Situational awareness and health protective responses to pandemic influenza A (H1N1) in Hong Kong: a cross-sectional study

Exploring the Singapore general population's trust in COVID-19 information from different sources and its association with perceived risk of infection during the pandemic

Background

The degree of public trust in the government's competence is crucial in preventing the spread of misinformation and reducing psychological distress during a pandemic. The study aimed to (i) explore the trust in COVID-19 information from different sources and trust in the ability of the World Health Organization (WHO), government departments and related institutions in handling the epidemic in Singapore and (ii) its association with perceived risk of infection among Singapore residents.

Methods

A total of 1,129 participants (aged 21 and above) were recruited from a cross-sectional study examining the well-being and resilience of Singapore's population between May 2020 to June 2021. Trust in COVID-19 information from different sources was measured on a 10-point scale and an ordinal 7-point scale was used for perceived risk of infection. Descriptive statistics and multivariate logistic regression model were conducted.

Results

85.5% reported high trust in COVID-19 information from the government and their ability in handling the pandemic. Participants also reported high trust in COVID-19 information from local public health or infectious disease experts (84.4%) and traditional media (77.2%). Low trust in the ability of government departments and related institutions was associated with higher future (1 month) perceived risk of infection (OR: 5.7, 95% CI 1.02-32.45) and low trust in social media was associated with higher current perceived risk of infection (OR: 2.4, 95% CI 1.09-5.24).

Discussion

The present study provided insight on the level of trust on COVID-19 information from different sources and its associated perceived risks of infection. Future qualitative studies are recommended to facilitate better understanding of public trust and identify strategies for how it can be effectively addressed to support future public health responses.

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.

Health Beliefs, Protective Behaviors, and Information-Seeking

BACKGROUND

The outbreak of COVID-19 caused severe damage to public health globally and served as a stark reminder of the potential for future pandemics. Promoting protective behaviors to prevent the spread of any contagious disease thus remains a priority. Although research has shown that health beliefs can affect protective behaviors, few studies have examined the role of information-seeking in this relationship.

OBJECTIVES

On the basis of the health belief model, this research focused on whether health beliefs affect personal protective behaviors through health information-seeking behaviors.

METHODS

This cross-sectional study with a causal-comparative design used an online questionnaire to investigate the Taiwanese public's health beliefs, protective behaviors, and information-seeking behaviors during the COVID-19 pandemic. Data were analyzed using descriptive statistics and multiple regression analysis.

RESULTS

Between September 2021 and January 2022, 322 valid questionnaires were collected. The results revealed that the effects of two health beliefs-self-efficacy and perceived benefits-on handwashing, social distancing, practicing good cough etiquette, and keeping one's environment clean and well ventilated were partially mediated by the frequency of official information-seeking.

DISCUSSION

Results of this study support the regular and timely promotion of pandemic prevention measures through official sites. Promoting official information-seeking can help enhance protective behaviors.

Longitudinal study of the role of COVID worry versus general anxiety in predicting vaccination and other COVID-preventive behaviors

OBJECTIVE

The COVID-19 pandemic highlighted the critical role of public engagement in health protective behaviors (e.g. masking, vaccination) to reduce viral spread and impact. Future public health efforts may be facilitated by identifying factors that impact the likelihood of adopting these behaviors. This study evaluated whether COVID-specific worry and/or generalized anxiety predicted subsequent uptake of COVID-19 vaccination and engagement in other COVID-preventive behaviors.

METHOD AND MEASURES

Participants (N = 205) completed an online survey in July 2020, shortly after the onset of the pandemic, and a follow-up survey, over a year later, after vaccines were available to the public.

RESULTS

Findings indicate that those reporting greater COVID-worry on the initial survey were more likely to get vaccinated against COVID-19 by the follow-up survey and to report greater engagement in COVID-protective behaviors at both timepoints. By contrast, lower levels of generalized anxiety predicted greater likelihood of vaccination by follow-up and greater engagement in other COVID-protective behaviors on the initial survey.

CONCLUSIONS

These findings suggest that worry about a specific health threat may have a protective function, motivating protective behavior, whereas elevated levels of generalized anxiety appear to undermine health protective behavior and should be aggressively addressed.

Analysis of COVID-19 Incidence and Protective Potential of Persisting IgG Class Antibodies against SARS-CoV-2 Infection in Hospital Staff in Poland

The immune responses to both SARS-CoV-2 infection and vaccines are of key importance in prevention efforts. In April and May 2020, 703 study participants tested for COVID-19 by PCR tests were registered. In June and July 2020, they were examined for the presence of SARS-CoV-2 S1/S2 IgG. From October 2020 to January 2021, those among the study population with COVID-19 confirmed by PCR tests were registered, and the same group of participants was invited to be examined again for the presence of SARS-CoV-2 antibodies. In June 2020, antibodies were detected in only 88% of those who had PCR-confirmed COVID-19 in April-May 2020, which suggests that a significant proportion of persons in the Polish population do not produce antibodies after contact with SARS-CoV-2 antigens or rapidly lose them and reach levels below the lab detection limit. The levels of IgG class anti-SARS-CoV-2 antibodies were significantly lower among people who previously had COVID-19 than for those who had received COVID-19 vaccination, which confirms the high immunogenicity of the vaccines against COVID-19 in the Polish population. The study confirms that a detectable level of IgG class anti-SARS-CoV-2 antibodies cannot be considered a reliable marker of the presence and strength of COVID-19 immunity preventing individuals from acquiring SARS-CoV-2 infection.

A Case-Control Study on Factors of HPV Vaccination for Mother and Daughter in China

(1) Background: To explore the influencing factors of human papillomavirus (HPV) vaccination among mothers and daughters so as to provide evidence and strategies for improving the HPV vaccination rate of 9-18-years-old girls. (2) A questionnaire survey was conducted among the mothers of 9-18-year-old girls from June to August 2022. The participants were divided into the mother and daughter vaccinated group (M1D1), the mother-only vaccinated group (M1D0), and the unvaccinated group (M0D0). Univariate tests, the logistic regression model, and the Health Belief Model (HBM) were employed to explore the influencing factors. (3) Results: A total of 3004 valid questionnaires were collected. According to the regions, Totally 102, 204, and 408 mothers and daughters were selected from the M1D1, M1D0, and M0D0 groups, respectively. The mother having given her daughter sex education (OR = 3.64; 95%CI 1.70, 7.80), the mother's high perception of disease severity (OR = 1.79; 95%CI 1.02, 3.17), and the mother's high level of trust in formal information (OR = 2.18; 95%CI 1.26, 3.78) were all protective factors for both the mother and her daughter's vaccination. The mother's rural residence (OR = 0.51; 95%CI 0.28, 0.92) was a risk factor for vaccination of both mother and daughter. The mother's education of high school or above (OR = 2.12; 95%CI 1.06, 4.22), the mother's high level of HPV and HPV vaccine knowledge (OR = 1.72; 95%CI 1.14, 2.58), and the mother's high level of trust in formal information (OR = 1.72; 95%CI 1.15, 2.57) were protective factors of mother-only vaccination. The older the mother (OR = 0.95; 95%CI 0.91, 0.99) was classed as a risk factor for mother-only vaccination. "Waiting until the daughters are older to receive the 9-valent vaccine" is the main reason why the daughters of M1D0 and M0D0 are not vaccinated". (4) Chinese mothers had a high willingness to vaccinate their daughters with the HPV vaccine. The higher education level of the mother, giving sex education to the daughter, the older ages of mothers and daughters, the mother's high level of HPV and HPV vaccine knowledge, a high level of perception of the disease severity, and a high level of trust in formal information were promoting factors of HPV vaccination for mother and daughter, and rural residence was a risk factor to vaccination. To promote HPV vaccination in girls from 9-18 years old, communities could provide health education to rural mothers with low education levels; the government could advocate for HPV vaccination through issuing policy documents; and doctors and the CDC could popularize the optimal age for HPV vaccination to encourage mothers to vaccinate their daughters at the age of 9-14 years old.

Use of interviewer-administered telephone surveys during infectious disease outbreaks, epidemics and pandemics: a scoping review

INTRODUCTION

During the COVID-19 crisis, researchers had to collect data remotely. Telephone surveys and interviews can quickly gather data from a distance without heavy expense. Although interviewer-administered telephone surveys (IATS) can accommodate the needs of international public health research, the literature on their use during infectious disease outbreaks is scarce. This scoping review aimed to map the characteristics of IATS during infectious disease outbreaks.

