Determinants of Preventive Behaviors in Response to the COVID-19 Pandemic in France: Comparing the Sociocultural, Psychosocial, and Social Cognitive Explanations

Two-Year-Span Breast Cancer Screening Uptake in Japan after the COVID-19 Pandemic and Its Association with the COVID-19 Vaccination

There is limited information on whether the COVID-19 pandemic was associated with decreased breast cancer screening uptake and if COVID-19 vaccination was associated with an increase in screening uptake. Our study explored the uptake of breast cancer screening in Japan after the COVID-19 pandemic and assessed its association with the COVID-19 vaccination. We analyzed data from the Japan COVID-19 and Society Internet Survey (JACSIS), a web-based prospective cohort survey, and we included 6110 women without cancer history who were aged 40 to 74 years that participated in the 2012 and 2022 surveys. We examined the regular breast cancer screening uptake before and after the pandemic and employed a multivariable Poisson regression model to seek any association between COVID-19 vaccination and screening uptake. Of 6110, 38.2% regularly participated in screening before the pandemic and 46.9% did so after the pandemic. Individuals unvaccinated due to health reasons (incidence rate ratio (IRR) = 0.47, 95% CI: 0.29-0.77, p = 0.003) and for other reasons (IRR = 0.73, 95% CI: 0.62-0.86, p < 0.001) were less likely to undergo screening compared to fully vaccinated individuals. There was no long-term decrease in breast cancer screening uptake after the pandemic in Japan. Vaccination was linked to increased uptake, but there was no dose relationship.

Trust as a catalyst: revealing the impact of government trust and professional trust on public health policy compliance during a pandemic

BACKGROUND

Existing research has extensively explored the relationship between government trust and compliance behaviour, but significant controversies exist. Some studies suggest a strong positive correlation between the two. Other studies have found that government trust hinders compliance behaviour. However, during the pandemic, the effectiveness of public health policies largely depends on the public's compliance with these policies. To examine the aforementioned controversies, this study utilizes survey data on the Chinese population during the COVID-19 period to explore the relationship between compliance with public health policies and government trust.

METHODS

The study conducted a questionnaire survey of 1,395 individuals from 25 provinces in China from mid-November to mid-December 2022. Firstly, we categorized the public's compliance behaviour with public health policies based on the results of factor analysis. Subsequently, we examined the impact of government trust and professional trust on compliance behaviour with public health policies by constructing a structural equation model.

RESULTS

Based on the results of factor analysis, we classified public adherence to public health policies into protective compliance and restrictive compliance. Results from the structural equation model show a positive correlation between the public's trust in the government and both protective and restrictive compliance, with a stronger influence on protective compliance. Government trust also exerts a positive impact on restrictive compliance behaviour through professional trust. Additionally, the study indicates a significant positive correlation between the public's professional trust and restrictive compliance, while it does not significantly affect protective compliance. Moreover, the public from rural areas demonstrates a greater willingness to adhere to both types of public health policies. Married individuals exhibit a stronger inclination toward protective compliance, while females show a stronger tendency toward restrictive compliance.

CONCLUSION

The study revealed a significant positive impact of government trust and professional trust on compliance behaviour with public health policies during the COVID-19 pandemic, refuting any negative correlation between government trust and compliance behaviour. Normative motivations for compliance behaviour had a substantial impact on adherence. These findings offer valuable insights for future public health crisis management and public policy formulation.

Unraveling socioeconomic determinants of health-related behavior, reception of information, and perceptions on disease disclosure at the time of the COVID-19 pandemic: did health insurance curb the disparities in the Philippines?

BACKGROUND

The study uncovers micro and macro socioeconomic disparities in terms of health behavior, disease perception, and reception of information. Furthermore, findings shed light on the possible role of health insurance on access to information, disease perception and the adoption of preventive behaviors in the context of a public health emergency such as the COVID-19 pandemic.

METHODS

This study employed a cross-sectional design using the Philippine Demographic and Health Survey (DHS). With a total of 29,809 respondents, it evaluated the individual or household and systemwide socioeconomic determinants of four different outcomes: receipt of information, disease perception, uptake of free preventive services, and treatment-seeking behavior. In addition to logistic regression models with the socioeconomic variables as the independent variables, models for the evaluation of the moderating effect of insurance ownership were fitted. Predicted probabilities were reported for the analysis of moderating effects.

RESULTS

Findings show that individual and householdsocioeconomic determinants affected health-behavior and access to or receipt of information pertinent to the COVID-19 pandemic. Both education and wealth affected the receipt of information such that individuals in more advantaged socioeconomic positions were at least 30% more likely to have received information on COVID-19. Wealth was also associated to treatment-seeking behavior. Regional differences were seen across all dependent variables. Moreover, the study provides evidence that ownership of insurance can close education-based gaps in the uptake of free vaccination and COVID-19 testing.

CONCLUSION

It is imperative that targeted efforts be maximized by utilizing existing strategies and mechanisms to reach the marginalized and disadvantaged segments of the population. Health insurance may give off added benefits that increase proficiency in navigating through the healthcare system. Further research may focus on examining pathways by which health insurance or social policies may be used to leverage responses to public health or environmental emergencies.

Timing of preventive behavior in the case of a new and evolving health risk: the case of COVID-19 vaccination

BACKGROUND

Time preferences for preventive behavior under novel risks and uncertain contexts may differ from timing preferences related to familiar risks. Therefore, it is crucial to examine drivers of preventative health behavior timing in light of new health risks. Using the case of COVID-19, we examine factors affecting vaccination timing plans when vaccines were widely available in the European Union (EU).

METHODS

We use data from the Flash Eurobarometer 494 survey (May 21-26, 2021), which collected information on EU residents' attitudes towards COVID-19 vaccinations. We also use the 'Our World in Data' vaccination database for country-level COVID-19 vaccination rates. Probit regressions were conducted to determine how local vaccination rates, trust in information sources, social norms, vaccine safety beliefs, and risk understanding affected the probability of COVID-19 vaccination delay.

RESULTS

Of total participants (n = 26,106), 9,063 (34.7%) were vaccinated, 7,114 (27.3%) wanted to get vaccinated as soon as possible, 5,168 (19.8%) wanted to delay vaccination and 2,962 (11.4%) resisted vaccination. Participants were more likely to delay COVID-19 vaccination if they lived in a country with lower vaccination prevalence, trusted online social networks, family, friends, and colleagues for vaccination information, were eager to follow vaccination-related social norms, expressed vaccine safety concerns, and understood the risk of catching COVID-19 without a vaccine to be lower.

CONCLUSIONS

Results from the study contribute to understanding important factors that predict timing of vaccination plans. These findings can also contribute to the wider knowledge base about timing of preventive behavior uptake in novel risk contexts.

Utility and Utilization of Patient-Reported Experience Measures for the Supplementary COVID-19 Protective Actions at the Ovidius Clinical Hospital in Romania

Patient-reported experience measures (PREMs) provide assessments of patients' subjective experiences and perceptions regarding their interactions with the healthcare system and its services. We present a cross-sectional study of the patient perception and evolution of COVID-19 cases performed at Ovidius Clinical Hospital in Romania during the COVID-19 pandemic. The study objective is to explore the utility and the utilization of PREMs in monitoring patient perceptions of the supplementary protective actions. During the pandemic, the hospital implemented early supplementary protective actions, like PCR and lung CT, to all surgically admitted patients in the hospital alongside government-recommended actions. At the same time, functional PREMs were used to evaluate patient perceptions regarding these supplementary actions. The research was carried out for 19 months between June 2020 and December 2021. The findings revealed that opinions about the severity of the COVID-19 pandemic, the personal risk of infection, and the perception of protective actions in the hospital were not correlated. Conclusions: The patients' appreciation of the COVID-19 protective actions taken by the hospital is related more to the general perceptions induced by the number of cases presented in the mass media and less by perceptions of the gravity of the problem or the risk of infection. In a hospital, the primary mission of patient safety is essential, and it must be fulfilled even if the patients are not sure or fully convinced that this is for their benefit. For management decisions and monitoring, using PREMs can be essential in a situation when general evidence is not conclusive.

Health protective behaviours during the COVID-19 pandemic: Risk adaptation or habituation?

