Factors associated with preventive behaviors for COVID-19 among adolescents in South Korea

YouTube vloggers set the stage: How public (non)compliance with COVID-19 regulations affects adolescents

INTRODUCTION

YouTube vloggers may be important socialization figures, yet their influence on adolescents' health-related behaviors and cognitions is largely untested. In this two-study mixed-method project, we first assessed the extent of (non)compliance to COVID-19 regulations by vloggers on YouTube and how viewers reacted to this. Second, we experimentally assessed the effects of vlogger behavior paired with viewer evaluations on adolescents' COVID-19-related attitudes, intentions, and behavior.

METHODS

For Study 1, we coded 240 vlogs of eight popular Dutch vloggers on YouTube recorded in the period of February 2020-March 2021. For our 2 × 2 between-subjects experiment in Study 2, Dutch adolescents (N = 285, Mage = 12.99, SD = 1.02, 41.8% girls) were randomly assigned to conditions in which they saw vlogs showing either compliance or noncompliance to COVID-19 regulations, and to conditions in which they saw either supportive or dismissive comments under these vlogs.

RESULTS

Study 1: Vloggers' noncompliance with COVID-19 regulations was not uncommon and received relatively more viewer support than compliance, suggesting that portrayed noncompliance may be potentially influential. Study 2: Adolescents were more worried about COVID-19 after they watched a compliant (vs. noncompliant) vlogger. Also, vlogger noncompliance decreased adolescents' perceived importance of COVID-19 regulations and rule-setting for adolescents who identified strongly with the vloggers they watched.

CONCLUSIONS

Vloggers' (non)compliance affects adolescents' COVID-19-related worrying, and attitudes and behavior of adolescents who identify with vloggers strongly. This seems concerning given the sometimes harmful and risky behaviors vloggers portray online but could potentially also be employed to encourage healthy behaviors.

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

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

The moderating influence of celebrity endorsement on intention to engage in infection prevention behaviours

Although the use of celebrities for communication within social marketing to influence voluntary behaviour change has received significant attention, its application to promote infection preventive behaviours, such as frequent handwashing with soap, has received limited attention. Using the health belief model (HBM), the study examined the moderating effect of celebrity endorsement (CE) on the relationship between the predictors of HBM such as perceived severity, susceptibility, benefits, barriers, self-efficacy and target audiences' intention to avoid handshaking, frequently wash hands with soap and cover mouth with an elbow when coughing. Data from 562 respondents were analysed using PLS-SEM. The result shows that CE significantly moderate the relationship between target audiences' perception of severity, susceptibility, self-efficacy and cues to action and intention to perform the recommended infection preventive behaviours. Thus, when a celebrity is employed as a conduit for delivering a social marketing message, particularly about infection preventive behaviour, target audiences are more likely to take action to perform the recommended behaviour. Theoretically, the study shows that although the HBM has been extensively applied to explain health-related behaviours, using celebrities to endorse the various constructs of the HBM significantly enhances the predictive ability of the model.

Temporal changes in mental response and prevention patterns, and their impact from uncertainty stress during the transition in China from the COVID-19 epidemic to sporadic infection

An epidemic of a highly lethal disease can overwhelm people emotionally and physically. Little is known about how public mental and preventive patterns changed during the transition from the COVID-19 epidemic to sporadic infection. This study examined changing trends of metal response and behavioral variables, and their impact from uncertainty stress in this process in China. A prospective longitudinal observation design was utilized. There were 7 waves of surveys from COVID-19 epidemic status to the sporadic infection period. Sixty-two participants completed all observation points and were included in the study. The Mann-Kendall Test was used to assess changing trends across the seven observation points. The nonparametric linear mixed effects model was used to examine the association between uncertainty stress and mental and behavioral responses. The mean uncertainty stress did not change significantly over the observation period (Z: -0.911, p > 0.05). This trend was also true for perceived risk, perceived severity, self-efficacy for prevention, and prevention behavior. There was a statistically significant downward trend in irrational beliefs about prevention (Z: -4.993, p < 0.01), sleep (Z: -2.499, p < 0.05), emotions (Z: -5.650, p < 0.01), and lifestyle (Z: -5.978, p < 0.01). The results showed that uncertainty stress was positively associated with irrational beliefs (β: 0.16298, p < 0.01), their sleep (β: 0.02070, p < 0.05), emotions (β: 0.03462, p < 0.01), and lifestyle (β: 0.02056, p < 0.05). High levels of uncertainty stress were negatively associated with self-efficacy for prevention and prevention behavior, β was -1.33210 (p < 0.01) and -0.82742 (p < 0.01). These results may have important policy and disease prevention in post-epidemic times.

Meta-analysis on application of Protection Motivation Theory in preventive behaviors against COVID-19

The present study aims to conduct a systematic review and meta-analysis on quantitative conclusion and appraisal of findings from Protection Motivation Theory to predict protective behaviors against COVID-19. This meta-analysis covered the period between 2019 and 2022. Web of Science, Science Direct, Scopus, Emerald, PubMed, Springer, Sage, Online Wiley Library, Taylor & Francis and ProQuest were searched to find related articles to the study topic. Using Effect Size of Random model, the quality of each study, homogeneous of studies and Publication bias of data were analyzed and assessed by CMA2 software. The results indicate that perceived severity (β=0.197), perceived vulnerability (β=0.160), response efficacy (β=0.251) and self-efficacy (β=0.270) are positively associated with COVID-19 disease. In addition, the results show that Response cost (β=-0.074) is a negative and weak predictor of motivation to protect against COVID-19. The results of this study regarding Protection Motivation Theory (PMT)- as a very strong and flexible theory during outbreak of COVID-19- may suggest that despite positive protection, the mean of Effect Size of total PMT elements is less than average size. Meta-analysis of studies shows that coping appraisal variables provide the strongest predictors of behavior and intention. Furthermore, self-efficacy was identified as the most important determinant in protective behaviors against COVID-19.

