Knowledge, Perceptions, and Preferred Information Sources Related to COVID-19 Among Central Pennsylvania Adults Early in the Pandemic: A Mixed Methods Cross-Sectional Survey

Descriptions of Scientific Evidence and Uncertainty of Unproven COVID-19 Therapies in US News: Content Analysis Study

BACKGROUND

Politicization and misinformation or disinformation of unproven COVID-19 therapies have resulted in communication challenges in presenting science to the public, especially in times of heightened public trepidation and uncertainty.

OBJECTIVE

This study aims to examine how scientific evidence and uncertainty were portrayed in US news on 3 unproven COVID-19 therapeutics, prior to the development of proven therapeutics and vaccines.

METHODS

We conducted a media analysis of unproven COVID-19 therapeutics in early 2020. A total of 479 discussions of unproven COVID-19 therapeutics (hydroxychloroquine, remdesivir, and convalescent plasma) in traditional and online US news reports from January 1, 2020, to July 30, 2020, were systematically analyzed for theme, scientific evidence, evidence details and limitations, safety, efficacy, and sources of authority.

RESULTS

The majority of discussions included scientific evidence (n=322, 67%) although only 24% (n=116) of them mentioned publications. "Government" was the most frequently named source of authority for safety and efficacy claims on remdesivir (n=43, 35%) while "expert" claims were mostly mentioned for convalescent plasma (n=22, 38%). Most claims on hydroxychloroquine (n=236, 79%) were offered by a "prominent person," of which 97% (n=230) were from former US President Trump. Despite the inclusion of scientific evidence, many claims of the safety and efficacy were made by nonexperts. Few news reports expressed scientific uncertainty in discussions of unproven COVID-19 therapeutics as limitations of evidence were infrequently included in the body of news reports (n=125, 26%) and rarely found in headlines (n=2, 2%) or lead paragraphs (n=9, 9%; P<.001).

CONCLUSIONS

These results highlight that while scientific evidence is discussed relatively frequently in news reports, scientific uncertainty is infrequently reported and rarely found in prominent headlines and lead paragraphs.

Pandemics: past, present, and future: multitasking challenges in need of cross-disciplinary, transdisciplinary, and multidisciplinary collaborative solutions

The extensive history of pandemics has spanned many centuries, profoundly impacting societies, economies, and public health, and thereby shaping the course of history in various ways. Advances in medicine, science, and public health practices have played a pivotal role in mitigating the effects of pandemics over time. This review explores the scientific landscape of contemporary pandemics, examining their diverse and complex nature. It goes beyond the biological aspects of pandemics to consider socioeconomic, environmental, and technological factors. Through a scientific lens, this study aims to understand the complexities of pandemics and contribute to the expanding knowledge base that helps humanity strengthen its defenses against global health threats. By elucidating the enigmas of pandemics, the study hopes to foster a more resilient and prepared global health environment. Highlighting the importance of a multidisciplinary, cross-disciplinary, and transdisciplinary approach, this exploration emphasizes the critical need to integrate biological, socioeconomic, environmental, and technological domains to develop more robust defenses against these global health challenges.

A Cross-Sectional Analysis of Community Perceptions of Flu and COVID-19 Vaccines at Turtle Creek Primary Care Center

BACKGROUND

Influenza (flu) and COVID-19 vaccination rates are subpar across the US, especially in racial and/or socioeconomic minority groups who are understudied in public health literature.

OBJECTIVE

The objective of this mixed-methods study was to elucidate attitudes of patients at the Turtle Creek Primary Care Center, a clinic that cares for ∼70% non-white patients, towards flu and COVID-19 vaccines, with the goal of establishing vaccine education gaps and increasing vaccine uptake in minority communities.

DESIGN/PATIENTS

This study was conducted as a cross-sectional analysis. Authors completed 123 patient phone surveys of patients cared for at the Turtle Creek clinic inquiring about flu and COVID-19 infection status and vaccination uptake (August 26-October 10, 2021).

