Gender differences in perceived risk of COVID-19

Don't say it's over: The perceived epidemic stage and COVID preventive behaviour

Little is known about the perceptions of the COVID-19 pandemic's dynamic and its effect on self-protective behaviour. Using survey data from 1343 university students we explored how the perceived temporal distance to the COVID pandemic peak associates with risk perception and the adherence of preventive behaviours. Results show that individuals differ in their perception of the pandemic stage despite being in the same environment. The belief that the COVID peak is in the past was associated with less perceived risk and decreased self-protection. A high COVID-19 media involvement and trust in the authorities were associated with higher perceived risk and preventive behaviour implementation. Overall, the perception that the pandemic wave is in its final stages could be an independent predictor of more risky behaviour. Thus, the communication of the pandemic dynamic should be provided by policy makers with caution to avoid the possibility of discounting the risk.

Mixed-methods study of university students' perceptions of COVID-19 and media consumption from March 2020 -April 2022

Longitudinal mixed-methods research is necessary to understand the changing dynamics of pandemic perceptions, the adoption of health behaviours, and use of media during a public health emergency. During the first two years of the COVID-19 pandemic, we used a mixed-methods approach to survey young adults attending a large Canadian public university. Six online convenience survey samples were collected (Spring 2020, Summer 2020, Fall 2020, Spring 2021, Fall 2021, Spring 2022) (n = 4932) and 110 semi-structured interviews were conducted. Female gender was associated with higher perceptions of severity, susceptibility, and the adoption of new health behaviours. Perceptions of severity and anxiety/fear about contracting COVID-19 after reading/hearing a news report decreased overall over time, while perceptions of susceptibility increased through time overall. Social media was the most used form of media and was the form of media that participants judged to make them feel most anxious/fearful about contracting COVID-19. Those who felt anxious after hearing a COVID-19 news report were 8.43 times more likely to judge COVID-19 as severe and 2.07 times more likely to judge their own susceptibility as high. Interviews revealed perceptions of information overload, passive information intake, and a narrowed geographical focus over time. The decrease in judgements of COVID-19 severity with the accompanying increase in judgements of susceptibility over the first two years of the pandemic demonstrate the dynamics of changing pandemic attitudes. Health communication efforts targeting university students in future major health events need to consider these shifting dynamics and ensure that health information distributed via social media meets the needs of university students.

Communicating uncertainties regarding COVID-19 vaccination: Moderating roles of trust in science, government, and society

This study examined how uncertainty affects information seeking and avoidance behaviors via information insufficiency in the COVID-19 vaccination context. It also investigated how trust in science, government, and society moderate the effects of information insufficiency. An online experiment with 131 Korean adults showed that uncertainty indirectly affects information seeking intentions via information insufficiency, which is moderated by science trust and governmental trust. It also showed that uncertainty indirectly affects information avoidance intentions via information insufficiency, which is moderated by social trust.

Risk Perceptions Regarding COVID-19 and Compliance with Protective Measures of Midwifery and Nursing Senior Students

OBJECTIVE

This study aims to examine the risk perceptions of midwifery and nursing senior students regarding COVID-19 and compliance with vaccination and protective measures.

METHOD

This cross-sectional study was conducted in two academic years on senior midwifery and nursing students (n = 358). In the present study, the descriptive characteristics of the students and the COVID-19 risk perception scale were used.

RESULTS

The students' COVID-19 Risk Perception Scale scores were at a moderate level and a similar level in both years of this study. More than 80% of the students were fully vaccinated, and the family history of COVID-19 was positive in approximately half of them. In the second year of the pandemic, they paid less attention to social distance and avoidance of being indoors.

CONCLUSION

Although the COVID-19 risk perceptions of future health professional students remained at a similar level during the examined period, it was found that in the second year of the pandemic, they started to get used to the process and paid less attention to social protective measures.

Perceptions of COVID-19 Risk: How Did People Adapt to the Novel Risk?

BACKGROUND

There is limited understanding of how risk perceptions changed as the US population gained experience with COVID-19. The objectives were to examine risk perceptions and determine the factors associated with risk perceptions and how these changed over the first 18 mo of the pandemic.

METHODS

Seven cross-sectional online surveys were fielded between May 2020 and October 2021. The study included a population-weighted sample of 138,303 US adults drawn from a market research platform, with an average 68% cooperation rate. Respondents' risk perception of developing COVID in the next 30 days was assessed at each time point. We examined relationships between 30-day risk perceptions and various factors (including sociodemographic features, health, COVID-19 experience, political affiliation, and psychological variables).

