Intention and Practice on Personal Preventive Measures Against the COVID-19 Pandemic Among Adults with Chronic Conditions in Southern Ethiopia: A Survey Using the Theory of Planned Behavior

Intention and practice on personal preventive measures against COVID-19 among older adults in the Kingdom of Saudi Arabia: an epidemiological study using the Theory of Planned Behaviour

Introduction

Older adults aged 65 years and above are among the most vulnerable to adverse outcomes and death following a COVID-19 infection. The weekly epidemiological updates by the World Health Organisation show that the continued emergence of concerning subtypes of the virus indicates that the pandemic remains a public health concern and the public should continue to comply with personal preventive measures (PPMs). This study applies the Theory of Planned Behaviour (TPB) which is rooted in the field of Public Health, Epidemiology, and Preventive Medicine to Saudi older adults to predict their health behaviour.

Methods

This behavioural epidemiological study recruited older adult participants aged 65 years of age and above. A tool which consisted of sociodemographic and health-related questions, as well as questions regarding the components of the TPB, namely, Attitude, Subjective Norm, Perceived Behavioural Control was used. Bivariate analyses, followed by unadjusted and adjusted multivariable logistic regression analyses were performed to derive odds ratios and 95% confidence intervals.

Results

The total number of participants was 502. The mean age was 70.34 years, with similar distributions between males and females. In total, 52.2% intended to practice PPMs, whereas only 48% had a good practice. Also, 56% had a favourable Attitude towards PPMs, 61.4% had a positive Subjective Norm and 39.8% had perceived they had a high control over their behaviour. Females, and high educational status were predictors for high intention to practice PPMs (OR = 1.59, 95% CI = 1.01-2.52 and OR = 2.72, 95% CI = 1.44-5.16 respectively). Further predictors included Attitudes, Subjective Norm and Perceived Behavioural Control. Results also show that intention to practice was significantly associated with a lower odd of practicing PPMs (OR = 0.06, 95% CI = 0.04-0.10).

Conclusion

Current findings highlight the need to continue with public health efforts targeting vulnerable older adults. Also, the fact that intention negatively predicted practice highlights the need for further behavioural epidemiological studies addressing the intention-behaviour gap.

The predictors of the intention to receive Covid-19 vaccine using the health belief model and theory of planned behavior in South Khorasan province

BACKGROUND

Widespread vaccination coverage in the shortest time is one of the most effective ways for controlling the COVID-19 pandemic. Factors affecting people's intention to get the COVID-19 vaccine are of great importance. The present study aimed to investigate the predictors of the intention to receive the Covid-19 vaccine based on the constructs of the health belief model (HBM) and theory of planned behavior (TPB) in South Khorasan Province.

MATERIALS AND METHODS

In this cross-sectional-analytical study, 320 people over 18 years in South Khorasan province were randomly selected by cluster sampling method in 2021. The data was collected by a researcher-made questionnaire, including demographic information (9 questions), and the constructs of the health belief model (19 questions), and the theory of planned behavior (13 questions), using the self-report method. Finally, data were analyzed using t-test, ANOVA, linear regression, and Pearson correlation tests.

RESULTS

The mean age of the study participants was 36.57 ± 11.56 with a range of 18-66 years. In the regression model, perceived susceptibility (β = 0.247, P = 0.003), perceived severity (β = 0.247, P = 0.003) from HBM, attitude (β = 0.247, P = 0.003), and perceived behavioral control (β = 0.247, P = 0.003) from TPB were significant predictors of the intention to get the Covid-19 vaccine. The constructs of the two models were able to explain 33% of the variance of the intention to receive the Covid-19 vaccine.

CONCLUSIONS

The study findings reveal that HBM and TPB can predict factors affecting an individual's intention to receive the vaccine. The results can be utilized to design interventions with the aim of increasing vaccine uptake.

Does biogas energy influence the sustainable development of entrepreneurial business? An application of the extended theory of planned behavior

As a result of air pollution and accelerated climate change, entrepreneurship is gradually becoming a deciding factor in the global conversation about saving the planet with renewable energy sources. To sustain the economy and entrepreneurial culture for future generations, researchers and entrepreneurs seek environmentally friendly methods for supporting entrepreneurial enterprises. Fossil fuel-based energy has significantly impeded the country's sustainable development. Pakistan lacks research examining the connection between biogas energy technology and entrepreneurship. This study aims to cover this void in the literature by employing the theory of planned behavior to investigate bioenergy as a business prospect for supportable monetary growth. The primary data comprises 358 comprehensive questionnaire survey respondents. PLS-SEM verifies the model and examines the suppositions. According to pragmatic findings, all views are positively and substantially associated with the sustainable progress of business enterprises implementing biogas energy. In contrast, social media awareness had no moderating effect on the dependent variable. Consequently, social media awareness substantially modifies the associations between all independent variables adopting biogas energy. The results of this research indicate the standing of altering social customs regarding private enterprise, increasing businesspersons' consciousness of these matters, reforming controlling arrangements, and highlighting the assistance of business events made possible by biogas energy technology, which increases businesspeople's investment returns. Conclusively, the study's limits and approvals for future research are emphasized.