APPROACH/KEY RESULTS

We found that rates of vaccination were subpar in the Turtle Creek community, with only 54% having received the COVID-19 vaccine and only 44% receiving the flu vaccine regularly. There was a strong association between COVID-19 and flu vaccine acceptance and a notable correlation between vaccine acceptance and age. When assessing how vaccine acceptance was influenced by trusted sources of information, those who cited trusting "medical professionals" and "word of mouth" had higher odds of COVID-19 vaccine acceptance but those who cited trusting "social media" had decreased odds of acceptance. Finally, we uncovered 14 common factors for either vaccine acceptance or refusal that clustered into four overarching themes of trust, need, safety, and availability.

CONCLUSION

These data highlight the necessity of improved vaccine education and reveal targetable populations and approaches for disseminating vaccine information.

Perceptions and practices of people with a total laryngectomy during COVID-19 pandemic: A mixed methods analysis

PURPOSE

People with a total laryngectomy (PTL) confront safety threats related to altered airway anatomy and risk of adverse events is amplified during healthcare crises, as exemplified by COVID-19 pandemic. Understanding these challenges, how they are navigated by PTL, and what resources can be deployed to alleviate risk can improve interprofessional care by speech-language pathologists (SLPs), otolaryngologists, and other professionals.

MATERIALS AND METHODS

An online survey was disseminated to PTL in the United States during the COVID-19 pandemic, querying participants about safety concerns and sources of information accessed to address care. Descriptive statistics and Chi-square were used to analyze information sources consumed by tracheoesophageal, esophageal, and electrolaryngeal speakers. Content analysis was completed to identify themes and quantify responses by subtheme.

RESULTS

Among 173 respondent PTL, tracheoesophageal speakers preferentially sought otolaryngologist input, whereas esophageal and electrolaryngeal speakers more often chose SLPs (p < .01). Overall, tracheoesophageal speakers had more SLP or otolaryngologist contact. Many PTL reported stringent handwashing, neck cleaning, and hygienic risk mitigation strategies. Six themes emerged in content analysis involving risk of infection/transmission, heightened vigilance, changes to alaryngeal communication, modified tracheostoma coverage, diagnostic testing, and risk from comorbid conditions. Limited provider contact suggested pandemic barriers to healthcare access.

CONCLUSIONS

PTL have a range of laryngectomy-specific needs and concerns, and type of alaryngeal communication was associated with source of information sought. Collaborations among healthcare professionals need to be optimized to improve patient navigation and overall access to specialized care.

An Analysis of Various Factors Underlying Covid-19 Prevention Practice and Strategy in Jigjiga Town, Northeast Ethiopia

Background

COVID-19, a severe respiratory illness, is caused by the SARS-CoV-2 virus. The pandemic has devastated public health, economies, and social structures worldwide. In Ethiopia, the government and health authorities have implemented various COVID-19 prevention strategies to contain the spread of the virus. This study aims to investigates the factors influencing the implementation and effectiveness of COVID-19 prevention strategies in Jigjiga Town, Ethiopia.

Methods

A community-based cross-sectional study was conducted from April 2022 to December 2022, involving 593 participants in Jigjiga town. Multi-stage sampling techniques were used, and data was collected using a structured questionnaire covering demographic characteristics, socioeconomic status, attitude, knowledge, prevention practices, misconceptions, and COVID-19 prevention strategies. A multivariate model was developed to control for confounding, using variables suitable for multivariate logistic regression analysis with p-values less than 0.25. A variable is considered significant in multivariable logistic regression analysis if its p-value is less than 0.05.

Results

The study found that only 12.2% of participants used COVID-19 prevention strategies. Those with a bachelor's degree or higher had a strong association with prevention strategies (AOR: 20.08, 95% CI: 2.13-188.85). Participants informed about COVID-19 prevention were 6.886 times more likely to use strategies (95% CI: 2.975-15.938). People who received the COVID-19 vaccine were 1.14 times more likely to engage in reasonable preventive measures compared to those who did not get vaccinated.

Conclusion

The study reveals low COVID-19 prevention practices among participants, with only 12.2% utilizing preventive strategies. The covariate, the kinds of information received on COVID-19 prevention mechanisms, participants with a favorable attitude toward COVID-19, educational level, mask-wearing, social distancing, vaccination, hand hygiene, public health communication, and household income were significantly associated with COVID-19 prevention strategies. The COVID-19 vaccination promotes preventive practices, reduces infection risk, protects against severe illness, and decreases community spread.

