The importance of coping appraisal in behavioural responses to pandemic flu

Mpox knowledge, behaviours and barriers to public health measures among gay, bisexual and other men who have sex with men in the UK: a qualitative study to inform public health guidance and messaging

BACKGROUND

The 2022-23 mpox epidemic is the first-time sustained community transmission had been reported in countries without epidemiological links to endemic areas. During that period, the outbreak almost exclusively affected sexual networks of gay, bisexual, or other men who have sex with men (GBMSM) and people living with HIV. In efforts to control transmission, multiple public health measures were implemented, including vaccination, contact tracing and isolation. This study examines knowledge, attitudes, and perceptions of mpox among a sample of GBMSM during the 2022-23 outbreak in the UK, including facilitators for and barriers to the uptake of public health measures.

METHODS

Interviews were conducted with 44 GBMSM between May and December 2022. Data were analysed using reflexive thematic analysis. Positive and negative comments pertaining to public health measures were collated in a modified version of a 'table of changes' to inform optimisations to public health messages and guidance.

RESULTS

Most interviewees were well informed about mpox transmission mechanisms and were either willing to or currently adhering to public health measures, despite low perceptions of mpox severity. Measures that aligned with existing sexual health practices and norms were considered most acceptable. Connections to GBMSM networks and social media channels were found to increase exposure to sexual health information and norms influencing protective behaviours. Those excluded or marginalized from these networks found some measures challenging to perform or adhere to. Although social media was a key mode of information sharing, there were preferences for timely information from official sources to dispel exaggerated or misleading information.

CONCLUSIONS

There are differential needs, preferences, and experiences of GBMSM that limit the acceptability of some mitigation and prevention measures. Future public health interventions and campaigns should be co-designed in consultation with key groups and communities to ensure greater acceptability and credibility in different contexts and communities.

Are Fear Campaigns Effective for Increasing Adherence to COVID-Related Mitigation Measures?

BACKGROUND

Using fear to increase the uptake of preventative health behaviours is a longstanding practice, which could be useful in mitigating the spread of COVID-19. However, the impact of fear campaigns beyond behavioural outcomes has rarely been considered. It is possible that these threatening health messages could heighten health-related anxiety by inducing a tendency to interpret ambiguous stimuli in a threatening manner. This research aimed to evaluate the effects of fear-based articles about COVID-19, on intentions to adhere to mitigation measures and interpretation bias-a core maintenance factor in health anxiety.

METHOD

Two pilot studies were conducted with the aim of validating our novel COVID-related measures and assessing engagement with the threat manipulation. Following this, 375 community members were recruited through social media for the main study. Participants were then randomly allocated to read an article about COVID which was manipulated on both threat and efficacy. After reading the article, participants then completed measures of interpretation bias and intentions to engage in COVID-19 mitigation measures.

RESULTS

Although the threatening articles consistently produced greater COVID-related threat, they only generated a stronger interpretation bias in the first pilot study. Importantly, threat-based communications failed to enhance intentions to perform mitigation measures in any of the studies. Likewise, reading an article which bolstered self-efficacy did not increase intentions, compared to reading a low efficacy article.

CONCLUSION

This research suggests that fear appeals are unlikely to increase intentions to perform COVID-related mitigation measures.

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.

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

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

Cognitive and emotional factors related to COVID-19 among high-risk ethnically diverse adults at the onset of the New York City outbreak: A cross-sectional survey

A cross-sectional survey was conducted among high-risk, racially/ethnically diverse adults at the point in time when New York City (NYC) became the COVID-19 pandemic's global epicenter. The study objective was to assess the threat and coping appraisals (cognitive factors known to correspond with people's willingness to adopt behaviorally focused interventions) and levels of distress, anxiety, and intolerance for uncertainty (emotional factors). Survey respondents were recruited in April 2020 using an online survey with unpaid recruitment on the GetHealthyHeights.org community-oriented website. We also recruited participants that engaged in previous research studies to gain survey responses from community members at higher risk for COVID-19 complications due to comorbidities compared to the general population. Analysis was performed to test for differences in survey responses by comorbidities, age, race, ethnicity, and employment status. Results show that the devastating effects of the pandemic appear to have uniquely impacted minority respondents, who reported significantly higher levels of anxiety and were significantly more likely to report having little control over whether they will get COVID-19 compared with White/non-Hispanic respondents. Minority respondents also had significantly higher mean scores on the behaviorally focused dimension of the intolerance of uncertainty (IU) scale, which measures avoidance and paralysis in the face of uncertainty. In multivariate analysis, IU predicted anxiety levels, and this association was not mediated by cognitive factors (threat and coping appraisals). By conducting this survey early in the pandemic, our study uniquely evaluated cognitive and emotional factors among a racially/ethnically diverse group of NYC residents during the height of the COVID-19 pandemic. Our findings suggest the need to acknowledge the disparities that appear to exist in pandemic response and for culturally tailored messaging and interventions. Few studies have reported differences by race and ethnicity during pandemic exposure. Therefore, further research on factors that may influence pandemic response among minority populations is needed.

Early COVID-19 Home-Based Care Knowledge and Efficacies: Comparing Ghanaian and US Respondents

Home-based care messages were part of behavioral modification interventions to mitigate COVID-19 spread early in the pandemic. What remains unclear is the types of home-based care knowledge people have and whether different kinds of home-based care knowledge influence a person's self-efficacy and response efficacy in managing mild cases. Using a cross-sectional online survey, this exploratory study investigated differences in biomedical and alternative knowledge about COVID-19 home-based care and their association with self and response efficacy from respondents in Ghana and the US. With a total sample of 736 made up of 50.3% from Ghana and 49.7% from the US, the average age range was of 39-48 years. Sixty two percent were females and 38% males. Using chi-square goodness of fit tests, t-tests, and multiple regression for analysis, we found that US respondents had higher biomedical knowledge while Ghanaian respondents had higher alternative knowledge. Although self-efficacy and response efficacy were high in both countries, both kinds of knowledge did not independently improve respondents' self-efficacy or response efficacy. However, a combination of biomedical and alternative home-based care knowledge items predicted self and response efficacy. Health promoters need to consider ways of utilizing both knowledge types in a complimentary manner during disease outbreaks.

Association between Stress and Physical Fitness of University Students Post-COVID-19 Pandemic

Post-COVID-19 pandemic, most universities changed their educational model from online courses to onsite learning, allowing students to attend regular face-to-face classes. These changes can cause stress in students, which affects physical fitness. The aim of this study was to investigate the relationship between stress levels and physical fitness in female university students. The participants were 101 female university students, 18-23 years of age. All participants completed the Suan Prung Stress Test-60 (SPST-60). The physical fitness test included body composition, cardiorespiratory fitness, as well as musculoskeletal fitness. Multiple linear regression analysis was used to determine the associations between SPST-60 scores and physical fitness. A p-value < 0.05 was considered statistically significant. We found a negative correlation between the sources of stress scores, here environment, and maximal oxygen consumption (β = -0.291; 95% CI, -0.551, -0.031). We also found that symptoms of stress scores in the parasympathetic and sympathetic nervous systems were positively associated with waist-hip circumference ratio (WHR) (β = 0.010; 95% CI, 0.002, 0.017 and β = 0.006; 95% CI, 0.000, 0.012, respectively). Moreover, the symptoms of stress, here emotion, were positively associated with the WHR (β = 0.005; 95 %CI, 0.001, 0.009) and negatively associated with upper extremity muscle strength (β = -0.005; 95% CI, -0.009, 0.000). The results of this study confirmed the associations between stress levels in the post-COVID-19 pandemic era and WHR, maximal oxygen consumption, and upper extremity muscle strength. As a result, stress reduction or prevention alternatives should be considered in order to maintain physical fitness and prevent stress disorders.