Non-commuting intentions during COVID-19 in Nanjing, China: A hybrid latent class modeling approach

Non-commuting travel is essential for people to meet daily demands and regulate mental health, which is greatly disrupted due to the COVID-19 pandemic. To explore non-commuting intentions during COVID-19 across different groups of residents, this paper uses online survey data in Nanjing and constructs a hybrid latent class choice model that combines sociodemographic characteristics and psychological factors. Results showed that the respondents can be divided into two groups: the "cautious" group versus the "fearless" group. The "cautious" group with lower willingness to travel tend to be older, higher-income, higher-educated, female and full-time employees. Furthermore, the "cautious" group with higher perceived susceptibility is more obedient to government policies. In contrast, the "fearless" group is significantly affected by perceived severity and is more inclined to turn to personal protection against the pandemic. These results suggested that non-commuting trips were influenced not only by individual characteristics but also by psychological factors. Finally, the paper provides implications for the government to formulate COVID-19 management measures for the heterogeneity of different groups.

Adherence to preventive behaviours and associated factors towards COVID-19 among adults in Gurage zone, Ethiopia, 2020: a community-based cross-sectional study

OBJECTIVES

People's adherence to preventive practices for COVID-19 is fundamental to controlling the transmission of the virus. Therefore, this study is aimed at assessing adherence to preventive practices for COVID-19 and associated factors among the general population in Gurage zone, Ethiopia.

METHODS

A community-based cross-sectional study was conducted to assess preventive practices and associated factors for COVID-19 among adults in the Gurage zone. The study is based on health belief model constructs. The study involved 398 participants. A multistage sampling technique was employed to recruit study participants. An interviewer-administered, close-ended, structured questionnaire was used to collect data. Binary and multivariable logistic regressions were used to identify independent predictors of the outcome variable.

RESULTS

The overall adherence to all recommended preventive behaviours of COVID-19 was 17.7%. The majority of respondents (73.1%) practice at least one of the recommended preventive behaviours for COVID-19. Among adults' COVID-19 preventive behaviours score, wearing a face mask was the highest (82.3%) and social distancing was the lowest (35.4%). Residence adjusted OR (AOR)) 3.42 (95% CI 1.6 to 7.31), marital status AOR 0.33 (95% CI (0.15 to 0.71)), knowledge of the absence/presence of the COVID-19 vaccine AOR 0.45 (95% CI (0.21 to 0.95)) and self-rated level of knowledge as poor AOR 0.052 (95% CI 0.036 to 0.18) and self-rated level of knowledge as not bad AOR 0.14 (95% CI 0.09 to 0.82) were significantly associated with social distancing practice. Factors affecting other COVID-19 preventive behaviours are described in the 'Results' section.

CONCLUSION

Prevalence of good adherence to recommended preventive behaviours for COVID-19 was very low. Residence, marital status, knowledge of vaccine presence, knowledge of curative drug presence, knowledge of the incubation period, the self-rated level of knowledge and perceived risk to be infected with COVID-19 are significantly associated factors with adherence to preventive behaviours.

Covering the Distance: A Study of Parent and Teen Attitudes on COVID-19 Mitigation Measures During the COVID-19 Pandemic

Background The Unity® Consortium surveyed teens and parents and guardians of teens across the country at three distinct time points or waves during the COVID-19 pandemic to assess participant attitudes and beliefs regarding COVID-19 mitigation guidelines, such as mask-wearing and physical distancing. Methodology A third-party market research company conducted 15-minute, online surveys from nationally representative panels. Surveys were conducted at three distinct time points or waves (August 2020, February 2021, and June 2021) with 300 teens aged 13-18 years in each wave and 593/531/500 parents and guardians of teens aged 13-18 years in each wave, respectively. Participants responded using a five-point Likert scale (strongly agree to strongly disagree) on their COVID-19 experiences, including the perceived importance of strictly following mask-wearing and/or social distancing guidelines and the perceived effectiveness of mask-wearing and social distancing in preventing the spread of COVID-19. Data were analyzed for differences across waves and demographic variables. Statistical analyses included frequencies, analysis of variance (ANOVA), and t-tests/z-tests. Results While significantly more parents and teens in Waves 2 and 3 knew someone who was hospitalized or died due to COVID-19 compared to Wave 1, significantly fewer in Wave 3 reported experiencing a lot or some stress and worry regarding the pandemic. By Wave 3, 58% of teens and 56% of parents had received at least one dose of a COVID-19 vaccine. Despite changes in experiences over time, a significant majority of parents and teens consistently agreed on the importance and effectiveness of social distancing and masking guidelines against the spread of COVID-19. In Wave 3, the demographic variables significantly associated with agreement on importance included race (Black (92%) > White (80%)), community type (urban (91%) > suburban (79%) and rural (73%)), and positive vaccination status of parents and teens (92%/89%) > not vaccinated (73%/73%), respectively). The demographic variables significantly associated with agreement on effectiveness included race (Black (91%) > White (81%)), community type (urban (89%) > suburban (83%) and rural (71%)), and positive vaccination status of parents and teens (94%/90% > not vaccinated (72%/70%), respectively). Conclusions This study into the perceived importance and perceived effectiveness of mitigation strategies during the COVID-19 pandemic revealed differences in attitudes among sociodemographic groups. Understanding these differences can help shape how adherence to public health guidelines in a pandemic is promoted.

