Predicting intention to receive a seasonal influenza vaccination using Protection Motivation Theory

Motivating Protective Behavior against COVID-19: Fear Versus Hope

OBJECTIVES

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

METHODS

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

RESULTS

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

DISCUSSION

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

Investigating COVID-19 Vaccine Uptake Intention Using an Integrated Model of Protection Motivation Theory and an Extended Version of the Theory of Planned Behavior

As global governments continue to inoculate populations in the aftermath of the SARS-CoV-19 epidemic, health protection and related problems such as vaccination reluctance have sparked conflicting emotions and discourses. Stakeholder concerns about vaccination promotion have arisen in this context. Consequently, this research investigates vaccination uptake behavior using an integrated framework that includes protective motivation theory and an extended version of the theory of planned behavior. Except for perceived severity, empirical study results based on the structural equation modeling technique demonstrated a positive relationship between PMT factors (i.e. perceived vulnerability, reaction efficacy, self-efficacy, and cost response) and intention to vaccinate. TPB factors (attitude, perceived behavior control, subjective norm, personal moral norm, and descriptive norm) were also found to have a positive connection with intention. The model's utility and suitability are indicated by the predictive and explanatory potency score (R2 = .415). Study implications for COVID-19 vaccine uptake promotion and ideas for future investigations are explored in light of our findings.

Using behavioral theory to understand partisan differences in COVID-19 vaccination and booster intentions

In 2020, the Food and Drug Administration granted emergency use authorization for two COVID-19 vaccines. Two years later, the Centers for Disease Control and Prevention estimated that more than 250 million individuals had received at least one dose of the vaccine. Despite the large numbers of individuals vaccinated against COVID-19, partisan differences surrounding the COVID-19 vaccine emerged, creating a potential challenge for health communications aimed at increasing vaccine uptake. A better understanding of partisan differences in attitudes and intentions towards vaccination may help guide public health strategies aimed at increasing vaccine uptake. To determine whether a commonly used theory of behavioral intentions used to craft public health messages explains partisan differences in intentions. Data were drawn from a national panel of US adults and collected between February 21, 2022, and March 3, 2022, using an online survey (n = 1845). Among respondents identifying as either Democrat or Republican (n = 1466), path analysis models were estimated to test whether partisan differences in vaccination or booster intentions were explained by the theoretical constructs of protection motivation theory (PMT). PMT accounted for approximately half of the covariate-adjusted mean difference in COVID-19 vaccination intentions between Democrats and Republicans, and nearly all the mean difference in booster intentions. Party affiliation indirectly affected intentions via its association with perceived susceptibility to COVID-19, vaccine/booster efficacy, and perceived costs of getting a COVID-19 vaccine or booster dose. Compared with Democrats, Republicans may be less likely to get vaccinated or receive a booster dose because of beliefs that they are less susceptible to COVID-19, that the vaccine is less effective, and that vaccination comes with disadvantages. Theories of behavioral intentions can help to identify the underlying theoretical determinants driving behavioral differences between political groups.

Preventive behaviors against COVID-19 among health care providers in Iran: A cross-sectional study

Background and Aim

During outbreaks of infectious diseases, if healthcare providers do not follow the principles of prevention, the risk of personal infection increases and they become a source of infection spread. This study aimed to determine the factors related to the preventive health behaviors of COVID-19 among Iranian healthcare providers based on protection motivation theory (PMT).

Methods

This analytical cross-sectional study included 346 healthcare providers. Data was collected by an online researcher-made questionnaire based on PMT. To analyze the data, independent T tests, analysis of variance (ANOVA), Spearman correlation coefficient, multiple linear regression, and SPSS 22 software were used. α was considered as 0.05.

Results

85.3% of the healthcare providers would always wear masks, 80.7% would always refuse to kiss and touch hands with others, and 34.7% sometimes would exercise at home. The preventive behaviors were significantly correlated with protection motivation (r = 0.84), self-efficacy (r = 0.51), response efficiency (r = 0.43), perceived severity (r = 0.41) Fear (r = 0.21), perceived susceptibility (r = 0.11), response cost (r = -0.14), and reward (r = -0.15). PMT constructs were able to predict 77% of the variance of the behaviors and the protection motivation construct was the strongest predictor (β = 0.806). Income above 300 Dolars per month was significantly related to the decrease in the mean score of preventive behaviors against COVID-19. The female sex and the individual or family history of infectious diseases were significantly related to increasing the mean score of COVID-19 preventive behaviors.

Conclusion

Based on the study results, it is suggested that some educational interventions be designed and implemented with a focus on this construct and the perceived severity construct and that more attention be given to the education of health care providers with high-income levels, male providers, and the individuals without a history of corona infection in themselves or their family members.

Vicarious experiences of long COVID: A protection motivation theory analysis for vaccination intentions

Context

Long COVID can appear as a severe late consequence (sequela) of a COVID-19 infection, leading to the inability to work or participate in social life for an unknown amount of time. To see friends or family struggling with long COVID might influence people's risk perceptions, vaccine efficacy expectations, and self-efficacy perceptions to prevent COVID-19 and its consequences.

Methods

In an online survey in August 2022, n = 989 German-speaking participants indicated whether they knew someone who suffered from long COVID illness. Four dimensions of protection motivation theory (PMT) were assessed afterwards, as well as vaccination intentions.

Results

Multiple mediation analysis with participants who knew vs. didn't know someone with long COVID (n = 767) showed that knowing someone with long COVID was associated with higher perceived affective and cognitive risk of long COVID-19 as well as higher perceived vaccine efficacy. Self-efficacy, i.e., the ease to protect oneself against long COVID, was lower in participants who knew long-COVID patients. Indirect positive effects for response efficacy and affective risk suggest that vicarious experience with long COVID is associated with increased intentions to get a COVID-19 vaccine.

Conclusion

The protection from long COVID through vaccination are relevant aspects for individual decisions and health communication.

Investigating the factors related to protective behaviors against COVID-19 in healthcare workers: Application of extended parallel process model

Background and Aims

Preventive behaviors against coronavirus disease 2019 (COVID-19) are important, and messages that create a sense of danger are necessary to create these behaviors. One of the widely used models for designing risk messages is the Extended Parallel Process Model (EPPM). The present study was conducted to investigate the factors related to protective behaviors against COVID-19 in the personnel of the health department based on EPPM.

Methods

In this cross-sectional study, 699 personnel of the deputy health department of Chaharmahal and Bakhtiari province were included in the study by census method. Data were collected online using valid questionnaires, including demographic questions and history of contracting COVID-19 and the questionnaire of EPPM constructs. Data were analyzed in SPSS24 software, using descriptive and analytical statistics.

Results

The results showed that there were positive correlations between the protective behaviors and the constructs of perceived severity (p < 0.001, r = 0.542), perceived susceptibility (p < 0.001, r = 0.260), self-efficacy (p < 0.001, r = 0.594), response efficiency (p > 0.001, r = 0.522), and risk control (p > 0.001, r = 0.501). There was a negative correlation between protective behaviors and fear control (p < 0.001, r = 0.329). The results of multiple linear regression showed that these six constructs explained 49.8% of protective behaviors against COVID-19, among which the role of the perceived severity construct was stronger than other constructs.

Conclusion

Regarding the results, it is suggested that the results of this research be used in the development of training programs to improve protective behaviors in high-traffic offices, and by focusing on fear and risk control.