Anxiety, Stress and the Resilience of University Students during the First Wave of the COVID-19 Pandemic

The COVID-19 pandemic had an impact on everyone’s daily lives with short-term or long-term consequences. Among the affected population, university students were studied by researchers specifically due to the total change to their educational way of learning and the courses they attended. The present study aimed to assess the psychological difficulties experienced by the university students of Greece during the first wave of the outbreak. Methods: 288 university nursing students completed an electronic questionnaire after consent. The sample included students from all years of study. The questionnaire included demographic data and questions about mental health status, resilience level, coping strategies, positive and negative emotions and an optimism assessment. Results: Depression (44.8%), anxiety (36.8%) and stress (40.3%) were experienced by the students. Females had significantly greater anxiety and stress signs compared to males (p < 0.001). The resilience score was significantly greater in males, as it was for the Positive Affect Score. Students in the fourth year of study used significantly more active/positive coping strategies than students in the first (p = 0.016) or second year of study (p = 0.005). Conclusion: Several students experienced serious mental disorders during the first period of the COVID-19 outbreak. Variables such as gender, year of study, age, positive and negative affect score, life orientation test score and coping strategies were identified as factors contributing to this situation. Special attention must be paid to female students as they mentioned negative emotions more frequently than males. Further research on the academic population could be beneficial to university administrators.

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

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

Indonesian Scientists’ Behavior Relative to Research Data Governance in Preventing WMD-Applicable Technology Transfer

Performing research data governance is critical for preventing the transfer of technologies related to weapons of mass destruction (WMD). While research data governance is common in developed countries, it is still often considered less necessary by research organizations in developing countries such as Indonesia. An investigation of research data governance behavior for Indonesian scientists was conducted in this study. The theories of planned behavior (TPB) and protection motivation (PMT) were used to explain the relationships between different factors influencing scientists’ behavior. The theories have been widely used in the information security domain, and the approach was adopted to build the research model of this study. The obtained data were analyzed using partial least-squares structural equation modeling (PLS-SEM) to answer the main research question: “what factors determine the likelihood of practicing research data governance by Indonesian scientists to prevent WMD-applicable technology transfer?” By learning what motivates scientists to adopt research data governance practices, organizations can design relevant strategies that are directed explicitly at stimulating positive responses. The results of this study can also be applied in other developing countries that have similar situations, such as Indonesia.

Explicating gender disparity in wearing face masks during the COVID-19 pandemic

BACKGROUND

The available evidence suggests that women were more likely to wear face masks as a precaution during the COVID-19 pandemic. However, few studies have explicated this gender disparity in wearing face masks. This study investigates associations of demographic factors with wearing face masks in Malaysia during the COVID-19 pandemic, then explicates gender disparity in wearing face masks from the lens of the Protection Motivation Theory.

METHODS

The first part of this study employed a structured online survey of 708 Malaysian adult participants. Data collected were quantitatively analyzed by means of descriptive statistics, bivariate correlations, analysis of variance (ANOVA), and multiple linear regression. The second part of this study was conducted among 28 women to better understand gender disparity in protection motivations from the perspectives of women.

RESULTS

Gender has the strongest positive association with wearing face masks (p-value < .001), followed by age (p-value = .028). The Protection Motivation Theory adequately explicated the gender disparity in wearing face masks. Additionally, women were motivated to wear face masks beyond protection from the SARS-CoV-2.

CONCLUSION

Understanding the underlying motivations for wearing face masks informs design of gender-based public health messages to increase compliance with public health regulations and reduce morbidity and mortality for present and future public health crises.

Investigating a psychological model of mental conditions and coping during the COVID-19 pandemic driven by participatory methods

BACKGROUND

There is evidence of increased mental health problems during the early stages of the COVID-19 pandemic. We aimed to identify the factors that put certain groups of people at greater risk of mental health problems.

METHODS

We took a participatory approach, involving people with lived experience of mental health problems and/or carers, to generate a set of risk factors and potential moderators of the effects of COVID on mental health. An online cross-sectional survey was completed by 1464 United Kingdom residents between 24th April and 27th June 2020. The survey had questions on whether respondents were existing mental health service users and or carers, level of depression (PHQ9) and anxiety (GAD7), demographics, threat and coping appraisals, perceived resilience (BRS), and specific coping behaviours (validated as part of this study). The relationship between responses and coping strategies was measured using tetrachoric correlations. Structural equation modelling was used to test the model.

RESULTS

A model significantly fit our data (rel χ² = 2.05, RMSEA = 0.029 95%, CI (0.016, 0.042), CFI = 0.99, TLI = 0.98, SRMR = 0.014). Age and coping appraisal predicted anxiety and depression. Whereas, threat appraisal and ethnicity only predicted anxiety, and resilience only predicted depression. Additionally, specific coping behaviours predicted anxiety and depression, with overlap on distraction.

CONCLUSIONS

Some, but not all, risk factors significantly predict anxiety and depression. While there is a relationship between anxiety and depression, different factors may put people at greater risk of one or the other during the pandemic.

Determinants of emotional distress in neonatal healthcare professionals: An exploratory analysis

Background

High levels of mental health problems have been consistently reported among neonatal healthcare professionals. While studies suggest that personality, coping strategies and safety culture might contribute to the psychological wellbeing of healthcare professionals, they have not been systematically investigated in low-risk (i.e., neonatal wards; NWs) and high-risk (i.e., neonatal intensive care units; NICUs) neonatal contexts. The current study investigated potential predictors of professionals' emotional distress and whether they differ according to the work setting (i.e., NICUs vs. NWs).

Methods

Healthcare professionals (N = 314) from 7 level-3 (i.e., NICUs) and 6 level-2 (i.e., NWs) neonatal units in Tuscany were included. Emotional distress (i.e., anxiety, depression, psychosomatic, post-traumatic stress symptoms and emotional exhaustion), Behavioral Inhibition System (BIS) and Behavioral Approach System (BAS) sensitivity, coping strategies and safety culture were assessed through well-validated, self-reported questionnaires.

Results

Greater BIS/BAS sensitivity, avoidance coping strategies and a sub-dimension of safety culture (i.e., stress recognition) were significantly associated with greater risk of emotional distress, whereas job satisfaction emerged as a protective factor. Three specific profiles of professionals in term of personality, coping and safety culture were identified and further predicted emotional distress. Neonatal wards and NICUs personnel presented different associations between personality, coping and safety culture.

Conclusion

These findings highlighted significant modifiable contributors of neonatal mental healthcare professionals' wellbeing. Institutional initiatives that target these factors and, particularly, job satisfaction may promote professionals' emotional wellbeing and thus improve caring processes.

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.

A qualitative study of developers' discussions of their problems and joys during the early COVID-19 months

Many software developers started to work from home on a short notice during the early periods of COVID-19. A number of previous papers have studied the wellbeing and productivity of software developers during COVID-19. The studies mainly use surveys based on predefined questionnaires. In this paper, we investigate the problems and joys that software developers experienced during the early months of COVID-19 by analyzing their discussions in online forum devRant, where discussions can be open and not bound by predefined survey questionnaires. The devRant platform is designed for developers to share their joys and frustrations of life. We manually analyze 825 devRant posts between January and April 12, 2020 that developers created to discuss their situation during COVID-19. WHO declared COVID-19 as pandemic on March 11, 2020. As such, our data offers us insights in the early months of COVID-19. We manually label each post along two dimensions: the topics of the discussion and the expressed sentiment polarity (positive, negative, neutral). We observed 19 topics that we group into six categories: Workplace & Professional aspects, Personal & Family well-being, Technical Aspects, Lockdown preparedness, Financial concerns, and Societal and Educational concerns. Around 49% of the discussions are negative and 26% are positive. We find evidence of developers' struggles with lack of documentation to work remotely and with their loneliness while working from home. We find stories of their job loss with little or no savings to fallback to. The analysis of developer discussions in the early months of a pandemic will help various stakeholders (e.g., software companies) make important decision early to alleviate developer problems if such a pandemic or similar emergency situation occurs in near future. Software engineering research can make further efforts to develop automated tools for remote work (e.g., automated documentation).