Barriers and Intention to Get Vaccinated for COVID-19 and Associated Factors Among Adults in Southwest Ethiopia: A Theory of Planned Behavior Approach

Background

Different vaccines have been approved for use against coronavirus disease and distributed globally in different regions. Efforts should be made on the vaccination to control the spread and impacts of the coronavirus pandemic. However, the general population's attitudes and intention to uptake coronavirus disease 2019 (COVID-19) vaccinations were poor.

Objective

This study aimed to assess the barriers to and intention to be vaccinated against COVID-19 and the associated factors among adults in the Jimma zone, Ethiopia.

Methods

A community-based cross-sectional study with multistage sampling was conducted with 621 participants from 16 April to 17 May 2022. Multivariable logistic regression was used to identify factors associated with the outcome of interest. Statistical p-value ≤0.05 was set at p ≤ 0.05. Qualitative data were supplemented with quantitative results.

Results

The majority of the study participants (382 [61.5%]) intended to uptake the COVID-19 vaccine. In this study, travel history (Adjusted Odds Ratio (AOR) = 2.18, 95% CI 1.23-3.87), vaccination history (AOR = 2.64, 95% CI 1.69-4.12), perceptions of infection prevention for COVID-19 (AOR = 1.97, 95% CI 1.28-3.03), subjective norm (AOR = 2.27, 95% CI 1.52-3.39), and perceived behavioral control (PBC) (AOR = 2.30, 95% CI 1.55-3.41) were significantly associated with the intention to be vaccinated against COVID-19.

Conclusion

More than half of the adult participants intended to be vaccinated against COVID-19. The study participant's traveling history, vaccination history, perception of infection prevention for COVID-19, subjective norms, and Perceived Behavioral Control were significantly associated with the intention to be vaccinated.

Economic development, social media awareness, and technological innovation in biogas sector under climate change in the post-COVID-19 pandemic conditions

After COVID-19, financing for emerging nation reserves in renewable energy bases was deemed a crucial aspect of sustainable development. Investing in biogas energy plants can be highly beneficial for lowering the use of fossil fuels. Using a survey of shareholders, investors, biogas energy professionals, and active social media participants in Pakistan, this study evaluates the intentions of individual investors to invest in biogas energy plants. The primary purpose of this study is to increase investment intent for biogas energy projects following COVID-19. This study focuses on financing biogas energy plants in the post-COVID-19 era and evaluates the research's assumptions using partial least squares structural equation modeling (PLS-SEM). The study employed the technique of purposive sampling to acquire data for this investigation. The results indicate that attitudes, perceived biogas energy benefits, perceived investment attitudes, and supervisory structure evaluations inspire one's propensity to finance biogas vitality plant efforts. The study found a link between eco-friendly responsiveness, monetary benefits, and investors' actions. The aspiration of investors to mark such reserves was set up to be unpretentious by their risk aversion. Conferring to the facts, evaluating the monitoring structure is the critical factor. The previous studies on investment behavior and other forms of pro-environmental intent and action yielded contradictory results. In addition, the regulatory environment was evaluated to see how the theory of planned behavior (TPB) affects financiers' objectives to participate in biogas power plants. The consequences of the study indicate that feelings of pride and discernment of energy expansively affect people's desire to invest in biogas plants. Biogas energy efficacy has little effect on investors' decisions to invest in biogas energy plants. This study offers policymakers practical ideas on enhancing investments in biogas energy plants.

Knowledge and practice of personal protective measures against COVID-19 in Africa: a systematic review

BACKGROUND

The Coronavirus disease 2019 (COVID-19) pandemic being a newly evolving disease, its response measures largely depend on the practice of and compliance with personal protective measures (PPMs).

OBJECTIVE

This systematic review aimed to examine the knowledge and practice of COVID-19 PPMs in African countries, as documented in the published literature.

METHODS

A systematic search was conducted on Scopus, PubMed, and Web of Science databases using appropriate keywords and predefined eligibility criteria for the selection of relevant studies. Only population-based original research studies (including qualitative, quantitative, and mixed-method studies) done in Africa, and published in the English language were included. The screening process and data extraction were performed according to a pre-registered protocol in PROSPERO (CRD42022355101) and followed the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The quality of included studies was assessed using the Mixed-Method Appraisal Tool. Thematic analysis was used to systematically summarise the studies into four predefined domains: i) knowledge and perception about PPMs, ii) mask use, iii) social/physical distancing, and iv) hand washing/hygiene, including their respective levels and associated factors.

