Media exposure to COVID-19 information, risk perception, social and geographical proximity, and self-rated anxiety in China

PTSD and challenges among older Chinese in Shenzhen during COVID-19 pandemic: Trust in authority and medical professionals as moderators

AIM

This research aimed to comprehensively explore the impact of diverse challenges encountered by older adults on the development of post-traumatic stress disorder (PTSD). It delved into how these effects vary depending on individuals' levels of trust in authority and medical professionals, providing a nuanced understanding of the interplay between external challenges, personal trust, and mental health outcomes in the older population.

BACKGROUND

The COVID-19 pandemic has imposed significant hardships, particularly on the ageing population, with potential psychological repercussions such as PTSD. Notably, there is a dearth of research exploring this association within the context of Chinese older adults, a group that may experience unique impacts due to cultural differences in the face of global crises.

METHODS

Data were collected from a representative sample of 1,211 participants aged 60 years and above in Shenzhen. Logistic and hierarchical linear regression methods were utilized to investigate the relationship between the challenges posed by COVID-19, public trust, and the manifestation of PTSD symptoms.

FINDINGS

Higher levels of challenges related to 'supplies, services access and safety', 'abuse and conflicts', and 'anger and fear' were associated with PTSD. Furthermore, a lower level of challenges related to 'disease management and information' was associated with PTSD. Trust in authority or medical professionals was the moderator between the challenges brought about by COVID-19 and PTSD, which helped to lower the impact of challenges. Despite the challenges brought by COVID-19 to people, nurturing a stronger sense of trust in authority and medical professionals would ease older adults' psychological stress and concerns.

How Health Anxiety is Associated with Perceived Risk of Reinfection Among COVID-19 Infected People After the Epidemic Control Measures Lifted in China: A Multiple Mediating and Multi-Group Analysis

Background

After the lifting of epidemic control measures in China at the end of 2022, the number of COVID-19 infections has increased dramatically. Such an upsurge may intensify people's health anxiety and raise concerns about the risk of reinfection. While numerous studies have shown the correlation between them during the COVID-19, research on their underlying mechanism remains limited.

Purpose

This study aims to test the relationship and mechanism between health anxiety and perceived risk of reinfection among COVID-19 infected people from different occupational backgrounds.

Methods

A cross-sectional study was conducted from December 24th to 28th, 2022, after the epidemic control measures were lifted. A total of 1122 Chinese individuals were infected with COVID-19 (67.91% females, M age = 28.13) completed measures of health anxiety, perceived risk of reinfection, fear of COVID-19, online health information seeking (OHIS), and COVID-19 information fear of missing out (FOMO). Data were analyzed using multiple-mediation model and multi-group analysis.

Results

Health anxiety, perceived risk of reinfection, fear of COVID-19, OHIS and COVID-19 information FOMO were positively and significantly related to each other (r ranged from 0.25 to 0.77, all p < 0.001). Fear of COVID-19 (β = 0.27, p < 0.01), OHIS (β = 0.10, p < 0.001), and COVID-19 information FOMO (β = -0.05, p < 0.01) fully mediated the relationship between health anxiety and perceived risk of reinfection, the path of chaining mediation is also significant. Discrepancies in mediation models surfaced across the three types of work groups.

Conclusion

Findings suggest fear of COVID-19, OHIS and COVID-19 information FOMO may play significant mediating roles in explaining the relationship between health anxiety and perceived risk of reinfection. Interventions to reduce the perceived risk of reinfection should aim to improve the quality of online health information and individuals' online health literacy and reduce fear of COVID-19 during and after the pandemic.

The impact of COVID-19-induced distance learning on physical activity and dietary habits of female students in the Qassim Region

Background

The COVID-19 pandemic has profoundly affected the physical activity (PA) levels and dietary habits of individuals, particularly children and adolescents in Saudi Arabia, owing to widespread closures and social distancing measures, including school closures.

Methods

A cross-sectional study was conducted to assess the impact of distance learning (DL) on PA and dietary habits among public middle school girls during the pandemic. The Arab Teens Lifestyle Questionnaire (ATLS) was used to assess habitual PA, sedentary behavior, and dietary habits.

Results

A total of 300 middle school female students, with an average age of 14 years, participated in the study. The results indicated a generally low level of PA among students during DL and after school reopening, with a significant decrease in specific types of PA, such as walking and stair climbing during DL. However, after schools reopened, there was a significant increase in students' participation in activities such as swimming, dancing, and housework (P < 0.05). Moreover, sleep hours and TV-watching time increased compared to the DL period. Despite the prevalence of students frequently consuming soft drinks, sugary treats, fried and fast foods, as well as sweets and chocolates during the lockdown, middle school girls also consumed a lot of fruits and vegetables.

Conclusion

Assessing students' habitual PA and dietary habits during the lockdown may provide insights into their future health and well-being post-pandemic. This assessment can help in identifying strategies to redirect current PA levels to maintain health and prevent potential long-term health implications.

Two paths of news frames affecting support for particulate matter policies in South Korea: The moderating roles of media exposure and psychological distance

This study examined the paths through which the news frames of particulate matter (PM) influence support for governmental policies aiming to address PM. It also explored the mediating effects of anxiety and risk perception in the relationship between news frames and policy support, as well as the moderating effects of media exposure and psychological distance on the PM news framing effect. Based on an experimental design (N = 676), two groups of news frames were prepared for comparison: a narrative frame group and a numerical frame group. The results showed no significant differences in anxiety or risk perception between the two groups. Further, no significant mediating effects of anxiety or risk perception were found in the process through which PM news frames influence support for governmental policies. However, media exposure significantly moderated the effect of the narrative frame: With high (low) media exposure, the narrative frame positively (negatively) influenced policy support through risk perception. Moreover, when the level of psychological distance was low, the narrative frame positively influenced policy support through risk perception. This study contributes to the literature on news framing of PM by integrating cognitive and emotional mechanisms in forming policy attitudes.

The Impact of Short-Form Video and Optimistic Bias on Engagement in Oral Health Prevention: Integrating a KAP Model

College students are recognized as a demographic particularly susceptible to higher oral health risks due to irregular and unhealthy habits. While previous research has underscored these risks through descriptive studies within this group, a significant gap persists in the literature regarding the impact of contemporary media, specifically oral-health-related content, on the engagement in oral health prevention among Chinese college students. To address this gap, this study, guided by the extended knowledge-attitude-practice (KAP) theory model, explores the direct, mediated, and serially mediated mechanisms through which exposure to oral health short-form videos on Douyin influences their participation in oral health prevention. An empirical cross-sectional online survey was conducted, with valid data (N = 421) analyzed using descriptive statistics and hierarchical regression. Mediation and serial mediation analyses were also performed using SPSS version 25.0. The analysis revealed that exposure to oral health short-form videos had a positive direct effect on both oral health knowledge and the reduction of optimistic bias among Chinese college students. Furthermore, a significant serial mediation effect of oral health knowledge and oral health attitude was identified. The findings underscore the substantial applicability and explanatory power of the extended KAP theory model in understanding engagement in oral health prevention.

Factors influencing risk perception during Public Health Emergencies of International Concern (PHEIC): a scoping review

The unknownness and dread potential of a risk event shapes its perceived risk. A public health emergency of international concern (PHEIC) declaration by the World Health Organisation (WHO) is a signal for such an event. Understanding perceived risk then shapes risk-avoiding behaviours, important for health prevention. The review aims to consolidate the determinants of risk perception during a PHEIC, underscoring the need for grounding in context and theory. Studies published from 2010 until end-2020, searching PubMed, PsycINFO, MedlinePlus, PubPsych, and CINAHL, were included. Studies with only biological conceptualisations of risk, or no association to risk perception, were excluded. A total of 65 studies were included. Quality of the cross-sectional studies was assessed using Newcastle Ottawa Scale (NOS), yielding an average of 5.4 stars (out of 10). Factors were classified into three broad categories - individual, contextual, and media. Individual risk factors include emotions; beliefs, trust, and perceptions; immutable physical traits (sex, age, ethnicity); mutable traits (education, income, etc.); and knowledge, with no definitive correlation to risk perception. Contextual traits include pandemic experience, time, and location, with only time negatively correlated to risk perception. Media traits include exposure, attention, and framing of media, with no clear association to risk perception. One limitation is excluding a portion of COVID-19 studies due to censoring. Still, this lack of consensus highlights the need to better conceptualise "risk perception". Specifying the context and timing is also important since jurisdictions experience different outbreaks depending on outbreak histories. Using theories to ground risk perception research assists with these tasks.

