Emotional responses to prosocial messages increase willingness to self-isolate during the COVID-19 pandemic

Narrative or Facts: Two Paths to Vaccine Advocacy

The current study investigated the effectiveness of factual and narrative messages in promoting advocacy intentions among viewers of COVID-19 vaccination messaging. In an online posttest only experiment on Qualtrics online software, participants (N = 323) were randomly assigned to one of four conditions related to type of messaging (i.e. factual, narrative, both, control). The final model revealed that both types of messages work in generating advocacy but through two distinct influential pathways. Moreover, a message containing both facts and a narrative proved to be more effective than a message containing only a narrative or only facts.

Adopting the risk information seeking and processing model to examine the impact of personality on vaccination intentions in Taiwan

Using the risk information seeking and processing model, this study examined how five personality traits-extraversion, neuroticism, conscientiousness, openness to experience, and agreeableness-influenced individuals' information-seeking behaviors and vaccination intentions. An online survey was administered by a reputable polling company commissioned by this study. The survey employed age, education, gender, and income as distinct strata for sampling, which resulted in 1100 valid questionnaires. The following five conclusions were drawn from the data analysis: (1) Of the five personality traits, two-extraversion and conscientiousness-exhibited a notable impact on individuals' information-seeking behaviors and vaccination intentions. Individuals with the remaining three personality traits-neuroticism, agreeableness, and openness to experience-demonstrate either passive or no information-seeking behaviors on COVID-19. (2) Conscientiousness was the only personality trait linked to increased awareness of COVID-19 characteristics. Moreover, conscientious individuals were inclined to avoid depending on ISNs to seek COVID-19 information and developed vaccination intentions. In contrast, individuals high in agreeableness heavily depended on ISNs for COVID-19 information to initiate information-seeking behaviors. Meanwhile, individuals high in extraversion relied on two variables-affective responses and ISNs-to begin their information-seeking behaviors. (3) Respondents' perceptions of COVID-19 characteristics and their affective responses did not positively influence their perceived information insufficiency directly; instead, both needed to be mediated by ISNs to initiate their information-seeking behaviors. (4) In contrast to the two variables-perceived COVID-19 characteristics and affective responses-this study found that ISNs regarding COVID-19 played a more substantial role in shaping respondents' information-seeking behaviors and vaccination intentions. (5) Unexpectedly, openness to experience was found to have no impact on information-seeking behaviors during the COVID-19 pandemic.

The influence of COVID-19 on intertemporal choices in the health and economy domains

Background

With the spread of COVID-19, concerns regarding its adverse effects have arisen. Based on affect regulation theory and construal level theory, this study explored how COVID-19 affects intertemporal choice in the health and economy domains, self-other differences for intertemporal choice were also inspected. The study examined whether psychological safety can moderate the relationship between COVID-19 and intertemporal choice.

Methods

A 2 (COVID-19 status: pre-COVID-19, during-COVID-19) × 2 (decision maker role: decision for self, decision for others) × 2 (domain: health, economy) three-factor hybrid experiment was employed.

Results

(1) Individuals in during-COVID-19 condition preferred more immediate options. (2) Delayed options were preferred more in the health domain. Preference for immediate money options enhanced during than before COVID-19. However, COVID-19 status did not affect choices related to health. (3) Delayed options were preferred more when making intertemporal choices for others than for oneself under the pre-COVID-19 condition. Self-other differences for intertemporal choice disappeared during COVID-19. (4) Psychological safety moderated the effect of COVID-19 on intertemporal choice.

Conclusions

During COVID-19, individuals' impulsive preference of intertemporal choice increased. COVID-19 affected intertemporal choice regarding economy and the self-other differences for intertemporal choice. Psychological safety could buffer the effect of COVID-19 on intertemporal choice.

Value

This study can provide empirical evidence to affect regulation theory and level of explanation theory as well as guide individuals in making scientific decisions in health and economic domains under public health emergencies.

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.

"Let's get back to normal": emotions mediate the effects of persuasive messages on willingness to vaccinate for COVID-19

Objective

We examined the effectiveness of three different messages for persuading individuals to get vaccinated against COVID-19, and the role that emotions play in persuasion.

Methods

Four hundred-thirty-six participants reported their concern about the COVID-19 pandemic and confidence/hesitancy toward vaccines. Participants were randomly assigned to one of three text conditions: (1) self-interest: a persuasive message that focused on how much of a "serious threat COVID-19 is to you," and to get vaccinated to "protect yourself"; (2) self-interest + altruistic: a persuasive message that focused on the "threat to you and your community" and to get vaccinated to "protect you and your loved ones"; (3) self-interest + altruistic + normal: a persuasive message that included (2) but added "This is the only way we can get back to a normal life."; and, (4) a baseline control: no text. After reading, participants reported their emotions toward COVID-19 vaccines and their willingness to get vaccinated.

Results

Individuals in the self-interest + altruistic + normal condition were more willing to get vaccinated compared to the control condition and self-interest + altruistic condition. However, there were no differences in willingness between the self-interest + altruistic + normal condition and the self-interest condition. Moreover, emotions mediated relations between vaccine confidence/hesitancy and willingness.

Conclusion

A message that focuses on "getting back to normal" can achieve important public health action by increasing vaccine uptake to protect the population. Future work is needed across multiple countries and contexts (i.e., non-pandemic) to assess message effectiveness.

Resilience and Social Support Improve Mental Health and Quality of Life in Patients with Post-COVID-19 Syndrome

Physical and mental health problems among post-COVID-19 patients are common, even a year after infection. As there is no prior study available, we investigated the impacts of resilience and social support on anxiety, depression, and quality of life among patients with post-COVID-19 syndrome. We conducted a cross-sectional study with a convenience sample. The measures included the demographic and clinical characteristics of patients, the Brief Resilience Scale, the Multidimensional Scale of Perceived Social Support, the Patient Health Questionnaire-4 (PHQ-4), and the EuroQol-5D-3L. The mean age of patients was 44.8 years. The total PHQ-4 score suggested that 32.8% of patients with post-COVID-19 syndrome experienced severe psychological distress, 32.8% experienced moderate distress, 23% experienced mild distress, and 11.5% had no distress. Moreover, 60.7% of patients had anxiety scores of ≥3 and 69.7% had depression scores of ≥3, indicating possible major anxiety or depression disorder. The mean EQ-5D-3L index value was 0.36, and the mean EQ-5D-3L VAS was 54.1. Multivariable analysis identified that resilience and social support reduced anxiety and depression among patients. Also, we found a significant positive relationship between resilience and social support, and quality of life. Our findings suggest that resilience and social support can be protective by reducing anxiety and depression and improving quality of life among patients with post-COVID-19 syndrome. Policymakers should develop and implement healthcare management programs to provide psychological support to these patients.

Cultural tightness-looseness and normative social influence in eight Asian countries: Associations of individual and collective norms with vaccination intentions

RATIONALE

Countries worldwide faced the same public health crisis that required promoting the same health behavior-vaccinations-during the COVID-19 pandemic. Thus, scholars have a unique opportunity to test behavioral change theories across countries with different cultural backgrounds.

OBJECTIVE

Employing the extended theory of social normative behavior, this study examines the influence of individual and collective norms on COVID-19 vaccination intention across eight Asian countries. We examine how cultural tightness-looseness, defined as the degree of a culture's emphasis on norms and tolerance of deviant behavior, shapes normative social influence on COVID-19 vaccination intention.

