The AGE Effect on Protective Behaviors During the COVID-19 Outbreak: Sociodemographic, Perceptions and Psychological Accounts

Comparative Effectiveness and Safety of BNT162b2 and CoronaVac in Hong Kong: A Target Trial Emulation

OBJECTIVES

To evaluate the difference between BNT162b2 and CoronaVac in vaccine effectiveness and safety.

METHODS

This target trial emulation study included individuals aged ≥ 12 during 2022. Propensity score matching was applied to ensure group balance. The Cox proportional hazard model was used to compare the effectiveness outcomes including COVID-19 infection, severity, 28-day hospitalization and 28-day mortality after infection. Poisson regression was used for safety outcomes including 32 adverse events of special interests between groups.

RESULTS

639,818 and 1,804,388 individuals were identified for the 2-dose and 3-dose comparison, respectively. In 2-dose and 3-dose comparison, the hazard ratios (HRs) (95% confidence intervals [CI]) were 0.844 [0.833-0.856] and 0.749 [0.743-0.755] for COVID-19 infection, 0.692 [0.656-0.731] and 0.582 [0.559-0.605] for hospitalization, 0.566 [0.417-0.769] and 0.590 [0.458-0.76] for severe COVID-19, and 0.563 [0.456-0.697] and 0.457 [0.372-0.561] for mortality for BNT162b2 recipients versus CoronaVac recipients, respectively. Regarding safety, 2-dose BNT162b2 recipients had a significantly higher incidence of myocarditis (Incidence rate ratio[IRR][95% CI]: 8.999 [1.14-71.017]) versus CoronaVac recipients, but the difference was insignificant in 3-dose comparison (IRR [95% CI]: 2.000 [0.500-7.996]).

CONCLUSIONS

BNT162b2 has higher effectiveness among individuals aged ≥ 12 against COVID-19-related outcomes for SARS-CoV-2 omicron compared to CoronaVac, with almost 50% lower mortality risk. (200 words).

Cognition, affect, and behavioural changes among university students after 10 new guidelines were issued in China: An exploratory study

Objectives

Since late 2019, the coronavirus disease 2019 (COVID-19) epidemic has become a common public health concern globally. China has entered a new phase of prevention and control with the implementation of the 10 new guidelines epidemic prevention policy in early December 2022. The resurgence of the outbreak may cause negative consequences on the behaviour of university students. This study aimed to assess the relationship between cognition, affect, and behavioural changes among university students and the related influencing factors after 10 new guidelines were issued, as well as the difficulties or concerns encountered in the current epidemic prevention process. It also provides a reference for the government to formulate targeted epidemic prevention strategies.

Methods

This study is a cross-sectional investigation. Self-designed questionnaires were distributed to students of a university in Hangzhou between December 25, 2022, and March 13, 2023, using convenience and snowball sampling methods for online surveys. Data analysis involved descriptive analysis, non-parametric tests, correlation, multiple linear regression, and content analyses.

Results

University students had a moderate to high level of cognition about COVID-19 and a medium level of affect. However, the level of behavioural changes was low and the average score was 2.33 (2.00, 3.00). Multiple linear regression analysis revealed that female sex, higher grade, medical specialty, affective factor, and cognitive factor were influencing factors of behavioural changes, which accounted for 35.7% of the variance in behavioural change. Difficulties or concerns included apprehension (84.8%), lack of information (39.3%), and uncertainty about the future (55.1%).

Conclusions

The prevention behaviour of university students has slackened. Evidence-based tailored policy development is indicated. This study suggested that schools and the government can improve the effectiveness of epidemic prevention among university students by adjusting the strategy of epidemic prevention policy formulation, broadening the channels of epidemic prevention information dissemination, and improving the mechanism of "government-community-school-family" collaborative governance.

COVID-19 vaccine acceptance among college students in South Carolina: do information sources and trust in information matter?

BACKGROUND

For college students who are exposed to multimedia, the sources of COVID-19 vaccine information and their trust in these sources may play a role in shaping the vaccine acceptance spectrum (refusal, hesitancy, and acceptance).

METHODS

Based on an online survey among 1,062 college students in South Carolina, we investigated vaccine information sources among college students and examined how COVID-19 vaccine acceptance was associated with information source and trust level in each source.

RESULTS

The top three sources of COVID-19 vaccine information were health agencies, mass media, and personal social networks. Trust in mass media, health agencies, scientists, and pharmaceutical companies was negatively associated with vaccine refusal. Trust in government and scientists was negatively associated with vaccine hesitancy.

DISCUSSION

Our findings highlight the importance of restoring trust in government, healthcare system, scientists, and pharmaceutical industries in the COVID-19 era.

Older women's experience with COVID-19 pandemic: A study of risk perception and coping among culturally and linguistically diverse population in South Australia

BACKGROUND

A global catastrophe-the COVID-19 pandemic-appears to have two-dimensional health consequences for older adults: high risk of being infected and psychological distress. There is limited evidence on how the pandemic has impacted the life and coping of older adults who are culturally and linguistically diverse (CALD), women in particular. This study explored the COVID-19 risk perception and coping strategies of older CALD women in South Australia.

METHODS

A mixed-methods research design was employed, involving a 31-items coping and emergency preparation scale for survey and semi-structured interviews with participants. The older CALD women were approached through 11 multicultural NGOs. One hundred and nine women participants from 28 CALD communities completed the online surveys; 25 of them agreed to a telephone interview and provided their contact details. 15 older CALD women ultimately participated in interviews.

RESULTS

Mean sum-score of dread risk, unknown risk, and fear (M: 43.5; SD: 4.9) indicated that the participants were somewhat anxious and worried. Mean sum-score of coping (M: 79.8; SD: 9.3) reported their compliance with expert advice and disinfection practices but accessing health information (M: 2.8; SD 1.4) and tendency to minimize anxiety (M: 2.1; SD: 1.2) were below neutral. Significant variations were found in coping in terms of age, meaning that the women aged 75 years and older were less likely to cope with the pandemic (P = 0.01). Emergency preparation differed based on the participants' residence and occupation status. The deductive-inductive thematic analysis of interview data was framed around three priori themes: risks of being affected, emotional and behavioral coping, and emergency preparation and access to services.

CONCLUSIONS

Evidence shows a fear among the older CALD women with an endeavor to cope and prepare for emergency situations. This suggests the requirements for interventions that improve coping and reduce the risk of stress among them.

Learning from the COVID-19 pandemic: a systematic review of mathematical vaccine prioritization models

As the world becomes ever more connected, the chance of pandemics increases as well. The recent COVID-19 pandemic and the concurrent global mass vaccine roll-out provides an ideal setting to learn from and refine our understanding of infectious disease models for better future preparedness. In this review, we systematically analyze and categorize mathematical models that have been developed to design optimal vaccine prioritization strategies of an initially limited vaccine. As older individuals are disproportionately affected by COVID-19, the focus is on models that take age explicitly into account. The lower mobility and activity level of older individuals gives rise to non-trivial trade-offs. Secondary research questions concern the optimal time interval between vaccine doses and spatial vaccine distribution. This review showcases the effect of various modeling assumptions on model outcomes. A solid understanding of these relationships yields better infectious disease models and thus public health decisions during the next pandemic.