METHODS

IATS conducted principally during infectious disease outbreaks and answered by informants at least 18 years old were searched from PubMed and EBSCO. There was a manual addition of relevant documents identified during an initial search. Overall trends were reported using different groupings, including WHO regions, and study details were compared before and during the COVID-19 pandemic.

RESULTS

70 IATS published between 2003 and 2022 were identified. 57.1% were conducted during the COVID-19 pandemic. Among 30 IATS conducted before the COVID-19 pandemic in the world, only 3.3% were carried out in low-income and middle-income countries (LMICs). This percentage of studies in LMICs out of all the IATS rose to 32.5% during the pandemic. The share of qualitative studies grew from 6.7% before the COVID-19 outbreak to 32.5% during the outbreak. IATS performed during the COVID-19 pandemic focused on more diverse, specific population groups, such as patients and healthcare professionals. Mobile phones are increasingly used for IATS over time.

CONCLUSION

IATS are used globally with high frequency in the Western Pacific Region and high-income countries. Technical and financial challenges continue to exist, and assessments of inclusiveness and representativeness should be carefully conducted. A lack of details related to methods was observed, and this scoping review urges researchers using this data collection method in the future to specify how they executed IATS for better use and more efficient deployment.

Predicting COVID-19 vaccination intentions: the roles of threat appraisal, coping appraisal, subjective norms, and negative affect

BACKGROUND

As a new disease, communities possess little natural immunity to COVID-19 and vaccines are considered critical to preventing and reducing the incidence of severe illness. This study, inspired by Protection Motivation Theory (PMT), examines the relationship between citizens' threat appraisal, coping appraisal, subjective norms, negative affect, and their COVID-19 vaccination intentions.

METHODS

A sample of 340 citizens from two main cities in Mainland China, Xi'an and Wuxi, was used for data analysis. Structural Equation Modeling (SEM) was employed with latent and observed variables to test hypotheses. Data were analyzed using AMOS 24.0.

RESULTS

Several findings extend current understanding. Firstly, our proposed model explains 73% of the variance in vaccination intentions. Secondly, perceived severity only indirectly shapes COVID-19 vaccination intentions through negative affect. Thirdly, negative affect and response costs are negatively related to COVID-19 vaccination intentions. Finally, Perceived probability, subjective norms, response efficacy and self-efficacy are positively related to COVID-19 vaccination intentions; among them, self-efficacy contributes the most, followed by response efficacy and subjective norms, and lastly perceived probability.

CONCLUSION

Theoretically, this study increases current understanding about subjective norms and affective responses. We provoke a certain amount of thought about the role of affect response in relation to threat appraisal and vaccination intentions. Specifically, governments must be vigilant that citizens' negative affect, such as fear, may cause vaccine hesitation.

Understanding media empowerment: citizen journalism in Palestine

This study addresses the nature of citizen journalism in Palestine, with the chief aim of identifying its role in promoting professionalism, ethics, and objectivity, and empowering digital media, information accessibility, and democratization of media production. To this end, this study uses data from different universities across Palestine obtained through surveys that address digital media empowerment and non-professional users in the new media landscape. The study sample used was selected using the stratified sampling method. Upon completion of a pilot test, a total of 300 questionnaires were distributed among undergraduates of 10 universities across Palestine based on their willingness to participate and availability. Our results suggest that official media outlets can benefit from citizen journalism by providing accurate and valid sources of information to citizen journalists to increase engagement among their audiences as a result of enhanced perceptions of independency and credibility. However, our findings also reveal that citizen journalism does not make a significant difference in undermining gatekeeping practices over new media content in Palestine. Moreover, the results show that there is no relationship or correlation between the idea of adopting citizen journalism as a complementary method to traditional journalism and the credibility and reliability of news stories presented by citizen journalists.

Digital information channels during the COVID-19 global health emergency through a situational awareness lens: a study of Pakistani citizens

Purpose

The main aim of this study was to know the role of digital information and communication channels in developing citizens’ understanding regarding COVID-19 with reference to situation awareness. Furthermore, the impact of gender, age, qualification and area of respondents on citizens' perception and comprehension of COVID-19 was also investigated.

Design/methodology/approach

This quantitative study used an online survey and received 377 usable responses. The instrument was developed with the help of literature, and it was based on two constructs (perception of the element and comprehension of the current situation) of the situational awareness (SA) model. Data were collected from Pakistani citizens through a convenient sampling technique.

Findings

It was observed that the majority of citizens used electronic media, Facebook and WhatsApp for accessing COVID-19-related information. World Health Organization website played an important role in developing citizens’ understanding. Alert messages through mobile phone and apps played role in developing citizen’s understanding regarding COVID-19 situation. They perceived that media was effective in providing social distancing techniques. Moreover, they believed that government campaigns were helpful. Findings revealed that there was no significant impact of gender, age, qualification and area on citizens' perceptions and comprehension of COVID-19 through media.

Originality/value

This study is helpful for authorities in decision-making regarding COVID-19 and also filled the literature gap as, to the best of the authors’ knowledge, no comprehensive study has been conducted regarding the SA of COVID-19.

How health beliefs and sense of control predict adherence to COVID-19 prevention guidelines among young adults in South Korea

This study defined adherence to COVID-19 prevention guidelines as health behavior and examined whether the two constructs of the health belief model (i.e., perceived susceptibility and perceived severity) and sense of control predict the level of adherence among young adults in South Korea. An online survey (N = 200) conducted in June 2021, showed that perceived susceptibility, perceived severity, and sense of control positively predict adherence behavior. Sense of control significantly moderated the relationship between perceived susceptibility and adherence even after controlling for depression and perceived health status. Specifically, individuals with a lower level of perceived susceptibility still adhered to COVID-19 prevention guidelines if they had a higher level of sense of control. The finding demonstrates the key role of sense of control in promoting adherence to COVID-19 prevention guidelines and the relationship between sense of control and two constructs of the health belief model. Implication for public messaging targeted at young adults during pandemic situations is also discussed.

Preventive Behaviors and Information Sources during COVID-19 Pandemic: A Cross-Sectional Study in Japan

BACKGROUND

individual preventive behaviors are one of the key measures needed to prevent the spread of COVID-19. This study sought to identify the factors associated with the adoption of COVID-19 preventive measures, focusing specifically on information sources.

METHODS

we conducted a nationally representative cross-sectional survey of 30,053 Japanese adults in February 2021. The survey asked about socioeconomic, health-related, and psychological characteristics, attitudes toward immunization, and the use of information sources regarding COVID-19. We have constructed multivariable logistic regression to estimate the factors associated with the adoption of three preventive measures: 3Cs avoidance, hand hygiene and respiratory hygiene.

RESULTS

socioeconomic variables, psychological variables, and the use of information sources are significantly associated with the adoption of preventive measures. The more information sources one uses, the more likely one is to adopt preventive measures. Trust in healthcare professionals is positively associated with adopting preventive measures. On the other hand, negative correlations between trust in social media and preventive behaviors were observed.

CONCLUSIONS

encouraging access to multiple information sources, utilizing communication channels, and modifying messaging according to target groups are essential to promote COVID-19 preventive measures.

To mask or not to mask: Debunking the myths of mask-wearing during COVID-19 across cultures

Mask-wearing is the simplest yet most effective preventive behavior during COVID-19. However, it has sparked great controversy, particularly in America. Little is known about what psychosocial factors predict people’s decision to mask. This research challenges three myths about mask-wearing. First, does mask-wearing provide a false sense of security? Second, is knowledge of COVID-19 a more robust predictor than political ideology of mask-wearing behavior? Third, does resistance to masks reflect anti-authoritarianism or a lack of trust in government? With nationally representative samples across two cultures (N = 1,121), findings reveal a significant positive correlation between mask-wearing and other preventive behaviors. Moreover, knowledge of COVID-19 and trust in government significantly predicted mask-wearing. Implications of the results are also discussed in the cross-cultural context. Critically, findings could provide practical implications for public education and policymaking by uncovering how to more effectively promote compliance with recommended preventive behaviors during our ongoing struggle with COVID-19.

