Health belief model for coronavirus infection risk determinants

Caregivers' Perceived Threat Of Sickle Cell Disease Complications And Its Association With Hydroxyurea Use Among Children With Sickle Cell Disease In Dar Es Salaam, Tanzania

Purpose

Tanzania is the fifth country with the highest sickle cell disease (SCD) prevalence globally. Although hydroxyurea (HU) is available, only 25% of persons with SCD are reported to use it in Tanzania. Perceived disease threat is associated with medication usage in patients with chronic diseases. We assessed the factors associated with caregivers' perceived threat of SCD complications and its relationship with HU use among children with SCD in Dar-es-Salaam.

Methods

We conducted a cross-sectional hospital-based study from May to August 2023. We enrolled 374 caregivers of health-insured children with SCD from 4 public SCD clinics. We adapted the modified original and revised Champion's Health Belief Model Scales to derive perceived threat scores. We used Mann-Whitney and Kruskal-Wallis tests to compare the outcomes across sociodemographic characteristics and regression analysis for factors associated with perceived SCD threat.

Results

The median score (InterQuartile Range) for perceived threat of SCD complications was 559 (175, 598). Sixty-one percent of caregivers had a high SCD perceived threat. The caregivers of under-five children had 141 lower median SCD threat scores than those of children aged 13-17 years, p-value < 0.001. Participants from Regional Referral Hospitals (RRH) had lower median threat scores compared to participants attending Muhimbili National Hospital (MNH), 177 for Amana RRH, 325 Temeke RRH, 585 MNH Mloganzila, and 557 MNH Upanga, p-value <0.001. Children of caregivers with high perceived SCD threat were 3.4 times more likely to use HU compared to those with low SCD threat perception (Incidence Rate Ratio 3.4, 95% CI: 2.7-4.5).

Conclusion

The perceived threat of SCD predicts the likelihood of SCD patients using HU in Dar-es-Salaam, Tanzania. We recommend health education to caregivers aiming to improve their SCD threat perception and thus improve the use of HU among children with SCD in similar settings.

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

BACKGROUND

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

METHODS

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

RESULTS

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

CONCLUSIONS

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

Structural equation modeling analysis of health belief model-based determinants of COVID-19 preventive behavior of academic staff: a cross-sectional study

INTRODUCTION

Despite COVID-19 being highly contagious and spreading to several countries, the university community has overlooked prevention measures. For more than five decades, the Health Belief Model (HBM) has been a widely used conceptual framework in health behavior. structural equation modeling(SEM) analysis is an advanced statistical method capable of rectifying failures of the basic models and showing complex relations Thus this study aimed to determine the magnitude of COVID-19 prevention behavior and identify its associated factors using HBM and SEM analysis.

METHOD

An institutional-based cross-sectional study was conducted among academic staff of the University of Gondar in Ethiopia from April 10 to May 10/2021. Daniel Soper's sample size calculator was used to determine the sample size. Proportional allocation to each campus followed by a simple random sampling technique was employed to select study subjects. A pre-tested, structured questionnaire was used to collect the data. Structural equation modeling analysis was employed to show the relationship between health belief model constructs and their effect on preventive behavior.

RESULT

A total of 602 academic staff participated. The magnitude of good COVID-19 preventive behavior was 24.8%. The HBM explained 55% of the variance in preventive behavior. Perceived barriers (β = -0.37, p < 0.05), self-efficacy (β = 0.32, p < 0.05), perceived susceptibility (β = 0.23, p < 0.05), and perceived benefit (β = 0.16, p < 0.05) were the direct significant predictors of COVID 19 prevention behavior.

CONCLUSION

only a quarter of the academic staff have good COVID-19 preventive behavior. The HBM explained a great amount of variance in preventive behavior and Perceived barriers, benefits, susceptibility, and self-efficacy significantly associated with prevention behavior. Carefully planned intervention that considers those significant perceptions should be designed and implemented to raise COVID-19 prevention behavior.

Development of a scale for attitude toward sexually transmitted infections based on the Health Belief Model

OBJECTIVES

Determination of the attitudes of individuals toward sexually transmitted infections (STIs) can also help identify barriers to health service-seeking behavior. Hence, this study aimed to develop a scale for determining the attitudes of individuals toward sexually transmitted diseases.

STUDY DESIGN

This was a methodological study. The Health Belief Model (HBM) framework was used to elucidate the perceptions and interpretations of illnesses among individuals. After reviewing the relevant literature, an item pool was created to include 4 dimensions (perceived susceptibility (A), perceived severity (B), perceived benefit (C), and perceived barriers and self-efficacy (D)) about sexually transmitted diseases from the perspective of HBM. Exploratory factor analysis was conducted to evaluate the construct validity of the scale. Moreover, confirmatory factor analysis was used to examine the suitability of the items in terms of factor structures.

RESULTS

The final version of the scale comprised 19 items and 4 subdimensions. The first subdimension of the scale accounted for 20.11% of the total variance, whereas the second, third, and fourth subdimensions accounted for 17.83%, 12.50%, and 8.75% of the total variance, respectively. Collectively, these four subdimensions accounted for 59.19% of the total variance. The Cronbach's alpha reliability coefficient of the scale was found to be 0.74.

CONCLUSIONS

Briefly, the present study led to the development of a novel assessment tool, Attitude Toward Sexually Transmitted Infections Scale. Higher scores on the scale indicated higher likelihood of taking action for a possible STI treatment according to the HBM approach.

Effects of User Experience in Automated Information Processing on Perceived Usefulness of Digital Contact-Tracing Apps: Cross-Sectional Survey Study

BACKGROUND

In pandemic situations, digital contact tracing (DCT) can be an effective way to assess one's risk of infection and inform others in case of infection. DCT apps can support the information gathering and analysis processes of users aiming to trace contacts. However, users' use intention and use of DCT information may depend on the perceived benefits of contact tracing. While existing research has examined acceptance in DCT, automation-related user experience factors have been overlooked.

OBJECTIVE

We pursued three goals: (1) to analyze how automation-related user experience (ie, perceived trustworthiness, traceability, and usefulness) relates to user behavior toward a DCT app, (2) to contextualize these effects with health behavior factors (ie, threat appraisal and moral obligation), and (3) to collect qualitative data on user demands for improved DCT communication.

METHODS

Survey data were collected from 317 users of a nationwide-distributed DCT app during the COVID-19 pandemic after it had been in app stores for >1 year using a web-based convenience sample. We assessed automation-related user experience. In addition, we assessed threat appraisal and moral obligation regarding DCT use to estimate a partial least squares structural equation model predicting use intention. To provide practical steps to improve the user experience, we surveyed users' needs for improved communication of information via the app and analyzed their responses using thematic analysis.

RESULTS

Data validity and perceived usefulness showed a significant correlation of r=0.38 (P<.001), goal congruity and perceived usefulness correlated at r=0.47 (P<.001), and result diagnosticity and perceived usefulness had a strong correlation of r=0.56 (P<.001). In addition, a correlation of r=0.35 (P<.001) was observed between Subjective Information Processing Awareness and perceived usefulness, suggesting that automation-related changes might influence the perceived utility of DCT. Finally, a moderate positive correlation of r=0.47 (P<.001) was found between perceived usefulness and use intention, highlighting the connection between user experience variables and use intention. Partial least squares structural equation modeling explained 55.6% of the variance in use intention, with the strongest direct predictor being perceived trustworthiness (β=.54; P<.001) followed by moral obligation (β=.22; P<.001). Based on the qualitative data, users mainly demanded more detailed information about contacts (eg, place and time of contact). They also wanted to share information (eg, whether they wore a mask) to improve the accuracy and diagnosticity of risk calculation.

CONCLUSIONS

The perceived result diagnosticity of DCT apps is crucial for perceived trustworthiness and use intention. By designing for high diagnosticity for the user, DCT apps could improve their support in the action regulation of users, resulting in higher perceived trustworthiness and use in pandemic situations. In general, automation-related user experience has greater importance for use intention than general health behavior or experience.

Perceived Health Risks, Health Behaviors, and BMI Among Diverse Adults in Israel

INTRODUCTION

Obesity is associated with an increased relative risk of COVID-19-related mortality. The interplay of culture and religion in the overweight/obesity context has been minimally examined. The purpose of this study was to examine the association between preventive health behaviors, sociodemographic factors, and obesity among religiously diverse adults in Israel.