METHODS

We conducted a multicountry online survey (N = 2676) of unvaccinated individuals in China, Indonesia, Japan, Malaysia, Singapore, South Korea, Thailand, and Vietnam in May and June 2021, when COVID-19 vaccination mandates had not yet been implemented in those countries. We conducted hierarchical regression analyses with interaction terms for the total sample and then re-categorizied the eight countries as either "tight" (n = 1102) or "loose" (n = 1574) to examine three-way interactions between individual norms, collective norms, and cultural tightness-looseness.

RESULTS

Perceived injunctive norms exerted the strongest impact of all normative factors on vaccination intention. Collective injunctive norms' influence depended on both perceived injunctive and descriptive norms, which was larger when norms were lower (vs. higher). The interactive pattern between perceived and collective norms was more pronounced in countries with greater cultural tightness.

CONCLUSION

Our findings reveal nuanced patterns of how individual and collective social norms influence health behavioral decisions, depending on the degree of cultural tightness-looseness.

Prosocial Interventions and Health Outcomes: A Systematic Review and Meta-Analysis

Importance

Prosocial interventions encourage voluntary actions that benefit others. Community solidarity in response to the COVID-19 pandemic, expanding mutual aid programs, and health workforce issues have accelerated prosocial health interventions.

Objective

To investigate the association of prosocial interventions with health outcomes in clinical trials and observational studies.

Data Sources

In this systematic review and meta-analysis informed by the Cochrane Handbook for Systematic Reviews of Interventions, 5 databases (MEDLINE [via PubMed], Embase, CINAHL, PsycInfo, and Scopus) were searched from database inception through February 23, 2023. The search included terms for altruism and prosocial behaviors, health outcomes, and study type.

Study Selection

Included studies, determined by multiple reviewers, compared health outcomes in a prosocial intervention group with a nonintervention group.

Data Extraction and Synthesis

Following the Preferred Reporting Items for Systematic Reviews and Meta-analyses guideline, data extraction and synthesis captured quantitative and qualitative data. To pool data from quantitative studies, random-effects meta-analyses were used to estimate the impact of prosocial interventions. To combine data from quantitative and qualitive studies, data were transformed into qualitative narratives using meta-aggregation.

Main Outcomes and Measures

The main outcome was whether prosocial interventions were associated with improved health outcomes. Barriers to and facilitators of implementation of these interventions were assessed.

Results

The search identified 5229 citations; 30 studies were included in the synthesis. Studies indicated that prosocial interventions were associated with positive health outcomes for givers (17 studies [56.7]) and recipients (8 [26.7%]). Prosocial interventions included acts of kindness (12 studies [40.0%]), cash gifts (7 [23.3%]), pay-it-forward approaches (6 [20.0%]), and expressions of kindness (5 [16.7%]). Improvements were reported in depression, testing for sexually transmitted diseases, vaccine uptake, physical activity, and individual biomarkers. Data from 6 studies (20.0%) demonstrated that pay-it-forward approaches were associated with increased uptake of diagnostic tests or vaccines among vulnerable groups (moderate certainty of evidence). Data from 14 studies (46.7%) suggested that community connectedness facilitated prosocial interventions. Shared vulnerabilities among groups (eg, sexual minority individuals, older adults) may provide a context for collective mobilization to improve health in local communities.

Conclusions and Relevance

This systematic review and meta-analysis found that prosocial interventions were associated with improved health outcomes among vulnerable groups and have been useful for addressing health disparities. Further research is needed to develop and evaluate prosocial interventions.

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.

The Effects of Emotion, Spokesperson Type, and Benefit Appeals on Persuasion in Health Advertisements: Evidence from Macao

Enhancing public awareness for epidemic prevention is crucial for safeguarding public health. This experimental study investigated the effectiveness of a combined approach involving three persuasive elements in public health advertising. Specifically, the study examined the interplay between emotional appeals (fear messages versus efficacy messages) and spokesperson type on the public's response to health announcements. The results demonstrated that fear messages were more persuasive when conveyed by real human spokespersons (versus animated spokespersons), whereas efficacy messages were more acceptable when conveyed by animated spokespersons (versus real humans). Furthermore, the study revealed that the impact of emotional appeals and spokesperson type is moderated by benefit appeals (self-benefit or other-benefit). The joint effects of these persuasive variables on individuals' intention to adopt preventive measures indicated that the interactions significantly differed across the two types of benefit appeal. Taken together, the findings represent a pioneering contribution to the field of health communication by comparing the persuasive effects of different combinations of emotional appeals, spokesperson types, and benefit appeals on public behavior. These findings offer practical guidance for public communicators to design more appropriate health advertisements based on the results of this study, thereby enhancing public acceptance of disease prevention measures.

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

BACKGROUND

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

METHOD

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

RESULTS

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

CONCLUSION

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

Changes in Confidence, Feelings, and Perceived Necessity Concerning COVID-19 Booster

The COVID-19 booster first became available to all adults in the U.S. in November 2021 and a bivalent version in September 2022, but a large population remains booster-hesitant; only 17% of Americans have obtained the updated vaccine as of June 2023. We conducted two cross-sectional surveys in 2021 and 2022 (n = 1889 and 1319) to determine whether changes in booster-related feelings or perceptions had occurred and whether they altered vaccination rates over time. We found that both positive and negative emotions had grown stronger between the two years, with the prevalence of annoyance increasing the most (21.5% to 39.7%). The impact of trust on booster intention more than doubled (OR = 7.46 to 16.04). Although perceived risk of infection decreased, more participants in 2022 indicated uncertainty or unwillingness to obtain a new booster than in 2021, while the proportion refusing a booster remained constant at 22.5%. Confidence in the COVID-19 vaccine and feelings of hope from the booster motivated acceptance; both were stronger predictors of booster receptivity than prior vaccination history. Our findings signal a need to rebuild trust by informing people of their continued risk and appealing to positive, especially optimistic emotions to encourage booster uptake. Future research should explore longitudinal trends in behavior and feelings toward new booster doses and the impact of prolonged vaccine hesitancy on infection rates.

Relationships between COVID-19 and disaster risk in Costa Rican municipalities

The COVID-19 pandemic has had far-reaching impacts on every aspect of human life since the first confirmed case in December 2019. Costa Rica reported its first case of COVID-19 in March 2020, coinciding with a notable correlation between the occurrence of disaster events at the municipal scale over the past five decades. In Costa Rica, over 90% of disasters are hydrometeorological in nature, while geological disasters have caused significant economic and human losses throughout the country's history. To analyze the relationship between COVID-19 cases and disaster events in Costa Rica, two Generalized Linear Models (GLMs) were used to statistically evaluate the influence of socio-environmental parameters such as population density, social development index, road density, and non-forested areas. The results showed that population and road density are the most critical factors in explaining the spread of COVID-19, while population density and social development index can provide insights into disaster events at the municipal level in Costa Rica. This study provides valuable information for understanding municipal vulnerability and exposure to disasters in Costa Rica and can serve as a model for other countries to assess disaster risk.

Measuring information overload and message fatigue toward COVID-19 prevention messages in USA and China

COVID-19 prevention messages are a crucial component of disease mitigation strategies and the primary driver of health decision-making during the global pandemic. However, the constant and repetitive nature of COVID-19 messaging may cause unintended consequences. Among the commonly observed phenomena are information overload and message fatigue, which might be experienced differently depending on cultural background. Using measurement invariance testing, this study compared how individuals from two countries-USA (n = 493) and China (n = 571)-experienced information overload and message fatigue toward COVID-19 prevention messages. Findings revealed that people in China showed significantly lower level of information overload and message fatigue than those in the USA. This study explores the extent of the unintended persuasive effects that people have experienced during the COVID-19 pandemic in different societies, a comparison which has never been studied before, even outside of the context of COVID-19. The study also provides much-needed practical insights to develop public health initiatives that improve COVID-19 prevention communication, which can further reduce these unintended effects in both countries, and has implications for other countries as well.