Perceived Role of the School Nurse in Providing Pertinent COVID-19 Information to the School Community: Experiences of Public Health Graduate Students With School-Aged Children

The COVID-19 pandemic has been a major disruptor to school systems across the United States since March 2020. As a result, school nurses have had to adapt to these uncertain times. Previous research has demonstrated the impact of school nurses on student health; however, less is known about their role in educating the broader school community about COVID-19 prevention. In Spring 2022, four focus groups were conducted with public health graduate students with school-aged children, to assess perceptions of COVID-19 and public health emergency preparedness communication. MAXQDA was used for thematic analysis. School nurses were viewed as a credible source of COVID-19 information, especially for those who do not have access to healthcare services. While the primary role of school nurses is to provide health services to students, they also have the capacity to provide the community with vital public health emergency preparedness information.

Preferred Information Source Correlates to COVID-19 Risk Misperception

Inaccurate perceptions of COVID-19 (coronavirus disease 2019) risk may decrease compliance with public health mitigation practices, in turn increasing disease burden. The extent to which public perceptions of COVID-19 risk are inaccurate is not well studied. This study investigates the relationship between preferred information sources and inaccurate COVID-19 risk perception. A cross-sectional online survey of adults in the United States using online snowball techniques was administered between April 9, 2020 and July 12, 2020. Raking techniques were used to generate a representative U.S. sample from 10,650 respondents. Respondents who did not provide an answer to key questions were excluded. The remaining sample included 1,785 health care workers (HCW) and 4,843 non-HCW. Subjective risk was measured as the product of perceived likelihood of COVID-19 infection and perceived harm from infection. Objective risk was measured as a function of the presence of known COVID-19 risk factors. Discrepancies between subjective and objective risk were compared between respondents with different preferred information sources. Chi Square contingency tables and pair-wise correlation were used to evaluate differences to 95% confidence. For HCW and non-HCW, the greatest overestimation of personal COVID-19 risk assessment (p < .05 for all differences) were found in those whose preferred source of information was social media (HCW: 62.1%; non-HCW: 64.5%), followed by internet news sources (HCW: 59.6%, non-HCW%: 59.1%), government websites (HCW: 54%, non-HCW = 51.8%), other sources (HCW: 50.7%, non-HCW = 51.4%), and television news (HCW: 46.1%, non-HCW: 47.6%). Preferred information sources correlate with inaccuracies in personal COVID-19 risk assessment. Public health information campaigns should consider targeting groups whose preferred information sources correlate to higher inaccuracies in COVID-19 risk perceptions. [HLRP: Health Literacy Research and Practice. 2023;7(2):e105-e110.].

A mixed methods study exploring requests for unproven COVID therapies such as ivermectin and healthcare distrust in the rural South

The COVID-19 pandemic has led to contentious discourse regarding unproven COVID-19 therapies (UCTs),(e.g. ivermectin). Despite recommendations against it, ivermectin remains, in some areas, highly demanded. The goal of this study is to understand patient and provider perspectives about UCTs (e.g., ivermectin) and how responses to requests for UCTs impact healthcare distrust. This mixed methods observational study was conducted in a rural healthcare system in the Southern United States. Adults (n = 26) with a history of COVID-19 or clinicians (n = 8) from the same system were interviewed using questionnaires assessing healthcare distrust and qualitatively interviewed exploring perceptions about UCTs. Patient themes were: 1) Importance of anecdotal stories for decision-making; 2) Use of haphazard approaches to 'research'; 3) Strong distrust of government and healthcare organizations; 4) Inherent trust in local healthcare; 5) Decision-making as weighing pros/cons; and 6) Feeling a right to try medications. High survey medians indicated high distrust with differences of 8.5 points for those who requested/used ivermectin versus those who did not (p = 0.027). Clinician themes were: 1) Frustration when patients trust social media over clinicians; 2) Acceptance of community beliefs about UCTs; 3) Distrust originating outside of the healthcare system; 4) Feeling torn about prescribing UCTs to build trust; and 5) Variable educational strategies. When clinicians are perceived as aligned with government, this may void patients' trust of clinicians. Clinicians should leverage trust in local healthcare and distance themselves from distrusted information sources. Ethical questions arise regarding appropriateness of acquiescing to patient requests for ivermectin for building trust.

