Mask Wearing as Cultural Behavior: An Investigation Across 45 U.S. States During the COVID-19 Pandemic

Who can I count on: Honor, self-reliance, and family in the United States and Iran

Honor requires that individuals demonstrate their worth in the eyes of others. However, it is unclear how honor and its implications for behavior vary between societies. Here, we explore the tension between competing views about how to make sense of honor-as narrowly defined through self-reliance and self-defense or as broadly defined through strength of character. The former suggests that demonstrating the ability to defend one's self, is a crucial component of honor, while the latter allows the centrality of self-reliance to vary depending on circumstances. To examine these implications, we conducted studies in the U.S., where self-reliance is central to honor, and in Iran, where individual agency must be balanced against the interests of kin. Americans (Studies 1, 2a; n = 978) who endorsed honor values tended to ignore governmental COVID-19 measures because they preferred relying on themselves. In contrast, honor-minded Iranians (Study 2b; n = 201) adhered to public-health guidelines and did not prefer self-reliance. Moreover, honor-minded Iranians endorsed family-reliance, but did not moralize self-reliance (Study 3; n = 107), while honor-minded Americans endorsed family-reliance and moralized self-reliance (Study 3; n = 120). Results suggest that local norms may shape how honor is expressed across cultures.

A context-sensitive collectivism during the COVID-19 pandemic: Effect on the adoption of containment measures in China and the US

This study investigates individuals' adoption of containment measures (e.g., wearing masks) from the perspectives of cultural values and trust in two countries-China and the US. Distinguished from previous definitions that characterise cultural values as rigid and fixed concepts, this study reconceptualizes collectivism to be a context-sensitive construct. With survey data from a collectivism-prevalent culture (China, n = 1578) and an individualism-prevalent culture (the US, n = 1510), it unfolds the underlying mechanism by which collectivism influences people's adoption of containment measures in both countries. Results indicate that institutional trust serves as a significant mediator in this relationship. In both countries, individuals who hold a collectivistic value on the pandemic are more likely to endorse the adoption of containment measures. This endorsement is driven by their trust in public institutions, which stems from their collectivistic values. Additionally, slight distinctions emerge, revealing that collectivistic values directly predict the behaviours among Chinese individuals, whereas such a direct effect is not observed in the US. Practical implications will be offered.

Preliminary Validation of Two Brief Measures of Masculine and Feminine Honor Endorsement

Researchers have developed numerous individual differences measures to assess people's endorsement of honor ideology (i.e., beliefs regarding the importance of honor and reputation) with most ranging from 12-36 items in length. Despite having great utility, the length of these measures magnifies the costs associated with survey research, especially in research contexts that use large, representative samples (e.g., health surveys). The present study aimed to develop and validate single-item measures that assess participants' agreement with gender-specific honor prototypes, as well as short-form versions of the honor ideology for manhood (HIM) and honor ideology for womanhood (HIW) scales. An initial sample of participants (N = 879) completed single-item honor prototype measures, a battery of previously validated honor measures (including the HIM and HIW), and measures of constructs previously shown to be related to the dynamics of honor (e.g., aggression, firearm ownership). A second sample of participants (N = 100) completed the new measures, as well as an abbreviated battery of honor measures, to examine test-retest reliability. Results indicated that the new, brief measures were strongly correlated with both the original HIM and HIW as well as several other established honor measures. Moreover, the associations between these new measures and honor-related outcomes were nearly identical to those found with the original HIM and HIW. Our new measures also demonstrated acceptable test-retest reliability, despite being single-item scales. Overall, the present work provides preliminary support for several brief measures of honor endorsement that researchers can use when longer scales are not feasible.

Political party affiliation, social identity cues, and attitudes about protective mask-wearing during the COVID-19 pandemic in Germany