Adult age differences in risk perception and risk taking

Research on self-reported risk perception and risk taking suggests age-related decrements in risk preference, with older adults less likely to engage in general and domain-specific risk taking (i.e., in financial, health-related, ethical, career, and leisure contexts). Data relating to social risks, however, are inconsistent. With respect to behavioral risk-taking tasks, age-related differences vary depending on task characteristics and older adults' cognitive capacities. Specifically, older adults are less good at learning to take advantageous risks and take fewer risks when faced with gains, especially financial and mortality-based ones. We contextualize these trends by referencing relevant theoretical frameworks (see Frey et al., 2021 [1]) and by drawing on the COVID-19 pandemic to illustrate recent examples of age-related differences in real-life risk responses.

Evidence of How Physicians and Their Patients Adopt mHealth Apps in Germany: Exploratory Qualitative Study

BACKGROUND

The enactment of the "Act to Improve Healthcare Provision through Digitalisation and Innovation " (Digital Healthcare Act; Digitale-Versorgung-Gesetz [DVG]) in Germany has introduced a paradigm shift in medical practice, allowing physicians to prescribe mobile health (mHealth) apps alongside traditional medications. This transformation imposes a dual responsibility on physicians to acquaint themselves with qualifying apps and align them with patient diagnoses, while requiring patients to adhere to the prescribed app use, similar to pharmaceutical adherence. This transition, particularly challenging for older generations who are less skilled with technology, underscores a significant evolution in Germany's medical landscape.

OBJECTIVE

This study aims to investigate physicians' responses to this novel treatment option, their strategies for adapting to this form of prescription, and the willingness of patients to adhere to prescribed mHealth apps.

METHODS

Using an exploratory qualitative study design, we conducted semistructured interviews with 28 physicians and 30 potential patients aged 50 years and older from August 2020 to June 2021.

RESULTS

The findings reveal several factors influencing the adoption of mHealth apps, prompting a nuanced understanding of adoption research. Notably, both physicians and patients demonstrated a lack of information regarding mHealth apps and their positive health impacts, contributing to a deficiency in trust. Physicians' self-perceived digital competence and their evaluation of patients' digital proficiency emerge as pivotal factors influencing the prescription of mHealth apps.

CONCLUSIONS

Our study provides comprehensive insights into the prescription process and the fundamental factors shaping the adoption of mHealth apps in Germany. The identified information gaps on both the physicians' and patients' sides contribute to a trust deficit and hindered digital competence. This research advances the understanding of adoption dynamics regarding digital health technologies and highlights crucial considerations for the successful integration of digital health apps into medical practice.

A planned behavior theory-based explanatory model of protective behavior against COVID-19, with an age perspective

In this study, an explanatory model of protective behaviors against COVID-19 transmission based on the theory of planned behavior is tested using a sample of 904 individuals by adding two relevant variables in the COVID-19 context: skepticism and responsibility toward COVID-19 transmission. Responsibility and the intention to behave in a protective way act as mediators in predicting protective behaviors. The model is invariant between younger and older people, although some path differences were found: the perception that individuals have about the extent to which their reference group adopts protective behaviors directly influences individual protective behavior for younger but not older people, for whom subjective social norms were only indirect predictors of such behavior. Additionally, the rates in all the variables showed that the group under 35 took more risks in the context of protective behaviors against COVID-19: they exhibited more skepticism, lower behavioral control, perceived fewer positive social norms regarding protective behaviors, felt less responsible for spreading the disease, had less intention to behave in a protective way, and finally adopted fewer protective behaviors. Developers of intervention strategies and campaigns should contemplate such variables and focus on differences according to age.

Later Life as a Daring Experience: Factors Associated with Older Adults' Risk Perception

Risk perception refers to people's subjective judgments about the possibility of negative occurrences and the extent to which they are concerned with them. Previous studies have found that older adults who were exposed to ongoing terror threats developed later-life and terror risk perceptions. These studies showed that high risk perception has negative psychological and physiological consequences. This study aimed to identify the factors associated with the development of both later-life risk perception and terror risk perception in later life. Data were collected via an online survey with 306 Internet users aged 50 years and over, half resided in a high-risk zone while the remainder lived in a low-risk zone. The Perceived Risk Scale, measures of depressive symptoms, life satisfaction, social support, spirituality, internet use, and personal background were applied. Low self-rated health was associated with terror and later-life risk perceptions, regardless of the risk zone. After controlling for personal background, only depressive symptoms significantly correlated with high risk perceptions. These findings suggest that older adults with poorer self-rated health, secular beliefs, and elevated depressive symptoms may be susceptible to developing high risk perceptions. Clinicians should encourage older adults to identify preserving resources to improve adjustment to late life stressors.

Predictors of fear control related to COVID-19 among older population: an investigation on COVID-19 risk perception and health related quality of life during the pandemic

BACKGROUND

The aim of this study was to examine the role of demographic characteristics, general health and health related quality of life on the fear control. Also, the aim of study was to explore how older people percept the COVID-19 pandemic by using the component of the expanded parallel process model (EPPM), and how the possible perception may contribute to probable behavior responses to prevention and control of COVID-19.

METHODS

The present study is a cross-sectional study that was conducted in Tabriz, a city in north of Iran from February to April 2021, the period that correspond with the fourth wave of COVID-19. To collect information, the Covid-19 risk perception questionnaire (based on EPPM model including efficacy, defensive responses, and perceived threat) and health related quality of life (HQOL) Short Form-36 questionnaire were used. Discriminate value was calculated to estimate fear control and danger control. Univariate and multivariable logistic regression were calculated to examine the effect of demographic characteristics, general health and health-related quality of life on the fear control.

RESULTS

The mean age of the 350 participants was 67.9 (6.4) years. A total of 83.1% of participants were engaged in danger control processes and 16.9% in fear control processes. According to the multivariable results, significant predictors for fear control were: gender 1.57 (95% CI 1.05-2.34, 0.025), education 7.38 (1.42-38.35, p = 0.017), economic status 1.31 (0.4-0.63, p = 0.029), and significant protective factors for fear control were: body pain 0.97 (0.94-0.99, p = 0.041), general health 0.96 (0.93-0.98, p = 0.032), physical health 0.94 (0.90-0.98) and total quality of life 0.024 (0.89-0.98).

CONCLUSIONS

Strong associations of fear control were found with being female, being illiterate, and having a good economic status and also body pain, general health, physical health and total HQOL were significantly associated with danger control. Since, most of elderly populations have adequately higher perceptions of efficacy to counteract their threat perceptions to continue motivating these older people to engage in COVID-19 self-protective behaviors, it is necessary to emphasis on the susceptibility of target population and the severity of the COVID-19 threats.