Communicating with ethnic minorities during COVID-19: An experimental test of the effect of self-, ingroup-, and intergroup-focused messages

Developing messaging to encourage minorities to adhere to health recommendations has been a complex task for governments worldwide during the COVID-19 crisis. Here, we propose and tests a new typology of messages among minorities that can be used to mobilize compliance and engagement. This typology comprises three messaging treatments emphasizing personal, ingroup, and intergroup benefits. We examine, via an experimental field study, whether there is a difference in the effect of these messages on two policy outcomes, social distancing and vaccine hesitancy, among the Arab minority living in Israel. The findings suggest that social messages, i.e., ingroup and intergroup messages, positively affect social distancing, while self-messaging harms social distancing compliance. Regarding vaccine intake, within the social messages tested, intergroup-focused messages were more effective than ingroup-focused messages for vaccination intentions only among citizens with low trust in the government. We discuss the findings in detail and propose new avenues in theory and practice to foster health policy compliance among minorities.

Eliciting Opinions on Health Messaging During the COVID-19 Pandemic: Qualitative Survey Study

BACKGROUND

Effective public health messaging has been necessary throughout the COVID-19 pandemic, but stakeholders have struggled to communicate critical information to the public, especially in different types of locations such as urban and rural areas.

OBJECTIVE

This study aimed to identify opportunities to improve COVID-19 messages for community distribution in rural and urban settings and to summarize the findings to inform future messaging.

METHODS

We purposively sampled by region (urban or rural) and participant type (general public or health care professional) to survey participants about their opinions on 4 COVID-19 health messages. We designed open-ended survey questions and analyzed the data using pragmatic health equity implementation science approaches. Following the qualitative analysis of the survey responses, we designed refined COVID-19 messages incorporating participant feedback and redistributed them via a short survey.

RESULTS

In total, 67 participants consented and enrolled: 31 (46%) community participants from the rural Southeast Missouri Bootheel, 27 (40%) community participants from urban St Louis, and 9 (13%) health care professionals from St Louis. Overall, we found no qualitative differences between the responses of our urban and rural samples to the open-ended questions. Participants across groups wanted familiar COVID-19 protocols, personal choice in COVID-19 preventive behaviors, and clear source information. Health care professionals contextualized their suggestions within the specific needs of their patients. All groups suggested practices consistent with health-literate communications. We reached 83% (54/65) of the participants for message redistribution, and most had overwhelmingly positive responses to the refined messages.

CONCLUSIONS

We suggest convenient methods for community involvement in the creation of health messages by using a brief web-based survey. We identified areas of improvement for future health messaging, such as reaffirming the preventive practices advertised early in a crisis, framing messages such that they allow for personal choice of preventive behavior, highlighting well-known source information, using plain language, and crafting messages that are applicable to the readers' circumstances.

Predictors of changing patterns of adherence to containment measures during the early stage of COVID-19 pandemic: an international longitudinal study

BACKGROUND

Identifying common factors that affect public adherence to COVID-19 containment measures can directly inform the development of official public health communication strategies. The present international longitudinal study aimed to examine whether prosociality, together with other theoretically derived motivating factors (self-efficacy, perceived susceptibility and severity of COVID-19, perceived social support) predict the change in adherence to COVID-19 containment strategies.

METHOD

In wave 1 of data collection, adults from eight geographical regions completed online surveys beginning in April 2020, and wave 2 began in June and ended in September 2020. Hypothesized predictors included prosociality, self-efficacy in following COVID-19 containment measures, perceived susceptibility to COVID-19, perceived severity of COVID-19 and perceived social support. Baseline covariates included age, sex, history of COVID-19 infection and geographical regions. Participants who reported adhering to specific containment measures, including physical distancing, avoidance of non-essential travel and hand hygiene, were classified as adherence. The dependent variable was the category of adherence, which was constructed based on changes in adherence across the survey period and included four categories: non-adherence, less adherence, greater adherence and sustained adherence (which was designated as the reference category).

RESULTS

In total, 2189 adult participants (82% female, 57.2% aged 31-59 years) from East Asia (217 [9.7%]), West Asia (246 [11.2%]), North and South America (131 [6.0%]), Northern Europe (600 [27.4%]), Western Europe (322 [14.7%]), Southern Europe (433 [19.8%]), Eastern Europe (148 [6.8%]) and other regions (96 [4.4%]) were analyzed. Adjusted multinomial logistic regression analyses showed that prosociality, self-efficacy, perceived susceptibility and severity of COVID-19 were significant factors affecting adherence. Participants with greater self-efficacy at wave 1 were less likely to become non-adherence at wave 2 by 26% (adjusted odds ratio [aOR], 0.74; 95% CI, 0.71 to 0.77; P < .001), while those with greater prosociality at wave 1 were less likely to become less adherence at wave 2 by 23% (aOR, 0.77; 95% CI, 0.75 to 0.79; P = .04).

CONCLUSIONS

This study provides evidence that in addition to emphasizing the potential severity of COVID-19 and the potential susceptibility to contact with the virus, fostering self-efficacy in following containment strategies and prosociality appears to be a viable public health education or communication strategy to combat COVID-19.

The roles of social norms and leadership in health communication in the context of COVID-19

The global struggle with the COVID-19 pandemic has lasted for almost three years. Although national and local leaders have often called on the public to comply with preventive measures through health communication, large sections of society sometimes violated precautions and did not adequately follow these calls. We propose that social norms and leaders' identity entrepreneurship characteristics could be essential in effective health communication. In line with this notion, we investigated the effects of social norm types and leadership on complying with preventive measures, the intention to be vaccinated, and prosocial behavioral tendency through a high-powered experiment that focused on three factors: leadership quality (presence/lack of entrepreneurship), descriptive norm (supportive/obstructive), and injunctive norm (supportive/obstructive). Results showed that when support for injunctive and descriptive norms was present, people tended to more readily adhere to preventive measures, get vaccinated, and engage in prosocial behavior. There was also a significant effect of the interaction between descriptive and injunctive norms on compliance with preventive measures. The compliance level was highest when both norm types were supportive and lowest when both were obstructive. The effect decreased in the discrepant norms condition, where one type of norm was supportive and the other obstructive. There is also a significant interaction between leadership and the descriptive norm, indicating that a combination of an entrepreneur leader and a supportive descriptive norm increases compliance with the preventive measure. We discussed the role of leadership and social norms in effective health communication.

Priming congruence and COVID-19 vaccination intention: a mediation analysis

BACKGROUND

This study took place at the height of the fifth wave of COVID-19 in France, coinciding with stigmatizing communication toward the unvaccinated. We hypothesized that adherence to this communication would facilitate or inhibit the effects of priming on vaccination intention, depending on whether the priming included a dimension of connection to others.

PARTICIPANTS AND PROCEDURE

In a convenience online French sample (N = 1800, M age = 26.30), vaccination intention was asked after love priming, no love/prejudice priming, materialism priming, or a control condition. Participants also reported their adherence to restrictive measures, i.e., media control, vaccination pass, and mandatory vaccination.

RESULTS

Vaccination intention was higher in the no love/prejudice and materialism conditions than in the love and control conditions. Adherence to restrictive measures mediated the effect of prejudice or materialism priming on intention to get vaccinated.

CONCLUSIONS

Implications of these results are discussed in light of the socially situated cognition perspective and the congruence of (a) a societal context of communication toward the vaccine and the unvaccinated, (b) the participant's degree of adherence to that communication, (c) the theme of priming, whether or not related to feeling connected to others. Implications of materialism priming are discussed, and the effect of commitment on intention to get vaccinated.