RESULTS

COVID risk perceptions were stable across the 2020 surveys and showed a significant decrease in the 2021 surveys. Several factors, including older age, worse health, high COVID worry, in-person employment type, higher income, Democratic political party affiliation (the relatively more liberal party in the United States), low tolerance of uncertainty, and high anxiety were strongly associated with higher 30-d risk perceptions in 2020. One notable change occurred in 2021, in that younger adults (aged 18-29 y) had significantly higher 30-d risk perceptions than older adults did (aged 65 y and older) after vaccination. Initial differences in perception by political party attenuated over time. Higher 30-d risk perceptions were significantly associated with engaging in preventive behaviors.

LIMITATIONS

Cross-sectional samples, risk perception item focused on incidence not severity.

CONCLUSIONS

COVID risk perceptions decreased over time. Understanding the longitudinal pattern of risk perceptions and the factors associated with 30-d risk perceptions over time provides valuable insights to guide public health communication campaigns.

HIGHLIGHTS

The study assessed COVID-19 risk perceptions at 7 time points over 18 mo of the pandemic in large samples of US adults.Risk perceptions were fairly stable until the introduction of vaccines in early 2021, at which point they showed a marked reduction.Higher COVID-19 30-d risk perceptions were significantly associated with the preventive behaviors of masking, limiting social contact, avoiding restaurants, and not entertaining visitors at home.

Prevalence, predictors and reasons for COVID-19 vaccine hesitancy: Results of a global online survey

Vaccine hesitancy has the potential to cripple efforts to end the COVID-19 pandemic. Policy makers need to be informed about the scale, nature and drivers of this problem, both domestically and globally, so that effective interventions can be designed. To this end, we conducted a statistical analysis of data from the CANDOUR survey (n = 15,536), which was carried out in 13 countries representing approximately half of the global population. Both pooled and country-level ordered regression models were estimated to identify predictors of vaccine hesitancy and reasons for not getting vaccinated. We found high levels of hesitancy, particularly in high-income countries. Factors driving moderate hesitancy differed from those driving extreme hesitancy. A lack of trust in health care providers was consistently the underlying driver of more extreme hesitancy. Predictors of moderate hesitancy varied across countries, though being younger and female was typically associated with greater hesitancy. While political ideology played a role in vaccine hesitancy in some countries, this effect was often moderated by income level, particularly in the US. Overall, the results suggest that different interventions such as mass-media campaigns and monetary incentives may be needed to target the moderately versus extremely hesitant. The lack of trust in health care professionals that drives extreme hesitancy may reflect deep societal mistrust in science and institutions and be challenging to overcome.

A Longitudinal Investigation of the Impact of COVID-19 on Patients With Chronic Pain

The COVID-19 pandemic prompted unexpected changes in the healthcare system. This current longitudinal study had 2 aims: 1) describe the trajectory of pandemic-associated stressors and patient-reported health outcomes among patients receiving treatment at a tertiary pain clinic over 2 years (May 2020 to June 2022); and 2) identify vulnerable subgroups. We assessed changes in pandemic-associated stressors and patient-reported health outcome measures. The study sample included 1270 adult patients who were predominantly female (74.6%), White (66.2%), non-Hispanic (80.6%), married (66.1%), not on disability (71.2%), college-educated (59.45%), and not currently working (57.9%). We conducted linear mixed effect modeling to examine the main effect of time with controlling for a random intercept. Findings revealed a significant main effect of time for all pandemic-associated stressors except financial impact. Over time, patients reported increased proximity to COVID-19, but decreased pandemic-associated stressors. A significant improvement was also observed in pain intensity, pain catastrophizing, and PROMIS-pain interference, sleep, anxiety, anger, and depression scores. Demographic-based subgroup analyses for pandemic-associated stressors revealed that younger adults, Hispanics, Asians, and patients receiving disability compensation were vulnerable groups either during the initial visit or follow-up visits. We observed additional differential pandemic effects between groups based on participant sex, education level, and working status. In conclusion, despite unanticipated changes in pain care services during the pandemic, patients receiving pain treatments adjusted to pandemic-related stressors and improved their health status over time. As the current study observed differential pandemic impacts on patient subgroups, future studies should investigate and address the unmet needs of vulnerable subgroups. PERSPECTIVE: Over a 2-year timeframe, the pandemic did not adversely influence physical and mental health among treatment-seeking patients with chronic pain. Patients reported small but significant improvements across indices of physical and psychosocial health. Differential impacts emerged among groups based on ethnicity, age, disability status, gender, education level, and working status.