Development of health belief in emerging infectious respiratory disease preventive behaviors' scale

We developed a psychometric scale based on the Health Belief Model to predict preventive behaviors against emerging respiratory infectious diseases and verified its validity and reliability. Initial items on five constructs of the Health Belief Model were derived through focus group interviews and a literature review. These items were revised and supplemented through expert consultation to verify content validity. Data were collected from June 27, 2021, to July 5, 2021. We used the data of 201 adults aged 19-65 years for item analysis and assessment of construct, convergent, and discriminant validities and reliability. The final Health Belief in Emerging Infectious Respiratory Disease Preventive Behaviors' Scale (HB-EIRD Preventive Behaviors' Scale) included 23 items on five factors, and cumulative explanatory variation was 63.0%. The fit indices were acceptable. Cronbach's α was 0.77. The scale can be scored 23-92; a higher score indicates stronger preventive behaviors. The HB-EIRD Preventive Behaviors' Scale can be used to evaluate patients' health beliefs and predict preventive behaviors against emerging respiratory infectious diseases. This foundational knowledge can facilitate disease prevention and promote public health measures.

Restaurant Diners' Switching Behavior During the COVID-19 Pandemic: Protection Motivation Theory

The unsettling fear of COVID-19 infections has caused a new trend in consumer behavior in the food and beverage industry. The unprecedented COVID-19 pandemic has shifted consumers' preferences from eat-in to online delivery. This research aims to measure the impact of consumers' motivation to protect themselves from contracting COVID-19, which explains why people switch from eat-in to online food delivery. We adopted the theory of protection motivation (PMT) to explain consumer switching behavior during the COVID-19 pandemic. The present study investigated the mediating effect of switching intention on the relationship between vulnerability, altruistic fear, anticipated regret, and switching behavior. Simultaneously, we examined the role of brand awareness as a moderator of behavioral choices of consumers switching from eat-in to online delivery. We collected data from 681 eatery consumers in Kuala Terengganu, Malaysia, using scenario-based survey questionnaires (327 eat-in respondents and 354 online delivery respondents). Then, the data were analyzed using structural equation modeling (SEM). This new generation analysis was conducted using the analysis of moment structure (AMOS) (v.24.0) and the statistical package for social science (SPSS-version 25.0). The results indicated that consumer vulnerability, altruistic fear, and anticipated regret of COVID-19 increased consumers' propensity to shift from eat-in to online food delivery. Allegedly, consumer behavioral control and intention of switching toward online delivery were pointedly affected by switching behavior. The results indicated that consumer vulnerability, altruistic fear, and anticipated regret of COVID-19 increased the shifting of restaurant dine-in patterns and made the intention to switch to online delivery. Consumers' alleged behavioral control and their intention of switching toward online delivery were pointedly affected by switching behavior. We also found that brand awareness moderately affects switching behavior toward restaurant settings. The present research contributes to developing the consumer behavior model of switching from eat-in to online delivery. This study also provides eatery customers and the business community with a safer and healthier proposition of shifting to online food delivery during the pandemic.

Personality, gender, and age resilience to the mental health effects of COVID-19

RATIONALE

Understanding the impact of COVID-19 on different population cohorts and which personality traits affected individual's coping responses can help identify strategies to promote self-directed behaviours, thereby enhancing and maintaining individual's mental well-being.

OBJECTIVE

Using longitudinal data for the UK, we examine the impact of the COVID-19 pandemic on individuals' mental well-being, focusing on age, gender, and personality traits as possible modifiers.

METHODS

We explore the longitudinal nature of the data using individual fixed effects models, which implicitly control for unobserved time-invariant individual-level characteristics. Our sample is an unbalanced panel consisting of 373,555 person-years observations, observed from 2009 until June 2020.

RESULTS

The negative impacts of the first months of the pandemic period are found to be larger for young adults (aged 16-25 years) and vary by personality traits. The increase in psychological distress symptoms is more pronounced for individuals who score higher in neuroticism, extroversion, and openness to experience. Indeed, for introverted young people, recent events may have actually brought a sense of calm. Other findings indicate that worsening in the psychological distress level occurs alongside with increased feelings of loneliness.

CONCLUSIONS

Our findings support the theoretical knowledge that different people have different psychological and behaviour responses and personality concepts can be used when studying individual's adaptive behaviour in critical situations such as COVID-19. Our results indicate the necessity of public health programmes to assist distressed young individuals.

Facilitating free and paid vaccine acceptance in Malaysia: effectiveness of vaccine and fear of COVID-19

Purpose

This study aims to examine how demographic and psychological predictors of free and paid vaccine acceptance operate within an infectious environment. The psychological predictors were derived from the protection motivation theory (PMT), including the appraised effectiveness of vaccine in containing the pandemic and the fear of COVID-19.

Design/methodology/approach

A representative data set that consists of responses from 2,850 Malaysians was used in this study. Multi-level modelling was used to analyse the data.

Findings

Results indicated that the acceptance of free and paid vaccination did not differ by region. This suggests that the effects of the included psychological predictors on vaccine acceptance are independent from the environment. Malaysians are more likely to endorse both free and paid vaccination when it is perceived as effective in controlling the pandemic. When the vaccine is deemed as an effective preventive of COVID-19, Malaysians tend to seek free vaccination. Although fear of COVID-19 did significantly predict the endorsement of vaccination, it is a weaker predictor than the perceived effectiveness of vaccine.

Originality/value

This research used a large representative data set and the PMT framework in addressing vaccine acceptance in Malaysia.

Nudging physical distancing behaviors during the pandemic: a field experiment on passengers in the subway stations of shiraz, Iran

Background

The possibility of the emergence of new pandemics necessitates further research into using simple strategies to promote social distancing behaviors in public. Most of the current evidence on effectiveness of physical distancing interventions is based on self-report and measure of intention which will not necessarily predict actual behavior.

Methods

A field experimental study was conducted in the subway stations of Shiraz, Southern Iran. The interventions were based on intuitions from protection motivation theory and consisted of using environmental nudges to notify the passengers of the pandemic situation (threat appeal) and a verbal advice on keeping a safe physical distance as an effective method of protection against COVID-19 (coping message). Average physical distancing was estimated as the number of steps between two consecutive passengers and was compared between interventions (n = 1045) and the control (n = 855) groups.

Results

A total of 1900 people riding on subway escalators were directly observed during two intervention conditions and the control condition. Under either threat or coping-based interventions, passengers were two times more likely (OR 2.0, 95%CI 1.5–2.7, P <  0.001) to keep a physical distance of at least 1.2 m from the traveler in front compared with those who did receive no intervention. The Kruskal-Wallis test revealed that there was a significant improvement in physical distancing behaviors with coping advice compared with threat appeal and the control conditions (χ2 = 120.84, df = 2, p <  0.001).

Conclusions

Our findings suggest that simple and inexpensive theory-based interventions can be used in crowded public spaces to promote physical distancing within the context of the pandemic.