Many epidemiological works show that human behaviours play a fundamental role in the spread of infectious diseases. However, we still do not know much about how people modify their Health Protective Behaviours (HPB), such as hygiene or social distancing measures, over time in response to the health threat during an epidemic. In this study, we examined the role of the epidemiological context in engagement in HPB through two possible mechanisms highlighted by research into decision-making under risk: risk adaptation and risk habituation. These two different mechanisms were assumed to explain to a large extent the temporal variations in the public's responsiveness to the health threat during the COVID-19 pandemic. To test them, we used self-reported data collected through a series of 25 cross-sectional surveys conducted in France among representative samples of the adult population, from March 2020 to September 2021 (N = 50,019). Interestingly, we found that both mechanisms accounted relatively well for the temporal variation in the adoption of social distancing during the pandemic, which is remarkable given their different assumptions about the underlying social cognitive processes involved in response to a health threat. These results suggest that strengthening the incentives to encourage people to maintain health protective behaviours and to counter risk habituation effects is crucial to disease control and prevention over time.

Resilience and Social Support Improve Mental Health and Quality of Life in Patients with Post-COVID-19 Syndrome

Physical and mental health problems among post-COVID-19 patients are common, even a year after infection. As there is no prior study available, we investigated the impacts of resilience and social support on anxiety, depression, and quality of life among patients with post-COVID-19 syndrome. We conducted a cross-sectional study with a convenience sample. The measures included the demographic and clinical characteristics of patients, the Brief Resilience Scale, the Multidimensional Scale of Perceived Social Support, the Patient Health Questionnaire-4 (PHQ-4), and the EuroQol-5D-3L. The mean age of patients was 44.8 years. The total PHQ-4 score suggested that 32.8% of patients with post-COVID-19 syndrome experienced severe psychological distress, 32.8% experienced moderate distress, 23% experienced mild distress, and 11.5% had no distress. Moreover, 60.7% of patients had anxiety scores of ≥3 and 69.7% had depression scores of ≥3, indicating possible major anxiety or depression disorder. The mean EQ-5D-3L index value was 0.36, and the mean EQ-5D-3L VAS was 54.1. Multivariable analysis identified that resilience and social support reduced anxiety and depression among patients. Also, we found a significant positive relationship between resilience and social support, and quality of life. Our findings suggest that resilience and social support can be protective by reducing anxiety and depression and improving quality of life among patients with post-COVID-19 syndrome. Policymakers should develop and implement healthcare management programs to provide psychological support to these patients.

Determine the factors that affected COVID-19 prevention behaviors based on constructs of social cognition theory

BACKGROUND

COVID-19 is a universal challenge and novel disease is one of the core public health concerns. This study aimed to determine the factors that affected COVID-19 prevention behaviors (CPB) based on constructs of Social Cognition Theory (SCT).

METHODS

This cross-sectional study was conducted on 426 participants referred to health centers of Arak from October 2021 to February 2022, and they were selected through a multi-stage random sampling method. Data were collected via a self-administered questionnaire which includes socio-demographic data (6 items), COVID-19 prevention behaviors (12 items), and SCT constructs related to COVID-19 (32 items). SPSS Ver-16 statistical software was used to analyze the data with one-way ANOVA, independent samples t-test, and multiple linear regressions. The significance level of α = 0.05 was considered for all tests.

RESULTS

The mean age was 37.8 years (SD = 12.2) and ranged from 17 to 81. According to the results, 51.2% had higher education and 52.6% of the participants were female. The mean (SD) of COVID-19 preventive behaviors was 43 (SD = 7.8) out of 60. There was statistical association between CPB and three constructs of SCT. Multiple regression showed that the outcomes expectations (β = 0.11, p < 0.001), self-regulation (β = 0.41, p < 0.001), and self-efficacy (β = 0.30, p < 0.001), age, gender, and history of COVID 19infection were associated with CPB and those described 61% of the variance of CPB.

CONCLUSION

Rendering to the result of this study constructs of SCT is the key predictor of participants' CPB. Hence, based on these predictors, effective interventions and healthy messages could be designed based on this predictor-outcomes expectations, self-regulation, social support, and self-efficacy which can be beneficial to improve healthy behavior.

[Factors associated with adherence to COVID-19 preventive behaviors in ELSA-Brasil participants]

The aim of the study is to assess the adherence to recommended prevention measures during the COVID-19 pandemic and to investigate the factors associated with this adherence in the adult population. This study has a cross-sectional design and used data from the complementary study Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) - COVID, conducted from 2020 to 2021. Data were analyzed using the chi-square test and multinomial logistic regression. The sample consisted of 5,440 participants. The preventive measure with the highest adherence was the use of a face mask (95.5%). There was greater adherence by females and lower chance of adherence by white people, by those who consume alcoholic beverages, people who were retired, as well as for those who live alone or who have family members who did not follow the recommendations to stay at home. Greater adherence to preventive behaviors was observed in only one third of the participating population, which demonstrates that there was a need for greater awareness of the risks in specific populations. The findings contribute to improving our understanding about health promotion and COVID-19 prevention.

Self-reported interoception, worries and protective behaviors during the COVID-19 pandemic: a longitudinal study

BACKGROUND

Protective behaviors were essential for minimizing the spread of the virus during the coronavirus disease 2019 (COVID-19) pandemic. It is often assumed that awareness of bodily sensations (interoception) can improve decision-making and facilitate adaptive behavior.

OBJECTIVE

This paper investigates cross-sectional and longitudinal relationships between different aspects of self-reported interoception, trait anxiety, COVID-related worry, and health protective behaviors.

METHODS

The study was conducted on a community sample of 265 adults. The two data collection phases took place online, before (baseline) and during the second wave of the COVID-19 pandemic in Hungary.

RESULTS

Contrary to our expectations, neither cross-sectional nor longitudinal associations were found between protective behaviors and indicators of self-reported interoception. However, worry at baseline predicted protective behaviors during the second wave, even after controlling for socio-economical characteristics and protective behaviors at baseline.

CONCLUSION

Our results highlight the adaptivity of health-related worry when behavioral steps to avoid threats are known and available. Also, higher level of perceived interoception did not appear to be health protective under these circumstances.

Identification of factors associated with non-adherence to recommended COVID-19 preventive behaviours: a cross-sectional study based on a survey among 1004 French primary care professionals

OBJECTIVES

Since the beginning of the COVID-19 pandemic, adherence to preventive behaviours to limit virus spread has been a major issue. The study objective was to identify factors associated with non-adherence to preventive behaviours among general practitioners (GPs) during the COVID-19 pandemic using data from a questionnaire completed during the French National Congress of General Medicine in June 2021.

DESIGN

This descriptive study relied on data collected with a questionnaire during the national congress on general medicine in Bordeaux, France, from 16-18 June 2021.

SETTING

The study was conducted in primary care in France.

PARTICIPANTS

Out of a total of 1004 GPs and GP trainees, 755 completed the questionnaire during conferences and 249 were contacted by mail.

RESULTS

The questionnaire included questions on sociodemographic characteristics and COVID-19 related preventive behaviours, beliefs and experiences. Answers to questions that explored the Health Belief Model components were selected and then compared among participants who reported appropriate preventive behaviours (wearing face masks and social distancing) and participants who reported non-adherence. Analysis was based on multivariate logistic regression.The responders' mean age was 35.8 years; 61.64% were women, 61.9% were practising GPs and 37.2% were GP trainees. Moreover, 96.6% of participants had completed the COVID-19 vaccination schedule. Non-adherence (reported by 72/1004 participants) was more frequent among smokers (OR=2.57, 95% CI 1.29 to 4.83, p=0.005) and younger participants (OR=0.95, 95% CI 0.92 to 0.98, p=0.005). Complete COVID-19 vaccination or a previous infection was not associated with non-adherence and has been poorly described.

CONCLUSION

More studies are needed to confirm the factors involved in the adoption of COVID-19 preventive behaviours by healthcare professionals and to explore the beliefs and barriers to the adoption of these behaviours.

