Preventive behaviours and family inequalities during the COVID-19 pandemic: a cross-sectional study in China

How perceived risk influences college students' preventive behavior: Novel data of COVID-19 campus lockdown from Wuhan, China

Following preventive behaviors is a key measure to protect people from infectious diseases. Protection motivation theory (PMT) suggests that perceived risk motivates individuals to take protective measures. The COVID-19 pandemic has posed unprecedented stress to the public, and changes in perceived risk may be more pronounced among college students than among other groups due to the related campus lockdown. With 1,119 college students recruited as research subjects, a quantitative research was conducted in Wuhan, China, to deduce the relationship between the perceived risk and preventive behavior of college students, as well as between the mediation effect of individual affect and the moderating effect of physical exercise. The results showed that the preventive behavior of college students was significantly affected by perceived risk, and both positive affect and negative affect played a mediating role between perceived risk and preventive behavior. Specifically, positive affect aided the relationship between perceived risk and preventive behavior, negative affect was detrimental to their relationship, and the mediation effect of positive affect is significantly higher than that of negative affect. Furthermore, physical exercise played a moderating role in the mediation effects of positive affect and negative affect. Therefore, appropriate measures should be taken to strengthen Chinese college students' perceived risk and provide them with corresponding guidance. The importance of physical exercise should also be emphasized to help college students with low perceived risk reduce negative affect, increase positive affect, and promote their preventive behavior.

Understanding Information Processing and Protective Behaviors during the Pandemic: A Three-Wave Longitudinal Study

BACKGROUND

Few existing studies have examined information processing as an independent variable to predict subsequent information behaviors in a pandemic context, and the mechanism of subsequent information behavior processing following the initial or prior information behavior is unclear.

OBJECTIVE

Our study aims to apply the risk information seeking and processing model to explain the mechanism of subsequent systematic information processing in the context of the COVID-19 pandemic.

METHODS

A three-wave longitudinal online national survey was administered during the period of July 2020 to September 2020. Path analysis was conducted to test the relationships between prior and subsequent systematic information processing and protective behaviors.

RESULTS

One important finding was the key role of prior systematic information processing, as indirect hazard experience was found to be a direct predictor of risk perception (β = 0.15, p = 0.004) and an indirect predictor of protective behaviors. Another important finding was the central role of information insufficiency as a mediator/driving force in subsequent systematic information processing and protective behavior.

CONCLUSIONS

The study has made important contributions in that it extends the scholarship on health information behaviors by (a) highlighting that relevant hazard experience in risk information seeking and processing model should be expanded to include indirect experience, and (b) providing the mechanism of subsequent systematic information processing following prior information processing. Our study also provides practical implications on health/risk communication and protective behaviors' promotion in the pandemic context.

Correlation Between Ontological Insecurity and Daily Epidemic Prevention Behavior Among Inpatients During the COVID-19 Pandemic

This study evaluates inpatients' ontological insecurity and daily epidemic prevention behavior during the pandemic and explores the factors influencing daily epidemic prevention behaviors. The outbreak of coronavirus disease (COVID-19) in December 2019 caused a global public health crisis that has affected the very structure of society and the order of daily life. Ontological security is the ability to predict the impact of changes in social environments on personal security, such as during the pandemic. A cross-sectional study was used to collect data from 1185 inpatients of a hospital in Zhejiang, China, from July 11 to August 9, 2021. Our questionnaire recorded information on demographics, ontological insecurity, and daily epidemic prevention behaviors. The Mann-Whitney U test, Kruskal-Wallis H test, Spearman's correlation analysis, and logistic regression analysis were used to determine the influencing factors of daily epidemic prevention behavior on ontological security. Results showed a negative correlation between inpatients' ontological insecurity and daily epidemic prevention behavior (r = -.253, P < .001). The logistic regression analysis showed that the independent factors affecting daily epidemic prevention behavior include ontological insecurity (OR: 0.952; 95% CI: 0.937-0.968) (P < .001), sex (OR: 1.292; 95% CI: 1.004-1.663), age (OR: 0.880; 95%: 0.790-0.980), education (OR: 1.307; 95% CI: 1.098-1.556), and occupation [famers vs civil servants, staff or professional (OR: 0.596; 95% CI: 0.374-0.949),other versus civil servants, staff, or professional (OR: 0.693; 95% CI: 0.503-0.953)] (P < .05). Inpatients were shown to have good ontological security during the COVID-19 epidemic, younger patients, female patients, patients with stronger ontological security, patients with a higher educational level, and those who work in a fixed unit or organization showed higher levels of daily epidemic prevention behavior. Hospital managers should strengthen the intervention management of epidemic prevention behavior based on patient characteristics.

