Protective Behavior against COVID-19 among the Public in Kuwait: An Examination of the Protection Motivation Theory, Trust in Government, and Sociodemographic Factors

The causal relationship model of factors influencing COVID-19 preventive behaviors during the post-pandemic era and implications for health prevention strategies: a case of Bangkok City, Thailand

BACKGROUND

Though, many countries are currently in the COVID post-pandemic era, people's health protective behaviours are still essential to protect their health and well-being. This study aims to evaluate people's understanding and perceptions of COVID-19 risk characteristics (i.e. threat occurrence, threat severity, perceived susceptibility and exposure), the health risk perception towards COVID-19, and health protective behaviours. The study also aims to estimate the associations among these factors by the analysis of structural equation modelling (SEM).

METHODS

From 15 October to 9 November 2022, questionnaire surveys were administrated to 521 people living in Bangkok of Thailand by using the convenience sampling technique. The analyses were carried out in three phases including descriptive statistical analyses, a measurement model assessment using a confirmatory factor analysis (CFA), and structural equation modelling (SEM) analysis.

RESULTS

The results of descriptive analyses demonstrated that the majority of respondents, 39.9%, had the age between 20 and 30 years old, and 61.4% of them were female. Approximately 52.1% of them had a bachelor's degree. Upon analysing individuals' understanding and perceptions of all risk characteristics, individuals' understanding of COVID-19 severity did not statistically affect health risk perception towards COVID-19, whereas perceived exposure had the strongest effect and in turn influenced health protective behaviours. Perceived susceptibility and understanding of the threat occurrence also significantly affected health risk perception, and indirectly affected health protective behaviours.

CONCLUSIONS

This study implies that though the potential health impact of COVID-19 is perceived as less severe, people can still construct a perception of its risk particularly based on their perceived exposure and susceptibility. Thus, communicating people about exposure conditions and susceptibility can greatly contribute to people' construction of risk perception towards COVID-19 which subsequently leads to the decision to perform health protective behaviours.

Social Vulnerability and Compliance With World Health Organization Advice on Protective Behaviors Against COVID-19 in African and Asia Pacific Countries: Factor Analysis to Develop a Social Vulnerability Index

BACKGROUND

COVID-19 protective behaviors are key interventions advised by the World Health Organization (WHO) to prevent COVID-19 transmission. However, achieving compliance with this advice is often challenging, particularly among socially vulnerable groups.

OBJECTIVE

We developed a social vulnerability index (SVI) to predict individuals' propensity to adhere to the WHO advice on protective behaviors against COVID-19 and identify changes in social vulnerability as Omicron evolved in African countries between January 2022 and August 2022 and Asia Pacific countries between August 2021 and June 2022.

METHODS

In African countries, baseline data were collected from 14 countries (n=15,375) during the first Omicron wave, and follow-up data were collected from 7 countries (n=7179) after the wave. In Asia Pacific countries, baseline data were collected from 14 countries (n=12,866) before the first Omicron wave, and follow-up data were collected from 9 countries (n=8737) after the wave. Countries' socioeconomic and health profiles were retrieved from relevant databases. To construct the SVI for each of the 4 data sets, variables associated with COVID-19 protective behaviors were included in a factor analysis using polychoric correlation with varimax rotation. Influential factors were adjusted for cardinality, summed, and min-max normalized from 0 to 1 (most to least vulnerable). Scores for compliance with the WHO advice were calculated using individuals' self-reported protective behaviors against COVID-19. Multiple linear regression analyses were used to assess the associations between the SVI and scores for compliance to WHO advice to validate the index.

RESULTS

In Africa, factors contributing to social vulnerability included literacy and media use, trust in health care workers and government, and country income and infrastructure. In Asia Pacific, social vulnerability was determined by literacy, country income and infrastructure, and population density. The index was associated with compliance with the WHO advice in both time points in African countries but only during the follow-up period in Asia Pacific countries. At baseline, the index values in African countries ranged from 0.00 to 0.31 in 13 countries, with 1 country having an index value of 1.00. The index values in Asia Pacific countries ranged from 0.00 to 0.23 in 12 countries, with 2 countries having index values of 0.79 and 1.00. During the follow-up phase, the index values decreased in 6 of 7 African countries and the 2 most vulnerable Asia Pacific countries. The index values of the least vulnerable countries remained unchanged in both regions.

CONCLUSIONS

In both regions, significant inequalities in social vulnerability to compliance with WHO advice were observed at baseline, and the gaps became larger after the first Omicron wave. Understanding the dimensions that influence social vulnerability to protective behaviors against COVID-19 may underpin targeted interventions to enhance compliance with WHO recommendations and mitigate the impact of future pandemics among vulnerable groups.

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.

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.

Effect of educational intervention based on protection motivation theory on preventive behaviors of respiratory infections among hospital staff

Background

Hospital staff represent a vulnerable population for respiratory diseases. Consequently, the implementation of training programs becomes imperative as a preventive measure against such infections in these populations. The current study was conducted to examine the impact of an educational intervention based on the Protection Motivation Theory (PMT) on preventive behaviors for respiratory infections among a group of hospital staff.

Methods

This experimental study involves a sample of 150 hospital staff from Gachsaran City, Iran, in 2021-2022. The sampling technique involved the utilization of a random assignment approach to allocate individuals into two distinct groups: the experimental group, consisting of 75 participants, and the control group, also including 75 individuals. The data collection instrument was a questionnaire designed in accordance with the PMT. This questionnaire was administered to both the experimental and control groups prior to the intervention as well as two months following the intervention. The intervention program consisted of a total of five sessions, each lasting for 60 min, for the experimental group. These sessions were conducted on a weekly basis over a period of two and a half months. Specifically, there were two sessions held every month and one session held every two weeks. Following the completion of the program, the data was entered into SPSS-24 statistical software for analysis using paired t-tests, independent t-tests, and chi-square tests.

Results

The results indicated that prior to the intervention, there was no significant difference between the two groups in terms of perceived vulnerability constructs (p = 0.25), perceived severity (p = 0.63), perceived response (p = 0.32), and perceived reward (p = 0.11). Besides, there was no considerable distinction in perceived self-efficacy (p = 0.84), perceived response cost (p = 0.33), fear (p = 0.45), behavior motivation (p = 0.51), knowledge (p = 92), or vaccination behavior (p = 0.12) before the educational intervention. However, a significant change was noticed in each of the mentioned variables between the two groups after the intervention (p < 0.05).