Prevalence and Factors Associated With PTSD-Like Symptoms Linked to the COVID-19 Pandemic Among Patients With Major Depressive Disorders Seeking Emergency Care

The aim of this study was to evaluate the psychological impact and coping strategies experienced by depressed inpatients during the second wave of the COVID-19 pandemic in Italy. We recruited 75 depressed inpatients. Logistic regression was used to determine predictors of PTSD-like symptoms measured with Impact of Event Scale-Revised. Predicting variables were age, sex, the Coping Orientation to Problems Experienced subscales scores, the Anxiety Status Inventory total score, and the Patient Health Questionnaire-9 total score. The prevalence of PTSD-like stress symptoms was 41.33%. Age, social and avoidance coping strategies, and anxiety levels were significant predictors of PTSD-like symptoms. Our findings suggest that the COVID-19 pandemic in depressed inpatients is associated with PTSD-like stress symptoms, anxiety, and maladaptive coping.

Television, News Media, Social Media and Adolescents’ and Young Adults’ Violations of the COVID-19 Lockdown Measures: A Prototype Willingness Model

During the COVID-19 pandemic, television and social media informed and entertained people. This cross-sectional study among adolescents and young adults (n = 859, 71.94% female, M_age = 20.55, SD_age = 4.59) examined the associations between pro- and anti-governmental (social) media and youth’s violations of the lockdown measures following the prototype willingness model (PWM). Data were collected during Belgium’s first and strictest lockdown. The results largely confirmed the applicability of the PWM in a public health context. Posting of and exposure to anti-governmental social media messages positively related to violations of the regulations via higher descriptive norm perceptions of peers violating the measures and positive attitudes towards violations. Pro-governmental media interactions (i.e., exposure to news media and pro-governmental social media messages) negatively related to violations via negative attitudes towards violations. No support emerged for the role of (televised) series, prototype favorability, or subjective norms in the PWM. Differences in posting versus exposure of social media messages were found. Posting generally related stronger to risk cognitions and behaviors compared to exposure. Gender and age moderated some of the examined relations in the PWM. Implications for media research and health campaigns are discussed.

The fear of COVID-19 and job insecurity impact on depression and anxiety: An empirical study in China in the COVID-19 pandemic aftermath

The employees' psychological health and resilience in times of emergency and general uncertainty was chosen due to the immense implications for economics, entrepreneurs, psychologists and psychiatrists, and policymakers. This study aims to provide an insight into uncertainty-induced anxiety and depression among Chinese employees in the aftermath of the COVID-19 outbreak. Analysis performed in the context of China in the COVID-19 pandemic aftermath is significant due to the universal nature of external shock impact on psychological welfare, applicable across nations and business sectors and in similar contexts. The statistical analysis was performed with SEM software AMOS version 23. The research model consisting of fear of COVID-19, job insecurity, anxiety, depression, was empirically tested. A purposive sampling technique was applied with the online questionnaire shared with employees in companies located in China. Respondents were working in educational services, information technology, engineering, electronics, and other sectors on white-collar jobs. The data collection was conducted from May to August 2020, in the aftermath of the COVID-19 pandemic in China. The research sample consisting of 283 respondents was used for analysis. Path analysis was performed, and standardized parameter estimates, standard errors, and p-values were calculated. The results indicate a positive and significant impact of job insecurity on depression and anxiety. Furthermore, results indicate that the fear of COVID-19 significantly impacts anxiety and depression but does not impact job insecurity. The findings can be used in a multidisciplinary effort to mitigate the psychological damage. Furthermore, they complement the ongoing epidemiological and scientific discourse on people's personal health and choice of coping.

What makes Dutch youth comply with preventive COVID-19 measures? An explorative study

The measures to contain the spread of COVID-19 are challenging for youth, especially the social isolation measures. These measures are antagonistic to healthy youth development, which requires sufficient social contact with peers and adults. This explorative study examined what factors are associated with adherence to COVID-19 measures in a sample of Dutch youth (N = 263; 79.8% female) with ages ranging between 16 and 24 years (M = 21.1 years; SD = 2.44 years), who completed an online questionnaire about their compliance to measures, resilience, coping strategies, mental health, and availability of a natural mentor. Results showed that youth with fewer depressive symptoms adhered better to measures of social distance. Youth who were less suspicious, more resilient, and those with an active coping strategy or a natural mentor more often complied with COVID-19 measures. These results can be used to help youth comply with the COVID-19 measures.

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

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

How dialogic internal communication fosters employees' safety behavior during the COVID-19 pandemic

As employees return to the workplace amidst the COVID-19 pandemic, ensuring safety and health at work remains a top priority for organizations. Grounded in dialogic theory and protection motivation theory, this study examines how dialogic communication, as a type of strategic internal communication, can encourage employees to engage in safety behaviors in the workplace during the COVID-19 pandemic via heightened efficacy and perceived threat. An online survey of full-time employees of different industries returning to the workplace during the COVID-19 pandemic is conducted. Results suggest that the communal relationship of employees with their organization, influenced by dialogic internal communication, fosters their efficacy and perceived threat of COVID-19 in the workplace, which in turn increases their safety behaviors. Theoretical and practical implications for public relations and internal communication studies are discussed.

To distance or to help: People's ambivalent attitude towards residents from the COVID-19 epicenter

The COVID-19 pandemic has led to drastic changes in the world. One prominent aspect has been the transformation in interpersonal relations, especially people's attitude towards residents from COVID epicenters. Using a 2-wave national study in mainland China during the pandemic outbreak, this study examined Chinese people's distancing and helping intentions towards residents from Hubei Province, the epicenter of China at that time. Results suggested that individuals had an ambivalent attitude towards denizens from the epicenter. Specifically, people felt greater risk when they perceived a higher severity of the pandemic and so were more likely to distance from epicenter residents. However, individuals showed greater empathy towards epicenter residents when they felt a higher severity of the pandemic and, therefore, were more likely to help them. Group identity moderated these effects: those with a higher identification as Chinese were more inclined to help Hubei residents, but those with a lower identification as Chinese were more prone to distance from them. The findings provide important implications in understanding interpersonal relationships during the pandemic.

Relationships among adult playfulness, stress, and coping during the COVID-19 pandemic

The COVID-19 pandemic created high levels of stress that negatively affect mental health and well-being. The stress and coping process is influenced by individual difference factors, such as personality, that impact perceptual processes and emotional reactions. Adult playfulness is a personality characteristic that may lead to better mental and physical health outcomes. We test a theoretical model to determine whether the two factors of perceived stress, perceived self-efficacy (PSE) and perceived helplessness (PH), mediate the relationship among playfulness and coping in adults (N = 694). Scores on the Perceived Stress Scale were high indicating high levels of pandemic-related stress. The SEM model demonstrated direct effects of playfulness on PSE, PH, adaptive, maladaptive, and supportive coping. Both dimensions of perceived stress were partial mediators in the relationship among playfulness and coping outcomes. Findings illustrate the pathways by which adult playfulness can amplify or attenuate the impact of stress perceptions on coping strategies. The importance of building psychological resources such as playfulness to boost adaptive outcomes in stressful situations such as the COVID-19 pandemic is discussed.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s12144-022-02870-0.

Examining the role of COVID-19 testing availability on intention to isolate: A Randomized hypothetical scenario

BACKGROUND

Little information exists on how COVID-19 testing influences intentions to engage in risky behavior. Understanding the behavioral effects of diagnostic testing may highlight the role of adequate testing on controlling viral transmission. In order to evaluate these effects, simulated scenarios were conducted evaluating participant intentions to self-isolate based on COVID-19 diagnostic testing availability and results.

METHODS

Participants from the United States were recruited through an online survey platform (Amazon Mechanical Turk) and randomized to one of three hypothetical scenarios. Each scenario asked participants to imagine having symptoms consistent with COVID-19 along with a clinical diagnosis from their physician. However, scenarios differed in either testing availability (testing available v. unavailable) or testing result (positive v. negative test). The primary outcome was intention to engage in high-risk COVID-19 behaviors, measured using an 11-item mean score (range 1-7) that was pre-registered prior to data collection. Multi-variable linear regression was used to compare the mean composite scores between conditions. The randomized survey was conducted between July 23rd to July 29th, 2020.