Examining factors impacting acceptance of COVID-19 countermeasures among structurally marginalised Canadians

The COVID-19 pandemic highlighted and exacerbated inequities in health for structurally marginalised Canadians. Their location on society's hierarchies constrained their ability to access healthcare and follow recommended health behaviours. The aim of this article is to identify, from the perspective of marginalised populations, factors influencing the acceptance or rejection of COVID-19 countermeasures by structurally marginalised Canadians. Interviews were conducted with Canadians 18 + who identified as Black (n = 8), First Nations, Métis, or Inuit (n = 7) and low-income (<40,000 annual household income) (n = 8) between August and December 2021. Measures were said to impact well-being and interfere with revenue generating activities. Longstanding unfavourable living and environmental conditions as they relate to structural marginalisation was said to fuel anger toward the government and lead to a greater reluctance to accept countermeasures. Participants described concerns about government decisions being made without considering their unique contexts, or knowledge of the experiences of the population for whom these decisions were being made. Effective proactive action from government is important to foster trust with marginalised populations to support acceptance of health information and address growing inequities. Action that demonstrates government competence and commitment to the interests of marginalised populations is critical.

Sleep quality and the evolution of the COVID-19 pandemic in five European countries

The COVID-19 pandemic has led to lifestyle changes across Europe with a likely impact on sleep quality. This investigation considers sleep quality in relation to the evolution of the COVID-19 pandemic in five European countries. Using panel regressions and keeping policy responses to COVID-19 constant, we show that an increase in the four-week average daily COVID-19 deaths/100,000 inhabitants (our proxy for the evolution of the pandemic) significantly reduced sleep quality in France, Germany, Italy, Spain, and Sweden between April 2020 and June 2021. Our results are robust to a battery of sensitivity tests and are larger for women, parents and young adults. Additionally, we show that about half of the reduction in sleep quality caused by the evolution of the pandemic can be attributed to changes in lifestyles, worsened mental health and negative attitudes toward COVID-19 and its management (lower degree of confidence in government, greater fear of being infected). In contrast, changes in one's own infection-status from the SARS-CoV-2 virus or sleep duration are not significant mediators of the relationship between COVID-19-related deaths and sleep quality.

Identifying Health Equity Factors That Influence the Public's Perception of COVID-19 Health Information and Recommendations: A Scoping Review

The COVID-19 pandemic has impacted global public health and public trust in health recommendations. Trust in health information may waver in the context of health inequities. The objective of this scoping review is to map evidence on public perceptions of COVID-19 prevention information using the PROGRESS-Plus health equity framework. We systematically searched the MEDLINE, Cochrane Central Register of Controlled Trials, PsycInfo, and Embase databases from January 2020 to July 2021. We identified 792 citations and 31 studies published in 15 countries that met all inclusion criteria. The majority (30/31; 96.7%) of the studies used an observational design (74.2% cross-sectional, 16.1% cohort, 6.5% case study, 3.2% experimental trials). Most studies (61.3%) reported on perception, understanding, and uptake, and 35.5% reported on engagement, compliance, and adherence to COVID-19 measures. The most frequently reported sources of COVID-related information were social media, TV, news (newspapers/news websites), and government sources. We identified five important equity factors related to public trust and uptake of recommendations: education and health literacy (19 studies; 61.3%), gender (15 studies; 48.4%), age (15 studies; 48.4%), socioeconomic status (11 studies; 35.5%), and place of residence (10 studies; 32.3%). Our review suggests that equity factors play a role in public perception of COVID-19 information and recommendations. A future systematic review could be conducted to estimate the impact of equity factors on perception and behavior outcomes.

