Do health beliefs, personality traits, and interpersonal concerns predict TB prevention behavior among Japanese adults?

Using the Health Belief Model to Predict Tuberculosis Preventive Behaviors Among Tuberculosis Patients' Household Contacts During the COVID-19 Pandemic in the Border Areas of Northern Thailand

OBJECTIVES

The coronavirus disease 2019 pandemic has exacerbated the rate of tuberculosis (TB) infection among close contacts of TB patients in remote regions. However, research on preventive behaviors, guided by the Health Belief Model (HBM), among household contacts of TB cases is scarce. This study aimed to employ the HBM as a framework to predict TB preventive behaviors among household contacts of TB patients in the border areas of Northern Thailand.

METHODS

A cross-sectional study with multi-stage random sampling was conducted in Chiang Rai Province. The study included 422 TB patients' household contacts aged 18 years or older who had available chest X-ray (CXR) results. A self-administered questionnaire was used to conduct the survey.

RESULTS

The participants' mean age was 42.93 years. Pearson correlation analysis showed that TB preventive behavior scores were significantly correlated with TB knowledge (r=0.397), perceived susceptibility (r=0.565), perceived severity (r=0.452), perceived benefits (r=0.581), self-efficacy (r=0.526), and cues to action (r=0.179). Binary logistic regression revealed that the modeled odds of having an abnormal CXR decreased by 30.0% for each 1-point score increase in preventive behavior (odds ratio, 0.70; 95% confidence interval, 0.61 to 0.79).

CONCLUSIONS

HBM constructs were able to explain preventive behaviors among TB patients' household contacts. The HBM could be used in health promotion programs to improve TB preventive behaviors and avoid negative outcomes.

Vaccine Hesitancy and Susceptibility to SARS-CoV-2 Misinformation in Japanese Youth: The Contribution of Personality Traits and National Identity

During the pandemic, the Japanese government drew upon the cultural concept of jishuku, or personal self-constraint, requesting that individuals accept responsibility for their behaviors and consider minimizing the potential negative impact on others. While the jishuku approach to pandemic management rests upon the established and persuasive influence of cultural norms, variability in adherence can be expected according to age. This article documents an investigation into factors impacting vaccine hesitancy and susceptibility to SARS-CoV-2 misinformation among Japanese youth. The point of departure is the belief that attitudes and behaviors, such as those underpinning the jishuku approach to pandemic management, arise from within a relational framework. Therefore, developmental characteristics, such as personality traits, and in-group affinity attachments, such as facets of national identity, can be expected to function as predictors of health attitudes and behaviors. The tested structural model of hypothesized interactions accounted for 14% of the observed variance in vaccine hesitancy and 20% in susceptibility to SARS-CoV-2 misinformation. With the inclusion of gender, political ideology, and trust in government SARS-CoV-2 response as control variables, the respecified model increased the amount of variance observed in vaccine hesitancy to 30% and to 25% in susceptibility to SARS-CoV-2 misinformation. The outcomes are discussed in relation to the communication of coherent public health discourse relative to personality traits and facets of national identity.

The Effects of Emotion, Spokesperson Type, and Benefit Appeals on Persuasion in Health Advertisements: Evidence from Macao

Enhancing public awareness for epidemic prevention is crucial for safeguarding public health. This experimental study investigated the effectiveness of a combined approach involving three persuasive elements in public health advertising. Specifically, the study examined the interplay between emotional appeals (fear messages versus efficacy messages) and spokesperson type on the public's response to health announcements. The results demonstrated that fear messages were more persuasive when conveyed by real human spokespersons (versus animated spokespersons), whereas efficacy messages were more acceptable when conveyed by animated spokespersons (versus real humans). Furthermore, the study revealed that the impact of emotional appeals and spokesperson type is moderated by benefit appeals (self-benefit or other-benefit). The joint effects of these persuasive variables on individuals' intention to adopt preventive measures indicated that the interactions significantly differed across the two types of benefit appeal. Taken together, the findings represent a pioneering contribution to the field of health communication by comparing the persuasive effects of different combinations of emotional appeals, spokesperson types, and benefit appeals on public behavior. These findings offer practical guidance for public communicators to design more appropriate health advertisements based on the results of this study, thereby enhancing public acceptance of disease prevention measures.