METHODS

Using a quantitative cross-sectional design, an online survey was distributed to diverse adults in Israel during the pandemic using social media, email, and snowball methods.

RESULTS

Participants included 635 adults: 69.1% Jewish, 26.5% Muslim, and 4.4% "other." Jewish adults scored lower than others on perceived personal risk (p < .001), infection spread risk (p < .001), and preventive behaviors engagement (p < .005). Higher body mass index (BMI) predicted higher personal risk and higher likelihood of preventive behaviors engagement (p < .001).

DISCUSSION

Results demonstrate the association between religion, health risk perceptions, and COVID-19-related health behaviors. Nurses should consider the influence of culture and religion on health practices and recommend relevant lifestyle modifications to reduce COVID-19 risks.

The use of self-protective measures to prevent COVID-19 spread: an application of the health belief model

This study uses a health belief model to examine the preventive behavioral orientation or self-protective measures adopted by people in the face of the current COVID-19 pandemic. A total of 603 participants were selected from the city of Bangalore, India. The data was collected through an online survey with participants' age varying between 17 and 54 and mean as 23 years (SD = 4.32). The findings revealed that perceived barrier has significant negative impact, while perceived threat, perceived consequences, perceived benefits, community and individual self-efficacy, and general health cues have a positive influence on an individual's intention to follow self-protective measures against COVID-19. Based on the constructs of the health belief model, this study proposes multiple health-related interventions to reduce the spread of COVID-19.

Investigating the factors related to protective behaviors against COVID-19 in healthcare workers: Application of extended parallel process model

Background and Aims

Preventive behaviors against coronavirus disease 2019 (COVID-19) are important, and messages that create a sense of danger are necessary to create these behaviors. One of the widely used models for designing risk messages is the Extended Parallel Process Model (EPPM). The present study was conducted to investigate the factors related to protective behaviors against COVID-19 in the personnel of the health department based on EPPM.

Methods

In this cross-sectional study, 699 personnel of the deputy health department of Chaharmahal and Bakhtiari province were included in the study by census method. Data were collected online using valid questionnaires, including demographic questions and history of contracting COVID-19 and the questionnaire of EPPM constructs. Data were analyzed in SPSS24 software, using descriptive and analytical statistics.

Results

The results showed that there were positive correlations between the protective behaviors and the constructs of perceived severity (p < 0.001, r = 0.542), perceived susceptibility (p < 0.001, r = 0.260), self-efficacy (p < 0.001, r = 0.594), response efficiency (p > 0.001, r = 0.522), and risk control (p > 0.001, r = 0.501). There was a negative correlation between protective behaviors and fear control (p < 0.001, r = 0.329). The results of multiple linear regression showed that these six constructs explained 49.8% of protective behaviors against COVID-19, among which the role of the perceived severity construct was stronger than other constructs.

Conclusion

Regarding the results, it is suggested that the results of this research be used in the development of training programs to improve protective behaviors in high-traffic offices, and by focusing on fear and risk control.

A machine learning ensemble approach to predicting factors affecting the intention and usage behavior towards online groceries applications in the Philippines

The emergence of e-commerce platforms, especially online grocery shopping, is heightened by the COVID-19 pandemic. Filipino consumers started to adapt online due to the strict quarantine implementations in the country. This study intended to predict and evaluate factors influencing the intention and usage behavior towards online groceries incorporating the integrated Protection Motivation Theory and an extended Unified Theory of Acceptance and Use of Technology applying machine learning ensemble. A total of 373 Filipino consumers of online groceries responded to the survey and evaluated factors under the integrated framework. Artificial Neural Network that is 96.63 % accurate with aligned with the result of the Random Forest Classifier (96 % accuracy with 0.00 standard deviation) having Perceived Benefits as the most significant factor followed by Perceived Vulnerability, Behavioral Intention, Performance Expectancy, and Perceived. These factors will lead to very high usage of online grocery applications. It was established that machine learning algorithms can be used in predicting consumer behavior. These findings may be applied and extended to serve as a framework for government agencies and grocers to market convenient and safe grocery shopping globally.

Protective motivators and precautionary behaviors against COVID-19 in Turkey

In this research, we investigated the protection motivators and precautionary behaviors against coronavirus disease 2019 (COVID-19) and the associations between them. To do this, we developed two original scales, collected data (2783 responses) using an online survey, after removing the responses (319), which were filled in incompletely or incorrectly in the questionnaire, we obtained 2464 participants covering the aged 18+ population in Turkey. Based on random sampling, our sample complies with these ratios and generally reflects the aged 18+ population of Turkey. We confirmed the psychometrical validity and reliability of our two scales using the collected data. Herewith, we found that perceived susceptibility of COVID-19 infection is very high, perceived severity of COVID-19 is medium, COVID-19 related information seeking is high, beliefs on precautions' efficacy is high and also the practice of precautionary behaviors is high. Our research depicts that all protection motivators significantly are related with the practice of precautionary behaviors (routine and leisure). However, with the only exception of perceived severity of COVID-19 is not related with precautionary behaviors (routine). Besides, we saw that females' average in all variables is significantly higher than males and some variables are sensitive to age, education level, marital status and the number of children. We believe that the findings provide essential inputs for authorities in establishing public health policies against the present pandemic and likely ones in the future.

Empowering Communities During the COVID-19 Pandemic Through Mothers' Support Groups: Evidence From a Community Engagement Initiative in Sri Lanka

Community empowerment has previously been used to mitigate the effects of health emergencies, such as outbreaks of Ebola virus disease and Zika virus. In Sri Lanka, mothers' support groups (MSGs) aim to promote community health, well-being, and nutrition practices through community engagement. With the emergence of the COVID-19 pandemic, MSGs were mobilized by the Health Promotion Bureau in response to the pandemic. Key activities MSGs engaged in during the COVID-19 response included establishing communication networks, creating a supportive environment for preventive behaviors, organizing vaccination clinics, distributing essential food and medicine, organizing recreational activities, promoting home gardening, and monitoring community activities. We examine how these community-based empowerment initiatives successfully assisted in the pandemic response. Health officials can help to build more resilient communities that are better prepared for future health emergencies by valuing the community-level methods used in overcoming COVID-19 and further strengthening the skills of community group members.

Association between COVID-19 infection rates by region and implementation of non-pharmaceutical interventions: a cross-sectional study in Japan

BACKGROUND

During a pandemic, non-pharmaceutical interventions (NPIs) play an important role in protecting oneself and others from infection. There are large regional differences in COVID-19 infection rates in Japan. We hypothesized that the local infection incidence may affect adherence to individual NPIs.

METHODS

This cross-sectional study was conducted online among full-time workers in Japan in December 2020. The questionnaire asked the respondents to identify their habits regarding seven common NPIs (wearing masks, washing hands after the bathroom, disinfecting hands when entering indoors, gargling when returning home, ventilating the room, disinfecting or washing hands after touching frequently touched surfaces, carrying alcohol sanitizers when outdoors).

RESULTS

A total of 27 036 participants were analyzed. Compared with the region with the lowest infection rate, five of the seven NPIs showed statistically significant trends across regional infection levels, the two exceptions being wearing masks and washing hands after the bathroom. Multivariate adjustment did not change these trends.

CONCLUSIONS

This study found that NPIs were more prevalent in regions with higher incidence rates of COVID-19 in Japanese workers. The findings suggest that the implementation of NPIs was influenced not only by personal attributes but also by contextual effects of the local infection level.

Validity and Reliability of the COVID-19 Knowledge, Attitude and Behavior Scale

BACKGROUND

The aim of this research is to develop a scale that will evaluate the knowledge, attitudes and behaviors of employees about COVID-19 and to test its validity and reliability.

METHODOLOGY

The methodological type of research was used between August-November 2020, under observation in organized industrial zones. Information was collected from a total of 543 employees. Confirmatory factor analysis and correlation analysis were performed for the value, item-total correlations and construct validity. SPSS 25.0 (IBM Inc., Armonk, NY, USA), Jasp 0.14 (University of Amsterdam) and Lisrel 9.1(Scientific Software International, Inc., Chapel Hill, NC, USA) programs were used in the analysis.