Predicting the use of a COVID-19 contact tracing application: A study across two points of measurements

Contact tracing mobile applications (apps) were important in combating the COVID-19 pandemic. Most previous studies predicting contact tracing app use were cross-sectional and not theory-based. This study aimed at contributing to a better understanding of app use intentions and app use by applying an extended version of the protection motivation theory across two measurement points while accounting for the development of the pandemic. A total of N = 1525 participants from Switzerland (Mage = 53.70, SD = 18.73; 47% female; n = 270 completed both assessments) reported on risk perceptions, response efficacy, self-efficacy, social norms, trust in government, trust in the healthcare system, active search of COVID-19-related information, intentions for and actual (self-reported) app use. Analyses included country-specific incidences and death toll. Increases in response-efficacy, self-efficacy, trust in government, and the active search of COVID-19-related information predicted increased app-use intentions. Increases in self-efficacy, intentions, and the active search of COVID-19-related information predicted increased self-reported app use. Risk perceptions, incidence, and death toll were unrelated to both outcomes. Across an aggravation of the pandemic situation, intentions for and app use were primarily related to response-efficacy, self-efficacy, trust in government, and the active search of COVID-19-related information.

A Protection Motivation Theory-Based Empowerment Intervention for Promoting Health Behaviors in Women With Human Papillomavirus: An Experimental Study

ABSTRACT

This experimental study on 70 women with human papillomavirus, referred to the specialized obstetrics and gynecology clinics of public hospitals in Iran in 2021, revealed that implementing the protection motivation theory-based empowerment intervention could promote their health behaviors.

Smoking cessation policy and treatments derived from the protective motivation of smokers: a study on graphic health warning labels

Introduction

Smoking is a leading public health risk. Many countries are reducing the demand for tobacco through graphic health warning labels (GHWLs). This study aims to explore smokers' perceptions of GHWLs and analyze the effect of GHWLs on their behavioral intentions to quit smoking.

Methods

A theoretical model is designed by synthesizing protection motivation theory, an extension of the extended parallel process model, and the theory of planned behavior. We collected a cross-sectional sample of 547 anonymous smokers through a stratified random sampling strategy. GHWLs published in 2011 by the US Food and Drug Administration were used in the survey to assess smokers' responses to them, and then the hypotheses are validated through structural equation models.

Results

The results suggest that perceived severity, perceived vulnerability, response efficacy, and health anxiety have a significant impact on smokers' protection motivation. Furthermore, smokers' protection motivation directly impacts the behavioral intention to quit smoking and indirectly influences intention to quit through attitudes.

Discussion

These findings have practical implications for the implementation and improvement of GHWLs policies. Meanwhile, this study enriches the literature on public health protection measures (i.e., GHWLs) and smokers' behavioral intention to quit smoking.

Changes in Students' Perceptions Regarding Adolescent Vaccinations through a Before-After Study Conducted during the COVID-19 Pandemic: GIRASOLE Project Study

The COVID-19 pandemic caused a reduction in vaccination coverage for all age groups, especially in non-infant age. The main objective of the present study is to evaluate the effectiveness of an online intervention conducted among adolescents during the COVID-19 pandemic in increasing knowledge and positive attitudes toward vaccinations. The study, which took place online from March to May 2021, involved 267 students from six lower secondary schools in Palermo city (Italy); they filled out the questionnaire before and after the intervention. The questionnaire was based on the protection motivation theory (PMT), which estimates the improvement in vaccination-related knowledge and attitudes. The pre- and post-intervention comparison showed a significant increase in the perception of the disease severity: strongly agree pre-intervention n = 150 (58.6%) and post-intervention n = 173 (67.6%, p < 0.001), rated on a five-point Likert scale. In a multivariate analysis, the factor associated with the improvement in the score after the intervention was the school dropout index (low vs. very high dropout index OR 4.5; p < 0.03). The educational intervention was more effective in schools with lower early school leaving rates, an indirect index of socio-economic status. The topic of vaccination has caught the adolescents' attention, it is, therefore, important that interventions tackling teenagers are tailored to reduce their emotional tension about the perception of adverse effects and improve vaccination coverage.

Health and Environmental Protective Behavioral Intentions for Reducing Harm from Water Pollutants

Understanding what motivates people to adopt protective behaviors is important in developing effective risk messaging. Motivations may vary depending on the nature of the risk and whether it poses a personal or impersonal threat. Water pollution creates both personal (human health) and impersonal (environmental) threats, yet few studies have examined people's motivations to protect both personal health and environmental health. Protection motivation theory (PMT) uses four key variables to predict what motivates individuals to protect themselves in relation to a perceived threat. Using data from an online survey (n = 621), we investigated the relationships between PMT variables related to health and environmental protective behavioral intentions related to toxic water pollutants among residents in Oregon, Idaho, and Washington, USA. Among PMT variables, high self-efficacy (belief in one's own capacity to carry out certain behaviors) significantly predicted both health and environmental protective behavioral intentions for water pollutants, while perceived severity of the threat was only significant in the environmental behavioral intentions model. Perceived vulnerability and response efficacy (belief that a specific behavior will effectively mitigate the threat) were significant in both models. Education level, political affiliation, and subjective knowledge of pollutants were significant predictors of environmental protective behavioral intentions, but not health protective behavioral intentions. The results of this study suggest that when communicating environmental risks of water pollution, highlighting self-efficacy in messaging is particularly important to promote protective environmental and personal health behavior.

Using the theory of planned behavior to assess willingness and attitudes towards COVID-19 vaccination among a predominantly white U.S. college sample

Objective

Through the lens of behavioral models such as the Theory of Planned Behavior (TPB) and the Health Belief Model, the present study (1) investigated U.S. university students' willingness to receive the COVID-19 vaccine and (2) examined predictors (e.g. demographics, past vaccine experience, TPB constructs) of vaccine willingness.

Method

University students (n = 170) completed a survey assessing demographics, health behaviors, attitudes, perceived severity/susceptibility, norms, and vaccine intentions related to the COVID-19 pandemic. Data were collected from April 2020 through July 2020.

Results

Overall, 56.5% of participants indicated that they would be willing to receive the COVID-19 vaccine once it is available, 39.4% were unsure of whether they would receive the vaccine, and 4.1% indicated they would not receive the vaccine. Multinomial logistic regression indicated that greater adherence to CDC guidelines (p = .030) and greater perceived pro-vaccine norms (p < .001) predicted greater vaccine willingness.

Conclusions

Results from this study are consistent with previous literature on vaccine hesitancy, whereby normative beliefs and adherence to CDC guidelines were found to be determinants of vaccine willingness. To reduce transmission of the COVID-19 pandemic, interventions aimed at promoting positive attitudes towards vaccination should aim to incorporate these observed determinants.

The disease or the vaccination: Which is more important when deciding whether to vaccinate?

RATIONALE

Vaccinations provide adequate protection against many virus-related diseases. Nonetheless, many individuals refuse voluntary vaccinations, and their refusal could contribute to the spread of diseases. Previous research on the intention to vaccinate has been limited by focusing on a single target group.

OBJECTIVE

In this study, we develop an integrated theoretical framework incorporating the dual approach with relevant theories related to both disease and vaccination. Our objective is to examine the behavioral reasons for the decision to vaccinate or not. The vaccination-related appraisals concern aspects of vaccination and the disease-related appraisals concern aspects of COVID-19. The framework is applied to the much-discussed context of COVID-19 vaccination.

METHOD

We investigate the intention to vaccinate of two target groups, unvaccinated individuals and twice-vaccinated individuals, with a partial squares structured equation model.

RESULTS

Our results show that unvaccinated individuals are driven in their intention to vaccinate by their attitude (toward vaccination); factors relating to the disease have no impact. In contrast, when deciding whether to be revaccinated, twice-vaccinated individuals balance factors relating to vaccination and factors relating to disease.

CONCLUSIONS

We conclude that the proposed integrated theoretical model is appropriate for investigating diverse target groups and deriving implications.