This cross-sectional study aimed to determine 1) whether German citizens' adherence to health professionals' recommendations and mandates regarding protective masks during the COVID-19 pandemic varied according to their political party affiliations, and 2) how behavioral cues provided by members of shared social groups, such as family and friends, influenced individual mask-wearing behavior. A quota-based sample of German voters (n = 330) consisting of 55 citizens whose voting intentions aligned with each of the country's six main political parties responded to an online questionnaire consisting of multiple-choice and open-ended questions. Univariate descriptive statistical analyses of quantitative data were conducted, and multiple regressions were performed to determine log odds and significant variations among group-based responses. A pragmatic inductive coding process was used to conduct a thematic analysis of qualitative data. Results indicated that those participants who expressed an intention to vote for the populist radical right party were the least likely to follow health experts' recommendations and the most likely to express anger and dissatisfaction over mask mandates. Prospective Left Party voters were the most likely to adhere to the advice of their doctors, while those associated with the Green Party were the most likely to adhere to the advice of public health experts. Most survey participants reported aligning their mask-wearing behavior with that of family and friends, with prospective CDU/CSU voters particularly likely to consider the mask-wearing behavior of family members. The results indicate that public health officials should consider how group-related factors influence public health compliance in order to encourage protective mask-wearing in the future.

Examining the cultural influence on online stances towards COVID-19 preventive measures and their impact on incidence and mortality: A global stance detection analysis of tweets

During the COVID-19 pandemic, nations implemented various preventive measures, triggering varying online responses. This study examines cultural influences on public online stances toward these measures and their impacts on COVID-19 cases/deaths. Stance detection analysis was used to analyze 16,428,557 Tweets regarding COVID-19 preventive measures from 95 countries, selected based on Hofstede's cultural dimensions. To ensure the variety of population, countries were chosen based on Twitter data availability and a minimum sample size of 385 tweets, achieving a 95% confidence level with a 5% margin of error. The weighted regression analysis revealed that the relationship between culture and online stances depends on the cultural congruence of each measure. Specifically, power distance positively predicted stances for all measures, while indulgence had a negative effect overall. Effects of other cultural indices varied across measures. Individualism negatively affected face coverings stances. Uncertainty avoidance influenced lockdown and vaccination stances negatively but had a positive effect on social distancing stances. Long-term orientation negatively affected lockdown and social distancing stances but positively influenced quarantine stances. Cultural tightness only negatively affected face coverings and quarantine stances. Online stances toward face coverings mediated the relationship between cultural indices and COVID-19 cases/deaths. As such, public health officials should consider cultural profiles and use culturally congruent communication strategies when implementing preventive measures for future pandemics. Furthermore, leveraging digital tools is vital in navigating and shaping online stances to enhance the effectiveness of these measures.

Inferring COVID-19 testing and vaccination behavior from New Jersey testing data

Characterizing the relationship between disease testing behaviors and infectious disease dynamics is of great importance for public health. Tests for both current and past infection can influence disease-related behaviors at the individual level, while population-level knowledge of an epidemic's course may feed back to affect one's likelihood of taking a test. The COVID-19 pandemic has generated testing data on an unprecedented scale for tests detecting both current infection (PCR, antigen) and past infection (serology); this opens the way to characterizing the complex relationship between testing behavior and infection dynamics. Leveraging a rich database of individualized COVID-19 testing histories in New Jersey, we analyze the behavioral relationships between PCR and serology tests, infection, and vaccination. We quantify interactions between individuals' test-taking tendencies and their past testing and infection histories, finding that PCR tests were disproportionately taken by people currently infected, and serology tests were disproportionately taken by people with past infection or vaccination. The effects of previous positive test results on testing behavior are less consistent, as individuals with past PCR positives were more likely to take subsequent PCR and serology tests at some periods of the epidemic time course and less likely at others. Lastly, we fit a model to the titer values collected from serology tests to infer vaccination trends, finding a marked decrease in vaccination rates among individuals who had previously received a positive PCR test. These results exemplify the utility of individualized testing histories in uncovering hidden behavioral variables affecting testing and vaccination.

Does wearing a mask promote consumer uniqueness seeking?

As a motivational factor, uniqueness drives individuals to seek and choose unique goods or experiences. The act of wearing masks obscures individuals' facial features and influences their desire for uniqueness. This study aims to explore how wearing masks promotes individual uniqueness- seeking behavior. Three experiments were performed using various product categories (Starbucks coffee cups, sweatshirts, suitcases, and baseball caps) and sample types (college student and adult samples). Experiment results show that wearing masks obscures individuals' facial features and weakens their self- perceived uniqueness, thereby increasing their willingness to actively purchase unique products. This study is the first to examine the effect of wearing masks on individuals' choice of unique products. Practically, the results suggest that customized products can compensate for the lack of self-perceived uniqueness brought about by facial occlusion, thus providing valuable guidance for companies and retailers that offer customized services in formulating and designing marketing strategies.