Conclusion

The results of this study indicated that the implementation of an educational intervention grounded in the PMT yields positive outcomes in enhancing preventative behaviors pertaining to respiratory infections. Hence, it is recommended to utilize an intervention grounded in this theory among hospital staff as a viable approach to mitigating the occurrence of respiratory infections.

Association of COVID-19 information media, providers, and content with vaccine uptake among Tokyo residents

To elucidate appropriate ways to induce behavior that prevents the spread of infection, we examined the association between COVID-19 vaccination and COVID-19-related information after more than 85% of the population had been vaccinated. Nonprobability quota sampling was used to recruit 2000 Tokyo residents as participants. The association between previous vaccine uptake and how much people thought they were affected by each of nine media, seven providers, and four content types of information was assessed using an online survey form. Subjective influence was assessed, and order logistic regression analyses were performed. We further calculated standardized partial regression coefficients for the independent variables. The results showed that while people did not think they were strongly affected by any COVID-19 information, significant positive associations between 9 of 20 variables, and significant negative associations between 7 of 20 variables were observed with vaccine uptake. The regression analysis involving the interaction terms between independent variables and sex showed a significant association between vaccine uptake and only daily conversation. Simple slope analysis showed a stronger positive association for females than for males. Regression analysis with interaction terms between each independent variable and age showed a significant association between vaccine uptake and print newspapers, social networking services, prefectural governors, family/relatives, accessibility, side effects, and supply visibility. Simple slope analysis also showed that the positive association between the subjective influence of newspapers and vaccine uptake was observed only for older people (≥69 years), and that of prefectural governors was more significant for older than younger people (≤32 years). In contrast, the trustworthy information provided by family/relatives was positively associated with vaccine uptake only for younger people. These results suggest that careful consideration must be given to the differences in age and sex to provide appropriate information that motivates Tokyo residents to receive vaccination during COVID-19 pandemic.

Personal protective behaviors in response to COVID-19: a longitudinal application of protection motivation theory

Introduction

Disease outbreaks are expected to occur more frequently and spread more rapidly in the age of globalization. Personal protective behaviors strongly affect infection and death rates worldwide. It is therefore of prime importance to better understand which factors predict personal protective behaviors during a pandemic. Protection motivation theory (PMT) proposes that people's motivation to protect themselves is based on two appraisal processes: threat appraisal and coping appraisal. Building on PMT, this longitudinal study aimed to predict personal protective behaviors in response to COVID-19, including hand hygiene, physical distancing, and mask wearing.

Method

In the first wave of the study (November, 2020), the two appraisal processes as specified in PMT as well as intentions to perform protective behaviors were assessed in a representative sample of German adults (N = 328). In the second wave of this study, which was conducted one month later, the frequency of protective behaviors was measured. Structural equation modeling was used to test whether threat and coping appraisal predicted intentions and protective behaviors.

Results

Response rate for the second wave was high (87%). For all three behaviors, self-efficacy predicted intentions and also indirectly behavior (i.e., mediated via intentions). Furthermore, exploratory tests of alternative theoretical models suggested that both self-efficacy and costs have direct effects (i.e., independent from their relationship with intentions) on performed behavior.

Conclusion

To support individuals to engage in protective behaviors during a pandemic, it is important to reduce barriers to action and to foster individuals' self-efficacy.

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

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

Association between trust in COVID-19 information sources and engaging in infection prevention behaviors in Japan: A longitudinal study

OBJECTIVE

We examined changes in people's trust in information sources in Japan during the COVID-19 pandemic over the course of 1 year and investigated longitudinal associations between trust in such sources and engaging in infection prevention behaviors.

METHODS

We conducted a longitudinal survey of Japanese populations under a declared state of emergency at two time points, August 2020 and August 2021. We surveyed sociodemographic data, seven Trust in COVID-19 information sources and six COVID-19 preventive behaviors.

RESULTS

In all, 784 participants completed the two surveys. Physicians were the most consistently trusted information source over the 1-year period. We identified three preventive behaviors that were positively associated with trust in physicians as an information source (social distancing, wearing masks, and washing hands with soap), four preventive behaviors that were positively associated with trusting infected patients (social distancing, using ventilation, wearing masks, and using hand sanitizer), and one preventative behavior that was negatively associated with trust in government (avoiding closed spaces).

CONCLUSION

In the ongoing pandemic, information from physicians and patients may encourage people to engage in long-term preventive behaviors.

PRACTICE IMPLICATIONS

Physicians and patients should be promoted as trusted and behavior influencing sources of information during the pandemic.

Threat Appraisal, Resilience, and Health Behaviors in Recovered COVID-19 Patients: The Serial Mediation of Coping and Meaning-Making

Research indicates that both cognitive appraisal and personal resources can noticeably influence health behaviors, as individuals modify their health convictions and practices on the basis of threat appraisal, personality, and meaning. The aim of the current study was to investigate whether coping strategies and meaning-making can serially mediate the relationship of threat appraisal and resilience with health behaviors in recovered COVID-19 patients. Self-report measures of threat appraisal, resilience, coping, meaning-making, and health behaviors were completed by 266 participants (aged 17 to 78, 51.5% female) who had recovered from COVID-19. The serial mediation analysis showed that the relationship of threat appraisal and resilience with health behaviors was mediated by problem-focused coping, meaning-focused coping, and meaning-making, but not by emotion-focused coping. These results suggest that associations among threat perception, resilience, and health behavior depend to some extent on the interplay of coping and meaning-making, which reveals their unique role in the process of recovery from COVID-19, with potential implications for health interventions.

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

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

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.

Survey on public awareness, attitudes and self-protective behavior adoption in different periods of COVID-19

Introduction

The outbreak and spread of the pandemics have been an issue of critical concern globally, posing a significant threat to the health sector globally. This study aimed to examine the basic knowledge and attitudes toward the recommended protective measures at different times, respond to the COVID-19 pandemic, and provide recommendations for developing targeted strategies and measures for preventing and controlling public health emergencies.

Methods

The study used self-filled questionnaires to examine the public's knowledge, attitudes, and practices on COVID-19 at two different period, from 20 to 31 March 2020 (the beginning period) and 22-27 April 2022 (the regular epidemic prevention and control period). Descriptive and quantitative analyses were used for statistical analysis.

