Using an integrated social cognition model to predict COVID-19 preventive behaviours

Protecting children from COVID-19: examining U.S. parents motivation and behaviour using an integrated model of self-determination theory and the theory of planned behaviour

OBJECTIVES

This longitudinal study applied the integrated model of self-determination theory (SDT) and the theory of planned behaviour (TPB) to explain COVID-19 preventive behaviours among parents of young children in the United States.

DESIGN

The study adopted a two-wave longitudinal study design. Parents (N = 681) completed self-report questionnaires related to measures of SDT and the TPB constructs and behavioural adherence at baseline and after one month. We used standardised residual change scores to test the structural relationships of the integrated model.

RESULTS

The parameter estimates of the model (CFI > .96, TLI > .86, RMSEA = .05, SRMR = .03) fit acceptably well to the data. Psychological need support was positively and significantly linked to autonomous and controlled motivation and amotivation. Autonomous motivation was positively and significantly correlated with TPB factors, and intention. Intention was a significant and positive predictor of behavioural adherence.

CONCLUSION

The integrated model of SDT and the TPB appeared to be applicable to the explanation of COVID-19 prevention among the U.S. parents. Longitudinal data showed that a psychological need supportive social environment was related to favourable motivation, social cognition beliefs, intention and behavioural adherence to the preventive behaviours of parents protecting their young children from COVID-19.

The strength of conspiracy beliefs versus scientific information: the case of COVID 19 preventive behaviours

Controlling the spread of COVID-19 requires individuals to adopt preventive behaviours, but conspiracy beliefs about its origin are spreading. The aim of this paper is to better comprehend the strength of conspiracy beliefs versus objective COVID-19 information to predict people's adherence to protective behaviours (getting vaccinated, being tracked through APPs, and keeping social distance from infected people). Study 1 shows that COVID-19 implicit theories detected in the Pre-study were activated as independent factors that constitute people's interpretations of the virus origin. These beliefs were related to a lesser intention to engage in preventive behaviours and a higher level of mistrust in institutional information, although some beliefs generate positive expectations about COVID-19 consequences. In Study 2, conducted with a different sample, official COVID-19 information was included as an independent variable, but this new variable did not further explain results. Lastly, Study 3 consisting of both previous samples confirmed that conspiracy beliefs had a direct effect on a lesser willingness to engage in preventive actions, a higher mistrust, and positive expectations about COVID-19 consequences. We conclude that objective COVID-19 information did not buffer the effect of conspiracy beliefs; they interfere with actions to prevent it by taking institutions as scapegoats or complicit with secret powers.

Effects of Individuals' Cultural Orientations and Trust in Government Health Communication Sources on Behavioral Intentions During a Pandemic: A Cross-Country Study

Public health messages disseminated by trusted government authorities are likely to have more influence over individuals' intentions and behaviors. However, individuals worldwide have different levels of trust in government authorities, which leads to varying levels of compliance intentions. Additionally, these trust levels may vary during major public crises, such as pandemics. Based on a COVID-19 pandemic communication survey (N = 3,065) disseminated throughout six countries (Australia, Finland, Italy, South Korea, Sweden, and the United States), this study examined the association among trust in distinct government sources, cultural orientations, and health behavioral intentions. Findings indicated that trust in official health communication sources at four governmental levels (i.e. national government, the head of the national government, the national health authority, and the chief representative of the national health authority) was related to vaccination intentions and other behavioral compliance intentions (i.e. willingness to prevent COVID-19 infection in other ways). Meanwhile, these direct associations were mediated by the cultural orientations of power distance and uncertainty avoidance. Findings also revealed that the direct association of trust in government sources and the indirect relationship through the above cultural orientations varied by country. This study offers insight into the important role of credible sources and individuals' cultural orientations in the domain of health communication aimed at influencing behavioral intentions.

The risk perception of COVID-19 and pandemic-related behaviors: a moderated mediation model of political trust and self-efficacy

As the pandemic continues to spread across the world, the spread of the novel coronavirus disease 2019 (COVID-19) and its recurrence pose challenges for pandemic control in all countries worldwide. The present study examines the mediating role of political trust in the relationship between risk perception and pandemic-related behaviors (preventive behaviors and hoarding behaviors), and the moderating effect of self-efficacy on this relationship. The responses of 827 Chinese residents revealed that political trust plays a mediating role in the relationship between risk perception and pandemic-related behaviors. The relationship between risk perception and political trust was significant for individuals with low self-efficacy, while it became weaker for those with high self-efficacy.

Pandemic fatigue, behavioral intention and predictors of COVID-19 vaccination among individuals living with HIV in Bench Sheko Zone, in Southern Ethiopia, application of TBP: a facility based cross sectional study

Introduction

People living with HIV often face inequalities and negative outcomes, which make them vulnerable. To protect this population and achieve herd immunity, it is crucial for COVID-19 vaccination efforts to prioritize and encourage vaccination among people living with HIV (PLWH). However, in Ethiopia, there is a lack of motivation in this regard. To tackle this issue, a study was conducted in the Bench Sheko Zone of Southwest Ethiopia. The study aimed to assess pandemic fatigue, behavioral intention to get vaccinated, and factors influencing COVID-19 vaccine acceptance among PLWH in that region.

Methods

A facility-based cross-sectional study was conducted among individuals living with HIV who were over 18 years old in Bench-Sheko Zone, located in Southwest Ethiopia. The study included a total of 590 participants from four ART healthcare facilities within the zone. The researchers utilized the Theory of Planned Behavior to examine the predictors of intention to use preconception care. Multiple linear regression analysis was employed to determine these predictors, with a p-value of less than 0.05 considered as indicative of a significant association. The final analysis of the study involved the use of linear regression analysis, and the measure of association was presented as the standardized B coefficient following a multivariable logistic regression analysis.

Result

In the conducted study, the response rate was an impressive 98%. The researchers aimed to investigate the behavioral intention toward the COVID-19 vaccine, which was found to be 55.7%. The average age of the participants in the study was 34.65 ± 6.67. The study was the assessment of pandemic fatigue, which had a mean value of 17.22 ± 5.28. During the multivariate linear regression analysis, four predictor variables were identified. Among these, three variables, namely subjective norm, pandemic fatigue, and age, positively influenced the behavioral intention toward the COVID-19 vaccine. Comprehending these factors can assist healthcare professionals and policymakers in formulating precise interventions and strategies aimed at enhancing the acceptance and adoption of vaccines.

Conclusion

The study indicates that individuals living with HIV have shown lower vaccine intention compared to previous research. The study identifies subjective norm, pandemic control measures, income, and age as predictors of individuals' intention to receive the COVID-19 vaccine.

Political Party Collective Norms, Perceived Norms, and Mask Wearing Behavior: A Test of the Theory of Normative Social Behavior

The theory of normative social behavior (TNSB) postulates that people are influenced by others' behaviors, which they observe from messages and experience. In addition to focusing on perceived (i.e., descriptive and injunctive) norms, the TNSB was expanded to include collective norms, which represent what people actually do. Testing this expanded theoretical model, the current study examined whether two types of collective norms - collective political norms and collective regional norms - interacted with descriptive norms to influence pandemic mask wearing behavior expectations among U.S. adults (N = 444). The interaction was statistically significant for collective political norms (β = -.74, p = .009) but not collective regional norms (β = -.16, p = .85). Specifically, descriptive norms were related to increased mask wearing expectation for all values of political party collective norms, but the effects were stronger when political party collective norms were low (i.e., low mask wearing behavior was normative). The findings support the inclusion of collective norms in the TNSB, clarify the relationships among different types of norms, and provide insights for norms-based interventions.