The impacts and implications of the community face mask use during the Covid-19 pandemic: A qualitative narrative interview study

INTRODUCTION

A range of nonpharmaceutical public health interventions has been introduced in many countries following the rapid spread of Covid-19 since 2020, including recommendations or mandates for the use of face masks or coverings in the community. While the effectiveness of face masks in reducing Covid-19 transmission has been extensively discussed, scant attention has been paid to the lived experience of those wearing face masks.

METHOD

Drawing on 40 narrative interviews with a purposive sample of people in the United Kingdom, with a particular focus on marginalised and minoritized groups, our paper explores experiences of face mask use during the pandemic.

RESULTS

We find that face masks have a range of societal, health and safety impacts, and prompted positive and negative emotional responses for users. We map our findings onto Lorenc and Oliver's framework for intervention risks. We suggest that qualitative data offer particular insights into the experiences of public health interventions, allowing the potential downsides and risks of interventions to be more fully considered and informing public health policies that might avoid inadvertent harm, particularly towards marginalised groups.

PATIENT OR PUBLIC CONTRIBUTION

The study primarily involved members of the public in the conduct of the research, namely through participation in interviews (email and telephone). The conception for the study involved extensive discussions on social media with a range of people, and we received input and ideas from presentations we delivered on the preliminary analysis.

Persuasive Messages for Improving Adherence to COVID-19 Prevention Behaviors: Randomized Online Experiment

BACKGROUND

Adherence to nonpharmaceutical interventions for COVID-19, including physical distancing, masking, staying home while sick, and avoiding crowded indoor spaces, remains critical for limiting the spread of COVID-19.

OBJECTIVE

The aim of this study was to test the effectiveness of using various persuasive appeals (deontological moral frame, empathy, identifiable victim, goal proximity, and reciprocity) at improving intentions to adhere to prevention behaviors.

METHODS

A randomized online experiment using a representative sample of adult Canadian residents with respect to age, ethnicity, and province of residence was performed from March 3 to March 6, 2021. Participants indicated their intentions to follow public health guidelines, saw one of six flyers featuring a persuasive appeal or no appeal, and then rated their intentions a second time. Known correlates of attitudes toward public health measures were also measured.

RESULTS

Intentions to adhere to public health measures increased in all appeal conditions. The message featuring an empathy appeal resulted in a greater increase in intentions than the control (no appeal) message. Moreover, the effectiveness of persuasive appeals was moderated by baseline intentions. Deontological, empathy, identifiable victim, and reciprocity appeals improved intentions more than the control message, but only for people with lower baseline intentions to adhere to nonpharmaceutical interventions.

CONCLUSIONS

Public health marketing campaigns aiming to increase adherence to COVID-19 protective behaviors could achieve modest gains by employing a range of persuasive appeals. However, to maximize impact, it is important that these campaigns be targeted to the right individuals.

TRIAL REGISTRATION

ClinicalTrials.gov NCT05722106; https://clinicaltrials.gov/ct2/show/NCT05722106.

Empathy moderates the relationship between cognitive load and prosocial behaviour

Cognitive load reduces both empathy and prosocial behaviour. However, studies demonstrating these effects have induced cognitive load in a temporally limited, artificial manner that fails to capture real-world cognitive load. Drawing from cognitive load theory, we investigated whether naturally occurring cognitive load from the ongoing COVID-19 pandemic moderated the relationship between empathy and prosocial behaviour (operationalised as support for public health measures). This large study in an Australian sample (N = 600) identified negative relationships between pandemic fatigue, empathy for people vulnerable to COVID-19, and prosocial behaviour, and a positive relationship between empathy and prosocial behaviour. Additionally, we found that the negative effect of the pandemic on prosocial behaviour depended on empathy for vulnerable others, with pandemic fatigue's effects lowest for those with the highest empathy. These findings highlight the interrelationships of cognitive load and empathy, and the potential value of eliciting empathy to ease the impact of real-world cognitive load on prosocial behaviour.

Behavioral responses for facemask use messages to prevent COVID-19 among residents of Bahir Dar City, Ethiopia: an application of extended parallel process model

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic causes major morbidity and mortality in the world. Timely behavioral response assessment of the community is important to shape the next effective interventions and risk communication strategies to adopt preventive behavior. Hence, this study aimed to assess behavioral responses for facemask-use messages to prevent COVID-19 and its predictors among residents of Bahir Dar City, Ethiopia, 2021 by using the Extended Parallel Process Model.  METHODS: A community-based cross-sectional study was conducted with the guide of the Extended Parallel Process Model in Bahir Dar city from March 9 to April 9, 2021. A multistage sampling technique was used, and data was collected through a face-to-face interviewer-administered questionnaire using Epicollect5. Descriptive statistics and Binary logistic regression were computed using SPSS V.25. Variable with P < 0.25 in the bivariable analysis was a candidate for multivariable analysis to control confounding effect. In multivariable analysis, variables with P < 0.05 were considered statistically significant and the result was presented using an adjusted odd ratio (AOR) with a 95% confidence interval (CI).

RESULTS

A total of 616 participants with a response rate of 97.1% were included. Of the total participants, 229(37.2%) were in the danger control response. The behavioral response was affected by Occupational status [AOR (95%CI) 3.53(1.67-7.46)], the number of people living together [AOR (95%CI) 2.62(1.28-5.39)], self-control [AOR (95%CI) 1.14(1.05-1.25)], a friend for the preferred source of information [AOR (95%CI) 5.18(3.22-8.33)] and printed materials for the preferred channel [AOR (95%CI) 2.14(1.35-3.43)].

CONCLUSION

Above one-third of the participants were in the danger control response. Occupational status, number of people living together, self-control, a friend for the preferred source of information, and printed materials for the preferred channel were independent predictors of resident behavioral response to the use of facemasks. Policymakers should consider students and people who live alone. Message developers should use a friendly person to transmit messages and should prepare printed materials. Activities and strategies should also focus on self-control and perceived efficacy without ignoring the perceived threat.

Varieties of Mobility Measures: Comparing Survey and Mobile Phone Data during the COVID-19 Pandemic

Human mobility has become a major variable of interest during the COVID-19 pandemic and central to policy decisions all around the world. To measure individual mobility, research relies on a variety of indicators that commonly stem from two main data sources: survey self-reports and behavioral mobility data from mobile phones. However, little is known about how mobility from survey self-reports relates to popular mobility estimates using data from the Global System for Mobile Communications (GSM) and the Global Positioning System (GPS). Spanning March 2020 until April 2021, this study compares self-reported mobility from a panel survey in Austria to aggregated mobility estimates utilizing (1) GSM data and (2) Google's GPS-based Community Mobility Reports. Our analyses show that correlations in mobility changes over time are high, both in general and when comparing subgroups by age, gender, and mobility category. However, while these trends are similar, the size of relative mobility changes over time differs substantially between different mobility estimates. Overall, while our findings suggest that these mobility estimates manage to capture similar latent variables, especially when focusing on changes in mobility over time, researchers should be aware of the specific form of mobility different data sources capture.

Flattening the COVID-19 curve: Emotions mediate the effects of a persuasive message on preventive action

Introduction

Across four countries (Canada, USA, UK, and Italy), we explored the effects of persuasive messages on intended and actual preventive actions related to COVID-19, and the role of emotions as a potential mechanism for explaining these effects.

Methods

One thousand seventy-eight participants first reported their level of concern and emotions about COVID-19 and then received a positive persuasive text, negative persuasive text, or no text. After reading, participants reported their emotions about the pandemic and their willingness to take preventive action. One week following, the same participants reported the frequency with which they engaged in preventive action and behaviors that increased the risk of contracting COVID-19.