RESULTS

83.1% of the participants in the study are male, the average age is 37.4 ± 8.0, 76.1% are married, and 49.4% are high school graduates. The Cronbach alpha value of the COVID-19 information part is 0.86 in total, the contamination information dimension is 0.71 and the protection information dimension is 0.84. The COVID-19 attitude section consists of four sub-dimensions and 13 items classified within the framework of the health belief model. In summary, the goodness of fit values for the knowledge, attitude and behavior sections, respectively, are: RMSEA values 0.05, 0.03 and 0.04; CFI values 0.98, 0.98 and 0.99; GFI values 0.97, 0.97 and 0.99.

CONCLUSIONS

It has been determined that the internal consistency of the COVID-19 knowledge, attitude and behavior scale conducted on employees is high and compatible, and its validity findings are sufficient. The scale is recommended as an applicable tool to measure COVID-19 knowledge, attitudes and behaviors.

Community Safety Behavior in Response to Coronavirus Pandemic

The purpose of this study is to explore the behavior and lifestyle of individuals in response to the coronavirus that the safety behavior of people in the coronavirus disease of 2019 pandemic. Hence, the study integrates the theory of planned behavior and the health belief model to understand the behavioral change in response to the coronavirus pandemic. The current study is qualitative therefore, a survey-based online questionnaire was used for data collection from university students and staff (faculty and nonfaculty) residing in top-tier cities of Pakistan, nonprobability convenient sampling was used to approach the audience. A two-stage approach was used to test the model using partial least square (variance-based structural equation modeling). The reliability and validity of the measurement model indicate that the data is reliable and valid. Outcomes prove all the relationships as proposed by the study, except for the impact of perceived barriers on intention and individual safety behavior. Perceived barriers act as obstacles that abstain individuals from following the standard operating procedures. The research agenda provides new insights into the fields of marketing, health care, consumer behavior, and behavioral studies. It contributes to the existing literature in the field of social marketing by studying the behavior and changes in the behavior of people in the global pandemic.

Is oral health literacy associated with conceptions of care and behavior related to the prevention of COVID-19?

The aim of the present study was to investigate the impact of oral health literacy (OHL) on conceptions of care and behaviors related to COVID-19. The sample came from two preliminary cross-sectional studies that determined the level of OHL of parents/guardians of six-to-12-year-old children in two major Brazilian cities (Curitiba and Belo Horizonte). Functional OHL was measured using the Brazilian version of the Rapid Estimate of Adult Literacy in Dentistry (BREALD-30) and the Health Literacy Dental Scale (HeLD-14) for the evaluation of interactive OHL. Participants were recruited through e-mail, social media, and telephone contact. The questionnaire on conceptions of care and behaviors related to COVID-19 was created based on the guidelines of the World Health Organization. Two hundred nineteen individuals participated in the study. There was no significant difference in socioeconomic and demographic variables and in the medians of BREALD and HeLD-14 between the two cities (P>0.05). Higher levels of functional OHL were associated with an appropriate conception that individual care affects collective care (P=0.038), but with an inappropriate conception of seeking medical assistance in cases of mild symptoms (P=0.030). Higher levels of interactive OHL were related to social distancing behavior in the city of Curitiba (P=0.049) and in the overall sample (P=0.040). It is concluded that functional OHL was associated with two of the investigated conceptions about COVID-19, while interactive OHL was associated with social distancing behavior. These data may suggest that different dimensions of the OHL can have an impact on different aspects of coping with the pandemic.

I have decided about my COVID-19 vaccine, what about my child?

Vaccination has been instrumental in controlling the COVID-19 pandemic, with numbers of new cases decreasing rapidly even as restrictions to control the spread of the virus were removed. The first stage of the vaccination campaign in Israel covered individuals aged 16 and older, following the U.S. Food and Drug Administration's approval of the vaccine. While the campaign was later extended to those aged 12 and older, some parents continue to have doubts and concerns about the vaccine. Data were collected via an online questionnaire during April 2021; 516 parents participated. This research adopted a holistic approach that combines factors relating to vaccine acceptance previously reported in the literature. The acceptance of pediatric COVID-19 vaccination among parents varied by their children's age groups, at 44.7%, 53.2%, and 66.4% among parents with children aged 0-6, 6-12, and 12-16, respectively. The results of this study indicate that different sets of variables affect the willingness of parents to vaccinate their children, depending on their child's age. Moreover, a holistic approach is necessary in order to correctly verify the significant variables. Parents who evaluate the vaccine as more beneficial have a higher probability of being willing to vaccinate. In addition, for ages 12-16, parental willingness to vaccinate is associated with access to information, trust, and neighborhood norms. Those evaluating information about the vaccine as more fake news show higher probability to vaccinate their children. The timing of the survey is highly relevant, especially considering the uncertainty about the effectiveness and side effects of the vaccine.

Group-based trajectory modeling to identify health beliefs of COVID-19 vaccination and its predictors: A cohort study in China

OBJECTIVES

This study aimed to characterize distinct patterns of change in health beliefs and their dimensions of COVID-19 vaccination and to evaluate the predictors of various trajectory groups.

METHODS

A total of 1129 participants who completed two doses of COVID-19 vaccines in China were included in this prospective study. Participants' characteristics and health beliefs regarding COVID-19 vaccination were collected before and after the two doses of COVID-19 vaccination. A group-based trajectory model was used to identify the distinct longitudinal patterns of health beliefs and their dimensions. A multinomial logistic regression model was conducted to determine the predictors of different trajectory groups.

RESULTS

The group-based trajectory model identified two to four distinct patterns of global health beliefs and their domains, namely, very low-stable (16.1%), low-stable (30.2%), medium-stable (45.6%), and high-stable (8.1%) trajectories for global health beliefs. And the five domains of health beliefs showed two or three trajectory stable progression, which were similar to the global health beliefs trajectories. Sex, occupation post, adverse reactions foreboding, and quality of life were associated with the trajectory of global health beliefs or at least one domain of health beliefs.

CONCLUSIONS

During the study, individuals' health beliefs about COVID-19 vaccination were stable without the interference of external factors. Based on the impact of sex, occupation post, adverse reactions foreboding, and quality of life on individuals' health beliefs, personalized interventions can be developed to improve public health beliefs about COVID-19 vaccination and reduce vaccination hesitancy.

Factors contributing to vaccine hesitancy and reduced vaccine confidence in rural underserved populations

Vaccination remains one of the most effective ways to limit the spread of infectious diseases, and reduce mortality and morbidity in rural areas. Waning public confidence in vaccines, especially the COVID-19 vaccine, remains a cause for concern. A number of individuals in the US and worldwide remain complacent, choosing not to be vaccinated and/or delay COVID-19 vaccination, resulting in suboptimal herd immunity. The primary goal of this study is to identify modifiable factors contributing to COVID-19 vaccine hesitancy among vaccine-eligible individuals with access to vaccines in two under-resourced rural states, Alaska and Idaho. This qualitative study used semi-structured interviews with providers and focus groups with community participants in Alaska and Idaho. A moderator's guide was used to facilitate interviews and focus groups conducted and recorded using Zoom and transcribed verbatim. Thematic, qualitative analysis was conducted using QDA Miner. Themes and subthemes that emerged were labeled, categorized, and compared to previously described determinants of general vaccine hesitancy: established contextual, individual and/or social influences, vaccine and vaccination-specific concerns. Themes (n = 9) and sub-themes (n = 51) identified during the qualitative analysis highlighted a factor's contributing to COVID-19 vaccine hesitancy and poor vaccine uptake. Relevant influenceable factors were grouped into three main categories: confidence, complacency, and convenience. Vaccines are effective public health interventions to promote health and prevent diseases in rural areas. Practical solutions to engage healthcare providers, researchers, vaccine advocates, vaccine manufacturers, and other partners in local communities are needed to increase public trust in immunization systems to achieve community immunity.

