Compliance and Self-Reporting During the COVID-19 Pandemic: A Cross-Cultural Study of Trust and Self-Conscious Emotions in the United States, Italy, and South Korea

Credibility Perceptions of Information and Vaccine Intention: The Role of Collective Vs. Individual Framing Messages

After four years into the pandemic, we know that COVID-19 vaccines are effective, and it is crucial to increase public compliance with getting the COVID-19 vaccines. The current study examines the interplay of credibility perceptions, perceived benefits, and two different types of vaccine promotion messages: individual versus collective. Data was collected using an online randomized experiment. Findings demonstrated that individual versus collective frames did not influence everyone similarly. The results show a significantly moderated mediation model, such that the association between message frame and vaccine intention was mediated by the credibility of the message, and the relationship between message frame and perceived credibility was moderated by perceived benefits of the vaccine.

Interdependency or submission to authority? The impacts of horizontal and vertical collectivist orientation on vaccine attitudes in mainland China

Culture has a profound impact on preventive measures during the COVID-19 pandemic. Previous research has revealed that collectivism is associated with more effective responses to COVID-19 on the national or regional level. However, the impact of different components of collectivist orientation on vaccine attitudes remains insufficiently explored on the individual level. Two survey studies conducted in August 2021 in mainland China consistently found that individual-level horizontal collectivist orientation, rather than vertical collectivist orientation, was linked with more favourable vaccine attitudes. Specifically, Study 1 (N = 731) indicated that horizontal collectivist orientation was positive associated with vaccination intention indirectly via risk perception, and horizontal collectivist orientation was also positively associated with vaccination persuasion both directly and indirectly via risk perception. Study 2 (N = 1481), employing multilevel modelling, demonstrated that the link between horizontal collectivist orientation and confidence in vaccines remained robust regardless of provincial-level variations in socioeconomic development and cultural tightness. These findings convergently suggest that the positive vaccine attitudes among mainland Chinese are primarily driven by an amplified risk perception due to concern for others, rather than submission to authority.

Alternative Systems: The Interplay Between Criminal Groups' Influence and Political Trust on Civic Honesty in the Global Context

Individuals' endorsement of standards of civic honesty is necessary for democracies to flourish. A critical driver of civic honesty is the relationship of trust between individuals and institutions. Research has yet to systematically assess the contextual factors that may moderate this relationship. In this study, we examined the societal influence of organized criminal groups. Criminal groups operate as alternative systems of authority that erode the reliability of institutions' moral standards. We employed a new indicator that quantifies their societal influence to test the hypothesis that the association between individuals' political trust and civic honesty would weaken in countries more strongly affected by criminal groups. Multilevel evidence across 83 representative national samples (N = 128,839) supported this hypothesis. Moreover, the association between political trust and civic honesty was negative in contexts where criminal groups' influence was more extreme. We discuss the implications of the findings and future research directions.

Cultural dynamics influencing decision-making during the COVID-19 pandemic: the Italian case

The COVID-19 pandemic has brought about significant changes to the life of most individuals, worldwide. This study explores the cultural factors influencing decision-making during the pandemic, and is part of the CORNER Project, funded by the Research Council of Norway, aimed at understanding institutional response in the early phases of the Covid-19 emergency in Norway, Sweden, and Italy. Semi-structured interviews with key political-administrative leaders in Italy (N = 35) were conducted and content-analyzed, allowing the identification of the underlying cultural dynamics that played a role in these decisions. Thematic analysis was used to assess the influence of cultural factors on the crisis management and early reaction of institutions and citizens to the spread of Covid. In line with previous studies, and as expected, the individualism vs. collectivism dimension can explain differential health outcomes during the outbreak. In this paper we argue that individualism-collectivism cultural values can also play a pivotal role in public compliance with Covid-19 restrictions, and psychological responses during the pandemic.

Compliance with World Health Organization COVID-19 preventive behaviors in rural counties in Western Kenya: a cross-sectional study

Introduction

the World Health Organization (WHO) recommended various measures to tackle COVID-19, and were adopted by many governments, targeting behavior change among citizens to lower the transmission. There was a paucity of data on the patterns of compliance with different measures within individuals and whether people adhere to all recommended measures or cautiously prefer few but not others. Understanding compliance behaviors and associated factors is important for developing interventions to increase compliance.

Methods

cross-sectional study was conducted among adults in the western region of Kenya. A sample of 806 participants was selected using a stratified sampling method. A structured questionnaire was used to gather data from the participants. Compliance was assessed with six behaviors: hand sanitation, proper hygiene, no handshaking, social distancing, and other guidelines. Latent analysis was used to identify behavioral patterns. Descriptive statistics were used to assess demographic characteristics, in terms of frequency distribution, and percentages. Multinomial logistic regression was used to assess the association between demographic characteristics and compliance level.