Results and discussion

The survey collected 2375 valid questionnaires. A comparison of the two periods reveals that as the epidemic continued over a long period, the level of knowledge, attitudes toward preventive measures, risk perceptions, and adoption behavior of the respondents at the beginning of the epidemic were significantly higher than during the regular epidemic prevention and control period. With the upsurge in the spread of the epidemic, the public needs a multi-channel, targeted, and all-round guidance and information on prevention and control of the COVID-19, and internalizes knowledge into individual's behavior of actively responding to diseases.When the epidemic lasts for a long time, the relevant agencies should strengthen their monitoring role to promote public compliance with the recommended measures.

Associations between Vaccination Behavior and Trust in Information Sources Regarding COVID-19 Vaccines under Emergency Approval in Japan: A Cross-Sectional Study

We examined the association between COVID-19 vaccination behavior and trust in COVID-19-related information sources during the initial period of COVID-19 vaccination in Japan. A cross-sectional survey was conducted in August 2021, 5 months after the start of COVID-19 vaccination for the general public under emergency approval. Participants were recruited using non-probability quota sampling from among Japanese residents who were under a declared state of emergency. Sociodemographic data, vaccination behavior, and levels of trust in eight media sources of information and three interpersonal information sources were assessed using an online survey form. A total of 784 participants completed the survey. The results of multiple logistic regression analysis showed that age, household income, underlying medical conditions, and living with family were significantly associated with COVID-19 vaccination behavior. Regarding COVID-19 vaccine information sources, trust in public health experts as a source of media information and primary care physicians as a source of interpersonal information showed significantly positive associations with COVID-19 vaccination behavior (odds ratio [OR] = 1.157, 95% confidence interval [CI] 1.017-1.31; OR = 1.076; 95% CI 1.006-1.150, respectively). Increasing trust in public health experts and primary care physicians and disseminating vaccine information from these sources will help promote vaccination under emergency approval.

Impact of media trust and personal epidemic experience on epidemic prevention behaviors in the context of COVID-19: A cross-sectional study based on protection motivation theory

Objective

This study aimed to elucidate the impact of media trust on epidemic prevention motivation and behaviors based on the Protection Motivation Theory (PMT) and to evaluate the moderation effect of personal epidemic experience, which focused on the differences in two groups with or without epidemic experience.

Methods

The exogenous constructs and PMT model and scale were constructed through literature analysis, and a web-based questionnaire survey was conducted among 428 individuals aged above 18 years in China. Statistical analysis and hypothesis testing were performed in SPSS 26 and SmartPLS 3.

Results

Traditional media trust accounted for the largest weight in media trust (w = 0.492, p-value < 0.001), followed by social media (w = 0.463, p-value < 0.001), and interpersonal communication (w = 0.290, p-value < 0.001). Media trust was positively and significantly related to both threat appraisal (β = 0.210, p-value < 0.001) and coping appraisal (β = 0.260, p-value < 0.001). Threat appraisal (β = 0.105, p-value < 0.05) and coping appraisal (β = 0.545, p-value < 0.001) were positively and significantly related to epidemic prevention motivation, which positively and significantly related to epidemic prevention behaviors (β = 0.492, p-value < 0.001). The R² values of epidemic prevention motivation and behavior are 0.350 and 0.240, respectively, indicating an acceptable explanation. Multiple-group analysis revealed five significant differences in paths between the two groups, indicating personal epidemic experience acting as a slight moderator on these paths.

Conclusion

Traditional media trust and social media trust were the important elements in COVID-19 prevention and control, and public health departments and governments should ensure the accuracy and reliability of information from traditional and social media. Simultaneously, the media should balance threat information and efficacy information in order to generate the public's prevention motivation and behaviors.

Impact of mental health, job insecurity, and COVID-19 symptoms on protective behavior changes among White, Black, and other minorities in the US

INTRODUCTION

Job insecurity such as loss of jobs or reduced wages has become a serious social problem in the US since COVID-19 started. Combined with psychological distress and experience of COVID-19 symptoms, the changes of people's protective behaviors vary across states in the US.

METHODS

This research investigated racial differences in the COVID-19 related factors among White, Black, and other minorities in the US, and examined how mental health mediated the impact of job insecurity on protective behaviors, and how the COVID-19 symptoms moderated the mediation effect of mental health. The 731 valid responses in a cross-sectional survey from May 23 to 27, 2020, in the US were analyzed with independent sample t-tests, Pearson's chi-square tests, and path analysis.

RESULTS

The findings showed that there were significant differences in job insecurity and Nonpharmaceutical Interventions (NPIs) practice among White, Black, and other minorities. Job insecurity was significantly negatively associated with NPIs practice and was significantly positively associated with mental health. Mental health significantly partially mediated the effect of job insecurity on NPIs practice, in that job insecurity is a better predictor of NPIs practice for individuals with worse mental health than that for individuals with better mental health. Experience of COVID-19 symptoms moderates the mediation effect of mental health on the relationship between job insecurity and NPIs practice, in that mental health is a better predictor of NPIs practice for individuals with a higher experience of COVID-19 symptoms than for individuals with a lower experience of COVID-19 symptoms.

DISCUSSION

The findings in this study shed lights on psychological and behavioral studies of people's behavior changes during a pandemic. The study indicates the importance of treating mental health to promote protective behaviors during a pandemic, as well as advocating for employees by identifying the needs for those whose jobs were negatively impacted the most.

Trust and Coping Beliefs Contribute to Racial Disparities in COVID-19 Vaccination Intention

Racial disparities in intention to obtain the COVID-19 vaccination have been noted in academic and popular press reports. The present study sought to identify cognitive and affective factors that contribute to the observed lack of acceptance of COVID-19 vaccination, even before a vaccine was made publicly available, among Black and White Americans through a national survey (N = 487; 50.6% female, 24.8% Black). Our findings are consistent with previous studies that Black respondents had lower intention to obtain the eventual COVID-19 vaccine than White respondents. Protection motivation theory's construct of coping efficacy and an additional COVID-19-relevant variable, trust in vaccination, mediated the effect of race on behavioral intention. Lastly, beliefs were elicited from Black and White Americans to identify communication strategies regarding the issue.