The predictors of the intention to receive Covid-19 vaccine using the health belief model and theory of planned behavior in South Khorasan province

BACKGROUND

Widespread vaccination coverage in the shortest time is one of the most effective ways for controlling the COVID-19 pandemic. Factors affecting people's intention to get the COVID-19 vaccine are of great importance. The present study aimed to investigate the predictors of the intention to receive the Covid-19 vaccine based on the constructs of the health belief model (HBM) and theory of planned behavior (TPB) in South Khorasan Province.

MATERIALS AND METHODS

In this cross-sectional-analytical study, 320 people over 18 years in South Khorasan province were randomly selected by cluster sampling method in 2021. The data was collected by a researcher-made questionnaire, including demographic information (9 questions), and the constructs of the health belief model (19 questions), and the theory of planned behavior (13 questions), using the self-report method. Finally, data were analyzed using t-test, ANOVA, linear regression, and Pearson correlation tests.

RESULTS

The mean age of the study participants was 36.57 ± 11.56 with a range of 18-66 years. In the regression model, perceived susceptibility (β = 0.247, P = 0.003), perceived severity (β = 0.247, P = 0.003) from HBM, attitude (β = 0.247, P = 0.003), and perceived behavioral control (β = 0.247, P = 0.003) from TPB were significant predictors of the intention to get the Covid-19 vaccine. The constructs of the two models were able to explain 33% of the variance of the intention to receive the Covid-19 vaccine.

CONCLUSIONS

The study findings reveal that HBM and TPB can predict factors affecting an individual's intention to receive the vaccine. The results can be utilized to design interventions with the aim of increasing vaccine uptake.

Determine the factors that affected COVID-19 prevention behaviors based on constructs of social cognition theory

BACKGROUND

COVID-19 is a universal challenge and novel disease is one of the core public health concerns. This study aimed to determine the factors that affected COVID-19 prevention behaviors (CPB) based on constructs of Social Cognition Theory (SCT).

METHODS

This cross-sectional study was conducted on 426 participants referred to health centers of Arak from October 2021 to February 2022, and they were selected through a multi-stage random sampling method. Data were collected via a self-administered questionnaire which includes socio-demographic data (6 items), COVID-19 prevention behaviors (12 items), and SCT constructs related to COVID-19 (32 items). SPSS Ver-16 statistical software was used to analyze the data with one-way ANOVA, independent samples t-test, and multiple linear regressions. The significance level of α = 0.05 was considered for all tests.

RESULTS

The mean age was 37.8 years (SD = 12.2) and ranged from 17 to 81. According to the results, 51.2% had higher education and 52.6% of the participants were female. The mean (SD) of COVID-19 preventive behaviors was 43 (SD = 7.8) out of 60. There was statistical association between CPB and three constructs of SCT. Multiple regression showed that the outcomes expectations (β = 0.11, p < 0.001), self-regulation (β = 0.41, p < 0.001), and self-efficacy (β = 0.30, p < 0.001), age, gender, and history of COVID 19infection were associated with CPB and those described 61% of the variance of CPB.

CONCLUSION

Rendering to the result of this study constructs of SCT is the key predictor of participants' CPB. Hence, based on these predictors, effective interventions and healthy messages could be designed based on this predictor-outcomes expectations, self-regulation, social support, and self-efficacy which can be beneficial to improve healthy behavior.

Basic psychological needs, quality of motivation, and protective behavior intentions: a nationally representative survey study

Objective

Building on the Self-Determination Theory, this study examines how basic psychological need satisfaction related to COVID-19 behavioral measures is associated with motivation quality and whether motivation quality is associated with intention to wear a face mask and to avoid meeting others.

Methods

Cross-sectional survey study involving a nationally representative sample of Finnish adult population aged 18-79 (N = 2272, M age = 48.63, SD = 16.89, 975 men and 1297 women) was conducted in Finland in May 2021 when protective behaviors were recommended to prevent acceleration of the epidemic. Measures included scales of Basic Psychological Need Satisfaction in Adhering to COVID Prevention Measures, Motivation to Adhere to COVID Prevention Measures, Perceived Personal Risk, Fear of COVID-19, and Protective Behavior Intention. Analysis of variance tests, linear regression analysis, and multinomial logistic regression were conducted. Perceived personal risk and fear of COVID-19 were controlled for in the regression analyses.

Results

All three psychological needs were positively related to autonomous motivation (all p < .001). Autonomous motivation (range OR = 1.82-3.55, p = .001) was consistently related to intention to wear a mask and intention to avoid meeting people. Controlled motivation (range OR = .66-.93, p = .001-.457) was associated with decreased protective behavior intentions. The effects of amotivation (range OR = .65-1.02, p = .001-.911) varied across analyses.

Conclusions

Fostering autonomous motivation could increase adherence to protective behaviors in situations without clear mandates.

Very small effects of an imagery-based randomised trial to promote adherence to wearing face coverings during the COVID-19 pandemic and identification of future intervention targets

OBJECTIVE

Mental imagery interventions are a cost-effective way of promoting health behaviour change. We tested a mental imagery intervention designed to promote adherence to wearing face coverings during the COVID-19 pandemic.Design: A four-arm randomised controlled trial to explore potential mechanisms of action. Main outcome measures: Measures of behaviour (frequency of self-reported face covering adherence), theory of planned behaviour constructs (i.e. intention, attitudes, subjective norms, and perceived behavioural control), personality traits, imagery ability and barrier self-efficacy were measured at baseline (T1). Behaviour was also assessed at four-week follow-up (T2).Results: Of 297 participants, a majority always wore face coverings (N = 216, 73% overall sample). Logistic regression analyses revealed no intervention effects on changes in adherence to wearing face coverings, though T1 wearing of face coverings and being male predicted T2 behaviour. Subgroup analysis of participants self-reporting 'suboptimal T1 adherence, revealed that T2 non-adherence was predicted by being a non-student and by subjective norms and lower T1 intention to wear face coverings.Conclusion: Imagery-based interventions to increase face covering wearing adherence may exert significant public health effects but only when conducted on a very large scale. Our findings suggest that interventions should target men and disrupt habitual past behaviour.

Mental health hygiene during a health crisis: Exploring factors associated with media-induced secondary trauma in relation to the COVID-19 pandemic

Aims

Given the risk of developing vicarious trauma through news media has increased during the pandemic, we explored risk factors associated with media induced secondary trauma, and its behavioral and psychological implications.

Methods

An international study (N = 1066), with a diverse sample, was administered in July 2020. We used standardized and validated questionnaires to measure news consumption, media-related trauma, compliance, and paranoia.

Results

Greater frequency of news consumption, accessing news via social media and WHO, and believing in conspiracy theories increased likelihood of developing media-induced secondary trauma. News related trauma was associated with greater compliance with safety measures and increased paranoid ideation. Media-trauma however exhibited a greater association with paranoia than compliance.

Conclusion

Findings highlight the need to facilitate a collaborative intervention, with public, media houses, health safety officials, and social scientists to have a deeper understanding of potential psychological costs of news consumption patterns.

Behind closed doors: Protective social behavior during the COVID-19 pandemic

The success of personal non-pharmaceutical interventions as a public health strategy requires a high level of compliance from individuals in private social settings. Strategies to increase compliance in these hard-to-reach settings depend upon a comprehensive understanding of the patterns and predictors of protective social behavior. Social cognitive models of protective behavior emphasize the contribution of individual-level factors while social-ecological models emphasize the contribution of environmental factors. This study draws on 28 waves of survey data from the Understanding Coronavirus in America survey to measure patterns of adherence to two protective social behaviors-private social-distancing behavior and private masking behavior-during the COVID-19 pandemic and to assess the role individual and environmental factors play in predicting adherence. Results show that patterns of adherence fall into three categories marked by high, moderate, and low levels of adherence, with just under half of respondents exhibiting a high level of adherence. Health beliefs emerge as the single strongest predictor of adherence. All other environmental and individual-level predictors have relatively poor predictive power or primarily indirect effects.