University students' living conditions during the COVID-19 pandemic and predictors of their subjective health views: A cross-sectional survey

This study aimed to explore the factors influencing subjective health views based on the living conditions and concerns of university students during the coronavirus infection 2019 (COVID-19) pandemic. From March to April 2021, a questionnaire survey was administered to 8,547 Japanese university students, and logistic regression analysis was used to explore factors related to subjective health views. The results showed that satisfaction with quality of sleep (OR = 2.651, 95% Cl 2.370-2.966,p < 0.001), satisfaction with university life (OR = 2.486, 95%Cl 2.215-2.789, p < 0.001), satisfaction with diet (OR = 1.849, 95% CI: 1.496-2.285, p < 0.001), regular exercise (OR = 1.759, 95% CI: 1.594-1.941, p < 0.001), consciousness of nutritional balance (OR = 1.276, 95% CI: 1.147-1.420,p < 0.001), eating breakfast every day (OR = 1.247, 95% CI: 1.121-1.387, p < 0.001), and consuming soft drinks at least once a week (OR = 0.865, 95% CI: 0.755-0.966, p = 0.010) were positive factors for subjective views of health. On the other hand, anxiety about whether the necessary credits can be obtained (OR = 0.885, 95% CI: 0.799-0.980, p = 0.019), infection from minimal outings (OR = 0.881, 95% CI: 0.794-0.976, p = 0.016) building and maintaining friendships on campus (OR = 0.867, 95% CI: 0.767-0.980, p = 0.023), and being able to continue working (OR = 0.713, 95% CI: 0.640-0.795, p < 0.001) were identified as negative factors. To ensure a healthy university life during the COVID-19 pandemic or future pandemic, supports tailored to students' living conditions and measures to address their anxieties are required.

The relationships of perceived susceptibility, perceived severity, and subjective norms with COVID-19 preventive behaviors: a secondary data analysis comparing adolescents and emerging adults in South Korea

PURPOSE

Based on the health belief model and theory of planned behavior, this study investigated how age group (adolescence and emerging adulthood) moderated the relative effects of perceived susceptibility, perceived severity, and subjective norms on preventive behavior against coronavirus disease 2019 (COVID-19).

METHODS

This secondary data analysis utilized data from adolescents (n=272) and emerging adults (n=239). Hierarchical multiple regression analysis was performed to test the moderating effect of age group on the relationships among variables.

RESULTS

Higher perceived susceptibility (β=.21, p<.001), perceived severity (β=.14, p=.002), subjective norms (friends) (β=.26, p<.001), subjective norms (parents) (β=.44, p<.001), and subjective norms (schools) (β=.28, p<.001) enhanced COVID-19 preventive behaviors. Moderated regression analysis showed that subjective norms (friends and school) impacted preventive behavior in adolescents more than in emerging adults.

CONCLUSION

Given the need to increase perceived susceptibility and severity among adolescents and emerging adults, these findings provide baseline data for designing effective COVID-19 prevention interventions that consider the developmental characteristics of different age groups. Interventions by health centers at universities can strengthen COVID-19 preventive behavior among emerging adults. As adolescents are influenced by friends, their peer roles must be strengthened to enhance adherence to COVID-19 preventive guidelines.

Understanding COVID: Collaborative Government Campaign for Citizen Digital Health Literacy in the COVID-19 Pandemic

The strategy "Understanding COVID" was a Public Health campaign designed in 2020 and launched in 2021 in Asturias-Spain to provide reliable and comprehensive information oriented to vulnerable populations. The campaign involved groups considered socially vulnerable and/or highly exposed to COVID-19 infection: shopkeepers and hoteliers, worship and religious event participants, school children and their families, and scattered rural populations exposed to the digital divide. The purpose of this article was to describe the design of the "Understanding COVID" strategy and the evaluation of the implementation process. The strategy included the design and use of several educational resources and communication strategies, including some hundred online training sessions based on the published studies and adapted to the language and dissemination approaches, that reached 1056 people of different ages and target groups, an accessible website, an informative video channel, posters and other pedagogical actions in education centers. It required a great coordination effort involving different public and third-sector entities to provide the intended pandemic protection and prevention information at that difficult time. A communication strategy was implemented to achieve different goals: reaching a diverse population and adapting the published studies to different ages and groups, focusing on making it comprehensible and accessible for them. In conclusion, given there is a common and sufficiently important goal, it is possible to achieve effective collaboration between different governmental bodies to develop a coordinated strategy to reach the most vulnerable populations while taking into consideration their different interests and needs.

Factors Affecting Preventive Behaviors for Safety and Health at Work during the COVID-19 Pandemic among Thai Construction Workers

Occupational health and safety risks are of major concerns in construction industry. The COVID-19 outbreak provides an additional risk that could drastically affect the safety risks and health of construction workers. Understanding the factors that affect the health and safety of construction workers is significant in reducing risky behaviors and enhancing worker preventive behaviors. Via integrating the Protection Motivation Theory (PMT) and the extended Theory of Planned Behavior (TPB), this study investigates the factors that affect preventive behaviors among construction workers during the COVID-19 pandemic in Bangkok, Thailand. A total of 610 Thai construction workers participated in an online questionnaire survey, which consisted of nine factors with 43 questions. Structure equation modeling (SEM) was adopted to analyze the causal relationships among the latent variable. The SEM results indicated that organizational support and knowledge about COVID-19 had significant (p < 0.0001) direct influences on perceived vulnerability and perceived severity. In addition, perceived vulnerability and perceived severity had significant direct influences on perceived behavioral control. Perceived severity had significant (p < 0.0001) direct influence on attitude towards behavior. Moreover, perceived behavioral control and attitude towards behavior had significant (p < 0.0001) direct influence on intention to follow the preventive measure. Furthermore, the intention to follow the preventive measure had significant (p < 0.0001) direct influences on the COVID-19 preventive behavior. Of note, organizational support and knowledge about COVID-19 had significant (p < 0.0001) indirect influence on COVID-19 preventive behavior. The findings of this study may assist project managers/supervisors and authorities in the construction industry in understanding the challenge during COVID-19 and possible similar epidemics in the future. In addition, conducting effective strategies would improve construction industry safety and promote preventive behaviors among construction workers.