Collective Views of Vaccination Predict Vaccine Hesitancy and Willingness to Receive a COVID-19 Vaccine

We examined the association between sociodemographic factors, views of vaccines as being an individual choice to protect oneself vs. a collective choice to protect others, general vaccine hesitancy, and willingness to receive a COVID-19 vaccine. In a sample of adults (N = 619; 33% non-white), we showed that demographic factors explain significant variance in both vaccine hesitancy and willingness to receive a COVID-19 vaccine. Viewing vaccines as an individual choice to protect oneself explained additional variance in vaccine hesitancy. However, people who viewed vaccines as a collective choice to protect others showed both less vaccine hesitancy and greater willingness to receive a COVID-19 vaccine. These findings suggest that promoting prosocial attitudes about vaccinations may decrease vaccine hesitancy and increase vaccine uptake.

Application of Protection Motivation Theory to COVID-19 vaccination among a predominantly Hispanic sample of adolescents

Despite the efficacy and widespread availability of COVID-19 vaccines, vaccine uptake has been relatively low in U.S. Hispanic communities, especially among adolescents. This study examined vaccination status among 444 high school students in predominantly Hispanic neighborhoods of Los Angeles County, California in May-June 2022 (mean age = 15.74 years, 55% female, 93% Hispanic). Guided by Protection Motivation Theory, we hypothesized that the odds of being fully vaccinated (at least 2 vaccine doses) would be significantly associated with higher levels of perceived severity, perceived vulnerability, response efficacy, and self-efficacy. 79% of the respondents were fully vaccinated. Binary logistic regression analyses found that response efficacy (belief in the effectiveness of the COVID-19 vaccine) and self-efficacy to get vaccinated were significantly associated with the likelihood of being fully vaccinated. Perceived severity of COVID-19 and perceived vulnerability to COVID-19 were not associated with the likelihood of being fully vaccinated. Results indicate that health communications are needed to convince Hispanic adolescents and their parents that the COVID-19 vaccine is effective, and outreach efforts are needed to remove barriers to vaccination among this population.

How scared are Americans of the Zika virus? The role of threat, efficacy, and third-person perception to induce protective behaviors

This study examines how public perception of threat and efficacy (on self and others) influence their tendency to take preventive action against the Zika virus by surveying 1,152 U.S. adults in Texas and Florida. Findings show that individuals were likely to take protective actions when they: (1) saw a high risk of the disease (high threat) and were confident about their ability to reduce the danger (high efficacy); and (2) perceived others as having a high risk (high threat), but lacked the ability to reduce the danger (low efficacy). Further, the study discusses practical implications for the design of public health campaigns.

Secondary Risk in COVID-19 Vaccination Intentions: A Theoretical Contribution to the Protection Motivation Paradigm

This study presents an original model that features the emotion of fear of COVID-19 as a direct effect on vaccination intentions. A central research question addressed in the study is what roles do the emotion of fear of contracting COVID-19 and the threat posed by uptake of the COVID-19 vaccination play in levels of vaccination intention? The study used a structural equation model (SEM) and applied the SmartPLS 3.2.6 data analysis tool for model estimation and multivariate analysis variables. A key finding is that vaccination resistance is strongest when fear of COVID-19 is lower, and vaccination threat higher. Vaccination threat appraisal and vaccination intention were found to have a negative relationship. Response costs at higher levels lessen motivation for COVID-19 vaccination. Research implications include research-based targeting of differing segments by their primary fear, either fear of COVID-19 or of the preventative vaccine.

Predicting COVID-19 vaccination intentions: the roles of threat appraisal, coping appraisal, subjective norms, and negative affect

BACKGROUND

As a new disease, communities possess little natural immunity to COVID-19 and vaccines are considered critical to preventing and reducing the incidence of severe illness. This study, inspired by Protection Motivation Theory (PMT), examines the relationship between citizens' threat appraisal, coping appraisal, subjective norms, negative affect, and their COVID-19 vaccination intentions.

METHODS

A sample of 340 citizens from two main cities in Mainland China, Xi'an and Wuxi, was used for data analysis. Structural Equation Modeling (SEM) was employed with latent and observed variables to test hypotheses. Data were analyzed using AMOS 24.0.

RESULTS

Several findings extend current understanding. Firstly, our proposed model explains 73% of the variance in vaccination intentions. Secondly, perceived severity only indirectly shapes COVID-19 vaccination intentions through negative affect. Thirdly, negative affect and response costs are negatively related to COVID-19 vaccination intentions. Finally, Perceived probability, subjective norms, response efficacy and self-efficacy are positively related to COVID-19 vaccination intentions; among them, self-efficacy contributes the most, followed by response efficacy and subjective norms, and lastly perceived probability.

CONCLUSION

Theoretically, this study increases current understanding about subjective norms and affective responses. We provoke a certain amount of thought about the role of affect response in relation to threat appraisal and vaccination intentions. Specifically, governments must be vigilant that citizens' negative affect, such as fear, may cause vaccine hesitation.

An Empirical Study on Physical Subhealth Risk Perception: A Physical Examination Data of Tertiary Grade-A Hospitals in Anhui Province, China

Background

Physical subhealth directly correlates to people's work effectiveness and quality of life, so subhealth prevention has become an urgent medical problem.

Methods

A random sampling method was used to conduct a questionnaire survey of physical examinees from June to September, 2019. In total, 770 people participated in our study. The Pearson correlation and multiple stepwise regression analysis were used to explore the relationship among demographic variables, physical subhealth, and risk perception. Also, this study used a two-way interaction moderated multiple regression approach to examine the moderating effects of demographic variables on physical subhealth and risk perception.

Results

The risk perception level was negatively associated with physical health. Age, education level, and subhealth proportion in the work unit all significantly and positively influence physical health, whereas living place, subhealth duration, and marital status negatively influence physical health. Living place, average annual household income, number of employees in the work unit, and subhealth proportion in the work unit significantly and positively influence the risk perception, and only age negatively influences the risk perception. The number of children had a moderating effect on physical subhealth and risk perception (Interaction coefficient α = -0.3, P < 0.05).

Conclusions

To achieve the overall improvement of public health, relevant management departments can provide targeted interventions for the public with different levels of risk perception. Also, the physical subhealth of the public can be addressed by encouraging the public to attach importance to education, improving the public living environment to build a livable city, strengthening psychological guidance and intervention for couples heading toward divorce to reduce the divorce rate, focusing on the health of work unit employees and regularly organizing employees to attend medical checkups, and actively responding to the national policy of family planning.

Education level modifies parental hesitancy about COVID-19 vaccinations for their children

It is important to encourage parental acceptance of children's vaccination against COVID-19 to ensure population immunity and mitigate morbidity and mortality. This study drew upon protection motivation theory (PMT) to explore the factors of parental hesitancy about vaccinating their children. A national online survey was performed in China. A total of 2054 Chinese parents of children aged 6-12 years were included in this study. They reported on measures that assessed hesitancy about children's vaccination against COVID-19, PMT constructs (susceptibility, severity, response efficacy, self-efficacy, and response costs) and sociodemographic characteristics. Chinese parents reported a hesitancy rate of 29.4% for children's vaccination. Parents with higher level education were more likely to hesitate to vaccinate their children against COVID-19. After controlling for parents' and children's demographic variables, logistic regression showed that parents' hesitancy about their children's vaccination increased if parents had lower levels of susceptibility, response efficacy or self-efficacy, as well as higher levels of response costs. In addition, a high educational level can significantly increase the promotive effect of response cost and the protective effect of response efficacy on vaccine hesitancy. In conclusion, our findings suggested that PMT can explain parents' vaccine hesitancy and that education level can modify the effect of copying appraisal, but not threat appraisal, on parental hesitancy. This study will help public health officials send targeted messages to parents to improve the rate of COVID-19 vaccination in children aged 6-12 years and thus reach a higher level of immunity in the population.

