Cultural contexts during a pandemic: a qualitative description of cultural factors that shape protective behaviours in the Chinese-Canadian community

Knowledge, attitude and preventive practice toward Covid-19 and associated factors among outpatients in a rural hospital in Vietnam

Background

The COVID-19 pandemic has emphasized the critical role of public knowledge, attitudes, and practices (KAP) in disease containment. Understanding these aspects can guide health promotion initiatives and policy decisions.

Design and methods

This cross-sectional study examined the KAP concerning COVID-19 prevention in Vietnam. Participants' sociodemographic data, along with KAP toward COVID-19, were collected in a survey utilizing a standardized questionnaire. Uni- and multivariable logistic regression were used to identify factors associated with poor level of KAP.

Results

Of 335 participants, 97 (28.9%) had poor knowledge, 52 (15.5%) poor attitude, and 48 (14.3%) poor practices. Older age (OR = 2.23; p = 0.024), minority non-Kinh ethnicity (OR = 3.05; p = 0.03), education below high school (OR = 8.80; p < 0.001), limited social media access (OR = 2.86; p = 0.002), and limited mobile phone usage (OR = 3.08; p = 0.001) increased poor knowledge risks. Non-Kinh ethnicity (OR = 5.00; p = 0.005) and lower education (OR = 14.79; p < 0.001) were linked to poor attitude. Older age (OR = 2.26; p = 0.035), lower education (OR = 5.74; p = 0.003), and poor knowledge (OR = 3.33; p = 0.005) were associated with poor practices.

Conclusions

Elderly individuals, those with low education, and limited media access had elevated risks of poor KAP. Emphasizing public health media and targeted education, especially for underserved groups, is vital for effective epidemic management and future strategy planning.

Exploring the Barriers and Facilitators of Mask-Wearing Behavior During the COVID-19 Pandemic in Taiwan, the United States, the Netherlands, and Haiti: A Qualitative Study

OBJECTIVE

This study explored the barriers and facilitators of mask-wearing behaviors during the pandemic in Taiwan, the United States, the Netherlands, and Haiti.

METHODS

Face-to-face interviews were conducted in Taiwan and online interviews were conducted with participants in the United States, the Netherlands, and Haiti.

RESULTS

In general, the habit of wearing a mask before coronavirus disease 2019 (COVID-19) was reported by Taiwanese participants. Additionally, Taiwanese participants perceived that wearing a mask was a social responsibility during the pandemic, suggesting that the collectivistic context might influence mask-wearing behavior. Unlike the Taiwanese population, some people in the United States and the Netherlands were reluctant to wear masks due to perceived restrictions on their freedom. Participants from Haiti mentioned that people who wore masks encountered violence, bullying, and discrimination. The results of this study suggest that political leadership and mask mandates have a strong impact on people's mask-wearing behavior.

CONCLUSIONS

These findings have valuable implications for the design of diverse behavioral interventions to enhance mask-wearing as part of infectious disease preparedness. Additionally, the findings from these countries offer valuable insights for the development of effective public health interventions to enhance society's resilience during the current pandemic and future infectious disease outbreaks.

Hand Hygiene, Face Mask Use, and Associated Factors during the COVID-19 Pandemic among the Students of Mongar Higher Secondary School, Bhutan: A Cross-Sectional Study

Non-pharmacological measures, such as hand hygiene and face mask use, continue to play an important role in the fight against the COVID-19 pandemic. However, there is a paucity of studies on the adherence to these measures among students in Bhutan. Therefore, we aimed to investigate hand hygiene and face mask-wearing behaviours, as well as their associated factors, among the students of Mongar Higher Secondary School, Bhutan. We conducted a cross-sectional study amongst the students of Mongar Higher Secondary School in Bhutan. The students self-answered the questionnaire on web-based Google Forms. Multivariable logistic regression for good hand washing and face mask use was conducted in order to identify statistically significant socio-demographic covariates. The correlation between hand hygiene and mask use was investigated using Pearson’s correlation coefficient. A total of 533 students completed the survey questionnaire, 52.9% (282) of whom were female students. Facebook (44.3%, 236) and TV (35.5%, 189) were the two most popular sources of information on COVID-19 prevention and control. Good (scores of ≥80% of total scores) hand hygiene and face mask use were reported in 33.6% (179) and 22.1% (118) of students. In multivariable logistic regression, male students presented 79% (adjusted odds ratio [AOR] = 1.79, 95% confidence interval [CI] = 1.23−2.613) odds of engaging in good hand hygiene, compared to female students. Compared to grade 9, those in grade 10 were 60% (AOR = 0.4, 95% CI 0.158−0.998) less likely to engage in good hand hygiene. Boarding students presented 68% (AOR = 1.68, 95% CI 1.001, 2.813) higher odds of wearing a face mask compared to day students. There was a significant positive correlation between good hand hygiene and face mask use (r = 0.3671, p-value < 0.001). Good hand hygiene and face mask use were reported in less than one-third of the study participants. It is recommended to continue educating students on good hand hygiene and face mask use through popular information sources.

How culture orientation influences the COVID-19 pandemic: An empirical analysis

Purpose

This study aims to investigate the mediational path of the influence of cultural orientation on the COVID-19 pandemic outcome at the national level and find out whether some culture-related factors can have a moderating effect on the influence of culture.