Correlates of COVID-19 Preventative Behaviors before and after Vaccination Availability

As the COVID-19 pandemic progressed, various preventative behaviors and eventually vaccinations became available to decrease the spread of the virus. The current study examined a variety of variables (i.e., age, COVID-19-related economic hardship, interpersonal concern, personality, fear of COVID-19, normative beliefs, political beliefs, and vaccine hesitancy) to better understand predictors of preventative behaviors and vaccination status at different points throughout the pandemic. Online questionnaires, administered through Qualtrics, were used to collect data using two convenience samples. One was a small sample (N = 44) of non-student participants before the vaccine was readily available. The other sample (N = 274) included college student participants and occurred after the vaccine had been available to all participants. Results suggest that several variables (i.e., fear of COVID-19, normative beliefs, interpersonal concern, and openness) were consistent predictors of public health behaviors at both points in time and across differently aged samples. Other variables (i.e., agreeableness, extraversion, conscientiousness, and economic hardship) were less consistent with their relationships with public health behaviors. Implications related to both research and public health are discussed.

Threat Appraisal, Resilience, and Health Behaviors in Recovered COVID-19 Patients: The Serial Mediation of Coping and Meaning-Making

Research indicates that both cognitive appraisal and personal resources can noticeably influence health behaviors, as individuals modify their health convictions and practices on the basis of threat appraisal, personality, and meaning. The aim of the current study was to investigate whether coping strategies and meaning-making can serially mediate the relationship of threat appraisal and resilience with health behaviors in recovered COVID-19 patients. Self-report measures of threat appraisal, resilience, coping, meaning-making, and health behaviors were completed by 266 participants (aged 17 to 78, 51.5% female) who had recovered from COVID-19. The serial mediation analysis showed that the relationship of threat appraisal and resilience with health behaviors was mediated by problem-focused coping, meaning-focused coping, and meaning-making, but not by emotion-focused coping. These results suggest that associations among threat perception, resilience, and health behavior depend to some extent on the interplay of coping and meaning-making, which reveals their unique role in the process of recovery from COVID-19, with potential implications for health interventions.

Can Press Freedom Enhance the Effect of News Exposure on COVID-19 Health Beliefs? A Health Belief Model Perspective

News media can influence citizens' health beliefs about COVID-19 and eventually their vaccination intention. However, existing literature has rarely investigated how such effect is contingent upon a country-level factor: press freedom. Situated in the Health Belief Model, this study draws upon a multi-national survey (N = 3,599), involving 10 major cities in Asia to address the research gap. Results showed that news exposure has a positive effect on personal health beliefs on COVID-19, affecting their vaccination intention. More interestingly, the relationship between news exposure and personal health beliefs about COVID-19 was negatively moderated by level of press freedom - that is, the relationship between news exposure and personal health beliefs is stronger in cities that belong to countries with low levels of press freedom.

Testing the Effectiveness of the Health Belief Model in Predicting Preventive Behavior During the COVID-19 Pandemic: The Case of Romania and Italy

We use a cultural psychology approach to examine the relevance of the Health Belief Model (HBM) for predicting a variety of behaviors that had been recommended by health officials during the initial stages of the COVID-19 lockdown for containing the spread of the virus and not overburdening the health system in Europe. Our study is grounded in the assumption that health behavior is activated based on locally relevant perceptions of threats, susceptibility and benefits in engaging in protective behavior, which requires careful attention to how these perceptions might be structured and activated. We assess the validity of the HBM in two European countries that have been relatively understudied, using simultaneous measurements during acute periods of infection in Romania and Italy. An online questionnaire provided a total of (N = 1863) valid answers from both countries. First, to understand individual difference patterns within and across populations, we fit a General Linear Model in which endorsement was predicted by behavior, country, their interaction, and a random effect for participants. Second, we assess the effect of demographics and health beliefs on prevention behaviors by fitting a multi-group path model across countries, in which each behavior was predicted by the observed health belief variables and demographics. Health beliefs showed stronger relationships with the recommended behaviors than demographics. Confirming previously reported relationships, self-efficacy, perceived severity, and perceived benefits were consistently related to the greater adoption of individual behaviors, whereas greater perceived barriers were related to lower adoption of health behaviors. However, we also point to important location specific effects that suggest that local norms shape protective behavior in highly contextualized ways.

Attitudes towards social distancing in response to COVID-19

OBJECTIVES

COVID-19 has highlighted differences in our engagement in health prevention behaviors. The Health Belief Model (HBM), personality traits (conscientiousness, extraversion, and neuroticism), and sociodemographic variables were used to evaluate social distancing during the first month of a state-mandated Stay At Home (SAH) order.

DESIGN

A web-based convenience sample of 645 Ohioans was surveyed. Hierarchical linear regression and mediation analysis were used to examine predictors of social distancing attitudes and behaviors and whether health beliefs mediated the relationship between personality and social distancing.