Explaining US travel behavior with perceived threat of pandemic, consumer sentiment, and economic policy uncertainty

Since the COVID-19 outbreak, consumer behavior has been affected by the perceived threat of the pandemic and economic uncertainty. This paper aims to explore the dynamic effects of COVID-19, consumer sentiment, economic policy uncertainty, and fuel prices on travel behavior in the United States. Using updated daily trip data, the results show that consumer sentiment has a positive long-run impact on travel demand for air and auto, suggesting that a positive change in consumer sentiment can boost demand for these modes of transportation in the long term. Additionally, consumer sentiment has a favorable effect (1.34) on demand for long-distance trips, but it has a negative impact (-0.42) on the number of people staying at home. Economic and political shocks have a detrimental impact on demand for air and auto travel, suggesting that consumers reduce the frequency and cost of these transport services if they have pessimistic expectations about the future state of the economy and policy. However, in the short term, US travelers appear to be insensitive to shocks in consumer sentiment and economic policy uncertainty. Regarding the perceived threat of the pandemic, the results indicate that rising COVID-19 cases have a negative long-term effect on demand for air travel (-0.09) and public transit (-0.19), while they are positively associated with demand for auto travel (0.06). Similarly, the increasing number of deaths due to COVID-19 has led to a shift from shared-use mass transportation (air travel and public transit) to private autos and non-motorized travel, such as walking in the short term.

Socioeconomic and risk-related drivers of compliance with measures to prevent SARS-CoV-2 infection: evidence from the Munich-based KoCo19 study

OBJECTIVES

Although a growing share of the population in many countries has been vaccinated against the SARS-CoV-2 virus to different degrees, social distancing and hygienic non-pharmaceutical interventions still play a substantial role in containing the pandemic. The goal of this study was to investigate which factors are correlated with a higher compliance with these regulations in the context of a cohort study in the city of Munich, southern Germany, during the summer of 2020, i.e. after the first lockdown phase.

METHODS

Using self-reported compliance with six regulations and personal hygiene rules (washing hands, avoiding touching face, wearing a mask, keeping distance, avoiding social gatherings, avoiding public spaces) we extracted two compliance factor scores, namely compliance with personal hygiene measures and compliance with social distancing regulations. Using linear and logistic regressions, we estimated the correlation of several socio-demographic and risk perception variables with both compliance scores.

RESULTS

Risk aversion proved to be a consistent and significant driver of compliance across all compliance behaviors. Furthermore, being female, being retired and having a migration background were positively associated with compliance with personal hygiene regulations, whereas older age was related with a higher compliance with social distancing regulations. Generally, socioeconomic characteristics were not related with compliance, except for education, which was negatively related with compliance with personal hygiene measures.

CONCLUSIONS

Our results suggest that for a targeted approach to improve compliance with measures to prevent SARS-CoV-2 infection, special attention should be given to younger, male and risk-prone individuals.

Testing a simple and frugal model of health protective behaviour in epidemic times

The COVID-19 epidemic highlighted the necessity to integrate dynamic human behaviour change into infectious disease transmission models. The adoption of health protective behaviour, such as handwashing or staying at home, depends on both epidemiological and personal variables. However, only a few models have been proposed in the recent literature to account for behavioural change in response to the health threat over time. This study aims to estimate the relevance of TELL ME, a simple and frugal agent-based model developed following the 2009 H1N1 outbreak to explain individual engagement in health protective behaviours in epidemic times and how communication can influence this. Basically, TELL ME includes a behavioural rule to simulate individual decisions to adopt health protective behaviours. To test this rule, we used behavioural data from a series of 12 cross-sectional surveys in France over a 6-month period (May to November 2020). Samples were representative of the French population (N = 24,003). We found the TELL ME behavioural rule to be associated with a moderate to high error rate in representing the adoption of behaviours, indicating that parameter values are not constant over time and that other key variables influence individual decisions. These results highlight the crucial need for longitudinal behavioural data to better calibrate epidemiological models accounting for public responses to infectious disease threats.

A system dynamics model of the COVID-19 pandemic considering risk perception: A case study of Iran

The new coronavirus disease 2019 (COVID-19) has become a complex issue around the world. As the disease advancing and death rates are continuously increasing, governments are trying to control the situation by implementing different response policies. In order to implement appropriate policies, we need to consider the behavior of the people. Risk perception (RP) is a critical component in many health behavior change theories studies. People's RP can shape their behavior. This research presents a system dynamics (SD) model of the COVID-19 outbreak considering RP. The proposed model considers effective factors on RP, including different media types, awareness, and public acceptable death rate. In addition, the simplifying assumption of permanent immunity due to infection has been eliminated, and reinfection is considered; thus, different waves of the pandemic have been simulated. Using the presented model, the trend of advancing and death rates due to the COVID-19 pandemic in Iran can be predicted. Some policies are proposed for pandemic management. Policies are categorized as the capacity of hospitals, preventive behaviors, and accepted death rate. The results show that the proposed policies are effective. In this case, reducing the accepted death rate was the most effective policy to manage the pandemics. About 20% reduction in the accepted death rate causes about 23% reduction in cumulative death and delays at epidemic peak. The mean daily error in predicting the death rate is less than 10%.

Social Environment and Attitudes toward COVID-19 Anti-Contagious Measures: An Explorative Study from Italy

Social and cultural aspects (i.e., political decision making, discourses in the public sphere, and people's mindsets) played a crucial role in the ways people responded to the COVID-19 pandemic. Framed with the Semiotic-Cultural Psychological Theory (SCPT), the present work aims to explore how individual ways of making sense of their social environment affected individuals' perception of government measures aimed at managing the pandemic and the adherence to such measures. An online survey was administered from January to April 2021 to the Italian population. Retrieved questionnaires (N = 378) were analyzed through a Multiple Correspondence Analysis (MCA) to detect the factorial dimensions underpinning (dis)similarities in the respondents' ways of interpreting their social environment. Extracted factors were interpreted as markers of Latent Dimensions of Sense (LDSs) organizing respondents' worldviews. Finally, three regression models tested the role of LDSs in supporting the individual satisfaction with the measures adopted to contain the social contagion defined at national level, individual adherence to the containment measures and the perception of the population's adherence to them. Results highlight that all the three measures are associated with a negative view of the social environment characterized by a lack of confidence in public institutions (health system, government), public roles and other people. Findings are discussed on the one hand to shed light on the role of deep-rooted cultural views in defining personal evaluations of government measures and adherence capacity. On the other hand, we suggest that taking into account people's meaning-making can guide public health officials and policy makers to comprehend what favors or hinders adaptive responses to emergencies or social crises.

The Determinants of Adherence to Public Health and Social Measures Against COVID-19 Among the General Population in South Korea: National Survey Study

BACKGROUND

The COVID-19 pandemic has created devastating health, social, economic, and political effects that will have long-lasting impacts. Public health efforts to reduce the spread of COVID-19 are the priority of national policies for responding to the pandemic globally. Public health and social measures (PHSMs) have been shown to be effective when used alone or in combination with other measures, reducing the risk of spreading COVID-19. However, there is insufficient evidence on the status of compliance with PHSMs in the general population for the prevention of COVID-19 in public areas, including Korea.

OBJECTIVE

The aim of this study was to assess levels of compliance with the recommended PHSMs against SARS-CoV-2 infection and their predictors among the general population by using national data.

METHODS

This study was a secondary data analysis of the National Survey of Infectious Disease Preventive Behaviors in Community, which was conducted by the Korea Centers for Disease Control and Prevention Agency (KDCA) between October 12 and October 30, 2020. The primary study was cross-sectional, using stratified sampling via an adjusted proportional allocation method to select representative samples and ensure the stability of samples. The data were collected through phone interviews conducted by trained enumerators using a structured questionnaire. PHSM adherence was measured using a 10-item comprehensive infectious disease prevention behavior (CIDPB) scale, and each sociocognitive factor, including perceived susceptibility to SARS-CoV-2 infection, perceived severity of SARS-CoV-2 infection, perceived confidence in performing preventive behaviors related to COVID-19, information comprehension ability, and trust in information from the KDCA, was measured. A total of 4003 participants were included in the final analysis. Tobit regression and a decision tree analysis were performed to identify the predictors of preventive measures and the target groups for intervention.

RESULTS

We discovered that women scored 1.34 points higher on the CIDPB scale than men (P<.001). Compared to the group aged 19 to 29 years, those aged 50 to 59 years and those older than 60 years scored 1.89 and 2.48 points higher on the CIDPB scale (P<.001), respectively. The perceived severity of infection, confidence in preventive behaviors, information comprehension ability, and trust in information from the KDCA were significant positive determinants of CIDPBs (P<.001). The perceived susceptibility to infection showed a significant negative relationship with CIDPBs (P<.001).