An association between individual's risk perceptions and delayed or foregone healthcare services during the COVID-19 pandemic in Korea

BACKGROUND

Existing evidence highlights that the COVID-19 pandemic is associated with a large reduction in healthcare utilization for routine and less-urgent services around the world including Korea. During the COVID-19 pandemic, delayed and foregone healthcare are driven by various factors, and risk perception, a complex psychological construct, is one of them. The aim of this study was to examine how COVID-19 risk perceptions influence delayed and foregone care during the pandemic in Korea.

METHODS

The Koreans' Happiness Survey (KHS) 2020 was used to analyze responses from 13,491 individuals over 19 years of age residing in Korea. To assess delayed and foregone care, self-reported delayed or foregone care after the COVID-19 outbreak was used. COVID-19 risk perceptions were analyzed in terms of fear and severity of the pandemic based on responses from the participants. Logistic regression models, stratified by gender, were used to examine the relationship between COVID-19 risk perception and delayed/foregone healthcare.

RESULTS

Among the total 13,491 individuals included in the study, 4.0% (n = 541) reported delayed and foregone care in 2020. The results showed that higher level of fear of COVID-19 was associated with an increased likelihood of reporting delayed and foregone care in Korean adults (OR = 1.36, 95% CI = 1.08-1.73). The gender-stratified model revealed that greater fear of COVID-19 was associated with higher odds of delayed and foregone healthcare (OR = 1.71, 95%CI = 1.23-2.39) among women while the perceived severity did not have any association. However, the perceived severity was associated with a higher likelihood of delayed and foregone care in men (OR = 1.17, 95%CI = 1.04-1.32), but no association was found between fear of COVID-19 and delayed and foregone healthcare in men.

CONCLUSIONS

To ensure the timely use of any needed healthcare services, it is worth considering establishing policy interventions to mitigate unnecessary fear and worries about COVID-19. This can be achieved by providing accurate information on the virus, protective measures, and treatment.

The association between the risk perceptions of COVID-19, trust in the government, political ideologies, and socio-demographic factors: A year-long cross-sectional study in South Korea

Risk perception research, targeting the general public, necessitates the study of the multi-faceted aspects of perceived risk through a holistic approach. This study aimed to investigate the association between the two dimensions of risk perception of COVID-19, i.e., risk as a feeling and analysis, trust in the current government, political ideologies, and socio-demographic factors in South Korea. This study used a year-long repeated cross-sectional design, in which a national sample (n = 23,018) participated in 23 consecutive telephone surveys from February 2020 to February 2021. Most factors differed in the magnitude and direction of their relationships with the two dimensions of risk perception. However, trust in the current government, alone, delineated an association in the same direction for both dimensions, i.e., those with a lower level of trust exhibited higher levels of cognitive and affective risk perception. Although these results did not change significantly during the one-year observation period, they are related to the political interpretation of risk. This study revealed that affective and cognitive risk perceptions addressed different dimensions of risk perception. These findings could help governments and health authorities better understand the nature and mechanisms of public risk perception when implementing countermeasures and policies in response to the COVID-19 pandemic and other public health emergencies.

Measuring the missing: Knowledge, risk perceptions and self-protection practices of COVID-19 among the Asian population in New Zealand: An online survey

Aim

Asians are the second largest and fastest growing non-European population in New Zealand but are under-researched in terms of their COVID-19 pandemic response. The paper aims to illustrates Asians' risk perceptions and knowledge of COVID-19, and self-protection practices to avoid infection and prevent community transmission.

Subject and methods

An online survey was used to collect data and received 402 valid responses. Data analyses included: 1) a descriptive analysis by using Chi-square tests and a Kruskal-Wallis rank sum tests to explore associations between responses and the four demographic variables (i.e. age, gender, country of origin/ethnicity, and region); and 2) a correlation analysis between different survey objectives.