Age-based spatial disparities of COVID-19 incidence rates in the United States counties

COVID-19 incidence disparities have been documented in the literature, but the different driving factors among age groups have yet to be explicitly explained. This study proposes a community-based COVID-19 spatial disparity model, considering different levels of geographic units (individual and community), various contextual variables, multiple COVID-19 outcomes, and different geographic contextual elements. The model assumes the existence of age nonstationarity effects on health determinants, suggesting that health effects of contextual variables vary among place and age groups. Based on this conceptual model and theory, the study selected 62 county-level variables for 1,748 U.S. counties during the pandemic, and created an Adjustable COVID-19 Potential Exposure Index (ACOVIDPEI) using principal component analysis (PCA). The validation was done with 71,521,009 COVID-19 patients in the U.S. from January 2020 through June 2022, with high incidence rates shifting from the Midwest, South Carolina, North Carolina, Arizona, and Tennessee to the West and East coasts. This study corroborates the age nonstationarity effect of health determinants on COVID-19 exposures. These results empirically identify the geographic disparities of COVID-19 incidence rates among age groups and provide the evidentiary guide for targeting pandemic recovery, mitigation, and preparedness in communities.

Effects of housing layout and perceived behavioral control over social distancing in relation between social isolation and psychological distress during pandemic of COVID-19

Due to the results of the COVID-19 epidemic on health, the positive effect of social distancing has been highlighted. Nevertheless, the effect of housing layouts on resident's perceived behavioral control over social distancing in shared open spaces have been rarely investigated in the context of pandemic. Filling this gap, the current study examines the moderating effect of perceived behavioral control on the relationship between social isolation and psychological distress. Data from 1349 women residing in 9 gated communities during the Iranian national lockdown were collected. The results of ANOVA indicate that there is a significant difference between various housing layouts in terms of residents' perceived behavioral control. Respondent in courtyard blocks layout reported higher perceived behavioral control over social distancing than in linear and freestanding blocks. The findings of structural equation modeling identified perceived behavioral control as a buffer against the effect of social isolation on psychological distress.

Impact of COVID-19 Pandemic on Tourist Travel Risk Perception and Travel Behaviour: A Case Study of Poland

This article aims to identify the impact of the COVID-19 pandemic on the perception of the risk of travel and travel behaviour by Poles. The study was conducted using the survey method and the CAWI technique and was carried out in January 2021. The final research sample consisted of 509 respondents. Tourism has always been exposed to various threats: natural disasters, terrorism, etc. In such cases, tourists choose a different, safe direction. However, in 2020, tourism found itself facing a crisis that brought it to a complete stop worldwide. The spread of the COVID-19 virus and safety concerns, as well as global travel restrictions, led to a change in travel during this time. The results show that the respondents resigned especially from going abroad for security reasons, choosing to rather stay in the country and other places that, from their point of view, were safer places to rest.

Psychosocial Predictors and Mediators Relating to the Preventive Behaviors of Hospital Workers During the COVID-19 Pandemic in Turkey

OBJECTIVE

The aim is to analyze the relation of psychosocial factors to COVID-19 contraction, vaccination, and preventive health behavior in and outside work.

METHODS

The questionnaire data from hospital-workers in Turkey is analyzed using independent-samples t-test, logistic regression, linear regression, and mediation analyses. We developed a questionnaire on mask-hygiene-distance measures and also used previously developed scales including the Big Five Personality Questionnaire, Young Schema Questionnaire Short Form 3, Schwartz's Basic Human Values Scale, Short Dark Triad.

RESULTS

The odds of being infected by COVID-19 increases by self-direction. The odds of being vaccinated increases by age and conformity, and decreases by emotional stability. Education predicts certain preventive behaviors at work negatively and outside work positively. Older age, being a woman, having chronic disease, the self-transcendence and conservation values, agreeableness, and conscientiousness predict more preventive behaviors. The self-enhancement and openness to change values, the Dark Triad, and early maladaptive schemas predict more risky behaviors.

CONCLUSIONS

Designing prohealth policies requires further elaboration on the relation of psychosocial factors to preventive behaviors.

Older adults' subjective experiences of the COVID-19 outbreak and lockdown in Italy: A qualitative study

OBJECTIVE

To evaluate the subjective experience of the COVID-19 outbreak in healthy older adults and develop a model of the older population's psychological adaptation to the COVID-19 pandemic.

METHODS

A qualitative grounded theory approach was taken to the study design and analysis, using semi-structured interviews to collect data from 19 community-active Italian older people by telephone during the first wave of COVID-19 (May 2020).

RESULTS

The theory emerging from the study conceptualized the COVID-19 subjective experience in older people as an adjustment process to the disruption of habits, social contacts, and routines that prompted a meaning-making process to face this adverse experience. Three emergent categories included 'loss, uncertainty, and distress' as the psychological impact of the pandemic emergency, 'making sense of COVID-19' as a subjective sense-making process of the pandemic, and 'living with the pandemic' as agency and self-management within the pandemic experience. The resulting narratives encompassed themes, i.e. risk perception, representation of the self, connection with past-time memories, and compliance with safety measures.

CONCLUSION

The results have implications for designing effective messages to promote hope, social responsibility, and commitment in aging during the COVID-19 pandemic and for health workers who wish to support the psychological health of older adults.

Perceived COVID-19 Severity, Risk of Infection, and Prevention Self-Efficacy in Saudi Arabia During Lockdown: A Population-Based National Study

Evidence shows that the risk perception of humans can significantly affect their response to a threat. This population-based, cross-sectional study explored the determinants of perceived disease seriousness, perceived disease infectiveness, and perceived prevention self-efficacy of coronavirus disease (COVID-19), during the lockdown period, using the health belief model for preventive behavior (HBMPB) among 4423 adults in Saudi Arabia from 13 provinces. Multivariate binary regression was used to analyze the independent factors of three risk perception variables and to measure their effect on adherence to preventive measures. Overall, COVID-19 seriousness was perceived to be higher than that of diabetes and lower than that of a heart attack, while its infectiousness was perceived to be high by 75.3% of the participants. Furthermore, 66.6% had a low perception of their prevention self-efficacy. The HBMPB showed independent effects of all three risk perception parameters on adherence to the preventive measures, including perceived seriousness (Odd's ratio [OR] = 1.26; 95% confidence interval [95% CI] = 1.01-1.56), infectiousness (OR = 1.90; 95% CI = 1.52-2.38), and prevention self-efficacy (OR = 1.51; 95% CI = 1.20-1.91). Authorities should maintain an optimal level of communication on the COVID-19 risk, communicate more about the virus' cycle and the disease to demystify the rationale of the preventive measures, and enhance confidence in their efficiency.