Perceived Risk for Dengue Infection Mediates the Relationship between Attitude and Practice for Dengue Prevention: A Study in Seremban, Malaysia

Dengue remains a public health concern due to limited curative treatment and safe vaccine availability. Prevention by individual is utmost necessary but its practice is still lacking. Perceived risk to disease has been reported to exert a good effect on health behaviour change. However, limited evidence showed its relationship towards attitude and practice for dengue prevention. Hence, we aim to measure the mediating effect of dengue risk perception in the relationship between dengue attitude and dengue prevention practice. A cross-sectional study was conducted from April 2021 to November 2021 in a district of Seremban using a pre-validated questionnaire. Informed consent was obtained from the respondents prior to inclusion in the study. The study was approved by the ethical research committee. A total of 347 respondents took part in the survey, but only 341 data points were included in the final analysis. The majority of the respondents were female (63.0%), of Malay ethnicity (86.8%), married (55.4%), and currently employed (71.0%). The pooled confirmatory factor analysis result demonstrated an RMSEA value of 0.038 (<0.08), CFI value of 0.969 (>0.90), TLI value of 0.9565 (>0.90), and ChiSq/df = 1.479 (<3.0). All the hypotheses for direct effect yielded a significant and positive relationship. Bootstrapping analysis to test for mediation revealed a partial mediation effect as both indirect and direct effects are significant. Risk perception is a mediator variable between attitude and dengue prevention practice. Therefore, our recommendation is to increase health awareness activity that helps to improve individual's risk perception through active health promotion and a health educational campaign that inculcates dengue risk messages. Ultimately, this effort can enhance good health prevention behaviour.

Regional Disparities in COVID-19 Vaccine Hesitancy: The Moderating Role of Social Distancing and Vaccine Rollout in the U.S

This study examines the relationship between statewide contexts and individuals’ COVID-19 vaccine hesitancy by using the Household Pulse Survey, a national and near real-time data timely deployed by the U.S. Census Bureau. Controlling for the individual- and state-level variables in addition to temporal effect, this study finds that racial and ethnic minorities and COVID-19-infected people are more hesitant than their counterparts to receive a vaccine. Individuals who reside in a state where more stringent social distancing measures – particularly mask mandate – are implemented and vaccine rollout conditions are better appear to be less hesitant to receive a COVID-19 vaccine. Vulnerable subpopulation groups such as people of color and COVID-19-infected individuals are more hesitant to vaccine uptake even if regional circumstances are equal. These findings suggest that the continuation and extension of vaccine campaigns at the regional as well as individual levels are all important for expediting COVID-19 vaccination and reducing vaccine hesitancy as the world is in the middle of the third year of the pandemic.

Assessment of perceived risk and precautionary behavior toward COVID-19 pandemic using the health belief model, Saudi Arabia

Background

The global threat of the COVID-19 pandemic continues to evolve forming the most impactful health crises in modern history, necessities of individuals adhering to mandatory behavior change that limits the spread of the pandemic. The purpose of the current study is to identify behavioral responses of the health sciences university students during the period of the COVID-19 pandemic and determine risk perceptions using the health belief model (HBM).

Methods

A cross-sectional study using an online survey distributed among health sciences female university students in Riyadh, KSA. The questionnaire was used to assess sociodemographic characteristics; knowledge about COVID-19 and its preventive measures, risk perceptions, and beliefs using the HBM; and their actual adoption of precautionary measures.

Results

The mean age of 286 respondents was 21.6 years (SD 2.5). They had good knowledge, positive risk perception, and good practice. Fifty-seven percent of the respondents adhere satisfactorily to COVID-19 precautionary behavior. Respondents with positive overall risk perception had around 6 times significantly higher adherence compared to those with negative risk perception. Perceived benefits have higher odds of adherence to COVID-19 precautionary behavior. Similarly, cues to action were a significant determinant of adherence to COVID-19 precautionary behavior.

Conclusions

The constructs of the HBM provided good measurement of risk perception and the respondent students had good knowledge. Yet, significant gaps were shown between COVID-19 perceived risks and the students’ actual practice of personal hygienic measures, particularly hand hygiene. To put an end to the present COVID-19 and its upcoming waves, it is highly recommended to direct COVID-19 training programs specifically tailored towards university students.

Measuring the Intention in Favour and Against Getting Vaccinated from COVID-19 Using the Health Belief Model: Cross-Sectional Study of Pakistan

Vaccination is without a doubt one of the most efficient ways to stop the COVID-19 pandemic from spreading. The goal of this study was to look into the acceptance and resistance to COVID-19 vaccination and its associated components using the Health Belief Model, which is a framework for changing health behaviours (HBM). The current study is quantitative; hence data was collected from attendants of patients admitted to hospitals in Pakistan's top-tier cities using a survey-based self-administered questionnaire. Nonprobability convenient sampling was utilised to approach the respondents. The model was tested in two stages using partial least squares (variance-based structural equation modelling). The measurement model's reliability and validity imply that the data is reliable and valid. Except for the impact of benefits on accepting behaviour, all of the study postulated relationships are supported by the results. The study agenda adds to our understanding of health care, immunisation, consumer behaviour, and behavioural research. It adds to the body of knowledge in the fields of immunisation and behavioural research by examining people's behaviours and changes during the worldwide mass vaccination period.

Components Affecting the Promotion of COVID-19 Disease Prevention Behaviors among Iranian Students: A Qualitative Study by Using the PRECEDE Model

Background

COVID-19 is a social health problem. Several risk factors threaten students, and schools can provide a suitable environment for managing and performing health promotion programs. Given the extensive spread of the disease and the existence of multilevel components affecting the adoption of preventive behaviors, understanding the views and opinions of the audience about the barriers and facilitators affecting the behavior using qualitative studies can be one of the ways to have a successful intervention.

Materials and Methods

This was a qualitative study performed by a directed content analysis method while using the PRECEDE model (predisposing, reinforcing, enabling constructs in educational diagnosis and evaluation). In total, 38 individuals (teachers, parents, and students) were entered into the study using the purposive sampling method. Data were collected by semistructured interviews, and the implemented data were systematically classified into five stages (condensed meaning units, code, subcategory, category, and theme) and were arranged and analyzed.

Results

The findings are classified into three themes of predisposing, enabling, and reinforcing factors. In addition, perceived sensitivity, perceived intensity, mental beliefs, behavior outcome evaluation, and perceived power were considered as subcategories of predisposing factors, whereas normative beliefs and motivation for adherence to protocols were subcategories of reinforcing factors, and control beliefs were subcategories of enabling factors.

Conclusion

Our findings could be used as a guide to design educational interventions aiming at promoting COVID-19 prevention behaviors in schools.

Determinants of COVID-19 Related Perception among University of Gondar Academic Staff, Gondar, Ethiopia, 2021: A Structural Equation Modeling Approach

Introduction. Public perceptions of pandemic risk and prevention measures influence adherence to COVID-19 prevention efforts. Even though several factors influence public perceptions, there has been no research on the predictors of COVID-19-related perception in Ethiopia and there are few articles among academic staff worldwide. Thus, this study aims to assess predictors of COVID-19-related perception among Gondar University academic staff. Method. Institutional based cross-sectional study was conducted from April 10 to May 10, 2021. Daniel Soper’s calculator was used to determine the sample size. A simple random sampling technique was employed. Data were collected through a self-administered questionnaire and analyzed using Stata V14. Structural equation modeling was performed to identify determinants of COVID-19 related perception. A $p$ value less than 0.05 and a 95% confidence interval of β were used to declare the statistical significance of the variables. Result. A total of 602 academic staff participated. Mean age of participants was 32.38 (±5.83) years. Family size (β = 0.12), chronic illness (β = −0.19), knowledge (β = 0.11), and cues to action (β = 0.43) were significantly associated with perceived susceptibility. Similarly, educational status (β = −0.11), perceived susceptibility (β = 0.61), and cues to action (β = 0.13) were significantly associated with perceived severity. Likewise, knowledge (β = 0.11) and cues to action (β = 0.62) were significant predictors of self-efficacy. Correspondingly, knowledge (β = 0.23), chronic illness (β = 0.09), profession (β = −0.09), perceived susceptibility (β = 0.19), perceived severity (β = 0.23), and self-efficacy (β = 0.29) were significant predictors of perceived benefit. Similarly, age (β = −0.18), profession (β = 0.10), and perceived susceptibility (β = −0.39) were significantly associated with perceived barriers. Conclusion. Several sociodemographic and other factors affect COVID-19 related perceptions. Intervention should consider those factors to improve COVID-19 prevention practice.

Factors associated with the use of the N95 respirator in university students in the daily life of COVID-19

OBJECTIVE

To identify the factors associated with the use of the N95 respirator in Nursing and Medical students in the daily life of the covid-19 pandemic.

METHODS

Descriptive-analytical cross-sectional study carried out in 2020. A total of 830 students from three universities in Peru participated in the study. Associations were evaluated using Pearson's Chi-Square and multivariate Poisson modeling with log linkage.