RESULTS

A total of 58 studies across 12 African countries were included, and these were published between 2019 and 2022. African communities, including various population groups, had varying levels of knowledge and practice of COVID-19 PPMs, with lack of personal protective equipment (PPE) (mainly face masks), and side effects (among health care workers) being the major reasons for poor compliance. Lower rates of handwashing/ hygiene were particularly noted in several African countries, especially among the urban poor and slum-dwellers, with the main barrier being the lack of safe and clean water. Various cognitive (knowledge and perception), socio-demographic and economic factors were associated with the practice of COVID-19 PPMs. Moreover, there were evident research inequalities on the regional level, where East Africa contributed 36.2%, West Africa 20.7%, North Africa 17.2%, Southern Africa 6.9%, and no single-country study from Central Africa. Nonetheless, the overall quality of the included studies was generally good, as they satisfied most of the quality assessment criteria.

CONCLUSIONS

There is a need to enhance local capacity to produce and supply PPE. Consideration of various cognitive, demographic and socioeconomic differences, with extra focus on the most vulnerable, is crucial for inclusive and more effective strategies against the pandemic. Moreover, more focus and involvement in community behavioral research are needed to fully understand and address the dynamics of the current pandemic in Africa.

CLINICALTRIAL

The study protocol was registered in PROSPERO (CRD42022355101).

Social workers' adaptation in times of pandemic crisis: A Hong Kong case

Through the lens of the theory of planned behavior, this article explores how social workers adapt to a new situation due to the outbreak of the COVID-19 pandemic. Three focus group sessions were conducted with 23 social workers from child and youth, family, and elderly services in Hong Kong. Three major themes were generated: (1) repositioning the social work profession, (2) renegotiating contracts with funders, and (3) exploring novel intervention methods. Implications of the findings are discussed. To ensure social workers can respond effectively in crises, an evolving nature of the profession is advocated to enshrine its spirit to serve.

The effects of information framing on self-protective behavior: Evidence from the COVID-19 vaccine uptake

Objectives

The Healthy China 2030 strategy outlines the government's plans for healthcare reform, emphasizing the need for increased awareness about infectious diseases to prevent and fight future infections. Information campaigns can be used as a medium to raise awareness and encourage citizens' willingness to protect themselves against diseases, such as COVID-19. Extant studies have found that individual health behavior decision-making can be changed under different information frames. However, limited evidence is available about emerging infectious diseases. Based on the Prospect Theory and Theory of Planned Behavior, the impact of information frames on self-protective behavior-vaccination against COVID-19 is investigated in this study.

Methods

A 2(gain/loss frame)*2(factual/emotional frame) intergroup experimental design was designed to explore the effects of different information frames. 228 valid participants in China were recruited and the experiment was performed online.

Results

First, the gain frame was more effective in promoting public self-protection behavior than the loss frame under information frame intervention. Compared with the factual frame, the emotional frame is more effective in reducing individual risk perception. Second, perceptual behavior control has masking effects on self-protection behavior under the influence of the gain/loss frame. Third, age, subjective norms, attitudes, and the gain frame, have predictive effects on self-protection behavior.

Conclusions

This study provides empirical evidence on the impact of information framing interventions on public self-protection behavior during the COVID-19 pandemic and provides important practical implications for public administrators and media practitioners.

COVID 19 prevention practice of patients with known chronic illness in Ethiopia: A systemic review and meta-analysis

Introduction

There were different studies done and found a highly variable level of COVID 19 prevention practice; however, there was no summarized evidence on the prevention practice of chronic disease patients in Ethiopia. This systematic review and meta-analysis aims to assess the pooled prevalence of COVID 19 prevention practice and associated factors among chronic disease patients in Ethiopia.

Method

Systematic review and meta-analysis were conducted using PRISMA guidelines. Comprehensive literature was searched in international databases. A weighted inverse variance random effect model was used to estimate pooled prevalence. Cochrane Q-test and I2 statistics were computed to assess heterogeneity among studies. Funnel plot and Eggers test were done to assess publication bias. Review manager software was used to identify determinants of COVID 19 prevention practice.

Result

Overall, 437 articles were retrieved and finally 8 articles were included in this review. The pooled prevalence of good COVID 19 prevention practices was 44.02% (95%CI (35.98%-52.06%). Being rurally reside (AOR = 2.39, 95% CI (1.30-4.41)), having educational status of cannot read and write (AOR = 2.32, 95% CI (1.22-4.40)), and poor knowledge (AOR = 2.43, 95% CI (1.64-3.60)) positively associated with poor practice.