CONCLUSIONS

Female sex, older age, lower income, and sociocognitive factors were found to be significant determinants of adhering to PHSMs. The findings suggest the need for tailored interventions for target groups; specifically, the age group that was the most active at work indicated the highest potential to spread infection. Adequate public health education and health communication for promoting adherence to PHSMs should be emphasized, and behavior change strategies for those with low perceived confidence in performing PHSMs should be prioritized.

Understanding online health information seeking behavior of older adults: A social cognitive perspective

Introduction

Online health information seeking has been verified to play a crucial role in improving public health and has received close scholarly attention. However, the seeking behavior of older adults, especially the underlying mechanism through which they are motivated to seek health information online, remains unclear. This study addresses the issue by proposing a theoretical model leveraging social cognitive theory.

Methods

IT self-efficacy and IT innovativeness were identified as personal factors and professional support and social support were identified as environmental factors. We conducted a survey that included 347 older people in China and examined the research hypotheses with a structural equation model.

Results

IT self-efficacy and IT innovativeness facilitate older adults to seek health information online by increasing their perceived benefit of using the internet. Additionally, professional support and social support enhanced older adults' online seeking behavior by promoting their health awareness. We also found that perceived benefit displayed a stronger impact than health awareness on older adults' behavior related to searching for health information online.

Conclusion

This study reveals that IT self-efficacy, IT innovativeness, professional support, and social support will promote older adults to seek health information online by enhancing their health awareness and perceived benefit. The findings of this study provide significant theoretical and practical implications.

Preventive behaviours during the pandemic: The role of collective rituals, emotional synchrony, social norms and moral obligation

The present research focuses on the role of collective, social influence and intraindividual processes in shaping preventive behaviours during the COVID-19 pandemic. In two correlational studies conducted in Spain, we explored the impact of participation in the ritual of collective applause (carried out daily for over 70 days during the lockdown) and perceived social norms in fostering behavioural adherence to public health measures, as well as the mediating role of perceived emotional synchrony and a sense of moral obligation. The first study (general population, N = 528) was conducted in June 2020, just after the end of the lockdown, and the second study (students, N = 292) was carried out eight months later. The results of the structural equations modelling (SEM) consistently confirmed that active participation in collective applause was linked to more intense emotional synchrony and indirectly predicted self-reported preventive behaviour. Perceived social norms predicted self-reported behavioural compliance directly and also indirectly, via feelings of moral obligation. The discussion addresses some meaningful variations in the results and also focuses on the implications of the findings for both theory and psychosocial intervention.

A. M, Park A, Parveen S, Kim S. Evolution and consequences of individual responses during the COVID-19 outbreak

In a long-lasting major disease outbreak such as that of COVID-19, the challenge for public health authorities is to keep people motivated and keen on following safety guidelines. In this study, a compartmental model with a heterogeneous transmission rate (based on awareness) is utilized to hypothesize about the public adoption of preventive guidelines. Three subsequent outbreaks in South Korea, Pakistan, and Japan were analyzed as case studies. The transmission, behavior change, and behavioral change ease rates of the disease were measured in these countries. The parameters were estimated using the maximum likelihood method with an additional identifiability analysis performed to determine the uniqueness of the estimated parameters for quantitatively comparing them during the first three waves of COVID-19. The mathematical analysis and simulation results show that individual responses had a significant effect on the outbreak. Individuals declining to follow the public health guidelines in Korea and Japan between the second and third waves contributed to making the third peak the highest of the three peaks. In Pakistan, however, individual responses to following public health guidelines were maintained between the second and third waves, resulting in the third peak being lower than the first, rather than being associated with the highest transmission rate. Thus, maintaining a high level of awareness is critical for containing the spread. Improvised public health campaigns are recommended to sustain individual attention and maintain a high level of awareness.

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

Objectives

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

Methods

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

Results

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

Conclusion

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

The Roles of Health and e-Health Literacy, Conspiracy Beliefs and Political Sympathy in the Adherence to Preventive Measures Recommended during the Pandemic

Adherence to preventive measures is of the utmost importance for limiting the spreading of the coronavirus. Many predictors of adopting preventive behaviors have been analyzed in different countries during the COVID-19 pandemic. Objectives: The study’s main aim was to assess the roles of health (HL) and e-health literacy (eHL), conspiracy beliefs, political sympathy, and religious practices in the adherence to COVID-19 preventive measures after adjusting for sociodemographic factors. The analysis was based on the data obtained from a survey conducted among 2410 adult Internet users in Poland in October 2020. The survey was performed with a computer-assisted web-based interviewing technique. Survey data were analyzed through uni- and multivariable linear regression models. The multivariable regression model revealed that after adjusting for sociodemographic variables, the preventive measures score (PMS) was significantly associated with HL (B = 0.04, p < 0.001), eHL (B = 0.03, p < 0.001) and the COVID-19-related conspiracy beliefs score (C19CBS) (B = −0.24, p < 0.001). There was also a significant statistical relationship between PMS and political sympathies and religious practices. HL and eHL are key factors eligible for modification through appropriate interventions and showing positive effects in compliance with preventive measures. Conspiracy beliefs, political sympathy and religious beliefs are independently associated with the adherence.

Determining the Prevalence and Correlates of COVID-19 Booster Vaccine Hesitancy in the Singapore Population Following the Completion of the Primary Vaccination Series

In response to declining vaccine-induced immunity and the emergence of new COVID-19 variants, COVID-19 booster vaccination programmes have been widely launched in several high-income countries. However, public response has been slow, and scepticism about these programmes is rising in these settings. This study sought to identify the sociodemographic, emotional, and psychological factors associated with COVID-19 booster vaccine hesitancy in Singapore. Derived from a community cohort, 1005 fully vaccinated adults (62.1% female, mean age = 42.6 years) that had not received their COVID-19 booster shots completed an online survey between October and November 2021 on vaccination beliefs, intentions, and behaviours. Results indicated that despite completing the primary COVID-19 vaccination, 30.5% of those surveyed were hesitant about receiving the booster shot (25.9% unsure; 4.7% refused the booster), and 39.2% perceived more vaccine risks than benefits. Multivariable models indicated that a tertiary education, lower COVID-19 threat perception, lower perceived benefits, higher perceived concerns, a decreased need for booster vaccination, and a lower benefit/concerns differential score were associated with higher odds of booster vaccine hesitancy. Success in the primary vaccination series may not warrant widespread public acceptance for recurrent COVID-19 vaccination doses. In addressing booster vaccine hesitancy as restrictive measures and mandates are lifted, health perceptions relevant or unique to booster vaccine uptake should be considered.

COVID-19 and seasonal flu vaccination hesitancy: Links to personality and general intelligence in a large, UK cohort

Vaccines are a powerful and relatively safe tool to protect against a range of serious diseases. Nonetheless, a sizeable minority of people express ‘vaccination hesitancy’. Accordingly, understanding the bases of this hesitancy represents a significant public health opportunity. In the present study we sought to examine the role of Big Five personality traits and general intelligence as predictors of vaccination hesitancy across two vaccination types in a large (N = 9667) sample of UK adults drawn from the Understanding Society longitudinal household study. We found that lower levels of general intelligence were associated with COVID-19 and seasonal flu vaccination hesitancy, and lower levels of neuroticism was associated with COVID-19 vaccination hesitancy. Although the self-reported reasons for being vaccine hesitant indicated a range of factors were important to people, lower general intelligence was associated with virtually all of these reasons. In contrast, Big Five personality traits showed more nuanced patterns of association.

The impact of health literacy levels on women’s fear of contracting Covid-19 and their attitudes toward holistic complementary and alternative medicine: Mediation analysis results

Researchers aim to examine mediating variable role of health literacy in the relationship between fear of contracting Covid-19 in women and use of holistic complementary alternative medicine. The study was conducted as descriptive cross-sectional. The researchers collected study data by conducting an online questionnaire from 285 women between April 01 and June 30, 2021. In our study, a significant relationship was found between education level and health literacy, having a chronic illness, not being able to find a permanent job and fear of Covid-19 (p < 0.05). Positive correlation exists between fear of contracting Covid-19 and Holistic Complementary and Alternative Medicine Practice (correlation between HCAM Practice β=.21). When health literacy variable is included, the level of relationship decreases (β=.18). The researchers determined that as the level of health literacy increased, the women resorted to HCAM practices less despite their fear of contracting Covid-19.