Methodology

Cultural dimension theory of Hofstede is used to quantify the degree of each dimension of culture orientation. The cross-section regression model is adopted to test if culture orientations affect the pandemic outcome, controlling for democracy, economy, education, population, age, and time. Then, a mediational analysis is conducted to examine if policy response is the mediator that culture makes an impact on the pandemic outcome. Finally, a moderation analysis is carried out to determine how each control variable has moderated the influence.

Findings

The cross-section regression results showed that culture orientation influences the outcome of the COVID-19 pandemic at the 99% confidence level and that among the six cultural dimensions, collectivism-individualism has the most significant impact. It has also been found that policy response is the mediator of cultural influence, and culture-related factors can moderate the influence.

Contribution

The contribution of this research lies in developing the assertion that culture influences pandemic outcomes. Our findings indicate that collectivism-individualism culture orientation affects the effectiveness of epidemic controls the most among the six culture dimensions. Additionally, our research is the first to study the mediating effect of policy responses and the moderating effect of culture-related factors on the influence of cultural orientation on the pandemic outcome.

“This is Going to Stay”: A Longitudinal Mixed Method Pilot Study on the Psychological Impact of Living Through a Pandemic

Living through the COVID-19 pandemic has been proven to have psychological impacts among individuals in both sport and non-sport populations. However, there is little available research comparing athlete and non-athlete populations in this context, especially among a non-western sample. This study employs a novel, longitudinal mixed method sequential explanatory research design to compare the impact of the COVID-19 pandemic between athlete and non-athlete populations and the role of physical activity. Phase A was a quantitative study measuring the psychological impact using the Impact of Event Scale-Revised among both groups ( n   =  32). Phase B was a qualitative study, with a sample ( n  =  7) participating in experiential interviews, exploring the lived experiences of participants over a 7-month period since Phase A was completed. Results indicated that athletes had lower psychological impact of the pandemic compared to non-athletes. Reflexive thematic analysis indicated that over the 7-month longitudinal period, athletes and non-athletes had different experiences across the themes of ‘Appraisal and Coping’, ‘Cognitions’, and ‘Impact of the Pandemic’. Findings show A) a clear longitudinal impact of COVID-19 over a 7-month period; B) there is a clear contrast between sport and non-sport populations, with participants indicating sport and physical activity to be a protective factor limiting negative psychological impact. Findings are discussed with recommendations for physical activity and sport for reducing psychological impact among both athletes and non-athletes.

Collectivism, individualism and COVID-19 prevention: a cross sectional study of personality, culture and behavior among Canadians

Background

Collectivism has been identified as a protective factor against COVID-19 - perhaps due to increased conformity with social norms regarding prevention behaviors. Other studies have also found that individualism can inspire uptake of preventative behaviors as a means of personal protection. It is possible that these cultural orientations may promote different patterns of prevention (e.g. mask wearing vs. social distancing). Furthermore, existing studies examining the role of individualism and collectivism during the COVID-19 pandemic have frequently failed to account for other psychological processes, including differences in personality, which could help provide a better understanding of the psychological process underlying prevention behavior.

Methods

Participants were recruited using social media advertisements. The Cultural Orientations Scale measured individualism-collectivism and hierarchism-egalitarianism. The Ten Item Personality Inventory measured the five factor model of personality. Multivariable models, dominance analyses and structural equation mediation tests were used to identify the most important predictors of COVID-19 prevention behavior (i.e. mask-wearing, hand-washing, reducing social interactions, physical distancing, staying at home and social bubbling), controlling for demographic and situational factors.

Results

Among 774 participants, most (i.e. 60-80%) reported uptake of COVID-19 prevention behaviors. Higher vertical (hierarchical) collectivism was associated with staying at home and higher horizontal (egalitarian) individualism was associated with mask-wearing and reducing social interactions. Neither Vertical Collectivism nor Horizontal Collectivism were significantly associated with any of the prevention behaviors when controlling for personality traits and confounding variables. Agreeableness was identified as a key mediator of the correlation between these cultural orientations on general uptake of COVID-19 prevention behaviors.

Conclusions

Cultural orientations (e.g. collectivism-individualism, hierarchism-egalitarianism) and personality traits (e.g. Agreeableness) are salient correlates of COVID-19 prevention behaviors and therefore should be accounted for in the development, design and delivery of health promotion messages aiming to increase uptake of these behaviors.

Anti-Chinese stigma in the Greater Toronto Area during COVID-19: Aiming the spotlight towards community capacity

Due to the geographic origins of the first major outbreak of COVID-19 in Wuhan, China, individuals of Chinese ethnic origin around the world have experienced discrimination, xenophobia, and racism during the pandemic. Discriminatory actions have ranged from outright physical aggression to subtle microaggressions. While reports (both media and academic) have highlighted such incidents, this paper argues that when the conversation starts and stops at the reporting of experiences of stigma, the narrative remains as the victimization of the community. Instead, instances of COVID-19 stigma and discrimination are only one aspect of this story, where other aspects include a deeper understanding of the community itself along with an awareness of the capacity that the Chinese diaspora community brings forward to help overcome COVID-19. We focus our discussion on the Greater Toronto Area (GTA) in Canada, a global urban center that has a sizeable ethnic Chinese diaspora community, and argue that highlighting the early actions that the community took to help broader society in dealing with COVID-19 at the start of the pandemic may help to reframe anti-Chinese stigma during the pandemic. These early actions include physical distancing, mask-wearing, sanitation and advocacy. Findings for this case-study are informed by media monitoring and interviews with 83 individuals identifying as ethnically Chinese living across the GTA.