Conclusion

Good COVID 19 prevention practices of chronic disease patients in Ethiopia was low. Rural residence, educational status of cannot read and write and poor knowledge was positively associated with poor practice. Therefore, policymakers and program planners should target those high-risk groups in improving their awareness to enhance their practice specifically focusing on those who are rural reside and with low educational status.

Application of behavioral change theory and models on COVID-19 preventive behaviors, worldwide: A systematic review

Objective:

This systematic review aimed to assess the global application of behavioral change theory and models on COVID-19 preventive behaviors.

Methods:

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedure. Databases such as PubMed/MIDLINE, Web of Science, Scopus, EMB ASE, World Health Organization libraries, and Google Scholar were used to search all published articles in the area of application of behavioral change theory and model on COVID-19 preventive behavior until October 1, 2022. Studies published in another language other than English were excluded. Two independent reviewers did the article selection and quality check. A third reviewer asked if any disagreement were found.

Result:

Seventeen thousand four hundred thirty-six total articles were retrieved from all sources after the removal of duplicated articles and those not evaluating the outcome of interest were excluded. Finally, 82 articles done using behavioral change theory and model on COVID-19 preventive behaviors were included. The health belief model (HBM) and theory of planned behavior (TPB) were most commonly used in COVID-19 preventive behaviors. The constructs of most behavioral theories and models were significantly associated with COVID-19 preventive behaviors such as hand washing, face mask use, vaccine uptake, social isolation, self-quarantine, social distance, and use of sanitizers.

Conclusion:

This systematic review summarizes comprehensive evidence on the application of behavioral change theory and model on COVID-19 preventive behaviors globally. A total of seven behavioral change theories and models were included. The HBM and TPBs were most commonly used for COVID-19 preventive behaviors. Therefore, the application of behavioral change theory and models is recommended for developing behavioral change interventional strategies.

Health Disparities in Online COVID-19 Information Seeking and Protective Behaviors: A Two-Wave Longitudinal Study

The COVID-19 outbreak was declared a pandemic by the World Health Organization and claimed hundreds of thousands of lives in the U.S. However, the adoption of protective behaviors in response to COVID-19 varies among sociodemographic groups. To better understand the disparities in U.S. adults' adoption of protective behaviors in relation to sociodemographic factors, we conducted a two-wave panel survey in the U.S. Although sociodemographic factors were not found to be significant predictors in lagged regression analysis, results from a cross-sectional analysis showed that the White, younger, and higher educated individuals were more likely to take protective behaviors. Furthermore, based on the structural equation modeling, indirect effects were observed. Specifically, online COVID-19 information seeking mediated the effects of age and education on performance of protective behaviors, and subjective norms and online COVID-19 information seeking were found to be significant serial mediators of these relationships. The study not only extends the health disparities and health information seeking literature, but also offers practical insights to health campaigns and interventions promoting protective behaviors during a pandemic and reducing health disparities.

Compliance with COVID-19 preventive measures among chronic disease patients in Wolaita and Dawuro zones, Southern Ethiopia: A proportional odds model

Introduction

So far, shreds of evidence have shown that COVID-19 related hospitalization, serious outcomes, and mortality were high among individuals with chronic medical conditions. However, strict compliance with basic public health measures such as hand washing with soap, social distancing, and wearing masks has been recommended and proven effective in preventing transmission of the infection. Therefore, this study aimed to determine the level of compliance with COVID-19 preventive measures and identify its predictors among patients with common chronic diseases in public hospitals of Southern Ethiopia by applying the proportional odds model.

Methods

A facility-based cross-sectional study was employed in public hospitals of Southern Ethiopia between February and March 2021. Using a systematic random sampling technique, 419 patients with common chronic diseases were recruited. Data were collected using an Open Data Kit and then submitted to the online server. The proportional odds model was employed, and the level of significance was declared at a p-value of less than 0.05.

Results

This study revealed that 55.2% (95%CI: 50.4%-59.9%) of the study participants had low compliance levels with COVID-19 preventive measures. The final proportional odds model identified that perceived susceptibility (AOR: 0.91, 95%CI: 0.84, 0.97), cues to action (AOR: 0.89, 95%CI: 0.85, 0.94), having access to drinking water piped into the dwelling (AOR: 0.52, 95%CI: 0.32, 0.84), having no access to any internet (AOR: 0.62, 95%CI: 0.42, 0.92), having no functional refrigerator (AOR: 2.17, 95%CI: 1.26, 3.74), and having poor knowledge (AOR: 1.42, 95%CI: 1.02, 1.98) were the independent predictors of low compliance level with COVID-19 preventive measures.