RESULTS

Statistically significant differences were found between the preference to use the N95 respirator in relation to masks according to the activity they perform (p=0.001) and where they live (p=0.005). The multivariate analysis reported that the associated characteristics were age, activity performed, perception and fear of being infected by covid-19.

CONCLUSION

The choice of N95 respirator is influenced by individual factors and perceptions. Spaces are needed to discuss daily life, the way of living, caring and educating, considering the socioeconomic dimensions and beliefs.

Knowledge, Attitudes, and Practices of COVID-19 Vaccination among Adults in Singapore: A Cross-Sectional Study

Public health measures promoting compliance of COVID-19 vaccination requires understanding of knowledge, attitudes, and practices (KAP). This study explored the KAP and risk factors influencing COVID-19 vaccination, including changes in preventive practices before and after vaccination in a high-income country, Singapore. An online cross-sectional study among Singaporeans and permanent residents aged 21 years and older was conducted from July to August 2021. Univariate and multivariable logistic regressions using RStudio version 1.4.1106 was performed to assess associations between demographic factors, KAP, and vaccination status. P values < 0.05 were considered statistically significant. A total of 869 respondents completed the survey. Individuals with higher knowledge (adjusted odds ratio [aOR] = 2.00, P = 0.024), perceived efficacy (aOR = 1.19, P = 0.004), perceived safety (aOR = 1.20, P = 0.005), and willingness to uptake (aOR = 1.55, P < 0.001) scores were more likely to be vaccinated. There was a significant increase in the use of proper handwashing techniques among the vaccinated group before and after vaccinations. The governmental risk communication approaches have been useful in instilling high levels of vaccine knowledge. High levels of good attitudes about and knowledge of COVID-19 vaccination were associated with a high level of vaccination practices. Good perceived vaccine efficacy and confidence in government were also associated with positive vaccine uptake. This study paves the way for more targeted government measures to be implemented to improve vaccination rates of COVID-19 booster vaccines in a high-income country like Singapore.

Should I Stay or Should I Go? Risk Perception and Use of Local Public Transport During the COVID-19 Pandemic

In light of the climate crisis, the transport sector needs to be urgently transformed and the number of users of local public transport needs to be increased. However, the first year of the COVID-19 pandemic severely affected public transport with passenger numbers declining up to 80% in Germany. In addition to a general decrease in mobility during lockdowns, we can observe a shift in decision-making in regards to modes of transportation, with public transport losing out. We argue that this change in behavior can be explained by the fact that people tend to overestimate the risk of COVID-19 transmission in public transport. In order to understand risk perception in users and non-users of public transport during the pandemic, a representative survey (N = 918) in a German major city was conducted at the peak of the third wave of the pandemic in April 2021. We identified four main target groups of public transport use during the pandemic: Loyal users (n = 193), reducers (n = 175), pandemic-dropouts (n = 331) and non-users (n = 219). We found reducers (r = 0.12), pandemic-dropouts (r = 0.32) and non-users (r = 0.22) to perceive an increased perception of infection risk for public transport as compared loyal users. This increased risk perception was specific to public transport - it did not generalize to other day-to-day situations, such as going to the grocery store or visiting a hairdresser. This finding can be taken as an indication that risk perception for an infection plays a crucial role in stepping back from public transport use during the pandemic. In addition, however, there were other differences in terms of needs and concerns between the different target groups during the pandemic. Based on our findings, we discuss which tools and interventions might convince these different groups to hop-(back)-on public transport. Our study highlights how risk perception will play an important role in attracting new and former passengers and is the basis for the interventions and developments that will build a pandemic-resistant public transport in the future.

Predicting preventive travel behaviors under the COVID-19 pandemic through an integration of Health Belief Model and Value-Belief-Norm

This study developed a conceptual framework for a preventive travel decision-making process amidst the COVID-19 pandemic, combining the Health Belief Model (HBM) and Value-Belief-Norm (VBN). Analyzing 409 responses collected from an online survey, this study verified the integrated model as a salient theory addressing the importance of social components and health belief factors in affecting behavior. The model revealed that altruistic value influences the HBM variables, whereas personal norms mediate preventive behaviors and beliefs in both VBN and HBM. These findings offer new theoretical insights into decision-making process and provide practitioners with effective crisis management strategies concerning pro-social and health beliefs.

COVID-19 Vaccine Hesitancy in Israel Immediately Before the Vaccine Operation

The development of a vaccine for COVID-19 presented hope for a way out of the global crisis caused by the virus. However, a potential barrier may be vaccine hesitancy, and identifying the factors that affect it is critical, especially concerning a new vaccine technology. The purpose of this research is to identify the factors that effects vaccine hesitancy by using a holistic view. The data were collected from 504 people in December 2020, 3 days before the vaccine operation started in Israel. The analysis included three categories of determinants: (1) contextual influences; (2) health records; and (3) perceived health attitudes. The results indicate that different sets of variables affect willingness to accept the vaccine among the whole spectrum of the vaccine-hesitant and the undecided subsample. In the full sample, gender, age, income, influenza vaccine, perceived trust, perceived susceptibility, perceived benefits, and perceived barriers affected vaccine acceptance. The perceived level of suffering from COVID-19 was associated with willingness to vaccinate, and when religious beliefs increased, the intention to vaccinate decreased. For the undecided subsample, the factors included gender, influenza vaccine, trust in the vaccine company, and perceived vaccine benefits and barriers. The results suggest that efforts of governments and health institutions should focus on women and highlight the vaccine as an opportunity to "go back to normal" without worries. Those results will help implement vaccine strategy in the following cases: if infant vaccination is pursued and if emergency vaccines or new vaccine technologies emerge for another pandemic as well.

Faith, Fear, and Facts: A COVID-19 Vaccination Hesitancy Intervention for Black Church Congregations

Background: Blacks are dying from the novel coronavirus of 2019 (COVID-19) at disproportionate rates and tend to have more COVID-19 vaccine hesitancy than Whites. These disparities may be attributable to health knowledge and government/medical mistrust stemming from negative experiences with the medical system historically and presently (e.g., the Tuskegee Experiment, provider maltreatment). Method: The present study assessed COVID-19 vaccine hesitancy and the effectiveness of a 1.5 h, dialogue-based, web intervention hosted by an academic–community partnership team. The webinar included approximately 220 male and female, English speaking, Black churchgoers in the western U.S. The webinar focused on the psychology of fear and facts about the vaccine development. Results: The sample was mostly females who had higher vaccine hesitancy than men. A third of participants feared hospitalization if they contracted COVID-19. Many participants reported that learning facts about COVID-19 was most impactful. Statistical analyses indicated an increased willingness to get vaccinated after the webinar in comparison to before (t(25) = −3.08, p = 0.005). Conclusion: The findings suggest that virtual webinars may be effective at reducing COVID-19 vaccine hesitancy among Black churchgoers and may be applicable in addressing other health behaviors.

Factors Associated with COVID-19 Vaccine Intentions among South Carolina Residents

Despite evidence of vaccine safety and efficacy, vaccine hesitancy remains a major global health threat. The COVID-19 vaccine has presented unique vaccine hesitancy concerns compared to parental vaccine hesitancy towards childhood vaccines. South Carolina (SC) is home to a largely conservative population and historically has some of the lowest vaccination coverage rates in the United States of America. The goal of the current study was to identify factors associated with COVID-19 vaccine intentions among SC residents. From November 2020 to September 2021, 300,000 invitations to participate in community testing and complete an online survey were mailed to randomly selected SC residents. The survey collected data about behaviors and attitudes towards COVID-19 vaccines, as well as demographic and health characteristics. Of the 10,626 survey participants, 69.9% reported being vaccinated against COVID-19. Among those not vaccinated, 65.5% reported vaccine intentions. Logistic regression analyses were performed to examine factors associated with COVID-19 vaccine intentions. Multivariate logistic regression results indicated that confidence in the safety of the COVID-19 vaccines increased the likelihood of vaccine intentions, while younger age (<60 years) decreased the likelihood of vaccine intentions. To increase vaccine intentions and uptake, public health and government officials in South Carolina and other conservative states should target younger populations and address concerns about COVID-19 vaccine safety.

Using the Health Belief Model to Predict Vaccination Intention Among COVID-19 Unvaccinated People in Thai Communities

Background

The coronavirus disease 2019 (COVID-19) pandemic has become one of the biggest challenges to individual health and the public health system worldwide. COVID-19 morbidity and mortality are increasing, impacting almost every country including Thailand. This study used the Health Belief Model (HBM) as a framework to examine the intention of unvaccinated people living in northern Thailand to receive COVID-19 vaccines.