Preventive Behaviors and Influencing Factors among Thai Residents in Endemic Areas during the Highest Epidemic Peak of the COVID-19 Outbreak

This research aims to investigate COVID-19 preventive behavior and influencing factors among Thai residents during the highest epidemic peak of COVID-19. Nine hundred and forty-six residents in five districts with high COVID-19 infection cases in Thailand were systematically included in this cross-sectional survey. The results showed that 87.2% and 65.2% of the residents had a high level of general knowledge and preventive measures, respectively. As to COVID-19 attitudes, poor levels of attitude among Thai residents were found in risk perception (53.6%) and mistrust issues (70.4%). Moreover, this study presents good preventive behavior (77.0%) among Thai residents. Multiple logistic regression showed that the influence factors of COVID-19 preventive behavior were the young age group (AOR 2.97, 95% CI 1.68-5.25), high income (AOR 1.38, 95% CI 1.03-1.86), and high level of general COVID-19 knowledge (AOR 2.21, 95% CI 1.64-2.96). The conclusion was that providing information on COVID-19 via social media was the key mechanism of policy action for increasing the level of COVID-19 preventive behavior during the highest epidemic peak in Thailand. In addition, the pandemic preparedness and response policy, with resident participation and involvement, could be recommended for the resilience of pandemic preparedness.

Combined Impact of Omicron Vaccination and Environmental Risk Exposure: A Thailand Case Study

This research aimed to determine the levels of COVID-19 booster dose vaccinations in Thai populations in areas with environmental risk exposure during the Omicron outbreak. Five of twenty provinces in Thailand were selected by assessing environmental risk exposure for study settings. A total of 1038 people were interviewed by a structured questionnaire. The predicting factors of COVID-19 booster dose vaccinations were analyzed by univariate and multivariate analysis. The results showed that 69.4% (95% CI 66.5-72.1) of the population was vaccinated with COVID-19 booster doses. Multiple logistics regression revealed that the female gender (AOR 1.49, 95% CI 1.11-2.00), all age groups from 38 to 60 years old, all education levels of at least secondary school, high income (AOR 1.16, 95% CI 1.15-2.24), populations having experience with COVID-19 infection (AOR 2.27, 95% CI 2.05-3.76), knowledge of vaccine (AOR 1.78, 95% CI 1.11-2.83), and trusting attitude (AOR 1.76, 95% CI 1.32-2.36) were factors among those more likely to take COVID-19 booster dose vaccinations in high-environmental-risk-exposure areas. Therefore, an effective booster dose campaign with education programs to increase attitudes toward booster vaccinations should be implemented for the resilience of COVID-19 prevention and control.

Exploration of COVID-19 Pandemic Prevention Behaviors among Healthcare Workers

Since the outbreak of COVID-19, the pandemic has become an important topic of global public health. To reduce the rapid spread of the pandemic, compliance with preventive behaviors has become one of the important guidelines from the World Health Organization (WHO). Healthcare workers stand on the frontline for pandemic prevention, and preventive behaviors are essential measures to protect their health and safety. The purpose of this study was to propose an integrative model that explained and predicted COVID-19 preventive behaviors among healthcare workers. The study integrated workplace safety climate and the health belief model (HBM) to verify the impact of workplace safety climate and health belief factors on the safety attitude, safety compliance, and safety satisfaction of healthcare workers performing COVID-19 pandemic prevention behaviors. A cross-sectional study was conducted from March to August 2021 with a self-administered online questionnaire. The sample of the study was drawn from healthcare workers of a famous medical institution in Taipei City as research subjects. After collecting 273 valid questionnaires and verifying them through the analysis of structural equation modeling (SEM), the findings revealed that workplace safety climate had an impact on health belief factors, and then health belief factors had impacts on safety attitudes. In addition, safety attitude affected safety compliance, while safety compliance further affected safety satisfaction. The study showed that workplace safety climate can strengthen healthcare workers' health beliefs and further affect their safety attitudes, safety compliance, and safety satisfaction. The study attempted to propose a model of healthcare workers' pandemic prevention behaviors as a reference for medical facility administrators in real practice.

Trends in health behaviors and mental health among Korean adolescents in Korea over 5 years, 2017-2021: focusing on the comparisons before and during the COVID-19 pandemic

Objectives

We investigated recent trends in health behaviors and mental health conditions among Korean adolescents from 2017 to 2021 and compared the changes before and during the coronavirus disease 2019 (COVID-19) pandemic.

Methods

Data analysis was conducted on 289,415 adolescents participating in the Korea Youth Risk Behavior Web-Based Survey, an annual cross-sectional study from 2017 to 2021. All analysis was conducted using sex stratification, and the annual percentage change (APC) was calculated.

Results

Alcohol consumption and smoking decreased in the first year of the COVID-19 pandemic compared with before, except for girls from the low-income level. The prevalence of inadequate physical activity for both boys and girls increased in 2020 compared with the pre-COVID-19 period and decreased again by 2021. The prevalence of obesity in both sexes increased regardless of the period (boys, APC = 8.2%, 95% confidence intervals (CI), 6.4-10.1; girls, APC = 3.3%, 95% CI, 1.8-4.8). The prevalence of stress, depression, and suicidal ideation, plans, and attempts for both sexes decreased in 2020 compared to the pre-COVID-19 period. By 2021, this prevalence had returned to a level similar to before the pandemic. No significant APC changes were observed in the prevalence of mental health.

Conclusions

These findings demonstrate the trends and APCs in health behaviors and mental health conditions among Korean adolescents over the last 5 years. We must pay attention to the heterogeneous and multifaceted features of the COVID-19 pandemic.

Application of behavioral change theory and models on COVID-19 preventive behaviors, worldwide: A systematic review

Objective:

This systematic review aimed to assess the global application of behavioral change theory and models on COVID-19 preventive behaviors.

Methods:

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedure. Databases such as PubMed/MIDLINE, Web of Science, Scopus, EMB ASE, World Health Organization libraries, and Google Scholar were used to search all published articles in the area of application of behavioral change theory and model on COVID-19 preventive behavior until October 1, 2022. Studies published in another language other than English were excluded. Two independent reviewers did the article selection and quality check. A third reviewer asked if any disagreement were found.

Result:

Seventeen thousand four hundred thirty-six total articles were retrieved from all sources after the removal of duplicated articles and those not evaluating the outcome of interest were excluded. Finally, 82 articles done using behavioral change theory and model on COVID-19 preventive behaviors were included. The health belief model (HBM) and theory of planned behavior (TPB) were most commonly used in COVID-19 preventive behaviors. The constructs of most behavioral theories and models were significantly associated with COVID-19 preventive behaviors such as hand washing, face mask use, vaccine uptake, social isolation, self-quarantine, social distance, and use of sanitizers.