Results

compliance was highest for masking (85.3%), and was lowest for social distancing (60.2%). The majority of participants were found to be full compliers (class 1: 40.5%), there was an increased probability of full compliance among those aged between 18-30 years (OR= 1.042; 95% CI: 0.307-13.052, p < 0.040) compared to those aged ≥70.

Conclusion

using facemasks had the highest rate of compliance, followed by hand sanitization and proper hygiene. However, overall, the findings showed that while compliance with some protocol behaviors is high, individuals comply consistently across recommended compliance behaviors.

Unraveling the Dark Side of Social Norms-Toward a Research Agenda on the Challenges of Social Norms in Health Communication

Social norms are a promising means in health crisis communication because they can guide collective action to reduce risk. However, recent research on the COVID-19 pandemic suggests that social norms may have not fully supported strategic goals and even contributed to phenomena that hindered risk reduction, calling into question the potential of social norms campaigns. This became most evident during the COVID-19 pandemic in the emergence of alternative norms of measure opposition, stigmatization of norm-deviant individuals, and the issue of free-riding. The article analyzes these phenomena from a social identity and communication perspective and outlines areas for further inquiry in health and crisis communication. The goal is to pave the way for a research agenda dedicated to the dark side of social norms to unlock the full potential of social norms in times of (health) crisis.

Predicting attitudes toward mitigation interventions and social distancing behaviors at the onset of the COVID-19 pandemic in the United States

Aim

The goal of this research was to assess the influence of adult attachment, personality, and cultural orientation on social distancing and attitudes toward COVID-19 mitigation interventions.

Methods

Survey data was collected across two samples (NMTurk = 201, Nsnowball = 242) in the US from April 29 to May 11, 2020. Adult attachment was assessed via the Experiences in Close Relationships Scale-Short Form (ECR-S; Wei, M., Russell, D. W., Mallinckrodt, B., & Vogel, D. L. (2007). The experiences in close relationship scale (ECR)-short form: Reliability, validity, and factor structure. Journal of Personality Assessment, 88(2), 187-204), personality was assessed via the Ten Item Personality Inventory (TIPI; Gosling, S. D., Rentfrow, P. J., & Swann, W. B. (2003). A very brief measure of the Big-Five personality domains. Journal of Research in Personality, 37(6), 504-528), cultural orientation was assessed via the Horizontal and Vertical Individualism and Collectivism Scale (Triandis, H. C., & Galfand, M. J. (1998). Converging measurement of horizontal and vertical individualism and collectivism. Journal of Personality and Social Psychology, 74(1), 118-128), and social distancing and attitudes toward mitigation interventions were assessed via self-report measures developed for this assessment.

Results

In the MTurk sample, agreeableness (β = .19) and conscientiousness (β = .26) predicted positive mitigation intervention attitudes. Agreeableness (β = .24) and vertical collectivism (β = .25) positively predicted social distancing, while attachment anxiety (β = -.32) and vertical individualism (β = -.32) negatively predicted social distancing. In our snowball sample, residing primarily in New York, openness (β = .18) and horizontal collectivism (β = .16) predicted positive intervention attitudes, while horizontal individualism (β = -.20) predicted negative attitudes. Social contact in this sample was low and not associated with predictor variables. In both samples, mitigation attitudes and social distancing were only moderately correlated.

Implications

Our findings highlight the inherent inconsistency between attitudes and behaviors as well as the potential impact of mandated interventions on both attitudes and behavior.

[COVID-19-related self-stigma: association with vulnerability and trust in institutions]

BACKGROUND

Self-stigmatization in the context of infectious diseases can be a psychosocial burden and reduce the cooperation with infection control measures. This study investigates for the first time the level of self-stigmatization among individuals with different social and medical vulnerabilities in Germany.

METHODS

Data are derived from an online survey (CAWI: Computer Assisted Web Interview) conducted during the COVID-19 pandemic in winter 2020/21. The quota sample (N = 2536) is representative for the key variables gender, age, education, and place of residence for the German adult population. For operationalizing COVID-19 related self-stigmatization, we developed a new scale. We also collected information on medical and social vulnerabilities as well as trust in institutions. Data analysis was based on descriptive statistics and multiple ordinary least squares (OLS) regression.

RESULTS

Overall, we find a level of self-stigmatization slightly over the scale mean. While socially vulnerable groups do not have higher levels of self-stigmatization - with the exception of women - individuals with medical vulnerabilities (higher infection risks, poor health status, risk group) show higher levels of self-stigma. Higher trust in institutions is associated with higher levels of self-stigmatization.

DISCUSSION

Stigmatization should be regularly monitored during pandemics and considered in communication measures. Thus, it is important to pay attention to less stigmatizing formulations and to point out risks without defining risk groups.

