Perceived effectiveness of public health measures and positive attitudes during a pandemic: a large cross-sectional study in Shanghai, China

Knowledge, attitudes, practices, and perception of COVID-19 preventive measures among adult residents of Matadi (Democratic Republic of the Congo) after the third epidemic wave

Background

Several governments from African countries, including the Democratic Republic of the Congo (DRC), implemented stringent public health measures to curb COVID-19 transmission in the early phases of the pandemic. While these restrictive measures are believed to have contributed to lowering case incidence and related mortality in DRC, data on the population's knowledge and adherence are limited. This study aimed to assess the knowledge, perception, attitudes, and practices of COVID-19 preventive measures and associated factors among adult residents of Matadi, thereby generating evidence for a strategy adjustment as the COVID-19 response is transitioning from emergency to control status.

Methods

We used data from a population-based cross-sectional study conducted in October 2021. Consenting participants were enrolled through a multi-stage cluster sampling approach and administered a pre-tested structured questionnaire using a mobile application (Epicollect 5). We analyzed adult participants' data using STATA 15.1. Univariable and multivariable analyses were applied to identify factors associated with good knowledge, good perception, positive attitude and good practice.

Results

We included 1,269 adult respondents for the secondary analysis. One respondent in six was female. The median age was 36 years (IQR 24-50). Most respondents (76.5%) had good knowledge. Respondents aged 40-49 years and those with vocational education level were 1.7 time (AOR 1.75, 95% CI 1.07-2.87) and twice as likely (AOR 2.06, 95% CI 1.01-4.21) to have good knowledge. Preventive measures were perceived as efficient by 45% of respondents. Good perception was associated with education level, profession, average household monthly income and good knowledge. Only 40% of respondents had a positive attitude. A positive attitude was associated with age, education level, and good knowledge. Respondents having good practice represented 5.8%. Good practice was associated with good knowledge, attitude and perception.

Conclusion

Most respondents were knowledgeable, had a good perception of government-related COVID-19 preventive measures, a moderately positive attitude and an extremely low level of good practice. Current COVID-19 preventive strategies, including vaccination rollout, need adjustment into high-efficiency, context-based and risk group-specific interventions. Evidence generated by this study will improve preparedness and response to future outbreaks.

Meta-analysis of KAP toward COVID-19 in Chinese residents

Background

During the coronavirus disease-2019 (COVID-19) pandemic, there have been many studies on knowledge, attitudes, and practices (KAP) toward prevention of COVID-19 infection in China. Except for symptomatic treatment and vaccination, KAP toward COVID-19 plays an important role in the prevention of COVID-19. There is no systematic evaluation and meta-analysis of KAP toward COVID-19 in China. This study is the earliest meta-analysis of KAP toward COVID-19 in China's general population. Hence, this systematic review aimed to summarize the knowledge, attitudes, and practices (KAP) of Chinese residents toward COVID-19 during the pandemic.

Methodology

Following the PRISMA guidelines, articles relevant to COVID-19 KAP that were conducted among the Chinese population were found in databases such as Scopus, ProQuest, PubMed, EMbase, Web of Science, Cochrane Library, China Biology Medicine, China National Knowledge Infrastructure, CQVIP, Wanfang and Google Scholar. A random-effect meta-analysis is used to summarize studies on knowledge, attitudes, and practice levels toward COVID-19 infection in China's general population.

Results

Fifty-seven articles published between August 2020 and November 2022 were included in this review. Overall, 75% (95% CI: 72-79%) of Chinese residents had good knowledge about COVID-19, 80% (95% CI: 73-87%) of Chinese residents had a positive attitude toward COVID-19 pandemic control and prevention (they believe that Chinese people will win the battle against the epidemic), and the aggregated proportion of residents with a correct practice toward COVID-19 was 84% (95% CI: 82-87%, I2 = 99.7%).In the gender subgroup analysis, there is no significant difference between Chinese men and Chinese women in terms of their understanding of COVID-19. However, Chinese women tend to have slightly higher levels of knowledge and a more positive attitude toward the virus compared to Chinese men. When considering the urban and rural subgroup analysis, it was found that Chinese urban residents have a better understanding of COVID-19 compared to Chinese rural residents. Interestingly, the rural population displayed higher rates of correct behavior and positive attitudes toward COVID-19 compared to the urban population. Furthermore, in the subgroup analysis based on different regions in China, the eastern, central, and southwestern regions exhibited higher levels of knowledge awareness compared to other regions. It is worth noting that all regions in China demonstrated good rates of correct behavior and positive attitudes toward COVID-19.

Conclusion

This study reviews the level of KAP toward COVID-19 during the pandemic period in China. The results show that the KAP toward COVID-19 in Chinese residents was above a favorable level, but the lack of translation of knowledge into practice should be further reflected on and improved. A subgroup analysis suggests that certain groups need more attention, such as males and people living in rural areas. Policy makers should pay attention to the results of this study and use them as a reference for the development of prevention and control strategies for major public health events that may occur in the future.

Systematic Review Registration

https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=348246, CRD42022348246.