Socio-psychological factors associated with anticipated stigma toward COVID-19: a cross-sectional study in Japan

BACKGROUND

The stigmatization against COVID-19 has become a public issue. However, it remains unknown which individual factor contributes to anticipated stigma formation. This study explored socio-psychological factors associated with anticipated stigma toward coronavirus disease 2019 (COVID-19).

METHODS

We obtained cross-sectional data regarding 1,638 middle-aged community residents (mean age, 48.5 years) from a population-based survey in metropolitan Tokyo, Japan during the third wave of the COVID-19 pandemic, when a regional public health emergency had been declared in December 2020 and January 2021. We hypothesized that perceived risk of infection, normative beliefs about preventive behaviors, and past experiences of stigmatization unrelated to COVID-19 would be associated with anticipated stigma. Modified Poisson regression was conducted to examine associations after adjustments for demographic and socioeconomic statuses.

RESULTS

Higher perceived risk (adjusted prevalence ratio [APR] = 1.17; 95% confidence interval [CI, 1.08-1.27]), past experiences of stigmatization (APR = 1.09; 95% CI [1.00-1.19]), and higher normative beliefs about preventive behaviors (APR = 1.18; 95% CI [1.11-1.26]) were independently associated with anticipated stigma.

CONCLUSIONS

These results suggest that intervention messages to increase risk perception and normative beliefs to enhance protective behaviors may have the unintended effect of increasing anticipated stigma in the context of the COVID-19 pandemic.

Exploration into the Influencing Factors for the Intention of the Public to Vaccinate against Infectious Diseases Based on the Theory of Planned Behavior-Example of the COVID-19 Vaccine

OBJECTIVES

The coronavirus disease 2019 (COVID-19) was applied as an example, and the Theory of Planned Behavior (TPB) was used as a conceptual model. This study aimed to explore the impact of subjective norms (SNs), attitude towards the behavior (ATT), and perceived behavioral control (PBC) on the intention of the public for regular vaccination during COVID-19. The outcomes can provide certain recommendations for relevant policymakers in developing targeted health education intervention programs in the event of similar events.

METHODS

An online survey was performed between 17 April and 14 May 2021, via the online survey platform "WENJUANXING". The multistage stratified cluster sampling was employed, and 2098 participants (1114 males; 53.10%) with a mean age of 31.22 years (SD = 8.29) completed the survey. The survey covered the factors influencing the public's intention to receive future regular vaccinations during COVID-19 based on TPB. The effects of different variables on the public's vaccination intention were analyzed using hierarchical stepwise regression.

RESULTS

The public's intention to receive the COVID-19 vaccine (i.e., behavioral intention) in the future was taken as the dependent variable. Gender, age, marital status, education level, per capita monthly household income, vaccine-related knowledge, whether the COVID-19 vaccine was received, subjective norms (SNs), attitude towards the behavior (ATT), and perceived behavioral control (PBC) were used as independent variables. In this way, a hierarchical stepwise multiple regression model was developed. It can be seen from the final model that gender, age, vaccine-related knowledge, vaccination, attitude, SNs, and PBC were all influential factors in the public's intention to get vaccinated in the future, with R² = 0.399 and adjusted R² = 0.397 (p < 0.001).

CONCLUSION

TPB explains the intention of the public to receive future vaccinations to a large extent, and ATT and SNs are the most important influencing factors. It is suggested that vaccine intervention programs be developed to enhance public awareness and acceptance of vaccination. This can be achieved in three aspects, namely, improving the ATT of the public, SNs, and PBC. Furthermore, the influence of gender, age, vaccine knowledge, and previous vaccination behavior on vaccination intention should be taken into account.

A Cross-Sectional Study and Observational Assessment of Shoppers' COVID-19 Prevention Behaviors in Southwestern Ontario, Canada

OBJECTIVE

The aim of this study was to observe the level of alcohol-based sanitizer, mask use, and physical distancing across indoor community settings in Guelph, ON, Canada, and to identify potential barriers to practicing these behaviors.

METHODS

Shoppers were observed in June 2022 across 21 establishments. Discrete in-person observations were conducted and electronically recorded using smartphones. Multilevel logistic regression models were fitted to identify possible covariates for the 3 behavioral outcomes.

RESULTS

Of 946 observed shoppers, 69% shopped alone, 72% had at least 1 hand occupied, 26% touched their face, 29% physically distanced ≥ 2 m, 6% used hand sanitizer, and 29% wore masks. Sanitizer use was more commonly observed among people who wore masks and in establishments with coronavirus disease (COVID-19) signage posted at the entrance. Mask use was more commonly observed during days without precipitation and in establishments with some or all touch-free entrances. Shoppers more commonly physically distanced ≥ 2 m when they were shopping alone.

CONCLUSIONS

This supports evidence for environmental context influencing COVID-19 preventive behaviors. Intervention efforts aimed at visible signage, tailored messaging, and redesigning spaces to facilitate preventive behaviors may be effective at increasing adherence during outbreaks.

How Motivation to Reduce Uncertainty Predicts COVID-19 Behavioral Responses: Strategic Health Communication Insights for Managing an Ongoing Pandemic

During highly uncertain times such as the coronavirus disease 2019 (COVID-19) pandemic, it is vital to understand and predict individuals’ responses to governments’ crisis and risk communication. This study draws on the Orientation-Stimulus-Orientation-Response (O-S-O-R) model to examine (1) whether uncertainty reduction motivation (a pre-orientation factor) drove Americans to turn to traditional news media and/or social media (stimuli) to obtain COVID-19 information; (2) if these media preferences shaped their COVID-19 knowledge, cognitive information vetting, and trust in government communication (post-orientation factors); and finally (3) whether these factors contributed to their intended and actual behaviors (responses), such as getting vaccinated. Thus, this study explores how multiple communicative and cognitive mechanisms contribute to public compliance with government health recommendations during a pandemic. Mediation analyses showed positive indirect effects between uncertainty reduction motivation and behavioral outcomes via use of social media (in relation to traditional news media) and COVID-19 knowledge and cognitive information vetting. This study discusses theoretical and practical health communication implications of these findings.

Predictors of changing patterns of adherence to containment measures during the early stage of COVID-19 pandemic: an international longitudinal study

BACKGROUND

Identifying common factors that affect public adherence to COVID-19 containment measures can directly inform the development of official public health communication strategies. The present international longitudinal study aimed to examine whether prosociality, together with other theoretically derived motivating factors (self-efficacy, perceived susceptibility and severity of COVID-19, perceived social support) predict the change in adherence to COVID-19 containment strategies.

METHOD

In wave 1 of data collection, adults from eight geographical regions completed online surveys beginning in April 2020, and wave 2 began in June and ended in September 2020. Hypothesized predictors included prosociality, self-efficacy in following COVID-19 containment measures, perceived susceptibility to COVID-19, perceived severity of COVID-19 and perceived social support. Baseline covariates included age, sex, history of COVID-19 infection and geographical regions. Participants who reported adhering to specific containment measures, including physical distancing, avoidance of non-essential travel and hand hygiene, were classified as adherence. The dependent variable was the category of adherence, which was constructed based on changes in adherence across the survey period and included four categories: non-adherence, less adherence, greater adherence and sustained adherence (which was designated as the reference category).