The mediating role of pro-environmental attitude and intention on the translation from climate change health risk perception to pro-environmental behavior

Climate change is a serious environmental issue appearing in China. As a public service institution operating around the clock, the negative impact of hospitals on the environment is evident, promoting their workers' pro-environmental behavior (PEB) through increasing climate change health risk perception (CHRP) is an effective method to protect the environment and achieve sustainable development. This study investigates how CHRP shapes pro-environmental attitude (PEA), pro-environmental intention (PEI), and pro-environmental behavior (PEB) among hospital workers. Using structural equation modeling (SEM) to determine the chain of causation from CHRP to PEB among hospital workers. The result shows that CHRP positively affects PEA and PEI, and PEI positively affects their PEB. In addition, although CHRP has no significant direct effect on PEB, it can play a crucial indirect effect through the mediating role of PEI. Moreover, the result of multiple regression shows that there are significant differences regarding PEA, PEI, and PEB.

The Effect of Information Exposure on Stigma Toward the COVID-19 Patient Mediated by Perceived Risk, Attribution of Blame and Protection Norm Conformity

This study employed the model of stigma communication (MSC) to analyze how exposure to COVID-19-related information affected stigma-related information sharing about people who contracted COVID-19 during the pandemic and examined the cognitive process of the MSC in a collectivist culture. Based on a survey of 526 social media users during the COVID-19 pandemic in China, the study found that exposure to contact tracing information and pandemic control information had different impact on stigma-related information sharing through a series of cognitive variables. A dual-path model showed that perceived personal risk influenced stigma-related information sharing through attribution of blame toward the infected (the personal path), while perceived social risk influenced stigma-related information sharing through protection norm conformity (the social path). Compared to the personal path, the social path is more salient in shaping stigmatized attitudes and behaviors. The findings and discussions added to our understanding of the intricate stigma communication process in a collectivist culture.

The moderated-mediation role of risk perception and intolerance of uncertainty in the association between residual symptoms and psychological distress: a cross-sectional study after COVID-19 policy lifted in China

BACKGROUND

A considerable number of individuals infected with COVID-19 experience residual symptoms after the acute phase. However, the correlation between residual symptoms and psychological distress and underlying mechanisms are scarcely studied. We aim to explore the association between residual symptoms of COVID-19 and psychological distress, specifically depression, anxiety, and fear of COVID-19, and examine the role of risk perception and intolerance of uncertainty in the association.

METHODS

A cross-sectional survey was conducted by online questionnaire-based approach in mid-January 2023. Self-reported demographic characteristics, COVID-19-related information, and residual symptoms were collected. Depression, anxiety, fear, risk perception and intolerance of uncertainty were evaluated using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Fear of COVID-19 Scale (FCV-19S), COVID-19 Risk Perception Scale and Intolerance of Uncertainty Scale-12 (IUS-12), respectively. Linear regression analyses were conducted to explore the associations. A moderated mediation model was then constructed to examine the role of risk perception of COVID-19 and intolerance of uncertainty in the association between residual symptoms and psychological distress.

RESULTS

1735 participants effectively completed the survey. 34.9% of the patients experienced residual symptoms after acute phase of COVID-19. Psychological distress was markedly increased by COVID-19 infection, while residual symptoms had a significant impact on psychological distress (Ps < 0.001), including depression (β = 0.23), anxiety (β = 0.21), and fear of COVID-19 (β = 0.14). Risk perception served as a mediator between residual symptoms and all forms of psychological distress, while intolerance of uncertainty moderated the effect of risk perception on depression and anxiety.

CONCLUSION

A considerable proportion of patients experience residual symptoms after acute phase of COVID-19, which have a significant impact on psychological distress. Risk perception and intolerance of uncertainty play a moderated-mediation role in the association between residual symptoms and depression/anxiety. It highly suggests that effective treatment for residual symptoms, maintaining appropriate risk perception and improving intolerance of uncertainty are critical strategies to alleviate COVID-19 infection-associated psychological distress.

Emergency appointments and psychological distress during COVID-19 lockdown among orthodontic patients in Spain

Background

COVID-19 created an unexpected situation for dental patients. However, the impact of the lockdown on orthodontic patients is still unknown. Hence, this study was conducted to analyse the number and type of emergencies, distress and fear of getting infected among brackets and aligners orthodontic patients during the COVID-19 lockdown.

Material and Methods

A total of 324 questionnaires about emergency appointments during the lockdown and Kessler Psychological Distress Scale-K10 were distributed between March and December 2022 among patients who were on active orthodontic treatment during lockdown at the Master of Orthodontics at the University Alfonso X el Sabio during February and December 2022. Chi-square was used to compare groups.

Results

Emergency appointment was needed by 37.78% of patients during lockdown: 73.5% among those with aligners and 45.9% with brackets (p<.01). Loose bracket was the most prevalent emergency for bracket patients and lack of aligners among invisible orthodontic patients. Of those, 36.95% in need of orthodontic emergency appointments didn´t attend the clinic for fear of being infected; 21% of patients had high or very high anxiety levels.

Conclusions

Orthodontic patients had moderate levels of anxiety and fear of being infected during lockdown. Of these, 31.78% needed an emergency appointment. Key words:Orthodontics, COVID-19, dental healthcare, dentistry, emergency.

Impact of closed-off management due to COVID-19 rebound on maternal depression during pregnancy

BACKGROUND

This study aimed to assess the impacts of closed-off measures with different strictness levels (lockdown, partial lockdown and non-lockdown) and geographic proximity to patients with coronavirus disease 2019 (COVID-19) on prenatal depression during an epidemic rebound of COVID-19.

METHODS

This was a cross-sectional web-based survey including 880 pregnant women. Depressive symptoms were measured by Self-Rating Depression Scale (SDS) and geographic proximity was calculated using Geographic Information Systems. Linear and logistic regression were used to assess the associations of closed-off measures and geographic proximity with SDS scores and depressive symptoms. Restricted cubic splines were used to model non-linear associations between geographic proximity and depression symptoms.

RESULTS

Compared with those living in non-lockdown areas, women in lockdown areas had higher SDS scores (adjusted β: 3.51, 95% CI: 1.80, 5.21) and greater risk of depressive symptoms (adjusted OR: 4.00, 95% CI: 2.18, 7.35), but evidence for partial lockdown was not obvious. A progressive increase in the risk of depressive symptoms was found with decreasing distance to COVID-19 patients when geographic proximity was <8 kilometers. Compared to those in the 5th quintile of geographic proximity, women in the first, second and third quintiles had at least 6 times higher risk of depressive symptoms.

CONCLUSIONS

Pregnant women under strict closed-off management during COVID-19 epidemic have high risk of depression. A specific range around the residences of reported COVID-19 patients should be underlined as potential clustering of high prenatal depression levels. Our findings highlight the importance of enhancing mental health management during the COVID-19 epidemic for pregnant women.

Effects of emotion coaching group programme for mothers of preschool children with smart device overdependence: a mixed methods study

BACKGROUND

Smart device overdependence adversely affects the overall development of preschool children. This study aimed to provide an emotion coaching group programme to mothers raising preschool children who are overly dependent on smart devices and to confirm the programme's effectiveness.

METHODS

This concurrent embedded mixed methods study used a non-equivalent control group pre-post design to verify the quantitative effect of the programme, and a descriptive research design to verify the qualitative effect. The study collected data from June 2019 to March 2021 from 51 (25 experimental, 26 control) mothers raising children aged 3-6 years in South Korea. The quantitative study examined the effects of an eight-session programme, conducted once a week for two hours, on mothers' emotional intelligence, parenting behaviour, and their children's attachment stability and smart device overdependence using a non-equivalent control group pre-post design. The analysis used a generalized estimate equation. For qualitative research, focus group interviews were used as a descriptive research design method, and content analysis was used for analysis.

RESULTS

Quantitatively, the results showed significant differences between the experimental and control groups in terms of changes in maternal emotional intelligence (χ2 = 14.99, p = .001), maternal positive parenting behaviour (χ2 = 9.32, p = .009), children's unstable attachment to their mothers (χ2 = 9.49, p = .009), and children's overdependence on smart devices (χ2 = 14.48, p = .001). Qualitatively, the study derived five themes for the experiences of mothers who participated in the programme: "hope for desirable parenting without emotional difficulties," "feelings touched by reflection," "warm but authoritative parenting," "children who became responsible by gaining psychological stability," and "changed view of my home."