RESULTS

A total of 1400 participants were recruited through a national, online, opt-in survey. Out of 1194 respondents (41.6% male, 58.4% female) with a median age of 38.5 years, participants who had no testing available in their clinical scenario showed significantly greater intentions to engage in behavior facilitating COVID-19 transmission compared to those who received a positive confirmatory test result scenario (mean absolute difference (SE): 0.14 (0.06), P = 0.016), equating to an 11.1% increase in mean score risky behavior intentions. Intention to engage in behaviors that can spread COVID-19 were also positively associated with male gender, poor health status, and Republican party affiliation.

CONCLUSION

Testing availability appears to play an independent role in influencing behaviors facilitating COVID-19 transmission. Such findings shed light on the possible negative externalities of testing unavailability.

TRIAL REGISTRATION

Effect of Availability of COVID-19 Testing on Choice to Isolate and Socially Distance, NCT04459520, https://clinicaltrials.gov/ct2/show/NCT04459520.

Psychological Impact and Compliance with Staying at Home of the Public to COVID-19 Outbreak during Chinese Spring Festival

In December 2019, COVID-19 was reported in Wuhan, China. Most of the studies related to the psychological impact and compliance with staying at home due to COVID-19 focused on ten days or one month after the initial “stay-at-home” phase of the COVID-19 pandemic. The early psychological impact and behavior change to COVID-19 during the Chinese Spring Festival (the start time for recommendations to stay at home) is uncertain. In this study, people from 23 provinces in China were recruited to participate in an online survey, using Credamo. Psychological impact and compliance with staying at home were evaluated by a self-designed and validated questionnaire. The results indicated that anxiety was the most often reported feeling (mean: 3.69), followed by sadness (mean: 3.63). Participants employed in foreign-owned companies were most likely to express anxiety and sadness. Overall, 61.8% of participants reported hardly going out, whereas 2.4% said they frequently went out during the initial “stay-at-home” phase of the COVID-19 pandemic. Participants with higher levels of anxiety and sadness were most likely to stay at home against the spread of COVID-19, as were female gender. This survey is an important study of the first reaction to staying at home during the initial “stay-at-home” phase coinciding with Chinese Spring Festival. Our findings identified factors associated with higher level of psychological impact and better compliance with staying at home recommendations during Chinese Spring Festival. The findings can be used to formulate precaution interventions to improve the mental health of vulnerable groups and high uptake of policy during the COVID-19 epidemic.

Did we learn something positive out of the COVID-19 pandemic? Post-traumatic growth and mental health in the general population

Background

When facing a traumatic event, some people may experience positive changes, defined as posttraumatic growth (PTG).

Methods

Understanding the possible positive consequences of the pandemic on the individual level is crucial for the development of supportive psychosocial interventions. The present paper aims to: 1) evaluate the levels of PTG in the general population; 2) to identify predictors of each dimension of post-traumatic growth.

Results

The majority of the sample (67%, N = 13,889) did not report any significant improvement in any domain of PTG. Participants reported the highest levels of growth in the dimension of “appreciation of life” (2.3 ± 1.4), while the lowest level was found in the “spiritual change” (1.2 ± 1.2). Female participants reported a slightly higher level of PTG in areas of personal strength (p < .002) and appreciation for life (p < .007) compared to male participants, while no significant association was found with age. At the multivariate regression models, weighted for the propensity score, only the initial week of lockdown (between 9-15 April) had a negative impact on the dimension of “relating to others” (B = −.107, 95% CI = −.181 to −.032, p < .005), while over time no other effects were found. The duration of exposure to lockdown measures did not influence the other dimensions of PTG.

Conclusions

The assessment of the levels of PTG is of great importance for the development of ad hoc supportive psychosocial interventions. From a public health perspective, the identification of protective factors is crucial for developing ad-hoc tailored interventions and for preventing the development of full-blown mental disorders in large scale.

To vaccinate or not to vaccinate!? Predictors of willingness to receive Covid-19 vaccination in Europe, the U.S., and China

Researcher teams around the globe including the "Project Lightspeed" are intensively working on vaccines to fight the Covid-19 pandemic. However, the availability of effective vaccines does not guarantee the vaccination willingness among the population. In spring 2021, we investigated the vaccination willingness and its potential predictors in representative online samples in nine countries (China, France, Germany, Poland, Russia, Spain, Sweden, U.K., U.S.). Of the 9,264 participants, 79.9% revealed Covid-19 vaccination willingness. The highest willingness was in the U.K., followed by Spain and China, the lowest in Russia. In most countries, the perception of governmental Covid-19 measures as useful and the use of television reports as Covid-19 information source positively predicted the willingness. Further factors such as demographic variables, mental and physical health status, evaluation of governmental communication, social media use, and general adherence to Covid-19 measures showed a country-specific predictive pattern. Recommendations how to increase the vaccination willingness are provided.

Analysis of the Impact of Media Trust on the Public's Motivation to Receive Future Vaccinations for COVID-19 Based on Protection Motivation Theory

Object: Media trust is one of the essential factors affecting health behavior. Based on the protection motivation theory (PMT), this study explores the impact of different public media trust (traditional media, social media, interpersonal communication) on future COVID-19 vaccine motivation. Methods: The online survey was conducted from 14 April to 30 April 2021, and 2098 adults were recruited to participate in the online survey through the Wenjuanxing online survey platform. The survey included the PMT constructs (threat appraisal, coping appraisal, and motivation for future COVID-19 vaccination), trust in different media, vaccine hesitation reasons, and implementation of other non-pharmaceutical interventions. Structural equation model (SEM) was used for latent variable analysis, and Spearman linear correlation coefficient matrix was used to explore the relationships between variables. Results: In terms of trust in different media, participants who had a higher education level (p = 0.038), who was married (p = 0.002), and who had not been vaccinated against COVID-19 during the survey (p = 0.002) show greater trust in traditional media. Participants who were married (p = 0.001), who had a relatively high income (p = 0.020), and who had not been vaccinated (p = 0.044) show greater trust in social media. Older participants (p < 0.001) and married (p < 0.001) showed greater trust in interpersonal communication. In the structural equation, trust in traditional media had a direct positive impact on perceived severity (β = 0.172, p < 0.001) and a direct negative impact on internal rewards (β = -0.061, p < 0.05). Trust in both traditional and social media separately had a direct positive impact on self-efficacy (β = 0.327, p < 0.001; β = 0.138, p < 0.001) and response efficiency (β = 0.250, p < 0.001; β = 0.097, p < 0.05) and a direct negative impact on response costs (β = -0.329, p < 0.001; β = -0.114, p < 0.001). Trust in interpersonal communication had a direct positive impact on external rewards (β = 0.186, p < 0.001) and response costs (β = 0.091, p < 0.001). Overall, traditional media trust had an indirect positive influence on vaccine motivation (β = 0.311), social media trust had an indirect positive influence on vaccine motivation (β = 0.110), and interpersonal communication had an indirect negative influence on vaccine motivation (β = -0.022). Conclusion: This study supports the use of PMT as an intermediate variable to explore the effect of media trust on vaccination intention. High trust in traditional media has helped reduce vaccine hesitation, increased the public's future COVID-19 vaccination motivation, and maintained other non-pharmacological interventions. Social media also had a certain promotion effect on vaccine motivation. In this context, attention should also be paid to interpersonal communication, and the science publicity work was suggested for an individual's family members and friends in the future to improve the quality and ability of interpersonal communication.