The role of risk perception, risk communication, and demographic factors in COVID-19 preventive behaviors: an online survey in Iran

Objectives

This study investigated preventive behaviors toward coronavirus disease 2019 (COVID-19) and related factors in a Kurdish Iranian sample.

Methods

This online survey was conducted among the population aged 18 and above in Kermanshah Province, in western Iran, in April 2020. Samples were invited and recruited through social media. Data were collected using a questionnaire consisting of 4 sections (questions on demographic variables, risk perception, risk communication, and COVID-19 preventive behaviors) and analyzed using Stata ver. 8.

Results

The Pearson correlation test showed that risk communication was significantly correlated with COVID-19 preventive behaviors (r=0.320, p<0.01). In the final model, where the explanatory power increased with the entry of the risk communication variable, the variables explained a total of 14% of variance in COVID-19 preventive behaviors. Sex (β=−0.482), risk perception (β=0.047), and risk communication (β=0.662) were significant determinants.

Conclusion

Risk communication and risk perception related to COVID-19, as well as being a woman, were determinants of COVID-19 preventive behaviors.

Differences in comprehending and acting on pandemic health risk information: a qualitative study using mental models

BACKGROUND

A worldwide pandemic of a new and unknown virus is characterised by scientific uncertainty. However, despite this uncertainty, health authorities must still communicate complex health risk information to the public. The mental models approach to risk communication describes how people perceive and make decisions about complex risks, with the aim of identifying decision-relevant information that can be incorporated into risk communication interventions. This study explored how people use mental models to make sense of scientific information and apply it to their lives and behaviour in the context of COVID-19.

METHODS

This qualitative study enrolled 15 male and female participants of different ages, with different levels of education and occupational backgrounds and from different geographical regions of Norway. The participants were interviewed individually, and the interview data were subjected to thematic analysis. The interview data were compared to a expert model of COVID-19 health risk communication based on online information from the Norwegian Institute of Public Health. Materials in the interview data not represented by expert model codes were coded inductively. The participants' perceptions of and behaviours related to health risk information were analysed across three themes: virus transmission, risk mitigation and consequences of COVID-19.

RESULTS

The results indicate that people placed different meanings on the medical and scientific words used by experts to explain the pandemic (e.g., virus transmission and the reproduction number). While some people wanted to understand why certain behaviour and activities were considered high risk, others preferred simple, clear messages explaining what to do and how to protect themselves. Similarly, information about health consequences produced panic in some interviewees and awareness in others.

CONCLUSION

There is no one-size-fits-all approach to public health risk communication. Empowering people with decision-relevant information necessitates targeted and balanced risk communication.

Health Beliefs, Trust in Media Sources, Health Literacy, and Preventive Behaviors among High-Risk Chinese for COVID-19

The coronavirus disease (COVID-19) broke out in China in January 2020 and has been effectively controlled in April 2020 after China's relentless efforts. People's engagement in disease-related preventive behaviors is crucial in containing such infectious disease. Vulnerable populations often have higher chances of developing severe illness from COVID-19 and the mortality rate is also higher. Thus, at-risk populations for COVID-19 request extra attention. The current study conducted a national online survey among vulnerable populations in China in early February 2020 to examine their engagement in coronavirus-related preventive health behaviors (e.g., frequent handwashing) and the potential determinants including factors from the Health Belief Model, trust in different media sources, and health literacy. The results suggested that the vulnerable populations' engagement in coronavirus-related preventive behaviors were significantly associated with barriers, benefits, self-efficacy, trust in doctors' social media, and trust in TV for COVID-19-related information. Besides, barriers, benefits, self-efficacy, trust in doctors' social media, and trust in TV mediated the effects of health literacy on preventive behaviors. Our findings provided directions for future health promotions and interventions targeting vulnerable populations to enhance their preventive behaviors in China.

Health awareness of rural households towards COVID-19 pandemic in India: Evidence from Rural Impact Survey of the World Bank

This paper aims at analysing the level of awareness of the symptoms and the methods of protection from COVID-19 based on the Rural Impact Survey of the World Bank, collected from 5200 households belonging to six states in India that is, Andhra Pradesh, Bihar, Jharkhand, Madhya Pradesh, Rajasthan, and Uttar Pradesh. Data has been analysed using chi-square test and regression analysis. Results of the analysis indicate that about 70.8% rural households are aware of the symptom of coronavirus, and 81.9% are aware of the preventive measures for controlling the spread of COVID-19. Analysis indicates a significant association between awareness level on symptoms and prevention of COVID-19 and socio-demographics and location. The study further analyses the key determinants of awareness of COVID-19 symptoms and preventive measures using the logistics regression model, indicating that age, gender, education, income, poverty status, access to information, cash relief and medical services are the determining factors of health awareness on COVID-19 pandemic among rural households in India. Considering the importance of self-protecting measures in fighting the pandemic, this paper highlights the importance of strengthening public awareness for containing the spread of the COVID-19 pandemic.

The role of information quality, trust and anxiety on intention to buy food supplements at the time of COVID-19 outbreak

Purpose

The purpose of this study is to analyze the factors affecting consumer`s intention to buy food supplements during COVID-19 pandemic using the expanding theory of planned behavior model. The variables of perceived information quality, trust and anxiety are integrated in the model of this study.

Design/methodology/approach

A total of 553 valid questionnaire responses were collected via an online survey in the epicenter of the pandemic in Indonesia, such as Jakarta and surrounding cities. To evaluate the causal links between latent variables, structural equation modeling was adopted using LISREL software. Before the research hypothesis had been tested, validity and reliability analysis was carried out to make sure the measurement can be used.

Findings

The findings indicate that perceived information quality influences trust and anxiety, and then both of them influence attitude toward food supplements. Moreover, the intentions to buy food supplements are determined by the consumer`s attitude.

Research limitations/implications

This study assumes all consumers have similar access to information because they are living in the greater Jakarta. Nevertheless, in fact, the access of information is not similar between age groups and locations. Future research may wish to differentiate evaluations of a full-information group from those of the limited-information groups.

Originality/value

This study provides a model of consumers` buying intentions toward food supplement products in the time of a health crisis such as the COVID-19 pandemic as a novelty. The implications of this study provide meaningful direction for marketing decisions and policy interventions in developing food supplement industries.

Government Trust and Motivational Factors on Health Protective Behaviors to Prevent COVID-19 Among Young Adults

Objective: The purpose of this study was to determine the influence of government trust on young adults’ adoption of health behaviors to prevent infection with the SARS-CoV-2 virus.

Method: We tested the hypothesis that government trust would directly and indirectly (through worry/fear and subjective norms) influence the adoption of health-protective behaviors. A sample of 1,136 university students completed a web survey after Chile’s first wave of infections.

Results: The results indicate that low government trust only indirectly (through subjective norms) influenced health-protective behaviors. Conversely, worry/fear was the primary motivating factor for adopting health-protective behaviors in young adults, followed by subjective norms.

Conclusion: In scenarios where people perceive low government trust, emotions and social norms are the motivational factors with the most significant predictive power on the adoption of health-protective behaviors.

Measuring the Impact of Greece as a Safe Branding Tourist Destination: Evidence from Spain and Greece

After the first wave of the COVID-19 outbreak, many tourist destinations promoted a safe, COVID-free image to attract tourists. The main purpose of this paper is to examine and analyze the effect that the image of a place as a safe tourist destination (STD)—in our case, Greece—can have on the decision-making processes of tourists who were willing to take summer holidays in 2020 amid the COVID-19 pandemic. We examined the relationships between destination safety perceptions, trust, attractive attributes of destinations, travel intentions, and health-protective behavior for domestic and inbound tourists from Spain. This study confirms differences in destination safety perceptions among domestic and inbound tourists from countries that have suffered significant negative impacts due to the novel coronavirus.

What makes Dutch youth comply with preventive COVID-19 measures? An explorative study

The measures to contain the spread of COVID-19 are challenging for youth, especially the social isolation measures. These measures are antagonistic to healthy youth development, which requires sufficient social contact with peers and adults. This explorative study examined what factors are associated with adherence to COVID-19 measures in a sample of Dutch youth (N = 263; 79.8% female) with ages ranging between 16 and 24 years (M = 21.1 years; SD = 2.44 years), who completed an online questionnaire about their compliance to measures, resilience, coping strategies, mental health, and availability of a natural mentor. Results showed that youth with fewer depressive symptoms adhered better to measures of social distance. Youth who were less suspicious, more resilient, and those with an active coping strategy or a natural mentor more often complied with COVID-19 measures. These results can be used to help youth comply with the COVID-19 measures.