CONCLUSIONS

The emotion coaching group programme was effective in improving the emotional intelligence and parenting behaviour of mothers raising preschool children. The programme also improved preschool children's attachment stability to their mothers and overdependence on smart devices. The programme can be useful in community practice, and the present study can be used as evidence for education and research related to device overdependence.

The impact of health literacy interventions on glycemic control and self-management outcomes among type 2 diabetes mellitus: A systematic review

Diabetes imposes an increasing health and economic burden on individuals living with it and their societies worldwide. Glycemic control is necessary to reduce morbidity and mortality of type 2 diabetes mellitus (T2DM). Self-management is the primary tool for managing diabetes. Health literacy (HL) is the primary driver of self-management activities. The aim of this review is to evaluate the impact of HL interventions on glycemic control and self-management outcomes among T2DM. MEDLINE, CINAHL, PubMed, Cochrane, Scopus, and Web of Science were searched for eligible papers. Fifteen randomized controlled trials published in English between 1997 and 2021, used HL-driven intervention, and measured the level of glycohemoglobin A1c (HbA1c) and self-management of T2DM patients were included in this review. The findings showed that HL-driven intervention had a positive impact on glycemic control and improved self-management behaviors. The level of glycemic control and self-management skills were improved through individual and telephone-based intervention respectively. Community worker-led interventions were effective in improvements in diabetes knowledge and self-care behaviors; however, nurse-led interventions were effective in glycemic control. Better glycemic control is achieved in hospital settings compared to outpatient settings. HL interventions yielded better improvement in self-management among people with longer diabetes duration (more than 7 years). It was possible to achieve a large reduction in HbA1c level after a 3-month intervention in hospital settings. HL-driven interventions are effective in glycemic and diabetes self-management outcomes.

Understanding early experiences of Chinese frontline nurses during the COVID-19 pandemic: A text mining and thematic analysis of social media information

This study aims to explore the early experiences of frontline nurses at the beginning of the COVID-19 pandemic in China as expressed through social media posts. This study used an explanatory sequential mixed-method design. Text mining was used for sentiment analysis. The chi-square test was used to compare the differences in the composition ratio of sentiment classification of posts in different months. Word frequency was statistically analyzed. Further thematic analysis was also performed. The primary sentiments of the posts were discovered to be positive and neutral. The number of posts containing positive emotions was the lowest in January, peaked in March, and gradually declined in April 2020. The following nurse-oriented narrative themes were developed: "To see and be seen," "Moving forward amid adversity and support," and "Returning to everyday life and constructing meaning." The sentiments of Chinese nurses in response to the pandemic fluctuated, with positive emotions in the early stage, but it could not be sustained. This study recommends nurses could be encouraged to engage in expressive writing while adhering to ethical guidelines.

The impact of the intensity of media use on potential tourists' risk perception and travel protective behavioral intentions in COVID-19

Introduction

In light of the COVID-19 pandemic, there is an increased need for potential travelers to gather information about their trips to mitigate perceived risks. This study aims to understand the relationship between the intensity of media use (both new and traditional), epidemic risk perception, and tourism protection behavior intention among potential tourists.

Methods

A total of 491 valid questionnaires were collected in Shanghai, China. Factor analysis, path analysis, and effect analysis were conducted using SPSS and AMOS to examine the impact of different media types on epidemic risk perception and tourism protection behavior.

Results

The findings indicate a positive association between new media use intensity and epidemic risk perception, as well as an intention to adopt safety-conscious tourism behaviors. In contrast, traditional media usage is inversely associated with risk perception but has no significant influence on protective behavior. The results also highlight the role of demographic factors, such as age, education level, occupation, and income, in modulating the relationship between media usage and risk perception.

Discussion

The contrasting effects of new and traditional media suggest the need for a tailored approach in epidemic communication strategies. Public health officials should leverage new media to enhance risk perception and safety-oriented behaviors, while recognizing the role of traditional media in managing lower risk perceptions and assuaging panic. The study emphasizes the importance of personalized messaging based on demographic disparities in media usage and perception. The mediating role of risk perception in shaping protective behaviors offers insights for promoting adherence to safety protocols.

Conclusion

This study contributes to a comprehensive understanding of media influences during health crises, emphasizing the responsibility of media platforms in transmitting accurate information. The findings call for a nuanced approach to epidemic communication, considering the strengths and weaknesses of different media types. Segmented and personalized messaging strategies can cater to demographic variations in media usage and perception. Enhancing risk perception through tailored messaging can promote protective behaviors and effectively manage public sentiment during health crises.

Later Life as a Daring Experience: Factors Associated with Older Adults' Risk Perception

Risk perception refers to people's subjective judgments about the possibility of negative occurrences and the extent to which they are concerned with them. Previous studies have found that older adults who were exposed to ongoing terror threats developed later-life and terror risk perceptions. These studies showed that high risk perception has negative psychological and physiological consequences. This study aimed to identify the factors associated with the development of both later-life risk perception and terror risk perception in later life. Data were collected via an online survey with 306 Internet users aged 50 years and over, half resided in a high-risk zone while the remainder lived in a low-risk zone. The Perceived Risk Scale, measures of depressive symptoms, life satisfaction, social support, spirituality, internet use, and personal background were applied. Low self-rated health was associated with terror and later-life risk perceptions, regardless of the risk zone. After controlling for personal background, only depressive symptoms significantly correlated with high risk perceptions. These findings suggest that older adults with poorer self-rated health, secular beliefs, and elevated depressive symptoms may be susceptible to developing high risk perceptions. Clinicians should encourage older adults to identify preserving resources to improve adjustment to late life stressors.

Immigrants' Experiences and Perceptions of COVID-19 Information in Norway

When the COVID-19 virus hit the world, immigrants were overrepresented among those infected. In Norway, throughout the pandemic, there were far higher infection rates in people of Somali and Pakistani descent than in the rest of the population. The first aim of this study is to explore the experiences and perceptions of immigrants from Somalia and Pakistan living in Oslo regarding the different sources of COVID-19 information that they referred to at the beginning of the pandemic. The second aim is to suggest and discuss measures to improve practice in the event of a new pandemic. Four semi-structured focus-group interviews were conducted with a total of 27 first-generation immigrants from Somalia and Pakistan. The results showed that the immigrants found various COVID-19 information sources to be important. These sources are further presented in three categories: (1) COVID-19 information from the authorities through mass communication; (2) family, friends, and local environments as sources of information; (3) information from religious communities and volunteer resource personnel. We conclude that the participants were active users of available information from different sources and channels. Stigmatization made a negative contribution and religion made a positive contribution to coping and to trust in the authorities.

How does social presence influence public crisis information sharing intention? Situational pressure perspective

Objective

Public crises seriously affect social stability and personal health. When individuals are in a public crisis environment, they will have the impulse and intention to share information, which is a behavioral attitude shown in the face of a crisis. Public crisis information sharing intention will be affected by many factors. This study aims to examine how the process of social presence may influence information sharing intentions during a public crisis and the mediating effects of situational pressure, including risk perception of disease infection and consistency of perception of opinion climate.

Methods

This was a cross-sectional study with 505 youth SNS users. In order to collect as suitable samples as possible, a research website was commissioned to conduct a questionnaire in the early stages of the COVID-19 pandemic in China. This questionnaire was utilized to measure social presence, risk perception of disease infection, consistency of perception of opinion climate and intention to share information about COVID-19. Structural equation modeling was used to examine variable relationships in the research model.

Results

The results showed that social presence was significantly and positively associated with risk perception of disease infection (B = 0.42, p < 0.001), consistency of perception of opinion climate (B = 0.43, p < 0.001) and intention to share information about COVID-19 (B = 0.48, p < 0.001). Risk perception of disease infection (B = 0.19, p < 0.001) and consistency of perception of opinion climate (B = 0.18, p = 0.002) positively predicted youth SNS users' intention to share information about COVID-19. Risk perception of disease infection and consistency of perception of opinion climate mediated the relationship between social presence and intention to share information about COVID-19 (Z = 2.66, CI: 0.03, 0.15; Z = 2.66, CI: 0.02, 0.16).