Compliance with COVID-19 preventative health measures in the United Kingdom: a latent profile analysis

Governments have adopted unprecedented measures to assist in slowing the spread of the COVID-19 pandemic, but compliance varies among individuals. This UK study uses latent profile analysis to identify four classes of individuals on factors believed to influence compliance. Those who sought health information from authoritative sources and actively sought information from multiple sources were most compliant. Profile differences in compliance and vaccination status were also primarily driven by trust in healthcare institutions over trust in government. These findings contribute to understanding compliance profiles and emphasise the importance of authoritative information and trust in healthcare systems.

Covid-19 skepticism and public health norms during refugee assistance: does skepticism always lead to poor safety protocol adherence?

BACKGROUND

Skepticism about COVID-19's existence or severity has spread as fast as the disease itself, and in some populations has been shown to undermine protective public health behaviors that can mitigate infection. For populations that are especially vulnerable to COVID spread and severity, such as refugees, COVID skepticism is particularly problematic.

METHODS

We examine data collected from observations of humanitarian services provided to refugees in Lebanon, Türkiye, and Jordan to determine if skepticism is related to adherence to specific health-protective protocols (masking, social distancing, and hand sanitizing), and whether the effects of COVID skepticism are mediated by particular populations of refugees or the country in which those refugees receive assistance.

RESULTS

We found that community skepticism (the frequency of COVID skepticism expressed by others within a service location) is associated with lower adherence to certain protocols and not others. We also found that with certain protocols, the country in which refugees receive services mediates the relationship between community skepticism and protocol adherence, but for other protocols the relationship between skepticism and adherence is independent of either country in which refugees reside or the refugee population being served.

CONCLUSIONS

The existence of skepticism about COVID-19 does not always lead to an unwillingness to take protective measures to avoid infection. The mechanisms underlying the relationship between skepticism and adherence to health-protective protocols vary based on the type of protocol in question. In order to increase protocol adherence, the specific variables predicting adherence to different protocols need to be assessed in order to increase adherence and improve public health during humanitarian services.

Polarization and the Psychology of Collectives

Achieving global sustainability in the face of climate change, pandemics, and other global systemic threats will require collective intelligence and collective action beyond what we are currently experiencing. Increasing polarization within nations and populist trends that undercut international cooperation make the problem even harder. Allegiance within groups is often strengthened because of conflict among groups, leading to a form of polarization termed "affective." Hope for addressing these global problems will require recognition of the commonality in threats facing all groups collective intelligence that integrates relevant inputs from all sources but fights misinformation and coordinated, cooperative collective action. Elinor Ostrom's notion of polycentric governance, involving centers of decision-making from the local to the global in a complex interacting framework, may provide a possible pathway to achieve these goals.

Exploring the Barriers and Facilitators of Mask-Wearing Behavior During the COVID-19 Pandemic in Taiwan, the United States, the Netherlands, and Haiti: A Qualitative Study

OBJECTIVE

This study explored the barriers and facilitators of mask-wearing behaviors during the pandemic in Taiwan, the United States, the Netherlands, and Haiti.

METHODS

Face-to-face interviews were conducted in Taiwan and online interviews were conducted with participants in the United States, the Netherlands, and Haiti.

RESULTS

In general, the habit of wearing a mask before coronavirus disease 2019 (COVID-19) was reported by Taiwanese participants. Additionally, Taiwanese participants perceived that wearing a mask was a social responsibility during the pandemic, suggesting that the collectivistic context might influence mask-wearing behavior. Unlike the Taiwanese population, some people in the United States and the Netherlands were reluctant to wear masks due to perceived restrictions on their freedom. Participants from Haiti mentioned that people who wore masks encountered violence, bullying, and discrimination. The results of this study suggest that political leadership and mask mandates have a strong impact on people's mask-wearing behavior.

CONCLUSIONS

These findings have valuable implications for the design of diverse behavioral interventions to enhance mask-wearing as part of infectious disease preparedness. Additionally, the findings from these countries offer valuable insights for the development of effective public health interventions to enhance society's resilience during the current pandemic and future infectious disease outbreaks.

