Urban and Rural Disparities of Personal Health Behaviors and the Influencing Factors During the COVID-19 Outbreak in China: Based on an Extended IMB Model

Financial information security behavior in online banking

The ubiquitous use of information technology in modern life leads to many problems of financial information security. Such security issues could be due to users’ insecure behaviors during their financial transactions. The purpose of this study was to investigate the university teacher's financial information security behavior (FISB) and to examine the factors that influence their FISB. By using a survey method, the study collected primary data quantitatively. A closed-ended questionnaire based on IMB Model (Information Motivation Behavioral Skills Model) was developed. The population of the study comprised teachers from six faculties of University of the Punjab, Lahore, Pakistan. A simple random sampling technique was used to collect the data from the teachers via a print-format based questionnaire. The structural equation model (SEM) was used to test the proposed model by using ADANCO (2.1). ADANCO is a software that is used for SEM analysis. The results exhibited that a majority of the teachers are frequent users of online banking. The findings confirmed that measures familiarity and self-efficacy have a direct impact on the financial information security behavior of the respondents and self-efficacy mediates the relation between threat awareness and financial information security behavior. The study concludes that online banking users can perform secure behavior during online transactions if they are familiar with security measures and are confident to perform different online banking-related tasks. It is, therefore, suggested that individuals may be familiarized with the financial information security measures so that they may believe in their selves and develop secure financial information behavior. This can be done through awareness seminars and hands-on training by the Federal Investigation Agency in liaison with banks and educational institutions. The present study has contributed to the domain of financial information security behavior in the local context.

Circulating Illness and Changes in Thermometer Use Behavior: Series of Cross-sectional Analyses

BACKGROUND

Temperature-taking behaviors vary with levels of circulating infectious illness; however, little is known about how these behaviors differ by demographic characteristics. Populations with higher perceived risks of illness are more likely to adopt protective health behaviors.

OBJECTIVE

We investigated differences in temperature-taking frequency and the proportion of readings that were feverish among demographic groups (age, gender, urban/rural status) over influenza offseason; influenza season; and waves 1, 2, and 3 of the COVID-19 pandemic.

METHODS

Using data from smart thermometers collected from May 1, 2019, to February 28, 2021, across the United States, we calculated the frequency of temperature-taking and the proportion of temperature readings that were feverish. Mixed-effects negative binomial and mixed-effects logistic regression analyses were performed to identify demographic characteristics associated with temperature-taking frequency and the proportion of feverish readings, respectively. Separate models were fit over five study periods: influenza offseason (n=122,480), influenza season (n=174,191), wave 1 of COVID-19 (n=350,385), wave 2 (n=366,489), and wave 3 (n=391,578).

RESULTS

Both temperature-taking frequency and the proportion of feverish readings differed by study period (ANOVA P<.001) and were the highest during influenza season. During all periods, children aged 2-5 years and 6-11 years had significantly higher frequencies of temperature-taking than users aged 19-30 years, and children had the highest proportion of feverish readings of all age groups, after adjusting for covariates. During wave 1 of COVID-19, users over the age of 60 years had 1.79 times (95% CI 1.76-1.83) the rate of temperature-taking as users aged 19-30 years and 74% lower odds (95% CI 72%-75%) of a reading being feverish. Across all periods, men had significantly lower temperature-taking frequency and significantly higher odds of having a feverish reading compared to women. Users living in urban areas had significantly higher frequencies of temperature-taking than rural users during all periods, except wave 2 of COVID-19, and urban users had higher odds of a reading being feverish in all study periods except wave 1 of COVID-19.

CONCLUSIONS

Temperature-taking behavior and the proportion of readings that were feverish are associated with both population disease levels and individual demographic characteristics. Differences in the health behavior of temperature-taking may reflect changes in both perceived and actual illness risk. Specifically, older adults may have experienced an increase in perceived risk during the first three waves of COVID-19, leading to increased rates of temperature monitoring, even when their odds of fever were lower than those of younger adults. Men's perceived risk of circulating infectious illnesses such as influenza and COVID-19 may be lower than that of women, since men took their temperature less frequently and each temperature had a higher odds of being feverish across all study periods. Infectious disease surveillance should recognize and incorporate how behavior impacts illness monitoring and testing.

Compliance with Standard Precaution and Its Relationship with Views on Infection Control and Prevention Policy among Chinese University Students during the COVID-19 Pandemic

Background: COVID-19 has placed tremendous pressure on the global public health system and has changed daily life. Aim: To examine the relationships between the perceived threat, perceived stress, coping responses and infection control practices towards the COVID-19 pandemic among university students in China. Methods: Using a cross-sectional survey, 4392 students were recruited from six universities in two regions of China. Methods: Data were collected via an online platform using self-reported questionnaires. Hierarchical multiple regression analyses were performed to predict the variables on COVID-19 infection control practices. Results: Pearson correlation coefficients showed a significant negative relationship between perceived stress and COVID-19 infection control practices. A significant positive relationship was observed between wishful thinking and empathetic responding, and infection control practices. Hierarchical multiple regression analyses revealed that gender, geographical location, perceived stress and emotion-focused and relationship-focused coping responses were predictors of COVID-19 infection control practices. Conclusions: The findings suggest that university students displayed moderate levels of stress, using wishful thinking and empathetic responses as coping strategies. Counselling services should therefore emphasise reassurance and empathy. Male university students tended to be less compliant with social distancing. Both counselling and public health measures should recognise the importance of gender differences. Nurses should integrate these findings into future health programme planning and interventions.