Results

Results revealed that the positive persuasive text significantly increased individuals' willingness to and actual engagement in preventive action and reduced risky behaviors 1 week following the intervention compared to the control condition. Moreover, significant differences were found between the positive persuasive text condition and negative persuasive text condition whereby individuals who read the positive text were more willing and actually engaged in more preventive action compared to those who read the negative text. No differences were found, however, at the 1-week follow-up for social distancing and isolation behaviors. Results also revealed that specific discrete emotions mediated relations between the effects of the texts and preventive action (both willing and actual).

Discussion

This research highlights the power of educational interventions to prompt behavioral change and has implications for pandemic-related interventions, government policy on health promotion messages, and future research.

Group-based trajectories and predictors of adherence to physical distancing during the COVID-19 pandemic

Objective: This study sought to identify psychosocial predictors of trajectories of adherence to physical distancing alongside changes in public health measures during the COVID-19 pandemic. Design: A three-time point longitudinal survey during the first two waves of the COVID-19 pandemic. Methods: Participants (N = 1003) completed self-report measures of adherence to physical distancing over an 8-month period at the start (T1) and end (T2) of the first wave of the pandemic, and the start of the second wave of the pandemic (T3). Participants also completed measures of their health beliefs related to the self and others, social norms, emotional distress, and sociodemographic characteristics. Results: Using group-based trajectory modeling, four trajectories of adherence to physical distancing emerged: a high-adherence trajectory, a slow-declining trajectory, a fluctuating trajectory, and a fast-declining trajectory. The most important psychosocial predictors of poorer adherence trajectories included perceptions of lower self-efficacy and higher barriers to adherence, as well as lower prosocial attitudes towards physical distancing. Conclusion: Public health messages targeting these factors may be most relevant to promote sustained adherence to physical distancing over time in the context of a pandemic.

How providing public COVID-19 mitigation instructions in a foreign language can increase people's sense of control

Processing information in a learned foreign language can alter one's judgment or cognitive evaluation of stimuli. Documented consequences include a reduction in perceived negativity and perceived severity of crime or diseases. The global COVID-19 pandemic has offered a unique opportunity to investigate this phenomenon in a real-life public health communication context. The aim of this study is to investigate how foreign language processing influences people's reaction towards freedom-restrictive messages. In our experimental study (N = 605), we presented participants with pandemic mitigation instructions in their native language versus a learned foreign language and assessed their perceived sense of control, cognitive evaluation of the instructions, and the intention to adhere to them. The results indicated that the use of a foreign language influenced people's perceived sense of control in a way that might intuitively be surprising: foreign language enhanced sense of control. This positively influenced the cognitive evaluation of the instructions' effectiveness and the intention to comply with them. The present research demonstrates that foreign language processing influences individuals' responses to specific, real-life instructions. Our results provide important contributions to the literature on foreign language effects and public communication and enable practitioners to more accurately predict recipient responses to global crisis communications.

Personality and city culture predict attitudes and practices toward mosquitoes and mosquito-borne diseases in South Texas

Personality is known to affect compliance with health-protective behaviors and it has been shown that effective public health messaging can be informed by an understanding of that relationship. Thus, we aimed to evaluate the role personality might play in implementing personal protective measures (PPMs) that can prevent mosquito-borne diseases. This is the first mosquito-related knowledge, attitudes, and practices (KAP) study to incorporate a measure of personality using the Big Five: openness, conscientiousness, extraversion, agreeableness, and neuroticism. KAP studies in Gulf-coast and Mexican border-states in the U.S. are few. Ours is only the second KAP study to take place in Texas despite known local transmission and established mosquito populations capable of transmitting dengue, zika, chikungunya, and West Nile viruses. The KAP survey was administered in three neighborhoods in San Antonio, a large, Hispanic-majority, urban city that is segregated economically and ecologically. We found that openness, agreeableness, and extraversion predicted certain attitudes and PPMs, and that KAP and personality measures did not differ along ethnic or neighborhood lines. Perceptions toward the city's role in mosquito control and education was an important factor in predicting PPMs, suggesting that city culture (attitudes common throughout the city as opposed to attitudes differing by ethnicity and neighborhood) may be most salient in developing public health messaging in San Antonio.

Emotional Appeals and Social Support in Organizational YouTube Videos During COVID-19

Through a content analysis of 106 organizational YouTube videos during COVID-19 from March to September 2020 and sentiment analysis of the 9398 audiences’ comments, this study aims to analyze the emotional appeals, social support, and preventive behaviors reflected in the organizational YouTube videos and how such message features influenced audience engagement and audience comments sentiment. We found that hope and happiness are the two emotions used most frequently. Emotional appeals changed over time. Though videos in March and April mainly adopted fear and anxiety appeals, humor became more dominant after May, 2020. Emotional appeals also increased views and positive comments. Videos providing informational and emotional support received more likes. Videos produced at different stages of the pandemic also promoted preventive behaviors differently, with more videos promoting wearing masks after May. Sports/entertainment industries produced videos that received more positive comments than other industries.

"I can't do it": A qualitative study exploring case and contact experiences with COVID-19 contact tracing

BACKGROUND

Low engagement in contact tracing for COVID-19 dramatically reduces its impact, but little is known about how experiences, environments and characteristics of cases and contacts influence engagement.

METHODS

We recruited a convenience sample of COVID-19 cases and contacts from the New Haven Health Department's contact tracing program for interviews about their contact tracing experiences. We analyzed transcripts thematically, organized themes using the Capability, Opportunity, Motivation, Behavior (COM-B) model, and identified candidate interventions using the linked Behavior Change Wheel Framework.

RESULTS

We interviewed 21 cases and 12 contacts. Many felt physically or psychologically incapable of contact tracing participation due to symptoms or uncertainty about protocols. Environmental factors and social contacts also influenced engagement. Finally, physical symptoms, emotions and low trust in and expectations of public health authorities influenced motivation to participate.

CONCLUSION

To improve contact tracing uptake, programs should respond to clients' physical and emotional needs; increase clarity of public communications; address structural and social factors that shape behaviors and opportunities; and establish and maintain trust. We identify multiple potential interventions that may help achieve these goals.

Exploring the Association between Negative Emotions and COVID-19 Vaccine Acceptance: A Cross-Sectional Analysis of Unvaccinated Adults in Sweden

The coronavirus disease 2019 (COVID-19) pandemic has had a significant impact on individuals’ mental health. This study aimed to investigate how negative emotions toward the COVID-19 pandemic, including feeling anxious, depressed, upset, and stressed, were associated with COVID-19 vaccine acceptance in Sweden. The study is a cross-sectional online survey conducted between 21–28 May 2021, using three nested hierarchical logistic regression models to assess the association. The study included 965 unvaccinated individuals, 51.2% (n = 494) of whom reported their intention to get vaccinated. We observed graded positive associations between reported negative emotions and vaccine acceptance. Individuals who experienced economic stress had lower odds of vaccine acceptance while having a positive opinion of the government’s response to COVID-19 was associated with higher odds of being vaccine-acceptant. In conclusion, unvaccinated individuals experiencing negative emotions about the pandemic were more willing to get the vaccine. On the contrary, those with a negative opinion about the government’s response, and those that had experienced economic stress were less likely to accept the immunization.