Conclusion:

This systematic review summarizes comprehensive evidence on the application of behavioral change theory and model on COVID-19 preventive behaviors globally. A total of seven behavioral change theories and models were included. The HBM and TPBs were most commonly used for COVID-19 preventive behaviors. Therefore, the application of behavioral change theory and models is recommended for developing behavioral change interventional strategies.

Factors Associated with Handwashing Behaviors During the COVID-19 Pandemic: An Analysis of the Community Health Survey in Korea

Introduction

Handwashing is the most effective preventive behavior for coronavirus disease-19 (COVID-19) infection. However, research has shown the lower handwashing behaviors among Korean adults.

Objectives

This study aims to analyze factors associated with handwashing as a preventive behavior for COVID-19 infection based on the health belief model (HBM) and the theory of planned behavior (TPB) behavioral theories.

Methods

This secondary data analysis utilized the Community Health Survey developed by Disease Control and Prevention Agency conducted in 2020. Sampling method was stratified and targeted 900 people living in the territory of each community public health center. In total, 228,344 cases were used in the analysis. Handwashing behavior, perceived susceptibility, perceived severity, subjective norm, and influenza vaccine uptake were used in the analysis. Regression analysis using weighing strategy by stratification and domain analysis was used.

Results

Less washing hand was associated with older age (B = 0.01, p < .001), males (B = 0.42, p < .001), not receiving an influenza vaccine (B = 0.09, p < .001), perceived susceptibility (B = 0.12, p < .001), subjective norm (B = 0.05, p < .001), and perceived severity (B = -0.04, p < .001).

Conclusion

While perceived susceptibility and social norm had positive association, perceived severity had a negative association with handwashing. Considering the Korean culture, creating a shared norm for frequent handwashing could be beneficial to promote handwashing rather than emphasizing the disease and its consequences.

The predictors of COVID-19 preventive health behaviors among adolescents: the role of health belief model and health literacy

Aim

The present study aimed to evaluate the predictive role of the Health Belief Model (HBM) constructs and health literacy (HL) in shaping the coronavirus disease 2019 (COVID-19) preventive health behaviors (PHBs) among adolescents.

Methods

This cross-sectional study was conducted with 503 adolescent girls and boys, randomly selected via cluster sampling. For this purpose, the data were collected online through four research tools, including the demographic-clinical characteristics information questionnaire, the COVID-19 PHB Scale based on HBM, and the Health Literacy Scale for COVID-19. The data analysis was then performed by regression analysis along with the structural equation modeling (SEM), considering the significance level of 0.05.

Results

The regression analysis results demonstrated that following the one-unit increase in the values of self-efficacy and cues to action, the COVID-19 PHBs elevated by 0.063 and 0.078 units, respectively. In addition, the COVID-19 PHBs subsided by 0.018 with the rise in the value of perceived barriers (P < 0.001). According to the path analysis, the direct path from the COVID-19-related HL to the COVID-19 PHBs (B = 0.097, β = 0.087, 95% confidence interval [CI] = 0.005 to 0.189) was significant. Furthermore, the indirect path from the COVID-19-related HL to the COVID-19 PHBs through perceived susceptibility (B = 0.017, β = 0.015, 95% CI = 0.001 to 0.032), perceived barriers (B = 0.029, β = 0.026, 95% CI = 0.004 to 0.055), self-efficacy (B = 0.094, β = 0.084, 95% CI = 0.031 to 0.156), and cues to action (B = 0.153, β = 0.137, 95% CI = 0.092 to 0.215) was significant.

Conclusion

In keeping with the study results, it is essential to take some effective measures to boost the HBM constructs and HL among adolescents to improve their PHBs during pandemics such as COVID-19.

Adherence to COVID-19 preventive measures and associated factors in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Reluctance to the COVID-19 preventive measures have been repeatedly reported in Ethiopia although compliance with these actions is the key step to minimize the pandemic's burden. Hence, this systematic review and meta-analysis aims to address the gap in the literature by determining the pooled magnitude of adherence to COVID-19 preventive measures and identifying its associated factors in Ethiopia.

MATERIALS AND METHODS

The electronic databases used to search articles were PubMed/MEDLINE, CINAHL, Web of Science, ScienceDirect, Research4Life and other sources of grey literature including Google Scholar and World Health Organization (WHO) database portals for low- and middle-income countries. Full English-language articles published between 2019 and 2022 were eligible for the review and meta-analysis. Relevant data extracted and descriptive summaries of the studies presented in tabular form. The methodological quality of articles assessed using the Joanna Briggs Institute (JBI) quality assessment tool. The pooled magnitude of adherence determined by applying a random-effects model at a 95% CI.

RESULTS

Of 1029 records identified, 15 articles were included in the systematic review and 11 were selected for meta-analysis. The pooled estimate of adherence to COVID-19 preventive measures in Ethiopia was 41.15% (95% CI:32.16-50.14%). Furthermore, perceived COVID-19 disease severity (AOR:1.77, 95% CI: (1.40-2.25)), attitude (AOR:1.85, 95% CI: (1.36-2.53)) and knowledge (AOR:2.51, 95% CI: (1.67-3.78)) to COVID-19 preventive measures showed significant association with adherence to COVID-19 preventive measures.

CONCLUSION

The magnitude of adherence to COVID-19 preventive measures in Ethiopia appeared to be low. Therefore, the government of Ethiopia and other stakeholders should mobilize resources to improve the adherence level of the community to the COVID-19 preventive measures and decrease public fatigue.

Factors associated with intention to take COVID-19 vaccine among the university students in Bangladesh

Purpose

This study examined the Bangladeshi university students' intention to take coronavirus disease 2019 (COVID-19) vaccines by assessing the Health Belief Model and Theory of Planned Behavior.

Materials and Methods

University students were queried on their intention to take COVID-19 vaccines. The sample used in this study (n=310) was obtained through an online survey among university students (age, 18-25 years old) from August 7 to September 18, 2021.