Perceptions and knowledge regarding the COVID-19 pandemic between U.S. and China: a mixed methods study

BACKGROUND

SARS-CoV-2, a new coronavirus first reported by China on December 31st, 2019, has led to a global health crisis that continues to challenge governments and public health organizations. Understanding COVID-19 knowledge, attitudes, and practices (KAP) is key for informing messaging strategies to contain the pandemic. Cross-national studies (e.g.: comparing China to the U.S.) are needed to better understand how trans-cultural differences may drive differences in pandemic response and behaviors. The goal of the study is to compare knowledge and perceptions of COVID-19 between adults in China and the U.S. These data will provide insight into challenges these nations may face in coordinating pandemic response.

METHODS

This is a convergent mixed methods study comparing responses from China and the U.S. to a multinational COVID-19 KAP online survey. The survey included five quantitative constructs and five open-ended questions. Chinese respondents (n = 56) were matched for gender, age, education, perceived social standing, and time of survey completion with a U.S. cohort (n = 57) drawn from 10,620 U.S.

RESPONDENTS

Quantitative responses were compared using T-test & Fisher-Exact tests. Inductive thematic analysis was applied to open-ended questions.

RESULTS

Both U.S. and Chinese samples had relatively high intention to follow preventive behaviors overall. Differences in intended compliance with a specific recommendation appear to be driven by the different cultural norms in U.S. and China. Both groups expressed trepidation about the speed of COVID-19 vaccine development, driven by concern for safety among Chinese respondents, and concern for efficacy among U.S.

RESPONDENTS

The Chinese cohort expressed worries about other countries' passive handling of the pandemic while the U.S. cohort focused on domestic responses from individuals and government. U.S. participants appeared more knowledgeable on some aspects of COVID-19. Different perspectives regarding COVID-19 origins were identified among the two groups. Participants from both samples reported high trust in health professionals and international health organizations.

CONCLUSIONS

Mixed methods data from this cross-national analysis suggests sociocultural differences likely influence perceptions and knowledge of COVID-19 and its related public health policies. Discovering and addressing these culturally-based differences and perceptions are essential to coordinate a global pandemic response.

Assessing the Intention, Attitudes, and Social Influences on COVID-19 Preventive Behaviors Among Non-rural Black and Rural Appalachian White Populations: A Faith-Based Community Study

Introduction

The COVID-19 pandemic has had detrimental impacts in non-rural Black and rural Appalachian populations. Yet despite the pandemic's magnitude, there is a scarcity of research exploring potential influences of attitudes and social influences within these populations on their adherence to COVID-19 public health preventive behaviors.

Purpose

This study examines the intention, attitudes, and social influences to adhere to COVID-19 preventive behaviors among non-rural Black and rural Appalachian congregants in Kentucky by integrating the Theory of Planned Behavior (TPB).

Methods

Secondary analysis of cross-sectional data was used to assess the association between the TPB constructs and four key public health behaviors: obeying a stay-at-home order, social distancing, good hygiene practices, and wearing a mask in public. Generalized estimating equation-type logistic regression models were fit for all binary outcomes.

Results

A total of 942 respondents completed the survey. Eighty-nine per cent were older than 36 years, and 73% were female. Of the respondents who were White, 97.7% lived in rural Appalachia Kentucky, and of those who were Black, 93.5% lived in non-rural Kentucky. Attitude towards the behavior was negatively associated with the stay-at-home order ( p=0.003). Both attitude toward the behavior ( p<0.001) and the subjective norm ( p=0.025) were negatively associated with mask wearing. Perceived behavioral control was positively associated with mask wearing ( p=0.023) with non-rural respondents more likely to wear a mask than rural ones ( p<0.001). None of the TPB constructs showed significant association with hygiene practices or with social distancing.

Implications

This study provides further insight into the cultural and societal influences that intersect during a global pandemic. The intention to comply with public health recommendations may vary at favorable and unfavorable levels. The results lend support to the importance of designing effective, culturally tailored communication for future public health preparedness.

The Mutual Influence of the World Health Organization (WHO) and Twitter Users During COVID-19: Network Agenda-Setting Analysis

BACKGROUND

Little is known about the role of the World Health Organization (WHO) in communicating with the public on social media during a global health emergency. More specifically, there is no study about the relationship between the agendas of the WHO and Twitter users during the COVID-19 pandemic.

OBJECTIVE

This study utilizes the network agenda-setting model to investigate the mutual relationship between the agenda of the WHO's official Twitter account and the agenda of 7.5 million of its Twitter followers regarding COVID-19.