Acceptance of Public Health Measures During the COVID-19 Pandemic: A Cross-Sectional Study of the Swiss Population's Beliefs, Attitudes, Trust, and Information-Seeking Behavior

Objectives: This study aimed to advance the understanding of the factors associated with population acceptance of public health measures during the COVID-19 pandemic. Methods: In January 2022, we conducted a cross-sectional survey of the Swiss population (N = 2,587). Questionnaires were administered through computer-assisted web interviewing. Measures covered included information-seeking behavior, attitudes towards and beliefs about public health measures enacted, and trust in institutions. Results: Television and newspapers were the most used information sources. Those with higher education levels were more likely to use channels from public institutions, newspapers, and television. The most important criterion for reliable information was scientific evidence. Trust was highest for doctors, healthcare workers, universities, research institutes, and public health institutions. Acceptance of public health measures was high overall, and attitudes, beliefs, information-seeking behavior, and trust were positively related to acceptance. Trust in science remained stable, while trust in public health institutions decreased slightly. Conclusion: While nurturing a two-way dialogue with the population, institutions should target communication considering age and culture, improve risk communication, ground messages in scientific evidence, and ensure mass media presence.

Storing paediatric genomic data for sequential interrogation across the lifespan

Genomic sequencing (GS) is increasingly used in paediatric medicine to aid in screening, research and treatment. Some health systems are trialling GS as a first-line test in newborn screening programmes. Questions about what to do with genomic data after it has been generated are becoming more pertinent. While other research has outlined the ethical reasons for storing deidentified genomic data to be used in research, the ethical case for storing data for future clinical use has not been explicated. In this paper, we examine the ethical case for storing genomic data with the intention of using it as a lifetime health resource. In this model, genomic data would be stored with the intention of reanalysis at certain points through one's life. We argue this could benefit individuals and create an important public resource. However, several ethical challenges must first be met to achieve these benefits. We explore issues related to privacy, consent, justice and equality. We conclude by arguing that health systems should be moving towards futures that allow for the sequential interrogation of genomic data throughout the lifespan.

The perception of risk in contracting and spreading COVID-19 amongst individuals, households and vulnerable groups in England: a longitudinal qualitative study

BACKGROUND

Social distancing restrictions to manage the COVID-19 pandemic were put in place from March 2020 in the United Kingdom (UK), with those classed as "highly clinically vulnerable" advised to shield entirely and remain at home. However, personal risk perception has been shown to comprise of various elements beyond those outlined in the national pandemic guidance. It is unclear whether those deemed COVID-19 vulnerable identified as high-risk to COVID-19 and thus complied with the relevant advice. The aim of this research is to explore the perception of risk in catching and spreading COVID-19, amongst individuals from individual households, and vulnerable groups in a region of the UK.

METHODS

Two individual, semi-structured interviews were conducted, four-weeks apart, with adults living in households in the Liverpool City Region. At the follow-up interview, participants were given the option of using photo-elicitation to guide the discussion. Reflexive thematic analysis was employed to conceptualise themes. The qualitative analysis was underpinned with symbolic interactionism.

RESULTS

Twenty-seven participants (13:14 males:females, and 20 with a vulnerable risk factor to COVID-19) completed a baseline interview, and 15 of these completed a follow-up interview four-weeks later. Following thematic analysis, two overarching themes were conceptualised, with subthemes discussed: theme 1) Confusion and trust in the risk prevention guidance; and theme 2) Navigating risk: compliance and non-compliance with public health guidance.

CONCLUSION

Participants developed their own understanding of COVID-19 risk perception through personal experience and comparison with others around them, irrespective of vulnerability status. COVID-19 guidance was not complied with as intended by the government, and at times even rejected due to lack of trust. The format in which future pandemic guidance is conveyed must be carefully considered, and take into account individuals' experiences that may lead to non-compliance. The findings from our study can inform future public health policy and interventions for COVID-19 and future pandemics.

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.

Perceived COVID-19 susceptibility and preventive behaviors: moderating effects of social support in Italy and South Korea

BACKGROUND

The COVID-19 pandemic hit Italy much harder than South Korea. As a way of explaining the different impact in the two countries, this study examines the moderating role of social support on the relationship between perceived susceptibility and preventive behaviors in the two countries.

METHODS

Surveys were conducted in South Korea (n = 1396) and Italy (n = 487) of participants aged 50 to 89 years.

RESULTS

South Koreans felt higher levels of perceived social support than their Italian counterparts. As would be expected, greater perceived susceptibility was associated with increased preventive behavior. Furthermore, a significant three-way interaction effect was found for perceived susceptibility, social support, and country. For Italians, a person who feels him/herself highly susceptible will increase preventive behaviors, if there is a lot of social support. On the other hand, for South Koreans, those with a low level of susceptibility perform more preventive measures than people with a high level of susceptibility if there is a lot of social support.

CONCLUSIONS

This study provides insights into how cognitive factors, such as susceptibility and severity, as well as social and environmental factors can be taken into account, and the public be told the real risk and given behavioral guidelines when a pandemic is approaching. Given the critical role of social support as a coping mechanism in crisis situations, societies should mull over ways to increase emotional and instrumental support.