Cognitive Factors Associated With Public Acceptance of COVID-19 Nonpharmaceutical Prevention Measures: Cross-sectional Study

Background

During the COVID-19 crisis, protests against restrictions emerged and rule violations increased, provoking peaks in new positive cases, forcing authorities in France to impose fines to slow down the spread of the disease. Due to these challenges, subsequent implementations of preventive measures in response to COVID-19 recurrences or other pandemics could present difficulties for decision makers. A better understanding of the factors underlying the public acceptance of COVID-19 nonpharmaceutical preventive measures may therefore contribute greatly to the design of more effective public communication during future pandemics.

Objective

The aim of this study was to evaluate the acceptance of COVID-19 nonpharmaceutical prevention measures in France. The specific objectives were (1) to examine the public’s acceptance of COVID-19 nonpharmaceutical prevention measures and (2) to assess the association of the public’s acceptance of these prevention measures and their perception of COVID-19.

Methods

Data were collected from 2004 individuals through an online survey conducted 6-8 weeks after the first lockdown in France. For objective 1, participants were asked the extent to which they supported 8 COVID-19 nonpharmaceutical preventive measures using a 4-point Likert scale. For objective 2, COVID-19–related perceptions were assessed using a 5-point Likert scale from an adapted version of Witte’s Extended Parallel Process Model. Sociodemographic and environmental variables were also collected. The public’s acceptance factors were estimated using an unweighted least squares factorial analysis, and their associations with perceptions of COVID-19, expressed as rate ratios (RR) and 95% CIs, were estimated using generalized linear Poisson regression models. Statistical analyses were performed using the SPSS statistical package.

Results

The acceptance rate reached 86.1% for individual protective measures, such as making masks mandatory in public open spaces, and 70.0% for collective restrictions, such as isolating the most vulnerable people (1604/2004, 80%) or forbidding public gatherings (n=1590, 79.3%). The least popular restrictions were closing all schools/universities and nonessential commerce such as bars and restaurants (n=1146, 57.2%). Acceptance of collective restrictions was positively associated with their perceived efficacy (RR 1.02, 95% CI 1.01-1.03), fear of COVID-19 (RR 1.04, 95% CI 1.03-1.05), and perceived severity of COVID-19 (RR 1.04, 95% CI 1.03-1.06), and negatively with age >60 years (RR 0.89, 95% CI 0.81-0.98). Acceptance of individual protective measures was associated with their perceived efficacy (RR 1.03, 95% CI 1.03-1.04), fear of COVID-19 (RR 1.02, 1.01-1.03), and perceived severity of COVID-19 (RR 1.03, 1.01-1.05).

Conclusions

Acceptance rates of COVID-19 nonpharmaceutical measures were rather high, but varied according to their perceived social cost, and were more related to collective than personal protection. Nonpharmaceutical measures that minimize social costs while controlling the spread of the disease are more likely to be accepted during pandemics.

Psychosocial Factors Associated With Adherence to COVID-19 Preventive Measures in Low-Middle- Income Countries, December 2020 to February 2021

Objectives: To investigate psychosocial factors associated with adherence to COVID-19 preventive measures in low- and middle-income countries (LMICs). Methods: This online cross-sectional survey included 10,183 adults (median age 45 years) from nine LMICs. Participants were asked about adhering to four COVID-19 preventive measures (physical distancing, wearing a face mask, hand, and cough hygiene); a composite adherence score was calculated, ranging from 0-4 positive responses. Psychosocial measures included worry, anxiety, depression, social and demographic, and COVID-19 related factors. Results: Factors associated with adherence to more preventive measures included being a participant from Malaysia or Bangladesh, older age, higher education, belonging to the healthcare sector (either as or worker), having health personnel as a trusted source of COVID-19 information/advice, possessing correct COVID-19 knowledge, worry or fear about being (re)infected with COVID-19, and screening negative for general anxiety symptoms. Conclusion: Moderate to high adherence to COVID-19 preventive measures was found, with significant variations across countries. Psychosocial factors (worry, anxiety, knowledge, education, age, and country) seemed determinant in predicting the number of measures to which participants adhered.

Pregnant women’s unmet need to communicate with a health professional during the SARS-CoV-2 pandemic lockdown in France: The Covimater cross-sectional study

During the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic lockdown, communication between pregnant women and health professionals may have become complicated due to restrictions on movement and saturated health services. This could have impacts on pregnancy monitoring and women’s wellbeing. We aimed to i) describe the unmet need of pregnant women living in France to communicate with health professionals about the pandemic and their pregnancy during the lockdown, ii) assess the socio-demographic, medical and contextual factors associated with this unmet need. The Covimater cross-sectional study, conducted in July 2020, includes data on 500 adult women’s experiences of pregnancy during the first lockdown period in France (i.e., from March to May 2020). The women, all residents in metropolitan France, answered a web-based questionnaire about their conversations with health professionals during the lockdown, as well as their social and medical characteristics. A robust variance Poisson regression model was used to estimate crude or adjusted prevalence ratios (aPRs) for their unmet need to communicate with health professionals about the pandemic and their pregnancy. Forty-one percent of participants reported an unmet need to communicate with a health professional during the lockdown, mainly about the risk of transmitting SARS-CoV-2 to their baby and the consequences for the latter. Factors associated were: i) being professionally inactive (aPR = 1.58,CI95%[(1.14–2.21]), ii) having an educational level below secondary school diploma (1.38,[1.05,-1.81]), iii) having experienced serious arguments/violence (2.12,[1.28–3.52]), iv) being very worried about the pandemic (1.41,[1.11–1.78]), v) being primiparous (1.36,[1.06–1.74]) and vi) having had pregnancy consultations postponed/cancelled by health professionals during the lockdown (1.35,[1.06–1.73]). These results can be used to develop targeted strategies that ensure pregnant women are able to i) communicate with health professionals about the potential impact of the SARS-CoV-2 pandemic on their pregnancy, and ii) access up-to-date and reliable information on the consequences of SARS-CoV-2 for themselves and their child.

Perception of the SARS-CoV-2 pandemic by pregnant women during the first lockdown in France: worry, perceived vulnerability, adoption and maintenance of prevention measures according to the Covimater study

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Participants’ main worries concerned risks for their pregnancy or relatives.

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Perceived vulnerability linked to obesity and lack of professional health advice.

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Knowledge of viral transmission favoured implementation of prevention measures.

Background

We aimed to describe pregnant women’s worry about the SARS-CoV-2 pandemic, the associated reasons, their perceived vulnerability to this infection, and factors influencing continued poor/non-existent or decreased implementation of preventive measures over time.

Method

A cross-sectional study was conducted in July 2020 using a web-questionnaire completed by 500 women who were pregnant during the first lockdown in France (March–May 2020). Questions focused on worry caused by the pandemic, perceived vulnerability to infection by SARS-CoV-2 and implementation of preventive measures during and after lockdown. A robust variance Poisson regression model was used to estimate adjusted prevalence ratios (aPR) for perceived vulnerability and continued poor/non-existent or decreased implementation of preventive measures.

Results

Participants felt significantly more vulnerable to infection than women of childbearing age who were included in a parallel study on the French general population, but were significantly less worried about the pandemic. Obese participants and those who unsuccessfully sought exchanges with healthcare professionals about their infection risk felt significantly more vulnerable (aPR = 1.32 95%CI[1.05–1.64] and 1.88 [1.43–2.48], respectively). Participants with continued poor/non-existent or decreased implementation of preventive measures two months after the lockdown ended were more likely to have experienced violence during the lockdown (2.06, [1.32–3.22]), or to live in areas less affected by the pandemic (1.66 [1.05–2.62]). A good knowledge of viral transmission (0.54 [0.30–0.97]) and a high perceived vulnerability score (0.66 [0.44–0.99]) were associated with maintained/increased implementation of preventive measures.

Conclusions

Our results can guide prevention and support policies for pregnant women during pandemics, current or future.