Results

Although over 90% of respondents showed their willingness to take the COVID-19 vaccine, around 37.3% of respondents still desired to wait and see to take the vaccine. The most frequently cited reasons for vaccines hesitancy were concerns over side effects (62.4%). There is still an unmet need for adequate information on COVID-19 vaccines (81.4%). Results of the binary logistic regression model showed that students from private universities (odds ratio [OR], 0.19; 95% confidence interval [CI], 0.04-0.97), respondents who concerned about the vaccine safety (OR, 0.07; 95% CI, 0.01-0.44) and side effects of vaccine (OR, 0.21; 95% CI, 0.05-0.89) were less willing to take COVID-19 vaccine. On the other hand, desire to wait to take COVID-19 vaccines was associated with marital status (OR, 7.76; 95% CI, 1.50-40.27); COVID-19 preventive behavior, including use of facemask (OR, 0.25; 95% CI, 0.09-0.70) and maintain social distance (OR,1.75; 95% CI, 1.00-3.07); COVID-19 infection (OR, 0.50; 95% CI, 0.26-0.99); provide more information on vaccines (OR, 2.32; 95% CI, 1.06-5.09); the perceived side effects (OR, 2.82; 95% CI, 1.54-5.17); and effectiveness of COVID-19 vaccines (OR, 2.41; 95% CI, 1.16-5.01).

Conclusion

Public health managers should provide adequate information on COVID-19 vaccines to address the concerns about the safety and side effects of the vaccines.

Adherence to Coronavirus Disease 2019 Preventive Measures in a Representative Sample of the Population of the Canton of Vaud, Switzerland

Objectives: We quantified adherence to COVID-19 preventive measures and explored associated factors, after the first and during the second Swiss epidemic waves.

Methods: With an observational cohort study in a representative sample of individuals aged 15 years and more, we analysed the association between self-reported adherence to COVID-19 preventive measures (respect of simple hygiene rules; respect of social distancing rules; wearing a mask) and socio-demographic factors, the existence of a chronic disease, and the existence of a previous confirmed COVID-19 episode.

Results: Highest adherence was to simple hygiene rules, followed by social distancing rules and mask wearing, with a slight decrease for simple hygiene rules and a strong increase for mask wearing between visits. Men were significantly less likely to respect simple hygiene rules and wear a mask in public. Participants aged 65 years and more (versus 25–64 years) and those with at least one chronic disease (versus none) were two times more likely to respect social distancing rules and wear a mask.

Conclusion: Adherence to social distancing rules and mask wearing was rather poor, especially compared to other countries.

Components Affecting the Promotion of COVID-19 Disease Prevention Behaviors among Iranian Students: A Qualitative Study by Using the PRECEDE Model

Background

COVID-19 is a social health problem. Several risk factors threaten students, and schools can provide a suitable environment for managing and performing health promotion programs. Given the extensive spread of the disease and the existence of multilevel components affecting the adoption of preventive behaviors, understanding the views and opinions of the audience about the barriers and facilitators affecting the behavior using qualitative studies can be one of the ways to have a successful intervention.

Materials and Methods

This was a qualitative study performed by a directed content analysis method while using the PRECEDE model (predisposing, reinforcing, enabling constructs in educational diagnosis and evaluation). In total, 38 individuals (teachers, parents, and students) were entered into the study using the purposive sampling method. Data were collected by semistructured interviews, and the implemented data were systematically classified into five stages (condensed meaning units, code, subcategory, category, and theme) and were arranged and analyzed.

Results

The findings are classified into three themes of predisposing, enabling, and reinforcing factors. In addition, perceived sensitivity, perceived intensity, mental beliefs, behavior outcome evaluation, and perceived power were considered as subcategories of predisposing factors, whereas normative beliefs and motivation for adherence to protocols were subcategories of reinforcing factors, and control beliefs were subcategories of enabling factors.

Conclusion

Our findings could be used as a guide to design educational interventions aiming at promoting COVID-19 prevention behaviors in schools.

Infection preventive behaviors and its association with perceived threat and perceived social factors during the COVID-19 pandemic in South Korea: 2020 community health survey

BACKGROUND

This study examined why some individuals have not properly performed health prevention behavior during the coronavirus disease 2019 (COVID-19) pandemic. We used data from a community health survey conducted by public health centers in South Korea to identify factors affecting COVID-19 prevention behavior in urban and rural areas. Also, we examined whether individual-level demographic, socio-psychological, and structural variables affected COVID-19 prevention behavior by referring to a model explaining individuals' health prevention behavior. In particular, the study is significant as not many other measures were suggested besides compliance with personal quarantine rules during the early phase of the pandemic in 2020. We hope that the results of this study will be considered in further analysis of infection preventive behavior and in future health crises.

METHODS

Probability proportional and systematic sampling were used to collect data in 2020 from 229,269 individuals. After exclusion, the valid data from 141,902 adults (86,163 urban and 44,739 rural) were analyzed. We performed t-tests and analyses of variance to ascertain the differences in COVID-19 preventive behaviors according to demographic characteristics, and a post-hoc analysis was conducted using Scheffé's test. Factors that affected participants' COVID-19 preventive behaviors were analyzed using multiple regression analyses.

RESULTS

The variables significantly influencing COVID-19 preventive behaviors in urban areas were age, gender, living with two or more people, educational level, monthly household income, working status, influenza vaccination, daily life stress, and perceived threat. In rural areas, age, gender, living with two or more people, education level, influenza vaccination, daily life stress, perceived threat, and perceived social factors were significantly associated with increased COVID-19 preventive behaviors.

CONCLUSIONS

Several demographic characteristics were associated with urban and rural residents' COVID-19-related preventive behaviors. A different approach is needed for the two regions in future policy. Future studies should aim to improve the power of the model and include other factors that may be related to COVID-19 preventive behavior.

Does Temporal Stability Moderate Reasoned Action Approach Relations With Covid-19 Preventive Behaviors?

Background

Preventive behaviors continue to play an important role in reducing the spread of the SARS-CoV-2 virus.