In Whom Do We Trust? A Multifoci Person-Centered Perspective on Institutional Trust during COVID-19

Institutional trust plays a crucial role when a nation is facing mega crises (e.g., the COVID-19 pandemic) and has implications for employee work experiences and well-being. To date, researchers largely consider how institutional trust or trust in government may predict variables of interest in isolation. However, this variable-centered perspective ignores the possibility that there are subpopulations of employees who may differ in their trust in different institutions (i.e., the state government, the federal government). To address this, we examined institutional trust with two foci (i.e., trust in state government and trust in federal government) from a person-centered perspective. Using latent profile analysis and data from 492 U.S.-based employees, we identified five trust profiles: high trustors, federal trustors, state trustors, the ambivalent, and distrusters, and found that these profiles differentially predicted attitudes towards and behavioral compliance with CDC recommended COVID-19 prevention practices, job insecurity, affective commitment, helping behavior, and psychological well-being.

Source of Information on Intentions to Adopt Protective Behaviours During COVID-19 in China

Introduction: COVID-19 spread across China and other countries in a matter of weeks. Yet, it is uncertain how people have responded to protective behaviours in this pandemic. This study aims to evaluate how trust in different types of information sources influences the intention to adopt protective behaviours. Methods: In total, 122 Chinese completed a survey on Qualtrics in March 2021. Data on demographic information, protective behaviours, trust in formal information, trust in informal information, perceived risk, worry and social desirability were collected. Structural equation modelling (SEM) was used to identify associations between these variables. Results: Trust in formal information was significantly associated with perceived risk (β = -.18) and significantly and positively associated with worry (β = .28). Trust in informal information was significantly and positively associated with perceived risk (β = .57). Subsequently, perceived risk was significantly associated with social distancing (β = -.17), and worry was significantly and positively associated with mask wearing (β = .25) and significantly associated with hand washing (β = -.27). Trust in formal information was significantly and positively associated with hand washing (β = .26) while trust in informal information was significantly and positively associated with social distancing and hand washing (β = .26). Perceived risk was significantly and positively associated with worry (β = .32). Conclusion: People who trust in informal information from social media and interpersonal communication would be more likely to adopt mask wearing and hand washing protective behaviours. People who trust in formal information from government-agency source would have a lower perceived risk of COVID-19 and are less likely to adopt social distancing, but people who trust in formal information have a greater worry about contracting COVID-19 and are more likely to wear masks.

Antecedents of self-protective behavior during the COVID-19 pandemic in Bangladesh

CONTEXT

Self-protective behavior (SPB) plays a significant role in controlling the spread of infection of a pandemic like coronavirus disease (COVID-19). Little research has been conducted to examine critical factors influencing SPB, especially in a developing country like Bangladesh.

AIMS

This study aimed to develop and test a theoretical model based on the extended information-motivation-behavior (IMB) skills model to investigate factors associated with SPB among Bangladeshi people.

METHODS

An online, cross-sectional survey was conducted on Bangladesh citizens (18 years and older) from June 1 and July 31, 2020. A total of 459 responses were used to assess the proposed model's overall fit and test the hypothesized relationships among the model constructs.

STATISTICAL ANALYSIS USED

The data were analyzed using partial least squares structural equation modeling to identify relationships among model variables.

RESULTS

Health information-seeking behavior, health motivation, self-efficacy, and health consciousness (HC) (P < 0.05) had a significant impact on SPB among Bangladeshi people. The results identified the consequences of various degrees of HC on SPB in the COVID-19 outbreak.

CONCLUSIONS

This study confirms the IMB model's applicability for analyzing SPB among people in developing countries like Bangladesh. The findings of this study could guide policymakers to develop and implement targeted strategies to ensure timely and transparent information for motivating people to improve SPB during the COVID-19 and in case of a future outbreak of an epidemic.

The impact of COVID-19 on European tourists' attitudes to air travel and the consequences for tourist destination evoked set formation

We study how risk conditions derived from the COVID-19 pandemic may impact on both the desire to travel and intention to visit of tourists and, therefore, on different stages of the destination choice process. We analyse 5134 million flight searches and 379 million flight picks during 2020 for the 17 largest European tourism source markets. An unweighted index number is employed to measure the average variation for searches and picks, for the year 2020, in relation to the reference base period (year 2019). This is done for air travel in general and to Spain specifically. The study then proceeds to conduct an analysis of 17 international travel destinations that are in the evoked sets of the two largest outbound markets in Europe (Germany and UK). We also identify which markets are most favourable to Spain. The research design can inform cost-efficient marketing decisions in a situation of high uncertainty.

Citizen journalism reduces the credibility deficit of authoritarian government in risk communication amid COVID-19 outbreaks

During the outbreak of an epidemic, the success in risk communications to make the public comply with disease preventive measures depends on the public’s trust in the government. In this study, we aim to understand how media audiences update their trust in the government during the COVID-19 outbreak depending on the information they received. We conducted an online survey experiment in February 2020 in Hong Kong (n = 1,016) in which respondents were randomly provided with a government press release and an endorsement either from an official or a non-official source. This study shows that the information from a non-official source enhances the credibility of official government messages. Our findings imply that dictators can actually “borrow credibility” from their citizen journalists and even nondemocratic leaders can make themselves more trustworthy to potential dissenters through citizen journalism. Allowing information flow from non-official sources can be a practical measure for governments to address the problem of a credibility deficit during a pandemic.

Early and Later Perceptions and Reactions to the COVID-19 Pandemic in Germany: On Predictors of Behavioral Responses and Guideline Adherence During the Restrictions

In March 2020, the German government enacted measures on movement restrictions and social distancing due to the COVID-19 pandemic. As this situation was previously unknown, it raised numerous questions about people's perceptions of and behavioral responses to these new policies. In this context, we were specifically interested in people's trust in official information, predictors for self-prepping behavior and health behavior to protect oneself and others, and determinants for adherence to social distancing guidelines. To explore these questions, we conducted three studies in which a total of 1,368 participants were surveyed (Study 1 N=377, March 2020; Study 2 N=461, April 2020; Study 3 N=530, April 2021) across Germany between March 2020 and April 2021. Results showed striking differences in the level of trust in official statistics (depending on the source). Furthermore, all three studies showed congruent findings regarding the influence of different factors on the respective behavioral responses. Trust in official statistics predicted behavioral responses in all three studies. However, it did not influence adherence to social distancing guidelines in 2020, but in 2021. Furthermore, adherence to social distancing guidelines was associated with higher acceptance rates of the measures and being older. Being female and less right-wing orientated were positively associated with guidelines adherence only in the studies from 2020. This year, political orientation moderated the association between acceptance of the measures and guideline adherence. This investigation is one of the first to examine perceptions and reactions during the COVID-19 pandemic in Germany across 1year and provides insights into important dimensions that need to be considered when communicating with the public.

What influences people's responses to public health messages for managing risks and preventing infectious diseases? A rapid systematic review of the evidence and recommendations

BACKGROUND

Individual behaviour changes, such as hand hygiene and physical distancing, are required on a population scale to reduce transmission of infectious diseases such as COVID-19. However, little is known about effective methods of communicating risk reducing information, and how populations might respond.

OBJECTIVE

To synthesise evidence relating to what (1) characterises effective public health messages for managing risk and preventing infectious disease and (2) influences people's responses to messages.

DESIGN

A rapid systematic review was conducted. Protocol is published on Prospero CRD42020188704.

DATA SOURCES

Electronic databases were searched: Ovid Medline, Ovid PsycINFO and Healthevidence.org, and grey literature (PsyarXiv, OSF Preprints) up to May 2020.

STUDY SELECTION

All study designs that (1) evaluated public health messaging interventions targeted at adults and (2) concerned a communicable disease spread via primary route of transmission of respiratory and/or touch were included. Outcomes included preventative behaviours, perceptions/awareness and intentions. Non-English language papers were excluded.