Results

The descriptive analysis of the survey found that while ethnicity (within the Asian category) was the most influential variable that resulted in varying responses to many questions, gender and age were other two important variables in influencing the answering patterns. The correlation analysis found a positive correlation between the perceived 'dangerousness' of COVID-19 and respondents' overall compliance behaviour to New Zealand authorities' recommendations to prevent spread of COVID-19.

Conclusion

The majority of the respondents provided correct answers to the questions about the vulnerable populations, symptoms, asymptomatic transmission and potential sequelae of COVID-19; however, their understanding of the availability of a cure for, and the incubation period of COVID-19 was not consistent with the official information. The research also found that the higher perceived dangerousness of COVID-19, the better compliance to self-protection practices among the surveyed population.

Explaining the gender gap in COVID-19 vaccination attitudes

BACKGROUND

Women have been significantly more likely than men to express hesitancy toward COVID-19 vaccination and, to a lesser extent, to refuse vaccination altogether. This gender gap is puzzling because women have been more likely to perceive higher risks from COVID-19, to approve more restrictive measures to fight the pandemic and to be more compliant with such measures.

METHODS

This article studies the gender gap in COVID-19 vaccination attitudes using two nationally representative surveys of public opinion fielded in February 2021 and May 2021 in 27 European countries. The data are analyzed using generalized additive models and multivariate logistic regression.

RESULTS

The data analyses show that hypotheses about (i) pregnancy, fertility and breastfeeding concerns, (ii) higher trust in Internet and social networks as sources of medical information, (iii) lower trust in health authorities and (iv) lower perceived risks of getting infected with COVID-19 cannot account for the gender gap in vaccine hesitancy. One explanation that receives support from the data is that women are more likely to believe that COVID-19 vaccines are unsafe and ineffective and this leads them to perceive the net benefits of vaccination as lower than the associated risks.

CONCLUSIONS

The gender gap in COVID-19 vaccine hesitancy results to a large extent from women perceiving higher risks than benefits of the vaccines. While accounting for this and other factors decreases the gap in vaccine hesitancy, it does not eliminate it completely, which suggests further research is needed.

What accounts for the variation in COVID-19 vaccine hesitancy in Eastern, Southern and Western Europe?

In the wake of mass COVID-19 vaccination campaigns in 2021, significant differences in vaccine skepticism emerged across Europe, with Eastern European countries in particular facing very high levels of vaccine hesitancy and refusal. This study investigates the determinants of COVID-19 vaccine hesitancy and refusal, with a focus on these differences across Eastern, Southern and Western Europe. The statistical analyses are based on individual-level survey data comprising quota-based representative samples from 27 European countries from May 2021. The study finds that demographic variables have complex associations with vaccine hesitancy and refusal. The relationships with age and education are non-linear. Trust in different sources of health-related information has significant associations as well, with people who trust the Internet, social networks and 'people around' in particular being much more likely to express vaccine skepticism. Beliefs in the safety and effectiveness of vaccines have large predictive power. Importantly, this study shows that the associations of demographic, belief-related and other individual-level factors with vaccine hesitancy and refusal are context-specific. Yet, explanations of the differences in vaccine hesitancy across Eastern, Southern and Eastern Europe need to focus on why levels of trust and vaccine-relevant beliefs differ across regions, because the effects of these variables appear to be similar. It is the much higher prevalence of factors such as distrust of national governments and medical processionals as sources of relevant medical information in Eastern Europe that are relevant for explaining the higher levels of vaccine skepticism observed in that region.

Understanding Australian Government Risk Communication Early in the COVID-19 Pandemic: Sociodemographics, Risk Attitudes and Media Consumption

Effective risk communication is essential for government and health authorities to effectively manage public health during the Coronavirus disease (COVID-19) pandemic. Understanding the factors that influence people's perceptions of crisis-related risk messages is critical to identify gaps and inequalities in population risk communication. Using a longitudinal survey of a representative adult sample, we examined risk communication about COVID-19 during April-June 2020 in Australia across sociodemographic groups especially the at-risk groups, accounting for and exploring the effects of risk attitudes and media engagement. Our findings showed that individuals who were younger, more left-wing, more risk-tolerant, and had a current or a history of mental disorders perceived risk communication of the Australian Government to be lower quality. On the other hand, greater consumption of information from televisions was found to be associated with more positive attitudes toward government risk communication. Our results also revealed the importance of effective and high-quality risk communication in gaining the public endorsement of various public health directions. We discuss the implications of results in terms of the development of effective public communications that lead to health-protective behaviors and effectively scaffold public understanding of risk.