Methods

This cross-sectional study was conducted during October and November 2021. A total of 1,024 participants who are currently living in four northern provinces of Thailand, Chiang Mai, Chiang Rai, Lamphun, and Phayao, were recruited to participate in the study. The questionnaire was developed using an HBM structure to obtain information about the perceived severity, perceived susceptibility, self-efficacy, perceived benefits and barriers, cues to action, and preventive behaviors relating to COVID-19 vaccination and the decision to become vaccinated. Multiple linear regression was used to analyze the data.

Results

The unvaccinated participants were an average of 44.45 ± 16.63 years of age and more than half were women (54.5%). The COVID-19 preventive behavior score used perceived severity (B = 0.26), self-efficacy (B = 0.51), perceived benefits and barriers (B = 0.11), and cues to action (B = 0.18) after adjusting for age, underlying disease, and body mass index (R² = 42.5%). The COVID-19 vaccination decision score was positively correlated with perceived severity (B = 0.13), perceived susceptibility (B = 0.25), perceived benefits and barriers (B = 0.21), and cues to action (B = 0.27) after adjusting for underlying disease (R² = 38.7%).

Discussion

The results demonstrated the usefulness of using the HBM structure to understand individual intention to receive a COVID-19 vaccine. Communities should consider a COVID-19 health campaign and programs that use the HBM model as a framework for altering perceptions and beliefs about the COVID-19 vaccine and improving vaccination rates among unvaccinated people in rural northern Thailand.

Factors associated with COVID-19 vaccination intent in Singapore, Australia and Hong Kong

Background

COVID-19 pandemic has caused significant morbidity and mortality globally. As vaccines have been developed under expedited conditions, their safety and efficacy are being questioned by some populations leading to vaccine hesitancy, resulting in delayed vaccine uptake and herd immunity. This study aims to adopt a combination of Health Belief Model and other independent risk factors associated with high vaccine acceptance.

Methods

An anonymized cross-sectional survey was distributed between 15 January and 3 February 2021 across Singapore, Hong Kong and Australia among adult respondents through a certified online panel. Exploratory factor analysis and confirmatory factor analysis were carried out to assess perception constructs followed by multivariate regression modelling to assess factors associated with high vaccine acceptance against SARS_CoV-2.

Results

A total of 3,133 anonymised participants from Singapore (n = 1,009), Australia (n = 1,118) and Hong Kong (n = 1,006) completed the survey. While age and gender were not significantly associated, Asian ethnicity, current smokers and self-efficacy were significant associated factors of increased vaccine acceptance. While specific practices like taking micronutrients more frequently, cleaning and disinfecting their house more often were positively associated with increased vaccine acceptance, seeking medical help for COVID-19 symptoms like loss of smell/taste and overall COVID-19 knowledge score were negatively associated. Increased likelihood of vaccine acceptance was seen among those that obtained COVID-19 information less frequently and used digital media or non-health-related sources like influencers as a source of information. Among the eight perception constructs, perceived susceptibility and perceived response efficacy were positively associated, while perceived barriers were negatively associated with high vaccine acceptance.

Conclusion

While demographic parameters have weak association with vaccine acceptance, perceptions and practices parameters can help to better understand and influence vaccine acceptance. Study findings should provide guidance on the risk communication strategy to enhance vaccine acceptance for vaccination and boosters against new SARS-CoV-2 variants.

Egyptians’ Perceptions of COVID-19: Applying the Health Belief Model: A Cross-sectional Study

BACKGROUND: Many studies have found that assessing COVID-19 preventive behaviors using the health belief model (HBM) to understand both motives and fears is critical to better controlling the disease. AIM: The aim of the study was to assess the perceptions of social distancing as a preventive measure during the COVID-19 pandemic using the HBM among a sample of the Egyptian population. METHODS: An exploratory cross-sectional study was conducted using an online survey distributed through one of Egypt’s most popular social media platforms. Four hundred and seventy people responded to the survey. The survey constructed of two sections; the first section for sociodemographic data and Section 2 was for HBM constructs of self-efficacy, perceived susceptibility, and severity to COVID-19 prevention benefits and barriers. RESULTS: More than half of the participants (59.8%) were in the age range of 20–29, with an average age of 29.0 ± 6.4 years. Two hundred ninety-seven participants (63.2%) were females; 60.2% lived in the canal region; 57.9% were single; and 70% had university degrees. There were statistically significant differences regarding gender; females’ perceived higher scores in almost all model constructs (benefits, susceptibility, severity, self-efficacy, and total score). Many statistically significant differences were observed; those who were older than 30 years had higher scores in barriers, benefits, self-efficacy, and total score than younger ones. Similarly, married participants reported higher scores in barriers, benefits, self-efficacy, and total score than younger ones. Postgraduate education perceived higher scores than university in benefits, susceptibility, self-efficacy, and total score. CONCLUSION: In the present study, the majority of respondents had relatively high perceived benefits, severity, and self-efficacy, with the lower perceived self-COVID-19 susceptibility but higher for family members. Females perceived higher scores in almost all model constructs (benefits, susceptibility, severity, self-efficacy, and total score).

Testing the Effectiveness of the Health Belief Model in Predicting Preventive Behavior During the COVID-19 Pandemic: The Case of Romania and Italy

We use a cultural psychology approach to examine the relevance of the Health Belief Model (HBM) for predicting a variety of behaviors that had been recommended by health officials during the initial stages of the COVID-19 lockdown for containing the spread of the virus and not overburdening the health system in Europe. Our study is grounded in the assumption that health behavior is activated based on locally relevant perceptions of threats, susceptibility and benefits in engaging in protective behavior, which requires careful attention to how these perceptions might be structured and activated. We assess the validity of the HBM in two European countries that have been relatively understudied, using simultaneous measurements during acute periods of infection in Romania and Italy. An online questionnaire provided a total of (N = 1863) valid answers from both countries. First, to understand individual difference patterns within and across populations, we fit a General Linear Model in which endorsement was predicted by behavior, country, their interaction, and a random effect for participants. Second, we assess the effect of demographics and health beliefs on prevention behaviors by fitting a multi-group path model across countries, in which each behavior was predicted by the observed health belief variables and demographics. Health beliefs showed stronger relationships with the recommended behaviors than demographics. Confirming previously reported relationships, self-efficacy, perceived severity, and perceived benefits were consistently related to the greater adoption of individual behaviors, whereas greater perceived barriers were related to lower adoption of health behaviors. However, we also point to important location specific effects that suggest that local norms shape protective behavior in highly contextualized ways.

Factores asociados al uso del respirador N95 en universitarios en lo cotidiano de la COVID-19

RESUMEN Objetivo: Identificar los factores asociados al uso del respirador N95 en estudiantes de Enfermería y Medicina Humana en lo cotidiano de la pandemia COVID-19. Métodos: Estudio descriptivo-analítico transversal realizado en el año 2020. Participaron 830 estudiantes de tres universidades de Perú. Se evaluaron asociaciones mediante Chi Cuadrado de Pearson y modelamiento multivariado de Poisson con link log. Resultados: Se encontró diferencias estadísticamente significativas entre la preferencia de usar el respirador N95 en comparación con las mascarillas según la actividad que desempeñan (p=0,001) y lugar de residencia (p=0,005). El análisis multivariado reportó que las características asociadas fueron la edad, la actividad que desempeña, percepción y miedo de que podrían infectarse con COVID-19. Conclusión: En la preferencia de elegir el respirador N95, intervienen factores individuales y las percepciones. Se necesitan espacios para discutir lo cotidiano, la manera de vivir, cuidar y educar; considerando dimensiones socioeconómicas y creencias.

Social distancing practice and associated factors in response to COVID-19 pandemic at West Guji Zone, Southern Ethiopia, 2021: A community based cross-sectional study

BACKGROUND

Curtailing physical contact between individuals reduces transmission and spread of the disease. Social distancing is an accepted and effective strategy to delay the disease spread and reduce the magnitude of outbreaks of pandemic COVID-19. However, no study quantified social distancing practice and associated factors in the current study area. Therefore, the study aimed to assess social distancing practice and associated factors in response to COVID-19 pandemic in West Guji Zone, Southern Ethiopia, 2020.