Mental Health and the COVID-19 Pandemic: Observational Evidence from Malaysia

The interplay of physical, social, and economic factors during the pandemic adversely affected the mental health of healthy people and exacerbated pre-existing mental disorders. This study aimed to determine the impact of the COVID-19 pandemic on the mental health of the general population in Malaysia. A cross-sectional study involving 1246 participants was conducted. A validated questionnaire consisting of the level of knowledge and practice of precautionary behaviors, the Depression, Anxiety, and Stress Scales (DASS), and the World Health Organization Quality of Life-Brief Version (WHOQOL-BREF) was used as an instrument to assess the impacts of the COVID-19 pandemic. Results revealed that most participants possessed a high level of knowledge about COVID-19 and practiced wearing face masks daily as a precautionary measure. The average DASS scores were beyond the mild to moderate cut-off point for all three domains. The present study found that prolonged lockdowns had significantly impacted (p < 0.05), the mental health of the general population in Malaysia, reducing quality of life during the pandemic. Employment status, financial instability, and low annual incomes appeared to be risk factors (p < 0.05) contributing to mental distress, while older age played a protective role (p < 0.05). This is the first large-scale study in Malaysia to assess the impacts of the COVID-19 pandemic on the general population.

Depression and Medicine Use among Older Adults during the COVID-19 Pandemic: The Role of Psychosocial Resources and COVID-19 Perceived Susceptibility

A relationship was found between the COVID-19 pandemic and depression among older adults and between depressed mood and increased use of antidepressant medication among older adults during the pandemic. With the aim of broadening the understanding of these relationships, the study examined whether COVID-19 perceived susceptibility mediates the relationship between psychosocial resources (optimism and perceived social support) and depressive symptoms and medication use. Participants included 383 older adults (M = 71.75, SD = 6.77) reporting on socio-demographics, health characteristics, depression, optimism, social support, and COVID-19 perceived susceptibility. Medication use was retrieved from participants medical files. Lower optimism, lower social support, and higher COVID-19 perceived susceptibility were associated with greater depression, related with higher medication use. The findings emphasize the buffering effect of psychosocial resources on the adverse effects of depression affecting older adults during the COVID-19 pandemic, and consequently, the increased use of medication in this population. Practitioners should focus interventions on enhancing optimism and expanding social support among older adults. Moreover, interventions focused on alleviating depression among older adults should aim at improving perceptions of perceived susceptibility in the older population.

Socio-demographic characteristics and their relation to medical service consumption among elderly in Israel during the COVID-19 lockdown in 2020 as compared to the corresponding period in 2019

PURPOSE

The COVID-19 pandemic has led to the isolation of the population in Israel, including the elderly. The present study aimed to compare the consumption of medical services among adults over the age of 65 in Israel at the time of the first COVID-19 lockdown relative to the corresponding period the year before.

METHODS

We conducted a retrospective longitudinal observational quantitative research based on the Natali Healthcare Solutions Israel database of subscribers. Company subscribers over the age of 65 (N = 103,955) were included in the sample (64.5% women) in two time periods, before the COVID-19 outbreak-P1, in 2019, and during the first COVID-19 lockdown- P2 in 2020. Logistic regression was applied to examine service consumption for study variables.

RESULTS

The average number of referrals to services was lower during the COVID-19 lockdown period (M = 0.3658, SD = 0.781) compared to the corresponding period in the previous year (M = 0.5402, SD = 0.935). The average number of ambulance orders, doctor home visits and service refusals were higher when compared to the same period in the previous year. During both time periods, women (P1- M = 0.5631, SD = 0.951; P2- M = 0.3846, SD = 0.800) required significantly more (p < .000) services than men (P1- M = 0.5114, SD = 0.910; P2- M = 0.3417, SD = 0.753). Older, widowed people, living in non-Jewish/mixed localities, or in average or below average socioeconomic status localities required relatively more services to those with opposite socio-demographic traits (p < .000).

SUMMARY AND CONCLUSIONS

In a large sample of elderly in Israel, findings indicate a decrease in referrals to medical care during the first COVID-19 lockdown period, yet an increase in ambulance orders, doctor visits and service refusals. Socio-demographic characteristics showed a similar effect in both time periods. The period of the first COVID-19 lockdown was characterized by a higher incidence of medical service refusals as compared to the equivalent period in the previous year.

The Relationship between COVID-19 Protection Behaviors and Pandemic-Related Knowledge, Perceptions, Worry Content, and Public Trust in a Turkish Sample

Background: This study aimed to explore the effect of knowledge, COVID-19-related perceptions, and public trust on protective behaviors in Turkish people. Methods: Data were collected from an online survey (Turkish COVID-19 Snapshot Monitoring) conducted between July 2020 and January 2021. The recommended protective behaviors (hand cleaning, wearing a face mask, and physical distancing) to prevent COVID-19 were examined. The impacts of the following variables on protective behaviors were investigated using logistic regression analysis: knowledge, cognitive and affective risk perception, pandemic-related worry content, public trust, conspiracy thinking, and COVID-19 vaccine willingness. Results: Out of a total of 4210 adult respondents, 13.8% reported nonadherence to protection behavior, and 86.2% reported full adherence. Males and young (aged 18−30 years) people tend to show less adherence. Perceived self-efficacy, susceptibility, and correct knowledge were positively related to more adherence to protective behavior. Perceptual and emotional factors explaining protective behavior were perceived proximity, stress level, and worrying about the relatives who depended on them. Trust in health professionals and vaccine willingness were positive predictors, while conspiracy thinking and acquiring less information (<2, daily) were negative predictors. Unexpectedly, trust in the Ministry of Health showed a weak but negative association with protection behavior. Conclusions: Perceived stress, altruistic worries, and public trust seem to shape protection behaviors in addition to individuals’ knowledge and cognitive risk perception in respondents. Males and young people may have a greater risk for nonadherence. Reliable, transparent, and culture-specific health communication that considers these issues is required.

The Relationship between the Need for Closure and Coronavirus Fear: The Mediating Effect of Beliefs in Conspiracy Theories about COVID-19

This study investigated the relationship between fear of the coronavirus, belief in COVID-19 conspiracy theories, and dimensions of the need for cognitive closure. As there is evidence of associations between these variables, we hypothesized that the relationship between the need for closure dimensions and coronavirus fear may be mediated by conspiracy beliefs about COVID-19. We analyzed the results from 380 individuals who completed online versions of three scales: the Fear of COVID-19 Scale, a short version of the Need for Closure Scale, and-designed for this study-the Conspiracy Theories about the Coronavirus Scale. The results showed that belief in COVID-19 conspiracy theories fully mediated the relationship between the fear of the coronavirus and avoidance of ambiguity, as well as closed-mindedness. The findings provided evidence that beliefs in conspiracy theories may play a significant role in reducing the level of coronavirus fear in people with high levels of these traits. In addition, a partial mediation between the fear of the coronavirus and the need for predictability was found. The limitations and implications of the research are discussed.

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.