Factors Influencing Compliance with COVID-19 Health Measures: A Spanish Study to Improve Adherence Campaigns

Since the spread of the COVID-19 virus was declared a pandemic, different measures have been taken to control it, including frequent hand-washing, the use of face masks and social distancing. Given the importance of these measures, the present study aims to assess compliance with them in a Spanish sample of 722 people aged between 18 and 65 years. It also aims to determine which factors influence the levels of compliance observed. Participants complied more with the rules in the public spaces. The younger group had lower levels of compliance than the older group. No differences were found in accordance with sex. It was shown that overall, the agents that most influenced compliance were family, testimonials and friends and fines. Some differences were observed in relation to age, and significant sex differences were found in some of these factors, with women scoring higher than men. The results are discussed in terms of their usefulness for the design of information campaigns that seek to foster a greater degree of engagement by the entire population and, ultimately, greater control of the pandemic, in addition to serving as a basis for the early prevention of the spread of new viruses in the future.

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

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

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

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

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

Relationship between Socio-Demographic Factors and Adherence to Social Distancing Recommendations During Covid-19 Pandemic in Gonabad, Iran: A Cross-Sectional Study

Background

Adherence to social distancing recommendations provided by health authorities plays an important role in the prevention and control of COVID-19 transmission, regarding the lack of effective drug therapies. Therefore, this study aimed to identify the relationship between socio-demographic factors and adherence to social distancing recommendations during COVID-19 pandemic in Gonabad, Iran.

Methods

In this cross-sectional study, 587 subjects aged 15 and older were selected using the convenience sampling method from urban and rural areas in Gonabad, Iran, from July to September 2020. Data were collected online using a socio-demographic characteristics form, the adherence to social distancing recommendations scale, and a coronavirus disease awareness survey. Subsequently, the obtained data were analyzed in SPSS software (version 16) using hierarchical linear regression. The statistical significance was considered as P<0.05.

Results

72.23% (95% confidence interval: 68.41%-75.82%) of the participants followed the recommendations of social distancing at the high level. Nevertheless, many differences were observed in the subgroups which resulted from the socio-demographic characteristics of the participants. According to the multiple linear regression model, sex (β=0.24, P<0.001) was the most important determinant of adherence to social behavioral recommendations, followed by occupation (β=0.15, P<0.001), age (β=0.14, P=0.007), awareness (β=0.13, P=0.001), and history of mental illness (β=-0.08, P=0.049).

Conclusion

For the effective management of pandemics, the general public health policies should also consider the variability in responses and behavioral changes caused by socio-demographic characteristics, rather than focusing only on general measures, such as social distancing.

Predictors of COVID-19 preventive behaviours in a sample of the Turkish population

AIM

This research aimed to determine predictors of COVID-19 preventive behaviours in a sample of the Turkish population.

METHODS

The study was conducted with 575 individuals. COVID-19 preventive behaviours were evaluated with a 19-item scale scored from 19 to 95. Knowledge on COVID-19 was evaluated with a 22-item scale scored from 0 to 22. General health literacy was evaluated with the Turkey Health Literacy Scale (THLS), which was scored from 0 to 50.

RESULTS

The average COVID-19 preventive behaviours score was moderately high in this sample of the Turkish population. Being female, having a higher level of education, better economic status, being a non-smoker, having a higher level of COVID-19 knowledge and better general health literacy score were significant predictors of COVID-19 preventive behaviours (P < 0.05).

CONCLUSION

Sociodemographic characteristics, knowledge of COVID-19 and general health literacy are crucial in preventing COVID-19 infections in a sample of the Turkish population.

Educational inequalities in risk perception, perceived effectiveness, trust, and preventive behaviour in the onset of the COVID-19 pandemic in Germany

Objectives

This study analysed educational inequalities in risk perception, perceived effectiveness, trust and adherence to preventive behaviours in the onset of the COVID-19 pandemic in Germany.

Study design

This was a cross-sectional online survey.

Methods

Data were obtained from the GESIS Panel Special Survey on the coronavirus SARS-CoV-2 Outbreak in Germany, including 2949 participants. Stepwise linear regression was conducted to analyse educational inequalities in risk perception, perceived effectiveness, trust and adherence to preventive behaviours considering age, gender, family status and household size as covariates.

Results

We found lower levels in risk perception, trust towards scientists and adherence to preventive behaviour among individuals with lower education, a lower level of trust towards general practitioners among individuals with higher education and no (clear) educational inequalities in perceived effectiveness and trust towards local and governmental authorities.

Conclusion

The results underline the relevance of a comprehensive and strategic management in communicating the risks of the pandemic and the benefits of preventive health behaviours by politics and public health. Risk and benefit communication must be adapted to the different needs of social groups in order to overcome educational inequalities in risk perception, trust and adherence to preventive behaviour.

The transmission game: Testing behavioral interventions in a pandemic-like simulation

During pandemics, effective nonpharmaceutical interventions encourage people to adjust their behavior in fast-changing environments in which exponential dynamics aggravate the conflict between the individual benefits of risk-taking and its social costs. Policy-makers need to know which interventions are most likely to promote socially advantageous behaviors. We designed a tool for initial evaluations of the effectiveness of large-scale interventions, the transmission game framework, which integrates simulations of outbreak dynamics into large-group experiments with monetary stakes. In two studies (n = 700), we found substantial differences in the effectiveness of five behavioral interventions. A simple injunctive-norms message proved most effective, followed by two interventions boosting participants' ability to anticipate the consequences of risky behavior. Interventions featuring descriptive norms or concurrent risk information failed to reduce risk-taking.

Understanding Compliant Behavior During a Pandemic: Contribution From the Perspective of Schema-Based Psychotherapy

Objective

The current study examined whether compliance with anti-pandemic measures during the COVID-19 pandemic relates to (a) importance of the fulfillment of core psychological needs, namely, relationship, self-esteem, efficacy, and pleasure; (b) coping behavior styles, namely, surrender, self-soothing, divert attention, and confrontation; and (c) worries or concerns beyond COVID-19 which may impair wellbeing.

Methods

This study used a cross-sectional design and online survey data from responses to a structured questionnaire developed within the theoretical framework of schema-based psychotherapy on psychological needs and coping behavior styles from 740 participants in Central Europe and West Africa.

Results

Analysis indicated that people with the psychological needs of “pleasure” and “efficacy” and the coping style of “surrender” were more likely to comply with anti-pandemic measures. We also found that people with the coping style of “confrontation” were less likely to comply. There were no statistically significant relationships between compliance and “relationship,” “self-esteem,” “self-soothing,” “divert attention,” and “existential concerns.”

Discussion

Our findings indicate that how likely a given individual is to comply with prescribed pandemic countermeasures varies based on their specific psychological needs and behavior styles. Therefore, to control contagion during a pandemic, authorities must recognize the relevance of human need fulfillment and their behavior styles and accordingly highlight and encourage admissible and feasible actions. The findings demonstrate that some individual differences in core psychological needs and coping behavior patterns predict compliance behavior.

Trust and credibility of information sources related to COVID-19 among high-risk ethnically diverse adults at the onset of the New York City outbreak: A cross-sectional survey conducted via a community health portal

In March 2020, days after New York shut down to mitigate the spread of COVID-19, we developed a cross-sectional, participant-administered electronic survey to explore how New Yorkers were impacted by and were responding to the ongoing crisis. A critical component of the survey was to assess how credible and trustworthy respondents found various information sources. To advertise and distribute the survey, we embedded an invitation to participate using a popup on the GetHealthyHeights.org website. GetHealthyHeights was designed using community-based participatory research for the medically-underserved, urban, and largely Latinx community of Washington Heights-Inwood, New York City. We received 321 responses from April through July 2020. Participant ages ranged from 25 to 87, and 25% were Latinx. Results showed that the choice of and trust in different COVID-19 information sources were observed to be significantly different across demographic variables, including gender, age, race, and chronic health conditions. In the domains of trust and information source credibility, designers should account for perspectives of diverse subgroups.

