Public engagement with emerging infectious disease: The case of MRSA in Britain

COVID-19 and Masking Disparities: Qualitative Analysis of Trust on the CDC's Facebook Page

This exploratory paper examines individual levels of risk assessment as impacting institutional trust in the CDC while also contributing to disparities in expressed willingness to mask early in the COVID-19 pandemic. Using both content and thematic analysis of the CDC's Facebook (FB) page from April 2020 and Gidden's modern risk society theory, I consider how social media (SM) users retrospectively perceived a dramatic change in public health (PH) advisory-from the CDC advising against masking in February 2020 (Time 1) to advising the use of "do-it-yourself" (DIY) cloth masking in April 2020 (Time 2)-through a lens of prior, self-guided research. Expressed "knowledge" of masking as preventative (or not) yielded unwavering and sometimes increasing distrust in the CDC based on user perception of the "correct" advisory, regardless of the CDC's position at Time 1 or Time 2. Simultaneously, disparities in masking behaviors appeared to be driven not by CDC guidance but by this same self-guided research. I show this via three themes: (1) claims of ineffectiveness for DIY masking (do not trust CDC now-no masking from the start); (2) conflict between the first and second CDC advisories on masking (do not trust CDC-either already masking anyway or will now); (3) disappointed in the CDC for length of time taken to make a DIY mask recommendation (do not trust CDC-either already masking anyway or will mask now). I discuss the imperative nature of two-way engagement with SM users by PH rather than using SM as a one-way mode of advisory dissemination. This and other recommendations may decrease disparities in preventative behaviors based on individual-level risk assessment as well as increase institutional trust and transparency.

"I think I might be a bit wobbly in my corona moral" - young people's moral functioning during the COVID-19 lockdown: A social representations approach

In this paper, we use social representations theory to examine how young people made sense of COVID-19 and the emergent behavioral guidelines during the lockdown in Denmark in Spring 2020. Further, we discuss how this informed their moral functioning. This research is explored through triangulation, investigating how COVID-19 was represented in central speeches by Danish leaders (N = 4) and by young people in focus groups (n = 5, N = 25) and individual interviews (N = 10). Results suggest that young people's moral functioning during COVID-19 depended on multiple, often polemic, representations. Consequently, their moral functioning was found to be an ambivalent practice, resulting in coping strategies of adaptation to their surroundings and othering fellow citizens deviating from the guidelines. In this context, coherent communication by authorities and community values are identified as key to promoting behavior change. As the social impact of COVID-19 is unprecedented in many societies, including the Danish, this study contributes to the field of emerging infectious diseases providing insights that are essential for the continued management of this and future pandemics.

How the home features in young adults' representations of loneliness: The impact of COVID-19

Loneliness is a rapidly growing problem globally and has attracted a great deal of attention in light of the COVID-19 pandemic. Young adults, and in particular, those residing in deprived areas are currently the loneliest group in the United Kingdom. Utilizing a novel-free association technique, young adults' experiences of loneliness were explored both prior to (n = 48) and during (n = 35) the COVID-19 pandemic. Drawing on social representations theory, a thematic analysis revealed that many young adults associated the experience of loneliness with their homes. Therefore, this comparative study aims to investigate how the home features in young adults' representations of loneliness, prior to and during the COVID-19 pandemic using a systematic qualitative methodology. Three salient themes emerged from the data in both periods: 'The Lonely Home,' 'The Socially Connected Home' and 'The Safe, Peaceful, Authentic Home'. 'The Lonely Home' and 'The Socially Connected Home' emerged as a dialogical antimony. Representations of home were similar across the two periods; however, there were some notable differences. In particular, the themes 'The Socially Connected Home' and 'The Safe, Peaceful, Authentic Home' were less frequently mentioned by the during-COVID-19 sample where the 'The Lonely Home' was more frequently mentioned by the during-COVID-19 sample. Overall, discussion of the home was more negatively valenced in the during-COVID-19 sample compared to the pre-COVID-19 sample. This comparative, exploratory study alerts us to the nature of the role that home plays in exacerbating or ameliorating loneliness both prior to and during the COVID-19 pandemic.

Impact of infectious disease epidemics on xenophobia: a systematic review

•

Xenophobia has a significant impact on the health of international migrants.

•

During an infectious disease outbreak, stigma and prejudice are highly pronounced.

•

Migrants, often seen as disease carriers, are socially rejected during epidemics.

•

Ensure an equal treatment and healthcare assistance for migrants is imperative.

•

Educational interventions are urgently needed to prevent xenophobic tendencies.