Governance Efforts for TB-Friendly Village Development during the COVID-19 Pandemic: Lessons Learned from Depok City, West Java, Indonesia

BACKGROUND: In 2020, TB patients in Indonesia reached 8.5% of the total number of TB patients globally, as the country with the second-highest TB cases. Depok is the city in the West Java region that has experienced an increase in TB cases. The existence of tuberculosis-friendly villages will reduce the stigmatization of tuberculosis (TB) patients and increase treatment compliance. AIM: This study aims to analyze various aspects of Depok City’s readiness to develop TB-friendly village governance –– including government commitment, infrastructure, resources, and organizational culture –– within the scope of academic, business, community, government, and media (ABCGM)’s role or penta-helix. METHODS: The initial stage of preparation involved conducting a literature review. This research employed an online survey of 230 respondents and 40 TB patients using a quantitative approach. The qualitative approach involved 15 stakeholders through interviews, discussions, and a website-based search. RESULTS: Overall, the respondents were well-informed about TB, but attitudes (50.9%) and behavior (41.3%) regarding TB prevention need improvement. The government budget is adequate, but coordination is lacking between stakeholders and community involvement. CONCLUSION: Depok City is not yet ready to develop TB-friendly villages in terms of human resources and organizational aspects. It is necessary to improve communication, information, and education regarding TB prevention and establish leadership policies as a legal basis to strengthen the governance and management of TB-friendly villages. Moreover, community involvement is an essential pillar of developing these villages.

Understanding the Behavioral Intentions about Holidays in the Shadow of the COVID-19 Pandemic: Application of Protection Motivation Theory

The research aims to investigate the emotional response and protective behaviors of domestic tourists’ post-pandemic period and their holiday intentions or holiday avoidance behaviors. For this reason, understanding tourist behavior during and after significant tourism crises is critical for the recovery of the tourism industry. To achieve this aim, first, we examine the effects of perceived vulnerability and perceived severity factors in the threat appraisal of domestic tourists, the effects of the response efficacy, response cost, and self-efficacy factors in the coping appraisal, and the effects of fear and hope factors as the anticipatory emotion responses regarding protection motivation. Second, we measure the effect of protection motivation on the factors of taking a vacation and avoiding a vacation, which constitute behavioral intention. This study applies the health-related protection motivation theory to explore how domestic tourists’ behavioral intentions are influenced by Coronavirus disease (COVID-19) in the post-pandemic period. The study includes citizens residing in Türkiye who have had at least one-holiday experience in the last five years. Online questionnaire surveys were administered to 1391 domestic tourists. In the research, in addition to testing the validity and reliability of the scales, simple linear regression analysis was used to test the model based on the hypotheses experimentally. The results show that factors have internal consistency reliability, convergent validity, and discriminant validity. Response cost and hope variables are ineffective in predicting the protection motivation, and all other effect sizes (f2) are positive. All hypotheses have been supported. However, the response cost (β = −0.029, p > 0.05) has no effect on protection motivation, thus only one is rejected. As a result, domestic tourists would like to maintain the assurance of their health and safety during a holiday. An integrated model with protection motivation theory and different theories as theory of planned behavior should be implemented. As a result, this will provide a more comprehensive understanding of the complexity involved in the sustainable behavioral intentions in the post-COVID era.

Risk Perception, Media, and Ordinary People's Intention to Engage in Self-Protective Behaviors in the Early Stage of COVID-19 Pandemic in China

Objective

This study aims to examine how risk perception is associated with engagement in preventative behaviors and testing during the COVID-19 pandemic in the early stage of the COVID-19 pandemic in China.

Methods

A cross-sectional survey was conducted in February 2020, eventually obtaining 1613 participants, participants'risk perceptions, demographics (sex, age, education level, marital status, and employment status), as well as their engagement in self-protective behaviors and testing were assessed.

Results

Risk perception significantly affected intention to engage in self-protective behaviors, the more risk people feel, the more likely they intend to take self-protective actions(β =0.0423; P < 0.01), and simultaneously, people obtaining information on COVID-19 from Official microblogs and public accounts(OMPA) (β =0.189; P < 0.01)and Online websites(OW) (β =0.143; P < 0.1)were more inclined to take self-protective behaviors during the COVID-19 pandemic. It also showed that the interaction of risk perception and Online websites negatively affected the intention to engage in self-protective behaviors(β = -0.0374; P < 0.05), and conversely, the interaction of risk perception and Overseas media(OM) positively affected self-protective intention(β = 0.0423; P < 0.1).

Conclusion

There was a close relationship between the risk perception and the intention to engage in self-protective behaviors. At the same time, the use of media not only directly affected the intention to engage in self-protective behaviors but also moderated the impact of risk perception on the self-protection intention. Specifically, official media directly strengthened the intention to engage in self-protective behaviors. Online websites not only directly affected self-protection intention but also moderated the effect of risk perception on it. Although overseas media had no direct effect on self-protection intention, they moderated the effect of risk perception on it. These conclusions have policy implications for governments' response to the COVID-19 epidemic.

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.

Motivation for protection in sexual relationship during the COVID-19 quarantine: analysis of the sociodemographic variables of the Iranian population

Background

Coronavirus is an infectious disease that has affected sexual life. Sexual activity has decreased for many people, and couples' physical contact has reduced. The present study aimed to determine the sexual relationship of Iranian people and related factors during the Corona home quarantine by focusing on all constructs of the protective motivation theory.

Methods

This cross-sectional online survey was conducted on Iranian people under in-home quarantine from July to December 2020 during the Covid-19 pandemic. Seven hundred sixteen people were selected by the convenience sampling method. The data was gathered by an ad-hoc tool consisting of demographic information and sexual relationship regarding protection motivation behavior in the Covid-19 pandemic. Participants should be able to complete the online questionnaire because the questionnaires were completed online. One-way ANOVA, independent T, and Pearson correlation tests were used to analyze the data in SPSS 16 software.

Results

Findings indicate the average age of the participants was 37.78 + 8.34 years. Most of them were women (%85.1), married (%91.3) and had a university education (%90.2). In addition, %42.5% of participants had Full-time jobs and %34.2 lived in Tehran. 49.9% obtained information about corona from TV. 63.3% of the participants and their spouses did not catch Covid-19. Employment status was the only variable that was significantly different from sexual relationships regarding protection motivation (p = 0.031). Perceived response efficiency with an average of 79.12 had the highest, and perceived self-efficacy with an average of 69.92 had the lowest mean score among the areas of sexual relationship. Among the protection motivation domains of sexual behavior that all had significant correlations, there was no significant correlation between perceived severity and perceived self-efficacy (p = 0.067).

Conclusion and implication

Perceived vulnerability is associated with employment status, place of residence, and age. Sexual relationships regarding protection motivations are only associated with employment status. Overall, participants in the present study reported high levels of perceived severity, perceived vulnerability, perceived response efficiency, and perceived costs Therefore, they reported a high level of motivation for protective and preventive behaviors in their sexual relationship. Our findings suggest that future interventions should focus on general cognition by developing appropriate knowledge about the severity and vulnerability of Covid-19 and sexual behaviors, improving perceived response efficiency, and self-efficacy of protective behavior through skills training.