METHODS AND MATERIALS

A Community based cross-sectional study design was conducted among randomly selected 410 household members of Bule Hora Town, West Guji Zone. Data were collected by pre-tested interviewer administered structured questionnaire adapted from previous peer reviewed articles. The data were coded and entered in to Epi data version 3.5 and analyzed by SPSS version 23. The bivariate and multivariate logistic regressions analysis was done to identify factors associated with social distancing practice. Adjusted odds ratio with 95% confidence interval and p value <0.05 were used to declare statistical significance.

RESULT

Out of 447 planned samples, 410 participants were successfully interviewed and included into final analysis; making the response rate of 91.7%. The median (±IQR) age of study participants was 28(±9) years. In this study, 38.3% [95% CI: 33.5%, 43.1%)] of the study participants have good social distancing practices for the prevention of COVID-19. Age group 26-30 years [AOR = 2.56(95% CI: 1.18-5.54)] and 31-35 years [AOR = 3.57(95%CI: 1.56-8.18)], employed [AOR = 6.10(95%CI: 3.46-10.74)],poor knowledge [AOR = 0.59 (95% CI:0.36-0.95)], negative attitude [AOR = 0.55 (95% CI:0.31-0.95)] and low perceived susceptibility [AOR = 0.33(95%CI: 0.20-0.54)] were significantly associated with good social distancing practice.

CONCLUSION

Social distancing practice is relatively poor in the study area. The knowledge and attitude level of participants were identified to be the major factors for the observed poor social distancing practice. Sustained efforts to improve awareness and attitudes towards COVID-19 prevention might improve adherence to social distancing practices.

Need to investigate COVID-19 beliefs for tailor-made sensitisation campaigns

OBJECTIVES

The main objective of this study was to investigate the COVID-19 beliefs of a random sample of Mauritian social media users.

STUDY DESIGN

Cross-sectional study.

METHODS

This quantitative research was undertaken by means of an online survey instrument, with questions on participants' behaviour towards COVID-19 and their beliefswith respect to susceptibility, barriers, benefits, cues to actions and self-efficacy.

RESULTS

In total, 405 participants completed the survey. Participants had a low mean COVID-19 perceived susceptibility and perceived severity. Significant differences in susceptibility were observed among different age groups, places of residence and educational levels. A significant difference in self-efficacy was found between people living in urban and rural areas. Participants aged <39 years showed a significantly lower perceived benefit of staying at home to avoid COVID-19 infection compared with those aged 39-54 years. Multiple linear regression modelling revealed that participants aged 39-65 years and those who were single were the most concerned about the risk of COVID-19 infection.

CONCLUSIONS

The findings of this study provide the basis for evidence-based health education programmes that are tailor-made for specific targeted audience. Sensitisation campaigns on the benefits of staying home should be aimed at younger social media users (aged <39 years). Community health centres in rural areas need to be involved in providing educational videos to empowering people towards self-efficacy.

COVID-19 related risk perception among taxi operators in Kingston and St. Andrew, Jamaica

BACKGROUND

In the Caribbean, all countries have confirmed COVID-19 cases. Considering the high infectivity of the virus, no preexisting immunity to the virus and an associated modest reproductive rate (R0), the high density of persons utilizing public transport is of immense public health concern. Public transport systems may facilitate and accelerate the transmission of the disease.

AIM

The aim of this study was to assess the COVID-19 related risk perceptions among taxi drivers by virtue of their occupation and the implications for health promotion interventions.

METHODS

A cross-sectional study was conducted in May 2020 among 282 taxi drivers in the Kingston and St. Andrew (KSA) metropolitan region in Jamaica. A 28-item anonymized self-administered questionnaire was used to collect data which was subsequently analyzed using SPSS version 20. A risk score was generated and the Mann-Whitney U and Kruskal Wallis tests were used to determine differences in the mean ranks for risk perception score as applicable. A 5% alpha level was utilized in determining statistical significance.

RESULTS

Risk perception scores ranged from 10 to 21 with a median of 17 (IQR 3.25) and there was no statistically significant difference in the median risk perception score by socio-demographic variables. There was however, a statistically significant positive correlation (Spearman's rho = 0.238, p=<0.001) between risk perception and knowledge. Approximately, 86% of respondents reported that they obtained COVID-19-related information from news reports (traditional media).

CONCLUSION

Taxi drivers perceive themselves to be at occupationally related risk of COVID-19. Therefore, greater understanding of this issue is paramount as it can aid in the crafting of initiatives that may enhance personal safety of both taxi drivers and commuters.

Health belief model and behavioural practice of urban poor towards COVID-19 in Nigeria

Poor adherence to promoting health behaviours is a significant challenge for prevention and management of infectious respiratory diseases. Non-pharmaceutical Interventions (NPIs) remain a proven behavioural practice for reducing the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) currently ravaging the world. Studies on Covid-19 have primarily focused on epidemiology, virology, and potential drug treatments to the neglect of behavioural practice of low-income settings. This study examines the extent health belief model predicts the behavior of 405 urban poor residents of Ogun State, which recorded the first index case in Nigeria, towards adoption Covid-19 NPIs. A cross-sectional study was conducted to find out the relationship between study participant characteristics, HBM constructs and unhealthy behavior. Study constructs were assessed on a four point Likert scale and were mean aggregated such that higher scores indicated stronger feelings about a construct. Findings shows that urban poor in the age group 30-40 years were more likely to feel susceptible to contracting Covid-19 (mean score: 2.59 and std. dev. 0.54), they also had a higher perception of the benefit of Covid-19 preventive behaviours than participants in other age groups (mean score: 2.95 and std. dev. 0.71). Also, the most prevalent unhealthy behaviour amongst urban poor residents was the indiscriminate use of facemasks as shown by almost half (47.6%) of participants who agreed that they use facemasks all the time even when alone. The study concludes that though urban poor residents feel threatened by Covid-19, nexus of factors such as low financial earnings, inadequate knowledge, and limited access to basic medical needs hamper the effective adoption of NPIs.

Assessing COVID-19 preventive behaviours using the health belief model: A Sri Lankan study

Objective

The novel coronavirus (COVID-19) is turning out to be one of the most severe public health crises in recent history. Promoting preventive behaviour among the public is of paramount importance to effectively contain the disease. Hence, this research attempts to identify factors that affect preventive behaviour against COVID-19.

Methods

The Health Belief Model (HBM), which outlines how perceived susceptibility, severity, benefits, barriers, and health motivation affect individuals’ health behaviour, served as the theoretical basis of the study. As the outcome measure of the study was cues to action against COVID-19, a regression analysis was conducted to explore how the aforementioned HBM constructs influence the cues to action. The data were collected using an online survey with a total of 307 respondents.

Results

The results revealed that perceived benefits (0.395, p < 0.001), self-efficacy (0.405, p < 0.001), and general health motivation (0.313, p < 0.001) had significant positive impacts on the cues to action taken to prevent COVID-19, whereas perceived barriers (−0.097, p < 0.05) had a significant negative impact. The statistical analysis further revealed that the cues to action taken to prevent COVID-19 were not significantly influenced by perceived susceptibility and perceived severity.

Conclusion

The study reinstates the usability of the HBM in exploring health behaviour. Importantly, the study findings suggest that by informing the public of the benefits of prevention and general health motivation, and by encouraging self-efficacy and eliminating the barriers to prevention, preventive actions against COVID-19 can be effectively promoted.

Risk perceptions of COVID-19 and its impact on precautionary behavior: A qualitative study

OBJECTIVE

The controlling of the COVID-19 pandemic is influenced by the precautionary behavior of the community, and such behavior is frequently related to individuals' risk perception. The current study aimed to explore risk perceptions and precautionary behavior in response to COVID-19.

METHOD

Qualitative in-depth interviews by telephone were undertaken with 26 participants from three affected cities in an initial stage of the disease outbreak, from May 3 to June 5, 2020. The method of analyzing data was inductive. The results were analyzed using interpretation, categorizing, and thematic analysis.

RESULTS

The perception of risk is influenced by numerous individual, community, and cultural factors; these perceptions act as triggers for precautionary behavior, with a tendency to deny risks or react with exaggeration in terms of the precautionary reactions related to COVID-19. The thematic analysis produced two major categories: 1) risk perception and 2) precautionary behavior. The analysis provides essential insight into risk perception and precautionary behavior.