Application of protection motivation theory and cultural tightness-looseness for predicting individuals' compliance with the government's recommended preventive measures during regular prevention and control of the COVID-19 pandemic in China

Introduction

In the period of regular prevention and control of the COVID-19 pandemic, the public must continue to comply with the government's recommended preventive measures to further curb the pandemic. Based on the theories of protection motivation and cultural tightness-looseness, this study investigates individuals' compliance with the government's recommended preventive measures during this period in China. It also establishes a moderated mediation model to explore the underlying mechanisms.

Methods

We used structural equation modeling and latent model structural equations to analyze data from an online survey of 443 participants.

Results

The analysis showed that media exposure significantly predicted perceived severity, maladaptive rewards, self-efficacy, response efficacy, and response cost. Perceived severity, self-efficacy, and response efficacy were positively associated with protection motivation, which, in turn, was positively associated with individuals' compliance. Additionally, protection motivation positively affected individuals' compliance via implementation intention, and perceived cultural tightness-looseness significantly moderated the association between protection motivation and implementation intention.

Discussion

This study helps to better understand individuals' compliance from a theoretical perspective and provide practical advice on promoting individuals' compliance with the government's precautionary measures.

The acceptance of SARS-CoV-2 rapid antigen self-testing: A cross-sectional study in China

Compared with the nucleic acid amplification test (NATT), the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapid antigen self-testing (RAST) has advantages in speed and convenience. However, little is known about people's acceptance and influencing factors for SARS-CoV-2 RAST. A cross-sectional study was conducted from April 21 to 30, 2022 in China. The χ² test and multivariate logistic regressions were used to identify the influencing factors. The structural equation model was used to test the extended protective motivation theory (PMT) model hypotheses. Among the total of 5107 participants, 62.5% were willing to accept the SARS-CoV-2 RAST. There were significant differences in acceptance among different residences (p < 0.001), educational level (p < 0.001), occupation (p < 0.001), monthly income (p < 0.001), travel frequency (p < 0.05), and feelings about NATT (p < 0.001). Response efficacy (β = 0.05; p = 0.025) and self-efficacy (β = 0.84; p < 0.001) had a positive effect, while response cost showed a negative effect (β = -0.07; p < 0.001). The public's major concerns about SARS-CoV-2 RAST are its reliability, testing method, price, and authority. Overall, a moderate intention to use SARS-CoV-2 RAST was found among the Chinese population. The extended PMT can be used for the prediction of intention to accept the RAST. We need to take measures to increase people's acceptance of SARS-CoV-2 RAST.

Afraid but misinformed: Conspiracist beliefs cancel the positive influence of fear of COVID-19 on vaccination intentions - Findings from a Romanian sample

Understanding the factors that make people more likely to refuse vaccination against COVID-19 is crucial in order to design public health messages efficient in increasing vaccination rates. As COVID-19 creates risks of seriously damaging health effects, fear of this disease is as a significant determinant of vaccination intentions, as indicated by past research. Nevertheless, this positive influence may be limited in people who do not consider vaccines as a solution to protect against COVID-19, especially those who hold conspiracist beliefs about the new coronavirus and, implicitly, about the newly developed vaccines. The present study examined in a cross-sectional design on a convenience sample (N = 564) the joint effect of fear of COVID-19 and conspiracist beliefs on vaccination intentions, advancing past research on their independent influences. Furthermore, we investigated and controlled the effects of perceived risk of catching COVID-19, trust in medical experts, attitude towards vaccination and socio-demographical characteristics (i.e., gender, age, and education), previously found to be associated to COVID-19 vaccination intentions. We also tested the effect of ambivalence towards vaccination, i.e., the degree to which people simultaneously hold positive and negative evaluations of this intervention, as the widespread misinformation on the new coronavirus and its vaccines may induce ambivalence on this latter issue in many people. The results showed that the positive effect of fear of COVID-19 on vaccination intentions emerged only in participants who tend not to endorse conspiracist ideas on the new coronavirus. Moreover, higher vaccine hesitancy was found in participants with higher ambivalence towards vaccination, in those who perceive the risk of being contaminated by the new coronavirus as low, and in those with more negative attitudes towards vaccines in general. Vaccine ambivalence also emerged as a mediator of the negative effects of conspiracist beliefs about COVID-19 on vaccination intentions. This pattern of findings suggests the public messages emphasizing the risks of COVID-19 should also combat misinformation in order to maximize vaccine uptake.

Desire to stay shorter time at the shopping mall: insight from protection motivation (PMT), behavioral inhibition system (BIS), reactance, and expectancy theories

After withdrawing the movement control order (MCO), new variant (Omicron) of COVID-19 returns as an outbreak again. Therefore, consumers are very much informed by various media to be more cautious in visiting shopping malls and spend less time in there. The purpose of this study was to identify the predictors influencing the desire to stay shorter at the shopping mall. This study was conducted in Malaysia, with the application of three psychological theories and one behavioural theory. This is quantitative research based on an online cross-sectional survey design. Data were collected from 296 respondents, by applying the online snowball sampling method through numerous media platforms i.e., Viber, WhatsApp, Messenger, and other apps in three severely affected cities in Malaysia i.e., Selangor state, Putrajaya, and Kuala Lumpur. SmartPLS was used to analyse the data. Using structural equation modelling, this study result shows risk, protection motivation, and fear have a significant effect on the desire to stay a shorter time at the shopping mall. Social norm moderates the association between fear and the desire to spend a shorter time at the shopping mall. These findings, highlight the need for a more empirical study to design more robust strategies, and a safer and risk-free shopping mall environment.

Predictors of protective behaviours during the Italian Covid-19 pandemic: an application of protection motivation theory

OBJECTIVE

The study investigated whether Protection Motivation Theory (PMT) constructs predicted recommended protective behaviours soon after the Italian lockdown and 1-year later.

DESIGN

A three-wave longitudinal design was used. Three-hundred-fifty-two adults completed online questionnaires with PMT and intention measures assessed during the Italian lockdown (T1), and behaviour measures assessed after 1-month (T2) and 1-year (T3).

OUTCOME MEASURES

Intentions to adopt behaviours (T1) and behaviour adherence at T2 and T3.

RESULTS

From T2 to T3, participants reported less adoption of distance behaviours, but higher face masks use. In SEM models, self-efficacy and perceived severity were the strongest predictors of intentions to engage in protective behaviours. Intentions (β = 0.490, p < 0.001) and fear arousal (β = 0.134 p = 0.035) predicted protective behaviours at T2. Intentions (β = 0.302, p = 0.001) and perceived severity (β = 0.431, p < 0.001) predicted protective behaviours at T3.

CONCLUSION

To increase intentions, intervention should highlight the severity of getting infected and target perceptions of one's ability to perform the protective behaviours. In addition, interventions should consider that at the beginning of the pandemic, fear predicted the adoption of preventive behaviours while perceived severity of the disease had a greater impact over time.

The emotion bias of health product consumers in the context of COVID-19

The ongoing COVID-19 has led to an increase in negative emotions and health awareness among consumers. This paper discusses the emotion bias of Chinese consumers during the three periods: the pre-COVID-19 period, the COVID-19 lockdown period, and the COVID-19 normalization period. This study takes health products as the research object and crawls relevant reviews on the JD platform to classify products. The data were classified into emotion, the intensity of emotion was calculated, and the logistic regression model and variance analysis were used to analyze the difference in emotion expression. The study reveals that consumers are willing to express fear and sadness during the COVID-19 lockdown era and are willing to express like emotions before the pandemic compared to the three periods. There are also differences in the emotional intensity of different product reviews. The intensity of emotional expression is more vigorous for consumers who purchase nutritional products, while for those who purchase healthcare equipment, the intensity of emotional expression is lower. This study offers the emotion bias of consumers in response to COVID-19 to provide a theoretical basis and reference solution for implementing marketing strategies for health product companies.