Go for zero tolerance: Cultural values, trust, and acceptance of zero-COVID policy in two Chinese societies

This study seeks to explain the wide acceptance of the stringent zero-COVID policy in two Chinese societies—Mainland China (n = 2,184) and Taiwan (n = 1,128)—from perspectives of cultural values and trust. By employing the efficacy mechanism, this study identifies significant indirect effects of trust in government and key opinion leaders (KOL) on people’s policy acceptance in both societies. Namely, people who interpret the pandemic as a collectivist issue and who trust in government will be more accepting of the zero-COVID policy, whereas those who framed the pandemic as an individual issue tend to refuse the policy. Trust in government and KOLs foster these direct relationships, but trust in government functions as a more important mediator in both societies. The different contexts of the two Chinese societies make the difference when shaping these relationships. These findings provide practical considerations for governmental agencies and public institutions that promote the acceptance of the zero-COVID policy during the pandemic.

Count on trust: the indirect effect of trust in government on policy compliance with health behavior instructions

Trust in government is considered a prominent factor for enhancing public compliance with government policies and instructions. The Coronavirus pandemic demonstrates the crucial role public compliance with governmentally issued health guidelines has in mitigating the pandemic. However, the mechanism explaining the trust-compliance association, particularly in regard to health-behavior compliance, is unclear. This article develops a new theoretical model, the Mediated Trust Model (MTM), for explaining the relationship between trust in government and public compliance with health instructions. The model extends the classic Health Belief Model for predicting health behavior by claiming that the perceptions regarding the instructions' costs, benefits and one's ability to perform them are affected by trust in government and mediate the trust-compliance association. The MTM was tested in four cross-sectional studies performed during the first 20 months of the Coronavirus pandemic in Israel on 3732 participants, for various health instructions. Implications for public health literature, policy compliance theory and policy makers are discussed.

Individual costs and community benefits: Collectivism and individuals' compliance with public health interventions

Differences in national responses to COVID-19 have been associated with the cultural value of collectivism. The present research builds on these findings by examining the relationship between collectivism at the individual level and adherence to public health recommendations to combat COVID-19 during the pre-vaccination stage of the pandemic, and examines different characteristics of collectivism (i.e., concern for community, trust in institutions, perceived social norms) as potential psychological mechanisms that could explain greater compliance. A study with a cross-section of American participants (N = 530) examined the relationship between collectivism and opting-in to digital contact tracing (DCT) and wearing face coverings in the general population. More collectivistic individuals were more likely to comply with public health interventions than less collectivistic individuals. While collectivism was positively associated with the three potential psychological mechanisms, only perceived social norms about the proportion of people performing the public health interventions explained the relationship between collectivism and compliance with both public health interventions. This research identifies specific pathways by which collectivism can lead to compliance with community-benefiting public health behaviors to combat contagious diseases and highlights the role of cultural orientation in shaping individuals' decisions that involve a tension between individual cost and community benefit.

Framing the meaning of COVID-19 and the psychological responses to it: Insights gleaned from selected theoretical approaches

This viewpoint article reviews theoretical approaches that are relevant to studying COVID-19 and the psychological reactions to it. We suggest that the published research can be viewed from four major theoretical perspectives: as a stress situation, traumatic event, shared reality/shared trauma, and loss and grief situation. We detail the terms and the main theory/ies underlying each approach and suggest how COVID-19 characteristics and the its' psychological consequences may be conceptualized in accordance with each approach. Additionally, we discuss the challenges and facets of each theoretical conceptualization that should be addressed in further research, and the necessity of exploring implications for practice.

Collectivism reduces objective mobility trends to public areas during the COVID-19 pandemic

In order to slow down the spread of the coronavirus, staying at home and avoiding going outside have been either strongly recommended or stringently enforced by governments all over the globe. Previous studies found that people with more collectivist orientation were more willing to comply with governmental guidelines and engage in preventive behaviors such as social distancing. However, these studies were based on self-report data within a short period. The current study aims to overcome these limitations by using objective mobility data generated by Google users all over the world during the past two years, thus providing a stronger test for the predictive effect of collectivism on preventive measures in response to the pandemic. We found consistent results at both the US state level (n = 50) and the country/territory level (n = 133), such that people in more collectivistic regions reduced their visits to and length of stay at certain public areas such as parks during the past two years. Our findings emphasize the importance of cultural values in face of global crises.