John Henryism Active Coping and COVID-19 policy compliance

The aim of this paper is to examine whether the way one copes with stressful situations, as measured by John Henryism Active Coping (JHAC), influences behavioral responses to the pandemic, such as whether they engaged in mask wearing, social distancing, and hand washing. The data for this study come from the 2020 Blair Center Poll, which was conducted by the Blair Center of Southern Politics and Society at the University of Arkansas. Results show that high JHAC had a significant effect on COVID-19 policy compliance. Additionally, there was an interaction effect between JHAC and race on COVID-19 policy compliance. This effect was significant for only African Americans and Hispanics-not Whites. In other words, among African Americans and Hispanics, high JHAC had a significant effect on their compliance with COVID-19 policies. These findings suggest that coping structures policy compliance during the COVID-19 pandemic.

Engaging Youth and Young Adults in the COVID-19 Pandemic Response via the "It's Our Turn" Crowdsourcing Contest

As the coronavirus disease (COVID-19) pandemic continued to progress into 2021, appeals were made to take a stronger focus on the perceptions and practices of youth and young adults (YYAs) regarding COVID-19 mitigation, as well as the impact of mitigation strategies on the overall wellbeing of YYAs. In this paper, we describe our efforts to increase YYA engagement in Arizona's COVID-19 response by pairing embedded values from youth participatory action research (YPAR) with a crowdsourcing challenge contest design. The research protocol and implementation are described, followed by a thematic analysis of YYA-led messaging portrayed in 23 contest submissions and reflections formed by 223 community voters after viewing contest submissions. The authors conclude that a YYA-led crowdsourcing contest presented an opportunity to (a.) investigate the perceptions and behaviors of YYAs and their networks regarding the COVID-19 pandemic and mitigation efforts and (b.) amplify the voices of YYAs in the pandemic response. Perhaps even more importantly, this approach also offered insight into the exacerbated impact of the pandemic on YYA mental health and wellbeing, and the utility of YPAR in raising awareness of these effects among the contexts and social networks of YYAs.

Poor air passenger knowledge of COVID-19 symptoms and behaviour undermines strategies aimed at preventing the import of SARS-CoV-2 into the UK

Air travel mediates transboundary movement of SARS-CoV-2. To prepare for future pandemics, we sought to understand air passenger behaviour and perceived risk during the COVID-19 pandemic. This study of UK adults (n = 2103) quantified knowledge of COVID-19 symptoms, perceived health risk of contracting COVID-19, likelihood of returning to the UK with COVID-19 symptoms, likelihood to obey self-quarantining guidelines, how safe air travellers felt when flying during the pandemic (n = 305), and perceptions towards face covering effectiveness.Overall knowledge of COVID-19 symptoms was poor. Men and younger age groups (18-44) were less informed than women and older age groups (44 +). A significant proportion (21%) of the population would likely travel back to the UK whilst displaying COVID-19 symptoms with many expressing that they would not fully comply with self-isolation guidelines. Overall, males and younger age groups had a reduced perceived personal risk from contracting COVID-19, posing a higher risk of transporting SARS-CoV-2 back to the UK. Poor passenger knowledge and behaviour undermines government guidelines and policies aimed at preventing SARS-CoV-2 entry into the UK. This supports the need for stricter, clearer and more targeted guidelines with point-of-departure viral testing and stricter quarantining upon arrival.

Avoidance of fitness or sports facilities during a lockdown: Gender and training environment could be protective factors

The COVID-19 pandemic has swept the world, claiming nearly seven million lives by now. Despite a decline in the mortality rate, in November 2022, the virus-linked death cases still exceeded 500 every day. There is a belief that it is over now, but similar health-crisis situations may re-occur, and therefore it is essential to learn from such human disasters. It is an accepted fact that the pandemic has changed people's lives worldwide. One specifically and significantly affected life domain, especially during the lockdown, is the practice of sports and planned physical activities. Hence, this study examined the exercise practices and attitudes towards attending fitness facilities in 3053 working adults during the pandemic, along with the differences associated with the preferred training environment, including fitness/sports facilities, home, outdoor, or their combinations. The results revealed that women (representing 55.3% of the sample) are more precautious than men. Further, exercise behavior and COVID-19 attitudes broadly vary among people choosing different training venues. In addition, age, exercise frequency, place of exercise, fear of infection, flexibility in training form, and desire to exercise freely are predictors of non-attendance (avoidance) of fitness/sports facilities during the lockdown. These results expand earlier findings to exercise settings, suggesting that women are more precautious than men in the exercise context too. They are also the first to indicate that the preferred exercise environment entails attitudes that shape exercise patterns and beliefs associated with the pandemic differently. Therefore, men and regular fitness center attendees need more attention and special guidance in enforcing legislative prevention measures during a health crisis.

