Predictors of the Social Distancing Behaviors during the COVID-19 Pandemic using Protection Motivation Theory in Iran: A cross sectional study

The effect of a self-learned virtual learning package on knowledge, attitude, and self-care behaviors of COVID-19 in people referred to health and treatment centers

BACKGROUND

COVID-19 is one of the most common diseases in recent years, the most important way to prevent is through self-care behaviors; therefore, it is important to these behaviors in people. According to the importance of promoting self-care behaviors of this disease, and according to the characteristics and effectiveness of interventions based on behavior change, this study aimed to investigate the effect of educational intervention on self-care behaviors of COVID-19 in a group of patients.

METHODS

This quasi-experimental study was conducted on 164 people who referred to health and treatment centers in Dehdasht City, Iran. The cluster sampling method divided the participants into experimental and control groups at random (82 people for each group). Data collection tool was a researcher-made questionnaire completed by the control and experimental groups before and three months after the intervention. The intervention program in this training group is to form a WhatsApp group and send messages in the form of audio files, text messages, text messages with photos, video messages, and PowerPoints. After creating the group and adding the participants, according to the agreement with the group members, every day of the week (8:00 am to 12:00 pm) to send educational files through the WhatsApp application. Also, the group members could ask their questions and problems to the researcher during the designated hours. The control group was also given routine care and follow-up at the centers, and no training was given regarding self-care behaviors. After entering the SPSS 24, data were analyzed by independent t, chi-square, and paired t statistical tests.

RESULTS

164 individuals working in healthcare services from health and treatment centers were included in this study. Before the intervention, demographic characteristics such as marital status, education level, medical history, and smoking history were similar between the two groups (P > 0.05), as indicated by the results of chi-square tests. Furthermore, there were no significant differences in the mean scores of knowledge, attitude, and self-care behaviors between the experimental and control groups prior to the intervention (P > 0.05), according to independent t-tests. Following the intervention, notable changes were observed. The post-intervention analysis revealed statistically significant differences between the experimental and control groups in terms of knowledge, attitude, and self-care behaviors (P = 0.001). Specifically, the experimental group exhibited significant improvements in these variables compared to the control group.

CONCLUSION

In this study, education led to the improvement of self-care behaviors in people who referred to health centers. Considering the importance of the role of health education in promoting self-care behaviors as well as preventing infectious diseases such as COVID-19, it is suggested that educational interventions focus on self-care behaviors in other diseases.

Effect of educational intervention based on protection motivation theory on preventive behaviors of respiratory infections among hospital staff

Background

Hospital staff represent a vulnerable population for respiratory diseases. Consequently, the implementation of training programs becomes imperative as a preventive measure against such infections in these populations. The current study was conducted to examine the impact of an educational intervention based on the Protection Motivation Theory (PMT) on preventive behaviors for respiratory infections among a group of hospital staff.

Methods

This experimental study involves a sample of 150 hospital staff from Gachsaran City, Iran, in 2021-2022. The sampling technique involved the utilization of a random assignment approach to allocate individuals into two distinct groups: the experimental group, consisting of 75 participants, and the control group, also including 75 individuals. The data collection instrument was a questionnaire designed in accordance with the PMT. This questionnaire was administered to both the experimental and control groups prior to the intervention as well as two months following the intervention. The intervention program consisted of a total of five sessions, each lasting for 60 min, for the experimental group. These sessions were conducted on a weekly basis over a period of two and a half months. Specifically, there were two sessions held every month and one session held every two weeks. Following the completion of the program, the data was entered into SPSS-24 statistical software for analysis using paired t-tests, independent t-tests, and chi-square tests.

Results

The results indicated that prior to the intervention, there was no significant difference between the two groups in terms of perceived vulnerability constructs (p = 0.25), perceived severity (p = 0.63), perceived response (p = 0.32), and perceived reward (p = 0.11). Besides, there was no considerable distinction in perceived self-efficacy (p = 0.84), perceived response cost (p = 0.33), fear (p = 0.45), behavior motivation (p = 0.51), knowledge (p = 92), or vaccination behavior (p = 0.12) before the educational intervention. However, a significant change was noticed in each of the mentioned variables between the two groups after the intervention (p < 0.05).

Conclusion

The results of this study indicated that the implementation of an educational intervention grounded in the PMT yields positive outcomes in enhancing preventative behaviors pertaining to respiratory infections. Hence, it is recommended to utilize an intervention grounded in this theory among hospital staff as a viable approach to mitigating the occurrence of respiratory infections.

Application of Protection Motivation Theory to COVID-19 vaccination among a predominantly Hispanic sample of adolescents

Despite the efficacy and widespread availability of COVID-19 vaccines, vaccine uptake has been relatively low in U.S. Hispanic communities, especially among adolescents. This study examined vaccination status among 444 high school students in predominantly Hispanic neighborhoods of Los Angeles County, California in May-June 2022 (mean age = 15.74 years, 55% female, 93% Hispanic). Guided by Protection Motivation Theory, we hypothesized that the odds of being fully vaccinated (at least 2 vaccine doses) would be significantly associated with higher levels of perceived severity, perceived vulnerability, response efficacy, and self-efficacy. 79% of the respondents were fully vaccinated. Binary logistic regression analyses found that response efficacy (belief in the effectiveness of the COVID-19 vaccine) and self-efficacy to get vaccinated were significantly associated with the likelihood of being fully vaccinated. Perceived severity of COVID-19 and perceived vulnerability to COVID-19 were not associated with the likelihood of being fully vaccinated. Results indicate that health communications are needed to convince Hispanic adolescents and their parents that the COVID-19 vaccine is effective, and outreach efforts are needed to remove barriers to vaccination among this population.

Meta-analysis on application of Protection Motivation Theory in preventive behaviors against COVID-19

The present study aims to conduct a systematic review and meta-analysis on quantitative conclusion and appraisal of findings from Protection Motivation Theory to predict protective behaviors against COVID-19. This meta-analysis covered the period between 2019 and 2022. Web of Science, Science Direct, Scopus, Emerald, PubMed, Springer, Sage, Online Wiley Library, Taylor & Francis and ProQuest were searched to find related articles to the study topic. Using Effect Size of Random model, the quality of each study, homogeneous of studies and Publication bias of data were analyzed and assessed by CMA2 software. The results indicate that perceived severity (β=0.197), perceived vulnerability (β=0.160), response efficacy (β=0.251) and self-efficacy (β=0.270) are positively associated with COVID-19 disease. In addition, the results show that Response cost (β=-0.074) is a negative and weak predictor of motivation to protect against COVID-19. The results of this study regarding Protection Motivation Theory (PMT)- as a very strong and flexible theory during outbreak of COVID-19- may suggest that despite positive protection, the mean of Effect Size of total PMT elements is less than average size. Meta-analysis of studies shows that coping appraisal variables provide the strongest predictors of behavior and intention. Furthermore, self-efficacy was identified as the most important determinant in protective behaviors against COVID-19.