RESULTS

In total, 2189 adult participants (82% female, 57.2% aged 31-59 years) from East Asia (217 [9.7%]), West Asia (246 [11.2%]), North and South America (131 [6.0%]), Northern Europe (600 [27.4%]), Western Europe (322 [14.7%]), Southern Europe (433 [19.8%]), Eastern Europe (148 [6.8%]) and other regions (96 [4.4%]) were analyzed. Adjusted multinomial logistic regression analyses showed that prosociality, self-efficacy, perceived susceptibility and severity of COVID-19 were significant factors affecting adherence. Participants with greater self-efficacy at wave 1 were less likely to become non-adherence at wave 2 by 26% (adjusted odds ratio [aOR], 0.74; 95% CI, 0.71 to 0.77; P < .001), while those with greater prosociality at wave 1 were less likely to become less adherence at wave 2 by 23% (aOR, 0.77; 95% CI, 0.75 to 0.79; P = .04).

CONCLUSIONS

This study provides evidence that in addition to emphasizing the potential severity of COVID-19 and the potential susceptibility to contact with the virus, fostering self-efficacy in following containment strategies and prosociality appears to be a viable public health education or communication strategy to combat COVID-19.

Understanding the barriers and facilitators of vaccine hesitancy towards the COVID-19 vaccine in healthcare workers and healthcare students worldwide: An Umbrella Review

BACKGROUND

Healthcare workers (HCWs) and healthcare students display high levels of vaccine hesitancy with impact on healthcare provision, patient safety, and health promotion. The factors related to vaccine hesitancy have been reported in several systematic reviews. However, this evidence needs to be synthesised, as interventions to reduce vaccination hesitancy in this population are needed.

METHODS

This Umbrella Review aimed to explore the barriers and facilitators of vaccine hesitancy toward the COVID-19 vaccine for HCWs and healthcare students. The review was performed and reported in accordance with Joanna Briggs Institutes guidelines and the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. A protocol was preregistered on PROSPERO (CRD42022327354). Eight databases were searched from November 2019 to 23rd May 2022 to identify any systematic reviews that explored factors associated with hesitancy towards the COVID-19 vaccine for HCWs or healthcare students.

RESULTS

A total of 31 studies were included in the review. The majority of studies (71%) were appraised as strong or moderate quality and there was a slight degree of overlap (<5%) of primary studies between the reviews. Vaccine hesitancy was more common among HCWs and healthcare students in specific occupational roles (e.g. nurses) than others (e.g. physicians). Frequent reasons for hesitancy were related to sociodemographic factors (gender, age, ethnicity), occupational factors (COVID-19 exposure, perceived risk, mandatory vaccination), health factors (vaccination history), vaccine-related factors (concerns about safety, efficacy, side-effects, rapid development, testing, approval and distribution of the vaccine), social factors (social pressure, altruism and collective responsibility), distrust factors (key social actors, pandemic management), information factors (inadequate information and sources, exposure to misinformation).

CONCLUSION

The results from this Umbrella Review have wide-reaching implications for the research area, healthcare systems and institutions and governments worldwide. Designing tailored strategies for specific occupational groups is pivotal to increasing vaccine uptake and securing a safe healthcare provision worldwide.

Why People Stayed Home During the COVID-19 Pandemic: Implications for Health Communication Across Four Countries

Staying at home substantially reduces the spread of COVID-19. Moreover, understanding why people stayed at home by addressing its social cognitive determinants can help create more effective communication to change behaviors. This study analyzed this outcome through an extended model of the theory of planned behavior based on risk perception and personal norms in four countries: the United States, Japan, Brazil, and Taiwan. 1,196 individuals participated in this study through a questionnaire focused on planned behavior, moral norms, and risk perception. The data showed that intention and perceived behavioral control influenced behavior significantly, while attitude, injunctive norms, perceived behavioral control, personal norms, and risk perception influenced intention. With multigroup analysis and ANOVA, we verified significant differences in the estimates and mean scores across cultures, revealing the need for scholars to analyze outcomes based on geography and local political culture. Given that health communications played a key role in managing the pandemic, this study clarifies the social cognitive determinants of staying at home and how the local political culture can impact their influence. Thus, we provide an evidence-based prescription for focused communications.

Correlation Between Ontological Insecurity and Daily Epidemic Prevention Behavior Among Inpatients During the COVID-19 Pandemic

This study evaluates inpatients' ontological insecurity and daily epidemic prevention behavior during the pandemic and explores the factors influencing daily epidemic prevention behaviors. The outbreak of coronavirus disease (COVID-19) in December 2019 caused a global public health crisis that has affected the very structure of society and the order of daily life. Ontological security is the ability to predict the impact of changes in social environments on personal security, such as during the pandemic. A cross-sectional study was used to collect data from 1185 inpatients of a hospital in Zhejiang, China, from July 11 to August 9, 2021. Our questionnaire recorded information on demographics, ontological insecurity, and daily epidemic prevention behaviors. The Mann-Whitney U test, Kruskal-Wallis H test, Spearman's correlation analysis, and logistic regression analysis were used to determine the influencing factors of daily epidemic prevention behavior on ontological security. Results showed a negative correlation between inpatients' ontological insecurity and daily epidemic prevention behavior (r = -.253, P < .001). The logistic regression analysis showed that the independent factors affecting daily epidemic prevention behavior include ontological insecurity (OR: 0.952; 95% CI: 0.937-0.968) (P < .001), sex (OR: 1.292; 95% CI: 1.004-1.663), age (OR: 0.880; 95%: 0.790-0.980), education (OR: 1.307; 95% CI: 1.098-1.556), and occupation [famers vs civil servants, staff or professional (OR: 0.596; 95% CI: 0.374-0.949),other versus civil servants, staff, or professional (OR: 0.693; 95% CI: 0.503-0.953)] (P < .05). Inpatients were shown to have good ontological security during the COVID-19 epidemic, younger patients, female patients, patients with stronger ontological security, patients with a higher educational level, and those who work in a fixed unit or organization showed higher levels of daily epidemic prevention behavior. Hospital managers should strengthen the intervention management of epidemic prevention behavior based on patient characteristics.

Understanding self-protective behaviors during COVID-19 Pandemic: Integrating the theory of planned behavior and O-S-O-R model

Adopting health preventive actions is one of the most effective ways to combat the COVID-19 pandemic. Based on the theory of planned behavior and the orientation-stimulus-orientation-response model, this study investigated the mechanisms by which health information exposure influenced individuals to adopt self-protective behaviors in the context of infectious disease. In this research, a convenience sampling was used and 2265 valid samples (Male = 843, 68.9% of participants aged range from 18 to 24) were collected in China. Structural equation modeling analysis was performed, and the analysis showed that health consciousness positively influenced the subsequent variables through interpersonal discussions and social media exposure to COVID-19-related information. The interaction between interpersonal discussion and social media exposure was found to be positively associated with the elements of the theory of planned behavior and risk perception. The findings also revealed that self-protective behavior was positively predicted by the components of the theory of planned behavior and risk perceptions, with subjective norms serving as the main predictor, followed by attitudes and self-efficacy.

Intention to maintain and willingness to stop: Applying a dual-process model to understanding the maintenance of COVID-19 preventive behaviors

Preventive behaviors have played an essential role in coping with COVID-19 and may continue to exerting a crucial impact on pandemic control in the future. This study aimed to evaluate the effectiveness of social-cognitive factors on maintenance of COVID-19 preventive behaviors based on a dual-process model, which encompasses a reasoned path via the intention to maintain and a social reaction path via the willingness to stop. We collected a probability sample of 472 community-dwelling adults. Social-cognitive factors, behavioral tendencies, and preventive behaviors of COVID-19 were measured. The results supported that the dual-process framework could account for individual differences in preventive behaviors. Self-efficacy and response cost significantly explained the intention to maintain preventive behaviors, while favorability of risk image and subjective norm significantly explained the willingness to stop preventive behaviors. Our findings proposed strategies for promoting individuals' maintenance of preventive behaviors during a pandemic. The development of prevention policies may focus on two paths: strengthening the intended path by enhancing self-efficacy and decreasing response cost of preventive behaviors and monitoring and improving social influences, such as risk prototype and subjective norm, which can reduce the willingness to stop preventive behaviors.