Quality of Life, Insomnia and Coping Strategies during COVID-19 Pandemic in Hospital Workers. A Cross-Sectional Study

COVID-19 became a pandemic in a few months, leading to adverse health outcomes, reducing the quality of life, affecting the sleep/wake cycle, and altering coping strategies, especially among hospital personnel. Life quality, insomnia, and coping strategies were thus assessed among hospital personnel during the first wave of the COVID-19 pandemic in Italy. This cross-sectional study was conducted from May to November 2020 through an online survey. There were 558 participants (28.5% males and 71.5% females) enrolled in two different metropolitan areas (in North and South of Italy, respectively). Three standardized questionnaires were administered: European Quality of life–5 Dimensions (EQ-5D), Athens Insomnia Scale (AIS), and Brief COPE. Differences in sociodemographic characteristics and work-related factors were also investigated in order to identify possible predictors through a generalized linear model and logistic regression analysis. Results showed good perceived life quality and high insomnia prevalence. After sample stratification, the statistical analysis highlighted that personal (gender, age, educational level) and work-related factors (employment in COVID wards, remote working) played different roles in predicting quality of life, insomnia, and coping attitude. Active, Planning, and Acceptance were the most frequently adopted coping strategies. Despite women confirming their attitude in reacting to the difficulties, adopting emotion-focused coping strategies, they showed a higher probability to develop insomnia, so a gender perspective should be considered in the health protection of this working category. An integrated approach should be implemented at individual, interpersonal and organizational levels aiming to monitor psychological distress, favor regular sharing and communication between peers, and also allow conciliation of work with family life. At the organizational level, preventive and protective measures adequate to work-related risk to COVID-19 should be adopted.

Mental Health and the Role of Physical Activity During the COVID-19 Pandemic

The COVID-19 pandemic and its related public health restrictions are having an increasingly serious impact on mental health, and measures need to be taken to curb this trend. The positive relationship between physical exercise and mental health has been well-established, but during the COVID-19 pandemic, with various restrictions, the space and facilities for physical exercise are limited. This article explores the relationship between physical exercise and mental health during the COVID-19 pandemic based on the latest research findings published in 2019-2021. We offer a novel model that consists of three central arguments. First, physical exercises during COVID-19, especially supervised exercises, are conducive to enhancing happiness and improving mental health. Second, physical exercise reduces people's anxiety, sadness and depression during the COVID-19 pandemic. Third, the maintenance and improvement of mental health are related to the intensity and frequency of physical exercise. Intensive and frequent physical exercise are conducive to maintaining mental health. Finally, this article proposes important directions for future research.

The predictors of adaptive and maladaptive coping behavior during the COVID-19 pandemic: The Protection Motivation Theory and the Big Five personality traits

The aim of this study was to evaluate the predictive value of the constructs proposed by two influential theoretical frameworks: the Protection Motivation Theory (PMT) and the Big Five (B5) model of personality in predicting health-related coping behavior during the SARS-CoV-2 pandemic. Both adaptive (i.e., preventive) and maladaptive (i.e., avoidant behavior and wishful thinking) coping behavior was measured. The study was conducted during the first wave of the pandemic. The sample consisted of 397 persons from the general Polish population. The findings provided strong support for the PMT constructs' predictive value, especially with regard to pandemic-related adaptive behavior. The B5 personality traits accounted for a small proportion of the variability of coping behavior, especially when maladaptive behavior was the outcome. The PMT model showed incremental validity over and above demographic variables and personality traits in predicting preventive behavior, avoidant behavior, and wishful thinking; however, the patterns of relationships differ across the types of coping behavior. According to the current results, to increase adherence to preventive measures during an epidemic, all the PMT constructs should be considered while persuasive communication to the public is formulated.

Expanding Protection Motivation Theory to Explain Willingness of COVID-19 Vaccination Uptake among Taiwanese University Students

Vaccination appears to be one of the effective strategies to control the COVID-19 pandemic. However, the challenge of vaccine hesitancy may lower the uptake rate and affect overall vaccine efficacy. Being a low-risk group in terms of serious consequences of infection, university students may possess low motivation to get vaccinated. Therefore, an expanded Protection Motivation Theory (PMT) incorporating perceived knowledge, adaptive response, and maladaptive response was proposed to investigate the COVID-19 vaccination intention among Taiwanese university students. University students (n = 924; 575 males; mean age = 25.29 years) completed an online survey during January to February 2021. The proposed expanded PMT model was examined using structural equation modeling (SEM). The results showed that perceived knowledge was significantly associated with coping appraisal (standardized coefficient (β) = 0.820; p < 0.001), and coping appraisal was significantly associated with adaptive response (β = 0.852; p < 0.001), maladaptive response (β = 0.300; p < 0.001) and intention (β = 0.533; p = 0.009). Moreover, maladaptive response (β = −0.173; p = 0.001) but not adaptive response (β = 0.148; p = 0.482) was significantly and negatively associated with intention. The present study’s results demonstrated a positive path between perceived knowledge, coping appraisal, and intention among university students. Therefore, improving knowledge among this population may increase the intention to uptake the vaccine.

What Is the Role of Resilience and Coping Strategies on the Mental Health of the General Population during the COVID-19 Pandemic? Results from the Italian Multicentric COMET Study

The effects of the COVID-19 pandemic on mental health are now well documented, however, few studies have been focused on the role of coping strategies and resilience in counterbalancing these detrimental effects. Data are derived from the COvid Mental hEalth Trial (COMET), a national multicentric trial carried out in the Italian general population. The final sample consisted of 20,720 participants, 53.1% (n = 11,000) of the sample reported low levels of resilience. Adaptive coping strategies and resilience levels did not have any significant protective impact on the levels of depressive, anxiety, and stress symptoms. Only self-distraction was a risk factor for poor mental health (Beta Coefficient, B = 0.1, 95% Confidence Interval, CI: 0.003 to 0.267 for stress symptoms; B = 0.2; 95% CI: 0.077 to 0.324 for anxiety symptoms and B = 0.2, 95% CI: 0.105 to 0.382 for depressive symptoms). High levels of resilience were predicted by adaptive coping strategies, such as acceptance (B = 1.8, CI 95% = 1.4–2.7). Exposure to the different weeks of lockdown, being infected by COVID-19, and being a healthcare professional did not influence the levels of resilience. Our findings should be carefully considered, since the low levels of resilience may represent the missing link between the pandemic and the current increase in mental health problems.

The impact of social distancing on community case count in the United States: Testing the efficacy of protection motivation theory during early stages of the COVID-19 pandemic

Centuries of practice and an array of public health literature support social distancing (SD), or self-quarantine, as a valuable nonpharmaceutical intervention. To convince individuals to engage in behaviors that limit infection, public health professionals communicate risk and hazard based on application of protection motivation theory (PMT). The COVID-19 pandemic presents an opportunity to explore the efficacy of PMT in the context of a novel coronavirus with unique public health implications. We test an integrative conceptual model of social distancing compliance in U.S. counties and examine the mediating impact of SD on community spread of infection. We find that PMT does impact individual behavior, observing that the proportion of vulnerable populations affects social distancing compliance. However, actions to protect individual health are made within the context of economic concerns and priorities. While results indicate that PMT influences behavior, the expected relationship between that behavior and spread of disease in the community is not found. We do not repudiate SD or the value of PMT, but we suggest that these results may indicate that communication of risk in the context of COVID-19 may need community, as well as individual, framing.

How generations differ in coping with a pandemic: The case of restaurant industry

The COVID-19 outbreak has had a negative impact on the restaurant industry and led to major sales and job losses. As it continues to threaten customers' health, it is expected to greatly influence their attitudes and behavior. Therefore, the current study aims to investigate the effects of threat and coping appraisals on consumers' co-creation behaviors during the COVID-19 pandemic. Grounded in protection motivation theory and co-creation theory, the moderating effect of generational cohorts is also investigated vis-a-vis the relationships between protection motivation appraisals and co-creation behaviors in the restaurant industry. Individuals between 18 and 55 years of age completed survey regarding their dine-in experience during the COVID-19 pandemic. The study indicates that customers' perceived severity, self-efficacy, and response efficacy are significant predictors of customers’ co-creation behaviors during the COVID-19 pandemic. The study provides important theoretical and practical implications for the field.