Conclusion

The study further deepens our understanding of the mechanisms underlying social presence and information sharing intentions. These new findings suggest that some situational cues, including media environment factors (social presence) and perceived stress factors (risk perception of disease infection, consistency of perception of opinion climate) may influence information sharing intention. From the perspective of communication psychology, this study enriched the assessment of information sharing on social media and contributes to understanding of social presence and situation pressure, and it helps to provide specific references for effectively promoting netizens' intention to share information about public crises.

Promoting COVID-19 prevention strategies in student dormitory setting: A qualitative study

OBJECTIVE

To explore the risk perceptions and COVID-19 prevention practices of dormitory residents in Indonesia. Participants: Nineteen dormitory residents, 3 staff and 1 dormitory manager were recruited from the Saint Theresa Avila student dormitory. Methods: This qualitative study used individual interviews and framework analysis. Results: Generally, the study confirms that there is a gap between risk perception and COVID-19 prevention practices among dormitory residents. There are barriers in accessing hand washing facilities and in complying with COVID-19 prevention protocols including not wearing masks, not following quarantine procedures and visiting friends' rooms. Conclusion: Dormitory managers and staff should repeatedly remind residents to wear masks and maintain safe distance through sending short messages on dormitory social media groups. In addition to psychological assistance and basic supplies during self-quarantine, providing sanitizer and installing posters detailing the hand-washing steps are essential at each hand-washing facility in the dormitory.

Protecting public's wellbeing against COVID-19 infodemic: The role of trust in information sources and rapid dissemination and transparency of information over time

Objectives

This study examined how trust in the information about COVID-19 from social media and official media as well as how the information was disseminated affect public's wellbeing directly and indirectly through perceived safety over time.

Methods

Two online surveys were conducted in China, with the first survey (Time1, N = 22,718) being at the early stage of the pandemic outbreak and the second one (Time 2, N = 2,901) two and a half years later during the zero-COVID policy lockdown period. Key measured variables include trust in official media and social media, perceived rapid dissemination and transparency of COVID-19-related information, perceived safety, and emotional responses toward the pandemic. Data analysis includes descriptive statistical analysis, independent samples t-test, Pearson correlations, and structural equation modeling.

Results

Trust in official media, perceived rapid dissemination and transparency of COVID-19-related information, perceived safety, as well as positive emotional response toward COVID-19 increased over time, while trust in social media and depressive response decreased over time. Trust in social media and official media played different roles in affecting public's wellbeing over time. Trust in social media was positively associated with depressive emotions and negatively associated with positive emotion directly and indirectly through decreased perceived safety at Time 1. However, the negative effect of trust in social media on public's wellbeing was largely decreased at Time 2. In contrast, trust in official media was linked to reduced depressive response and increased positive response directly and indirectly through perceived safety at both times. Rapid dissemination and transparency of COVID-19 information contributed to enhanced trust in official media at both times.

Conclusion

The findings highlight the important role of fostering public trust in official media through rapid dissemination and transparency of information in mitigating the negative impact of COVID-19 infodemic on public's wellbeing over time.

Exploring the relationship between exposure to COVID-19 and donations during the COVID-19 pandemic: The mediating roles of emotions and risk perception

Objective

Public emergency events like the COVID-19 pandemic are special occasions that need immediate massive funding from public donations. Thus, understanding the determinants of donation behaviors under public emergencies is important for both researchers and practitioners. This study investigated the effect of personal and local exposure to incidences of COVID-19 on donation behaviors. Specifically, we examined the mediating effects of risk perception and emotions on the relationship between exposure to COVID-19 and donation behaviors.

Methods

The data were from a survey distributed in China between March 20 and 30th, 2020. Participants' donation choice at the end of the survey was used to measure their donation behaviors. Participants' emotions, risk perception, and personal exposure were assessed in the questionnaire. Local exposure was the 30-day confirmed cases obtained from the National Health Commission of the People's Republic of China. A total of 8,720 participants (Mean age = 28.91, 43.6% females) completed the online survey.

Results

Based on the results from the mediation analysis, we found that people with stronger positive and negative emotions, higher risk perception, and more personal exposure to COVID-19 were more likely to donate. Furthermore, the effects of both personal and local exposure on donations are mediated by risk perception and negative emotion. Both higher personal and local exposure led to stronger negative emotions and higher risk perception, which in turn led to more donation behaviors.

Discussion

This study extends our knowledge of donation behaviors during public emergencies. Our results suggest that policymakers and charity organizations should elicit stronger emotions and risk perception by exposing the severity of the disaster in advertisements to promote donations.

Risk perception and gratitude mediate the negative relationship between COVID-19 management satisfaction and public anxiety

In this study, we explored whether satisfaction with government management, perception of risk, and gratitude influenced public anxiety during the COVID-19 pandemic in China. Using a cross-sectional, anonymous and confidential online survey, a nationwide sample of Chinese adults (N = 876) was targeted between March 25-March 30, 2020, a period in which newly confirmed cases significantly declined in China. The anxiety level was decreased as compared to that assessed during the peak period. Multiple parallel mediation modeling demonstrated that risk perception and gratitude partially mediated the relationship between satisfaction with government management and public anxiety. Increasing satisfaction and gratitude, as well as reducing risk perception contribute to the public's mental health. The results may shed light on the positive factors for psychological well-being during the COVID-19 pandemic and may aid potential strategies for the policy maker, the public, and the clinic to regulate negative emotions or future emerging infectious diseases.

Depression and Medicine Use among Older Adults during the COVID-19 Pandemic: The Role of Psychosocial Resources and COVID-19 Perceived Susceptibility

A relationship was found between the COVID-19 pandemic and depression among older adults and between depressed mood and increased use of antidepressant medication among older adults during the pandemic. With the aim of broadening the understanding of these relationships, the study examined whether COVID-19 perceived susceptibility mediates the relationship between psychosocial resources (optimism and perceived social support) and depressive symptoms and medication use. Participants included 383 older adults (M = 71.75, SD = 6.77) reporting on socio-demographics, health characteristics, depression, optimism, social support, and COVID-19 perceived susceptibility. Medication use was retrieved from participants medical files. Lower optimism, lower social support, and higher COVID-19 perceived susceptibility were associated with greater depression, related with higher medication use. The findings emphasize the buffering effect of psychosocial resources on the adverse effects of depression affecting older adults during the COVID-19 pandemic, and consequently, the increased use of medication in this population. Practitioners should focus interventions on enhancing optimism and expanding social support among older adults. Moreover, interventions focused on alleviating depression among older adults should aim at improving perceptions of perceived susceptibility in the older population.

Impact of social media on mental health of the general population during Covid-19 pandemic: A systematic review

During the COVID-19 pandemic, people are using social media more than usual routine because they rely on online sources to seek health information for themselves and their loved ones. The spread of inaccurate and misleading information via social media has a number of detrimental psychological effects on members of society. The aim of this systematic review was to describe the impact of social media on the mental health of the general population. An extensive systematic search was done till the last month of 2021 for collecting the evidence using the PRISMA technique. The search was mainly focused on the article leading with keywords and search engines used during the course of the study were Pubmed, Semantic Scholar, Mendeley, and Science direct. Articles for this study were selected based on the predetermined eligibility criteria and performed quality assessment by using the NHLBI quality assessment tool. Most of the studies included in this review are found fair (score between 9 and 12) quality. Out of 866 publications, 533 articles were included in the initial screening, after duplication removal 46 full-text articles were assessed for eligibility and 14 studies were selected for systematic review. In most of the studies, maximum participants used social media as a primary source of information. Relatively high rates of symptoms of depression (14.14% to 48.3%), anxiety (7.4% to 47.82%), and prevalence of stress increased to 37.67% are reported after exposure to social media for coverage of COVID-19 news in the general population. Risk factors of psychological distress are associated with female gender, younger age group, marital status, staying alone, and duration of exposure to mass media. Increased exposure to COVID-19 information through mass/social media is associated with highly significant levels of psychological health issues; mitigating the hazardous effect of social media exposure during the COVID-19 pandemic on the psychological health of the general population is an international public health priority.