Older adults' physical activity after lockdown: Testing the health action process approach and the moderating role of fear of Covid-19

The coronavirus pandemic has influenced many lives, particularly older adults'. Although isolation protects from infection, health behaviors like physical activity (PA) are important to reinstate after lockdown. However, fear of Covid-19 may act as a barrier, for example, by preventing people from going outside. Based on the health action process approach (HAPA), we investigated whether and why older adults' PA changed after lockdown, and whether fear of Covid-19 moderates the intention-behavior relationship. Participants of this longitudinal study aged 65+ from German-speaking Europe completed an online questionnaire about their PA, fear of Covid-19, and HAPA factors in April and May 2020. Data were analyzed using multiple linear regressions. Results showed that moderate to vigorous activity (MVPA) remained stable after lockdown and that self-efficacy most robustly influenced the intention to be active. PA was not explained by any volitional factor but was strongly related to past PA. Interestingly, the relationship of past and future MVPA was attenuated by fear of Covid-19, but this finding was not robust when outliers were removed. In conclusion, self-efficacy is the most important motivator for PA in older adults after an interruption like a lockdown. Strong physical activity habits may facilitate PA after a period of isolation.

Environmental determinants of infectious and chronic disease prevention behaviours: A systematic review and thematic synthesis of qualitative research

Regulatory health policies facilitate desired health behaviours in communities, and among them, smoke-free policies and COVID-19 restrictions have been widely implemented. Qualitative research studies have explored how these measures and other environmental influences shape preventive behaviours. The objective of this systematic review was to synthesize previously published qualitative research, generate across-study themes, and propose recommendations for behaviour change interventions. We used a comprehensive search strategy, relevance screening and confirmation, data extraction, quality assessment, thematic synthesis, and quality-of-evidence assessment. In total, 87 relevant studies were identified. Findings were grouped under six overarching themes and mapped under three categories: (i) the political environment, (ii) the sociocultural environment, and (iii) the physical environment. These findings provide insights into the environmental influences of behaviour and indicate future interventions may be more effective by considering moral norms, community norms, policy support, and group identity.

Application of the Capability, Opportunity, Motivation and Behavior (COM-B) model to identify predictors of two self-reported hand hygiene behaviors (handwashing and hand sanitizer use) to prevent COVID-19 infection among U.S. adults, Fall 2020

BACKGROUND

Handwashing with soap and water is an important way to prevent transmission of viruses and bacteria and worldwide it is estimated handwashing can prevent 1 in 5 viral respiratory infections. Frequent handwashing is associated with a decreased risk for infection with SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19). Using a hand sanitizer with at least 60% alcohol when handwashing is not feasible can also help prevent the transmission of viruses and bacteria.

OBJECTIVE

Since early 2020, the public has been encouraged to handwash frequently with soap and water and use alcohol-based hand sanitizer when soap and water are not available to reduce COVID-19 transmission. This study's objectives were to assess U.S. adults' perceptions of components of the Capability, Opportunity, Motivation and Behavior (COM-B) Model in relation to these two hand hygiene behaviors and to identify relationships between these components and hand hygiene behaviors.

METHODS

Items assessing capability, opportunity, motivation, and hand hygiene behaviors were included in FallStyles, a survey completed by 3,625 adults in the fall of 2020 through an online panel representative of the U.S.

POPULATION

We calculated composite capability, opportunity, and motivation measures and descriptive statistics for all measures. Finally, we conducted multiple logistic regressions to identify predictors of handwashing and hand sanitizer use.

RESULTS

Most respondents reported frequently washing hands with soap and water (89%) and using alcohol-based hand sanitizer (72%) to prevent coronavirus. For capability, over 90% of respondents said that neither behavior takes a lot of effort, but fewer agreed that they knew when, or how, they should engage in handwashing (67%; 74%) and hand sanitizer use (62%; 64%). For opportunity, over 95% of respondents said lack of time didn't make it hard to engage in either behavior; fewer said visual cues reminded them to engage in the behaviors (handwashing: 30%; sanitizer use: 48%). For motivation, the majority believed the two behaviors were good ways to prevent coronavirus illness (handwashing: 76%; sanitizer use: 59%). Regressions indicated that capability, opportunity, and particularly motivation were positively associated with both hand hygiene behaviors.

CONCLUSIONS

The COM-B model was a helpful framework for increasing understanding of hand hygiene behavior; it identified capability, opportunity, and motivation as predictors of both handwashing and hand sanitizer use.

Visiting crowded places during the COVID-19 pandemic. A panel study among adult Norwegians

Non-pharmaceutical interventions, including promotion of social distancing, have been applied extensively in managing the COVID-19 pandemic. Understanding cognitive and psychological factors regulating precautionary behavior is important for future management. The present study examines the importance of selected factors as predictors of having visited or intended to visit crowded places. Six online questionnaire-based waves of data collection were conducted in April-October 2020 in a Norwegian panel (≥18 years). Sample size at Wave 1 was 1,400. In the present study, "Visited or intended to visit crowded places" for different types of locations were the dependent variables. Predictors included the following categories of items: Perceived response effectiveness, Self-efficacy, Vulnerability, Facilitating factors and Barriers. Data were analyzed with frequency and percentage distributions, descriptives, correlations, principal components analysis, negative binomial-, binary logistic-, and multiple linear regression, and cross-lagged panel models. Analyses of dimensionality revealed that a distinction had to be made between Grocery stores, a location visited by most, and locations visited by few (e.g., "Pub," "Restaurants," "Sports event"). We merged the latter set of variables into a countscore denoted as "Crowded places." On the predictor side, 25 items were reduced to eight meanscores. Analyses of data from Wave 1 revealed a rather strong prediction of "Crowded places" and weaker associations with "Supermarket or other store for food." Across waves, in multiple negative binomial regression models, three meanscore predictors turned out to be consistently associated with "Crowded places." These include "Response effectiveness of individual action," "Self-efficacy with regard to avoiding people," and "Barriers." In a prospective cross-lagged model, a combined Response effectiveness and Self-efficacy score (Cognition) predicted behavior ("Visited or intended to visit crowded places") prospectively and vice versa. The results of this study suggest some potential to reduce people's visits to crowded locations during the pandemic through health education and behavior change approaches that focus on strengthening individuals' perceived response effectiveness and self-efficacy.

"I Refuse to Wear a Mask!" Examining the Relationship Between Grit and Preventative Behaviors and Well-Being: Mediating Role of Motivation

Despite government mandates to wear face masks in some public locations, why do some people still refuse to wear a face mask in public? This paper examines the relationship between grit, COVID-19 preventative health measure, and distress. Further, the mediating role of COVID-19 autonomous and controlled motivation is also investigated. The results suggest that grit is directly related to decreased distress and increased preventative behaviors. COVID-19 autonomous and controlled motivated mediated the relationship between grit, distress and preventive behaviors, such that COVID-19 autonomous motivation mediated the association between grit and preventive behaviors; while COVID-19 controlled motivation mediated the relationship between grit and psychological distress. These findings suggest that grit can be an important growth mindset in increasing preventative behaviors and individual well-being during the pandemic. Implications for human resource managers in attempting to help employees cope effectively during the pandemic are discussed.