Conclusion

In the study area, more than half of the participants had low compliance levels with COVID-19 preventive measures. Thus, the identified factors should be considered when designing, planning, and implementing new interventional strategies, so as to improve the participants’ compliance level.

State versus action orientation and compliance during the COVID-19 pandemic in Indonesia

This study explored the roles of activity versus state direction in how Indonesians adhered to COVID-19 preventive behaviour using the theory of planned behaviour (TPB). A total of 615 participants were gathered through a web questionnaire containing 68 questions. Structural equation modelling (SEM) was used to determine the causal relationships of the latent variable construct. The results revealed that information sources positively influence both attitudes and subjective norms toward preventive behaviour. The results also support self-regulation as a moderator of the main intent-behaviour relationship. Moreover, state-oriented people cannot self-regulate their behaviour to comply with COVID-19 protocols. This investigation provides productive experiences for strategists and managers to improve COVID-19 compliance. This paper's analysis also contributes to literature by revealing the intention to comply with COVID-19 protocols by emphasizing the role of self-regulation. The findings are relevant to practitioners and policymakers in the field of public health and managing of human behavior, particularly to improve of compliance with COVID-19 prevention. Therefore, governments or public health organizations can be utilized to improve the number of individuals who practice COVID-19 preventative behaviours now and in the future, but various factors must be addressed. Future directions and recommendations for improving TPB are suggested.

Belief Factors Associated With Employees' Intention to Evacuate During a Fire Alarm

BACKGROUND

Nonresidential fires and resultant injuries and deaths have been on the rise the last decade in the United States. Although evacuation is a primary prevention method, people in the workplace still fail to evacuate when they hear a fire alarm. The current formative study applied the Reasoned Action Approach (RAA) to identify belief factors associated with university employees' intention evacuate.

METHODS

Data were collected from employees at a large public university (N = 490) through an online survey. Multiple linear regression quantified the relative contribution of six RAA constructs that represent belief factors underlying employees' intention to leave the office building immediately the next time they hear a fire alarm.

FINDINGS

Nearly 60% of the variation in employees' intention to leave was predicted from the belief factors, adjusted R2 = 0.598, F(17, 472) = 43.80, p < .001. Controlling for demographic characteristics, five of the six RAA global constructs showed statistically significant independent associations with intention: instrumental attitude (B = .272, SE = .026, p < .001), experiential attitude (B = -.073, SE = .026, p = .024), injunctive norm (B = .210, SE = .075, p < .001), descriptive norm (B = .347, SE = .070, p < .001), and capacity (B = .178, SE = .077, p < .001).

CONCLUSIONS/APPLICATIONS TO PRACTICE

These findings show the RAA can be successfully applied to provide employees' perspective on safety decisions like evacuation. The belief factors' relative contributions can help safety professionals prioritize interventions to facilitate leaving immediately. Here the high weights for the two normative factors suggest addressing employees' descriptive beliefs that others like them leave and their injunctive beliefs that significant others, like supervisors and safety personnel, approve of their leaving.

COVID-19 Incidence Prediction Model Based on Community Behavior With Neural Networks

Abstract BACKGROUNDS : The COVID-19 pandemic has created a global health emergency that requires a public health response to prevent the spread of the virus. AIM: The purpose of this study was to determine the prediction model for the incidence of COVID-19 based on community behavior. METHODS: This study used a cross-sectional study design. The study population was all people aged >18 years in Medan City and obtained a sample of 395 people with stratified random sampling technique. The research instrument used a questionnaire in google form, then, using Microsoft Office Excel, we transferred the data from the survey to a computer program. Furthermore, the data was analyzed using the neural networks method. Then the features importance will be calculated using the Random Forest with Mean Decrease Impurity (RF-MDI) method. RESULT: The results showed that based on the confusion matrix, the prediction value for those who did not suffer from COVID-19 was correct from negative data = 8, the correct prediction value for COVID-19 from positive data = 8. While the incorrect prediction value for machines that predicted negative results but the actual data was positive = 2, and predicts a positive result but the actual data is negative = 4. Thus, based on the neural net classification method, the accuracy value is 72%. The results of this study indicate that poor preventive behavior by the community greatly affects the spread of COVID-19 cases. CONCLUSION: Poor community behavior, such as not limiting their interaction/contact with other people, not exercising frequently, leaving the house without keeping a safe distance, and not washing hands regularly, can all impact COVID-19 transmission in the community Keywords: Behavior Prediction Model, COVID-19 Incidence, Neural Network

Associations among political voting preference, high-risk health status, and preventative behaviors for COVID-19

BACKGROUND

We investigate the relationships among political preferences, risk for COVID-19 complications, and complying with preventative behaviors, such as social distancing, quarantine, and vaccination, as they remain incompletely understood. Since those with underlying health conditions have the highest mortality risk, prevention strategies targeting them and their caretakers effectively can save lives. Understanding caretakers' adherence is also crucial as their behavior affects the probability of transmission and quality of care, but is understudied. Examining the degree to which adherence to prevention measures within these populations is affected by their health status vs. voting preference, a key predictor of preventative behavior in the U. S, is imperative to improve targeted public health messaging. Knowledge of these associations could inform targeted COVID-19 campaigns to improve adherence for those at risk for severe consequences.