Party over pandemic: Polarized trust in political leaders and experts explains public support for COVID-19 policies

Two experiments examined the polarization of public support for COVID-19 policies due to people’s (lack of) trust in political leaders and nonpartisan experts. In diverse samples in the United States (Experiment 1; N = 1,802) and the United Kingdom (Experiment 2; N = 1,825), participants evaluated COVID-19 policies that were framed as proposed by ingroup political leaders, outgroup political leaders, nonpartisan experts, or, in the United States, a bipartisan group of political leaders. At the time of the study in April 2020, COVID-19 was an unfamiliar and shared threat. Therefore, there were theoretical reasons suggesting that attitudes toward COVID-19 policy may not have been politically polarized. Yet, our results demonstrated that even relatively early in the pandemic people supported policies from ingroup political leaders more than the same policies from outgroup leaders, extending prior research on how people align their policy stances to political elites from their own parties. People also trusted experts and ingroup political leaders more than they did outgroup political leaders. Partly because of this polarized trust, policies from experts and bipartisan groups were more widely supported than policies from ingroup political leaders. These results illustrate the potentially detrimental role political leaders may play and the potential for effective leadership by bipartisan groups and nonpartisan experts in shaping public policy attitudes during crises.

The association between protein levels in 24-hour urine samples and maternal and neonatal outcomes of pregnant women with preeclampsia

Objective

Hypertensive diseases of pregnancy are one of the leading causes of maternal and perinatal mortality worldwide. The aim of this study was to evaluate the association between protein levels in 24-hour urine samples and maternal and perinatal outcomes in preeclamptic patients.

Material and Methods

This retrospective cohort study was conducted with pregnant women who were diagnosed with preeclampsia (PE) and delivered in our clinic between 2010 and 2018. Patients were divided into those with a proteinuria value below 300 mg/24 h (non-proteinuria), proteinuria value between 300-2000 mg/24 h (mild proteinuria), proteinuria value between 2000-5000 mg/24 h (severe proteinuria) and proteinuria value >5000 mg/24 h (massive proteinuria) and were compared in terms of maternal and perinatal outcomes. Demographic characteristics (age, body mass index in kg/m2, gravidity), PE-related clinical symptoms (epigastric pain, neurological and respiratory symptoms), laboratory findings (24 h protein level, lactate dehydrogenase, aspartate aminotransferase, platelet count and creatine levels) were recorded in all patients.

Results

A total of 1,379 patients meeting the study criteria were included. There were 315 (23%) patients in the non-proteinuria group, 704 (51%) in the mild proteinuria group, 234 (17%) patients in the severe group and 126 (9%) patients in the massive proteinuria group. The massive proteinuria group was found to have the highest rates of maternal and prenatal complications. The Apgar score, umbilical cord pH value, birth weight, gestational week at delivery, intrauterine growth restriction and intrauterine fetal death were significantly higher in the massive proteinuria group.

Conclusion

Our data showed that the degree of proteinuria appears to be associated with maternal, fetal and neonatal outcomes among women diagnosed with PE. Women with proteinuria of >5000 mg/24 hours had notably poorer natal outcomes.

Predicting attitudinal and behavioral responses to COVID-19 pandemic using machine learning

At the beginning of 2020, COVID-19 became a global problem. Despite all the efforts to emphasize the relevance of preventive measures, not everyone adhered to them. Thus, learning more about the characteristics determining attitudinal and behavioral responses to the pandemic is crucial to improving future interventions. In this study, we applied machine learning on the multinational data collected by the International Collaboration on the Social and Moral Psychology of COVID-19 (N = 51,404) to test the predictive efficacy of constructs from social, moral, cognitive, and personality psychology, as well as socio-demographic factors, in the attitudinal and behavioral responses to the pandemic. The results point to several valuable insights. Internalized moral identity provided the most consistent predictive contribution-individuals perceiving moral traits as central to their self-concept reported higher adherence to preventive measures. Similar results were found for morality as cooperation, symbolized moral identity, self-control, open-mindedness, and collective narcissism, while the inverse relationship was evident for the endorsement of conspiracy theories. However, we also found a non-neglible variability in the explained variance and predictive contributions with respect to macro-level factors such as the pandemic stage or cultural region. Overall, the results underscore the importance of morality-related and contextual factors in understanding adherence to public health recommendations during the pandemic.

Collectivism, individualism and COVID-19 prevention: a cross sectional study of personality, culture and behavior among Canadians

Background

Collectivism has been identified as a protective factor against COVID-19 - perhaps due to increased conformity with social norms regarding prevention behaviors. Other studies have also found that individualism can inspire uptake of preventative behaviors as a means of personal protection. It is possible that these cultural orientations may promote different patterns of prevention (e.g. mask wearing vs. social distancing). Furthermore, existing studies examining the role of individualism and collectivism during the COVID-19 pandemic have frequently failed to account for other psychological processes, including differences in personality, which could help provide a better understanding of the psychological process underlying prevention behavior.

Methods

Participants were recruited using social media advertisements. The Cultural Orientations Scale measured individualism-collectivism and hierarchism-egalitarianism. The Ten Item Personality Inventory measured the five factor model of personality. Multivariable models, dominance analyses and structural equation mediation tests were used to identify the most important predictors of COVID-19 prevention behavior (i.e. mask-wearing, hand-washing, reducing social interactions, physical distancing, staying at home and social bubbling), controlling for demographic and situational factors.