Within-family influences on compliance with social-distancing measures during COVID-19 lockdowns in the United Kingdom

The compliance of adolescents, who are often unfairly portrayed as spreaders of COVID-19, with public health measures is essential for containing diseases. But does adolescents' compliance develop independently from their parents? Using nationally representative longitudinal data and cross-lagged structural equation panel models, here I study compliance with social-distancing measures of 6,752 triplets that comprise the adolescent child (age 19), their mother and their father during two national lockdowns in the United Kingdom. The results show that adolescents have the lowest and their mothers have the highest levels of compliance, and compliance generally drops over time. Moreover, mothers, whether the child lives at home or not, and fathers, when the child lives at home, have significant influence on their adolescent child's compliance. The child also influences their fathers' compliance. The parental influence on adolescents' compliance documented here suggests that family dynamics play a role in compliance with social-distancing guidelines, which may be useful for informing future health policy.

Predicting physical distancing over time during COVID-19: testing an integrated model

Objective: We applied an integrated social cognition model to predict physical distancing behavior, a key COVID-19 preventive behavior, over a four-month period. Design: A three-wave longitudinal survey design. Methods: Australian and US residents (N = 601) completed self-report measures of social cognition constructs (attitude, subjective norm, moral norm, perceived behavioral control [PBC]), intention, habit, and physical distancing behavior on an initial occasion (T1) and on two further occasions one week (T2) and four months (T3) later. Results: A structural equation model revealed that subjective norm, moral norm, and PBC, were consistent predictors of physical distancing intention on all three occasions. Intention and habit at T1 and T2 predicted physical distancing behavior at T2 and T3, respectively. Intention at T2 mediated effects of subjective norm, moral norm, and PBC at T2 on physical distancing behavior at T3, and habit at T1 and T2 mediated effects of behavior at T1 and T2 on follow-up behavior at T2 and T3, respectively. Conclusion: Normative (subjective and moral norms) and capacity (PBC) constructs were consistent predictors of physical distancing intention, and intention and habit were consistent predictors of physical distancing behavior. Interventions promoting physical distancing should target change in normative and personal capacity beliefs, and habit.Supplemental data for this article is available online at https://doi.org/10.1080/08870446.2021.1968397 .

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

OBJECTIVE

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

DESIGN

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

OUTCOME MEASURES

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

RESULTS

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

CONCLUSION

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

Improving Hand Hygiene Behavior Using a Novel Theory-Based Intervention During the COVID-19 Pandemic

BACKGROUND

Promoting the adoption of personal hygiene behaviors known to reduce the transmission of COVID-19, such as avoiding touching one's face with unwashed hands, is important for limiting the spread of infections.

PURPOSE

We aimed to test the efficacy of a theory-based intervention to promote the avoidance of touching one's face with unwashed hands to reduce the spread of COVID-19.

METHODS

We tested effects of an intervention employing imagery, persuasive communication, and planning techniques in two pre-registered studies adopting randomized controlled designs in samples of Australian (N = 254; Study 1) and US (N = 245; Study 2) residents. Participants were randomly assigned to theory-based intervention or education-only conditions (Study 1), or to theory-based intervention, education-only, and no-intervention control conditions (Study 2). The intervention was delivered online and participants completed measures of behavior and theory-based social cognition constructs pre-intervention and one-week postintervention.

RESULTS

Mixed-model ANOVAs revealed a significant increase in avoidance of touching the face with unwashed hands from pre-intervention to follow-up irrespective of intervention condition in both studies, but no significant condition effects. Exploratory analyses revealed significant effects of the theory-based intervention on behavior at follow-up in individuals with low pre-intervention risk perceptions in Study 2.

CONCLUSIONS

Results indicate high adoption of avoiding touching one's face with unwashed hands, with behavior increasing over time independent of the intervention. Future research should confirm risk perceptions as a moderator of the effect theory-based interventions on infection-prevention behaviors.

A district-level vulnerability assessment of next COVID-19 variant (Omicron BA.2) in Uttarakhand using quantitative SWOT analysis

COVID-19 has had an impact on the entire humankind and has been proved to spread in deadly waves. As a result, preparedness and planning are required to better deal with the epidemic's upcoming waves. Effective planning, on the other hand, necessitates detailed vulnerability assessments at all levels, from the national to the state or regional. There are several issues at the regional level, and each region has its own features. As a result, each region needs its own COVID-19 vulnerability assessment. In terms of climate, terrain and demographics, the state of Uttarakhand differs significantly from the rest of India. As a result, a vulnerability assessment of the next COVID-19 variation (Omicron BA.2) is required for district-level planning to meet regional concerns. A total of 17 variables were chosen for this study, including demographic, socio-economic, infrastructure, epidemiological and tourism-related factors. AHP was used to compute their weights. After applying min-max normalisation to the data, a district-level quantitative SWOT is created to compare the performance of 13 Uttarakhand districts. A COVID-19 vulnerability index (normalised R i ) ranging between 0 and 1 was produced, and district-level vulnerabilities were mapped. Quantitative SWOT results depict that Dehradun is a best performing district followed by Haridwar, while Bageshwar, Rudra Prayag, Champawat and Pithoragarh are on the weaker side and the normalised Ri proves Dehradun, Nainital, Champawat, Bageshwar and Chamoli to be least vulnerable to COVID-19 (normalised R i ≤ 0.25) and Pithoragarh to be the most vulnerable district (normalised R i > 0.90). Pauri Garwal and Uttarkashi are moderately vulnerable (normalised R i 0.50 to 0.75).

Social media addiction and emotions during the disaster recovery period-The moderating role of post-COVID timing

BACKGROUND

Social media addiction, a recently emerged term in medical science, has attracted the attention of researchers because of its significant physical and psychological effects on its users. The issue has attracted more attention during the COVID era because negative emotions (e.g., anxiety and fear) generated from the COVID pandemic may have increased social media addiction. Therefore, the present study investigates the role of negative emotions and social media addiction (SMA) on health problems during and after the COVID lockdown.

METHODS

A survey was conducted with 2926 participants aged between 25 and 45 years from all eight divisions of Bangladesh. The data collection period was between 2nd September- 13th October, 2020. Partial Least Square Structural Equation Modelling (PLS-SEM) was conducted for data analysis by controlling the respondents' working time, leisure time, gender, education, and age.

RESULTS

Our study showed that social media addiction and time spent on social media impact health. Interestingly, while anxiety about COVID increased social media addition, fear about COIVD reduced social media addition. Among all considered factors, long working hours contributed most to people's health issues, and its impact on social media addiction and hours was much higher than negative emotions. Furthermore, females were less addicted to social media and faced less health challenges than males.

CONCLUSION

The impacts of negative emotions generated by the COVID disaster on social media addiction and health issues should be reconsidered. Government and employers control people's working time, and stress should be a priority to solve people's social media addiction-related issues.

Typology and Characteristics of COVID-19 Preventive Measures Implementation

More than a year and a half has passed since the novel coronavirus (COVID-19) pandemic began, but according to the World Health Organization (WHO), the end is still a long way off. People must incorporate infection prevention behaviors into their daily lives, and the question for the future will not be whether or not to take countermeasures but how thoroughly to do so. In this study, I conducted an online survey of 1200 Japanese adults and identified four patterns of implementation of preventive measures. Those who took the most preventive measures were highly alert to the risk of COVID-19 and had strong anxiety about infection. They also positively evaluated risk management by medical institutions and the government, and they had positive feelings in their daily lives. On the other hand, those who took minimal measures, mainly mask wearing and handwashing, and those who took less than minimal measures did not feel much risk or anxiety about COVID-19. However, they evaluated the responses of the government and medical institutions less highly and reported having more negative feelings in their daily lives.