Predicting Compliance with Sanitary Behaviors among Students in Higher Education During the Second COVID-19 Wave: The Role of Health Anxiety and Risk Perception

To limit the spread of COVID-19, public authorities have recommended sanitary behaviors such as handwashing, mask-wearing, physical distancing, and social distancing. We recruited a large sample of higher education students in Belgium (N = 3201-3441) to investigate the role of sociodemographic variables, mental health, previous COVID-19 infections, academic involvement, and risk perception on adherence to these sanitary behaviors. This cross-sectional study took place during the second COVID-19 wave in Belgium, between February and March 2021. Analyses showed that living alone, being female, later in the academic curriculum, having higher general and health anxiety, higher academic involvement, and higher risk perception were positively associated with adherence to the four aforementioned sanitary behaviors. Conversely, previous infection with COVID-19 and having been quarantined were negative predictors. Our results show a set of predictors highly similar for the four sanitary behaviors. We discuss potential initiatives to increase adherence to sanitary behaviors in this group of highly educated youngsters.

Factors associated with COVID-19 masking behavior: an application of the Health Belief Model

Wearing a face mask is effective in minimizing the spread of coronavirus disease 2019 (COVID-19) among unvaccinated individuals and preventing severe illness among the vaccinated. Country, state and local guidelines promote, and at times mandate, mask-wearing despite it being publicly perceived as an individual's choice. Guided by the Health Belief Model (HBM), structural equation modeling was used to analyze longitudinal data in a sample of US adults aged 18-49 years to identify constructs that contribute to face mask-wearing. Results indicated that perceived COVID-19 severity, perceived masking benefits and self-efficacy were positively associated with masking behavior, and masking barriers were negatively associated with masking behavior. Perceived susceptibility to COVID-19 and cues to action were nonsignificant correlates of masking behavior. These results' theoretical and practical implications contribute to the literature on the HBM and the COVID-19 pandemic. Future directions and limitations are discussed.

COVID-19 and its genomic variants: Molecular pathogenesis and therapeutic interventions

Coronavirus disease-19 (COVID-19), caused by a β-coronavirus and its genomic variants, is associated with substantial morbidities and mortalities globally. The COVID-19 virus and its genomic variants enter host cells upon binding to the angiotensin converting enzyme 2 receptors that are expressed in a variety of tissues, but predominantly in the lungs, heart, and blood vessels. Patients afflicted with COVID-19 may be asymptomatic or present with critical symptoms possibly due to diverse lifestyles, immune responses, aging, and underlying medical conditions. Geriatric populations, especially men in comparison to women, with immunocompromised conditions, are most vulnerable to severe COVID-19 associated infections, complications, and mortalities. Notably, whereas immunomodulation, involving nutritional consumption, is essential to protecting an individual from COVID-19, immunosuppression is detrimental to a person with this aggressive disease. As such, immune health is inversely correlated to COVID-19 severity and resulting consequences. Advances in genomic and proteomic technologies have helped us to understand the molecular events underlying symptomatology, transmission and, pathogenesis of COVID-19 and its genomic variants. Accordingly, there has been development of a variety of therapeutic interventions, ranging from mask wearing to vaccination to medication. This review summarizes the current understanding of molecular pathogenesis of COVID-19, effects of comorbidities on COVID-19, and prospective therapeutic strategies for the prevention and treatment of this contagious disease.

Perceived risk of infection and death from COVID-19 among community members of low- and middle-income countries: A cross-sectional study

Background: Risk perceptions of coronavirus disease 2019 (COVID-19) are considered important as they impact community health behaviors. The aim of this study was to determine the perceived risk of infection and death due to COVID-19 and to assess the factors associated with such risk perceptions among community members in low- and middle-income countries (LMICs) in Africa, Asia, and South America.

Methods: An online cross-sectional study was conducted in 10 LMICs in Africa, Asia, and South America from February to May 2021. A questionnaire was utilized to assess the perceived risk of infection and death from COVID-19 and its plausible determinants. A logistic regression model was used to identify the factors associated with such risk perceptions.