Results

Among 774 participants, most (i.e. 60-80%) reported uptake of COVID-19 prevention behaviors. Higher vertical (hierarchical) collectivism was associated with staying at home and higher horizontal (egalitarian) individualism was associated with mask-wearing and reducing social interactions. Neither Vertical Collectivism nor Horizontal Collectivism were significantly associated with any of the prevention behaviors when controlling for personality traits and confounding variables. Agreeableness was identified as a key mediator of the correlation between these cultural orientations on general uptake of COVID-19 prevention behaviors.

Conclusions

Cultural orientations (e.g. collectivism-individualism, hierarchism-egalitarianism) and personality traits (e.g. Agreeableness) are salient correlates of COVID-19 prevention behaviors and therefore should be accounted for in the development, design and delivery of health promotion messages aiming to increase uptake of these behaviors.

Inequalities in Trust Levels and Compliance With Physical Distancing During COVID-19 Outbreaks: Comparing the Arab Minority and Jewish Populations in Israel

Objectives: This study explores associations between trust in directives and compliance with physical distancing by comparing two populations in Israel. Methods: Following two lockdowns, we conducted two cross-sectional surveys among the Arab minority and Jewish citizens of Israel (first survey, N = 613; second survey, N = 542). We conducted multivariable logistic regression analyses for the association between trust and compliance with physical distancing separately for each group in each survey. Results: In both surveys trust levels were significantly lower among Arabs than Jews (p < 0.001). Compared to Jews, Arabs were less likely to report compliance with physical distancing in the first and second surveys (OR = 0.52, 95% CI 0.32-0.84 and OR = 0.62, 95% CI 0.39-0.98, respectively). In both surveys trusting the directives was an important determinant of compliance with physical distancing among Jews only. Conclusion: Our findings indicate that momentum is important in building and maintaining public trust and compliance during pandemics. Policymakers should note the lack of trust among Arabs, which warrants further research and interventions.

An application of the extended parallel process model to protective behaviors against COVID-19 in South Korea

This study applied the extended parallel process model (EPPM) to investigate the factors affecting people's preventive behaviors against COVID-19, and thereby, draw relevant policy implications for current and future other epidemics. The EPPM was used to examine the danger control and fear control responses, along with the separate effects of their sub-factors (perceived susceptibility, perceived severity, response efficacy, and self-efficacy) on personal hygiene behaviors, social distancing measures, and fatalism. In total, data from an online survey of 813 adults were analyzed. The results of multiple regression analysis showed a strong effect of self-efficacy on danger control (ß = 0.23 for personal hygiene behaviors, β = 0.26 for social distancing) and fear control responses (ß = -0.13 for fatalism). However, based on the type of control response, the effect of perceived susceptibility and perceived severity, which were the main factors in threat appraisal, was insignificant or marginally significant. Further, a higher perceived severity was associated with higher fatalism in the fear control response (ß = 0.09). Those who were currently employed performed fewer social distancing measures compared to those who did not (ß = -0.11), whereas there was no difference in personal hygiene behaviors. These results suggest that risk communication in emerging infectious disease crises should provide customized information on people who are hard to comply with social distancing. Besides delivering the message of self-efficacy, policies should be implemented to create a social environment in which individuals can practice social distancing without constraints.

Trust in COVID-19 information sources and perceived risk among smokers: A nationally representative survey

BACKGROUND

Public health officials have classified smoking as a risk factor for COVID-19 disease severity. Smokers generally have less trust in health experts than do nonsmokers, leading to reduced risk perceptions. This study addresses smokers' trust in information sources about COVID-19 and how trust is associated with perceived COVID-19 susceptibility and severity among smokers.

METHODS AND FINDINGS

A nationally representative sample of 1,223 current smokers were surveyed between October and November 2020, indicating their level of trust in COVID-19 information sources, and their perceptions of risk from COVID-19. Multiple differences in trustworthiness emerged; smokers trusted their personal doctor for information about COVID-19 more than other information sources, while news media were generally distrusted. In addition, the FDA was trusted less than the NIH and CDC. Several "trust gaps" were observed, indicating disparities in levels of trust associated with gender, ethnicity, education, and political orientation, which had the strongest association with trust of all factors. Political orientation was also a significant predictor of COVID-19 risk perceptions, but there was no independent effect of political orientation when accounting for trust, which was predictive of all risk perception outcomes.

CONCLUSIONS

Trusted sources, such as personal doctors, may most effectively convey COVID-19 information across political orientations and sociodemographic groups. News media may be ineffective at informing smokers due to their low credibility. The results suggest that trust may explain the apparent effect of political orientation on COVID-19 risk perceptions. Implications for researchers, communication professionals, and policy makers are discussed.