Habit formation of preventive behaviours during the COVID-19 pandemic: a longitudinal study of physical distancing and hand washing

Background

Since the outbreak of the COVID-19 pandemic, physical distancing and hand washing have been used as effective means to reduce virus transmission in the Netherlands. However, these measures pose a societal challenge as they require people to change their customary behaviours in various contexts. The science of habit formation is potentially useful for informing policy-making in public health, but the current literature largely overlooked the role of habit in predicting and explaining these preventive behaviours. Our research aimed to describe habit formation processes of physical distancing and hand washing and to estimate the influences of habit strength and intention on behavioural adherence.

Methods

A longitudinal survey was conducted between July and November 2020 on a representative Dutch sample (n = 800). Respondents reported their intentions, habit strengths, and adherence regarding six context-specific preventive behaviours on a weekly basis. Temporal developments of the measured variables were visualized, quantified, and mapped onto five distinct phases of the pandemic. Regression models were used to test the effects of intention, habit strength, and their interaction on behavioural adherence.

Results

Dutch respondents generally had strong intentions to adhere to all preventive measures and their adherence rates were between 70% and 90%. They also self-reported to experience their behaviours as more automatic over time, and this increasing trend in habit strength was more evident for physical-distancing than for hand washing behaviours. For all six behaviours, both intention and habit strength predicted subsequent adherence (all ps < 2e-16). In addition, the predictive power of intention decreased over time and was weaker for respondents with strong habits for physical distancing when visiting supermarkets (B = -0.63, p <.0001) and having guests at home (B = -0.54, p <.0001) in the later phases of the study, but not for hand washing.

Conclusions

People’s adaptations to physical-distancing and hand washing measures involve both intentional and habitual processes. For public health management, our findings highlight the importance of using contextual cues to promote habit formation, especially for maintaining physical-distancing practices. For habit theories, our study provides a unique dataset that covers multiple health behaviours in a critical real-world setting.

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.

Determining the Prevalence and Correlates of COVID-19 Booster Vaccine Hesitancy in the Singapore Population Following the Completion of the Primary Vaccination Series

In response to declining vaccine-induced immunity and the emergence of new COVID-19 variants, COVID-19 booster vaccination programmes have been widely launched in several high-income countries. However, public response has been slow, and scepticism about these programmes is rising in these settings. This study sought to identify the sociodemographic, emotional, and psychological factors associated with COVID-19 booster vaccine hesitancy in Singapore. Derived from a community cohort, 1005 fully vaccinated adults (62.1% female, mean age = 42.6 years) that had not received their COVID-19 booster shots completed an online survey between October and November 2021 on vaccination beliefs, intentions, and behaviours. Results indicated that despite completing the primary COVID-19 vaccination, 30.5% of those surveyed were hesitant about receiving the booster shot (25.9% unsure; 4.7% refused the booster), and 39.2% perceived more vaccine risks than benefits. Multivariable models indicated that a tertiary education, lower COVID-19 threat perception, lower perceived benefits, higher perceived concerns, a decreased need for booster vaccination, and a lower benefit/concerns differential score were associated with higher odds of booster vaccine hesitancy. Success in the primary vaccination series may not warrant widespread public acceptance for recurrent COVID-19 vaccination doses. In addressing booster vaccine hesitancy as restrictive measures and mandates are lifted, health perceptions relevant or unique to booster vaccine uptake should be considered.

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.

Social cognition theories and behavior change in COVID-19: A conceptual review

The COVID-19 pandemic has had unprecedented health, economic, and social consequences worldwide. Although contact reductions and wearing face coverings have reduced infection rates, and vaccines have reduced illness severity, emergence of new variants of the coronavirus that causes COVID-19, and the shift from pandemic to endemic patterns of infection, highlights the importance of ongoing preventive behavior adherence to manage future outbreaks. Research applying social cognition theories may assist in explaining variance in these behaviors and inform the development of efficacious behavior change interventions to promote adherence. In the present article, we summarize research applying these theories to identify modifiable determinants of COVID-19 preventive behaviors and the mechanisms involved, and their utility in informing interventions. We identify limitations of these applications (e.g., overreliance on correlational data, lack of long-term behavioral follow-up), and suggest how they can be addressed. We demonstrate the virtue of augmenting theories with additional constructs (e.g., moral norms, anticipated regret) and processes (e.g., multiple action phases, automatic processes) to provide comprehensive, parsimonious behavioral explanations. We also outline how the theories contribute to testing mechanisms of action of behavioral interventions. Finally, we recommend future studies applying these theories to inform and test interventions to promote COVID-19 preventive behavior adherence.

The intention to get COVID-19 vaccine and vaccine uptake among cancer patients: An extension of the theory of planned behaviour (TPB)

The psychosocial impact of coronavirus disease 2019 (COVID-19) on human life is well-known. Although vaccine protection represents an effective way to control the spread of the virus, vaccination hesitancy may decrease individuals’ willingness to get vaccinated, including among cancer patients. Therefore, the objective of the current study was to examine the predictors of cancer patients’ intentions to receive COVID-19 vaccinations and vaccine uptake, using and integrating the theory of planned behaviour (TPB) and the health belief model (HBM). A sample of 276 Italian cancer patients (54% female and 46% male) ranging from 19 to 85 years (M = 49.64, SD = 11.53) was recruited by administering an online questionnaire. The current study results showed that cancer patients with higher trust in health authorities tended to have vaccine-positive subjective norms, perceived that vaccination was under their control, and viewed COVID-19 vaccines positively. On the other hand, the perceived risk of COVID-19 was related to subjective norms but not to perceived behavioural control or attitudes towards COVID-19 vaccination. The current study reveals that TPB variables can function effectively as mediators between perceived risk, trust, and intention to vaccinate but at different levels. Together, these findings suggest that effective interventions (both public health messaging and personal medical communications) should focus on enhancing trust in health authorities, while at the same time endeavouring to highlight subjective norms that are vaccine-positive.

Using the integrative model of behavioural prediction to understand COVID-19 vaccine hesitancy behaviour

The officials realized that the vaccination drive alone would not be  sufficient, but the individual's response towards getting vaccinated needs to be assessed and addressed, especially in India, where the diverse culture could widely affect the population's vaccination behaviour. The study aimed to identify the predictors of vaccine hesitancy behaviour using the health belief model and theory of planned behaviour and understand mediating and moderating influence of knowledge and social support on the relationship between the predictors and vaccine hesitancy behaviours among the Indian population. Data was collected from 1006 samples. Regression analysis was performed to assess the variances exerted on vaccine hesitancy behaviours. Also, SEM AMOS was employed to examine the mediation and moderation effects of knowledge about vaccines and social support. The findings indicated that around 11% of the respondents were hesitant to get vaccinated. The combined models of HBM and TPB provide high predictive power. The analysis also revealed that knowledge about vaccine significantly mediates partially between a few constructs of HBM and TPB concerning hesitancy. This study provides the theoretical framework and suggests that the health belief model and the theory of planned behaviour model could explain the psychological influences of vaccine hesitancy in India.

Association of Social-Cognitive Factors with Individual Preventive Behaviors of COVID-19 among a Mixed-Sample of Older Adults from China and Germany

Identifying modifiable correlates of older adults’ preventive behaviors is contributable to the prevention of the COVID-19 and future pandemics. This study aimed to examine the associations of social-cognitive factors (motivational and volitional factors) with three preventive behaviors (hand washing, facemask wearing, and physical distancing) in a mixed sample of older adults from China and Germany and to evaluate the moderating effects of countries. A total of 578 older adults (356 Chinese and 222 German) completed the online cross-sectional study. The questionnaire included demographics, three preventive behaviors before and during the pandemic, motivational factors (health knowledge, attitude, subjective norm, risk perception, motivational self-efficacy (MSE), intention), and volitional factors (volitional self-efficacy (VSE), planning, and self-monitoring) of preventive behaviors. Results showed that most social-cognitive factors were associated with three behaviors with small-to-moderate effect sizes (f² = 0.02 to 0.17), controlled for demographics and past behaviors. Country moderated five associations, including VSE and hand washing, self-monitoring and facemask wearing, MSE and physical distancing, VSE and physical distancing, and planning and physical distancing. Findings underline the generic importance of modifiable factors and give new insights to future intervention and policymaking. Country-related mechanisms should be considered when aiming to learn from other countries about the promotion of preventive behaviors.