Providing Solution in an Emergency: COVID-19 and Voice Behavior of Healthcare Professionals

This study investigates the mechanism between idiosyncratic deals (I-deals) and voice behavior, considering display aggression and deontic justice as mediating variables. We collected data from 702 nurses and their immediate supervisors who work with COVID-19 patients through survey questionnaires at two different times, and we analyzed the data using structural equation modeling (SEM). We found that I-deals are significantly associated with deontic justice and voice behavior. Moreover, I-deals are significant but negatively associated with displayed aggression, which is significant and negatively associated with voice behavior. In addition, deontic justice and display aggression mediate the association between I-deals and voice behavior. These findings suggest that the hospitals' top management should provide I-deals to nurses to improve their voice behavior.

Racial/Ethnic Differences in Prosocial Beliefs and Prevention Behavior During the COVID-19 Pandemic

Controlling the COVID-19 pandemic has required communities to engage in prosocial action, including behaviors that may inconvenience individuals, but protect the collective (e.g., mask wearing, social distancing). The purpose of this study was to understand to what extent COVID-19 prosocial beliefs and behavior differ by race/ethnicity and why this might be the case. A US nationally representative sample of 410 adults completed a survey about COVID-19 beliefs and prevention behaviors between June 12 and 18, 2020. Compared to White respondents, Black respondents perceived the risk of COVID-19 to be greater to the US population; and both Black and Latinx respondents thought it was more important to protect a variety of non-close others (e.g., people in their city or state). Black and Latinx respondents engaged in several prevention behaviors, including social distancing, to a greater extent than White respondents. There were indirect effects of Black vs. White race on engaging in protective behaviors through greater perceived risk to others and beliefs in the importance of protecting distal others. Results indicate that targeted messages promoting prevention, including vaccination with pro-social messages, may resonate with communities of color. They also suggest that lower levels of prosocial beliefs among White people have likely hindered the US response to the epidemic.

Engagement in digital interventions

The notion of "engagement," which plays an important role in various domains of psychology, is gaining increased currency as a concept that is critical to the success of digital interventions. However, engagement remains an ill-defined construct, with different fields generating their own domain-specific definitions. Moreover, given that digital interactions in real-world settings are characterized by multiple demands and choice alternatives competing for an individual's effort and attention, they involve fast and often impulsive decision-making. Prior research seeking to uncover the mechanisms underlying engagement has nonetheless focused mainly on psychological factors and social influences and neglected to account for the role of neural mechanisms that shape individual choices. This article aims to integrate theories and empirical evidence across multiple domains to define engagement and discuss opportunities and challenges to promote effective engagement in digital interventions. We also propose the affect-integration-motivation and attention-context-translation (AIM-ACT) framework, which is based on a neurophysiological account of engagement, to shed new light on how in-the-moment engagement unfolds in response to a digital stimulus. Building on this framework, we provide recommendations for designing strategies to promote engagement in digital interventions and highlight directions for future research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Asymmetrical friendships? People are willing to risk COVID-19 infection from friends but are reluctant to pass it on to them

Although most protective behaviors related to the COVID-19 pandemic come with personal costs, they will produce the largest benefit if everybody cooperates. This study explores two interacting factors that drive cooperation in this tension between private and collective interests. A preregistered experiment (N = 299) examined (a) how the quality of the relation among interacting partners (social proximity), and (b) how focusing on the risk of self-infection versus onward transmission affected intentions to engage in protective behaviors. The results suggested that risk focus was an important moderator of the relation between social proximity and protection intentions. Specifically, participants were more willing to accept the risk of self-infection from close others than from strangers, resulting in less caution toward a friend than toward a distant other. However, when onward transmission was the primary concern, participants were more reluctant to effect transmission to close others, resulting in more caution toward friends than strangers. These findings inform the debate about effective nonclinical measures against the pandemic. Practical implications for risk communication are discussed.

How do information overload and message fatigue reduce information processing in the era of COVID-19? An ability–motivation approach

The global outbreak of COVID-19 in 2020 has led to the dominance of COVID-19 prevention information on all media channels. Drawing on the ability–motivation model of information processing, this study examined how such an information overabundance hampered individuals’ ability and motivation to process in the era of COVID-19. With a survey conducted from 493 participants, we found that less message elaboration of COVID-19 prevention information was predicted by greater message fatigue, a state of low motivation due to information overabundance. In addition, greater message fatigue was accompanied by greater information overload, a state of low ability due to information overabundance. Moreover, certain motivation-related (i.e. health status, trait reactance and frequency of information seeking) and ability–related factors (i.e. health literacy, health status, trait anxiety and information quality) were found to be associated with message fatigue and information overload, respectively. The theoretical and practical implications are discussed.

Moral Disengagement, Dark Triad and Face Mask Wearing during the COVID-19 Pandemic

Not wearing a face mask, despite the sanitary recommendation, represented a public health risk during the COVID-19 pandemic. For this reason, the aim of the study was to determine the mediating role of moral disengagement in the relationship between the dark triad and face mask wearing during the second wave of the pandemic. We worked with a sample made up of 534 adults, who were administered the Dirty Dozen Dark test, the Moral Disengagement Mechanisms Scale and a questionnaire on the frequency of use of face masks. The results showed that moral disengagement mediates the effect of each trait of the dark triad (Machiavellianism, psychopathy and narcissism) on the use of face masks. It is concluded that those who possess any of the dark personality traits morally disengage in order not to use a face mask, exercising a reckless behavior of the possible contagion of COVID-19 to others.

Influence of diverse kinds of persuasive messages on intention to stay home during COVID-19 pandemic: Moderating role of media type

This study highlights the influence of diverse kinds of persuasive messages on intention to stay home during COVID-19 pandemic. The COVID-19 pandemic is believed to be the top modern societal challenge necessitating extensive collective action and collaboration. The statistical population included Iranian individuals by answering our online survey questionnaires at diverse phases of the COVID-19 pandemic. 406 completed questionnaires were gathered and analyzed. Note that, according to the official reports, Iran encountered COVID-19 disease since February 19, 2020. Data collection was started on July 18, 2020 (at the beginning of second wave of COVID-19 in Iran) and lasted until October 30, 2020. Various social network platforms including Instagram, WhatsApp, Facebook and Telegram were used for distribution of the questionnaires. According to the results, perceived severity and perceived self-efficacy had an insignificant direct influence on intention to stay home. From another perspective, perceived vulnerability (β = 0.261, CI = 0.059; 0.242]) and perceived response efficacy (β = 0.502, CI = 0.347; 0.656]) positively and significantly affected the intention to stay home. Moreover, no significant difference was found between these two kinds of media messages in research sample. Our findings showed that “perceived response efficacy” has the highest importance score of 0.502; if the perceived response efficacy performance is boosted by one unit point by individuals during COVID-19 pandemic, its overall intention to stay home will increase by 0.502. Besides, our results showed that lowest performance (78.104) is associated with perceived vulnerability highlighting an excellent opportunity for improvement in this area.

Intrinsic brain activity patterns across large-scale networks predict reciprocity propensity

Reciprocity is prevalent across human societies, but individuals are heterogeneous regarding their reciprocity propensity. Although a large body of task-based brain imaging measures has shed light on the neural underpinnings of reciprocity at group level, the neural basis underlying the individual differences in reciprocity propensity remains largely unclear. Here, we combined brain imaging and machine learning techniques to individually predict reciprocity propensity from resting-state brain activity measured by fractional amplitude of low-frequency fluctuation. The brain regions contributing to the prediction were then analyzed for functional connectivity and decoding analyses, allowing for a data-driven quantitative inference on psychophysiological functions. Our results indicated that patterns of resting-state brain activity across multiple brain systems were capable of predicting individual reciprocity propensity, with the contributing regions distributed across the salience (e.g., ventrolateral prefrontal cortex), fronto-parietal (e.g., dorsolateral prefrontal cortex), default mode (e.g., ventromedial prefrontal cortex), and sensorimotor (e.g., supplementary motor area) networks. Those contributing brain networks are implicated in emotion and cognitive control, mentalizing, and motor-based processes, respectively. Collectively, these findings provide novel evidence on the neural signatures underlying the individual differences in reciprocity, and lend support the assertion that reciprocity emerges from interactions among regions embodied in multiple large-scale brain networks.