METHODS

Content analysis was applied to 7090 tweets posted by the WHO on Twitter from January 1, 2020, to July 31, 2020, to identify the topics of tweets. The quadratic assignment procedure (QAP) was used to investigate the relationship between the WHO agenda network and the agenda network of the 6 Twitter user categories, including "health care professionals," "academics," "politicians," "print and electronic media," "legal professionals," and the "private sector." Additionally, 98 Granger causality statistical tests were performed to determine which topic in the WHO agenda had an effect on the corresponding topic in each Twitter user category and vice versa.

RESULTS

Content analysis revealed 7 topics that reflect the WHO agenda related to the COVID-19 pandemic, including "prevention," "solidarity," "charity," "teamwork," "ill-effect," "surveillance," and "credibility." Results of the QAP showed significant and strong correlations between the WHO agenda network and the agenda network of each Twitter user category. These results provide evidence that WHO had an overall effect on different types of Twitter users on the identified topics. For instance, the Granger causality tests indicated that the WHO tweets influenced politicians and print and electronic media about "surveillance." The WHO tweets also influenced academics and the private sector about "credibility" and print and electronic media about "ill-effect." Additionally, Twitter users affected some topics in the WHO. For instance, WHO followers affected "charity" and "prevention" in the WHO.

CONCLUSIONS

This paper extends theorizing on agenda setting by providing empirical evidence that agenda-setting effects vary by topic and types of Twitter users. Although prior studies showed that network agenda setting is a "one-way" model, the novel findings of this research confirm a "2-way" or "multiway" effect of agenda setting on social media due to the interactions between the content creators and audiences. The WHO can determine which topics should be promoted on social media during different phases of a pandemic and collaborate with other public health gatekeepers to collectively make them salient in the public.

Knowledge, Attitude, and Psychological Impacts of COVID-19 in Saudi Arabia

Background

The world has been facing an unprecedented pandemic of COVID-19 with over 336 million people infected and millions of deaths. This required an enormous communication effort response from governments, international, and individuals to keep the public informed about the outbreak. When a pandemic affects communities, individuals' knowledge and attitude are important factors to contain the outbreak. Thus, the purpose of this study is to measure individuals' knowledge and attitude toward COVID-19 and ascertain whether a need exists for mental health services for those who were affected by the pandemic.

Methods

A cross-sectional design was used to measure the knowledge, attitude, and psychological impacts about the COVID-19 pandemic among the Saudi population. Research participants were recruited using a snowball sampling technique through the social media platform WhatsApp. A total of 482 eligible individuals participated from various locations in Saudi Arabia represented almost all Saudi regions. The questionnaire consisted of seven questions evaluating knowledge, seven gauging attitudes, and 16 questions assessing anxiety and perceived need for mental healthcare services.

Results

A modest level of knowledge (59%) was found among the Saudi population sampled about the COVID-19 pandemic, and satisfactory knowledge (>80%) about its preventive measures. Anxiety and stress existed among the participants (79% obsessed with COVID-19), with an 88% approval rate for obtaining mental health services for individuals highly affected by the pandemic.

Conclusion

There is a need to increase awareness and provide continuous updates regarding the pandemic situation. Promoting access to mental health services is critical, as well as finding creative and suitable strategies to deliver mental health services to those who need them.

'Us-Versus-Them': Othering in COVID-19 public health behavior compliance

Objective

We explored public perceptions about the COVID-19 pandemic to learn how those attitudes may affect compliance with health behaviors.

Methods

Participants were Central Pennsylvania adults from diverse backgrounds purposively sampled (based on race, gender, educational attainment, and healthcare worker status) who responded to a mixed methods survey, completed between March 25–31, 2020. Four open-ended questions were analyzed, including: “What worries you most about the COVID-19 pandemic?” We applied a pragmatic, inductive coding process to conduct a qualitative, descriptive content analysis of responses.

Results

Of the 5,948 respondents, 538 were sampled for this qualitative analysis. Participants were 58% female, 56% with ≥ bachelor’s degree, and 50% from minority racial backgrounds. Qualitative descriptive analysis revealed four themes related to respondents’ health and societal concerns: lack of faith in others; fears of illness or death; frustration at perceived slow societal response; and a desire for transparency in communicating local COVID-19 information. An “us-versus-them” subtext emerged; participants attributed non-compliance with COVID-19 behaviors to other groups, setting themselves apart from those Others.