Condiciones de vulnerabilidad, sociodemográficas y clínicas de la población diagnosticada con COVID-19 incluida en la estrategia de atención primaria en salud del municipio de Mosquera 2020

Introducción: en diciembre de 2019 la Comisión Municipal de Salud y Sanidad de Wuhan, China, reportó 27 casos de neumonía de causa desconocida llegando a Colombia. Los municipios implementaron estrategias para minimizar contagios como lo hizo Mosquera, Cundinamarca, sin embargo no se conoció la caracterización de la población afectada por COVID-19. Objetivo: analizar las condiciones de vulnerabilidad, sociodemográficas y clínicas de la población con COVID-19 incluida en la estrategia de atención primaria en salud. Metodología: estudio cuantitativo, observacional, de corte transversal, retrospectivo, con análisis de condiciones de vulnerabilidad, características sociodemográficas y clínicas de la población diagnosticada con COVID-19 del municipio de Mosquera en la época de la pandemia durante el año 2020. Resultados: 4.610 casos positivos para COVID-19, 99% en la zona urbana, edad 5% entre 0-11 años, 4% entre 12-17 años, 21% entre 18-28 años, 59% entre 29-59 años y 12% más de 60 años. La población más afectada fueron adultos 58%, régimen contributivo 82% y mujeres 56%. Del total 73% fue sintomático, 92% no requirió hospitalización y la mayoría de los positivos tuvieron entre 2 a 3 contactos estrechos (29%), de los cuales 82% fue asintomático. Conclusiones: la pandemia por COVID-19 ha tenido impactos negativos desproporcionados en poblaciones desfavorecidas y desatendidas en todo el mundo. La desigualdad y los determinantes sociales relacionados que afectan a ciertos grupos, están en relación directamente con los resultados de salud adversos de las poblaciones vulnerables durante la pandemia.

Transit use reduction following COVID-19: The effect of threat appraisal, proactive coping and institutional trust

Transit systems suffered from a significant demand decrease during COVID-19. Understanding the psychological motivators underlying reduced transit use can help transit authorities and operators to take proactive action towards returning to the "new normal" and increasing their preparedness towards future pandemics. This study is based on the protection motivation theory to understand the effect of threat appraisal, and coping appraisal and denial mechanisms on transit use reduction for commuting. The behavioral framework is validated by a survey of 856 transit users in Israel during August 2020, three months after the end of the lockdown and before the vaccine administration. The results show that: i) Skepticism, risk ubiquity, and personal immunity beliefs lead to maladaptive threat appraisal; ii) wearing masks and social distancing are antecedents of fear of infection while using transit and reduced transit use; iii) higher perceived threat deters transit use, while trust in transit operators motivates transit use; and iv) in a franchised transit system, trust in transit operators depends on the perceived level-of-service and trust in the ability of government authorities to regulate, monitor and enforce transit operators' preventive and protective actions.

Covid-19 threat and coping: application of protection motivation theory to the pandemic experiences of people affected by amyotrophic lateral sclerosis

BACKGROUND

People with amyotrophic lateral sclerosis (ALS) are at high risk for severe outcomes from Covid-19 infection. Researchers exploring ALS and Covid-19 have focused primarily on system response and adaptation. Using Protection Motivation Theory, we investigated how people with ALS and family caregivers appraised and responded to Covid-19 threat, the 'costs' associated with pandemic response, and how health professionals and systems can better support people affected by ALS who are facing public health emergencies.

METHODS

Data were drawn from the 'ALS Talk Project,' an asynchronous, moderated focus group study. Participants were recruited from regions across Canada. Seven groups met online over 14 weeks between January and July 2020. Fifty-three participants contributed to Covid-19 discussions. Data were qualitatively analyzed using directed content analysis and the constant-comparative approach.

RESULTS

Participants learned about the Covid-19 pandemic from the media. They rapidly assessed their vulnerability and responded to Covid-19 threat by following recommendations from health authorities, information monitoring, and preparing for worst-case scenarios. Adopting protective behaviors had substantial response costs, including adaptations for medical care and home support workers, threatened access to advance care, and increased caregiver burden. Participants expressed need for ALS-specific, pandemic information from trusted health professionals and/or ALS health charities. Telemedicine introduced both conveniences and costs. Prior experience with ALS provided tools for coping with Covid-19. Threat and coping appraisal was a dynamic process involving ongoing vigilance and adaptation. Findings draw attention to the lack of emergency preparedness among participants and within health systems.

CONCLUSIONS

Clinicians should engage ALS patients and families in ongoing discussions about pandemic coping, strategies to mitigate response costs, care pathways in the event of Covid-19 infection, and changing information about Covid-19 variants and vaccines. Healthcare systems should incorporate flexible approaches for medical care, leveraging the benefits of telemedicine and facilitating in-person interaction as needed and where possible. Research is needed to identify strategies to mitigate response costs and to further explore the interaction between prior experience and coping. Further study is also needed to determine how communication about emergency preparedness might be effectively incorporated into clinical care for those with ALS and other medically vulnerable populations.

COVID-19 social distancing compliance mechanisms: UK evidence

Non-compliance with social distancing (SD) measures clearly has negative effects on both public health and post-pandemic economic recovery. However, little is as yet known about people's views on and factors influencing their behavioral intentions toward SD measures. This study draws on moral disengagement theory and the norm-activation model to investigate mechanisms that promote or hinder compliance with SD measures. A longitudinal research approach was adopted to compare changes in the main factors over three periods of the COVID-19 pandemic in England (UK). The results reveal significant differences between the three periods regarding intentions to comply with SD measures, altruistic value, moral obligation and moral disengagement, with no significant change in ascription of responsibility. Residents showed the strongest intentions to comply with SD measures during the first national lockdown, with the highest moral obligation and lowest moral disengagement levels, compared with the lowest intention to comply during the first re-opening period. Altruistic value is important in promoting moral obligation and compliance with SD measures, whereas the predictive powers of ascription of responsibility and moral disengagement were weaker than expected. These findings offer guidance to policymakers and researchers in developing more effective policies and public communication strategies. The results suggest that communication is key to normalizing SD compliance, which can be achieved most effectively by fostering residents' altruistic value and moral considerations. Particular attention must be paid to re-opening periods between lockdowns, with clear messages to remind residents of prosocial aspects of SD compliance and public health. In addition to appropriate communication and education, technologies such as apps, QR codes and contactless shopping settings may also be used to facilitate compliance with SD measures.