The Impact of the COVID-19 Pandemic on the General Public in Urban and Rural Areas in Southern Japan

Urban and rural areas are situated in contrasting physical and social settings, which influence their levels of exposure as well as their preventive behaviors in response to the COVID-19 outbreak. The study investigated whether there were differences between the areas regarding the levels of difficulty and anxiety felt by the general public during the first wave of COVID-19 in April and May 2020. We conducted an online questionnaire in Fukuoka and Kumamoto Prefecture in southern Japan via a private research company and collected a total of 913 valid responses from individuals whose conditions of employment were affected by the coronavirus outbreak. Although urban areas experienced higher case rates compared to rural areas, ordinal logistic regression analysis revealed no significant differences between urban and rural respondents concerning the level of difficulty in routine life. The daily-life contents which made them feel difficult during the first wave also did not differ largely between the contrasting areas. Urban respondents appeared to have experienced a higher level of difficulty in finding an alternative job, but how respondents found one, if successful, did not differ between urban and rural areas. The area of residence played a role in explaining the level of anxiety toward being infected, especially when the anxiety-related questions involved relationships with neighbors. Rural respondents showed a significantly higher level of anxiety toward causing neighbors trouble and being criticized if infected. Respondents who were better embedded in their communities generally felt more anxious about being infected, regardless of whether they lived in urban or rural areas. Women and respondents with children were more likely affected by abnormal situations caused by the COVID-19 outbreak. Our study highlights the prevailing impact of the COVID-19 pandemic on the general public regardless of whether in urban or rural settings, as well as the potential contribution of social ties among people to protecting communities from infectious pathogens.

Impact of the early 2020 COVID-19 crisis and lockdown on PrEP use among men who have sex with men (MSM) in France

OBJECTIVE

To describe changes in pre-exposure prophylaxis (PrEP) use during and following the COVID-19 lockdown in France (March-May 2020) and identify the factors associated with PrEP discontinuation among men who have sex with men (MSM) after the lockdown.

METHODS

Data from the, an anonymous, cross-sectional internet survey among MSM in July 2020, were analysed. Among respondents who were using PrEP prior to the lockdown, a binary logistic regression model was used to compare participants who were still taking PrEP (current PrEP users) with those who were not taking PrEP at the time of the survey (former PrEP users).

RESULTS

Among 8345 respondents, 946 were PrEP users before the lockdown, of whom 58.8% (n=556) reported stopping PrEP during the lockdown and 15.4% (n=146) were not using PrEP at the time of the survey. Among the 556 who stopped PrEP during lockdown, 86.5% (n=481) reported no sexual activity; 76.8% (n=427) restarted PrEP after lockdown. Former PrEP users were more likely to be younger, not living with a stable male sexual partner, report moderate anxiety, report increased psychoactive drug use during the lockdown, and report not having tested for HIV or STI since the end of the lockdown because they did not know where to go, preferred to wait or for another reason. Reporting fewer male sexual partners in the last 6 months was also significantly associated with being a former PrEP user.

CONCLUSIONS

MSM adapted PrEP use to their sexual activity during and after the French lockdown. After the lockdown, discontinued PrEP occurred more often among MSM who had fewer sexual partners and had mental health vulnerabilities. These factors could also be predictive of PrEP discontinuation in a more general context. PrEP users should be informed on how to safely stop/start PrEP and on the use of other prevention tools to reduce potential risk exposure during PrEP discontinuation.

Predicting hand washing, mask wearing and social distancing behaviors among older adults during the covid-19 pandemic: an integrated social cognition model

BACKGROUND

Older adults are at a higher risk from COVID-19. Individual preventive behaviors including frequent hand washing, mask wearing, and social distancing play important roles in reducing the transmission of COVID-19 in the community. This study aimed to identify the determinants of three preventive behaviors of older adults during the COVID-19 pandemic by using an Integrated Social Cognition Model.

METHODS

Using a prospective study design, 516 Chinese older adults from Hubei province of China (mean age = 67.55 years, SD = 6.60, 57.9% females) completed two online questionnaire surveys. The demographics, social cognition constructs (motivational self-efficacy, risk perception, attitude, subjective norm, health knowledge, intention, volitional self-efficacy, planning, action control) and three preventive behaviors were measured during the first-wave online survey from 18 May 2020 to 7 June 2020. One month later, three preventive behaviors were measured again during the second-wave online survey. Data were analyzed by structural equation modelling.

RESULTS

Models showed attitude, motivational self-efficacy and subjective norm were consistent predictors of intention, motivational self-efficacy was a consistent predictor of volitional self-efficacy, planning and volitional self-efficacy were consistent predictors of action control, and health knowledge was a consistent predictor of behaviors across all three preventive behaviors. In addition, mediating relationships were found in the model of hand washing behavior. In particular, planning (β = .109, p = .042) and action control (β = .056, p = .047) mediated between volitional self-efficacy and hand washing respectively. Action control also mediated between planning and hand washing (β = .087, p = .044). Moreover, the inclusion of past behaviors in three models attenuated most of the structural relations.

CONCLUSIONS

The current study's findings basically supported the Integrated Social Cognition Model and identified key modifiable determinants of preventive behaviors. Based on this model, future interventions aiming to promote COVID-19 preventive behaviors among older adults are warranted.

When and How Trust in Government Leads to Compliance with COVID-19 Precautionary Measures

Despite the risks of COVID-19, some people ignore the COVID-19 precautionary measures, endangering public health. We aimed to investigate how and in what conditions trust in government and health authorities encourage individuals to comply with COVID-19 precautionary measures. Based on a sample of 664 respondents, we found that an increase in the level of trust in government is associated with higher compliance with COVID-19 precautionary measures. We also found that problem awareness mediates the effect of trust in government on compliance with COVID-19 precautionary measures. In addition, we examined whether individualistic orientation moderates the mediating effect of problem awareness. We found that individualistic orientation mitigates the mediating effect of problem awareness in the relationship between trust in government and compliance behavior. The findings of this study have the potential to inform policy and practice by addressing the ways in which compliance with COVID-19 precautionary measures can be improved.

Systematic review of the effects of pandemic confinements on body weight and their determinants

Pandemics and subsequent lifestyle restrictions such as ‘lockdowns’ may have unintended consequences, including alterations in body weight. This systematic review assesses the impact of pandemic confinement on body weight and identifies contributory factors. A comprehensive literature search was performed in seven electronic databases and in grey sources from their inception until 1 July 2020 with an update in PubMed and Scopus on 1 February 2021. In total, 2361 unique records were retrieved, of which forty-one studies were identified eligible: one case–control study, fourteen cohort and twenty-six cross-sectional studies (469, 362 total participants). The participants ranged in age from 6 to 86 years. The proportion of female participants ranged from 37 % to 100 %. Pandemic confinements were associated with weight gain in 7·2–72·4 % of participants and weight loss in 11·1–32·0 % of participants. Weight gain ranged from 0·6 (sd 1·3) to 3·0 (sd 2·4) kg, and weight loss ranged from 2·0 (sd 1·4) to 2·9 (sd 1·5) kg. Weight gain occurred predominantly in participants who were already overweight or obese. Associated factors included increased consumption of unhealthy food with changes in physical activity and altered sleep patterns. Weight loss during the pandemic was observed in individuals with previous low weight, and those who ate less and were more physically active before lockdown. Maintaining a stable weight was more difficult in populations with reduced income, particularly in individuals with lower educational attainment. The findings of this systematic review highlight the short-term effects of pandemic confinements.

Mental imagery interventions to promote face covering use among UK university students and employees during the COVID-19 pandemic: study protocol for a randomized controlled trial

BACKGROUND

The 2020 COVID-19 pandemic has witnessed wide-ranging efforts to minimize the spread of the virus and to protect those most vulnerable to becoming unwell following viral infection. Core COVID-19 preventive measures include social distancing, regular hand washing, and wearing face coverings in public places. Understanding links between social cognitive factors relating to beliefs/skills is important in the context of the COVID-19 pandemic, as this can suggest which factors might be targeted via behaviour change interventions to promote adherence to COVID-19 preventative behaviours. In this context, mental imagery exercises-self-directed imagining of an anticipated outcome or processes linked to a defined behaviour/activity-offer a well-evidenced, relatively simple behaviour change intervention. In the mental imagery invention reported in this protocol, individuals will be randomly assigned to one of four separate conditions (outcome imagery, process imagery, outcome and process imagery, control).

METHODS

The primary objective of this randomized controlled study is to assess the effectiveness of a mental imagery intervention on wearing face coverings, as a defined core COVID-19 preventative behaviour. Participants will consist of UK university students and university employees of any age. Participants will be randomized to complete an 'outcome imagery' or a 'process imagery' exercise, both exercises (i.e. a combined condition) or neither exercise (i.e. a control condition). A total of 260 individuals will be recruited into the study. Outcomes for all study condition arms will be assessed at baseline (Time 1), immediately post-intervention (Time 2), and at 1-month follow-up (Time 3). The primary outcome is frequency of wearing face covering, as reported at T2 and T3. Secondary outcomes include intervention effects on face covering attitudes, social norms, perceived behavioural control and barrier self-efficacy at T2 and T3. Putative moderators of intervention effects are conscientiousness, narcissism and 'light triad' personality traits.