SYNTHESIS

Due to high heterogeneity studies were synthesised narratively focusing on determinants of intentions in the absence of measured adherence/preventative behaviours. Themes were developed independently by two researchers and discussed within team to reach consensus. Recommendations were translated from narrative synthesis to provide evidence-based methods in providing effective messaging.

RESULTS

Sixty-eight eligible papers were identified. Characteristics of effective messaging include delivery by credible sources, community engagement, increasing awareness/knowledge, mapping to stage of epidemic/pandemic. To influence intent effectively, public health messages need to be acceptable, increase understanding/perceptions of health threat and perceived susceptibility.

DISCUSSION

There are four key recommendations: (1) engage communities in development of messaging, (2) address uncertainty immediately and with transparency, (3) focus on unifying messages from sources and (4) frame messages aimed at increasing understanding, social responsibility and personal control. Embedding principles of behavioural science into public health messaging is an important step towards more effective health-risk communication during epidemics/pandemics.

COVID-19-related knowledge, risk perception, information seeking, and adherence to preventive behaviors among undergraduate students, southern Iran

Globally, the novel COVID-19 has been recognized as one of the most important pandemics and devastating diseases in human history, with many deaths and morbidities. In the absence of effective treatment and limited supply of COVID-19 vaccine, people must adhere to recommended preventive measures. This study aimed to determine the level of COVID-19 knowledge, perceived susceptibility, perceived severity, and health information-seeking and preventive behaviors as well as associated factors with preventive behaviors in a sample of Iranian students at Persian Gulf University. Data was collected using an online structured and validated questionnaire. Descriptive statistics, the Mann-Whitney U, Chi-square, and Spearman correlation tests were applied to analyze data. The significance level was set at P < 0.05. In total, 98% (319/325) of the participants completed the survey. A majority of participants were aware of the three main COVID-19 symptoms: fever, dry cough, and shortness of breath, while half of them were unaware of gastrointestinal problems caused by COVID-19. More than half of the subjects had a low perceived susceptibility and severity toward COVID-19. Most of the participants engaged in preventive behaviors and got COVID-19 information from social media and the Internet. Preventive behavior was associated with perceived susceptibility (P = 0.015), perceived severity (P = 0.014), and health information seeking (P < 0.001) of individuals toward COVID-19. The results of our research can help health authorities develop health promotion programs for student populations by providing baseline data.

It won't happen to me! Psychosocial factors influencing risk perception for respiratory infectious diseases: A scoping review

Understanding the determinants of risk perception for COVID-19 might help to promote self-preventive behaviours. This scoping review aimed to map the extent, variety and characteristics of the evidence on the possible determinants of risk perception for COVID-like diseases. PubMed, Scopus and Web of Science were searched for original, peer-reviewed English-written articles published up to March 2020 and investigating risk perception determinants for respiratory infectious diseases in adults. Titles and abstracts were screened, and full texts were analysed by the first author; when unsure, eligibility was discussed with the last author. Data were collected according to an extraction sheet developed by the first and last authors. The cross-sectional evidence covers a variety of diseases, countries and timings of testing. Mostly, questionnaires recorded socio-demographics, media exposure, trust in institutions, disease proximity and knowledge; psychological variables, including personality traits, distress and self-efficacy, were less investigated. A miscellaneous operationalization of risk perception emerged, including the likelihood of getting sick, perceived dangerousness, concerns or a combination of them. A comprehensive understanding of the substantial amount of evidence may be challenging due to methodological heterogeneity. Referring to uniform theoretical frameworks is recommended; also, longitudinal research may be implemented to probe causal relationships.

The effect of information-seeking behaviours on prevention behaviour implementation during the COVID-19 pandemic: mediating effects of anxiety and fear

OBJECTIVES

Identifying determinants of prevention behaviours during the emergence of a new infectious disease is important. We investigated the associations between information-seeking and prevention behaviours during the coronavirus disease 2019 (COVID-19) pandemic and mediating effects of psychiatric factors.

METHODS

In total, 1,970 participants from the Cardiovascular and Metabolic Etiology Research Center cohort participated in an online survey 55 days after the first COVID-19 case in Korea was diagnosed. Time spent seeking information related to COVID-19; information sources; psychiatric factors, including anxiety, depression, post-traumatic stress symptoms (PTSS), and the fear of COVID-19; and prevention behaviours were examined. The mediating effect of psychiatric factors was estimated using mediation analysis.

RESULTS

Time spent seeking information and information sources affected several behavioural responses. In men, anxiety mediated associations between information-seeking and prevention behaviours, including purchasing sanitary supplies (effect size [ES], 0.038; 95% confidence interval [CI], 0.002 to 0.095) and hoarding (ES, 0.029; 95% CI, 0.002 to 0.068). The fear of COVID-19 also mediated associations between information-seeking and prevention behaviours including refraining from going out (men: ES, 0.034; 95% CI, 0.009 to 0.068; women: ES, 0.052; 95% CI, 0.030 to 0.080), wearing face masks (men: ES, 0.085; 95% CI, 0.031 to 0.184), avoiding public transportation (men: ES, 0.020; 95% CI, 0.000 to 0.044; women: ES, 0.031; 95% CI, 0.015 to 0.051), hoarding (women: ES, 0.051; 95% CI, 0.029 to 0.792), and trying alternative remedies (men: ES, 0.024; 95% CI, 0.004 to 0.053). Depressive symptoms and PTSS did not have any mediating effects.

CONCLUSIONS

While the availability of information related to COVID-19 can help prevent infections, it can also promote anxiety and fear, leading to negative behaviours such as hoarding and trying unverified alternative treatments.

Trust in experts, not trust in national leadership, leads to greater uptake of recommended actions during the COVID-19 pandemic

Evidence suggests that people vary in their desire to undertake protective actions during a health emergency, and that trust in authorities may influence decision making. We sought to examine how the trust in health experts and trust in White House leadership during the COVID-19 pandemic impacts individuals' decisions to adopt recommended protective actions such as mask-wearing. A mediation analysis was conducted using cross-sectional U.S. survey data collected between March 27 and 30, 2020, to elucidate how individuals' trust in health experts and White House leadership, their perceptions of susceptibility and severity to COVID-19, and perceived benefits of protecting against COVID-19, influenced their uptake of recommended protective actions. Trust in health experts was associated with greater perceived severity of COVID-19 and benefits of taking action, which led to greater uptake of recommended actions. Trust in White House leadership was associated with lower perceived susceptibility to COVID-19 and was not associated with taking recommended actions. Having trust in health experts is a greater predictor of individuals' uptake of protective actions than having trust in White House leadership. Public health messaging should emphasize the severity of COVID-19 and the benefits of protecting oneself while ensuring consistency and transparency to regain trust in health experts.

A study of self-precaution against the background of the COVID-19 pandemic from the perspective of risk perception attitude theory and social support

BACKGROUND

In this research, the factors that influence the self-precautionary behavior during the pandemic are explored with the combination of social support and a risk perception attitude framework.

METHODS

An online survey was conducted among 429 members to collect information on demographic data, social support, perceptions of outbreak risk, health self-efficacy, and self-precautionary behaviors with the guide of the Social Support Scale, the COVID-19 Risk Perception Scale, the Health Self-Efficacy Scale and the Self-precautionary Behavior Scale.

RESULTS

The research shows that among the three dimensions of social support, both objective support and support utilization negatively predict risk perception, while subjective support positively predicts health self-efficacy; health self-efficacy and risk perception significantly predict self-precautionary behavior; the relationship between risk perception and self-precautionary behavior is significantly moderated by health self-efficacy.

CONCLUSIONS

The combined influence of social capital and risk perception attitudinal frameworks on self-precautionary behavior is highlighted in this study, with the relationship between the public's risk perception, health self-efficacy, and self-precautionary behavior intentions examined against the background of coronavirus disease 2019 (COVID-19). These findings contribute to understanding the impact of social capital factors on risk perception and health self-efficacy, which provides insight into the current status and influencing factors of the public's precautionary behavior and facilitates early intervention during a pandemic.