The Effect of Fear of COVID-19 on Green Purchase Behavior in Pakistan: A Multi-Group Analysis Between Infected and Non-infected

The coronavirus disease 2019 (COVID-19) pandemic and its effects on an individual's life have altered the consumer behavior. In the context of purchase and consumption, a shift from conventional to green purchase has been noticed. Although the factors underlying this shift were relatively unexplored, the study aimed to identify the factors that influenced a significant role in the green purchases during the outbreak and the relationship of these factors with green purchase behavior (GPB). Subsequently, this study investigates and interprets the role of fear of COVID-19 (FCV), psychological distress (PD), and mortality salience (MS) in predicting consumer's GPB. This research adopted a quantitative methodology using data collected from 432 respondents in various cities across Pakistan. Smart-PLS 3 was used to evaluate the measurement model, structural model, and multi-group analysis (MGA). Despite having the negative psychological and physical impact of the pandemic, a significant proportion of customers have switched to healthier and sustainable products. This research revealed that the FCV, PD, and MS plays a substantial role in adopting GPB. All the direct relationships were positive and significant. In addition, MS and PD partially mediate the effect of FCV on GPB. Furthermore, the MGA revealed that the infected respondents were interested in purchasing green products than uninfected respondents due to their FCV; conversely, the PD and MS were higher in uninfected individuals than infected ones. However, there is a vast literature on GPB, but little has investigated the cumulative impact of FCV, PD, and MS on GPB.

Protection Motivation and Food Waste Reduction Strategies

“Ugly food” refers to agricultural products that are discarded because their appearance is not attractive, even though their nutritional content is unaffected. In this study, protection motivation theory (PMT) was applied to analyze whether an individual’s awareness of food waste problems affects their “ugly food” purchase intention. Hence, the relationships between awareness of food waste problems, threat appraisal (severity and vulnerability), coping appraisal (response efficacy and self-efficacy), and ugly food purchase intention were analyzed. Additionally, a moderating effect analysis was conducted per consumer age. Descriptive statistical analysis, frequency, and SPSS reliability analysis were used, including confirmatory factor analysis, structural equation modeling, and multi-group analysis of the Amos program. For the final analysis, 361 samples were used. Results showed that awareness of food waste problems positively affected severity and vulnerability, response efficacy, and self-efficacy. Moreover, severity positively affected ugly food purchase intention and vulnerability did not. Response and self-efficacy positively affected ugly food purchase intention. In the moderating effect analysis per consumer age, the difference between severity and ugly food purchase intention and vulnerability and ugly food purchase intention was significant. This study has various academic and practical implications, and presents several strategies to reduce food waste to contribute to a sustainable future environment. It is also the first study linking the food waste problem, PMT, and ugly food purchase behavior.

Older adults’ perceptions of government handling of COVID-19: Predictors of protective behaviors from lockdown to post-lockdown

Background

Distrust, and more broadly, public perception of government’s handling of a crisis, has been a widely studied topic within health crisis research and suggests that these perceptions are significantly associated with the behavior of its citizens.

Purpose

To understand which aspects of the public’s perception of government handling of the COVID-19 pandemic predicted engagement of protective behaviors among older adults, who are the most vulnerable to COVID-19.

Methods

Participants were recruited from an ongoing biopsychosocial study on aging amongst community-dwelling older adults. There were two rounds of data collection, during the national lockdown and post-lockdown. The average length of follow-up was 5.88 months. N = 421 completed the first round of data collection and N = 318 subsequently completed the second round of questionnaires.

Results

During the lockdown, perceptions that pandemic-related measures in place were sufficient, effective, timely, provided a sense of safety, important information was easily accessible, and government handling of the pandemic could be trusted, were found to significantly predict engagement in protective behaviors. During post-lockdown, only perceptions that measures in place were sufficient, provided a sense of safety, and important information was easily accessible, remained significant predictors. The perception that COVID-19 measures were clear and easy to understand now became a significant predictor.

Conclusions

Public perceptions of government handling of the pandemic predicted engagement in protective behaviors but were less important during post-lockdown. To effectively engage older adults in protective behavior, our findings suggest for pandemic-related information to be accessible, introducing timely safety measures, and having easy-to-understand instructions for nuanced measures.

Investigating the Adoption of Precautionary Behaviors Among Young Rural Adults in South Iran During COVID-19

COVID-19 is an unprecedented challenge for public health worldwide. Reducing the incidence of the disease requires protective measures to prevent virus transmission. Understanding those factors influencing preventive behavior is the first step in preventing the spread of the disease. This study investigates factors affecting youth intention and preventive behaviors in the face of COVID-19 through the health belief model by using a cross-sectional survey collected through an online questionnaire. The sample comprises 304 rural youth in South Iran who were selected through a random sampling technique. The results reveal that perceived severity, perceived benefits, public health beliefs, perceived self-efficacy, and the cue to act positively and significantly affect preventive behaviors. The model explains 59% of variance changes in rural youth preventive behaviors during COVID-19. Cue to action is the strongest and self-efficacy was the weakest determinant of youth's preventive behavior. This study confirms that the HBM framework has appropriate predictive power and is an effective tool for investigating preventive behaviors during COVID-19. These results provide important policy implications for the development of policies that aim to avoid the further spread of COVID-19 between young citizens.

The Intolerance of Uncertainty and "Untact" Buying Behavior: The Mediating Role of the Perceived Risk of COVID-19 Variants and Protection Motivation

Draw on the protection motivation theory, this study investigated the impacts of intolerance of uncertainty on "untact" buying behavior, and examined the sequential mediating role of the perceived risk of COVID-19 variants and protection motivation. A total of 1,564 (M age = 20.75, SD = 1.92) young individuals participated in the survey. The serial mediation analysis results reveal that intolerance of uncertainty influences one's "untact" buying behavior through "perceived risk of COVID-19 variants - protection motivation." Both internal (intolerance of uncertainty, protection motivation) and external (risk of COVID-19) factors worked together to accelerate the transition of individuals' consumption behavior during COVID-19 pandemic. Therefore, our findings generate important implications for public mental health and economic recovery in the post-COVID-19 era.