Panic Food Purchasing amid COVID-19 Pandemic: Does the Impact of Perceived Severity, Anxiety and Self-Isolation Really Matter?

This research examines the influences of perceived severity, anxiety, and self-isolation intention, amid the coronavirus disease of 2019 (COVID-19), on panic food purchasing. The research adopted a quantitative approach using a pre-examined instrument, which was self-administered by the research team (with support from a data collection-specialised company) to consumers who were urgently shopping for food in the Kingdom of Saudi Arabia (KSA). The results of structural equation modelling (SEM) using analysis of a moment structures (AMOS) software showed a significant positive impact of perceived severity on consumers' anxiety and self-isolation intention amid the COVID-19 pandemic. Self-isolation intention was found to have a significant positive impact on the anxiety of consumers amid the pandemic. Additionally, perceived severity, anxiety, and self-isolation have a significant positive impact on panic food purchasing. Both anxiety and self-isolation were found to have partial mediating effects in the link between perceived severity and panic purchasing intention. The results of the current research contribute to a better understanding of factors that influence panic purchasing behaviour, especially amid a pandemic. This will help policymakers to deal with this behaviour when such issues arise in the future. Other implications for scholars and policy makers are discussed.

Career resilience of the tourism and hospitality workforce in the COVID-19: The protection motivation theory perspective

By applying the protection motivation theory, the study aims to investigate factors influencing tourism and hospitality (T&H) workers' career resilience when faced with health-related risks at work during a pandemic. Data were collected from 495 part-time and full-time employees in the Vietnamese tourism and hospitality sector. The study found that workers' perceived vulnerability and perceived severity of the pandemic were positively associated with career resilience. Perceived severity was positively related to self-efficacy and response efficacy, while perceived vulnerability was positively associated with self-efficacy only. Both self-efficacy and response efficacy positively influenced career resilience through the mediating role of health risk preventative behavior. Theoretically, the study advances the stream of research in resilience in general and career resilience in particular among T&H workers when faced with a health-related crisis. Practical implications are provided with recommendations on how to facilitate career resilience among T&H employees working in the current high-risk environment.

Fact boxes that inform individual decisions may contribute to a more positive evaluation of COVID-19 vaccinations at the population level

Objective

For an effective control of the SARS-CoV-2 pandemic with vaccines, most people in a population need to be vaccinated. It is thus important to know how to inform the public with reference to individual preferences–while also acknowledging the societal preference to encourage vaccinations. According to the health care standard of informed decision-making, a comparison of the benefits and harms of (not) having the vaccination would be required to inform undecided and skeptical people. To test evidence-based fact boxes, an established risk communication format, and to inform their development, we investigated their contribution to knowledge and evaluations of COVID-19 vaccines.

Methods

We conducted four studies (1, 2, and 4 were population-wide surveys with N = 1,942 to N = 6,056): Study 1 assessed the relationship between vaccination knowledge and intentions in Germany over three months. Study 2 assessed respective information gaps and needs of the population in Germany. In parallel, an experiment (Study 3) with a mixed design (presentation formats; pre-post-comparison) assessed the effect of fact boxes on risk perceptions and fear, using a convenience sample (N = 719). Study 4 examined how effective two fact box formats are for informing vaccination intentions, with a mixed experimental design: between-subjects (presentation formats) and within-subjects (pre-post-comparison).

Results

Study 1 showed that vaccination knowledge and vaccination intentions increased between November 2020 and February 2021. Study 2 revealed objective information requirements and subjective information needs. Study 3 showed that the fact box format is effective in adjusting risk perceptions concerning COVID-19. Based on those results, fact boxes were revised and implemented with the help of a national health authority in Germany. Study 4 showed that simple fact boxes increase vaccination knowledge and positive evaluations in skeptics and undecideds.

Conclusion

Fact boxes can inform COVID-19 vaccination intentions of undecided and skeptical people without threatening societal vaccination goals of the population.

Social media and COVID-19 vaccination hesitancy: mediating role of the COVID-19 vaccine perception

Individuals' COVID-19 vaccination behaviors were examined when the government introduced a new vaccine into the immunization program. The purpose of this study is to thoroughly examine the effects of COVID-19 risk perception (CR), COVID-19 vaccination perception (VC), and Social Media (SO) on COVID-19 vaccine hesitancy (HE) in Vietnam. Three hundred fifty samples were collected regarding a reluctance to vaccinate against COVID-19 from 6/2021 to 7/2021. This is when immunizations are administered and injected in Vietnam; hence, hesitation regarding injection is rather prevalent. Multivariate regression analysis is conducted on a dataset of 350 Vietnamese respondents using the Partial Least Squares-Structural Equation Modeling (PLS-SEM) approach. The main results indicated that the Perception Vaccine functions as a link between VC and HE. CR has a positive effect on both HE and VC; whereas VC has a negative impact on HE. Simultaneously, the study illustrates the detrimental effect of SO on immunity by comparing it to the influence of social media. The study's findings also demonstrated the critical role of protection motivational theory (PMT) and information theory in promoting vaccination efforts in Vietnam.

A large cross-sectional survey of COVID-19 vaccination willingness amongst healthcare students and professionals: Reveals generational patterns

AIMS

To determine coronavirus disease 2019 (COVID-19) vaccination hesitancy in healthcare professionals and healthcare students in Italy across four generations (baby boomers, generations X, Y and Z).

DESIGN

A cross-sectional descriptive study was performed through an online survey conducted from May to June 2021. The STROBE guidelines were adopted for reporting.

METHODS

Data were collected by initially sending a survey link to a convenience sample of healthcare professionals and students, which was followed by snowball sampling. The VAX scale was validated and adopted. An ANOVA was performed to detect differences in vaccine-hesitancy beliefs between the four generational groups.

RESULTS

The survey was completed by 1226 healthcare professionals and students. Worries about unforeseen future effects accounted for the higher vaccination hesitancy factor across generations. More positive attitudes towards COVID-19 vaccination were expressed by members of generation Z than by members of generation Y and baby boomers. Members of generation X had the highest vaccination hesitancy scores in the overall scale.

CONCLUSION

The results suggest that public health campaigns should take into account the generational differences in COVID-19 vaccination hesitancy to achieve higher levels of vaccine acceptance, including amongst healthcare professionals and students.

IMPACT

Vaccination is the most effective strategy to tackle the COVID-19 pandemic. The advice of health professionals strongly influences vaccination willingness in the general population. A consideration of the generational patterns in the COVID-19 vaccination hesitancy of healthcare workers and students may increase vaccination uptake in these populations, which in turn may lead to greater public acceptance of the vaccine.

Promoting Social Distancing and COVID-19 Vaccine Intentions to Mothers: Randomized Comparison of Information Sources in Social Media Messages

Background

Social media disseminated information and spread misinformation during the COVID-19 pandemic that affected prevention measures, including social distancing and vaccine acceptance.

Objective

In this study, we aimed to test the effect of a series of social media posts promoting COVID-19 nonpharmaceutical interventions (NPIs) and vaccine intentions and compare effects among 3 common types of information sources: government agency, near-peer parents, and news media.