METHODS

We conducted a nationally-representative online survey of U.S. adults between May-June 2020 assessing: 1) attempts to socially-distance; 2) willingness/ability to self-quarantine; and 3) intention of COVID-19 vaccination. We estimated the relationships between 1) political preferences 2) underlying health status, and 3) being a caretaker to someone with high-risk conditions and each dependent variable. Sensitivity analyses examined the associations between political preference and dependent variables among participants with high-risk conditions and/or obesity.

RESULTS

Among 908 participants, 75.2% engaged in social-distancing, 94.4% were willing/able to self-quarantine, and 60.1% intended to get vaccinated. Compared to participants intending to vote for Biden, participants who intended to vote for Trump were significantly less likely to have tried to socially-distance, self-quarantine, or intend to be vaccinated. We observed the same trends in analyses restricted to participants with underlying health conditions and their caretakers Underlying health status was independently associated with social distancing among individuals with obesity and another high-risk condition, but not other outcomes.

CONCLUSION

Engagement in preventative behavior is associated with political voting preference and not individual risk of severe COVID-19 or being a caretaker of a high-risk individual. Community based strategies and public health messaging should be tailored to individuals based on political preferences especially for those with obesity and other high-risk conditions. Efforts must be accompanied by broader public policy.

Assessment of public intention to get vaccination against COVID-19: Evidence from a developing country

OBJECTIVES

Widespread acceptance of the COVID-19 vaccine will be the next important step in fighting the novel coronavirus disease. Though the Pakistani government has successfully implemented robust policies to overcome the COVID-19 pandemic; however, studies assessing public intention to get COVID-19 vaccination (IGCV) are limited. The aim of this study is to deal with this literature gap and has also expanded the conceptual framework of planned behaviour theory. We have introduced three new considerations (risk perceptions of the pandemic, perceived benefits of the vaccine, and unavailability of vaccine) to have a better understanding of the influencing factors that encourage or discourage public IGCV.

METHODS

Results are based on a sample collected from 754 households using an inclusive questionnaire survey. Hypotheses are tested by utilizing the structural equation modelling approach.

RESULTS

The results disclose that the intention factors, that is, attitude, risk perceptions of the pandemic, and perceived benefits of the vaccine, impart positive effects on public IGCV. In contrast, the cost of the vaccine and the unavailability of the vaccine have negative effects. Notably, environmental concern has an insignificant effect.

CONCLUSIONS

Research findings emphasize the importance of publicizing the devastating impacts of COVID-19 on society and the environment, ensuring vaccination availability at an accessible price while simultaneously improving public healthcare practices.

Community Engagement in the Fight Against COVID-19: Knowledge, Attitude, and Prevention Practices Among Dire Dawa Residents, Eastern Ethiopia

Background: There is a global concern that coronavirus disease 2019 (COVID-19) cannot be addressed without the integration and active engagement of communities. We aimed to investigate the knowledge, attitude, and practices (KAP) of the residents in Eastern Ethiopia toward COVID-19. Method: A community-based cross-sectional study was conducted on May 1-30, 2020 among the residents of Dire Dawa, Eastern Ethiopia. Data were collected using a structured questionnaire on the awareness, knowledge, attitudes, and preventive practices toward COVID-19. We used random sampling to select the participants. Data was entered into the statistics and data (STATA) version for data cleaning and analysis. Binary logistic regression models with 95% CI were used to conduct bivariable [crude odds ratio (COR)] and multivariable [adjusted odds ratio (AOR)] analyses. Result: A total of 415 community residents responded to the questionnaire. Of those participants, 52.5% (95% CI 47.7-57) had adequate knowledge, 31.6% (95% CI 27-36) had favorable attitudes, and 49% (95% CI 45-50) had good practice toward the precautionary measures of COVID-19. Adequate knowledge had a significant association with urban residence (AOR = 5, 95% CI 3.1-8.4) and literacy (AOR = 3.1, 95% CI 1.5-6.7). Good preventions practices had a significant association with place of residence (AOR = 4.1, 95% CI 2.3-7.2), literacy (AOR = 2.9, 95% CI: 1,2-7.4), adequate knowledge (AOR = 3.5, 95% CI 2.3-5.8), and favorable attitude (AOR = 2.3, 95% CI 1.4-3.8) about the disease. Conclusion: The overall COVID-19-related KAP was inadequate in the majority of the residents of Dire Dawa that occupy irregular migration flows. These call for robust community-centered behavioral communication strategies that could bridge the gaps and help prevent and control COVID-19 and other future pandemics in their community.