The Threat of COVID-19 and Job Insecurity Impact on Depression and Anxiety: An Empirical Study in the USA

As the coronavirus disease 2019 pandemic causes a general concern regarding the overall mental health of employees worldwide, policymakers across nations are taking precautions for curtailing and scaling down dispersion of the coronavirus. In this study, we conceptualized a framework capturing recurring troublesome elements of mental states such as depression and general anxiety, assessing them by applying standard clinical inventory. The study explores the extent to which danger control and fear control under the Extended Parallel Processing Model (EPPM) threat impact job insecurity, with uncertainty phenomenon causing afflicting effect on the experiential nature of depression heightened by anxiety. With the aim to explore the job insecurity relationship with anxiety and depression, and measure the impact of EPPM threat, an empirical study was conducted in the United States on a sample of 347 white collar employees. Demographic data, EPPM threat, job insecurity, anxiety, and depression data were collected via a standardized questionnaire during the coronavirus disease 2019 (COVID-19) pandemic. The questionnaire consisting of multi-item scales was distributed online. All the scale items were evaluated on a 5-point Likert scale. SEM software AMOS version 23 was used to perform confirmatory factor analysis with maximum likelihood estimation. In the structural model, relationships between the threat of COVID-19, job insecurity, anxiety, and depression were assessed. The findings of the study suggest that job insecurity has a significant impact on depression and anxiety, whereas the threat of COVID-19 has a significant impact on depression. Mediating effects of job insecurity and EPPM threat impact on anxiety were not established in the study. The study contributes to the apprehension of the repercussions of major environmental disruptions on normal human functioning, and it investigates the effects of self-reported protective behaviors on risk perception. The study also explains the underlying mechanisms of coping behavior as possible antecedents to mental disorders. When subjected to stressful events, heightened psychological arousal causes physical and psychological challenges of affected employees to manifest as behavioral issues.

Exploring the predictors of health-protective behavior during the COVID-19 pandemic: A multi-country comparison

In recent years, examining the determinants of health behaviors on a multi-country level remains limited. Therefore, the purpose of this study is to explore the key factors that may enhance the adoption of health-protective behaviors during the COVID-19 pandemic in Morocco and India. A theoretical framework derived from the health belief model (HBM) was used for this research. Data was collected from a sample of 444 adult individuals split across Morocco (n = 215) and India (n = 229). Data analysis was carried out using two-stage multiple-analytic techniques. First, structural equation modeling (SEM) was employed to test the hypothesized relationships. Second, an artificial neural network (ANN) model was employed to rank the significant independent variables obtained from SEM analysis. The results of SEM showed that perceived benefit is the key predictor of the protective behavior in Morocco, followed by self-efficacy, and then perceived severity. By contrast, ANN analysis showed that perceived severity was the most vital factor for predicting the protective behavior in Morocco, followed by perceived benefits, and then self-efficacy. For the Indian sample, both SEM analysis and the ANN model revealed that the impact of perceived susceptibility on the adoption of the protective measure is stronger than that of cues to action. Theoretical contributions and managerial implications are also discussed toward the end.

Prevalence of unmasked and improperly masked behavior in indoor public areas during the COVID-19 pandemic: Analysis of a stratified random sample from Louisville, Kentucky

Wearing a facial mask can limit COVID-19 transmission. Measurements of communities' mask use behavior have mostly relied on self-report. This study's objective was to devise a method to measure the prevalence of improper mask use and no mask use in indoor public areas without relying on self-report. A stratified random sample of retail trade stores (public areas) in Louisville, Kentucky, USA, was selected and targeted for observation by trained surveyors during December 14-20, 2020. The stratification allowed for investigating mask use behavior by city district, retail trade group, and public area size. The total number of visited public areas was 382 where mask use behavior of 2,080 visitors and 1,510 staff were observed. The average prevalence of mask use among observed visitors was 96%, while the average prevalence of proper use was 86%. In 48% of the public areas, at least one improperly masked visitor was observed and in 17% at least one unmasked visitor was observed. The average prevalence of proper mask use among staff was 87%, similar to the average among visitors. However, the percentage of public areas where at least one improperly masked staff was observed was 33. Significant disparities in mask use and its proper use were observed among both visitors and staff by public area size, retail trade type, and geographical area. Observing unmasked and improperly masked visitors was more common in small (less than 1500 square feet) public areas than larger ones, specifically in food and grocery stores as compared to other retail stores. Also, the majority of the observed unmasked persons were male and middle-aged.

Acceptability and feasibility of strategies to shield the vulnerable during the COVID-19 outbreak: a qualitative study in six Sudanese communities

BACKGROUND

Shielding of high-risk groups from coronavirus disease (COVID-19) has been suggested as a realistic alternative to severe movement restrictions during the COVID-19 epidemic in low-income countries. The intervention entails the establishment of 'green zones' for high-risk persons to live in, either within their homes or in communal structures, in a safe and dignified manner, for extended periods of time during the epidemic. To our knowledge, this concept has not been tested or evaluated in resource-poor settings. This study aimed to explore the acceptability and feasibility of strategies to shield persons at higher risk of severe COVID-19 outcomes, during the COVID-19 epidemic in six communities in Sudan.

METHODS

We purposively sampled participants from six communities, illustrative of urban, rural and forcibly-displaced settings. In-depth telephone interviews were held with 59 members of households with one or more members at higher risk of severe COVID-19 outcomes. Follow-up interviews were held with 30 community members after movement restrictions were eased across the country. All interviews were audio-recorded, transcribed verbatim, and analysed using a two-stage deductive and inductive thematic analysis.

RESULTS

Most participants were aware that some people are at higher risk of severe COVID-19 outcomes but were unaware of the concept of shielding. Most participants found shielding acceptable and consistent with cultural inclinations to respect elders and protect the vulnerable. However, extra-household shielding arrangements were mostly seen as socially unacceptable. Participants reported feasibility concerns related to the reduced socialisation of shielded persons and loss of income for shielding families. The acceptability and feasibility of shielding strategies were reduced after movement restrictions were eased, as participants reported lower perception of risk in their communities and increased pressure to comply with social commitments outside the house.

CONCLUSION

Shielding is generally acceptable in the study communities. Acceptability is influenced by feasibility, and by contextual changes in the epidemic and associated policy response. The promotion of shielding should capitalise on the cultural and moral sense of duty towards elders and vulnerable groups. Communities and households should be provided with practical guidance to implement feasible shielding options. Households must be socially, psychologically and financially supported to adopt and sustain shielding effectively.

Twitter users’ coping behaviors during the COVID-19 lockdown: an analysis of tweets using mixed methods

Purpose

Using data from Twitter, the purpose of this paper is to assess the coping behaviour and reactions of social media users in response to the initial days of the COVID-19-related lockdown in different parts of the world.

Design/methodology/approach

This study follows the quasi-inductive approach which allows the development of pre-categories from other theories before the sampling and coding processes begin, for use in those processes. Data was extracted using relevant keywords from Twitter, and a sample was drawn from the Twitter data set to ensure the data is more manageable from a qualitative research standpoint and that meaningful interpretations can be drawn from the data analysis results. The data analysis is discussed in two parts: extraction and classification of data from Twitter using automated sentiment analysis; and qualitative data analysis of a smaller Twitter data sample.