Methods

A sample of mothers of teen daughters (N=303) recruited from a prior trial were enrolled in a 3 (information source) × 4 (assessment period) randomized factorial trial from January to March 2021 to evaluate the effects of information sources in a social media campaign addressing NPIs (ie, social distancing), COVID-19 vaccinations, media literacy, and mother–daughter communication about COVID-19. Mothers received 1 social media post per day in 3 randomly assigned Facebook private groups, Monday-Friday, covering all 4 topics each week, plus 1 additional post on a positive nonpandemic topic to promote engagement. Posts in the 3 groups had the same messages but differed by links to information from government agencies, near-peer parents, or news media in the post. Mothers reported on social distancing behavior and COVID-19 vaccine intentions for self and daughter, theoretic mediators, and covariates in baseline and 3-, 6-, and 9-week postrandomization assessments. Views, reactions, and comments related to each post were counted to measure engagement with the messages.

Results

Nearly all mothers (n=298, 98.3%) remained in the Facebook private groups throughout the 9-week trial period, and follow-up rates were high (n=276, 91.1%, completed the 3-week posttest; n=273, 90.1%, completed the 6-week posttest; n=275, 90.8%, completed the 9-week posttest; and n=244, 80.5%, completed all assessments). In intent-to-treat analyses, social distancing behavior by mothers (b=–0.10, 95% CI –0.12 to –0.08, P<.001) and daughters (b=–0.10, 95% CI –0.18 to –0.03, P<.001) decreased over time but vaccine intentions increased (mothers: b=0.34, 95% CI 0.19-0.49, P<.001; daughters: b=0.17, 95% CI 0.04-0.29, P=.01). Decrease in social distancing by daughters was greater in the near-peer source group (b=–0.04, 95% CI –0.07 to 0.00, P=.03) and lesser in the government agency group (b=0.05, 95% CI 0.02-0.09, P=.003). The higher perceived credibility of the assigned information source increased social distancing (mothers: b=0.29, 95% CI 0.09-0.49, P<.01; daughters: b=0.31, 95% CI 0.11-0.51, P<.01) and vaccine intentions (mothers: b=4.18, 95% CI 1.83-6.53, P<.001; daughters: b=3.36, 95% CI 1.67-5.04, P<.001). Mothers’ intentions to vaccinate self may have increased when they considered the near-peer source to be not credible (b=–0.50, 95% CI –0.99 to –0.01, P=.05).

Conclusions

Decreasing case counts, relaxation of government restrictions, and vaccine distribution during the study may explain the decreased social distancing and increased vaccine intentions. When promoting COVID-19 prevention, campaign planners may be more effective when selecting information sources that audiences consider credible, as no source was more credible in general.

Trial Registration

ClinicalTrials.gov NCT02835807; https://clinicaltrials.gov/ct2/show/NCT02835807

The Role of COVID-19 Vaccine Perception, Hope, and Fear on the Travel Bubble Program

The travel bubble program presented an appealing strategy for reopening international travel safely. However, a full vaccination regime is the foremost prerequisite of the program. Therefore, vaccination and the travel bubble are inextricably linked. This study investigated the roles of perceived vaccine efficacy, attitude towards the COVID-19 vaccine, and attitude toward the travel bubble on travel bubble intention. More importantly, the study also examined the mediating role of hope and fear among unvaccinated Korean adults between 20 and 29 years old. A total of 535 samples were collected to test the proposed conceptual model using structural equation modeling. In general, the results supported the proposed hypotheses. Notably, the intention to travel to a bubble destination was explained by 57% of the variance. Furthermore, hope mediated the relationship between vaccine attitude and travel bubble intention. Whereas fear mediated the relationship between perceived vaccine efficacy and intention. Hence, the findings suggest doubts around the vaccine efficacy and that a positive attitude towards the vaccine also install hope among the research samples.

An Integrated Approach to COVID-19 Preventive Behaviour Intentions: Protection Motivation Theory, Information Acquisition, and Trust

COVID-19 has been a global threat since November 2019 due to its high transmission rates and the issue of unwillingness to vaccinate. Effective risk management requires accurate health communication and public compliance with reccomended preventive behaviors. Therefore, we investigated predictors of COVID-19 preventive behavior intention based on Protection Motivation Theory (PMT) in addition to frequency of public's use of and trust in a group of COVID-19 related information sources. This cross-sectional study was conducted on 458 adults in Turkey with online survey. Results showed that all PMT components (except perceived susceptibility) accounted for 49% of the variance in protection motivation and there was relationship between information sources and protection motivation. Overall, our study findings suggested that being more informed and having confidence in the feasibility (self-efficacy) and effectiveness (response efficacy) of preventive behaviors may particularly help slow the disease spread.

Behavioral Intention and Its Predictors toward COVID-19 Booster Vaccination among Chinese Parents: Applying Two Behavioral Theories

The booster vaccination of COVID-19 is being implemented in most parts of the world. This study used behavioral psychology to investigate the predictors of parents' intentions regarding the COVID-19 booster vaccination for their children. This is a cross-sectional study with a self-designed questionnaire based on two behavioral theories-protective motivation theory (PMT) and theory of planned behavior (TPB). A stratified multi-stage sampling procedure was conducted in Nanjing, China, and multivariable regression analyses were applied to examine the parents' intentions. The intention rate was 87.3%. The response efficacy (ORa = 2.238, 95% CI: 1.360-3.682) and response cost (ORa = 0.484, 95% CI: 0.319-0.732) in the PMT, were significant psychological predictors of parents' intentions, and so were the attitude (ORa = 2.619, 95% CI: 1.480-4.636) and behavioral control (ORa = 3.743, 95% CI: 2.165-6.471) in the TPB. The findings of crucial independent predictors in the PMT and TPB constructs inform the evidence-based formulation and implementation of strategies for booster vaccination in children.

Protection motivation unmasked: Applying protection motivation theory to skepticism toward COVID-19 mask and vaccine mandates

Variants of COVID-19 have sparked controversy regarding mask and/or vaccine mandates in some sectors of the country. Many people hold polarized opinions about such mandates, and it is uncertain what predicts attitudes towards these protective behavior mandates. Through a snow-ball sampling procedure of respondents on social media platforms, this study examined skepticism of 774 respondents toward these mandates as a function of the Protection Motivation Theory (PMT) of health. Hierarchical linear regressions examined Protection Motivation (PM) as a predictor of mask and vaccine mandate skepticism independently and with political party affiliation as a control. PM alone accounted for 76% of the variance in mask mandate skepticism, p < 0.001 and 65% in vaccine mandate skepticism, p < 0.001. When political affiliation was entered (accounting for 28% of the variance in mask mandate skepticism, p < 0.001, and 26% in vaccine mandate skepticism, p < 0.001), PM still accounted for significant percentages of variance in both mask (50%) and vaccine (43%) mandate skepticism, ps < 0.001. Across regressions, perceived severity, outcome efficaciousness, and self-efficacy each directly accounted for unique variance in mask and vaccine mandate skepticism, ps < 0.001; only perceived vulnerability failed to account for unique variance in the regressions, ps > 0.05. Specifically, the more severe participants perceived COVID-19 to be and the greater the perceived efficacy of masks and vaccines preventing the spread of COVID-19, the lower participants' skepticism toward mask and vaccine mandates. Similarly, the higher participants' self-efficacy in wearing masks or receiving the vaccine, the lower their skepticism toward mask and vaccine mandates.

Two-Tailed Dogs, Social Unrest and COVID-19 Vaccination: Politics, Hesitancy and Vaccine Choice in Hungary and Thailand

BACKGROUND

A long tradition of research has shown an association between political orientation and vaccine uptake. However, we know little about political preferences and the choice of specific vaccines.

METHODS

We conducted two national surveys, in Hungary (Study 1, online, n = 1130) and Thailand (Study 2, on the street survey: n = 1052), testing associations between political allegiance, trust in government, vaccine willingness, and vaccine choice.