Machine-learning approaches to identify determining factors of happiness during the COVID-19 pandemic: retrospective cohort study

OBJECTIVE

To investigate determining factors of happiness during the COVID-19 pandemic.

DESIGN

Observational study.

SETTING

Large online surveys in Japan before and during the COVID-19 pandemic.

PARTICIPANTS

A random sample of 25 482 individuals who are representatives of the Japanese population.

MAIN OUTCOME MEASURE

Self-reported happiness measured using a 10-point Likert scale, where higher scores indicated higher levels of happiness. We defined participants with ≥8 on the scale as having high levels of happiness.

RESULTS

Among the 25 482 respondents, the median score of self-reported happiness was 7 (IQR 6-8), with 11 418 (45%) reporting high levels of happiness during the pandemic. The multivariable logistic regression model showed that meaning in life, having a spouse, trust in neighbours and female gender were positively associated with happiness (eg, adjusted OR (aOR) for meaning in life 4.17; 95% CI 3.92 to 4.43; p<0.001). Conversely, self-reported poor health, anxiety about future household income, psychiatric diseases except depression and feeling isolated were negatively associated with happiness (eg, aOR for self-reported poor health 0.44; 95% CI 0.39 to 0.48; p<0.001). Using machine-learning methods, we found that meaning in life and social capital (eg, having a spouse and trust in communities) were the strongest positive determinants of happiness, whereas poor health, anxiety about future household income and feeling isolated were important negative determinants of happiness. Among 6965 subjects who responded to questionnaires both before and during the COVID-19 pandemic, there was no systemic difference in the patterns as to determinants of declined happiness during the pandemic.

CONCLUSION

Using machine-learning methods on data from large online surveys in Japan, we found that interventions that have a positive impact on social capital as well as successful pandemic control and economic stimuli may effectively improve the population-level psychological well-being during the COVID-19 pandemic.

Behavioral compliance with preventive health measures for students with and without hearing disability during COVID-19 pandemic: A cross-sectional study

Background

Hearing loss affects over 1.5 billion individuals worldwide. Their disability and limited access to the coronavirus (COVID-19) pandemic information make them suffer a greater degree than ordinary people. However, the quantitative studies on the implementation of behavior compliance with preventive health measures for vulnerable groups such as people with hearing disability were limited. The purpose of this study was to explore the compliance with pandemic-related protective health measures among people with hearing disability.

Design

A cross-sectional survey, population-based cohort study of students aged 12-26 years with and without hearing disability was conducted. Behavioral compliance with preventive health measures was collected from the general education institutions and special education schools using an online questionnaire. Logistic regression and structural equation model were used to determine the associations among the demographic variables, different degrees of mental health status and psychological impacts, and preventive health behaviors.

Results

Among 1,589 participants, 485 (30.5%) students are with hearing disability (SHD), and 1,104 (69.5%) students with normal hearing (SNH). The SHD has a significantly lower degree of behavioral compliance with the preventive health measures than SNH has. Hearing disability and anxiety [odds ratio (OR) = 1.54-1.76, p < 0.05] are risk factors for avoiding sharing of utensils during mealtime. Hearing disability, male sex, father's education level, mother's profession, bedtime after 11:00 p.m., anxiety, and depression (OR = 1.45-2.95, p < 0.05) are risk factors for hand hygiene. Male sex (OR = 2.13, p < 0.001) is risk factor and being aged below 18 years old (OR = 0.62, p = 0.03) is protective factor for wearing masks. Exercise (OR = 0.32-0.70, p < 0.01) is the most protective factor for preventive health behaviors. Mediating effect of mental health status and psychological impacts between hearing level and the compliance with the preventive health measures was -0.044 (95% CI: -0.068 to -0.027).

Conclusions

To reduce the risk of contraction, update pandemic information, essential communication services, extra assistance, and support should be provided to these disabled persons who are more susceptible to a public health emergency.