DISCUSSION

This trial will contribute toward the currently sparse evidence base concerning behaviour change techniques designed to promote COVID-19 preventative behaviours among UK university students and university employees.

TRIAL REGISTRATION

ClinicalTrials.gov (U.S. National Library of Medicine) NCT04583449 . Retrospectively registered on 20 October 2020.

Factors related to compliance with the COVID-19 health regulations among young people

The coronavirus pandemic has affected all facets of our lives and all ages and social strata worldwide. Measures have been taken to protect against the spread of the virus, such as more rigorous hand hygiene, the use of face masks and social distancing. However, the focus has often been on young people, who have been seen as a group lacking sufficient respect for government-imposed measures. This review outlines the preventive measures that have been taken in different countries and discusses their specific impact on young people and adolescents, taking into account the developmental stage and concrete needs of this age group. It summarizes those studies that have provided information on compliance with preventive measures by young people and adolescents, concluding that although compliance levels among this age group are lower than among older adults, the general view of youths as non-compliant is not consistent with real, objective data. The review also summarizes different views regarding the possible reasons for this lower level of compliance, taking into account both social (gender and age) and personal factors (personality, empathy, prosociality, self-control, cognitive styles and motivations), and discusses the practical implications of these findings for the future.

Social determinants of adherence to COVID-19 preventive guidelines: a comprehensive review

Adherence to coronavirus disease 2019 (COVID-19) preventive guidelines (ACPG) is an important strategy to control the COVID-19 pandemic effectively. The present study aimed to identify and summarize the social determinants of ACPG among the general population. A comprehensive review was performed from December 2019 to February 2021 through searching electronic databases. Two independent reviewers assessed and selected relevant studies. Next, the characteristics and main findings of the included studies were summarized. Finally, the World Health Organization's conceptual framework of social determinants of health was used to synthesize the identified social determinants of ACPG. Forty-one of 453 retrieved articles met the inclusion criteria. The study results showed different patterns of ACPG among various communities. Furthermore, 84 social determinants were identified and categorized into structural and intermediary determinants. ACPG is a set of complex behaviors associated with different individual sociodemographic and behavioral characteristics; living and working conditions; COVID-19 knowledge, attitudes, and risk perceptions; exposure to sources and information level; leisure activities; social support; trust; social norms; psychosocial well-being; socio-economic position; and the socio-economic and political context. Interventions to promote ACPG among the general population should consider the identified social determinants of ACPG.

Impact of the SARS-CoV-2 pandemic and first lockdown on pregnancy monitoring in France: the COVIMATER cross-sectional study

BACKGROUND

In the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, consultations and pregnancy monitoring examinations had to be reorganised urgently. In addition, women themselves may have postponed or cancelled their medical monitoring for organisational reasons, for fear of contracting the disease caused by SARS-CoV-2 (COVID-19) or for other reasons of their own. Delayed care can have deleterious consequences for both the mother and the child. Our objective was therefore to study the impact of the SARS-CoV-2 pandemic and the first lockdown in France on voluntary changes by pregnant women in the medical monitoring of their pregnancy and the associated factors.

METHODS

A cross-sectional study was conducted in July 2020 using a web-questionnaire completed by 500 adult (> 18 years old) pregnant women during the first French lockdown (March-May 2020). A robust variance Poisson regression model was used to estimate adjusted prevalence ratios (aPRs).

RESULTS

Almost one women of five (23.4%) reported having voluntarily postponed or foregone at least one consultation or pregnancy check-up during the lockdown. Women who were professionally inactive (aPR = 1.98, CI95%[1.24-3.16]), who had experienced serious disputes or violence during the lockdown (1.47, [1.00-2.16]), who felt they received little or no support (1.71, [1.07-2.71]), and those who changed health professionals during the lockdown (1.57, [1.04-2.36]) were all more likely to have voluntarily changed their pregnancy monitoring. Higher level of worry about the pandemic was associated with a lower probability of voluntarily changing pregnancy monitoring (0.66, [0.46-0.96]).

CONCLUSIONS

Our results can guide prevention and support policies for pregnant women in the current and future pandemics.

Household visitation during the COVID-19 pandemic

The COVID-19 pandemic has posed novel risks related to the indoor mixing of individuals from different households and challenged policymakers to adequately regulate this behaviour. While in many cases household visits are necessary for the purpose of social care, they have been linked to broadening community transmission of the virus. In this study we propose a novel, privacy-preserving framework for the measurement of household visitation at national and regional scales, making use of passively collected mobility data. We implement this approach in England from January 2020 to May 2021. The measures expose significant spatial and temporal variation in household visitation patterns, impacted by both national and regional lockdown policies, and the rollout of the vaccination programme. The findings point to complex social processes unfolding differently over space and time, likely informed by variations in policy adherence, vaccine relaxation, and regional interventions.

Increasing acceptance of a vaccination program for coronavirus disease 2019 in France: A challenge for one of the world's most vaccine-hesitant countries

France is one of the most vaccine-hesitant countries in the world, including for coronavirus disease 2019 (COVID-19). After 10 months of restrictive measures and media coverage of the dangers of COVID-19, French attitudes towards a vaccine continue to deteriorate. The communication strategies of the government have not helped; in fact, they have made the situation worse.

Empirical studies on the national strategy for management of the COVID-19 pandemic in France have shed light on the reasons for vaccine hesitancy. These studies have identified four pillars for the vaccination strategy: i) Communication regarding the importance of herd immunity, ii) making healthcare workers the focus of the vaccination campaign, iii) citizen mobilization and guaranteed consultations, and iv) access to free vaccines without delay. This paper discusses the evidence supporting this strategy.

Solving Social Problems in Aging Rural Japanese Communities: The Development and Sustainability of the Osekkai Conference as a Social Prescribing during the COVID-19 Pandemic

Social prescribing is critical during the coronavirus disease 2019 (COVID-19) pandemic. Social prescribing refers to non-medical interventions related to culture and traditions; they are increasingly being proposed to address wider determinants of health as well as help patients improve health behaviors and manage their conditions effectively. Traditional and cultural behaviors in the community can be utilized for effective social prescribing. Due to the pandemic, social participation opportunities have decreased, resulting in the absence of Osekkai, a traditional Japanese behavior. A driver of Osekkai is the Osekkai conference; it is the model through which Osekkai is implemented in communities to bring resources and individuals together to address community needs. This research aims to clarify the Osekkai conference’s development process and how it can solve social problems, thereby leading to the creation of sustainable communities. We conducted semi-structured interviews with Osekkai conferences’ participants and organizers during the COVID-19 pandemic. We used thematic analysis to achieve the research aims. A total of 12 participants were interviewed. Five themes were developed from the thematic analysis: driver of the Osekkai conference’s development, trajectory of continuity, chain of Osekkai, changes in communities and participants, and sustainability of the conferences. This study showed how reviving traditional behaviors helps face initial difficulties. It described these increasing traditional behaviors in terms of social prescribing that changes the community’s and citizens’ social capital. Reviving traditional behaviors created new challenges and solutions during the pandemic.

Association between Immunoglobulin G Levels and Adverse Effects Following Vaccination with the BNT162b2 Vaccine among Japanese Healthcare Workers

The purpose of the study was to assess the association between the amount of immunoglobulin G (IgG) and the duration of adverse effects of COVID-19 vaccinations in the Japanese population. This cross-sectional study was conducted from April 2020 to August 2021 among workers at a community hospital. All participants received two doses of the BNT162b2 vaccine (Pfizer-BioNTech) in March and April 2021. Vaccine side effects were measured using a self-administered questionnaire. Serum anti-SARS-CoV-2 IgG was measured 3 months after vaccination. There was a total of 338 participants (mean age: 44.7 years). The incidence of adverse reactions after vaccination was higher in women. Adverse reactions associated with higher IgG levels included: erythema at the injection site after the first dose; induration and inflammation at the injection site; and systemic symptoms, e.g., fever and headache after the second dose. IgG levels were higher in younger participants. These findings could mitigate fears regarding the mild adverse effects of the COVID-19 vaccine and encourage uptake of the BNT162b2 vaccine.