 0.43) were less likely to be very worried. NYS (OR 2.66; 95% CI 1.77, 4.00) and national (OR 3.17; 95% CI 1.95, 5.16) respondents with probable depression were also more likely to be very worried. These characteristics can help identify those requiring intervention to maximize perceived threat to COVID-19 and encourage uptake of protective behaviors while protecting psychological wellbeing.

Knowledge, Attitudes, and Behavior Related to COVID-19 Testing: A Rapid Scoping Review

Testing programs for COVID-19 depend on the voluntary actions of members of the public for their success. Understanding people's knowledge, attitudes, and behavior related to COVID-19 testing is, therefore, key to the design of effective testing programs worldwide. This paper reports on the findings of a rapid scoping review to map the extent, characteristics, and scope of social science research on COVID-19 testing and identifies key themes from the literature. Main findings include the discoveries that people are largely accepting of testing technologies and guidelines and that a sense of social solidarity is a key motivator of testing uptake. The main barriers to accessing and undertaking testing include uncertainty about eligibility and how to access tests, difficulty interpreting symptoms, logistical issues including transport to and from test sites and the discomfort of sample extraction, and concerns about the consequences of a positive result. The review found that existing research was limited in depth and scope. More research employing longitudinal and qualitative methods based in under-resourced settings and examining intersections between testing and experiences of social, political, and economic vulnerability is needed. Last, the findings of this review suggest that testing should be understood as a social process that is inseparable from processes of contact tracing and isolation and is embedded in people's everyday routines, livelihoods and relationships.