Psychological Predictors of COVID-19 Prevention Behavior in Hungarian Women Across Different Generations

Prospective Attitudes towards Respiratory Syncytial Virus (RSV) Vaccination: Validation of a Survey Instrument among Young Females in Jordan Pending Vaccine Authorization

In May 2023, the U.S. FDA advisors endorsed Pfizer's pregnancy-administered vaccine (branded ABRYSVO) to protect infants from respiratory syncytial virus (RSV) infection. Vaccination can reduce the burden of RSV-related respiratory disease, with previous studies showing its substantial medical and financial burden in Jordan. However, pregnant women may exhibit hesitancy to get vaccinated due to concerns about potential risks to themselves or their fetuses. This study aimed to assess the acceptance of the RSV vaccine among young females and identify the determinants influencing their decision using a newly constructed instrument. A survey instrument was developed and validated, comprising 26 items to measure RSV vaccine acceptance. A cross-sectional study design was employed, with data collection from a sample of females aged 18 to 45 residing in Jordan during 5-6 July 2023, using a convenient approach via an online distributed questionnaire. The final study sample comprised 315 respondents, with 67.6% who have heard of RSV before the study. If the vaccine was safe, effective, and provided freely, 70.2% showed willingness to get the RSV vaccine, 15.2% resisted, and 14.6% were hesitant. Principal component analysis identified six internally consistent sub-scales with the following suggested themes: Advice, Burden, Conspiracy, Dangers, Efficiency, and Fear, comprising 21 items collectively as assigned as the "ABCDEF" scale for RSV vaccine acceptance. RSV vaccine acceptance in this study was associated with the advice and fear constructs. The validated survey instrument successfully captured important determinants of RSV vaccine acceptance among young females. RSV vaccine promotion efforts should focus on the following: enhancing vaccine education, improving trust in healthcare institutions and providers, reducing burdens through resolving cost issues and focusing on the role of social support, addressing safety concerns, and tailoring communication strategies to effectively promote the benefits of the vaccine. These insights can inform public health policies and interventions aiming to promote RSV vaccination and mitigate the burden of RSV-related diseases among infants. Follow-up studies are recommended with pregnant women as the target group to assess their attitude towards RSV vaccination and to confirm the validity of the conceived ABCDEF survey instrument.

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

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

Development and Validation of the Multidimensional COVID-19 Vaccine Hesitancy Scale

The aim of the study was to develop and validate the Multidimensional Covid-19 Vaccine Hesitancy Scale (CoVaH), a self-report measure to assess the beliefs and attitudes beneath vaccination hesitancy and reasons for vaccine refusal in the context of Covid-19. A sample of 1503 Hungarian respondents filled out the scale. Exploratory and confirmatory factor analysis was conducted to identify latent constructs underlying participants' responses. Findings show a robust three-factor solution for the 15-item CoVaH with high factor loadings on each factor: skepticism, risk perception and fear of Covid-19 vaccine. The CoVaH displayed very good fit indices (KMO = .94, RMSEA = 0.049, CFI = .983) and internal consistencies (α values > .89) and was found to have proper convergent, concurrent and discriminant validity in identifying Covid-19 vaccine hesitancy in the general population. The new scale adds to the literature through the identification of the fear of COVID-19 vaccines, as a newly highlighted explanatory variable of COVID-19 vaccine hesitancy, besides the other formerly identified components. The scale, available in English and Hungarian, allows the assessment of vaccine uptake hesitancy and has the potential to help targeted interventions, considering individual factors that interfere with vaccination acceptance.

The Role of Positive and Negative Information Processing in COVID-19 Vaccine Uptake in Women of Generation X, Y, and Z: The Power of Good is Stronger Than Bad in Youngsters?

Background

Positive and negative focus in information processing associated with age has a diverse role in COVID-19 vaccine uptake. The aim of the study was the exploration of the generational diversity among psychological predictors of COVID-19 vaccine uptake.

Methods

A cross-sectional research was conducted. The sample included 978 Hungarian women. Based on former literature findings, the COVID-19 vaccine uptake predictors were chosen from the health beliefs model, COVID-19 vaccine hesitancy, and psychological flexibility. Multivariate logistic regression analysis was conducted to investigate the predictors of COVID-19 vaccine uptake in women of Gen X, Gen Y, and Gen Z.