Social Media Overload and Anxiety Among University Students During the COVID-19 Omicron Wave Lockdown: A Cross-Sectional Study in Shanghai, China, 2022

Objectives: The increase in the intensity of social media use during the COVID-19 lockdown has affected mental health. Therefore, it is of practical implications to explore the association between social media overload and anxiety and the underlying mechanisms. Methods: Using data from 644 university students during the COVID-19 blockade in Shanghai from March to April 2022, the chain mediation model of information strain and risk perception of omicron between social media overload and anxiety was then tested using the macro PROCESS4.0 tool. Results: The findings showed that social media overload (including information overload and social overload) was positively associated with anxiety. This relationship was mediated by information strain and risk perception of Omicron. A chain mediating role of information strain and risk perception of Omicron has also been proved in this study. Conclusion: Social media overload has a positive effect on anxiety by increasing information strain and risk perception of Omicron. This study provides some implications for future interventions on how to use social media properly for mental health during the pandemic and health management of urban governance.

Application of protection motivation theory and cultural tightness-looseness for predicting individuals' compliance with the government's recommended preventive measures during regular prevention and control of the COVID-19 pandemic in China

Introduction

In the period of regular prevention and control of the COVID-19 pandemic, the public must continue to comply with the government's recommended preventive measures to further curb the pandemic. Based on the theories of protection motivation and cultural tightness-looseness, this study investigates individuals' compliance with the government's recommended preventive measures during this period in China. It also establishes a moderated mediation model to explore the underlying mechanisms.

Methods

We used structural equation modeling and latent model structural equations to analyze data from an online survey of 443 participants.

Results

The analysis showed that media exposure significantly predicted perceived severity, maladaptive rewards, self-efficacy, response efficacy, and response cost. Perceived severity, self-efficacy, and response efficacy were positively associated with protection motivation, which, in turn, was positively associated with individuals' compliance. Additionally, protection motivation positively affected individuals' compliance via implementation intention, and perceived cultural tightness-looseness significantly moderated the association between protection motivation and implementation intention.

Discussion

This study helps to better understand individuals' compliance from a theoretical perspective and provide practical advice on promoting individuals' compliance with the government's precautionary measures.

Effectiveness of a natural wellness group program using interactive real-time video for unmarried mothers: A quasi-experimental study

BACKGROUND

Unmarried mothers who raise their children alone in South Korea experience various difficulties in maintaining their health. Improving the health of unmarried mothers, who are socioeconomically vulnerable, is important not only for them but also for the healthy growth and development of their children. We aimed to implement a natural wellness group program using an interactive real-time video platform for unmarried mothers and to verify its effects.

METHODS

This quasi-experimental study utilized a sequential explanatory mixed-methods design. The participants were unmarried mothers raising children aged 0-6 years. The quantitative data collection occurred from August to November 2021. For the qualitative data collection, semi-structured interviews were conducted with seven participants from the experimental group. The experimental group received eight 90-minute weekly online sessions, whereas the control group received no intervention. The outcome variables were physical and mental health, depression, anxiety, self-esteem, and parenting stress.

RESULTS

A total of 42 unmarried mothers (21 experimental, 21 control) participated. The Wilcoxon signed-rank test revealed significant post-intervention differences in mental health, depression, and self-esteem in the experimental group. Moreover, a generalized estimating equation analysis revealed significant differences in self-esteem levels between the experimental and control groups. Four themes identified through qualitative analysis revealed that the natural wellness group program using interactive real-time video not only increased mothers' vitality and relaxation but also improved depression and anxiety, and had a positive effect on parenting stress.

CONCLUSIONS

Natural wellness group programs using interactive real-time videos can help improve the psychological health of unmarried mothers with young children, a group that tends to be socially and psychologically marginalized.

Associations between COVID-19 Risk Perceptions and Mental Health, Wellbeing, and Risk Behaviours

Background

Mental health has worsened, and substance use has increased for some people during the coronavirus (COVID-19) pandemic. Some cross-sectional studies suggest that higher COVID-19 risk perceptions are related to poorer mental health and greater risk behaviours (e.g., substance use). However, longitudinal and genetic data are needed to help to reduce the likelihood of reverse causality.

Methods

We used cross-sectional, longitudinal, and polygenic risk score (PRS; for anxiety, depression, wellbeing) data from the Avon Longitudinal Study of Parents and Children (ALSPAC). We examined cross-sectional and prospective longitudinal associations between COVID-19 risk perceptions (i.e., cognitive, affective, self, other, and a combined 'holistic' measure) and mental health (i.e., anxiety, depression), wellbeing, and risk behaviours. Pandemic (April-July 2020) and pre-pandemic (2003-2017) data (ns = 233-5,115) were included.

Results

Higher COVID-19 risk perceptions (holistic) were associated with anxiety (OR 2.78, 95% confidence interval [CI] 2.20 to 3.52), depression (OR 1.65, 95% CI 1.24 to 2.18), low wellbeing (OR 1.76, 95% CI 1.45 to 2.13), and increased alcohol use (OR 1.46, 95% CI 1.24 to 1.72). Higher COVID-19 risk perceptions were also associated with self-isolating given a suspected COVID-19 infection (OR 1.74, 95% CI 1.13 to 2.68), and less face-to-face contact (OR 0.83, 95% CI 0.70 to 0.98) and physical contact (OR 0.83, 95% CI 0.68 to 1.00). Pre-pandemic anxiety (OR 1.64, 95% CI 1.29 to 2.09) and low wellbeing (OR 1.41, 95% CI 1.15 to 1.74) were associated with higher COVID-19 risk perceptions. The depression PRS (b 0.21, 95% CI 0.02 to 0.40) and wellbeing PRS (b -0.29, 95% CI -0.48 to -0.09) were associated with higher and lower COVID-19 risk perceptions, respectively.

Conclusions

Poorer mental health and wellbeing are associated with higher COVID-19 risk perceptions, and longitudinal and genetic data suggest that they may play a causal role in COVID-19 risk perceptions.

Crisis communication strategies for health officials

Background

Mixed messaging among health officials are prevalent amid COVID-19. Crisis communication strategies have the potential to help health officials effectively address issues such as mixed messages and improve their crisis communication efficacy. However, there is a dearth of insights in the literature. Therefore, to bridge the research gap, this study aims to examine practical strategies health officials can utilize to improve their crisis communication efficacy.

Methods

A literature review on effective crisis communication strategies amid COVID-19 was conducted in PubMed, Scopus, and PsycINFO, with a focus on scholarly literature published in English.

Results

The findings of the study identified the following strategies that health officials can utilize to improve their crisis communication capabilities: (1) develop fact-based, transparent, and accountable messaging, (2) utilize people-centered and empathetic persuasive strategies, and (3) leverage international collaboration for consistent messaging and comprehensive crisis communication.

Conclusion

COVID-19 has challenged health officials with unprecedented crisis communication duties and responsibilities. In this study, we underscored the importance of effective crisis communication amid global health emergencies like COVID-19, and identified communication strategies health officials could adopt or adapt to improve their crisis communication efficacy. Future research could explore strategies health officials can use to better communicate with government officials and media professionals to further help health officials improve their crisis communication capabilities, their abilities to avoid preventable miscommunication or mixed messaging, and in turn, society's collective strengthen in curbing and controlling the pandemic.

Public Risk Perception Attribution Model and Governance Path in COVID-19: A Perspective Based on Risk Information

Background

Risk perception is a key factor influencing the public’s behavioral response to major public health events. The research on public risk perception promotes the emergency management system to adapt to the needs of modern development. This article is based on a risk information perspective, using the COVID-19 event as an example. From the micro and macro perspectives, the influencing factors of public risk perception in major public health events in China are extracted, and the attribution model and index system of public risk perception are established.

Methods

In this paper, the five-level Likert scale is used to collect and measure the risk perception variable questionnaire through the combination of online and offline methods (a total of 550 questionnaires, the overall Alpha coefficient of the questionnaire is 0.955, and the KMO test coefficient t=0.941), and through independent samples t-test, correlation analysis, multiple regression analysis and other methods to draw relevant conclusions.

Results

The results showed that gender and age were significantly associated with risk perception (p<0.005), and education level was significantly negatively associated with risk perception (p <0 0.005). Risk information attention and risk perception were significantly positively correlated (p<0.005), media credibility was significantly positively correlated with risk perception (p<0.005), while risk information identification and media exposure had no significant interaction with risk perception (p=0.125, p=0.352).

Conclusion

Factors such as gender, age, education level, place of residence, media exposure, media credibility, risk information attention, and recognition lead to different levels of risk perception. This conclusion helps to provide a basis for relevant departments to conduct public risk management of major public health events based on differences in risk perceptions.