Affective States During the First Wave of the COVID-19 Pandemic: Progression of Intensity and Relation With Public Health Compliance Behavior

The COVID-19 pandemic was expected to cause intense affective reactions. This situation provided a unique opportunity to examine the characteristics and correlates of emotions in a real-world context with great significance. Our study aimed to describe the progression of positive and negative affective states during the pandemic, and to investigate which affective states predicted compliance with public health measures. We undertook a survey of affective states in the province of Quebec at the beginning, the peak, and the aftermath of the first wave of the COVID-19 pandemic. We recruited 530 responders; 154 responded to all three surveys. We used self-report scales to measure affective states and compliance with public health measures. We then computed separate linear regressions for the three phases of our study, with compliance with health measures as the dependent variable. Affective states were generally most intense at the beginning of the pandemic. Fear-related pandemic-related affective states reliably predicted compliance with public health measures in the three phases of our study. Positively valenced affective states related to the societal response also contributed predictive value, but only at the peak of the first wave.

The Asymmetric Influence of Emotion in the Sharing of COVID-19 Science on Social Media: Observational Study

BACKGROUND

Unlike past pandemics, COVID-19 is different to the extent that there is an unprecedented surge in both peer-reviewed and preprint research publications, and important scientific conversations about it are rampant on online social networks, even among laypeople. Clearly, this new phenomenon of scientific discourse is not well understood in that we do not know the diffusion patterns of peer-reviewed publications vis-à-vis preprints and what makes them viral.

OBJECTIVE

This paper aimed to examine how the emotionality of messages about preprint and peer-reviewed publications shapes their diffusion through online social networks in order to inform health science communicators' and policy makers' decisions on how to promote reliable sharing of crucial pandemic science on social media.

METHODS

We collected a large sample of Twitter discussions of early (January to May 2020) COVID-19 medical research outputs, which were tracked by Altmetric, in both preprint servers and peer-reviewed journals, and conducted statistical analyses to examine emotional valence, specific emotions, and the role of scientists as content creators in influencing the retweet rate.

RESULTS

Our large-scale analyses (n=243,567) revealed that scientific publication tweets with positive emotions were transmitted faster than those with negative emotions, especially for messages about preprints. Our results also showed that scientists' participation in social media as content creators could accentuate the positive emotion effects on the sharing of peer-reviewed publications.

CONCLUSIONS

Clear communication of critical science is crucial in the nascent stage of a pandemic. By revealing the emotional dynamics in the social media sharing of COVID-19 scientific outputs, our study offers scientists and policy makers an avenue to shape the discussion and diffusion of emerging scientific publications through manipulation of the emotionality of tweets. Scientists could use emotional language to promote the diffusion of more reliable peer-reviewed articles, while avoiding using too much positive emotional language in social media messages about preprints if they think that it is too early to widely communicate the preprint (not peer reviewed) data to the public.

Motivating COVID-19 mitigation actions via personal norm: An extension of the norm activation model

OBJECTIVE

Given the prosocial nature of COVID-19 mitigation actions, the norm activation model (NAM) provides a theoretical framework to understand how these mitigation behaviors may be driven by activating personal norms. Aimed at delineating the relationship between awareness of consequences and ascription of responsibility, two key variables in the model, the present study examined to what extent this relationship was moderated by political ideology, individual efficacy, and collective efficacy.

METHOD

A cross-sectional online survey (N = 560) was implemented with a sample that matched the demographics of the national population in the U.S.

RESULTS

The relationship between awareness of consequences and ascription of responsibility was stronger among liberals and those reporting low levels of individual efficacy and collective efficacy.

CONCLUSION

Health behaviors such as COVID-19 mitigation actions can be motivated by activating individuals' sense of moral obligation, but the effectiveness of this approach depends on their political ideology and efficacy beliefs.

PRACTICE IMPLICATIONS

Campaigns can promote health behaviors by triggering the moral responsibility of the target audience through emphasizing severity of the consequences. This approach can be more effective for liberals and those that lack confidence in individual and collective abilities to avert the threat.

The Association between the Sense of Coherence and the Self-Reported Adherence to Guidelines during the First Months of the COVID-19 Pandemic in Israel

(1) Background: Social distancing became a central strategy employed to limit the spread of the SARS-CoV-2 virus. We explore self-reported adherence (SRA) and factors associated with SRA among Israeli adults at the end of the first national lockdown in Israel. (2) Methods: We conducted a cross-sectional consumer panel survey of 820 Israeli adults aged 18 to 70 in May and June 2020. We collected data on the SRA to the social distancing measures, sociodemographic variables, perceptions of pandemic-related danger and of protection provided by the social distancing measures, as well as Sense of Coherence (SoC). (3) Results: 60% of respondents reported complying with 7 measures. Higher SoC was associated with higher SRA (p = 0.04), and was related to income, marital status, age, profession, and education. The SRA was higher among Jews than Arabs (Jews: Mean = 10.5, SD = 4.5; Arabs: Mean = 9.1, SD = 4.1, p < 0.001) and among males (Males: Mean = 10.8, SD = 4.7; Females: Mean = 9, SD = 4.1; p = 0.003). SoC, perception of protection and perception of danger were associated with higher SRA (p = 0.42, p < 0.001 and p = 0.005 respectively). Single people reported higher levels of SRA than people in relationships (Partnered: Mean = 9.7, SD = 4.2, Non-partnered: Mean = 10.9, SD = 4.7, p = 0.033). (4) Conclusions: At the time of exit from the first lockdown, compliance with social distancing measures was high, with Jewish, single and male Israelis more likely to adhere to the guidelines. We identified the populations at risk for non-adherence and associated factors, reporting for the first time the correlation between SoC and SRA. Further research is needed to assess the role of these factors in Jewish and Arab populations.

Exploring the Impacts of Preventative Health Behaviors with Respect to COVID-19: An Altruistic Perspective

This study aims to explore the impact of gender and anxiety on various preventative health behaviors, and the relationships among these preventative health behaviors, individual well-being and depression, from the perspective of altruism. This study employed an online questionnaire survey, and 136 males and 204 females participated in the survey. The results of this study showed that females exhibited better preventative health behaviors than males, including hygiene habits, social distancing and behaviors intended to help others mitigate the epidemic. Anxiety regarding COVID-19 infection encouraged individuals to adopt hygienic habits and social distancing measures rather than to help others mitigate the epidemic. Hygiene habits improved the individual's psychological well-being. Helping others mitigate the epidemic improved the individual's psychological well-being and social well-being and contributed to reducing individual depression. However, the preventative health behavior involved in social distancing was not conducive to emotional well-being or social well-being. Affective elements are related to individual behaviors. Therefore, the use of prosocial, altruistic language may play an important role with respect to encouraging people to comply with preventative health behaviors in the context of COVID-19. In addition, it is worth noting that different preventative health behaviors may have different effects on people's mental health, especially when implementing social distancing-related epidemic mitigation behaviors. The question of how to prevent negative psychological effects in restricted actors must be answered, and the degree of life satisfaction experienced by those actors must also be taken into account.