Understanding Consumer Stockpiling during the COVID-19 Outbreak through the Theory of Planned Behavior

We use the theory of planned behavior (TPB) to investigate determinants of stockpiling behavior during the COVID-19 lockdown. We analyzed 518 responses to an online survey and used Partial Least Squares Path Modeling (PLS-PM) techniques to estimate relationships between variables. Negative attitude (perceived barriers) and others’ behavior (descriptive social norms) were revealed as significant predictors for both intention to over-purchase and the actual stockpiling behavior. The lack of significance obtained for perceived behavioral control (PBC) is also an important result, strengthening the evidence that factors’ contribution to TPB’s predictive power is strongly context-dependent, respectively that PBC is less relevant in settings dominated by uncertainty. The lack of significance is especially compelling when stockpiling behavior is regarded as deviant conduct from effective consumption. Our findings expand the understanding on the applicability of TPB and offer informed practical suggestions for improving managerial strategies, public and private ones, during extreme events when self-regulation and cognitive control are expedient but hard to achieve.

Coronavirus disease 2019 vaccine acceptance and perceived barriers among university students in northeast Ethiopia: A cross-sectional study

Background

Universities are places where students live and study in close contact to each other. Nowadays, the foundations of this particular group have been affected significantly by the rapid spread of the coronavirus disease 2019. The severity of the COVID-19 pandemic has demanded the emergency use of COVID-19 vaccines. However, there is still limited evidence in COVID-19 vaccine acceptability and perceived barriers among some subgroups, including university students. This study aimed to assess vaccine acceptance, associated factors, and perceived barriers among university students, Ethiopia.

Methods

A cross-sectional study was conducted in January 2021 at Debre Berhan University among 423 students. The participants were selected using simple random sampling technique. A semi-structured, pretested, and self-administered questionnaire was used to collect the data. Multivariable logistic-regression model was fitted to identify factors associated with vaccine acceptance. An adjusted odds ratio with 95% confidence interval and its p-value of ≤0.05 was used to declare significant association.

Results

The proportion of the COVID-19 vaccine acceptance was 69.3% (95% CI: 65, 74). Being knowledgeable (AOR: 2.43, CI: 1.57, 3.77), being a health science student (AOR: 2.25, CI: 1.43, 3.54), and being in a family practicing COVID-19 prevention (AOR: 1.73, CI: 1.06, 2.81) were found to be factors associated with COVID-19 vaccine acceptance.

Conclusion

Though, this study found a 69.3% acceptance of COVID-19 vaccine, there were noticeable perceived barriers and related factors in vaccine acceptance hesitancy. Thus, health education and communication regarding the vaccine are very crucial to alleviate the identified barriers.

Perceived severity, fear of retaliation, and suspect report intention of general public during COVID-19 pandemic: A moderated moderation analysis

Management of COVID-19 largely depends on the reporting of suspected or confirmed positive cases. This study examined public's suspect report intention during COVID-19 using and extending the theory of planned behavior by adding two incident-specific variables such as perceived severity of COVID-19 and fear of retaliation. Direct association of attitude, subjective norm, and perceived behavioral control with suspect report intention and moderating role of perceived severity of COVID-19 and fear of retaliation were probed. This study also investigated whether the moderation of perceived severity of COVID-19 (primary moderator) varies with different level of fear of retaliation (secondary moderator) using moderated moderation analysis. Analyzing data collected from 554 Indian citizens provides evidence that attitude, subjective norm, and perceived behavioral control were positively associated with suspect report intention. Perceived severity of COVID-19 and fear of retaliation negatively moderated such associations. When fear of retaliation was high, high perceived severity of COVID-19 did not positively moderate the association of attitude, subjective norm, and perceived behavioral control with suspect report intention. Perceived behavioral control was the most potent facilitator and fear of retaliation was the strongest inhibitor of suspect report intention. Understanding people's suspect report intention can assist in implementing awareness programs to encourage suspect report intention and stop the community spread of COVID-19.

Health Communication, Knowledge, Perception and Behavioral Responses to COVID-19 Outbreak in Dessie, Kombolcha and Kemissie Towns, Amhara Region, Northeast Ethiopia: A Mixed-Method Study

BACKGROUND

Despite the efforts made to mitigate the spread of COVID-19 in Ethiopia, new cases continue to rise. Therefore, to overcome the devastating effects of the outbreak, health communication and the community's knowledge, perception, and behavioral responses towards COVID-19 should be assessed.