Corporal and Cognizant Barriers to Voting: the Impact of COVID-19 on the 2020 Election Season in St. Louis

In 2020, two key elections in St. Louis, Missouri, took place in the midst of the intertwined pandemics of COVID-19 and racialized violence. Local community leaders in St. Louis emphasized a need to mobilize voters, particularly in communities of color, to engage in the elections in August and November 2020 as a tool for advancing health and racial equity. COVID-19 created a new set of barriers to voting. This study documents two typologies of challenges that organizers faced in their efforts to mobilize voters and increase participation in the election. The first is corporal — the use of one’s physical body and the risk within. The second is cognizant — the regulatory proficiency needed to navigate the shifting rules of the voting process. In this study, semi-structured interviews were conducted with a purposive sample of twenty-eight mobilizers working within low-income, poverty-impacted neighborhoods in St. Louis City and St. Louis County, which disproportionately consist of residents of color. Findings suggest COVID-19 created additional unforeseen barriers to voting. Corporal: Local ordinances that mandated limited in person gatherings and social distancing were serious obstacles to traditional voter mobilization efforts and created trepidation about in-person voting for fear of being exposed to the virus. Cognizant: The state of Missouri in an effort to address some of the public health concerns created additional rules for absentee or mail-in voting for limited populations with a complicated set of rules that confused mobilizers and voters.

Internal and external drivers for compliance with the COVID-19 preventive measures in Slovenia: The view from general deterrence and protection motivation

The emergence of a pandemic is usually accompanied by different measures-economic, social, preventive, and (self)protective. In the case of the COVID-19, several preventive measures were formally enforced by state authorities in the majority of countries worldwide. Thus, during the COVID-19 pandemic, the intertwining of formal and informal social control could be observed. Hence, in this study a cross-sectional design was chosen to explore the issue in Slovenia. To the best of our knowledge, this research is the first in the current literature to empirically test the general deterrence theory in pandemic circumstances (as external factors predicting individuals' compliance with the COVID-19 preventive measures). The results suggest an important role of informal punishment, with perceived informal severity being the only statistically significant factor from the general deterrence theory. In contrast to external factors, internal factors play a significantly greater role in promoting people's self-protective behavior in pandemic circumstances. During the unknown, the uncertain and delicate situations with which people have no previous experience, both personal beliefs about the effectiveness of measures and perceived self-efficacy are more important than fear of formal sanctions.

Trust in experts, not trust in national leadership, leads to greater uptake of recommended actions during the COVID-19 pandemic

Evidence suggests that people vary in their desire to undertake protective actions during a health emergency, and that trust in authorities may influence decision making. We sought to examine how the trust in health experts and trust in White House leadership during the COVID-19 pandemic impacts individuals' decisions to adopt recommended protective actions such as mask-wearing. A mediation analysis was conducted using cross-sectional U.S. survey data collected between March 27 and 30, 2020, to elucidate how individuals' trust in health experts and White House leadership, their perceptions of susceptibility and severity to COVID-19, and perceived benefits of protecting against COVID-19, influenced their uptake of recommended protective actions. Trust in health experts was associated with greater perceived severity of COVID-19 and benefits of taking action, which led to greater uptake of recommended actions. Trust in White House leadership was associated with lower perceived susceptibility to COVID-19 and was not associated with taking recommended actions. Having trust in health experts is a greater predictor of individuals' uptake of protective actions than having trust in White House leadership. Public health messaging should emphasize the severity of COVID-19 and the benefits of protecting oneself while ensuring consistency and transparency to regain trust in health experts.

The Influence of Sociodemographic Heterogeneity on the Perceptions of COVID-19: A Countrywide Survey Study in the USA

Background: Sociodemographic factors such as age, race, education, family income, and sex have been reported to influence COVID-related perceptions, reflected by knowledge, stress, and preventive behavior. We conducted a US-based survey to estimate the difference in COVID-related perceptions among diverse sociodemographic groups and the influence of sociodemographic heterogeneity on COVID-related perceptions. Methods: The survey enquired about sociodemographic parameters and relevant information to measure knowledge, stress, and preventive behavior. COVID-perception scores among sociodemographic subgroups were compared with ANOVA (Bonferroni). The general linear model (GLM) was used to estimate the association among sociodemographic factors and COVID-related perceptions. Results: Females (75%) and White participants (78%) were the predominant (N = 3734). Females, White participants, wealthy, and educated participants demonstrated better knowledge, while participants of minority races, younger ages, low incomes, and females experienced high stress. Females, African-Americans, and educated participants better adopted preventive behaviors. Race, family income, and sex were the highest contributors to the predictive model. Sociodemographic determinants had statistically significant associations with knowledge (F-score = 7.72, p < 0.001; foremost predictor: race), stress (F-score = 16.46, p < 0.001; foremost predictor: income), and preventive behavior (GLM: F-score = 7.72, p < 0.001, foremost predictor: sex). Conclusion: Sociodemographic heterogeneity significantly influenced COVID-related perceptions, while race, family income, and sex were the strongest determinants of COVID-related perceptions.

Perceived severity, fear of retaliation, and suspect report intention of general public during COVID-19 pandemic: A moderated moderation analysis

Management of COVID-19 largely depends on the reporting of suspected or confirmed positive cases. This study examined public's suspect report intention during COVID-19 using and extending the theory of planned behavior by adding two incident-specific variables such as perceived severity of COVID-19 and fear of retaliation. Direct association of attitude, subjective norm, and perceived behavioral control with suspect report intention and moderating role of perceived severity of COVID-19 and fear of retaliation were probed. This study also investigated whether the moderation of perceived severity of COVID-19 (primary moderator) varies with different level of fear of retaliation (secondary moderator) using moderated moderation analysis. Analyzing data collected from 554 Indian citizens provides evidence that attitude, subjective norm, and perceived behavioral control were positively associated with suspect report intention. Perceived severity of COVID-19 and fear of retaliation negatively moderated such associations. When fear of retaliation was high, high perceived severity of COVID-19 did not positively moderate the association of attitude, subjective norm, and perceived behavioral control with suspect report intention. Perceived behavioral control was the most potent facilitator and fear of retaliation was the strongest inhibitor of suspect report intention. Understanding people's suspect report intention can assist in implementing awareness programs to encourage suspect report intention and stop the community spread of COVID-19.

Government and social trust vs. hotel response efficacy: A protection motivation perspective on hotel stay intention during the COVID-19 pandemic

Based on protection motivation theory (PMT), this study conceptualizes a research framework to explain and examine customer intentions regarding hotel stays during the COVID-19 pandemic. Data were collected from 700 U.S. consumers via a crowdsourcing website in July 2020. Structural equation modeling was used to analyze the collected data for testing proposed hypotheses. The analytical results showed that the level of threat perceived by customers significantly reduced their intention to stay at a hotel. On the contrary, individual customer response efficacy significantly enhanced their intention to stay at a hotel. Additionally, both government and social trust, as well as hotel response efficacy, were found to significantly increase hotel stay intention by mediating the effects of threat perception and individual response efficacy. To the best of our knowledge, this study is one of the first attempts to apply PMT to explain customer hotel stay intentions during the COVID-19 pandemic.