Health-Risk Behaviors, COVID-19 Preventive Behaviors, and the Impact of the COVID-19 Pandemic on the Working-Age Population of Bangkok, Thailand

Although studies have extensively discussed the effects of COVID-19 on global health behaviors, little is known about the extent of COVID-19 preventive behaviors and their negative effects on the working-age population of Bangkok, Thailand. Therefore, this study aimed to examine health-risk behaviors, COVID-19 preventive behaviors, and the impact of the COVID-19 pandemic among the Thai working-age population. An online cross-sectional survey was conducted among working-age adults through a self-administered questionnaire. Data were analyzed with descriptive statistics and stepwise multiple regression. Of the 313 Thai participants (227 females, 72.5%), 84.0% had high levels of health-risk behaviors for preventing COVID-19 infection, most respondents (89.1%) had high levels of knowledge about COVID-19, and most respondents (61.7%) had high levels of overall COVID-19 preventive behaviors. Stepwise multiple regression revealed that health-risk behaviors (β = 0.445), knowledge of COVID-19 (β = 0.148), gender (β = 0.145), and age (β = 0.133) were predictive of COVID-19 preventive behaviors. Additionally, most respondents (48.9%) had moderate overall effects from COVID-19. Based on our findings, these factors must be considered when implementing public policies to improve COVID-19 preventive behaviors among the currently employed working-age population. In addition, appropriate interventions must be established and evaluated for the pandemic's long-term effects.

Effect of prior outbreak work experience to future outbreak responses for nurses in Hong Kong: A cross-sectional study

Background

During the early phase of the Coronavirus Disease 2019 (COVID-19) epidemic, health care workers had elevated levels of psychological distress. Historical exposure to disease outbreak may shape different pandemic responses among experienced health care workers.

Aim

Considering the unique experience of the 2003 SARS outbreak in Hong Kong, this study examined the association between prior epidemic work experience and anxiety levels, and the mediating role of perceived severity of COVID-19 and SARS in nurses.

Methods

In March 2020, a cross-sectional survey targeting practising nurses in Hong Kong was conducted during the early phase of the COVID-19 epidemic. The interrelationships among participants' work experience during the SARS outbreak, perceived severity of SARS and COVID-19, and anxiety level were elucidated using structural equation model (SEM).

Findings

Of 1,061 eligible nurses, a majority were female (90%) with a median age of 39 years (IQR = 32-49). A significant and negative indirect association was identified between SARS experience and anxiety levels (B=-0.04, p=0.04) in the SEM with a satisfactory fitness (CFI=0.95; RMSEA=0.06). SARS-experienced nurses perceived SARS to be less severe (B=-0.17, p=0.01), translated an equivalent perception to COVID-19 (B=1.29, p<0.001) and resulted in a lower level of anxiety (B=0.19, p<0.001).

Conclusions

The less vigorous perception towards the severity of SARS and COVID-19 may explain SARS-experienced nurses' less initial epidemic-induced anxiety. The possible role of outbreak-experienced nurses in supporting outbreak-inexperienced nurses, both emotionally and technically, should be considered when an epidemic commences. Interventions aiming to facilitate the understanding of emerging virus should also be in place.

Public engagement in decision-making regarding the management of the COVID-19 epidemic: Views and expectations of the 'publics'

Background

In the management of epidemics, like COVID‐19, trade‐offs have to be made between reducing mortality and morbidity and minimizing socioeconomic and political consequences. Traditionally, epidemic management (EM) has been guided and executed attentively by experts and policymakers. It can, however, still be controversial in the public sphere. In the last decades, public engagement (PE) has been successfully applied in various aspects of healthcare. This leads to the question if PE could be implemented in EM decision‐making.

Methods

From June to October 2020, seven deliberative discussion focus groups were executed with 35 Dutch citizens between 19 and 84 years old. Their views on PE in COVID‐19 management were explored. The deliberative approach allows for the education of participants on the topic before the discussion. The benefits, barriers, timing and possible forms of PE in EM were discussed.

Results

Almost all participants supported PE in EM, as they thought that integrating their experiences and ideas would benefit the quality of EM, and increase awareness and acceptance of measures. A fitting mode for PE was consultation, as it was deemed important to provide the public with possibilities to share ideas and feedback; however, final authority remained with experts. The publics could particularly provide input about communication campaigns and control measures. PE could be executed after the first acute phase of the epidemic and during evaluations.

Conclusions

This paper describes the construction of an empirically informed framework about the values and conditions for PE in EM from the perspective of the public. Participants expressed support to engage certain population groups and considered it valuable for the quality and effectiveness of EM; however, they expressed doubts about the feasibility of PE and the capabilities of citizens. In future studies, these results should be confirmed by a broader audience.

Patient or Public Contribution

No patients or members of the public were involved in the construction and execution of this study. This study was very exploratory, to gain a first insight into the views of the public in the Netherlands, and will be used to develop engagement practices accordingly. At this stage, the involvement of the public was not yet appropriate.

Association between COVID-19 infection and work exposure assessed by the Mat-O-Covid job exposure matrix in the CONSTANCES cohort

OBJECTIVES

The COVID-19 pandemic has brought to light a new occupational health threat. We aimed to evaluate the association between COVID-19 infection and work exposure to SARS-CoV-2 assessed by a job-exposure matrix (JEM), in a large population cohort. We also estimated the population-attributable fraction among exposed subjects.

METHODS

We used the SAPRIS-SERO sample of the CONSTANCES cohort, limited to subjects actively working, and with a job code available and a questionnaire on extra work activities. The following outcomes were assessed: COVID-19 diagnosis was made by a physician; a seropositivity to the ELISA-S test ('serology strict') and ELISA-S test intermediate with positive ELISA-NP or a positive neutralising antibodies SN ('serology large'). Job exposure was assessed using Mat-O-Covid, an expert-based JEM with an Index used as a continuous variable and a threshold at 13/1000.

RESULTS

The sample included 18 999 subjects with 389 different jobs, 47.7% were men with a mean age of 46.2 years (±9.2 years). The Mat-O-Covid index taken as a continuous variable or with a threshold greater than 13/1000 was associated with all the outcomes in bivariable and multivariable logistic models. ORs were between 1.30 and 1.58, and proportion of COVID-19 attributable to work among exposed participants was between 20% and 40%.

DISCUSSION

Using the Mat-O-Covid JEM applied to a large population, we found a significant association between work exposure to SARS-CoV-2 and COVID-19 infection, though the estimation of attributable fraction among exposed people remained low to moderate. Further studies during other exposed periods and with other methods are necessary.

Personal Protective Measures during the COVID-19 Pandemic in Germany

OBJECTIVES

The coronavirus SARS-CoV-2 is highly contagious and can only be contained if the majority of the population takes measures to protect themselves against infection. The present study aimed to investigate personal protective measures, their development over the course of the pandemic in Germany, and potential differences in behavior in terms of sex, age, and education.

METHODS

Data from 20 waves of the serial cross-sectional study "BfR-Corona-Monitor" were analyzed. The total sample consisted of N = 20,317 respondents (about 1000 per wave). Data were collected through telephone surveys between June 2020 and March 2021.

RESULTS

To protect themselves from infection, participants primarily relied on wearing covers for mouth and nose, keeping their distance from other individuals, and washing their hands thoroughly. Analyses over time showed a strong positive correlation between the number of measures taken and the national incidence rate. Sociodemographic differences also emerged, with women and those who are higher educated as well as younger respondents taking a higher number of protective measures.

CONCLUSIONS

Our results indicated that in times of greater infection risks, individuals adapted accordingly and took more protective measures. However, on the basis of sociodemographic differences, campaigns should especially focus on older individuals, the male sex, and those with lower education to enhance their protective behavior.