Predictors of Self-Reported Compliance with COVID-19 Preventive Guidelines: A Quantile Regression Model

The research used an online, convenience cross-sectional sample of adults aged ≥18 years old recruited from Shahroud County, Northeast of Iran. We measured the contribution of multiple determinants for association with behavioral compliance, at the time of the COVID-19 pandemic. The compliance score measured with this questionnaire can be within a range of 5 and 100. Compliance was bounded between 19 and 80 that has been distributed J-shape, so quantile logistic regression model has been fitted for that. Variables related to people's knowledge, including self-reported knowledge and following the news related to COVID-19, were the two main factors that accompanied behavioral compliance at all of its levels in the period of pandemic.

Location matters: Regional variation in association of community burden of COVID-19 with caregiver and youth worry

Our study characterized associations between three indicators of COVID-19's community-level impact in 20 geographically diverse metropolitan regions and how worried youth and their caregivers in the Adolescent Brain Cognitive Development℠ Study have been about COVID-19. County-level COVID-19 case/death rates and monthly unemployment rates were geocoded to participants' addresses. Caregivers' (vs. youths') COVID-19-related worry was more strongly associated with COVID-19's community impact, independent of sociodemographics and pre-pandemic anxiety levels, with these associations varying by location. Public-health agencies and healthcare providers should avoid adopting uniform "one-size-fits-all" approaches to addressing COVID-19-related emotional distress and must consider specific communities' needs, challenges, and strengths.

Sodium-glucose co-transporter 2 inhibitors and hematopoiesis

Many patients with diabetes mellitus, especially those with chronic kidney disorders, have some degree of anemia due to a spectrum of causes and underlying pathophysiologic pathways. As such, enhancement in erythropoiesis is important in these patients. Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a relatively new class of antidiabetic drugs with confirmed protective effects in kidney and cardiovascular tissues. Recent evidence suggests that these drugs may provide additional benefits in enhancing hematopoietic processes in diabetic patients. Though the exact mediating pathways have not been fully elucidated, cellular mechanisms are likely involved. In the current study, we present the potential pathways by which SGLT2i may modulate hematopoiesis and stimulate erythropoiesis.

The impact of social media on risk perceptions during COVID-19 in Saudi Arabia

Background

Social media is considered a critical source for seeking health information, especially during outbreaks. During the Coronavirus disease 2019 (COVID-19) pandemic, social media played an important role in disseminating information. However, it has been a source of misinformation in many communities throughout the pandemic. Whether this disseminated information has a positive or negative impact, individuals' risk perceptions of disease are influenced. It is important to explore factors that build public behaviors and their adaptation of risk reduction measures during the COVID-19 pandemic. Therefore, the aim of this study is to determine the role of social media and its impact on the risk perceptions of the COVID-19 in Saudi Arabia.

Methods

This was a cross-sectional study, and participants were recruited using different social media outlets between August to October 2020. The survey was delivered through Qualtrics platform targeting Saudi Arabian residents over the age of 18 years old. The questionnaire was delivered in English and Arabic. A convenience sampling was used to recruit participants to the study. The survey link was posted on several social media platforms.

Results

A total of 2,680 respondents completed the online survey. The results showed that male gender, individuals earning 4,000-12,000 SAR, and employed had positive and significant relationships with risk perception compared to their counterparts (β: 0.044, p-value: 0.035 and β: 0.051, p-value: 0.041, β: 0.108 p-value: < 0.001, β: 0.119 p-value: < 0.001), respectively. In second block, individuals exposed to social media had higher risk perception (β: 0.096, p-value < 0.001). In third block, self-efficacy was significantly but negatively associated with risk perception, indicating individuals who were self-efficient were less likely to perceive risk for the COVID-19 (β: -0.096, p-value < 0.001). There was no interactive effect of social media and self-efficacy on risk perception.

Conclusion

The current study results show that social media exposure to the COVID-19 information has a positive impact in shaping an individuals' risk perception. The study also suggests that there is a need for public officials and policymakers to develop effective communication strategies through risk communication campaigns targeted at women, individuals with lower socioeconomic status, and those who are single as they showed a negative relationship with risk perception.

The COVID-19 risk perceptions, health precautions, and emergency preparedness in older CALD adults in South Australia: A cross-sectional study

BACKGROUND

In Australia, the relationships of cultural contexts with health challenges in older culturally and linguistically diverse (CALD) adults during the COVID-19 remain under-investigated. This study explored the older CALD adults' risk perceptions of COVID-19, and identified demographics and risk perceptions associated with their health precautions and emergency preparation in South Australia.

METHODS

A cross-sectional online survey was conducted. 155 older adults aged 60 years and over from 28 CALD communities completed the surveys. We described demographics, risk perceptions, seven items of health precautions, and five items of emergency preparedness. Data were analyzed in Stata/MP version 13.0.

RESULTS

Mean sum-score of fear was 7.3 [SD 1.9], signifying that the participants were afraid of being infected with COVID-19. Health precaution items presented a mean sum-score of 24.8, with a compliance in washing and disinfecting hands [M: 4.4], avoiding public places and events [M: 3.9] and transports [M: 3.8], but they did not present high-alignment with staying at home and avoiding meeting at risk population groups. Overall health precautions were positively influenced by ethnicity [Asian β 3.40; 95% CI 1.21, 5.59; African β 5.46; 95% CI 0.76, 10.16]; perceptions of long-term effects [β 1.82; 95% CI 0.65, 2.99]; and fear [β 0.55; 95% CI 0.08, 1.01]. Mean sum-score of emergency preparedness was 14.9, which indicated the participants' responses, on average, did not prevent them from buying large quantities and storing essential goods.

CONCLUSION

A pandemic-related response plan is needed to ensure all older CALD adults receive and follow advice and care appropriately.

Religion, politics and COVID-19 risk perception among urban residents in Malawi

INTRODUCTION

Majority of Malawians have not yet adopted COVID-19 mitigation measures despite having knowledge about its infectivity, morbidity, and fatality. Understanding drivers of hesitancy to adoption of COVID-19 mitigation measures is critical as it can inform prevention programs. This study explores Malawians' COVID-19 risk perception, and the associated constraints in the adoption of mitigation efforts. A Health Belief Model (HBM) approach was used to understand perceived factors that undermine public health COVID-19 messages to reduce the spread of the pandemic in Malawi.

METHODS

The study applied rapid appraisal and photovoice qualitative inquiry to comprehend risk perception regarding COVID-19. We purposively selected 52 participants from three major cities in Malawi. Audio and video interviews were transcribed verbatim, and transcripts were coded manually to derive key themes and concepts.

RESULTS

The study identified that social factors particularly religious and political beliefs influenced COVID-19 risk perception. Specific religious beliefs pertaining to individuals recognizing signs of the 'Christian apocalypse' were particularly associated with lower risk perceptions. Politically, participants believed COVID-19 lockdown measures were a ploy by the then-ruling party to remain in power.

CONCLUSION

The study suggests that religious beliefs and political environment undermine self -perceived risk of contracting COVID-19 among urban dwellers in Malawi. We recommend that diverse actors in Malawi should collaborate to promote the dissemination of accurate COVID-19 discourses and reduce the severity of the pandemic's impact in Malawi.

Overexposure to COVID-19 information amplifies emotional distress: a latent moderated mediation model

An infodemic has accompanied the COVID-19 pandemic. This study explores whether overexposure to COVID-19-related information amplifies emotional distress. A cross-sectional online survey was conducted in China during the outbreak and after the peak of the pandemic (N = 1313). A latent moderated mediation model was built to analyze this relationship. COVID-19 information exposure was found to relate positively with emotional distress, and risk perception mediated the association between them. Additionally, psychological resilience moderated the mediating effects of risk perception. However, five factors of resilience differed in their moderating effects. This study offers theoretical and practical implications apropos clinical intervention and public health management.

Promoting Social Distancing and COVID-19 Vaccine Intentions to Mothers: Randomized Comparison of Information Sources in Social Media Messages

Background

Social media disseminated information and spread misinformation during the COVID-19 pandemic that affected prevention measures, including social distancing and vaccine acceptance.

Objective

In this study, we aimed to test the effect of a series of social media posts promoting COVID-19 nonpharmaceutical interventions (NPIs) and vaccine intentions and compare effects among 3 common types of information sources: government agency, near-peer parents, and news media.