RESULTS

In Hungary, those supporting the government or on the political right were more willing to be vaccinated, with this association strongest for government approved vaccines. These respondents were also more likely to accept Chinese and Russian vaccines and reject the Moderna vaccine. In Thailand, vaccinated respondents reported greater trust in the government, with preference for AstraZeneca associated with support for pro-government political parties and preference for Pfizer with anti-government attitudes.

CONCLUSIONS

Vaccine campaigns need to recognise the role of political loyalties not only in vaccine willingness, but in vaccine choice, especially given the mixing of vaccines across doses.

Medics as a Positive Deviant in Influenza Vaccination: The Role of Vaccine Beliefs, Self-Efficacy and Contextual Variables

The influenza vaccination rate remains unsatisfactorily low, especially in the healthy adult population. The positive deviant approach was used to identify key psychosocial factors explaining the intention of influenza vaccination in medics and compare them with those in non-medics. Methods: There were 709 participants, as follows: 301 medics and 408 non-medics. We conducted a cross-sectional study in which a multi-module self-administered questionnaire examining vaccination beliefs, risk perception, outcome expectations (gains or losses), facilitators’ relevance, vaccination self-efficacy and vaccination intention was adopted. We also gathered information on access to vaccination, the strength of the vaccination habit and sociodemographic variables. Results: We used SEM and were able to explain 78% of the variance in intention in medics and 56% in non-medics. We identified both direct and indirect effects between the studied variables. In both groups, the intention was related to vaccination self-efficacy, stronger habits and previous season vaccination, but access to vaccines was significant only in non-medics. Conclusions: Applying the positive deviance approach and considering medics as positive deviants in vaccination performance extended the perspective on what factors to focus on in the non-medical population. Vaccination promotion shortly before the flu season should target non- or low-intenders and also intenders by the delivery of balanced information affecting key vaccination cognitions. General pro-vaccine beliefs, which may act as implicit attitudes, should be created in advance to build proper grounds for specific outcome expectations and facilitators’ recognition. It should not be limited only to risk perception. Some level of evidence-based critical beliefs about vaccination can be beneficial.

Efficacy information influences intention to take COVID-19 vaccine

OBJECTIVES

A successful response to the COVID-19 pandemic requires achieving high levels of vaccine uptake. We tested whether directly contrasting the high efficacy of COVID-19 vaccines with the lower efficacy of the annual flu vaccine would increase intentions to take a COVID-19 vaccine.

DESIGN

A pre-registered online study of 481 participants compared four information conditions: (1) no information; (2) COVID-19 Vaccine Information Only; and COVID-19 Vaccine Information combined with flu vaccine information suggesting either (3) 60% efficacy or (4) 40% efficacy; we measured COVID-19 and flu vaccine intentions along with several other vaccine-related variables.

METHODS

The Prolific platform was used to recruit 481 UK participants (64% female; aged between 18 and 85 years) who had been pre-screened to have intermediate levels of vaccine hesitancy. After reading a short text (~200 words) about COVID-19 vaccines, participants were asked about their vaccination intentions.

RESULTS

Providing information about the safety and efficacy of the new COVID-19 vaccines resulted in vaccination intentions that were, on average, 0.39 standard deviations (SDs) higher than those in the no information condition; providing the same COVID vaccine efficacy information in the context of information about flu vaccine efficacy resulted in a further significant increase in vaccination intentions that were 0.68 SD higher than those in the no information condition. This positive contrast effect for the COVID-19 vaccine was not associated with reduced flu vaccine intentions.

CONCLUSIONS

Vaccination intentions can be strengthened through a simple messaging intervention that utilizes context effects to increase perceived response efficacy.

Cognitive underpinnings of COVID-19 vaccine hesitancy

RATIONALE

Vaccines save lives. Despite the undisputed value of vaccination, vaccine hesitancy continues to be a major global challenge, particularly throughout the COVID-19 global pandemic. Since vaccination decisions are counter-intuitive and cognitively demanding, we propose that vaccine hesitancy is associated with executive function-a group of high-level cognitive skills including attentional control, working memory, inhibition, self-regulation, cognitive flexibility, and strategic planning.

OBJECTIVE

We set out to test (i) whether vaccine hesitancy is driven by individual differences in executive function beyond established socio-demographic factors (e.g., education, political orientation, gender, ethnicity, age, religiosity) and depressed mood, and (ii) whether this relationship is exacerbated by situational stress.

METHODS

Two studies were conducted with U.S. residents. Using a cross-sectional design, Study 1 examined the associations between executive function, socio-demographic factors, COVID-19 conspiracy beliefs, trust in health authorities, and COVID-19 vaccine hesitancy. Using an experimental design, Study 2 focused solely on unvaccinated individuals and tested the interactive effect of executive function and stress on willingness to receive a COVID-19 vaccine. We used ordinal logistic regressions to analyze the data.

RESULTS

Individual differences in executive function predicted participants' COVID-19 conspiracy beliefs, trust in health authorities, and their willingness to vaccinate against COVID-19. Importantly, the unique contribution of executive function to vaccine hesitancy could not be explained by socio-demographic factors or depressed mood. Furthermore, Study 2 revealed that weaker executive function had detrimental effects on COVID-19 vaccine acceptance and trust in health authorities mainly under heightened stress.

CONCLUSIONS

Individual differences in executive function and situational stress jointly impact COVID-19 vaccination decisions and need to be considered together when designing health communications aimed at reducing COVID-19 vaccine hesitancy. Interventions that lower stress and promote trust have the potential to increase vaccine acceptance, especially for individuals with weaker executive function.

Applying an extended protection motivation theory to predict Covid-19 vaccination intentions and uptake in 50-64 year olds in the UK

Objectives

To examine the correlates of Covid-19 vaccination intentions and subsequent uptake as outlined in an extended version of protection motivation theory (PMT).

Design

A two-wave online survey conducted at the start of the vaccination rollout to 50–64 year olds in the UK and three months later.

Measures

Unvaccinated UK adults (N = 438) aged 50–64 completed baseline measures from PMT (perceived vulnerability, perceived severity, maladaptive response rewards, response efficacy, self-efficacy, response costs, intention) as well as measures of injunctive and descriptive norms, demographics, Covid-19 experiences, and past influenza vaccine uptake. Self-reported uptake of a Covid-19 vaccination was assessed three months later (n = 420).

Results

The extended PMT explained 59% of the variance in Covid-19 vaccination intentions, after controlling for demographics, Covid-19 experiences, and past influenza vaccine uptake. All extended PMT variables, with the exception of perceived severity and descriptive norms, were significant independent predictors of intention. In line with national figures, 94% of the sample reported having received a Covid-19 vaccination at follow-up with intention found to be the key predictor of uptake.

Conclusions

Interventions to increase Covid-19 vaccination uptake need to increase intentions to be vaccinated by emphasizing the benefits of vaccination (e.g., in terms of reducing risk) and likely approval from others while also addressing the concerns (e.g., safety issues) and common misperceptions (e.g., natural immunity versus vaccines) that people might have about Covid-19 vaccines. Future research is needed in countries, and on groups, with lower uptake rates.