The Impact of the COVID-19 Pandemic on the General Public in Urban and Rural Areas in Southern Japan

Urban and rural areas are situated in contrasting physical and social settings, which influence their levels of exposure as well as their preventive behaviors in response to the COVID-19 outbreak. The study investigated whether there were differences between the areas regarding the levels of difficulty and anxiety felt by the general public during the first wave of COVID-19 in April and May 2020. We conducted an online questionnaire in Fukuoka and Kumamoto Prefecture in southern Japan via a private research company and collected a total of 913 valid responses from individuals whose conditions of employment were affected by the coronavirus outbreak. Although urban areas experienced higher case rates compared to rural areas, ordinal logistic regression analysis revealed no significant differences between urban and rural respondents concerning the level of difficulty in routine life. The daily-life contents which made them feel difficult during the first wave also did not differ largely between the contrasting areas. Urban respondents appeared to have experienced a higher level of difficulty in finding an alternative job, but how respondents found one, if successful, did not differ between urban and rural areas. The area of residence played a role in explaining the level of anxiety toward being infected, especially when the anxiety-related questions involved relationships with neighbors. Rural respondents showed a significantly higher level of anxiety toward causing neighbors trouble and being criticized if infected. Respondents who were better embedded in their communities generally felt more anxious about being infected, regardless of whether they lived in urban or rural areas. Women and respondents with children were more likely affected by abnormal situations caused by the COVID-19 outbreak. Our study highlights the prevailing impact of the COVID-19 pandemic on the general public regardless of whether in urban or rural settings, as well as the potential contribution of social ties among people to protecting communities from infectious pathogens.

What Prompted the Adoption of Self-Protective Behaviors in Response to COVID-19? Evidence From Women Living in the Rural Areas of Western China

Background

Self-protective behaviors, such as handwashing and mask-wearing, are effective to reduce the spread of coronavirus disease (COVID-19), but few studies have focused on women living in rural areas who bear the brunt of the impacts of the pandemic due to their economic and social vulnerabilities. This study explores what prompted the adoption of self-protective behaviors in response to COVID-19 among women living in rural areas of western China.

Methods

The study sample consisted of 1,524 women from 116 townships across 10 counties in rural western China. We collected data in May and August 2020 on women's socioeconomic characteristics, exposure to COVID-19-related information, psychological response to COVID-19, and adoption of self-protective behaviors. Structural equation modeling (SEM) analyses were conducted to analyze the relations among the variables.

Results

During the lockdown, 1,221 (80.12%) of the 1,524 women in the study sample reported wearing a mask every time when they went outside and 1,021 (66.99%) reported handwashing with soap every time after they came home. Perceived efficacy had the strongest association with self-protective behaviors (β = 0.38; p < 0.001). Receiving public health guidance (β = 0.18; p < 0.001) was indirectly associated with more self-protective behaviors via greater perceived efficacy. Higher socioeconomic status was also directly associated with increased adoption of self-protective behaviors (β = 0.24; p < 0.001). Other variables, such as receiving surveillance and risk information, communication channels, perceived risks, and fear, were indirectly associated with the adoption of self-protective behaviors with smaller effect sizes (all β were lower than 0.10).

Conclusions

Not all women were able to adopt self-protective behaviors, such as mask-wearing and handwashing, during the COVID-19 pandemic in western China. To further encourage behavioral changes in response to public health crises, the government should develop clear and actionable guidelines and adopt targeted health communication strategies to reach the most disadvantaged groups of society. These findings may inform tailored responses to COVID-19 in other low- and middle-income countries.

Perception and practices towards Covid-19 amongst residents in Southern Nigeria

Background

Within a short duration, coronavirus disease 2019 (COVID-19) spread globally, affecting all facets of life and causing widespread panic. This study set out to assess the perception and practices towards COVID-19 of urban and rural residents in Akwa Ibom State, Nigeria.

Materials and Methods

A cross-sectional study design and multistaged sampling technique were used. Data were collected using an interviewer-administered questionnaire between October and December 2020. Scores assessing perception and practices were allocated and graded based on specific stratified demarcations. P < 0.05 was considered statistically significant.