Methods

A sample of mothers of teen daughters (N=303) recruited from a prior trial were enrolled in a 3 (information source) × 4 (assessment period) randomized factorial trial from January to March 2021 to evaluate the effects of information sources in a social media campaign addressing NPIs (ie, social distancing), COVID-19 vaccinations, media literacy, and mother-daughter communication about COVID-19. Mothers received 1 social media post per day in 3 randomly assigned Facebook private groups, Monday-Friday, covering all 4 topics each week, plus 1 additional post on a positive nonpandemic topic to promote engagement. Posts in the 3 groups had the same messages but differed by links to information from government agencies, near-peer parents, or news media in the post. Mothers reported on social distancing behavior and COVID-19 vaccine intentions for self and daughter, theoretic mediators, and covariates in baseline and 3-, 6-, and 9-week postrandomization assessments. Views, reactions, and comments related to each post were counted to measure engagement with the messages.

Results

Nearly all mothers (n=298, 98.3%) remained in the Facebook private groups throughout the 9-week trial period, and follow-up rates were high (n=276, 91.1%, completed the 3-week posttest; n=273, 90.1%, completed the 6-week posttest; n=275, 90.8%, completed the 9-week posttest; and n=244, 80.5%, completed all assessments). In intent-to-treat analyses, social distancing behavior by mothers (b=-0.10, 95% CI -0.12 to -0.08, P<.001) and daughters (b=-0.10, 95% CI -0.18 to -0.03, P<.001) decreased over time but vaccine intentions increased (mothers: b=0.34, 95% CI 0.19-0.49, P<.001; daughters: b=0.17, 95% CI 0.04-0.29, P=.01). Decrease in social distancing by daughters was greater in the near-peer source group (b=-0.04, 95% CI -0.07 to 0.00, P=.03) and lesser in the government agency group (b=0.05, 95% CI 0.02-0.09, P=.003). The higher perceived credibility of the assigned information source increased social distancing (mothers: b=0.29, 95% CI 0.09-0.49, P<.01; daughters: b=0.31, 95% CI 0.11-0.51, P<.01) and vaccine intentions (mothers: b=4.18, 95% CI 1.83-6.53, P<.001; daughters: b=3.36, 95% CI 1.67-5.04, P<.001). Mothers' intentions to vaccinate self may have increased when they considered the near-peer source to be not credible (b=-0.50, 95% CI -0.99 to -0.01, P=.05).

Conclusions

Decreasing case counts, relaxation of government restrictions, and vaccine distribution during the study may explain the decreased social distancing and increased vaccine intentions. When promoting COVID-19 prevention, campaign planners may be more effective when selecting information sources that audiences consider credible, as no source was more credible in general.

Trial Registration

ClinicalTrials.gov NCT02835807; https://clinicaltrials.gov/ct2/show/NCT02835807.

Analyzing Risk Communication, Trust, Risk Perception, Negative Emotions, and Behavioral Coping Strategies During the COVID-19 Pandemic in China Using a Structural Equation Model

Objective

Risk communication and the degree of trust are major factors that affect the public's behavioral coping strategies and play an important role in emergency risk management. However, the internal formation mechanism involved in the public's psychological behavior remains unclear. This study aimed to investigate the association among risk communication, trust, risk perception, negative emotions, and behavioral coping strategies during the coronavirus disease 2019 (COVID-19) pandemic, and to identify and quantify the factors that influence public behavior.

Methods

We launched an online survey through social media from April to July 2020 in China. Relevant data were elicited using a self-designed questionnaire that mainly examined respondent characteristics, risk communication, trust, risk perception, negative emotions, protective coping behavior, and excessive coping behavior in the context of the COVID-19 pandemic. A total of 735 valid responses were obtained. A structural equation model was then used to explore relationship pathways among the components.

Results

The higher the degree of risk communication (β = -0.10, p < 0.05) and trust (β = -0.22, p < 0.001), the lower the public risk perception. Risk communication and trust had a direct effect on public behavioral coping strategies during the COVID-19 pandemic. The higher the level of risk communication (β = 0.14, p < 0.001) or trust (β = 0.48, p < 0.001), the more likely it was that this would encourage the public to adopt protective coping behaviors, while the public was less likely to engage in excessive coping behaviors as the degree of trust increased (β = -0.12, p < 0.01). Risk perception influenced by poor risk communication and trust generated negative emotions (β = 0.31, p < 0.001), and such negative emotions further positively influenced public behavioral coping strategies (whether protective [β = 0.09, p < 0.05] or excessive [β = 0.24, p < 0.001] behaviors).

Conclusion

Risk communication, trust, risk perception, and negative emotions were significantly directly or indirectly related to public behavior. The findings provide useful information for emergency risk management and a theoretical basis for follow-up research on public coping behavior during the COVID-19 pandemic.

COVID-19 Vaccine Uptake in the Context of the First Delta Outbreak in China During the Early Summer of 2021: The Role of Geographical Distance and Vaccine Talk

Purpose

Vaccination is essential to control the prevalence of COVID-19. However, vaccine hesitancy has been a major issue globally. Some studies have suggested that community outbreaks might boost vaccine uptake. Consistent with that idea, vaccination rates increased dramatically during the first outbreak of the COVID-19 Delta variant in Guangdong, China, in June 2021. Based on the risk perception attitude theory, this study attempted to explore the joint effect of geographical distance to the outbreak and the frequency of talking about the COVID-19 vaccine (vaccine talk) on people’s COVID-19 vaccine uptake.

Methods

An anonymous self-report online questionnaire was completed by citizens living in Guangdong Province, China, from June 6 to 11, 2021, during the Delta variant outbreak in that region. The relationship between COVID-19 vaccine uptake, geographical distance to the epicenter of the outbreak, and vaccine talk was analyzed using logistic regression analysis.

Results

Data from 350 respondents were included in the final analysis. Results showed a negative association between geographical distance and COVID-19 vaccine uptake. Furthermore, the relationship was moderated by vaccine talk. Specifically, when individuals infrequently discussed vaccine talk with others, close distance to the epicenter of the outbreak served as a motivator for getting vaccinated, whereas for people who frequently discussed the vaccine, geographical distance might have played less of a role in motivating them to get vaccinated.

Conclusion

This research highlights the joint effect of geographical distance to the outbreak of COVID-19 and vaccine talk in COVID-19 vaccine uptake. While the findings may only be a starting point for launching a public health awareness campaign, encouraging people to engage in more conversations about vaccines may be a promising solution for future health emergencies, especially among people far from the outbreak.

Association between Self-Classification of COVID-19 Risk Levels and Adverse Lifestyle Changes among Physically Active Older Adults Following the Coronavirus Outbreak

The COVID-19 pandemic has imposed barriers to a healthy lifestyle, especially for older adults who are considered to be at a high-risk of infection. This study examined the associations between negative changes and the self-classification to COVID-19 risk level among physically active older adults who are members of a nationwide health club chain. A cross-sectional digital survey was sent to 19,160 older adults (age ≥ 65). The data collected included information on the subjects’ self-classification to the COVID-19 high-risk group (HRG) and changes in physical activity (PA), body weight, and smoking habits since the outbreak. Logistic regression models were used to investigate the associations between the dependent variables of ‘experienced a negative change’ and the independent variables. Of the 1670 survey respondents, 78.3% classified themselves as COVID-19 HRG. Over half of the respondents reported a reduction in PA hours, 26.6% reported weight gain, and 17.7% of smokers increased their amount of smoking. A self-classification to the HRG was associated with 1.46 (95%CI 1.10−1.93, p < 0.009) and 1.67 (95%CI 1.21−2.31, p < 0.002) greater odds for reduced hours of exercise and weight gain compared to the not high-risk group, respectively. Decision makers should consider how policies may cause barriers to a healthy lifestyle and develop risk communication strategies to encourage positive health-related behaviors, even during a pandemic.

The relationship between information overload and state of anxiety in the period of regular epidemic prevention and control in China: a moderated multiple mediation model

This study aimed to examine the relationship between information overload and individual state anxiety in the period of regular epidemic prevention and control and mediating effect of risk perception and positive coping styles. Further, we explored the moderating role of resilience. 847 Chinese participated in and completed measures of information overload, risk perception, positive coping styles, state anxiety, and resilience. The results of the analysis showed that information overload significantly predicted the level of individual state anxiety (β = 0.27, p < 0.001). Risk perception partially mediate the relationship between information overload and state anxiety (B = 0.08, 95%CI = [0.05, 0.11]) and positive coping styles also partially mediate the relationship between information overload and state anxiety(B = -0.14, 95%CI = [-0.18, -0.10]). In addition, resilience moderated the mediating effects of risk perception (β = -0.07, p < 0.05) and positive coping styles (β = -0.19, p < 0.001). Resilience also moderated the effect of information overload on state anxiety (β = -0.13, p < 0.001). These results offer positive significance for understanding the internal mechanism of the influence of information overload on individual state anxiety in the epidemic environment and shed light on how to reduce people's state anxiety during an epidemic.