Goals and good health: Undergraduates' goals for avoiding COVID-19

We observed COVID-19 concern during goal pursuit data collection, where some undergraduates self-reported COVID-19 specific goals. Thus, we analyzed the individual difference in students who self-reported COVID-19 specific goals in this current exploratory study. The results revealed (N = 496) that there were no differences in those who reported COVID-19 goals with their self-reporting of the Five-Factor Model. Additionally, participant's most reported goal was to 1) not contract COVID-19, 2) be social during COVID-19, and 3) follow health and safety protocols. This study provides researchers with both qualitative and quantitative evidence about college students' concern with COVID-19.

Examining conspiracy beliefs and COVID-19 in four countries: The role of disgust towards the political system and implications for prosocial behavior

Since late 2019, the coronavirus SARS-COV-2 responsible for the COVID-19 disease has continued to spread across different regions of the world. As a result, governments have been implementing measures for controlling the disease which rely on people's cooperation. In this research, we considered predictors and implications of people's beliefs that they “haven’t been told the ‘whole story’ about COVID-19.” Specifically, we examined the role of disgust towards the political system in predicting conspiratorial tendencies across four countries, in Europe (Italy and the UK), North America (the USA), and Asia (South Korea). In addition, we investigated the implications of conspiratorial beliefs for individuals’ intentions to engage in prosocial cooperative behavior. In line with the idea that feelings of disgust towards the political system may indicate that people perceive the system as violating core norms, results showed that disgust was associated with stronger conspiratorial tendencies. Individuals’ conspiratorial tendencies were in turn associated with lower intentions to help others during the pandemic. Results were broadly consistent across the countries tested. Directions for future research are discussed.

Active seeking of post-donation information to minimize a potential threat to transfusion safety: A pilot programme in the context of the COVID-19 pandemic

BACKGROUND AND OBJECTIVES

Early in the pandemic, the transmissibility of coronavirus disease-19 (COVID-19) by transfusion was unknown. We piloted a systematic, post-donation outreach programme to contact blood donors and inquired about symptoms post-donation.

MATERIALS AND METHODS

Persons who donated on on May 1 and 2, 2020 were contacted 3 days post-donation, by phone to assess COVID-19-related symptoms. Half of the donors were administered a short questionnaire, consisting of only three questions. Others were questioned using a longer, more specific questionnaire. If symptoms were reported, products were quarantined until donors were contacted again by a trained nurse who more thoroughly assessed the likelihood of COVID-19. Blood products were withdrawn if symptoms indicative of COVID-19 were identified.

RESULTS

Of 654 donors, 609 (93.1%) were successfully contacted. Of 310 donors who answered the short questionnaire and 299 who answered the long questionnaire, 19 (6.1%) and 8 (2.7%) had one or more symptoms, respectively. Based on the nurses' assessment, two donations (0.3%) had to be withdrawn.

CONCLUSION

These results suggest that actively seeking post-donation information might be feasible to mitigate emerging, unqualified transfusion risks.

Iron fists and velvet gloves: Investigating the associations between the stringency of governments' responses to COVID-19, stress, and compliance in the early stages of the pandemic

To tackle the spread of COVID-19, governments worldwide have implemented restrictive public health behavioural measures. Whether and when these measures lead to positive or negative psychological outcomes is still debated. In this study, drawing on a large sample of individuals (N_total  = 89,798) from 45 nations, we investigated whether the stringency of public health measures implemented at the outset of the COVID-19 pandemic in March-May 2020 was associated with individuals' levels of stress and compliance. Moreover, we addressed the question of how these associations may be moderated by the measures' implementation lag, nations' tolerance for unequal distributions of power (i.e., power distance), and individuals' institutional trust. Linear mixed models suggested that slower implementation of less stringent measures was associated with higher stress and lower compliance. Also, rapid implementation of stricter measures was associated with a mild increase in stress. Such effects were especially pronounced in countries with less tolerance for inequality. Albeit significant, the moderating effect of institutional trust was very small. The results suggest that it may be important to consider the measures' implementation lag when tackling the spread of COVID-19, but findings should be interpreted in relation to the data collection period.

The Role of Collectivism-Individualism in Attitudes Toward Compliance and Psychological Responses During the COVID-19 Pandemic

This study examined the role of individual differences in horizontal and vertical individualism and collectivism, trust and worries, and concerns about COVID-19 in predicting the attitudes toward compliance of health advice and psychological responses during the COVID-19 pandemic. Chinese university students (N=384, 324 female) completed measures of individualism and collectivism, trust, attitudes toward compliance, and psychological responses to the pandemic. Results showed that not only vertical collectivist orientation but also horizontal individualist orientation significantly predicted higher willingness to comply, whereas vertical individualist orientation significantly predicted lower willingness to comply. Vertical individualist and vertical collectivist orientations predicted higher psychological response in terms of distress, anxiety, and depression, while horizontal collectivistic orientation significantly predicted less psychological problems. Implications of the effect of individual-level cultural orientations on attitudes toward public health compliance and psychological well-being during global health crises are discussed.