Findings

This study found that during the lockdown the majority of users on Twitter shared positive opinions towards the lockdown. The results also found that people are keeping themselves engaged and entertained. Governments around the world have also gained support from Twitter users. This is despite the hardships being faced by citizens. The authors also found a number of users expressing negative sentiments. The results also found that several users on Twitter were fence-sitters and their opinions and emotions could swing either way depending on how the pandemic progresses and what action is taken by governments around the world.

Research limitations/implications

The authors add to the body of literature that has examined Twitter discussions around H1N1 using in-depth qualitative methods and conspiracy theories around COVID-19. In the long run, the government can help citizens develop routines that help the community adapt to a new dangerous environment – this has very effectively been shown in the context of wildfires in the context of disaster management. In the context of this research, the dominance of the positive themes within tweets is promising for policymakers and governments around the world. However, sentiments may wish to be monitored going forward as large-spikes in negative sentiment may highlight lockdown-fatigue.

Social implications

The psychology of humans during a pandemic can have a profound impact on how COVID-19 shapes up, and this shall also include how people behave with other people and with the larger environment. Lockdowns are the opposite of what societies strive to achieve, i.e. socializing.

Originality/value

This study is based on original Twitter data collected during the initial days of the COVID-19-induced lockdown. The topic of “lockdowns” and the “COVID-19” pandemic have not been studied together thus far. This study is highly topical.

Compliance without fear: Individual-level protective behaviour during the first wave of the COVID-19 pandemic

OBJECTIVES

The outbreak of the COVID-19 pandemic required rapid public compliance with advice from health authorities. Here, we ask who was most likely to do so during the first wave of the pandemic.

DESIGN

Quota-sampled cross-sectional and panel data from eight Western democracies (Denmark, France, Germany, Hungary, Italy, Sweden, the United Kingdom, and the United States).

METHODS

We fielded online public opinion surveys to 26,508 citizens between 19 March and 16 May. The surveys included questions about protective behaviour, perceptions of the pandemic (threat and self-efficacy), as well as broader attitudes towards society (institutional and interpersonal trust). We employ multilevel and fixed-effects regression models to analyse the relationship between these variables.

RESULTS

Consistent with prior research on epidemics, perceptions of threat turn out as culturally uniform determinants of both avoidant and preventive forms of protective behaviour. On this basis, authorities could foster compliance by appealing to fear of COVID-19, but there may be normative and practical limits to such a strategy. Instead, we find that another major source of compliance is a sense of self-efficacy. Using individual-level panel data, we find evidence that self-efficacy is amendable to change and exerts an effect on protective behaviour. Furthermore, the effects of fear are small among those who feel efficacious, creating a path to compliance without fear. In contrast, two other major candidates for facilitating compliance from the social sciences, interpersonal trust and institutional trust, have surprisingly little motivational power during the first wave of the COVID-19 pandemic.

CONCLUSIONS

To address future waves of the pandemic, health authorities should thus focus on facilitating self-efficacy in the public.

Health anxiety, perceived stress, and coping styles in the shadow of the COVID-19

Background

In the case of people who carry an increased number of anxiety traits and maladaptive coping strategies, psychosocial stressors may further increase the level of perceived stress they experience. In our research study, we aimed to examine the levels of perceived stress and health anxiety as well as coping styles among university students amid the COVID-19 pandemic.

Methods

A cross-sectional study was conducted using an online-based survey at the University of Debrecen during the official lockdown in Hungary when dormitories were closed, and teaching was conducted remotely. Our questionnaire solicited data using three assessment tools, namely, the Perceived Stress Scale (PSS), the Ways of Coping Questionnaire (WCQ), and the Short Health Anxiety Inventory (SHAI).

Results

A total of 1320 students have participated in our study and 31 non-eligible responses were excluded. Among the remaining 1289 participants, 948 (73.5%) and 341 (26.5%) were Hungarian and international students, respectively. Female students predominated the overall sample with 920 participants (71.4%). In general, there was a statistically significant positive relationship between perceived stress and health anxiety. Health anxiety and perceived stress levels were significantly higher among international students compared to domestic ones. Regarding coping, wishful thinking was associated with higher levels of stress and anxiety among international students, while being a goal-oriented person acted the opposite way. Among the domestic students, cognitive restructuring as a coping strategy was associated with lower levels of stress and anxiety. Concerning health anxiety, female students (domestic and international) had significantly higher levels of health anxiety compared to males. Moreover, female students had significantly higher levels of perceived stress compared to males in the international group, however, there was no significant difference in perceived stress between males and females in the domestic group.

Conclusion

The elevated perceived stress levels during major life events can be further deepened by disengagement from home (being away/abroad from country or family) and by using inadequate coping strategies. By following and adhering to the international recommendations, adopting proper coping methods, and equipping oneself with the required coping and stress management skills, the associated high levels of perceived stress and anxiety could be mitigated.

COVID-19 pandemic and lockdown stress consequences in people with and without Irritable Bowel Syndrome

Background

While all resources have been mobilized to fight COVID-19, this study aimed to analyze the consequences of lockdown and pandemic stress in participants with and without Irritable Bowel Syndrome (IBS).

Methodology

An online survey was proposed to people with or without IBS during the exponential phase of the pandemic in France. The questionnaire included questions about socio-demographic data, conditions of confinement, activities carried out, IBS characteristics, measurement of stress level, consequences on sleep, fatigue, anxiety and depression, and quality of life (both perceived non-specific and specific for IBS).

Results/Discussion

From March 31 to April 15, 2020, 304 participants, 232 with IBS and 72 without were included in the survey (mean age: 46.8 ± 16.8 years, female gender: 75.3%). Age, level of education, financial resources, living space per person and activities performed during confinement were identical in both groups. Stress linked to fear of COVID-19, lockdown and financial worries was at the same level in both groups, but the psychological consequences and deterioration of quality of life (QOL) were both higher in IBS participants. In a univariate analysis, teleworking, solitary confinement, and low household resources had a variable impact on the scores of depression, anxiety, fatigue and non-specific perceived QOL, but in a multivariate analysis, the only factor explaining a deterioration of non-specific QOL was the fact of suffering from IBS.

Conclusion/Perspectives

Stress linked to the COVID-19 pandemic and confinement is high and equivalent in both IBS and non-IBS participants, with higher psychological and QOL consequences in IBS patients who have altered coping capacities.

Non-pharmaceutical Interventions and the Infodemic on Twitter: Lessons Learned from Italy during the Covid-19 Pandemic

The COVID-19 pandemic changed expectations for information dissemination and use around the globe, challenging accepted models of communications, leadership, and social systems. We explore how social media discourse about COVID-19 in Italy was affected by the rapid spread of the virus, and how themes in postings changed with the adoption of social distancing measures and non-pharmaceutical interventions (NPI). We used topic modeling and social network analysis to highlight critical dimensions of conversations around COVID-19: 1) topics in social media postings about the Coronavirus; 2) the scope and reach of social networks; and 3) changes in social media content as the nation moved from partial to full social distancing. Twitter messages sent in Italy between February 11th and March 10th, 2020. 74,306 Tweets sent by institutions, news sources, elected officials, scientists and social media influencers. Messages were retweeted more than 1.2 million times globally. Non-parametric chi-square statistic with residual analysis to identify categories, chi-square test for linear trend, and Social Network Graphing. The first phase of the pandemic was dominated by social media influencers, followed by a focus on the economic consequences of the virus and placing blame on immigrants. As the crisis deepened, science-based themes began to predominate, with a focus on reducing the spread of the virus through physical distancing and business closures Our findings highlight the importance of messaging in social media in gaining the public's trust and engagement during a pandemic. This requires credible scientific voices to garner public support for effective mitigation. Fighting the spread of an infectious disease goes hand in hand with stemming the dissemination of lies, bad science, and misdirection.