Levels of Trust in Information Sources as a Predictor of Protective Health Behaviors During COVID-19 Pandemic: A UAE Cross-Sectional Study

Health information sources and the level of trust in a particular source may influence the subsequent adoption of advocated health behaviors. Information source preference and levels of trust are also likely to be influenced by sociodemographic (culture, age, gender) variables. Understanding these source-trust-behavior relationships across various national and cultural contexts is integral to improved health messaging. The present study identified the sources most frequently consulted to obtain information about COVID-19 during the pandemic's early stages in the United Arab Emirates (UAE). The study quantified levels of trust across an array of information sources, factoring in sociodemographic variables. Finally, the study explored the relationship between sociodemographic variables, levels of trust in information sources, and the adoption of COVID-19 related protective behaviors. Participants (n = 1585) were recruited during the first 2 weeks of April 2020 via announcements in the UAE media and through email networks. All participants completed a web-based survey presented in English or Arabic, as preferred. The most frequently consulted information sources were websites (health information websites), social media, government communications, and family and friends. The sources rated most trustworthy were: personal physicians, health care professionals, and government communications. There were differences in the use of sources and levels of trust according to age, gender, and education. The levels of trust in sources of information were associated with the adoption of protective behaviors, significantly so for citizens of the UAE. These findings may help inform the improvement of pandemic-related health messaging in multicultural contexts.

Health authorities' health risk communication with the public during pandemics: a rapid scoping review

BACKGROUND

Responses from the H1N1 swine flu pandemic and the recent COVID-19 coronavirus pandemic provide an opportunity for insight into the role of health authorities' ways of communicating health risk information to the public. We aimed to synthesise the existing evidence regarding different modes of communication used by health authorities in health risk communication with the public during a pandemic.

METHODS

We conducted a rapid scoping review. MEDLINE and EMBASE were searched for publications in English from January 2009 through October 2020, covering both the full H1N1 pandemic and the response phase during the COVID-19 pandemic. The search resulted in 1440 records, of which 48 studies met our eligibility criteria.

RESULTS

The present review identified studies across a broad interdisciplinary field of health risk communication. The majority focused on the H1N1 pandemic and the COVID-19 pandemic. A content analysis of the studies identified three categories for modes of communication: i) communication channels, ii) source credibility and iii) how the message is communicated. The identified studies on social media focused mainly on content and engagement, while studies on the effect of the use of social media and self-protective behaviour were lacking. Studies on the modes of communication that take the diversity of receivers in the field into account are lacking. A limited number of studies of health authorities' use of graphic and audio-visual means were identified, yet these did not consider/evaluate creative communication choices.

CONCLUSION

Experimental studies that investigate the effect of health authorities' videos and messages on social media platforms and self-protective behaviour are needed. More studies are needed across the fields of health risk communication and media studies, including visual communication, web design, video and digital marketing, at a time when online digital communication is central to reaching the public.

The role of race and scientific trust on support for COVID-19 social distancing measures in the United States

Pundits and academics across disciplines note that the human toll brought forth by the novel coronavirus (COVID-19) pandemic in the United States (U.S.) is fundamentally unequal for communities of color. Standing literature on public health posits that one of the chief predictors of racial disparity in health outcomes is a lack of institutional trust among minority communities. Furthermore, in our own county-level analysis from the U.S., we find that counties with higher percentages of Black and Hispanic residents have had vastly higher cumulative deaths from COVID-19. In light of this standing literature and our own analysis, it is critical to better understand how to mitigate or prevent these unequal outcomes for any future pandemic or public health emergency. Therefore, we assess the claim that raising institutional trust, primarily scientific trust, is key to mitigating these racial inequities. Leveraging a new, pre-pandemic measure of scientific trust, we find that trust in science, unlike trust in politicians or the media, significantly raises support for COVID-19 social distancing policies across racial lines. Our findings suggest that increasing scientific trust is essential to garnering support for public health policies that lessen the severity of the current, and potentially a future, pandemic.

One Hundred and Sixty-One Days in the Life of the Homopandemicus in Serbia: The Contribution of Information Credibility and Alertness in Predicting Engagement in Protective Behaviors

COVID-19 pandemic is a long-lasting process associated with dynamic changes within society and in individual psychological responses. Effective communication of measures by credible sources throughout the epidemic is one of the crucial factors for the containment of the disease, and the official communication about pandemics is straightforwardly directed toward changes in behavior via engagement in (self-)protective measures. Calls for the adherence to these measures are aimed at the general population, but people's reactions to these calls vary depending on, for example, their individual differences in cognitive and emotional responses to the situation. The focus of our study was the general narrative about the epidemic as conveyed by both state officials and media outlets in times of decreased social contacts due to the quarantine, in which relying on these sources of information is even more pivotal. Our aim was to explore the stability of the proposed mediational model during the course of the epidemic in Serbia. In the model, we tested the relationship between perceived credibility of information (PCI) and two types of protective behavior-the actual self-protective behavior (ASPB) and the hypothetical protective behavior (HPB), as well as the potential mediating role of alertness in these relationships time-wise. A cross-sectional study (N = 10,782, female = 79.1%) was being administered daily during the first epidemic wave and in three more 2-week time frames during the second wave. Based on the variability of these measures during the first epidemic wave, three stages of psychological responses were mapped (acute, adaptation, and relaxation stage), which were observed, with some deviations, also in the second wave. The mediational model was relatively robust after the initial few weeks, but the strength of pairwise relationships was more changeable. With both types of protective behaviors, the predictive power of PCI was partially mediated through alertness. This suggests that, while individual differences in cognitive and affective responses are important, so is coherent, focused, and credible communication in all stages of the epidemic, which emphasizes the communality aspect of the social containment of the infection. Our findings can thus be valuable in informing the planning of effective future communication.

Adaption of distance learning to continue the academic year amid COVID-19 lockdown

This work investigates the use of distance learning in saving students' academic year amid COVID-19 lockdown. It assesses the adoption of distance learning using various online application tools that have gained widespread attention during the coronavirus infectious disease 2019 (COVID-19) pandemic. Distance learning thrives as a legitimate alternative to classroom instructions, as major cities around the globe are locked down amid the COVID-19 pandemic. To save the academic year, educational institutions have reacted to the situation impulsively and adopted distance learning platforms using online resources. This study surveyed random undergraduate students to identify the impact of trust in formal and informal information sources, awareness and the readiness to adopt distance learning. In this study, we have hypothesized that adopting distance learning is an outcome of situational awareness and readiness, which is achieved by the trust in the information sources related to distance learning. The findings indicate that trust in information sources such as institute and media information or interpersonal communication related to distance learning programs is correlated with awareness (β = 0.423, t = 12.296, p = 0.000) and contribute to readiness (β = 0.593, t = 28.762, p = 0.001). The structural model path coefficient indicates that readiness strongly influences the adoption of distance learning (β = 0.660, t = 12.798, p = 0.000) amid the COVID-19 pandemic. Our proposed model recorded a predictive relevance (Q²) of 0.377 for awareness, 0.559 for readiness, and 0.309 for the adoption of distance learning, which explains how well the model and its parameter estimates reconstruct the values. This study concludes with implications for further research in this area.

Assessment of early COVID-19 compliance to and challenges with public health and social prevention measures in the Kingdom of Eswatini, using an online survey

Public health and social measures have been implemented around the world in a bid to prevent the spread of COVID-19. Public compliance with these measures is key in successfully controlling the pandemic. This online survey assessed the compliance and attitude of adults residing in the southern African Kingdom of Eswatini to government protection, activity and travel measures aimed at controlling the spread of COVID-19. A rapid online survey, comprising of 28 questions, was administered in May 2020. More than 90% of respondents knew the virus could kill anyone and most respondents (70%) reported to be compliant to public health and social measures. Females, those who did not use public transport and those aged 30 years and above were significantly (p<0.01) more compliant, particularly to protective and travel measures. Social media, television and official government websites were the primary source of ongoing COVID-19 information for respondents of this online survey, and these methods should continue to be employed to reach the public who regularly use the internet. More than half of essential workers who responded to the online survey reported to have their own personal protective equipment; however, 32% either did not have any protective equipment or shared their equipment with other staff members. Due to the survey being online, these results should not be generalised to populations of low socioeconomic status.