Primary Health Care and Hospital Management During COVID-19: Lessons from Lombardy

The pandemic due to SARS-CoV-2 tested the resilience of health systems worldwide. The outcome of the pandemic is impacted by health management choices made over the course of the disaster, which in turn are strongly dependent on the underlying healthcare system - as mirrored by the fact that regional pandemic experiences differ considerably: In Italy (a country most impacted by the COVID-19 outbreak), infection and mortality rates vary vastly between regions, with Lombardy - a comparatively well-equipped region with regard to hospitals and centers of scientific excellence - being amongst the worst-affected areas. Within this article, we focus on the challenges within primary health care and hospital organization, cooperation between primary and specialist care, and access to health care services: In Lombardy, neglected primary health care with a comparatively low availability of general practitioners (GPs) per inhabitant, the initial prioritization of hospitals during the pandemic while neglecting primary health care in terms of personal protective equipment (PPE), the lack of testing resources, and a failure to achieve coordinated support contributed to a quick overburdening of hospitals, where the dissolution of traditional departments into "macro-areas" may favor nosocomial infections during an ongoing pandemic. Neither specialized medicine nor privatization, but rather flexible public healthcare services working in consistent cooperation with GPs, show better efficiency in containing viral spread and managing patients. Strengthening the primary health care sector with regard to human and technical resources and supporting the coordination between the different levels of health care providers help to avoid overcrowded hospitals, while protecting patients and health care workers during large-scale health emergencies. Overall, further in-depth analysis of structural determinants is needed in order to develop more-resilient and integrative health care systems.

Social Distancing and COVID-19: Factors Associated With Compliance With Social Distancing Norms in Spain

This article describes patterns of compliance with social distancing measures among the Spanish population during the coronavirus disease-2019 (COVID-19) pandemic. It identifies several factors associated with higher or lower compliance with recommended measures of social distancing. This research is part of a 67-country study, titled the International COVID-19 study on Social & Moral Psychology, in which we use a Spanish dataset. Participants were residents in Spain aged 18 or above. The sample comprises 1,090 respondents, weighted to be representative of the Spanish population. Frequencies, correlations, bivariate analysis, and six models based on hierarchical multiple regressions were applied. The main finding is that most Spaniards are compliant with established guidelines of social distance during the pandemic (State of Alarm, before May 2020). Variables associated more with lower levels of compliance with these standards were explored. Six hierarchical multiple regression models found that compliance with social distance measures has a multifactorial explanation (R 2 between 20.4 and 49.1%). Sociodemographic factors, personal hygiene patterns, and the interaction between personal hygiene patterns and the support for political measures related to the coronavirus brought significant effects on the regression models. Less compliance was also associated with beliefs in some specific conspiracy theories with regard to COVID-19 or general conspiracy mentality (Conspiracy Mentality Questionnaire, CMQ), consumption patterns of traditional mass media (television, paper newspapers, magazines, and radio) and modern means to get informed (online digital newspapers, blogs, and social networks), political ideology, vote, trust in institutions, and political identification. Among the future lines of action in preventing the possible outbreak of the virus, we suggest measures to reinforce trust in official information, mainly linked to reducing the influence of disinformation and conspiracy theories parallel to the pandemic.

Making sense of the COVID-19 pandemic: A qualitative longitudinal study investigating the first and second wave in Italy

The COVID-19 pandemic further highlighted the crucial role of people's compliance for the success of measures designed to protect public health. Within the frame of Semiotic Cultural Psycho-social Theory, we discuss how the analysis of people's ways of making sense of the crisis scenario can help to identify the resources or constraints underlying the ways the citizens evaluate and comply with the anti-covid measures. This study aimed to examine how Italian adults interpreted what was happening in the first wave of the pandemic and how the interpretation varied in the period up to the beginning of the second wave. Diaries were collected for six months, from 11 April to 3 November 2020. Participants were periodically asked to talk about their life 'in the last few weeks'. A total number of 606 diaries were collected. The Automated Method for Content Analysis (ACASM) procedure was applied to the texts to detect the factorial dimensions - interpreted as the markers of latent dimensions of meanings- underpinning (dis)similarities in the respondents' discourses. ANOVA were applied to examine the dissimilarities in the association between factorial dimensions and production time. Findings show that significant transitions occurred over time in the main dimensions of meaning identified. Whereas the first phase was characterized by a focus on one's own daily life and the attempt to make sense of the changes occurring in the personal sphere, in the following phases the socio-economic impact of the crisis was brought to the fore, along with the hope to returning to the "normality" of the pre-rupture scenario. We argued that, despite the differences, a low sense of the interweaving between the personal and public sphere emerged in the accounts of the pandemic crisis throughout the sixth months considered; a split that, we speculate, can explain the "free for all" movement that occurred at the end of the first wave and the beginning of the second wave.

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

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