Geographic social inequalities in information-seeking response to the COVID-19 pandemic in China: longitudinal analysis of Baidu Index

The outbreak of the COVID-19 pandemic alarmed the public and initiated the uptake of preventive measures. However, the manner in which the public responded to these announcements, and whether individuals from different provinces responded similarly during the COVID-19 pandemic in China, remains largely unknown. We used an interrupted time-series analysis to examine the change in Baidu Search Index of selected COVID-19 related terms associated with the COVID-19 derived exposure variables. We analyzed the daily search index in Mainland China using segmented log-normal regressions with data from Jan 2017 to Mar 2021. In this longitudinal study of nearly one billion internet users, we found synchronous increases in COVID-19 related searches during the first wave of the COVID-19 pandemic and subsequent local outbreaks, irrespective of the location and severity of each outbreak. The most precipitous increase occurred in the week when most provinces activated their highest level of response to public health emergencies. Search interests increased more as Human Development Index (HDI) -an area level measure of socioeconomic status—increased. Searches on the index began to decline nationwide after the initiation of mass-scale lockdowns, but statistically significant increases continued to occur in conjunction with the report of major sporadic local outbreaks. The intense interest in COVID-19 related information at virtually the same time across different provinces indicates that the Chinese government utilizes multiple channels to keep the public informed of the pandemic. Regional socioeconomic status influenced search patterns.

Association of Social-Cognitive Factors with Individual Preventive Behaviors of COVID-19 among a Mixed-Sample of Older Adults from China and Germany

Identifying modifiable correlates of older adults’ preventive behaviors is contributable to the prevention of the COVID-19 and future pandemics. This study aimed to examine the associations of social-cognitive factors (motivational and volitional factors) with three preventive behaviors (hand washing, facemask wearing, and physical distancing) in a mixed sample of older adults from China and Germany and to evaluate the moderating effects of countries. A total of 578 older adults (356 Chinese and 222 German) completed the online cross-sectional study. The questionnaire included demographics, three preventive behaviors before and during the pandemic, motivational factors (health knowledge, attitude, subjective norm, risk perception, motivational self-efficacy (MSE), intention), and volitional factors (volitional self-efficacy (VSE), planning, and self-monitoring) of preventive behaviors. Results showed that most social-cognitive factors were associated with three behaviors with small-to-moderate effect sizes (f² = 0.02 to 0.17), controlled for demographics and past behaviors. Country moderated five associations, including VSE and hand washing, self-monitoring and facemask wearing, MSE and physical distancing, VSE and physical distancing, and planning and physical distancing. Findings underline the generic importance of modifiable factors and give new insights to future intervention and policymaking. Country-related mechanisms should be considered when aiming to learn from other countries about the promotion of preventive behaviors.

The Prevention Behaviors and Impact Mechanisms Among Different Chinese Social Classes at the Early Stage of COVID-19 Pandemic

Background

Whether the pandemic can be effectively prevented and controlled depends on the entire population’s adherence to recommendations and preventive behaviors. The present study aimed to investigate the social class differences and internal mechanisms of prevention behaviors in the COVID-19 pandemic.

Methods

We conducted an online cross-sectional survey among the general Chinese population at the early stage of the COVID-19 pandemic. The survey website’s subscribers could access the questionnaire through the Tencent online platform, and a total of 1948 participants voluntarily completed it. Most of the participants were female (n = 1257, 64.528%), between the ages of 18–29 (n = 999, 51.284%), university graduates (n = 1015, 52.105%), and had an annual family income below 100,000 yuan (n = 1119, 57.444%). The differences in COVID-19 prevention behaviors among different social classes, the mediating role of infectious threat perception and the moderating role of perceived epidemic transparency were examined.

Results

1) There were significant differences in prevention behaviors among different social classes. 2) The level of infectious threat perception played a mediating role in the relationship between social class and prevention behavior. When the individuals were from a lower social class, the level of threat perception and the level of COVID-19 prevention behaviors were also lower. 3) Perceived epidemic transparency played a moderating role in the relationship between social class and COVID-19 prevention behavior. It also played a moderating role in the relationship between social class and infectious threat perception.

Conclusion

In the implementation of epidemic prevention and control measures, different social classes should be targeted and guided differently. In particular, lower-class individuals can be guided by improving the perceptions of epidemic transparency and infectious threat.