Results

A total of 822 individuals from the selected households were interviewed (urban: 401, 48.8%; rural: 421, 51.2%). Majority of respondents urban (99.8%) and rural (97.9%) were aware of COVID-19. Most respondents had low risk-perception of COVID-19 (62.4%), with significantly more rural respondents having low-risk perception (70.6% rural vs. 54.0% urban). The general perception of COVID-19 amongst the respondents was good (79.2%) with no statistically significant difference between urban and rural residents. Most of the participants had good practices towards COVID-19, with significantly higher proportion of urban respondents having good practice (93.8%) compared to their rural counterparts (83.1%). Amongst rural residents, high-risk perception was associated with higher proportion of good practice (93.4%) compared to 84.5% of low-risk perception (P = 0.015).

Conclusions

The participants had high level of awareness, low risk perception, good general perception and good practices toward COVID-19. However, urban respondents showed better practices towards COVID-19. More attention should be directed towards improving COVID-19 perception and practices particularly amongst rural residents.

Urban-Rural Differences in Patterns and Associated Factors of Multimorbidity Among Older Adults in China: A Cross-Sectional Study Based on Apriori Algorithm and Multinomial Logistic Regression

Introduction: Multimorbidity has become one of the key issues in the public health sector. This study aimed to explore the urban–rural differences in patterns and associated factors of multimorbidity in China and to provide scientific reference for the development of health management strategies to reduce health inequality between urban and rural areas.

Methods: A cross-sectional study, which used a multi-stage random sampling method, was conducted effectively among 3,250 participants in the Shanxi province of China. The chi-square test was used to compare the prevalence of chronic diseases among older adults with different demographic characteristics. The Apriori algorithm and multinomial logistic regression were used to explore the patterns and associated factors of multimorbidity among older adults, respectively.

Results: The findings showed that 30.3% of older adults reported multimorbidity, with significantly higher proportions in rural areas. Among urban older adults, 10 binary chronic disease combinations with strong association strength were obtained. In addition, 11 binary chronic disease combinations and three ternary chronic disease combinations with strong association strength were obtained among rural older adults. In rural and urban areas, there is a large gap in patterns and factors associated with multimorbidity.

Conclusions: Multimorbidity was prevalent among older adults, which patterns mainly consisted of two or three chronic diseases. The patterns and associated factors of multimorbidity varied from urban to rural regions. Expanding the study of urban–rural differences in multimorbidity will help the country formulate more reasonable public health policies to maximize the benefits of medical services for all.

Repercussions of the COVID-19 Response in Pregnant Women in Western Uganda: Knowledge, Behavior, and Emotional State after the First Lockdown in 2020

Limited research exists on pregnant women's knowledge, attitudes, and behavior concerning COVID-19 in sub-Saharan Africa. We performed a cross-sectional study among 648 pregnant women in Fort Portal, Uganda, after the first lockdown starting in June 2020. Structured interviews were conducted at three different facilities during routine antenatal care, assessing sociodemographic background, knowledge of COVID-19, prevention behavior adherence, and psycho-emotional stress levels. We performed descriptive analyses and examined associated factors using multivariable logistic regression. In Fort Portal Region, 32.8% of pregnant women had a higher knowledge regarding the COVID-19 pandemic, while all women at least heard of COVID-19. 88.6% of the women showed low self-reported prevention behavior adherence. More than one third of the pregnant women experienced high psycho-emotional stress related to the pandemic (39.8%). The odds for psycho-emotional stress were increased among the age group 21-30 years (AOR 1.97; 95% CI 1.18-3.35) compared to women under the age of 21, and decreased in single or divorced women compared to women in partnerships (AOR 0.42; 0.22-0.77) and in women having less COVID-19-related knowledge (AOR 0.40; 0.27-0.58). In conclusion, prevention behavior adherence seemed challenging, and psycho-emotional stress was ubiquitous among our cohort. To avoid adverse consequences in maternal and neonatal health, campaigns for hygiene but also women's emotional state should be a major focus of community healthcare in exceptional times such as the SARS-CoV-2 pandemic.

Study on the Experience of Public Health System Construction in China's COVID-19 Prevention

Background: China's experience in the process of COVID-19 prevention provides a reference for other countries in the world. This article studied the experience of public health system construction in China's COVID-19 prevention. Methods: Based on literature review and theoretical analysis, this paper constructs a theoretical framework of national public health system construction in health crisis. Based on this theoretical framework, combined with the policies and measures formulated by the Chinese government in the process of COVID-19 prevention, this article evaluate the advantages and deficiencies of China's public health system construction in response to COVID-19. Results: The Chinese government ensured the adequate supply of health resources, improved people's ability to pay medical expenses, and adopted advanced public health propaganda methods based on the Internet to help people grasp the basic information and development trend of COVID-19 in the process of COVID-19 prevention. At the same time, the utilization efficiency of health resources was low in China, people's ability to pay for medical expenses was unequal, and the disclosure of virus information in the early stage of the outbreak of COVID-19 is not timely. Conclusions: Other countries can learn from the advantages of China's public health system construction and avoid China's deficiencies in the process of public health system construction, which will help them improve the efficiency of COVID-19 prevention.