Background Globally, xenophobia towards out-groups is frequently increased in times of economic and political instability, such as in infectious disease outbreaks. This systematic review aims to: (1) assess the xenophobic attitudes and behaviors towards migrants during disease outbreaks; and (2) identify adverse health outcomes linked to xenophobia. Methods We searched nine scientific databases to identify studies measuring xenophobic tendencies towards international migrants during disease outbreaks and evaluated the resulting adverse health effects. Results Eighteen articles were included in the review. The findings were grouped into: (1) xenophobia-related outcomes, including social exclusion, out-group avoidance, support for exclusionary health policies, othering, and germ aversion; and (2) mental health problems, such as anxiety and fear. Depending on the disease outbreak, different migrant populations were negatively affected, particularly Asians, Africans, and Latino people. Factors such as perceived vulnerability to disease, disgust sensitivity, medical mistrust individualism, collectivism, disease salience, social representation of disease and beliefs in different origins of disease were associated with xenophobia. Conclusions Overall, migrants can be a vulnerable population frequently blamed for spreading disease, promoting irrational fear, worry and stigma in various forms, thus leading to health inequities worldwide. It is urgent that societies adopt effective support strategies to combat xenophobia and structural forms of discrimination against migrants.

Coping with COVID-19: social representations underlying blaming processes and fear

Objective. This study examines how people socially represent the COVID-19 pandemic in the early stage of the health crisis in Europe. Specifically, this research analyses the days before and immediately after the declaration of the state of emergency in Spain, which resulted in the entire population being placed in lockdown. Design. For this purpose, we used the Grid Elaboration Method for free association elicited by the word "coronavirus". This exercise was completed by 1037 people from Spain. Main Outcome Measures. Responses were analysed using Iramuteq software for lexical analysis. Results. Before the state of emergency and lockdown, there was a repeat of many of the emotional and cognitive patterns seen in previous pandemics such us upward and downward blaming or feelings of anger and emotional fatigue. However, outward blaming patterns towards peers also emerged. Moreover, in the period following lockdown, we noted the emergence of new representations and emotions such as paralyzing distrust or resilience. Similarity analysis revealed that the "fear of pandemic" hides a wide variety of emotions. Conclusion. Understanding the blaming and fear processes that are linked to the emergence of the COVID-19 pandemic in Spain offers us practical implications for coping with the challenge of this new crisis.

Exploring the Motivation Behind Discrimination and Stigmatization Related to COVID-19: A Social Psychological Discussion Based on the Main Theoretical Explanations

The novel coronavirus (COVID-19), was first detected in Wuhan province in China during late December 2019 and was designated as being highly infectious. The World Health Organization (WHO) labeled it a "pandemic" on March 11, 2020. Throughout human history, experience has shown that prejudices and viruses spread simultaneously during a viral pandemic. Outgroup members have been associated with various diseases and non-human vectors of diseases. Some epidemics have been named according to various outgroups, just as the novel coronavirus has been referred to by some as the "Wuhan virus" or the "Chinese virus." Associating a virus with a sociodemographic group builds a false illusionary correlation, which can lead to stigmatization and discrimination. Pandemics can also stimulate violent xenophobic reactions. Besides the obvious harmful consequences for the individuals targeted, pandemic-related discrimination also affects the spread of the virus through its effect on public attitudes toward prevention and restriction, health service procurement, and in the establishment of health-related policies. It is important to first understand the relevant concepts and processes, and also to understand the underlying causes of discrimination in order to fight it. Social psychology offers multidimensional and comprehensive explanations of prejudice and discrimination. This review's primary aim was to examine the motivations behind COVID-19-related discrimination based on social psychological perspectives. In line with this aim, the review first defines discrimination in detail, plus the related concepts and main social psychological theories on prejudice and discrimination. Then, pandemic-related discrimination in light of past experiences is discussed and explanations put forward for the theoretical perspectives and inferences specific to COVID-19. Finally, recommendations are made in order to prevent and combat discrimination related to infectious diseases.

Risk society online: Zika virus, social media and distrust in the Centers for Disease Control and Prevention

While social construction of illness research has examined the redefinition of medically defined illness as non-illness by laypersons, nothing has considered this process alongside emerging infectious diseases (EIDs). Using Gidden's notion of modern risk society and distrust in expert authority, this paper examines how social media posts construct Zika virus as nonhazardous while displaying a distrust in research and prevention. Using qualitative content analysis, we examine 801 posts on the Centers for Disease Control and Prevention's (CDC) Facebook page to highlight the interplay between risk, the social construction of Zika and trust in experts. Three themes are discussed, including Zika: (i) as legitimate public health threat; (ii) as product of CDC corruption and (iii) used to question medical expertise. We find the latter two themes supportive of Gidden's focus on risk and distrust in expert authority and discuss the danger of constructing EIDs as products of corrupt expert authority on public health social media platforms.