Psychological Factors Affecting Risk Perception of COVID-19: Evidence from Peru and China

COVID-19 has spread around the world, causing a global pandemic, and to date is impacting in various ways in both developed and developing countries. We know that the spread of this virus is through people’s behavior despite the perceived risks. Risk perception plays an important role in decision-making to prevent infection. Using data from the online survey of participants in Peru and China (N = 1594), data were collected between 8 July 31 and August 2020. We found that levels of risk perception are relatively moderate, but higher in Peru compared to China. In both countries, anxiety, threat perception, self-confidence, and sex were found to be significant predictors of risk perception; however, trust in the information received by government and experts was significant only in Peru, whereas self-confidence had a significant negative effect only for China. Risk communication should be implemented through information programs aimed at reducing anxiety and improving self-confidence, taking into consideration gender differences. In addition, the information generated by the government should be based on empirical sources. Finally, the implications for effective risk communication and its impacts on the health field are discussed.

Worldviews, trust, and risk perceptions shape public acceptance of COVID-19 public health measures

Because of the outbreak of COVID-19, most countries have implemented measures aimed at reducing the number of infected people. However, these measures only work if they are generally accepted by the public. We conducted a two-wave longitudinal survey in Switzerland (n = 1,223) to study the factors that would influence perceived risks and the acceptance of the measures. Our findings showed that people with individualistic worldviews, high general interpersonal trust, low social trust, a low level of perceived risks, and the conviction that risks other than health risks were neglected had less acceptance of the implemented measures compared with people who held the opposite views on the mentioned variables. The number of infected people declined between survey waves 1 and 2. This desired effect not only reduced people's perceived risks but also decreased their social trust and increased the conviction that other risks were neglected. Finally, the acceptance of the measures declined. Our data also support the idea that reduced risk perceptions and a decline in social trust are important drivers for the reduction in the acceptance of the measures in survey wave 2. Our results suggest that as soon as the measures attain success or the public is tired of the implemented restrictions, public acceptance declines, and it seems difficult to prolong the measures as may be desirable from an epidemiological standpoint. The importance of worldviews and trust for public acceptance of the measures further suggests the necessity of a political discussion about the implemented measures.

How Trust in Information Sources Influences Preventative Measures Compliance during the COVID-19 Pandemic

This paper explores how trust in formal information sources (government and media) and informal information sources (interpersonal) about COVID-19 influences compliance with preventive measures. This cross-sectional study uses convenience sampling of 478 adult participants. Data analyses using structural equation modeling with multigroup comparisons examine hypothesized relationships between trust in information sources and preventative behaviors and social distancing. Results suggest that understanding of COVID-19 causes is related to trust in formal information sources, but not to trust in informal information. Self-efficacy for prevention is related to trust in informal information sources, but not to trust in formal information sources. Worry about contracting COVID-19 is related to trust in formal information sources, but not to informal ones. Engaging in preventive measures is linked to both self-efficacy for prevention and worry, while social distancing was related only to worry. These findings have important implications for public health policy guidelines centered on clear and truthful media messages. The findings also facilitate comparative analyses of reactions to information sources across a decade of evolving attitudes toward media and government, between two cultures (Hong Kong vs. the USA), and between two different global pandemics.

Reactions of older Swiss adults to the COVID-19 pandemic: A longitudinal survey on the acceptance of and adherence to public health measures

RATIONALE

An important public health strategy during the COVID-19 pandemic was the protection of people at risk of severe progressions of an infection; namely, older people and people with pre-existing conditions.

OBJECTIVE

To improve public health communication, it is vital to understand, which sociodemographic and psychological factors drive older people's acceptance of and compliance with public health measures.

METHOD

This goal was pursued in this three-wave longitudinal online study with older adults, collected between March and June during the COVID-19 pandemic in 2020 (N = 327; first and second wave during the national lockdown; third wave: after the lifting of most lockdown measures).

RESULTS

The results show that overall acceptance of and adherence to the public health measures were high among older adults and even more so for people with pre-existing conditions (e.g., cancer, type II diabetes). However, some infringements of the measures were observed, and the longitudinal analyses suggest that increases in social trust positively influenced acceptance of measures over time, while trivialising beliefs and health fears impacted older adults' compliance with protective measures over time.

CONCLUSIONS

This study offers insights into the behavioural responses of older adults to an ongoing threat and the associated uncertainty that is part of public communication about the pandemic and protective measures.

The Impact of Trust and Risk Perception on the Acceptance of Measures to Reduce COVID-19 Cases

The SARS-CoV-2 virus that causes COVID-19 has had a large impact on the lives of many people worldwide. At the peak of confirmed COVID-19 cases during the first wave in Switzerland (March-April 2020), we conducted a survey in the German-speaking part of the country (N = 1,585). The results suggest that the implemented measures are accepted. The survey participants are more concerned that other family members could catch the virus compared with themselves, and they are worried about its economic impact. The results suggest that how trust is measured is crucial because general trust and social trust have opposite effects on the participants' risk perceptions. People with high general trust perceive less risks associated with COVID-19 compared with people who have low general trust, and people with high social trust perceive more risks compared with people who have low social trust. The results further indicate that perceived risks are important drivers for the acceptance of the government's implemented measures to control COVID-19 and for more precautionary behavior (i.e., contact with fewer people and more hygienic behavior). Theoretical and practical implications of these findings are discussed.

Predicting engagement in behaviors to reduce the spread of COVID-19: the roles of the health belief model and political party affiliation

Efforts to control the spread of COVID-19 within the United States have been compromised by varying levels of engagement in preventive behaviors, such as mask wearing, social distancing and vaccine uptake. The purpose of this study was to evaluate potential predictors of both (1) engagement in behaviors aimed at reducing the spread of COVID-19 and (2) intention to get vaccinated against COVID-19. It was hypothesized that Health Belief Model (HBM) constructs would predict each outcome. Additionally, given the politicization of the pandemic in the US, HBM constructs were considered as possible mediators of a relationship between political party affiliation and each outcome. A total of 205 participants completed an online survey, and data from 186 were analyzed using linear and ordinal regressions. Findings indicate that greater perceived response efficacy predicted greater engagement in preventive behaviors and intention to get vaccinated. Other HBM constructs were not significant predictors of either outcome. Mediation analyses indicated that affiliation with the Republican Party predicted reduced engagement in preventive health behaviors and vaccination intention, although effects were fully and partially mediated by lower levels of response efficacy. Understanding the predictors of adherence to recommended strategies is essential to developing effective public health campaigns that address risk factors for non-adherence and target those least likely to adhere. Public health interventions aimed at reducing the spread of COVID-19 in the US should emphasize the efficacy of preventive behaviors and encourage public trust in the safety and efficacy of the COVID-19 vaccines, particularly among Republicans.

Canadian university students' perceptions of COVID-19 severity, susceptibility, and health behaviours during the early pandemic period

Objectives

We surveyed university students to assess their demographic factors, perceived severity, personal susceptibility, and the adoption of health behaviours in relation to COVID-19.

Study design

Ethics approval was obtained from the University of Toronto’s Research Ethics Board (#39169). Responses were collected between March 20 and April 17, 2020, capturing the first month of government-mandated social distancing in Ontario, Canada.

Methods

We distributed the online survey to the University of Toronto student population, yielding a total convenience sample of 592 participants. We summarised the results and conducted Mann-Whitney U and Kruskal-Wallis tests to explore relationships between demographic data and perceived severity of COVID-19. Pearson’s Chi-square tests were used to explore the relationship between demographic variables and perceived susceptibility, with phi being used to explore the strength of the association. A value of p ​< ​0.05 was used to determine significance.

Results

The majority of participants (60.1%) judged COVID-19 to be Very Severe; there was a significant relationship between being female and the adoption of new health behaviours. 57.4% indicated they felt susceptible to COVID-19, while 40.9% did not. Feeling susceptible was associated with studying a healthcare field or being personally affected by COVID-19. Individuals who stated they were not susceptible to COVID-19 declared mitigating factors such as new health behaviours to be a major driver in their perception.

Conclusion

University students believe COVID-19 is a severe disease and have adopted new and increased health behaviours to mitigate the spread. While this study demonstrates differing health behaviour adoption rates based upon demographic factors, overall this research finds young adults supportive and accepting of government policy as a protective and susceptibility-mitigating measure.

•

The majority of participants judged COVID-19 to be very severe.

•

Females more likely than other genders to adopt new health behaviours.