RESULTS

Most respondents agreed with and adhered to social distancing guidelines. HBM constructs were strong predictors of SAH attitudes, while personality accounted for little additional variance. Anxiety was indirectly related to overall social distancing attitudes and behavior through its relationship with health beliefs. However, violations of social distancing were best explained by situational factors (e.g., being an essential worker).

CONCLUSION

The results demonstrate the power of components of the HBM to explain attitudes and behaviors regarding the SAH order beyond any contribution from personality. By examining the role of personality and health beliefs on social distancing attitudes and behaviors, this research will benefit public health nurses and others tasked with communicating and promoting preventative health behavior.

Cross-Country Differences in Stay-at-Home Behaviors during Peaks in the COVID-19 Pandemic in China and the United States: The Roles of Health Beliefs and Behavioral Intention

The novel coronavirus disease 2019 (COVID-19) rapidly escalated to a global pandemic. To control the rate of transmission, governments advocated that the public practice social distancing, which included staying at home. However, compliance with stay-at-home orders has varied between countries such as China and the United States, and little is known about the mechanisms underlying the national differences. Based on the health belief model, the theory of reasoned action, and the technology acceptance model, health beliefs and behavioral intention are suggested as possible explanations. A total of 498 Chinese and 292 American college students were recruited to complete an online survey. The structural equation modeling results showed that health beliefs (i.e., perceived susceptibility, severity, and barriers) and behavioral intention played multiple mediating roles in the association between nationality and actual stay-at-home behaviors. Notably, the effect via perceived barriers → behavioral intention was stronger than the effects via perceived susceptibility and severity → behavioral intention. That is, American participants perceived high levels of susceptibility whereas Chinese participants perceived high levels of severity, especially few barriers, which further led to increased behavioral intention and more frequent stay-at-home behaviors. These findings not only facilitate a comprehensive understanding of cross-country differences in compliance with stay-at-home orders during peaks in the COVID-19 pandemic but also lend support for mitigation of the current global crisis and future disease prevention and health promotion efforts.

Personality and the use of cancer screenings. A systematic review

BACKGROUND

No systematic review exists synthesizing studies examining the association between personality factors and use of cancer screenings. Hence, the aim of this systematic review is to provide an overview of empirical findings from observational studies investigating the link between personality factors (in terms of agreeableness, conscientiousness, extraversion, neuroticism and openness to experience) and use of cancer screenings.

METHODS

Medline, PsycInfo and CINAHL were searched using predefined search terms. Observational studies examining the link between personality factors and use of cancer screenings using validated tools were included. Study selection, data extraction, and quality assessment were performed by two reviewers.

RESULTS

In total, n = 11 studies were included in our systematic review. There is mostly inconclusive evidence regarding the link between agreeableness, neuroticism, openness to experience and the use of cancer screenings. Clearer evidence was identified for an association between increased extraversion and an increased use of cancer screenings. Moreover, the majority of studies identified a link between increased conscientiousness and an increased use of cancer screenings.

DISCUSSION

Studies indicate that personality factors, particularly an increased extraversion and increased conscientiousness, are associated with an increased use of cancer screenings. This knowledge may be beneficial to address individuals at risk for underuse.

PROSPERO REGISTRATION NUMBER

CRD42020176830.

Adaptive and maladaptive behavior during the COVID-19 pandemic: The roles of Dark Triad traits, collective narcissism, and health beliefs

In a nationally representative sample from Poland (N = 755), we examined the relationships between the Dark Triad traits (i.e., psychopathy, Machiavellianism, and narcissism) and collective narcissism (i.e., agentic and communal) on the one hand, and behaviors related to the COVID-19 pandemic at (1) the zero-order level, at (2) the latent variance level, and (3) indirectly through health beliefs about the virus (i.e., the health belief model) on the other. We focused on preventive and hoarding behaviors as common reactions toward the pandemic. Participants characterized by the Dark Triad traits engaged less in prevention and more in hoarding, whereas those characterized by collective narcissism engaged in more hoarding only. Coronavirus-related health beliefs mediated patterns of prevention (fully) and hoarding (partially) in the latent Dark Triad (Dark Core) and collective narcissism. However, specific beliefs worked in opposite directions, resulting in a weak indirect effect for prevention and a null indirect effect for hoarding. The results point to the utility of health beliefs in predicting behaviors during the pandemic, explaining (at least in part) problematic behaviors associated with the dark personalities (i.e., Dark Triad, collective narcissism).