Conclusion

Our study uncovered Othering undertones in the context of the COVID-19 pandemic, occurring between groups of like-minded individuals with behavioral differences in ‘compliance’ versus ‘non-compliance’ with public health recommendations. Addressing the ‘us-versus-them’ mentality may be important for boosting compliance with recommended health behaviors.

COVID-19 Vaccine Acceptance and its Predictors among College Students in Addis Ababa, Ethiopia, 2021: A Cross-Sectional Survey

BACKGROUND

The coronavirus disease pandemic disrupted the normal social and economic activities of the people resulting in over 3 million deaths worldwide. Piece of literature depicted that predictors of vaccine acceptance are complex, multiple, and vary depending on the type of vaccine involved.

OBJECTIVE

The study aimed at assessing the COVID-19 acceptance and its predictors among college students in Addis Ababa, Ethiopia, 2021.

METHODS

A multi-center-institutional-based cross-sectional study was conducted among 407 participants from three institutions in Addis Ababa selected based on a simple random sampling method from May 01 to July 30, 2021. A self-administered structured questionnaire was used for the collection of data, after which informed consent was obtained from all the included study participants. Descriptive statistics was used for the summarization of the data. Binary (bivariate and multivariate) logistic regression was applied for the identification predictors of vaccine acceptance with their respective 95% confidence interval and less than 5% p-value for the ascertainment of presence of association.

RESULTS

The level of vaccine acceptance was 39.8% (95% CI: 35.0-44.7%). Being male (AOR: 0.463, 95% CI: 0.284-0.755, P < 0.001), living with children under the age of five (AOR: 2.295; 95% CI: 1.416-3.721, P < 0.05), living with an elderly (AOR: 1.609, 95% CI: 1.016-2.548, P < 0.05) and having had poor knowledge (AOR: 2.187, 95% CI: 1.391-3.438, P < 0.001) were predictors significantly associated with an increased level of vaccine acceptance.

CONCLUSION AND RECOMMENDATION

The level of vaccine acceptance among college students in Ethiopia was lower than necessary to achieve herd immunity. Sex, living with under-five children, and elderly, and knowledge were predictors of COVID-19 acceptance. Concerned bodies were suggested to work over the identified predictors of vaccine acceptance in the study settings.

The role of risk perception and affective response in the COVID-19 preventive behaviours of young adults: a mixed methods study of university students in the Netherlands

OBJECTIVES

Due to an increased infection rate among young adults, they need to adhere to the preventive guidelines to stop the spread of COVID-19 and protect vulnerable others. The purpose of this mixed methods study was to explore the role of risk perception and affective response in the preventive behaviours of young adults during the COVID-19 outbreak.

SETTING

This study followed a convergent mixed methods design, in which a quantitative online survey (n=1081) and 10 qualitative in-depth semistructured video interviews were conducted separately in the Netherlands during April-August 2020.

PARTICIPANTS

1081 participants filled in the online survey, and 10 participants participated in the interviews. Eligibility criteria included being a university student.

PRIMARY AND SECONDARY OUTCOME MEASURES

Data on risk perception, affective response, that is, worry, and adherence to preventive guidelines were combined and analysed during this study. There were no secondary outcome measures.

RESULTS

The results showed that young adults perceived their risk as low. Their affective response for their own well-being was also low; however, their affective response was high with regards to vulnerable others in their surroundings. Due to their high impersonal risk perception (ie, perceived risk to others) and high affective response, young adults adhered to most preventive guidelines relatively frequently. However, young adults sometimes neglected social distancing due to the negative effects on mental health and the uncertainty of the duration of the situation.

CONCLUSIONS

In conclusion, high impersonal risk perception and high affective response regarding others are key motivators in young adults' preventive behaviour. To maximise adherence to the preventive guidelines, risk communication should put emphasis on the benefits to vulnerable others' health when young adults adhere to the preventive guidelines.