Using Visual Metaphors in Health Messages: A Strategy to Increase Effectiveness for Mental Illness Communication

Depression is highly prevalent among college students. Although treatment is often available on university campuses, many stigma-based barriers prevent students from seeking help. Communication strategies, such as the use of metaphors, are needed to reduce barriers. Specially, the use of visual metaphors, as a strategic message design tactic, may be an effective communication strategy to increase message appeal and engagement. Using a 2-phase approach, this study first identified common metaphors students use to conceptualize mental illness. Messages incorporating conceptual and visual metaphors were then designed and tested to determine their potential in reducing stigma. Participants (n = 256) were randomly assigned to 1 of 4 conditions in a between-subjects experiment: messages with visual and textual metaphors, messages with straightforward visuals and textual metaphors, text-based metaphor messages, or a control group. Overall, metaphorical messages are appealing, the use of visual metaphors leads to greater message engagement, and messages based on conceptual metaphors have the potential to reduce stigma. The use of conceptual and visual metaphors in campaign design is an effective strategy to communicate about a complex health topic, such as mental illness, and should be considered for use in campaigns to reduce barriers for help-seeking behavior.

Understanding an Ebola outbreak: Social representations of emerging infectious diseases

This study examined the collective image of the 2014-2015 Ebola outbreak, to understand how people incorporate this epidemic in their everyday thinking. A free association exercise elicited by Ebola was answered by 294 people from Spain and the content was analysed using Alceste software. First, results showed that Ebola was represented as inherently African. Second, it was also depicted as a global threat creating fear. People also felt anger, and they blamed political authorities and the mass media for the failure to manage this crisis. Finally, this research underlines the importance of the social representations to understand how current outbreaks are cognitively represented and emotionally faced as a key factor to appropriately manage future epidemics.

Advocating for a Population-Specific Health Literacy for People With Visual Impairments

Health literacy, the ability to access, process, and understand health information, is enhanced by the visual senses among people who are typically sighted. Emotions, meaning, speed of knowledge transfer, level of attention, and degree of relevance are all manipulated by the visual design of health information when people can see. When consumers of health information are blind or visually impaired, they access, process, and understand their health information in a multitude of methods using a variety of accommodations depending upon their severity and type of impairment. They are taught, or they learn how, to accommodate their differences by using alternative sensory experiences and interpretations. In this article, we argue that due to the unique and powerful aspects of visual learning and due to the differences in knowledge creation when people are not visually oriented, health literacy must be considered a unique construct for people with visual impairment, which requires a distinctive theoretical basis for determining the impact of their mind-constructed representations of health.

Free Association in Psychology and the Grid Elaboration Method

This article traces the history of free association in psychoanalysis, cognitive psychology, and social psychology and builds on these traditions to develop a novel research method for eliciting how people think and feel about social and personal issues. These range from climate change to pandemics, from earthquakes to urban living. The method, termed the grid elaboration method (GEM), is distinctive in tapping the naturalistic thoughts and feelings that people hold in relation to such issues. It provides an instrument that elicits ecologically valid material that minimizes the interference of the investigator's perspective. A further aspect of the method is that it taps chains of association that are often emotive and implicit in nature, in keeping with current trends in psychological research. These facets are elaborated in this article, with reference to an exploration of the history of free association methodologies in psychology. The efficacy of the method is demonstrated using examples drawn from recent empirical work utilizing the GEM in a variety of domains. The method is evaluated, with areas for future exploration elucidated.

Salient beliefs about earthquake hazards and household preparedness

Prior research has found little or no direct link between beliefs about earthquake risk and household preparedness. Furthermore, only limited work has been conducted on how people's beliefs influence the nature and number of preparedness measures adopted. To address this gap, 48 qualitative interviews were undertaken with residents in three urban locations in New Zealand subject to seismic risk. The study aimed to identify the diverse hazard and preparedness-related beliefs people hold and to articulate how these are influenced by public education to encourage preparedness. The study also explored how beliefs and competencies at personal, social, and environmental levels interact to influence people's risk management choices. Three main categories of beliefs were found: hazard beliefs; preparedness beliefs; and personal beliefs. Several salient beliefs found previously to influence the preparedness process were confirmed by this study, including beliefs related to earthquakes being an inevitable and imminent threat, self-efficacy, outcome expectancy, personal responsibility, responsibility for others, and beliefs related to denial, fatalism, normalization bias, and optimistic bias. New salient beliefs were also identified (e.g., preparedness being a "way of life"), as well as insight into how some of these beliefs interact within the wider informational and societal context.

Public apprehension of emerging infectious diseases: are changes afoot?

Using social representations theory this paper casts light on the pattern of content that characterises the public response to emerging and re-emerging infectious diseases (EID). The pattern is: distancing the disease from the self/ one's in-groups; blame of particular entities for the disease's origin and/or spread; and stigmatisation of those who have contracted it and/or who are represented as having intensified its spread. This pattern is not unique to EID but extends to many risks, making EID fruitful events for understanding public apprehension of potential dangers. This process may be driven by worry, fear and anxiety since when levels of these are low, as has arguably been the case with the 2009/10 "Swine Flu" pandemic, the pattern transforms. The distancing-blame-stigma pattern may also be transformed by growing reflexivity, a feature of late modern societies, as well as material features of the epidemic and "EID fatigue".