Results: A total of 1,646 responses were included in the analysis of the perceived risk of becoming infected and dying from COVID-19. Our data suggested that 36.4% of participants had a high perceived risk of COVID-19 infection, while only 22.4% had a perceived risk of dying from COVID-19. Being a woman, working in healthcare-related sectors, contracting pulmonary disease, knowing people in the immediate social environment who are or have been infected with COVID-19, as well as seeing or reading about individuals infected with COVID-19 on social media or TV were all associated with a higher perceived risk of becoming infected with COVID-19. In addition, being a woman, elderly, having heart disease and pulmonary disease, knowing people in the immediate social environment who are or have been infected with COVID-19, and seeing or reading about individuals infected with COVID-19 on social media or TV had a higher perceived risk of dying from COVID-19.

Conclusions: The perceived risk of infection and death due to COVID-19 are relatively low among respondents; this suggests the need to conduct health campaigns to disseminate knowledge and information on the ongoing pandemic.

When do persuasive messages on vaccine safety steer COVID-19 vaccine acceptance and recommendations? Behavioural insights from a randomised controlled experiment in Malaysia

Introduction

Vaccine safety is a primary concern among vaccine-hesitant individuals. We examined how seven persuasive messages with different frames, all focusing on vaccine safety, influenced Malaysians to accept the COVID-19 vaccine, and recommend it to individuals with different health and age profiles; that is, healthy adults, the elderly, and people with pre-existing health conditions.

Methods

A randomised controlled experiment was conducted from 29 April to 7 June 2021, which coincided with the early phases of the national vaccination programme when vaccine uptake data were largely unavailable. 5784 Malaysians were randomly allocated into 14 experimental arms and exposed to one or two messages that promoted COVID-19 vaccination. Interventional messages were applied alone or in combination and compared against a control message. Outcome measures were assessed as intent to both take the vaccine and recommend it to healthy adults, the elderly, and people with pre-existing health conditions, before and after message exposure. Changes in intent were modelled and we estimated the average marginal effects based on changes in the predicted probability of responding with a positive intent for each of the four outcomes.

Results

We found that persuasive communication via several of the experimented messages improved recommendation intentions to people with pre-existing health conditions, with improvements ranging from 4 to 8 percentage points. In contrast, none of the messages neither significantly improved vaccination intentions, nor recommendations to healthy adults and the elderly. Instead, we found evidence suggestive of backfiring among certain outcomes with messages using negative attribute frames, risky choice frames, and priming descriptive norms.

Conclusion

Message frames that briefly communicate verbatim facts and stimulate rational thinking regarding vaccine safety may be ineffective at positively influencing vaccine-hesitant individuals. Messages intended to promote recommendations of novel health interventions to people with pre-existing health conditions should incorporate safety dimensions.

Trial registration number

NCT05244356.

Protection Motivation Theory and consumers’ food safety behaviour in response to COVID-19

The threat of COVID-19 has altered consumers shopping behaviour and increased consumers' willingness to purchase food using online food delivery services. Consumers were more likely to practice strict hand hygiene measures and were concerned with food safety. Such behaviours were likely driven by the fear and threat of contracting COVID-19. This study aims to use Protective Motivation Theory (PMT) to investigate how COVID-19 affects food shopping and food safety behaviour. An online, cross-sectional study was conducted in Indonesia and Malaysia to determine the protective motivation to engage in three food shopping and hygiene practices such as i) Safe food shopping behaviour; ii) Hand hygiene and avoiding cross contamination; and iii) Use of online food delivery services. Data were analysed using descriptive statistics, Spearman rho's correlation and binary logistic regression. A total of 1180 responses were received of which 1129 were valid. Gender was identified as a significant predictor across all food safety behaviours during COVID-19. Response efficacy and self-efficacy were significant predictors for food shopping behaviour while perceived severity significantly predicted hand hygiene practices after shopping. Age, frequency of food preparation and shopping, perceived severity, perceived vulnerability, response efficacy and self-efficacy were significant predictors for use of online food delivery services. Our findings suggest that women were more likely to engage in protective measures during food shopping, carry out hand hygiene practices after shopping and use online food delivery services during COVID-19. Participants with higher response and self-efficacy scores were more likely to shop from markets or shops with high hygiene standards while participants who perceived COVID-19 as a serious threat were more likely to clean and sanitise their hands after shopping. Participants also believed that the use of online food delivery services helps to reduce the risk of COVID-19 infection. However, foods should be purchased from trusted restaurants or takeaways. This is the first study to use Protection Motivation Theory to explore consumers' food shopping, hand hygiene and online food delivery practices during COVID-19.