Hand Washing: When Ritual Behavior Protects! Obsessive-Compulsive Symptoms in Young People during the COVID-19 Pandemic: A Narrative Review

The Coronavirus Disease 2019 (COVID-19) pandemic had a profound impact on the lifestyles and mental health of young people. It has been hypothesized that the focus on hygiene and the fear of contamination/infection during the pandemic may have exacerbated obsessive–compulsive (OC) symptoms in this population. OC symptoms are widespread in the general population, with varying degrees of intensity. At their most extreme, they manifest in obsessive–compulsive disorder (OCD), which is characterized by obsessive thoughts and compulsive behaviors. The present narrative review aimed at evaluating the relationship between the COVID-19 pandemic and OCD and OC symptoms in young people, especially children and adolescents with and without OCD, focusing on vulnerability and risk factors and the impact of lockdown measures. Of the six studies identified, four examined clinical samples diagnosed with OCD and two looked at community-based adolescent samples. Five of the six studies found that OC symptoms increased during the pandemic. Additionally, vulnerability to anxiety may constitute a risk condition and the lockdown measures and personal stressful life events can constitute potential triggers of OC symptoms, while ongoing treatment for OCD had a protective effect. The results suggest that, during the COVID-19 pandemic, obsessive and compulsive behavior (e.g., hand washing) in young people at the greatest risk should be monitored, and the intervention of mental health services should be maintained. More research is needed in this area.

Risk perception, anxiety, and depression among hospital pharmacists during the COVID-19 pandemic: The mediating effect of positive and negative affect

This study investigated the impacts of risk perception of COVID-19 on anxiety and depression symptoms among hospital pharmacists in China. We conducted a cross-sectional study with hospital pharmacists during the COVID-19 pandemic in China. Some 4,219 hospital pharmacists completed an online survey including demographic questions, risk perception of COVID-19, General Anxiety Disorder-7, Patient Health Questionnaire-9, and Positive and Negative Affect Schedule. Multivariate regression and mediation analyses were conducted. The results indicated that 41.9% and 29.4% of hospital pharmacists experienced mild to severe levels of anxiety and depression symptoms, respectively. In older age, a higher level of risk perception of COVID-19, and negative affect experience were risk factors, whereas positive affect experience was a protective factor for anxiety and depression symptoms among pharmacists. Experience of positive and negative affect mediated the relationship between risk perception of COVID-19 and anxiety and depression among hospital pharmacists in China. Timely mental health services need to be provided for hospital pharmacists during the COVID-19 pandemic.

Statistical Analysis of COVID-19 infections according to the gender and age in Najaf Province, Iraq

A newly discovered coronavirus, COVID-19, creates a new infectious illness. According to current clinical observations, people's age and gender appear to have a role in their vulnerability to COVID-19. This research aims to see whether there is an association between gender, age, and COVID-19 susceptibility in the public health department of Najaf. The study included 36607 subjects (evenly distributed between sexes), and their ages ranged from (<10 - 80) years. According to the study's findings, males were found to be more infected than females. Results of the research indicated that gender and Covid-19 had a strong correlation. According to the study, people between the ages of 30 and 39 were more common than people of other ages range. The study's findings revealed a significant difference between Covid-19 and the participants' ages. Keywords. Covid-19; Gender; Age; Najaf; Iraq.

Understanding the content of COVID-19 vaccination and pregnancy videos on YouTube: An analysis of videos published at the start of the vaccine rollout

Over 2 years into the COVID-19 pandemic, information on the safety and efficacy of COVID-19 vaccination, particularly for people in high-risk populations, has become a popular topic of discussion. The purpose of this study was to analyze the content and characteristics of YouTube videos related to COVID-19 vaccination and pregnancy. The 50 most viewed English language videos on pregnancy and COVID-19 vaccination were included in this study. The 50 YouTube videos were viewed 4,589,613 times, with 6% uploaded by consumers, 40% by medical professionals, and 44% by television or internet-based news. Videos from consumer sources more often mentioned a human trial of the COVID-19 vaccine (75% of consumer videos vs. 65% of medical professional videos and 31.8% of television or internet-based news videos, P = .036) and more often mentioned anti-vaccination sentiment, fear, or distrust of the vaccines (37.5% of consumer videos vs 5.0% of medical professional videos and 4.5% of television or internet-based news videos, P = .018). Videos uploaded by medical professionals more often mentioned emergency use of the COVID-19 vaccines (P = .016), passive immunity in general (P = .011), and that the COVID-19 vaccine is either unlikely to or will not cause harm in breastfeeding more often than did videos from consumer or television-based news sources (P = .034). New information regarding COVID-19 vaccination and pregnancy is continuing to emerge, and this study highlights that the information found in the most viewed YouTube videos on this topic can quickly become outdated.

Risk perceptions and COVID-19 protective behaviors: A two-wave longitudinal study of epidemic and post-epidemic periods

We investigated how perceived risk and protective behaviors changed as the coronavirus epidemic progressed. A longitudinal sample of 538 people responded to a COVID-19 risk perception questionnaire during the outbreak and post-epidemic periods. Using Structural Equation Modeling (SEM), we examined the mean level change of selected constructs and differences in their relationships. We tested a risk perception pathway in which affective attitude, informed by experience, shaped risk perceptions and protective behaviors. The model also postulated a social pathway in which cultural worldviews, like individualism and hierarchy, predicted risk perceptions and protective behaviors through social norms. Latent mean difference analyses revealed a decrease in social distancing behaviors and an increase in hygiene-cleanliness, corresponding to a reduction in risk perceptions and social norms and a rise in direct and indirect experience, while affective attitude remained substantially stable. Cross-sectional and longitudinal path analyses showed that affective risk perception, primarily informed by affective attitude, and social norms promoted behavior consistency regardless of epidemic contingencies. Instead, analytic risk perceptions were linked to protective behaviors only during the outbreak. Although risk perceptions dropped over time, analytic risk perceptions dropped more steeply than affective risk perceptions. Our findings supported the distinction between affective and deliberative processes in risk perception, reinforcing the view that affective reactions are needed to deploy analytic processes. Our study also supports the claim that perceived social norms are essential to understanding cultural worldview-related protective behaviors variability.

Relationship between Mother’s emotional intelligence, negative parenting behaviour, Preschooler’s attachment instability, and smart device overdependence

Background

As smart device overdependence among preschoolers could adversely affect their overall development, it is essential to understand the related factors of such overdependence. Mothers have a large influence on preschoolers; however,, the relationship between mothers’ emotional intelligence, negative parenting behaviour, preschoolers’ attachment instability, and smart device overdependence remain unclear. This study aims to develop and test a structural model to explain smart device overdependence among preschoolers.

Methods

The study collects and analyses data from January to May 2021 from 283 mothers raising children aged 3–6 years in South Korea. Questionnaires regarding mothers’ emotional intelligence and negative parenting behaviour, as well as preschoolers’ attachment instability and smart device overdependence, were used to collect data. The data were analysed by SPSS23.0 and AMOS 23.0 software and a structural equation model was constructed; p ≤ 0.05 was taken as significant.

Results

Mothers’ emotional intelligence had a direct negative relationship with mothers’ negative parenting behaviour (β = − 0.44) and an indirect negative relationship with preschoolers’ attachment instability (β = − 0.25) and preschoolers’ smart device overdependence (β = − 0.24). Mothers’ negative parenting behaviour had a direct positive relationship with preschoolers’ attachment instability (β = 0.56) and both direct and indirect positive relationships with preschoolers’ smart device overdependence (β = 0.55). Preschoolers’ attachment instability had a direct positive relationship with preschoolers’s smart device overdependence (β = 0.46).

Conclusions

Mothers’ emotional intelligence, negative parenting behaviour, and preschoolers’ attachment instability are associated with preschoolers’ vulnerability to smart device overdependence. These results are shown that more attention is needed to these variables in order to reduce preschoolers’ overdependence on smart devices. Additionally, we propose to develop and provide interventions based on these results.