Results

In Gen X women, the influence of significant predictors are more prone to the positivity in COVID-19 vaccine uptake behavior, perceived benefits being the most relevant, increasing the likelihood of vaccine uptake more than four times. In Gen Y women, perceived barriers, lack of confidence/skepticism and avoidance significantly reduce the probability of vaccine uptake, showing an accentuated negative focus in information processing related to COVID-19 vaccination. The vaccine uptake in Gen Z is predicted only by the perceived benefits, and the likelihood of COVID-19 vaccine uptake is heightened in chance more than 19 times.

Conclusion

Women belonging to Gen X or Gen Y, the perceived benefits hold the key to vaccine uptake, while in women of Gen Z, low risks, lack of threats, and accessibility could motivate the decision of vaccine uptake. The findings are useful in generation-adapted vaccination campaigns and can also serve as inspiration for evolutionary psychology studies on health behavior and the broad area of study in cognitive biases in health information processing.

Increased Risk Perception, Distress Intolerance and Health Anxiety in Stricter Lockdowns: Self-Control as a Key Protective Factor in Early Response to the COVID-19 Pandemic

Studies provide evidence that distress, (health) anxiety, and depressive symptoms were high during the first weeks of COVID-19 lockdown restrictions, decreasing over time (possibly due to individuals’ protective psychological factors). Relations between different lockdown restrictions, mental health issues, and protective factors need to be explored, since even small lockdown effects might increase the risk of future mental health issues. We merged objective lockdown stringency data with individual data (N = 1001) to examine differences in lockdown effects in strict lockdown (Romania) and mild lockdown (Hungary) conditions between March and May 2020 on stressors and mental health symptoms, taking protective factors into account. The stricter lockdown in Romania revealed higher levels of perceived risk of infection, distress intolerance, and COVID-19 health anxiety. Protective psychological factors were not affected by the lockdown measures. Surpassing psychological flexibility and resilient coping, self-control proved to be the most promising protective factor. It is recommended that future research merge objective data with study data to investigate the effects of different COVID-19 lockdown measures on mental health and protective factors. Policy decisions should consider lockdown-dependent consequences of mental health issues. Intervention programs are suggested to mitigate mental health issues and to strengthen peoples’ protective psychological factors.

Associations of COVID-19 Knowledge and Risk Perception with the Full Adoption of Preventive Behaviors in Seoul

This study explores the levels of COVID-19 knowledge, risk perception, and preventive behavior practice in Seoul, to determine whether knowledge and risk perception are significantly associated with the full adoption of preventive behaviors, for the delivery of a customized public campaign to Seoul's citizens. A total of 3000 Seoul residents participated in this study through an online questionnaire survey. They had a mean score of 84.6 for COVID-19 knowledge (range: 0-100 points) and 4.2 (range: 1-7 points) for risk perception. Of the participants, 33.4% practiced full adoption of all three preventive behaviors: hand hygiene, wearing a face mask, and social distancing; wearing a face mask was practiced the most (81.0%). Women significantly adopted these three preventive behaviors more often compared with men. Both COVID-19 knowledge and risk perception were found to be significantly associated with the full adoption of preventive behaviors; however, this association differed by the type of preventive behavior. This indicates that city-level information on the levels of COVID-19 knowledge, risk perception, and preventive behaviors should be clearly and periodically communicated among public officers and healthcare professionals to continually raise the public's awareness of the full adoption of non-pharmaceutical preventive behaviors.

Face Covered and Six Feet Apart: Behavioral Awareness Predicts Greater Adherence to Public Health Guidelines during the COVID-19 Pandemic

The COVID-19 pandemic has deleteriously impacted physical and mental health. Guidelines to limit the spread of COVID-19 include wearing a face covering in public, limiting close contacts, and physical distancing. In combatting this and future pandemics, it is essential to understand predictors of adherence, such as psychological flexibility. We hypothesized higher psychological flexibility would relate to greater adherence to public health guidelines. Participants (n = 265) were English-reading/speaking adults in the United States and were recruited through Amazon's Mechanical Turk. Included in the present analyses are data from June (n = 360) and July 2020 (n = 265). Measures included the Comprehensive Assessment of ACT Processes (CompACT), which measured psychological flexibility. Outcome measures included mask-wearing and number of close contacts, which were operationalized categorically (100% mask-wearing in public, ≤10 close contacts in past week). Two logistic regression models examined psychological flexibility and distress as predictors of adherence to mask-wearing and limiting close contacts, while controlling for demographic correlates. Results indicated that greater behavioral awareness predicted greater odds of mask-wearing and limiting close contacts. Psychological flexibility, and behavioral awareness specifically, should be investigated in future research as targets for intervention amidst global disasters.