Prevalence and Predictors of Intention to be Vaccinated Against COVID-19 in Thirteen Latin American and Caribbean Countries

The presence of a significant number of people who do not intend to be vaccinated could negatively impact efforts to control the COVID-19 pandemic. Therefore, this study sought to determine the prevalence of intention to be vaccinated against COVID-19 and associated sociodemographic and psychosocial factors in thirteen countries in Latin America and the Caribbean (LAC). A total of 5510 people from 13 LAC countries participated. Frequencies, percentages, bivariate analyses using chi-square tests, and Poisson regression analysis with robust variance were used. The countries with the highest prevalence of intention to be vaccinated were Brazil (96.94%), Cuba (89.59%), Chile (84.59%), and Mexico (78.33%). On the other hand, the countries with the lowest prevalence were El Salvador (54.01%), Paraguay (55.87%), and Uruguay (56.40%). Prevalence is also reported according to some sociodemographic and health variables. It was found that country, male sex, hours exposed to information about COVID-19, university education, living in an urban area, belief in the animal origin of the virus, perceived likelihood of contracting COVID-19, perceived severity of COVID-19, and concern about infecting others significantly predicted intention to be vaccinated in the 13 LAC countries. While most countries had a high prevalence of intention to be vaccinated, there are still subgroups that have levels of intention that may be insufficient to predict the presence of community immunity. In this sense, knowing the estimates of vaccination intention rates, as well as the associated sociodemographic and psychological factors, can be used to plan actions and interventions that will inform about the safety and benefits of vaccines, as well as strengthen trust in health authorities.

How Do Perceived Health Threats Affect the Junk Food Eating Behavior and Consequent Obesity? Moderating Role of Product Knowledge Hiding

The predominant use of junk food in our societies is continuously held responsible for the obese body physiques and overweight among the kids and adolescents. The current supportive environments where organic foods are limited, and new processed foods have been brought to the market with more variant tastes and acceptability for the kids and adolescents that have diverged their eating patterns. It has significantly contributed to the health issues and growth discrepancies of the users. However, the awareness of the food contents is an important milestone for understanding the risks associated with the usage of junk foods. A quantitative approach has been used in this study to measure the effect of perceived severity, vulnerability and fear on the junk food eating behaviors and ultimately on the obesity. The moderating role of product knowledge hiding has also been measured on the relationship of junk food eating and obesity. Structural equation modeling is used using the software Smart-PLS for measuring the hypothesis with a sample size of 228 selected through purposive sampling. The sample consisted of kids and adolescents who were reached on purpose for data collection. The current study has explored the role of perceived severity, vulnerability and the fear of using junk foods which have been found as a negative effect on junk food eating behavior which is positively associated with obesity among the kids and adolescents. The result of study shows that perceived threat has a negative effect on the junk food eating behavior of the adolescents. However, the positive relationship of junk food eating behavior with obesity can be decreased if the information about the products is not hidden. This study will be useful for making the consumers aware of the product knowledge hiding of the junk food usage. Moreover, it will help the users in creating understanding of risks allied with the use of junk food which may be addressed in order to avoid obesity issues in the kids and adolescents globally.

Willingness to Take the Booster Vaccine in a Nationally Representative Sample of Danes

We estimate the willingness to take the booster dose in a representative sample of Danes. We estimate an overall willingness in the adult Danish population of about 87 percent and a willingness of about 95.5 percent among primary vaccine takers. Moreover, we show that these percentages are significantly lower among younger populations, as well as among groups who do not see COVID-19 as a threat to society, those who do not feel that they have the ability to follow recommendations (‘self-efficacy’), those who do not perceive the advice of the health authorities as effective against disease spread (‘response efficacy’), and those who feel that the costs of following recommendations are high (‘response cost’).

Evolution of Select Epidemiological Modeling and the Rise of Population Sentiment Analysis: A Literature Review and COVID-19 Sentiment Illustration

With social networking enabling the expressions of billions of people to be posted online, sentiment analysis and massive computational power enables systematic mining of information about populations including their affective states with respect to epidemiological concerns during a pandemic. Gleaning rationale for behavioral choices, such as vaccine hesitancy, from public commentary expressed through social media channels may provide quantifiable and articulated sources of feedback that are useful for rapidly modifying or refining pandemic spread predictions, health protocols, vaccination offerings, and policy approaches. Additional potential gains of sentiment analysis may include lessening of vaccine hesitancy, reduction in civil disobedience, and most importantly, better healthcare outcomes for individuals and their communities. In this article, we highlight the evolution of select epidemiological models; conduct a critical review of models in terms of the level and depth of modeling of social media, social network factors, and sentiment analysis; and finally, partially illustrate sentiment analysis using COVID-19 Twitter data.

Do liberals want curbside pickup more than conservatives? Contactless shopping as protectionary action against the COVID-19 pandemic

Consumers showed a dramatically increased interest in contactless shopping in reaction to the COVID-19 pandemic. Based on the protection motivation theory, this study investigated how contactless shopping grew as a protectionary action against COVID-19. Findings from a nationwide online survey (n = 311) confirmed the impact of politicization of the pandemic on consumer responses for contactless shopping intention and the significance of threat and coping appraisals in taking protectionary actions. This study adds knowledge to the existing literature on contactless shopping and protection motivation theory. Results imply that retailers must invest in contactless shopping and provide an in-store shopping environment that prioritizes the health and safety of shoppers and employees to decrease the threat of virus infection during shopping. However, in doing so, retailers are recommended to develop different marketing strategies regarding contactless shopping based on consumers' political orientations.

Protection Motivation Theory and Intentions to Receive the COVID-19 Vaccine

Background. Declared a “public health threat of international concern” by the World Health Organization, the COVID-19 virus has caused the deaths of over half a million individuals in the United States in just the first 23 months after detection. The vaccine has recently been introduced to reduce this public health threat. However, due, in part, to the rapidity with which the vaccine was developed, many individuals display vaccine hesitancy. Purpose. The current study examined the utility of the Protection Motivation Theory of Health (PMT) in predicting intentions to receive the COVID-19 vaccine. Method. One hundred twenty-nine unvaccinated respondents (drawn from an initial sample of 255 participants) completed a survey assessing the components of the PMT and intentions to receive the vaccine. Respondents could also provide an open-ended response regarding any concerns they had with the vaccine. Conclusions. The PMT accounted for 76% of the variance in vaccine intentions. Vulnerability, outcome efficaciousness, and maladaptive response rewards each accounted for unique variance. Open-ended responses reflecting concerns with the vaccine fell into 8 categories, with the most common being concern with the long-term side effects of the vaccine. These results suggest that public health campaigns promoting the vaccine should focus on vulnerability to COVID-19, protective functions of the vaccine, and overcoming what people perceive as benefits of not receiving the vaccine.

Using an extended protection motivation theory to explain vaccine hesitancy: a cross-sectional study among Chinese adults

Background

Vaccine hesitancy was listed as one of the top 10 issues threatening global health in 2019. The objectives of this study were to (a) use an extended protection motivation theory (PMT) with an added trust component to identify predictors of vaccine hesitancy and (b) explore the predictive ability of vaccine hesitancy on vaccination behavior.

Methods

We conducted an online questionnaire from February 9 to April 9, 2021, in China. The target population was Chinese residents aged 18 and over. A total of 14,236 responses were received. Structural equation modeling was used to test the extended PMT model hypotheses.

Results

A total of 10,379 participants were finally included in this study, of whom 52.0% showed hesitancy toward vaccination. 2854 (27.5%) participants reported that they got flu shots in the past year, and 2561 (24.7%) participants were vaccinated against COVID-19. 2857 (27.5%) participants engaged in healthcare occupation. The model explained 85.7% variance of vaccine hesitancy. Self-efficacy was the strongest predictor, negatively associated with vaccine hesitancy (β = −0.584; p < .001). Response efficacy had a negative effect on vaccine hesitancy (β = −0.372; p < .001), while threat appraisal showed a positive effect (β = 0.104; p < .001). Compared with non-health workers, health workers showed more vaccine hesitancy, and response efficacy was the strongest predictor (β = −0.560; p < .001). Vaccine hesitancy had a negative effect on vaccination behavior (β = −0.483; p < .001), and the model explained 23.4% variance of vaccination behavior.

Conclusions

This study demonstrates that the extended PMT model is efficient in explaining vaccine hesitancy. However, the predictive ability of vaccine hesitancy on vaccination behavior is limited.