Purpose

This study aimed to apply the reasoned action approach (RAA) to predict Covid-19 preventive intentions and behavior and to test whether temporal stability moderates relations between RAA constructs and behavior.

Methods

A representative sample of UK adults (N = 603) completed measures of RAA variables (i.e., experiential attitudes, instrumental attitudes, injunctive norms, descriptive norms, capacity, autonomy and intention) in relation to six Covid-19 preventive behaviors (i.e., wearing face coverings, social distancing, hand sanitizing, avoiding the three Cs [closed spaces, crowded places, and close contacts], cleaning surfaces, and coughing/sneezing etiquette) at baseline (December 2020) and after 1 month. Self-reported behavior was assessed at baseline and after 1 and 2 months.

Results

The RAA was predictive of Covid-19 preventive intentions at time 1 and time 2; instrumental attitudes, descriptive norms, and capability were the strongest predictors at each time point. The RAA also predicted subsequent behavior across time points with intention, descriptive norms, and capability the strongest/most consistent predictors. Temporal stability moderated a number of RAA–behavior relationships including those for intention, descriptive norms, and capability. In each case, the relationships became stronger as temporal stability increased.

Conclusions

Health cognitions as outlined in the RAA provide appropriate targets for interventions to promote Covid-19 preventive intentions and behavior. Moreover, given that continued performance of Covid-19 preventive behaviors is crucial for reducing transmission of the SARS-CoV-2 virus, the results highlight the need for consistent messaging from governments and public health organizations to promote positive intentions and maintain preventive behavior.

Research on the Intervention and Prevention of College Students' Mental Health Crisis From the Perspective of Ideological and Physical Education

Present study has aimed to understand the intervention and prevention of the mental health crisis of college students. For this purpose, this study has checked the effect of trust in wellbeing information on preventive behavior and mental wellbeing. The target population taken for this study is the students of colleges situated in Mainland in China. The data was collected from the 458 students of the college. Smart PLS has been employed on the data to get the results using partial least square structural equation modeling. For this purpose, the data were analyzed in two stages, i.e., measurement model stage and the structural model stage. Results of this study have revealed that trust in wellbeing information plays a significant and positive role in setting preventive behavior and the mental wellbeing of students. Further, it has also been revealed that preventive behavior also plays a significant and positive role in mental wellbeing. Additionally, preventive behavior has been found as an important mediating variable among the relationship of trust in wellbeing information and mental wellbeing. Moreover, family support is crucial by positively moderating the relationship between preventive behavior and mental wellbeing. Many practical implications have been found among which the foremost is that the education institutes must undertake those efforts that aim to ensure the fairness in the information spread regarding the mental wellbeing during seminars, workshops and administration should play a positive role responsible for strengthening the mental health of students by managing ideas, improving student education management, innovating management techniques and methods.

Effective factors in people's preventive behaviors during covid-19 pandemic: a systematic review and meta-synthesis

Background

The overwhelming outbreak of covid-19 has forced governments all over the world to consider different measures to face this challenging situation. A vitally important element to the declining transmission of viruses is changing behaviors based on reliable information. This study was designed and implemented to identify factors affecting the preventive behaviors during the covid-19 pandemic.

Methods

This thematic synthesis was carried out in order to create a set of central themes that summarize all of the issues raised in the articles reviewed in this study. We used PRISMA 2020 guidelines to direct this systematic review and meta synthesis. The process of analyzing data includes three different stages: 1) creating codes; 2) production of descriptive themes; 3) and finally, the creation of analytical themes. The Standards for Reporting Qualitative Research checklist was used to evaluate the articles' quality.

Results

Five central themes emerged from 8 included articles, (1) Social factors (subthemes: environmental context, political leadership, multimedia), (2) Cultural factors (subthemes: national culture, religious culture, the family beliefs, work culture, foreign culture), (3) Economic factors (subthemes: economic situation of the individual, the government supports, infrastructures), (4) Personal factors (subthemes: people experiences, cognitive ability, physical factors, different motivational level, sense of responsibility, risk management, and self-management skills), and (5) Knowledge and Education factors (subthemes: access to information, skill training). Furthermore, SRQR items that were weakly reported were “researcher characteristics and reflexivity”, “Sampling strategy”, “Data collection methods”, “Data analysis”, and “techniques to enhance trustworthiness.

Conclusion

Health policymakers and other public health officials in various countries can use the factors listed to develop appropriate, evidence-based policies. They should investigate behavioral characteristics in their community based on their abilities, and then design and implement appropriate executive actions.

Internal and External Motivations and Risk Perception toward COVID-19 Vaccination in Adolescents in the U.S

The COVID-19 vaccine is widely available to adolescents in the U.S.; however, vaccine hesitancy poses a threat to full coverage. The literature shows that perceived risks and the presence or lack of motivators are determinants for vaccination decisions, yet research evidence from minors is scant. This study adopted the Protection Motivation framework to identify differences in these facilitators and compare the influence of internal and external motivators among American adolescents in COVID-19 vaccine uptake. A nationwide online survey analyzed 13−17-year-old teenagers’ COVID-19 beliefs as well as present or potential reasons for accepting the vaccine. Of the 439 participants, 21.18% were not and did not plan to get vaccinated. Another 52.39% had at least one dosage, of which over three-quarters were internally motivated (whereas those unvaccinated were more likely to be externally motivated, X2 = 4.117, p = 0.042). In unvaccinated individuals, older adolescents reported slightly more internal motivators than younger adolescents (t = −2.023, p = 0.046). Internal motivation was associated with higher risk perception (r2 = 0.06651, p = 0.001), but risk perception had a stronger relationship with vaccination status (r2 = 0.1816, p < 0.001), with vaccinated individuals showing higher risk perception than those unvaccinated (mean difference = 0.42 on a scale of 1−4; t = −3.603, p < 0.001); the risk perception difference was even greater between hesitant and non-hesitant participants (mean difference = 0.63; t = −0.892, p < 0.001). The relationship was moderated by perceived knowledge, where the difference in risk perception between vaccination status was only significant for those with low perceived knowledge (f = 10.59, p = 0.001). Increasing awareness of disease risks and stressing internal motivators may be key to improving uptake in young people. Future research could delve deeper into risk perception formation of adolescents and why and how it differs across populations.