METHODS

A community-based cross-sectional study design was conducted from June 15 to July 30, 2020, with 827 and 18 participants for the quantitative and qualitative study, respectively. The data were collected using ODK collect and exported to SPSS version 25 for analysis. Multivariate logistic regression was computed, and variables that had a significant association were interpreted at p <0.05 with a 95% CI. Additionally, the qualitative data were collected using in-depth interview and then transcribed, translated, and analyzed using thematic content analysis.

RESULTS

The majority (97.8%) of respondents obtained information about COVID-19 through broadcast media, and 58.5% of the participants had good knowledge of COVID-19. Likewise, 51.3%, 60.9%, 73.8%, 35.1%, and 74.2% of participants had high perceived susceptibility, severity, benefit, barrier, and self-efficacy to COVID-19, respectively. Additionally, 54.3% of respondents had good behavioral responses to COVID-19. Kombolcha town residents (AOR: 4.32, 95% CI, 2.02-9.2), aged from 25 to 34, and 35 to 44 years old (AOR: 2.62, 95% CI, 1.37-5.0), and (AOR: 2.23, 95% CI, 1.11-4.46), respectively, secondary or above education (AOR: 2.38, 95% CI, 1.17-4.86), good knowledge of COVID-19 (AOR: 2.07, 95% CI, 1.42-3.02), high perceived self-efficacy (AOR: 4.90, 95% CI, 3.10-7.75), and low perceived barriers (AOR: 3.17, 95% CI, 2.12-4.74) to COVID-19 preventive measures were significantly associated with the behavioral responses to COVID-19.

CONCLUSION

In this study, the behavioral responses to COVID-19 were relatively low. Therefore, continuous awareness creation is needed to scale up the community's knowledge and perceived self-efficacy. Furthermore, the general public, especially young people, should follow the government's COVID-19 prevention and control rules and regulations.

Preventive Behaviors During the COVID-19 Pandemic: Associations With Perceived Behavioral Control, Attitudes, and Subjective Norm

Background: The coronavirus disease 2019 (COVID-19) is a highly contagious and potentially fatal infectious disease that has swept the globe. To reduce the spread, it is important to engage in preventive behaviors recommended by health authorities, such as washing your hands, wearing a face mask, and social distancing. Aim: In the present study, we draw from the Theory of Planned Behavior (TPB) to examine the associations between perceived behavioral control, attitudes, and subjective norm and whether people engage in eight different preventive behaviors. Methods: For each of the preventive behaviors (washing hands; using hand sanitizer; not touching your face; social distancing; wearing a face mask; disinfecting surfaces; coughing in your elbow; staying home if sick), we conducted separate logistic regressions predicting whether the participants (N = 2,256; age range = 1898 years) reported engaging in the behavior from their perceived behavioral control, attitudes, and subjective norm. Results: We found that perceived behavioral control, attitudes, and subjective norm had independent significant associations with each preventive behavior. Moderation analyses revealed that for most behaviors the associations with perceived behavioral control were stronger for older adults than for younger adults. Limitation: The present study was cross-sectional; future longitudinal studies and interventions are needed to disentangle directionality. Conclusion: Our findings suggest several ways to increase adherence to health behaviors that reduce the spread of coronavirus and other infectious diseases.

Let's Not Joke about It Too Much! Exposure to COVID-19 Messaging, Attitudes and Protective Behavioral Intentions

Our study evaluates the role of exposure to COVID-19 messaging in negativity towards COVID-19 and the intentions to engage in protective behaviors. Building on the theory of planned behavior (TPB), we derive a mediation model and test it in a sample of 737 participants (556 Romanians and 181 Kazakhs). The exposure to general information concerning COVID-19 positively predicts negative attitudes, negative emotions and the emergence of subjective norms in relation to COVID-19, as well as the likelihood of engaging in protective behavioral intentions. The exposure to humoristic communication, however, diluted the positive association between exposure to general information and negative attitudes, as well as negative emotions. The results support the overall predictions of the TPB and report positive associations between negative attitudes towards COVID-19, subjective norms and behavioral control on the one hand, and protective behavioral intentions on the other. Negative emotions significantly predict the likelihood of engaging in protective behaviors. Our results also show that older respondents tend to develop more negative attitudes towards COVID-19, yet they do not report stronger intentions to engage in protective behaviors than younger respondents. An important emergent result shows that time lapse seems to increase negativity towards COVID-19, yet it does not directly increase the likelihood of engaging in protective behaviors. Implications for public health communication related to COVID-19 are discussed.