Typologies of people's preexisting political ideology and values would determine their post-pandemic mental health and political behaviors: Evidence from China

The pandemic of COVID-19 has caused economic and social crisis across the world. Existing studies have shown that the uncertain social context has profoundly affected people's life, triggering a variety of social psychological phenomena including the deterioration of mental health and the change of political behavioral patterns. However, little has been known about the differences in people's pre-pandemic political ideology and their influences on people's mental health and political behaviors after the pandemic. Using the secondary data from the 2018 and 2020 China Family Panel Studies, we measured nationalism tendencies, state performance ratings, social justice evaluation and life satisfaction of 29,629 adults before the pandemic. Using latent profile analysis (LPA), we examined the typologies of respondents' political ideology and values. Five types emerged to identify respondents with different political ideology and values: (Class-1) High nationalism tendency, country evaluation, social justice perception, and life satisfaction; (Class-2) Low life satisfaction; (Class-3) Moderate ratings; (Class-4) Low nationalism tendency; and (Class-5) Low country evaluation, low social justice perception. We further explored the predicting roles of those typologies on people's depressive symptoms and political engagement behaviors after the pandemic. We found that, after the pandemic, although the depressive symptoms of people with low life satisfaction (Class-2) and low country and society ratings (Class-5) eased, they still tended to have more severe depressive symptoms than the Moderate ratings group (Class-3). People with low life satisfaction (Class-2) were also less likely to follow political information than the moderate group (Class-3). Our research revealed how the psychology and behaviors of Chinese people with different political views changed when faced with uncertainty in social context. Further research needs to be carried out to depict how these changes occur.

Air travel choice, online meeting and passenger heterogeneity - An international study on travellers' preference during a pandemic

This study empirically identifies business travellers' preferences during the COVID-19 pandemic across different regions. A stated preference study was conducted during April to June 2021 on respondents in the U.S., the city of Shanghai in mainland China and Hong Kong. Generalised mixed multinomial logit (GMXL) models are estimated incorporating attributes of travel characteristics, severity levels of the pandemic, and health control measures at the airport. When an online meeting is inapplicable, respondents from Shanghai and Hong Kong highly value heath control measures, and are not sensitive to the time spent at airport health checkpoints. In comparison, U.S. respondents are averse to the time spent for health check, the reporting of personal information, travel history, symptoms, and the requirements of compulsory mask wearing and onsite sample testing. However, when online meeting is applicable, all the respondents show no appreciation for health control measures, while the U.S. respondents are twice more averse to the time spent at airport health checkpoints. Online meeting reduces the intention of international business travel amid the pandemic for passengers in Shanghai and Hong Kong, but imposes no significant effects on U.S. travellers. Such significant heterogeneity in traveller preference partly explains the different recovery patterns observed in various aviation markets, and justifies individualized travel arrangements and service priority in fulfilling pandemic control requirements across different regions. Our study also suggests that there are commonly accepted areas for global cooperation such as the sharing of vaccination record, and the option of online meeting calls for convenient travel arrangements amid pandemic to all countries.

Increased mask adherence after important politician infected with COVID-19

Objectives

To quantify changes in adherence to mask and distancing guidelines in outdoor settings in Philadelphia, PA before and after President Trump announced he was infected with COVID-19.

Methods

We used Systematic Observation of Masking Adherence and Distancing (SOMAD) to assess mask adherence in parks, playgrounds, and commercial streets in the 10 City Council districts in Philadelphia PA. We compared adherence rates between August and September 2020 and after October 2, 2020.

Results

Disparities in mask adherence existed by age group, gender, and race/ethnicity, with females wearing masks correctly more often than males, seniors having higher mask use than other age groups, and Asians having higher adherence than other race/ethnicities. Correct mask use did not increase after the City released additional mask guidance in September but did after Oct 2. Incorrect mask use also decreased, but the percentage not having masks at all was unchanged.

Conclusions

Vulnerability of leadership appears to influence population behavior. Public health departments likely need more resources to effectively and persuasively communicate critical safety messages related to COVID-19 transmission.

Public support for policies to improve population and planetary health: A population-based online experiment assessing impact of communicating evidence of multiple versus single benefits

Background

Effective interventions for reducing the consumption of products that harm population and planetary health often lack public support, impeding implementation. Communicating evidence of policies’ effectiveness can increase public support but there is uncertainty about the most effective ways of communicating this evidence. Some policies have multiple benefits such as both improving health and the environment. This study assesses whether communicating evidence of multiple versus single benefits of a policy increases its support.

Method

Participants (n = 4616) nationally representative of the British population were randomised to one of 24 groups in an online experiment with a 4 × 3 × 2 between-subjects factorial design. The messages that participants viewed differed according to the evidence they communicated (no message, effectiveness for changing behaviour, effectiveness for changing behaviour + one policy benefit, effectiveness for changing behaviour + three policy benefits), type of policy (taxation, availability) and the target behaviour (consumption of energy-dense food, alcohol, or meat). The primary outcome was policy support.

Results

In a full factorial ANOVA, there was a significant main effect of communicating evidence of effectiveness on policy support, which was similar across policies and behaviours. Communicating three benefits increased support relative to communicating one benefit (d = 0.15; p = 0.01). Communicating one benefit increased support compared to providing evidence for changing behaviour alone (d = 0.13; p = 0.004) or no message (d = 0.11 p = 0.022).

Conclusion

Communicating evidence of a policy's benefits increases support for policy action across different behaviours and policies. Presenting multiple benefits of policies enhances public support.

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Providing evidence of policies effectiveness at achieving policy goals increases public support.

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Uncertainty exists about the most effective ways of communicating this evidence.

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Evidence about multiple policy benefits increases support more than evidence for a single benefit.

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Effects are evident across behaviours and policies.