CONCLUSION

The risk perceptions and patterns of precautionary behavior could be unreliable, unhealthy, and culturally affected, which would influence the effectiveness of pandemic control measures. Further investigations with more data and including risk perception and precautionary behavior in the national response plan for emergency and crisis are highly recommended.

PRACTICE IMPLICATIONS

A greater understanding and ongoing assessment of COVID-19 risk perception could inform policymakers and health professionals who seek to promote precautionary behavior. This could also facilitate early interventions during pandemics.

Attachment, Personality and Locus of Control: Psychological Determinants of Risk Perception and Preventive Behaviors for COVID-19

Background: The understanding of factors that shape risk perception is crucial to modulate the perceived threat and, in turn, to promote optimal engagement in preventive actions. Methods: An on-line, cross-sectional, survey was conducted in Italy between May and July 2020 to investigate risk perception for COVID-19 and the adoption of preventive measures. A total of 964 volunteers participated in the study. Possible predictors of risk perception were identified through a hierarchical multiple linear regression analysis, including sociodemographic, epidemiological and, most of all, psychological factors. A path analysis was adopted to probe the possible mediating role of risk perception on the relationship between the independent variables considered and the adoption of preventive measures. Results: Focusing on the psychological predictors of risk perception, high levels of anxiety, an anxious attachment, and an external locus of control predicted higher perceived risk. Conversely, high levels of openness personality and of avoidant attachment predicted a lower perception of risk. In turn, the higher was the perceived risk the higher was the adoption of precautionary measures. Furthermore, psychological factors influenced the adoption of preventive behaviors both directly and indirectly through their effect on risk perception. Conclusions: Our findings might be taken into high consideration by stakeholders, who are responsible for promoting a truthful perception of risk and proper compliance with precautionary measures.

Beyond technology adoption: Examining home energy management systems, energy burdens and climate change perceptions during COVID-19 pandemic

The COVID-19 pandemic has rapidly changed our lives. While the global impacts of the pandemic are shocking, the implications for energy burdens, climate policy, and energy efficiency are salient. This study examines income differences in the acceptance of and willingness to pay for home energy management systems during the COVID-19 pandemic among 632 residents in New York. Additionally, this study examines energy profiles, energy burdens, climate change issues, risk perceptions, and social-psychological factors. Compared with low-income households, our findings suggest that high-income households use more energy, have higher utility bills during quarantine mandates, perceive a higher risk of COVID-19 infection, and perceive climate change issues to be better than before. Low-income households, however, experience the highest energy burdens. Regarding HEMS acceptance, high-income households are more willing to adopt energy and well-being-promoting features of HEMS and more willing to pay a higher monthly fee for all the features than other income groups. Overall, participants were more willing to pay a higher price for the energy features than the well-being-promoting features. Low-income households indicate lower social norms, personal norms, and perceived behavioral control over adopting HEMS; they also perceive HEMS to be more difficult to use and less useful. Higher-income households express a higher trust in utilities than low-income households. Surprisingly, cost concerns, technology anxiety, and cybersecurity concerns relating to HEMS do not differ across income groups. This paper addresses the interactions among technology attributes and social-psychological and demographic factors, and provides policy implications and insights for future research.

What are the measures taken to prevent COVID-19 infection among healthcare workers? A retrospective study in a cluster of primary care clinics in Singapore

OBJECTIVE

To examine factors contributing to the low COVID-19 infectivity rate among healthcare workers in SingHealth Polyclinics (SHP), Singapore, from February to July 2020.

DESIGN

Retrospective description, analysis and discussion of the factors and their contribution.

SETTING

Single-institution study.

METHODS

We describe and discuss the healthcare policies, infrastructure, people and processes contributing to the low COVID-19 infectivity rate in SHP.There were 1212 full-time and 198 contract staff. Of these, 171 SHP employees also supported the work in dormitories, isolation and community care facilities. During the review period, healthcare workers (HCWs) in SHP managed about 867 076 patient attendances, including 63 503 for upper respiratory tract infections, across its cluster of eight polyclinics. 29 642 swabs for COVID-19 were performed in SHP, with 126 positive results. 395 swabs were carried out in the dormitories and 59 were positive. Despite the high exposure, only two SHP staff were infected with COVID-19. Both have recovered well.

RESULTS

Provision of adequate personal protection equipment, zonal segregation of high-risk patients, reduction in physical patient visits, effective staff communication, implementation of self-declared temperature monitoring and the maintenance of sustainable workload and work hours of HCWs contributed to the mitigation of COVID-19 infection risk among our staff.

CONCLUSIONS

Until the widespread uptake of safe and effective vaccines against COVID-19, these measures are important in protecting HCWs. They are also important when managing future pandemics of similar nature to COVID-19.

Factors associated with preventive behaviors of COVID-19 among Indonesian nursing students: application of Health Belief Model

Objectives — This study aimed to examine factors associated with preventive behaviors of COVID-19 among Indonesian nursing students through The Health Belief Model. Material and Methods — A cross-sectional design was used in this study. This study was conducted in a school of nursing in Malang, Indonesia. A total of 112 undergraduate nursing students were recruited using convenience sampling. Data were collected by online-based questionnaires which were the demographic characteristics, questions about health belief model constructs, and questions about the preventive behaviors from COVID–19 during July 2020. Pearson product-moment was used to analyze the data. Results — This study found that cues to action have positive and significant correlation to preventive behavior of Covid-19. Perceive self-efficacy and perceive benefit have positive and significant correlation to cues to action. Furthermore, perceive self-efficacy also has positive correlation to perceive severity, perceive benefit, and has negative correlation to perceive barrier. Perceive benefit has negative correlation to perceive barrier. Conclusion — Cues to action was related to preventive behavior of Covid-19 among nursing student in this study. Therefore, the nursing student should improve their action in preventive behavior of COVID-19.

Critical health response in the time of COVID-19: lessons from the past

This article examines the South African government’s response to COVID-19 by exploring the strong emphasis that has been placed on South Africans taking personal responsibility for good health outcomes. This emphasis is based on the principles of the traditional Health Belief Model which is a commonly used model in global health systems. More recently, there has been a drive towards other health behaviour change models, like the COM-B model and Behaviour Change Wheel (BCW); nonetheless, these remain entrenched within the principles of individual health responsibility. However, the South African experience with the HIV epidemic serves as a backdrop to demonstrate that holding people personally accountable for health behaviour changes has major pitfalls; health risk is never objective and does not take place outside of subjective experience. This article makes the argument that risk-taking health behaviour change in the South African context has to consider community empowerment and capacity building.

Association between well-being and compliance with COVID-19 preventive measures by healthcare professionals: A cross-sectional study

IMPORTANCE

Knowledge and attitude influence compliance and individuals' practices. The risk and protective factors associated with high compliance to these preventive measures are critical to enhancing pandemic preparedness.

OBJECTIVE

This survey aims to assess differences in mental health, knowledge, attitudes, and practices (KAP) of preventive measures for COVID-19 amongst healthcare professionals (HCP) and non-healthcare professionals.

DESIGN

Multi-national cross-sectional study was carried out using electronic surveys between May-June 2020.

SETTING

Multi-national survey was distributed across 36 countries through social media, word-of-mouth, and electronic mail.

PARTICIPANTS

Participants ≥21 years working in healthcare and non-healthcare related professions.

MAIN OUTCOME

Risk factors determining the difference in KAP towards personal hygiene and social distancing measures during COVID-19 amongst HCP and non-HCP.

RESULTS

HCP were significantly more knowledgeable on personal hygiene (AdjOR 1.45, 95% CI -1.14 to 1.83) and social distancing (AdjOR 1.31, 95% CI -1.06 to 1.61) compared to non-HCP. They were more likely to have a positive attitude towards personal hygiene and 1.5 times more willing to participate in the contact tracing app. There was high compliance towards personal hygiene and social distancing measures amongst HCP. HCP with high compliance were 1.8 times more likely to flourish and more likely to have a high sense of emotional (AdjOR 1.94, 95% CI (1.44 to 2.61), social (AdjOR 2.07, 95% CI -1.55 to 2.78), and psychological (AdjOR 2.13, 95% CI (1.59-2.85) well-being.

CONCLUSION AND RELEVANCE

While healthcare professionals were more knowledgeable, had more positive attitudes, their higher sense of total well-being was seen to be more critical to enhance compliance. Therefore, focusing on the well-being of the general population would help to enhance their compliance towards the preventive measures for COVID-19.