Contrasting the COVID-19 Effects on Tourism Safety Perceptions and Coping Behavior among Young People during Two Pandemic Waves: Evidence from Egypt

The aim of this study is to analyze the impact of COVID-19 on tourism safety perceptions, acceptance of restrictions, and the intention to change behavior during the COVID-19 pandemic among young people. Taking Egypt as a case study, a total of 386 respondents were surveyed in two different pandemic periods, with data being collected during the first wave, in April and May 2020, and during the second wave, in December 2020 and January 2021. Data was analyzed using partial least squares structural equation modelling (PLS-SEM) with multigroup analysis (MGA). Results reveal significant differences between the first and the second coronavirus waves regarding the effects of perceived risk. Findings point to the heightened potential of the youth market segment in the current context and suggest that youngsters’ adaptive coping responses evolved towards self-regulatory behavior. Based on the results, theoretical and practical implications are drawn. Conceptually, the study has contributed to the clarification of the desensitization process experienced by youth over time, in the post-pandemic tourism context. Additionally, the activities’ safety perceptions being examined per se enlightened the relationship between risk susceptibility, safety perceptions, and coping attitudes and behavior. Findings suggest that special attention should be paid to crowded group settings, such as youth events, advising that authorities and tourism services should target their communication to different population segments and use appropriate safety messaging according to the evolution of health crises.

Impact of biological sex and gender-related factors on public engagement in protective health behaviours during the COVID-19 pandemic: cross-sectional analyses from a global survey

OBJECTIVE

Given the role of sociocultural gender in shaping human behaviours, the main objective of this study was to examine whether sex and gender-related factors were associated with the public's adherence to COVID-19-recommended protective health behaviours.

DESIGN

This was a retrospective analysis of the survey that captured data on people's awareness, attitudes and behaviours as they relate to the COVID-19 policies.

SETTING

Data from the International COVID-19 Awareness and Responses Evaluation survey collected between March 2020 and February 2021 from 175 countries.

PARTICIPANTS

Convenience sample around the world.

MAIN OUTCOME MEASURES

We examined the role of sex and gender-related factors in relation to non-adherence of protective health behaviours including: (1) hand washing; (2) mask wearing; and (3) physical distancing. Multivariable logistic regression was conducted to determine the factors associated with non-adherence to behaviours.

RESULTS

Among 48 668 respondents (mean age: 43 years; 71% female), 98.3% adopted hand washing, 68.5% mask wearing and 76.9% physical distancing. Compared with males, females were more likely to adopt hand washing (OR=1.97, 95% CI: 1.71 to 2.28) and maintain physical distancing (OR=1.28, 95% CI: 1.22 to 1.34). However, in multivariable sex-stratified models, females in countries with higher Gender Inequality Indexes (GII) were less likely to report hand washing (adjusted OR (aOR)=0.47, 95% CI: 0.21 to 1.05). Females who reported being employed (aOR=0.22, 95% CI: 0.10 to 0.48) and in countries with low/medium GIIs (aOR=0.18, 95% CI 0.06 to 0.51) were less likely to report mask wearing. Females who reported being employed were less likely to report physical distancing (aOR=0.39, 95% CI: 0.32 to 0.49).

CONCLUSION

While females showed greater adherence to COVID-19 protective health behaviours, gender-related factors, including employment status and high country-wide gender inequality, were independently associated with non-adherence. These findings may inform public health and vaccination policies in current as well as future pandemics.

Close kin influence COVID-19 precautionary behaviors and vaccine acceptance of older individuals

The family plays a central role in shaping health behaviors of its members through social control and support mechanisms. We investigate whether and to what extent close kin (i.e., partner and children) have mattered for older people in taking on precautionary behaviors (e.g., physical distancing) and vaccination during the COVID-19 pandemic in Europe. Drawing on data from the Survey of Health, Ageing and Retirement in Europe (SHARE), we combine its Corona Surveys (June-August 2020 and June-August 2021) with pre-COVID information (October 2019-March2020). We find that having close kin (especially a partner) is associated with a higher probability of both adopting precautionary behaviors and accepting a COVID-19 vaccine. Results are robust to controlling for other potential drivers of precautionary behaviors and vaccine acceptance, as well as to accounting for co-residence with kin. Our findings suggest that policy makers and practitioners may differently address kinless individuals when promoting public policy measures.

The Influence of Ethnic, Social, and Demographic Factors on Urban Slum Dwellers' Threat Appraisal, Awareness, and Protective Practices against COVID-19 in Thailand

This study aimed to analyze the influence of ethnicity and other demographic and social factors on urban slum dwellers' threat appraisal, awareness, and protective practices against COVID-19. It was conducted via 20 semi-structured interviews and 453 questionnaires for different ethnic groups from Thailand, Myanmar, Laos, and Cambodia in the slum communities of Khlong Toei, Bangkok-the largest slum in Thailand. A phenomenological approach was used to analyze the semi-structured interviews to understand dwellers' lived experiences and behaviors regarding COVID-19. The questionnaire data were analyzed using descriptive statistics and a multiple regression model. The main findings in this study were that age (elderly people), gender (female), ethnicity (foreign ethnic groups), and type of residential occupancy (living in unoccupied spaces, under tollways, and by railroads) were significant risk factors for vulnerability to COVID-19. Type of residential occupancy and occupation (daily wage workers) were risk factors for severity of COVID-19. Higher education and female gender were factors influencing COVID-19 awareness in all ethnic groups; women tended to practice COVID-19 protection guidelines better than men. Foreign ethnic groups and daily wage workers also performed better in COVID-19 protection practices than other groups. This study appeals for urgent intervention and special assistance from development organizations, the government, and society to ensure slum communities' access to clean water, sanitation, and health care, using dwellers' sociodemographic characteristics and ethnicity to help enhance their threat appraisal capacity and coping strategies with regard to the pandemic.

The COVID-19 risk perceptions, health precautions, and emergency preparedness in older CALD adults in South Australia: A cross-sectional study

Background

In Australia, the relationships of cultural contexts with health challenges in older culturally and linguistically diverse (CALD) adults during the COVID-19 remain under-investigated. This study explored the older CALD adults’ risk perceptions of COVID-19, and identified demographics and risk perceptions associated with their health precautions and emergency preparation in South Australia.

Methods

A cross-sectional online survey was conducted. 155 older adults aged 60 years and over from 28 CALD communities completed the surveys. We described demographics, risk perceptions, seven items of health precautions, and five items of emergency preparedness. Data were analyzed in Stata/MP version 13.0.

Results

Mean sum-score of fear was 7.3 [SD 1.9], signifying that the participants were afraid of being infected with COVID-19. Health precaution items presented a mean sum-score of 24.8, with a compliance in washing and disinfecting hands [M: 4.4], avoiding public places and events [M: 3.9] and transports [M: 3.8], but they did not present high-alignment with staying at home and avoiding meeting at risk population groups. Overall health precautions were positively influenced by ethnicity [Asian β 3.40; 95% CI 1.21, 5.59; African β 5.46; 95% CI 0.76, 10.16]; perceptions of long-term effects [β 1.82; 95% CI 0.65, 2.99]; and fear [β 0.55; 95% CI 0.08, 1.01]. Mean sum-score of emergency preparedness was 14.9, which indicated the participants’ responses, on average, did not prevent them from buying large quantities and storing essential goods.