The effect of habit on preventive behaviors: a two-wave longitudinal study to predict COVID-19 preventive behaviors

Objective: The COVID-19 pandemic is a continuing global threat. This study examined the effect of habit on the motivational aspects of COVID-19 preventive behaviors using a dual-motivation model, which hypothesizes that intentional and reactive motivations determine behavior. This study assumes that habit influences behaviors through the antecedents of the model and the interaction effects of intentional motivation × habit and reactive motivation × habit.

Design: This study conducted a longitudinal survey of 300 Japanese participants to predict preventive behaviors two weeks after the first survey. Moreover, it measured past and future COVID-19 self-reported preventive behaviors, attitudes, behavioral intentions, behavioral willingness, subjective and descriptive norms, self-efficacy, behavioral controls, and habits.

Results: The results showed the interaction effects of behavioral intention × habit and behavioral willingness × habit on preventive behaviors in addition to the effect of past behavior. The stronger the effect of habit, the stronger is the effect of behavioral intention and the weaker the effect of behavioral willingness.

Conclusion: The habituation of preventive behaviors strengthens the behavioral intention–behavior consistency. This study suggested that habit is an important factor for overcoming psychological barriers and for establishing preventive behaviors in daily life.

Health care worker knowledge and attitudes towards uniform laundering during the COVID-19 pandemic

Background

The COVID-19 pandemic raised concerns towards domestic laundering of healthcare worker (HCW) uniforms; this is common practice in countries such as the United Kingdom (UK) and United States. Previous research suggested 4-32% of nurses did not adhere to laundry policies, which could be an infection control risk. This study aimed to investigate the knowledge and attitudes of UK healthcare workers towards domestic laundering of uniforms during the COVID-19 pandemic.

Methods

Online and paper questionnaires were distributed to HCWs and nursing students who regularly wear uniforms. Differences in knowledge between HCWs were analyzed by Chi-squared tests and attitudes were examined using exploratory factor analysis.

Results

About 86% of participants (n = 1099 of 1277) laundered their uniforms domestically. Respondents were confident in laundering their uniforms appropriately (71%), however 17% failed to launder at the recommended temperature (60°C). Most participants (68%) would prefer their employer launder their uniforms, with mixed negative emotions towards domestic laundering. Limited provision of uniforms and changing and/or storage facilities were a barrier to following guidelines.

Conclusion

Most HCWs domestically launder their uniforms, despite a preference for professional laundering. One-fifth of HCWs deviated from the UK National Health Service uniform guidelines; onsite changing facilities were the most significant barrier towards adherence.

Predictors of COVID-19 preventive behaviours in a sample of the Turkish population

AIM

This research aimed to determine predictors of COVID-19 preventive behaviours in a sample of the Turkish population.

METHODS

The study was conducted with 575 individuals. COVID-19 preventive behaviours were evaluated with a 19-item scale scored from 19 to 95. Knowledge on COVID-19 was evaluated with a 22-item scale scored from 0 to 22. General health literacy was evaluated with the Turkey Health Literacy Scale (THLS), which was scored from 0 to 50.

RESULTS

The average COVID-19 preventive behaviours score was moderately high in this sample of the Turkish population. Being female, having a higher level of education, better economic status, being a non-smoker, having a higher level of COVID-19 knowledge and better general health literacy score were significant predictors of COVID-19 preventive behaviours (P < 0.05).

CONCLUSION

Sociodemographic characteristics, knowledge of COVID-19 and general health literacy are crucial in preventing COVID-19 infections in a sample of the Turkish population.

Effects of Perceived Benefit on Vitamin D Supplementation Intention: A Theory of Planned Behaviour Perspective

There are many factors that affect vitamin D supplementation, including those from the theory of planned behaviour (TPB); however, how the perceived benefit acts in the model remains unknown. In the current study, we tested the efficacy of the TPB and the impacts of the perceived benefit (PBE) in the model. The subjects were 287 customers who purchased vitD from pharmacies in major cities in Taiwan. A structured questionnaire was used to collect the data. t-tests, analysis of variance (ANOVA), regression analyses, and path analysis via SPSS and AMOS were used to analyse the data. The original TPB model explained 47.5% of the variance of intention with the three variables of attitude (β = 0.261), perceived behavioural control (β = 0.183), and subjective norms (β = 0.169). The model that incorporated PBE increased the explained variance to 59.7%, and PBE became the strongest predictor (β = 0.310) and a significant mediator linking attitude, subjective norms, perceived control (ANC) with supplementation intention. PBE and attitude were the two most important variables in predicting vitD supplementation intention. We suggest that updated information regarding dietary sources of vitD and its benefits should be included in health- or nutrition-related courses in education programs for the overall health of the nation.

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.

Using behavioural theory to understand adherence to behaviours that reduce transmission of COVID-19; evidence from the CHARIS representative national study

OBJECTIVES

To examine the ability of four models of behaviour, namely, Protection Motivation Theory (PMT), the Common Sense Self-Regulation Model (CS-SRM), and Social Cognitive Theory and the Reasoned Action Approach (SCT and RAA) to understand adherence to transmission-reducing behaviours (TRBs) advised by national governments for suppression of SARS-CoV2.

DESIGN

A series of six cross-sectional telephone surveys of a random representative sample of adults living in Scotland.

METHODS

Self-reported adherence to three TRBs (physical distancing, wearing a face covering and handwashing), PMT, CS-SRM, and SCT/RAA constructs, and sociodemographic variables were measured each week for 6 weeks (n = ~500 p/w; third June-15th July) via a 15 min telephone survey.

RESULTS

Adherence was high ('Always' or 'Most times') throughout for physical distancing and handwashing, and, when mandated, for wearing a face covering. Older people were more adherent to all TRBs. Constructs from all three models predicted all three TRBs. Intention and self-efficacy (SCT/RAA) were the only beliefs to predict to all three TRBs each week and for all groups equally; intention was the strongest predictor. The predictive utility of PMT and CS-SRM varied by TRB and by group. Of note was the observation that several illness beliefs were associated with adherence only for those who believed they had not had COVID-19.

CONCLUSIONS

The CHARIS project has identified beliefs about specific behaviours, the illness and the risks associated with lower adherence rates that might be addressed in national interventions. It confirms previous findings that some groups show lower levels of adherence and might be specially targeted.

Through the Second Wave: Analysis of the Psychological and Perceptive Changes in the Italian Population during the COVID-19 Pandemic

More than a year has passed since “patient 0” was found and COVID-19 is now an established reality that a lot of people have had to accept and coexist with. In Italy, the pandemic hit in “waves”, but the studies assessing the longitudinal impact of the pandemic in the general population are not many. In this paper, we compared data collected during the first wave with data gathered during the second one, so that we can provide insights about the Italian population’s psychological adaptation to the pandemic also by comparing them with pre-pandemic normative scores. From our results, it seemed that people were seeking a compromise: indeed, despite the still-relevant risk perception, people apparently “learned” how to deal with the pandemic as indicated by an increase in self-efficacy and a more internal locus of control.