•

Perceptions of personal susceptibility to COVID-19 varied.

•

New health behaviours named as key mitigating factor for judged susceptibility.

Association of Perceived Threat, Negative Emotions, and Self-Efficacy With Mental Health and Personal Protective Behavior Among Chinese Pregnant Women During the COVID-19 Pandemic: Cross-sectional Survey Study

BACKGROUND

COVID-19 is an emerging infectious disease that has created health care challenges worldwide. Pregnant women are particularly affected by this disease.

OBJECTIVE

The aims of this study are to assess the levels of perceived threat (susceptibility, severity, impact), negative emotions (fear, worry), and self-efficacy of pregnant women in China related to COVID-19 and to examine their associations with mental health (depression and anxiety) and personal protective behavior (wearing a face mask).

METHODS

A total of 4087 pregnant women from China completed a cross-sectional web-based survey between March 3 and 10, 2020.

RESULTS

The prevalence of probable depression and anxiety was 48.7% (1989/4087) and 33.0% (1347/4087), respectively; 23.8% participants (974/4087) reported always wearing a face mask when going out. Of the 4087 participants, 32.1% (1313) and 36.4% (1490) perceived themselves or their family members to be susceptible to COVID-19 infection, respectively; 3216-3518 (78.7%-86.1%) agreed the disease would have various severe consequences. Additionally, 2275 of the 4087 participants (55.7%) showed self-efficacy in protecting themselves from contracting COVID-19, and 2232 (54.6%) showed efficacy in protecting their family members; 1303 (31.9%) reported a high level of fear of the disease, and 2780-3056 (68.0%-74.8%) expressed worry about various aspects of COVID-19. The results of the multivariate multinominal logistic regression analyses showed that perceived severity, perceived impact, fear, and worry were risk factors for probable depression and anxiety, while self-efficacy was a protective factor. The results of the multivariate logistic regression analysis showed that perceived susceptibility was associated with always wearing a face mask.

CONCLUSIONS

Chinese pregnant women showed high levels of mental distress but low levels of personal protective behavior during the COVID-19 pandemic. Interventions are needed to promote the mental health and health behavior of pregnant women during the pandemic.

Knowledge, socio-cognitive perceptions and the practice of hand hygiene and social distancing during the COVID-19 pandemic: a cross-sectional study of UK university students

BACKGROUND

During the first wave of the COVID-19 pandemic, social distancing and hand hygiene have been the primary means of reducing transmission in the absence of effective treatments or vaccines, but understanding of their determinants is limited. This study aimed to investigate knowledge and socio-cognitive perceptions, and their associations with such protective behaviours, in UK university students.

METHODS

A cross-sectional online survey of 293 students was undertaken on 13 May 2020. Survey questions addressed demographics, knowledge of the disease and effectiveness of the protective measures, risk perception, socio-cognitive perceptions (e.g. attitude, social support, and self-efficacy), habit, time factors and trust, as well as the hand hygiene and social distancing behaviours. Multiple linear regression was used to identify the strongest associations of potential determinants with behaviour.

RESULTS

Participants reported high levels of social distancing with 88.9% answering "Mostly" or "Always" for every activity, but only 42.0% reporting the same for all hand hygiene activities. Knowledge of the effectiveness of each activity in preventing transmission was high, with 90.7% and 93.5% respectively identifying at least 7 of 8 hand hygiene or 9 of 10 social distancing activities correctly. Habit (β = 0.39, p = 0.001) and time factors (β = 0.28, p = 0.001) were the greatest contributors to unique variance in hand hygiene behaviour, followed by ethnicity (β = - 0.13, p = 0.014) and risk perception (β = 0.13, p = 0.016). For social distancing behaviour, the determinants were self-efficacy (β = 0.25, p < 0.001), perceived advantages (β = 0.15, p = 0.022), trust in policy (β = 0.14, p = 0.026) and gender (β = - 0.14, p = 0.016). Regression models explained 40% hand hygiene and 25% social distancing variance.

CONCLUSIONS

This study indicated that communications about effectiveness of hand hygiene and social distancing behaviours had been effective in terms of knowledge acquisition. However, in the light of likely second waves of COVID-19, attention to maintaining social distancing behaviour and improving hand hygiene behaviour may need to address more difficult areas of changing habits, overcoming time factors and building trust, as well as interventions to increase self-efficacy and address risk perception concerns.

Factors associated with non-adherence to social distancing rules during the COVID-19 pandemic: a logistic regression analysis

BACKGROUND

On March 23, 2020, the government of the United Kingdom told the British people to stay home, an unprecedented request designed to limit the spread of the COVID-19 virus and stop the National Health Service from being overwhelmed.

METHODS

This study undertook a cross-sectional design to survey a convenience sample of 681 residents of North London on their social distancing (SD) behaviours, demographics, housing situation, politics, psychology and social support using an online questionnaire. Logistic regression was used to measure the associations between these explanatory factors and non-adherence to all SD rules and intentional non-adherence to SD rules.

RESULTS

The vast majority (92.8%) of participants did not adhere to all SD rules and nearly half (48.6%) engaged in intentional non-adherence of rules. The odds of not adhering to all SD rules increased if a participant was not identified as highly vulnerable to COVID-19 [OR = 4.5], had lower control over others' distancing [OR = .724], had lower control over responsibilities for which coming into contact with others was unavoidable [OR = .642], and if SD behaviours were reported after lockdown was first relaxed [OR = .261]. The odds of intentionally not adhering to SD rules increased if a participant had a lower intention to socially distance [OR = .468], had lower control over others' distancing [OR = .829], had a doctoral degree compared to a master's degree [OR = .332], a professional qualification [OR = .307], a bachelor's degree [OR = .361] or work-related qualification [OR = .174], voted for the UK Government compared to not voting for the Government [OR = .461], perceived higher normative pressure from neighbours [OR = 1.121] and had greater support from friends [OR = 1.465].

CONCLUSIONS

Non-adherence to all SD rules had a stronger association with vulnerability to COVID-19 and control over SD, whereas intentional non-adherence had a stronger association with intention and anti-social psychological factors. It is recommended that people living in high-risk environments, such as those living in houses of multiple occupancy, should be specially supported when asked to stay at home, and public health messaging should emphasise shared responsibility and public consciousness.

Knowledge, Perceived Beliefs, and Preventive Behaviors Related to COVID-19 Among Chinese Older Adults: Cross-Sectional Web-Based Survey

BACKGROUND

The COVID-19 pandemic continues to pose an international public health threat. Prevention is of paramount importance to protect the high-risk group of older adults until specific treatments for COVID-19 become available; however, little work has been done to explore factors that promote preventive behaviors among this population.

OBJECTIVE

This study aims to investigate the knowledge, perceived beliefs, and preventive behaviors towards COVID-19 of older adults in China and determine the factors that influence their practice of preventive behaviors.

METHODS

From February 19 to March 19, 2020, a cross-sectional, web-based survey was administered to Chinese older adults in all 31 provinces of mainland China using a convenience sampling method to assess the respondents' knowledge, perceived beliefs, and preventive behaviors towards COVID-19. Standard descriptive statistics and hierarchical linear regression analyses were conducted to analyze the data.

RESULTS

A total of 1501 participants responded to the survey, and 1263 valid responses (84.1%) were obtained for further analysis. The overall correct rate on the knowledge questionnaire was 87%, overall positive beliefs regarding COVID-19 were found, and the mean behavior score was 13.73/15 (SD 1.62, range 5-15). The hierarchical linear regression showed that respondents who were married or cohabitating and who lived in areas with community-level control measures were more likely to practice preventive behaviors (P<.01). Knowledge (β=0.198, P<.001), perceived susceptibility (β=0.263, P=.03), perceived benefits (β=0.643, P<.001), and self-efficacy in preventing COVID-19 (β=0.468, P<.001) were also found to be significantly associated with preventive behaviors.

CONCLUSIONS

Most older residents had adequate knowledge and positive beliefs regarding COVID-19 and engaged in proactive behaviors to prevent the disease. Knowledge and beliefs were confirmed to be significantly associated with behavior responses. Our findings have significant implications in enhancing the effectiveness of COVID-19 prevention programs targeting the older population; these programs must be continued and strengthened as the epidemic continues.