Conclusion

A pandemic-related response plan is needed to ensure all older CALD adults receive and follow advice and care appropriately.

Public perceptions during the first wave of the COVID-19 pandemic in Canada: a demographic analysis of self-reported beliefs, behaviors, and information acquisition

Introduction

We explored associations between sociodemographic factors and public beliefs, behaviors, and information acquisition related to the coronavirus disease 2019 (COVID-19) to identify how the experiences of subpopulations in Canada may vary.

Methods

We administered a national online survey through Ipsos Incorporated to adults residing in Canada. Sampling was stratified by population age, sex, and regional distributions. We used descriptive statistics to summarize responses and test for differences based on gender, age, educational attainment, and household income using chi-squared tests, followed by weighted logistic regression.

Results

We collected 1996 eligible questionnaires between April 26th and May 1st, 2020. Respondents mean age was 50 years, 51% were women, 56% had a post-secondary degree, and 72% had a household income <$100,000. Our analysis found differences within the four demographic groups, with age effects most acutely evidenced. Respondents 65 years and older were more likely to perceive the pandemic as very serious, less likely to report declines in overall health, and more likely to intend to get vaccinated, compared to 18–29 year olds. Women overall were more likely to report negative outcomes than men, including stress due to the pandemic, and worsening social, mental/emotional, and spiritual health. Respondents 45 and older were more likely to seek and trust information from traditional Canadian news sources, while 18-29 year olds were more likely to seek and trust information on social media; overall, women and respondents with a post-secondary degree were more likely to access and trust online information from public health sites.

Conclusion

This study found important demographic differences in how adults living in Canada perceived the COVID-19 pandemic, the impacts on their health, and their preferences for information acquisition. Our results highlight the need to consider demographic characteristics in tailoring the format and information medium to improve large scale acceptance and uptake of mitigation and containment measures.

Optimistic Youth: Young Adults Predicted a Faster Decrease in Risk during COVID-19 Emergency State in Portugal

Perception of risk is known to change throughout the lifespan. Previous studies showed that younger adults are more prone to risk behaviours than older adults. Do these age-related differences influence risk perception during a pandemic crisis? Here, we investigated how age influenced predicted risk during the COVID-19 emergency state in Portugal. We show that time-projected estimations (e.g., appraisals based on 'now' vs. 'in two weeks' time', or 'in four weeks' time') of both risk behaviour and importance of transmission prevention decrease over time. Importantly, projected risk decreased more steeply for younger than older adults. Our findings suggest that younger adults have a different perception of epidemic-related risk than older adults. This seems to support the view that public health policy making during epidemics should differentially target younger adults.

Older Europeans' health perception and their adaptive behaviour during the COVID-19 pandemic

BACKGROUND

Although older adults are more vulnerable to the COVID-19 virus, a significant proportion of them do not follow recommended guidelines concerning preventive actions during the ongoing pandemic. This article analyses the role of biased health beliefs for adaptive health behaviour such as reduced mobility, protection in public spaces and hygiene measures, for the population aged 50 and older in 13 European countries.

METHODS

Health perception is measured based on the difference between self-reported health and physical performance tests for over 24 000 individuals included in the most recent Survey of Health, Ageing and Retirement in Europe. Logistic regressions are employed to explore how over- and underestimating health are related to preventive behaviours.

RESULTS

Results suggest that older adults who underestimate their health are more likely to show adaptive behaviour related to mobility reductions. In particular, they are more likely to stay at home, shop less and go for walks less often. In contrast, overestimating health is not significantly associated with reduced mobility. Protective behaviour in public spaces and adopting hygiene measures do not vary systematically between health perception groups.

CONCLUSION

As health beliefs appear relevant for the adoption of preventive health behaviours related to mobility, they have serious consequences for the health and well-being of older Europeans. Although adaptive behaviour helps to contain the virus, exaggerated mobility reduction in those who underestimate their health might be contributing to the already high social isolation and loneliness of older adults during the ongoing pandemic.

Older Adults' Perceived Risk Regarding COVID-19 and Intention to Vaccinate: Role of Health-Related Literacy

The current cross-sectional descriptive study aimed to explore the association between coronavirus disease 2019 (COVID-19)-related health literacy, perceived risk, and intention to receive a COVID-19 vaccine. A sample of 414 older adults completed several questionnaires regarding COVID-19 risk perception, intention to vaccinate, and health literacy. Results revealed that more than one half of older adults demonstrated perceived high risk related to COVID-19 infection. Moreover, 31.6% of older adults noted their unwillingness to get vaccinated, and 39.4% demonstrated low health literacy regarding COVID-19. A significant positive correlation was found among older adults' perceived risk regarding COVID-19 infection, intention toward vaccination against COVID-19, and COVID-19-related health literacy. Findings serve to aid the Ministry of Health in planning proactive steps to increase COVID-19 vaccine uptake in older adults. [Research in Gerontological Nursing, 15(2), 57-67.].

Early and Dynamic Socio-Academic Variables Related to Dropout Intention: A Predictive Model Made during the Pandemic

Social and academic integration variables have been shown to be relevant for the understanding of university dropout. However, there is less evidence regarding the influence of these variables on dropout intention, as well as the predictive models that explain their relationships. Improvements in this topic become relevant considering that dropout intention stands as a useful measure to anticipate and intervene this phenomenon. The objective of the present study was to evaluate a predictive model for university dropout intention that considers the relationships between social and academic variables during the first university semester of 2020. The research was conducted using a cross-sectional associative-predictive design, with a convenience sampling (n = 711) due to the restrictions of the pandemic period. The results showed a good fit of the proposed hypothetical model that explained 38.7% of dropout intention. Both social support and perceived social isolation predicted the sense of belonging and, through it, engagement. Previous academic performance predicted early academic performance and, through it, engagement. The set of variables predicted the intention to quit through engagement. These results are a contribution both to the understanding of the phenomenon and to guide potential interventions in the early stages of the university experience.

Fear of contamination among older adults in the post-COVID-19 era

This study assesses older adults' fear of contamination in the post-coronavirus disease 2019 (COVID-19) era, examining the factors associated with this fear and investigating its effects on their well-being and use of primary healthcare, considering the moderating effects of activities of daily living (ADL) and multimorbidity in these two relationships. A cross-sectional study was conducted in primary healthcare centers in three regions in Saudi Arabia with a convenience sample of 444 older adults diagnosed with chronic diseases. The results indicated that 77.9% of older adults had high contamination fear, predicted by their age, education level, gender, ADL, and previous COVID-19 infection experience. Subjective well-being and the number of primary healthcare visits in the post-COVID-19 era were negatively affected by contamination fear and both ADL and multimorbidity moderated these relationships. In conclusion, the study confirmed the need to focus on older adults' contamination fear to mitigate its negative effects on well-being and critical primary healthcare visits.