How COVID-19 can promote workplace cheating behavior via employee anxiety and self-interest - And how prosocial messages may overcome this effect

While scholars have debated whether environmental factors (e.g., air pollution) can prompt unethical behavior (e.g., crime), we argue that the COVID-19 pandemic provides a unique opportunity to inform this theoretical debate by elaborating on why these effects may occur, identifying how they can be overcome, and addressing methodological issues. Drawing on appraisal theories of emotion, we argue that appraising COVID-19 (i.e., an environmental factor) as a threat can elicit anxiety. This can focus employees on their own self-interest and prompt cheating behavior (i.e., unethical workplace behavior). However, we propose that these detrimental effects can be attenuated by prosocial messages (i.e., highlighting the meaningful and positive impact that employees' work can have on others). Our predictions were supported using a two-wave survey (N = 396) and an experiment (N = 163) with samples of full-time employees during the COVID-19 pandemic. Theoretically, our studies inform this ongoing debate by highlighting the importance of state anxiety and self-interest as key mechanisms and that drawing peoples' attention towards others can serve as a boundary condition. Practically, we provide insight into the ethical costs of COVID-19 in the workplace and identify a simple yet effective strategy that organizations can use to curtail workplace cheating behavior.

Covid-19 Vaccine Fact-checking Posts on Facebook: An Observational Study

BACKGROUND

Effective interventions aimed at correcting COVID-19 vaccine misinformation, known as fact-checking messages, are needed to combat the mounting anti-vaccine infodemic and alleviate vaccine hesitancy.

OBJECTIVE

This works investigates (a) the changes of the public's attitude toward COVID-19 vaccines over time, (b) the effectiveness of COVID-19 vaccine fact-checking information on social media engagement and attitude change, and (c) the emotion and linguistic features of COVID-19 vaccine fact-checking information ecosystem.

METHODS

We collected a dataset of 12,553 COVID-19 vaccine fact-checking Facebook posts and their associated comments (N=122,362) from January 2020 - March 2022 and conducted a series of natural language processing and statistical analyses to investigate trends in public attitude toward the vaccine in COVID-19 vaccine fact-checking posts and comments, and emotional and linguistic features of the COVID-19 fact-checking information ecosystem.

RESULTS

The percentage of fact-checking posts relative to all COVID-19 vaccine posts peaked in May of 2020 and then steadily decreased as the pandemic progressed (r = -.92, df = 21, t = -10.94, 95% CI = [-.97, -.82], P < .001). The salience of COVID-19 vaccine entities was significantly lower in comments (M = 0.03, t = 39.28, P < .001) than in posts (M = 0.09). Third-party fact checkers have been taking a more important role with more fact-checking over time (r = .63, df = 25, t = 4.06, 95% CI = [.33, .82], P < .001). COVID-19 vaccine fact-checking posts continued to be more analytical (r = .81, df = 25, t = 6.88, 95% CI = [.62, .91], P < .001) and more confident (r = .59, df = 25, t = 3.68, 95% CI = [.27, .79], P = .001) over time. While comments did not exhibit a significant increase in confidence over time, tentativeness in comments decreased significantly (r = -.62, df = 25, t = -3.94, 95% CI = [-.81, -.31], P = .001). While hospitals receive less engagement than other information sources, the comments expressed more positive attitudinal valence in comments compared to other information sources (b = 0.06, 95% CI = [0.00, 0.12], t = 2.03, P = .043).

CONCLUSIONS

The percentage of fact-checking posts relative to all posts about the vaccine steadily decreased after May of 2020. As the pandemic progressed, third-party fact checkers played a larger role in posting fact-checking COVID-19 vaccine posts. COVID-19 vaccine fact-checking posts continued to be more analytical and more confident over time, reflecting increased confidence in posts. Similarly, tentativeness in comments decreased; this likewise suggests that public uncertainty diminished over time. COVID-19 fact-checking vaccine posts from hospitals yielded more positive attitudes toward vaccination than other information sources. At the same time, hospitals received less engagement than other information sources. This suggests that hospitals should invest more in generating engaging public health campaigns on social media.

CLINICALTRIAL

Global COVID-19 vaccine inequity: Preferences for overseas vaccine donations over booster shots

As the supply of COVID-19 vaccines to low-income countries (LICs) remains limited, governments of high-income countries face a trade-off between domestic containment through booster shots and global containment by helping LICs acquire first doses ("vaccine nationalism" vs "vaccine internationalism"). We provide empirical evidence on how residents of a high-income country view this ethical dilemma by surveying 1527 UK adults recruited online. Support for vaccine donations to LICs is high. On average, study participants chose to donate 65% of UK's COVID-19 vaccines, which were ordered for booster shots, to LICs. Holding all other factors constant, women, younger individuals, and those who are not fully vaccinated preferred to donate a larger percentage to LICs. The UK public's preferences for prioritizing vaccine donations over booster shot programs suggest broad support for national policies that strike a balance between domestic containment and global philanthropy.

Role of COVID-19 Anxiety and Community Risk Factors on Physical Distancing Practice

Existing studies have focused primarily on self-oriented anxiety (i.e., anxiety over one’s infection) in the pandemic context, and the role of community risk is largely ignored. This study addressed these gaps by examining (a) self-oriented anxiety and two forms of others-oriented anxiety (i.e., anxiety concerning others’ health and societal problems), (b) the associations between all these forms of anxiety and physical distancing practice during the COVID-19 pandemic, and (c) the hypothesized moderating role of community risk factors. The participants were 703 U.S. community-dwelling adults who completed an online survey. Geo-identifier data were extracted to identify the number of confirmed COVID-19 cases and four social vulnerability indexes for the county in which each participant resided. Both forms of others-oriented anxiety were positively associated with physical distancing adoption, and the association was stronger among the participants residing in lower-risk communities (i.e., fewer confirmed COVID-19 cases, higher socioeconomic status, and better housing conditions). The study’s novel findings reveal the protective role of anxiety, particularly anxiety concerning others’ well-being, in encouraging people to adopt physical distancing during a pandemic. However, the protective role of anxiety is contingent upon certain community risk factors. Anxiety is more beneficial to residents of low- rather than high-risk communities.

Challenges and recommendations for COVID-19 public health messaging: a Canada-wide qualitative study using virtual focus groups

OBJECTIVES

To understand Canadian's attitudes and current behaviours towards COVID-19 public health measures (PHM), vaccination and current public health messaging, to provide recommendations for a public health intervention.

DESIGN

Ten focus groups were conducted with 2-7 participants/group in December 2020. Focus groups were transcribed verbatim and analysed using content and inductive thematic analysis. The capability opportunity motivation behaviour Model was used as our conceptual framework.

SETTING

Focus groups were conducted virtually across Canada.

PARTICIPANTS

Participants were recruited from a pool of individuals who previously completed a Canada-wide survey conducted by our research team.

MAIN OUTCOME MEASURE

Key barriers and facilitators towards COVID-19 PHM and vaccination, and recommendations for public health messaging.

RESULTS

Several themes were identified (1) participants' desire to protect family and friends was the main facilitator for adhering to PHM, while the main barrier was inconsistent PHM messaging and (2) participants were optimistic that the vaccine offers a return to normal, however, worries of vaccine efficacy and effectiveness were the main concerns. Participants felt that current public health messaging is inconsistent, lacks transparency and suggested that messaging should include scientific data presented by a trustworthy source.

CONCLUSIONS

We suggest six public health messaging recommendations to increase adherence to PHM and vaccination (1) use an unbiased scientist as a spokesperson, (2) openly address any unknowns, (3) more is better when sharing data, (4) use personalised stories to reinforce PHM and vaccinations, (5) humanise the message by calling out contradictions and (6) focus on the data and keep politics out.