Emerging Adults' Adherence to Preventative Health Guidelines in Response to COVID-19

Objective

To examine rates of emerging adults’ (EA) adherence to preventative health behavior recommendations during early months of the COVID-19 pandemic and to investigate demographic (i.e., gender, years of education, socioeconomic status, school enrollment status, and living situation) and exposure and impact-related correlates of adherence.

Methods

Participants were 273 [M (SD) age = 22 (2.1) years, 55% female, 32% from minoritized groups] EA completed an online survey of adherence to 11 preventative health behaviors recommended by the Centers for Disease Control (CDC) during summer 2020. Participants rated adherence via a visual analog scale. Participants also reported demographic information and completed the COVID-19 Exposure and Family Impact Adolescent and Young Adult Version (CEFIS-AYA).

Results

Median levels of adherence to preventative recommendations ranged from 66% to 100%. Highest adherence levels (Mdn > 90%) were reported for quarantining if exposed to COVID-19; covering mouth when sneezing; avoiding the elderly/those at high risk; and avoiding large gatherings. Median adherence was <80% for mask wearing; maintaining a 6-foot distance; avoiding in-person visits with romantic partners or friends; and disinfecting surfaces. Female gender was the only variable significantly associated with overall adherence, and it explained 4% of the variance.

Conclusions

Following guidelines related to social distancing practices may be particularly challenging for EA, possibly because of unique developmental needs of this group, and males may be at greater risk for non-adherence to CDC recommendations. Therefore, public health messaging and adherence intervention development should be designed with males and social distancing practices in mind.

Factors Related to COVID-19 Preventive Behaviors: A Structural Equation Model

Background: While COVID-19 has rapidly spread around the world, and vaccines are not widely available to the general population, the World Health Organization outlines preventive behavior as the most effective way to limit the rapid spread of the virus. Preventive behavior is associated with a number of factors that both encourage and discourage prevention. Aim: The aim of this research was to study COVID-19 threat appraisal, fear of COVID-19, trust in COVID-19 information sources, COVID-19 conspiracy beliefs and the relationship of socio-demographic variables (gender, age, level of education, place of residence, and employment status) to COVID-19 preventive behavior. Methods: The data originate from a national cross-sectional online survey (N = 2,608) undertaken in July 2020. The data were analyzed using structural equation modeling. Results: COVID-19 threat appraisal, trust in COVID-19 information sources, and fear of COVID-19 are all significant predictors of COVID-19 preventive behaviors. Together they explain 26.7% of the variance of this variable. COVID-19 conspiracy beliefs significantly negatively predict COVID-19 threat appraisal (R 2 = 0.206) and trust in COVID-19 information sources (R 2 = 0.190). COVID-19 threat appraisal contributes significantly and directly to the explanation of the fear of COVID-19 (R 2 = 0.134). Directly, as well as mediated by COVID-19 conspiracy beliefs, threat appraisal predicts trust in COVID-19 information sources (R 2 = 0.190). The relationship between COVID-19 threat appraisal and COVID-19 preventive behaviors is partially mediated by fear of COVID-19 (indirect effect 28.6%) and trust in information sources (15.8%). Socio-demographic variables add very little in prediction of COVID-19 preventive behavior. Conclusions: The study results demonstrate that COVID-19 threat appraisal is the most important factor associated with COVID-19 preventive behavior. Those Latvian residents with higher COVID-19 threat appraisal, experienced higher levels of fear of COVID-19, had more trust in COVID-19 information sources, and were more actively involved in following COVID-19 preventive behaviors. COVID-19 conspiracy beliefs negatively predict COVID-19 threat appraisal and trust in COVID-19 information sources, but not the COVID-19 preventive behaviors. Socio-demographic factors do not play an important role here.

Trust in Science, Perceived Vulnerability to Disease, and Adherence to Pharmacological and Non-pharmacological COVID-19 Recommendations

Protection motivation theory (PMT) is a theoretical framework informative for understanding behavioral intentions and choices during exceptional and uncommon circumstances, such as a pandemic of respiratory infectious disease. PMT postulates both the threat appraisal and the coping appraisal as predictors of health behaviors. Recent advances in the field of behavioral immune system (BIS) research suggest that humans are equipped with a set of psychological adaptations enabling them to detect the disease-threat and activate behavioral avoidance of pathogens. The present study, set within PMT framework and informed by the BIS research, aimed to explain and predict voluntary adherence to COVID-19 guidelines by perceived personal risk and vulnerability to disease as threat appraisal variables, and trust in science as the response efficacy element of coping appraisal. Gender, age, belief in the second wave, perceived personal risk, germ aversion, and trust in science were all found to be significant positive predictors of the intent to adhere to non-pharmacological COVID-19 recommendations, with the belief in the second wave, germ aversion, and trust in science being the most important ones. On the other hand, only the belief in the second wave and trust in science were significant positive predictors of the intent to adhere to pharmacological COVID-19 recommendations (i.e., to vaccinate). Interventions aimed at enhancing preventative measures adherence should take into account that the psychological mechanisms underlying adherence to these two types of recommendations are not identical.

The Determinants of Panic Buying during COVID-19

The COVID-19 pandemic has seen an unmatched level of panic buying globally, a type of herd behavior whereby consumers buy an uncommonly huge amount of products because of a perception of scarcity. Drawing on the health belief model, perceived scarcity, and anticipated regret theories, this paper formulated a theoretical model that linked the determinants of panic buying and analyzed their interrelationships. Subsequently, data were collated from 508 consumers through an online survey questionnaire in Singapore that was conducted during the early stage of the pandemic, before the onset of the circuit breaker in April 2020. Next, an analysis of the results was done through structural equation modeling. It showed that the effect of the health belief model dimensions (i.e., perceived susceptibility, perceived severity, outcome expectation, cues to action, and self-efficacy) on panic buying is partially mediated by the consumers' perceived scarcity of products. Furthermore, the effect of perceived scarcity on panic buying is partially mediated by consumers' anticipation of regret. This paper expands on the current theoretical understanding of panic buying behavior, giving insights into the possible measures and solutions that policymakers and relevant stakeholders can uptake to manage panic buying in future a pandemic or health crisis.