Factors associated with decision making on COVID-19 vaccine acceptance among college students in South Carolina

COVID-19 vaccination could be a promising approach in controlling the pandemic, but its success relies on the vaccine acceptance among various populations including young adults who are vulnerable to COVID-19 due to active lifestyle and perceived invulnerability. Vaccine acceptance decisions can be influenced by multiple factors and people may weigh these factors differently in decision making. The current study aimed to explore COVID-19 vaccine acceptance among college students in South Carolina and examine how they weigh these factors according to their COVID-19 vaccine acceptance levels (i.e. acceptance, hesitance, refusal). Online survey data were collected from 1062 college students in South Carolina between September and October 2020. Multinomial logistic regresssion was used to compare perceived importance of 12 factors affecting levels of vaccine acceptance, controlling for demographic variables. About 26.1% of participants reported they would definitely take COVID-19 vaccines when available. Compared to acceptance group, refusal and hesitance groups considered side effects and vaccine characteristics (e.g. where the vaccine is produced) as important. Hesitance group considered authoritative advice from school/college as important. Acceptance group considered authoritative advice from government/doctors and local availability of the vaccines and local availability of the vaccines as important. Our findings suggest relatively low vaccine acceptance among college students in South Carolina and different factors were considered in their vaccination decision according to their acceptance levels. Tailored vaccine promotion messages should address specific concerns among the refusal and hesitancy groups. Schools should attend to valid communication strategies in vaccine campaign since the hesitancy group considered school's advice as important. College health educators also need to pay attention to the refusal group who do not value duration of protection or authoritative advice as much as their counterparts in vaccine decision making.

How Did Awareness, Emotion, and Motivation Shape Behavior Toward COVID-19 in Tunisians?

This study was conducted to assess the psychological distress in the general population of Tunisia during the pandemic of COVID-19 and examines how awareness of the disease, emotional experience, and motivation shaped the behavior toward this outbreak. The study covers 1492 Tunisian participants. Gender effects and age limits were studied in relation with the seriousness of the disease and lockdown impacts. The data were analyzed and interpreted using the chi-square test, ANOVA, path analysis (PA), and confirmatory factor analysis (CFA). We found a significant effect of gender and age on the awareness of the pandemic dangerousness, the attitude, and the commitment to respect the preventive measures. Women are significantly more aware and committed than men to respect preventive health measures. The 35-45 age group showed more awareness and dedication than the other age groups, while the 20-35 age group showed the most less promise. PA and CFA results showed how awareness, emotion, and motivation shaped behavior toward COVID-19. This study provides practical and relevant information on behavior change during a pandemic crisis, which can orient communication campaigns and help policymakers.

Risk Perceptions, Knowledge and Behaviors of General and High-Risk Adult Populations Towards COVID-19: A Systematic Scoping Review

Objectives: The COVID-19 pandemic represents a major crisis for governments and populations. The public’s risk perceptions, knowledge, and behaviors are key factors that play a vital role in the transmission of infectious diseases. Our scoping review aims to map the early evidence on risk perceptions, knowledge, and behaviors of general and high-risk adult populations towards COVID-19.

Methods: A systematic scoping review was conducted of peer-reviewed articles in five databases on studies conducted during the early stages of COVID-19. Thirty-one studies meeting the inclusion criteria were appraised and analyzed.

Results: The levels of risk perceptions, knowledge, and behaviors towards COVID-19 were moderate to high in both general and high-risk adult populations. Adults were knowledgeable about preventive behaviors. Our review identified hand-washing and avoiding crowded places as dominant preventive behaviors. Being a female, older, more educated, and living in urban areas was associated with better knowledge of COVID-19 and appropriate preventive behaviors.

Conclusion: This review offers a first understanding of risk perceptions, knowledge and behaviors of adult populations during the early stages of the COVID-19 pandemic.

Older People in Germany During the COVID-19 Pandemic:The Least, the More, and the Most Affected

Older people have been identified as a particularly vulnerable group during the COVID-19 pandemic. However, the question of how older people actually fared during the COVID-19 pandemic has only been sporadically addressed. This article aims to partly fill this gap by classifying subgroups of older people using Latent Class Analysis. Indicators used are: risk perception, safety behavior, and well-being. To predict subgroup membership, age, gender, living arrangement, children, chronic illness, conflict, socioeconomic status, and migration history are controlled for. The data analyzed stem from a phone survey among 491 older people (75–100 years) in Germany conducted in September/October 2020. Results show that three subgroups of older people – the least, the more and the most affected – can be formed based on their risk perception, safety behavior, and well-being, indicating the usefulness of these three constructs for identifying and studying older people particularly affected by the COVID-19 pandemic and the measures taken to contain it.

A message of the majority with scientific evidence encourages young people to show their prosocial nature in COVID-19 vaccination

The most promising way to prevent the explosive spread of COVID-19 infection is to achieve herd immunity through vaccination. It is therefore important to motivate those who are less willing to be vaccinated. To address this issue, we conducted an online survey of 6232 Japanese people to investigate age- and gender-dependent differences in attitudes towards COVID-19 vaccination and the underlying psychological processes. We asked participants to read one of nine different messages about COVID-19 vaccination and rate their willingness to be vaccinated. We also collected their 17 social personality trait scores and demographic information. We found that males 10-20 years old were least willing to be vaccinated. We also found that prosocial traits are the driving force for young people, but the motivation in older people also depends on risk aversion and self-interest. Furthermore, an analysis of 9 different messages demonstrated that for young people (particularly males), the message emphasizing the majority's intention to vaccinate and scientific evidence for the safety of the vaccination had the strongest positive effect on the willingness to be vaccinated, suggesting that the "majority + scientific evidence" message nudges young people to show their prosocial nature in action.

How COVID-19 Pandemic Affected Urban Trips? Structural Interpretive Model of Online Shopping and Passengers Trips during the Pandemic

Changing people’s shopping behavior from face-to-face to online shopping during the COVID-19 pandemic led to reduced shopping trips, and this decrease directly affects traffic congestion and air pollution. Identifying the factors influencing the increase of online shopping behavior during the pandemic can be helpful for policymakers in the post-COVID-19 era. This study aims to discover the effect of factors related to the COVID-19 pandemic and demographic characteristics on shopping attitude and, consequently, on shopping trips. Based on the interviews of ten experts, factors associated with COVID-19 and demographic characteristics are selected as influential factors on shopping attitude and shopping trips. For pairwise comparisons between these factors, a web-based questionnaire was designed and given to thirty experts. The relationship between all factors is examined using interpretive structural modeling (ISM) and Microscopic–Macroscopic (MICMAC) analysis. In addition, to prioritize factors, the IAHP model is employed. Based on the results, five levels of influential factors affect shopping attitude, which affects shopping trips: level 1, age and gender; level 2, income and education; level 3, the household size and the COVID-19 awareness; level 4, COVID-19 attitude and COVID-19 practice; and level 5, norm subject and shopping personal control.