How Do Collective Efficiency and Norms Influence the Social Resilience of Iranian Villagers Against the COVID-19? The Mediating Role of Social Leadership

The main purpose of the present research was to investigate the effects of collective efficacy and norms on the social resilience against the COVID-19 with the mediating role of social leadership. To this end, a cross-sectional survey was carried out in the Kerman and Fars provinces of Iran. Finally, 206 villagers were selected as the sample for collecting the required information. The research tool was a close-ended questionnaire whose validity and reliability was evaluated and confirmed. The results of testing direct hypotheses using structural equation modeling revealed that collective efficacy, social leadership, and norms had significant positive effects on social resilience against the COVID-19 pandemic. Comparison of the standardized effects demonstrated that collective efficacy is the most powerful predictor of the social resilience of villagers. Furthermore, testing indirect (mediation) hypotheses revealed that social leadership can successfully mediate the effect of collective efficacy on social resilience against the COVID-19. Investigating the moderated indirect hypotheses showed that governmental supports moderated the effect of collective efficacy on social resilience. Taken together, the independent variables could account for 62% of social resilience variance change. In the end, the practitioners, decision-makers, and interveners of the COVID-19 management programs in rural communities were provided with some applicable recommendations to be able to foster social resilience against the COVID-19.

Knowledge, Attitude, and Practice (KAP) toward COVID-19 Pandemic among the Public in Taiwan: A Cross-Sectional Study

Purpose: Knowledge, attitude, and practice (KAP) models are often used by researchers in the field of public health to explore people’s healthy behaviors. Therefore, this study mainly explored the relationships among participants’ sociodemographic status, COVID-19 knowledge, affective attitudes, and preventive behaviors. Method: This study adopted an online survey, involving a total of 136 males and 204 females, and used a cross-sectional study to investigate the relationships between variables including gender, age, COVID-19 knowledge, positive affective attitudes (emotional wellbeing, psychological wellbeing, and social wellbeing), negative affective attitudes (negative self-perception and negative perceptions of life), and preventive behaviors (hygiene habits, reducing public activities, and helping others to prevent the epidemic). Results: The majority of participants in the study were knowledgeable about COVID-19. The mean COVID-19 knowledge score was 12.86 (SD = 1.34, range: 7−15 with a full score of 15), indicating a high level of knowledge. However, the key to decide whether participants adopt COVID-19 preventive behaviors was mainly their affective attitudes, especially positive affective attitudes (β = 0.18−0.25, p< 0.01), rather than COVID-19 disease knowledge (β = −0.01−0.08, p > 0.05). In addition, the sociodemographic status of the participants revealed obvious differences in the preventive behaviors; females had better preventive behaviors than males such as cooperating with the epidemic prevention hygiene habits (t = −5.08, p< 0.01), reducing public activities (t = −3.00, p< 0.01), and helping others to prevent the epidemic (t = −1.97, p< 0.05), while the older participants were more inclined to adopt preventive behaviors including epidemic prevention hygiene habits (β = 0.18, p = 0.001, R2 = 0.03), reducing public activities (β = 0.35, p< 0.001, R2 = 0.13), and helping others to prevent the epidemic (β = 0.27, p< 0.001, R2 = 0.07). Conclusions: Having adequate COVID-19 knowledge was not linked to higher involvement in precautionary behaviors. Attitudes toward COVID-19 may play a more critical function in prompting individuals to undertake preventive behaviors, and different positive affective attitudes had different predictive relationships with preventive behaviors.

The role of risk perception and affective response in the COVID-19 preventive behaviours of young adults: a mixed methods study of university students in the Netherlands

OBJECTIVES

Due to an increased infection rate among young adults, they need to adhere to the preventive guidelines to stop the spread of COVID-19 and protect vulnerable others. The purpose of this mixed methods study was to explore the role of risk perception and affective response in the preventive behaviours of young adults during the COVID-19 outbreak.

SETTING

This study followed a convergent mixed methods design, in which a quantitative online survey (n=1081) and 10 qualitative in-depth semistructured video interviews were conducted separately in the Netherlands during April-August 2020.

PARTICIPANTS

1081 participants filled in the online survey, and 10 participants participated in the interviews. Eligibility criteria included being a university student.

PRIMARY AND SECONDARY OUTCOME MEASURES

Data on risk perception, affective response, that is, worry, and adherence to preventive guidelines were combined and analysed during this study. There were no secondary outcome measures.

RESULTS

The results showed that young adults perceived their risk as low. Their affective response for their own well-being was also low; however, their affective response was high with regards to vulnerable others in their surroundings. Due to their high impersonal risk perception (ie, perceived risk to others) and high affective response, young adults adhered to most preventive guidelines relatively frequently. However, young adults sometimes neglected social distancing due to the negative effects on mental health and the uncertainty of the duration of the situation.

CONCLUSIONS

In conclusion, high impersonal risk perception and high affective response regarding others are key motivators in young adults' preventive behaviour. To maximise adherence to the preventive guidelines, risk communication should put emphasis on the benefits to vulnerable others' health when young adults adhere to the preventive guidelines.

Adolescence Amid a Pandemic: Short- and Long-Term Implications

Members of the Society for Research on Adolescents COVID-19 Response Team offer this commentary to accompany this special issue of the Journal of Research on Adolescence regarding the impact of the pandemic on adolescents' social, emotional, and academic functioning. In addition to outlining the critical need for scholarly collaboration to address the global impact of this crisis on adolescent development, we argue that a broad investigative lens is needed to guide research and recovery efforts targeting youth development. We then use this broad lens to consider dimensions of the pandemic impact relative to developmental implications within community and policy contexts, educational contexts, social contexts, and family contexts. Finally, we describe guideposts for setting a global, shared research agenda that can hasten research to recovery efforts surrounding the pandemic and youth development.