Healthy Immunity on Preventive Medicine for Combating COVID-19

Immunomodulation is influenced by the consumption of nutrients, and healthy immunity is pivotal to defending an individual from a variety of pathogens. The immune system is a network of intricately regulated biological processes that is comprised of many organs, cellular structures, and signaling molecules. A balanced diet, rich in vitamins, minerals, and antioxidants, is key to a strengthened immune system and, thus, crucial to proper functioning of various physiological activities. Conversely, deficiencies of these micronutrients, involving impaired immunity, are linked to numerous health complications, along with a host of pathologies. Coronavirus disease 2019 (COVID-19) is a dangerous infectious disease caused by a β-form of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its genomic variants, which enter host cells upon binding to the angiotensin converting enzyme 2 receptors, and is associated with substantial morbidities and mortalities globally. Patients afflicted with COVID-19 display asymptomatic to severe symptoms, occurrences of which are multifactorial and include diverse immune responses, sex and gender differences, aging, and underlying medical conditions. Geriatric populations, especially men in comparison to women, regardless of their states, are most vulnerable to severe COVID-19-associated infections and complications, with fatal outcomes. Advances in genomic and proteomic technologies help one understand molecular events, including host–pathogen interactions and pathogenesis of COVID-19 and, subsequently, have developed a variety of preventive measures urgently, ranging from mask wearing to vaccination to medication. Despite these approaches, no unique strategy is available today that can effectively prevent and/or treat this hostile disease. As a consequence, the maintenance of a boosted immune system could be considered a high priority of preventive medicine for combating COVID-19. Herein, we discuss the current level of understanding underlining the contribution of healthy immunity and its relevance to COVID-19 molecular pathogenesis, and potential therapeutic strategies, in the management of this devastating disease.

The perceived threat of COVID-19 and its impact on hygienic precautionary behaviors: A multi-countries study

OBJECTIVE(S)

To explore the perceived threats of COVID-19 and how it changed the personal hygienic precautionary behaviors across multiple countries in the Middle East and North Africa (MENA) region.

DESIGN

A cross-sectional descriptive design was used to survey the four targeted MENA countries: Jordan, Palestinian territories, Saudi Arabia, and Egypt.

SAMPLE

A nonprobability convenience sampling design was utilized. The link to the survey questionnaire was distributed through social media groups within Facebook^® and Twitter^® . The groups are known and accessible by known across the general population at the targeted countries.

MEASUREMENT

Data was collected using The Brief Illness Perception Questionnaire and an adapted instrument that examine the hygienic precautionary behaviors during COVID-19 pandemic.

RESULTS

Answers of participants (n = 2604) were valid and included in the study. The results show that a minimal perception of threat among the participants on most of the BIP-Q5 items (M = 12.9, SD = 7.2). Moreover, the highest compliance rates to recommended hygienic precautionary behaviors were found among populations above the age of 50 years (F = 2.89, p = .04), females (t = 5.18, p = .003), being married (F = 3.09, p = .029), and being a health care professional (t = -2.20, p = .028).

CONCLUSION

The perceived threat of COVID-19 and compliance rates with the recommended hygienic precautionary behaviors among Arab societies were found to below and need critically urgent attention.

Reassessing Gender Differences in COVID-19 Risk Perception and Behavior

OBJECTIVE

This article reassesses the gender differences in COVID-19 attitudes and behavior found in previous studies by examining to what extent the gender gap in the adoption of COVID-19 preventive behaviors is dependent on women's and men's perceptions of risk.

METHODS

The data utilized in this study were obtained from the "Understanding America Study Coronavirus in America ('COVID') Survey," conducted by the Center for Economic and Social Research (CESR), at the University of Southern California.

RESULT

This study shows that women are more risk averse than men, but that the gender gap in risk behavior depends on the level of risk that is associated with COVID-19.

CONCLUSION

Risk perception is a stronger driver of risk behavior for men than for women, who generally tend to adopt safe measures to protect themselves and others. Different messages should be delivered to women and men to increase compliance with norms.