Lower Intent to Comply with COVID-19 Public Health Recommendations Correlates to Higher Disease Burden in Following 30 Days

OBJECTIVES

We sought to determine whether self-reported intent to comply with public health recommendations correlates with future coronavirus disease 2019 (COVID-19) disease burden.

METHODS

A cross-sectional, online survey of US adults, recruited by snowball sampling, from April 9 to July 12, 2020. Primary measurements were participant survey responses about their intent to comply with public health recommendations. Each participant's intent to comply was compared with his or her local COVID-19 case trajectory, measured as the 7-day rolling median percentage change in COVID-19 confirmed cases within participants' 3-digit ZIP code area, using public county-level data, 30 days after participants completed the survey.

RESULTS

After applying raking techniques, the 10,650-participant sample was representative of US adults with respect to age, sex, race, and ethnicity. Intent to comply varied significantly by state and sex. Lower reported intent to comply was associated with higher COVID-19 case increases during the following 30 days. For every 3% increase in intent to comply with public health recommendations, which could be achieved by improving average compliance by a single point for a single item, we estimate a 9% reduction in new COVID-19 cases during the subsequent 30 days.

CONCLUSIONS

Self-reported intent to comply with public health recommendations may be used to predict COVID-19 disease burden. Measuring compliance intention offers an inexpensive, readily available method of predicting disease burden that can also identify populations most in need of public health education aimed at behavior change.

Developing and testing an automated qualitative assistant (AQUA) to support qualitative analysis

Qualitative research remains underused, in part due to the time and cost of annotating qualitative data (coding). Artificial intelligence (AI) has been suggested as a means to reduce those burdens, and has been used in exploratory studies to reduce the burden of coding. However, methods to date use AI analytical techniques that lack transparency, potentially limiting acceptance of results. We developed an automated qualitative assistant (AQUA) using a semiclassical approach, replacing Latent Semantic Indexing/Latent Dirichlet Allocation with a more transparent graph-theoretic topic extraction and clustering method. Applied to a large dataset of free-text survey responses, AQUA generated unsupervised topic categories and circle hierarchical representations of free-text responses, enabling rapid interpretation of data. When tasked with coding a subset of free-text data into user-defined qualitative categories, AQUA demonstrated intercoder reliability in several multicategory combinations with a Cohen’s kappa comparable to human coders (0.62–0.72), enabling researchers to automate coding on those categories for the entire dataset. The aim of this manuscript is to describe pertinent components of best practices of AI/machine learning (ML)-assisted qualitative methods, illustrating how primary care researchers may use AQUA to rapidly and accurately code large text datasets. The contribution of this article is providing guidance that should increase AI/ML transparency and reproducibility.

Compliance with the main preventive measures of COVID-19 in Spain: The role of knowledge, attitudes, practices, and risk perception

In epidemics such as COVID‐19, major changes need to be made to the population's behavior to prevent infection and stop disease transmission. The three most recommended preventive measures are wearing a mask, washing hands with soap or hydroalcoholic gel, and watching an interpersonal distance of at least two meters (3W) from other people. This study aimed to assess adherence to these COVID‐19‐related three preventive measures and its association with knowledge, attitudes, risk perception, and practices in Spain. The COSMO‐Spain survey, based on the WHO Behavioral Insights questionnaire on COVID‐19, was conducted in the general Spanish population using an online questionnaire (n = 1,033). Sociodemographic, knowledge, attitudes, practices, and risk perception variables were included. A multivariable logistic regression model was carried out to evaluate the factors associated with compliance with the three preventive measures. Half of the respondents (49.8%) were women with a median age of 45 (Inter‐quartile Range, IR = 21) years. In the logistic regression, the factors associated with 3W compliance were being over 45 years; knowing about how COVID‐19 spreads and wearing masks properly; appropriate attitudes towards COVID‐19 (greater agreement with mandatory mask use); high risk perception (feeling that the coronavirus is spreading rapidly, being concerned about non‐mask wearers), and adherence to other preventive measures against COVID‐19, such as staying at home. Adequate knowledge, attitudes and risk perception are determinants of 3W compliance. Developing effective health education programs and frequent communication strategies are necessary, particularly for those who adhere less to preventive measures.