A chronological review of COVID-19 case fatality rate and its secular trend and investigation of all-cause mortality and hospitalization during the Delta and Omicron waves in the United States: a retrospective cohort study

Introduction

Coronavirus disease 2019 (COVID-19) has caused more than 690 million deaths worldwide. Different results concerning the death rates of the Delta and Omicron variants have been recorded. We aimed to assess the secular trend of case fatality rate (CFR), identify risk factors associated with mortality following COVID-19 diagnosis, and investigate the risks of mortality and hospitalization during Delta and Omicron waves in the United States.

Methods

This study assessed 2,857,925 individuals diagnosed with COVID-19 in the United States from January 2020, to June 2022. The inclusion criterion was the presence of COVID-19 diagnostic codes in electronic medical record or a positive laboratory test of the SARS-CoV-2. Statistical analysis was bifurcated into two components, longitudinal analysis and comparative analysis. To assess the discrepancies in hospitalization and mortality rates for COVID-19, we identified the prevailing periods for the Delta and Omicron variants.

Results

Longitudinal analysis demonstrated four sharp surges in the number of deaths and CFR. The CFR was persistently higher in males and older age. The CFR of Black and White remained higher than Asians since January 2022. In comparative analysis, the adjusted hazard ratios for all-cause mortality and hospitalization were higher in Delta wave compared to the Omicron wave. Risk of all-cause mortality was found to be greater 14-30 days after a COVID-19 diagnosis, while the likelihood of hospitalization was higher in the first 14 days following a COVID-19 diagnosis in Delta wave compared with Omicron wave. Kaplan-Meier analysis revealed the cumulative probability of mortality was approximately 2-fold on day 30 in Delta than in Omicron cases (log-rank p < 0.001). The mortality risk ratio between the Delta and Omicron variants was 1.671 (95% Cl 1.615-1.729, log-rank p < 0.001). Delta also had a significantly increased mortality risk over Omicron in all age groups. The CFR of people aged above 80 years was extremely high as 17.33%.

Conclusion

Male sex and age seemed to be strong and independent risk factors of mortality in COVID-19. The Delta variant appears to cause more hospitalization and death than the Omicron variant.

Climates of Distrust in Medicine

Trust in medicine is often conceived of on an individual level, with respect to how people rely on particular clinicians or institutions. Yet as discussions of trust during the Covid-19 pandemic highlighted, trust decisions are not always as individual or interpersonal as this conception suggests. Rather, individual instances of trusting behavior are related to social trust, which is conceived as a willingness to be vulnerable to people in general, based on a sense of shared norms. In this essay, I propose that individual and social trust are connected to each other in what can be termed a "climate of trust." I explain how masking trends during the pandemic facilitated a "climate of distrust," and I consider the role that clinicians might play in transforming climates of distrust into climates of trust.

COVID-19 retreats and world recovers: A silver lining in the dark cloud

The coronavirus disease (COVID-19), which the World Health Organization classified as the Sixth Public Health Emergency Of International Concern (PHEIC) on January 30, 2020, is no longer a PHEIC. Millions were affected due to unawareness. The increase in fatalities and shortage of medicine was the first outrage of COVID-19. As per the Johns Hopkins COVID-19 resource center database, it was observed that the disease has spread dynamically across 200+ nations worldwide affecting more than 600 million people from 2019 to 2023, and over thousands of people were victimized regularly at a 2% mortality rate (approx.). In the midway, the mutant variants of concern like omicron, and delta have also created havoc and caused significant impact on public health, global economy, and lifestyle. Since 2019, 3 years now passed and the dynamic disease statistics seem decelerated; moreover, the prevalence of COVID-19 is also fading. The Johns Hopkins resource center has also stopped recording the data of the global pandemic recently from March 10, 2023. Hence, based on the facts, we are presenting a concise report on the pandemic from 2019 to 2023, which includes a brief discussion of the global pandemic. We have highlighted global epidemiology, emphasizing the Indian COVID scenario, vaccination across the globe, and the psychosocial and geopolitical consequences of COVID-19 with a brief background to pathology, clinical management, and the worldwide response against triage. A lot has changed and still needs to change after three tough years of COVID-19. Even though science has progressed and advanced research in medicine is pointing toward future generations, there is no standard care supplied for COVID-19-like calamities. COVID-19 cases might have declined but its influence on the society is still stagnant. This COVID experience has taught us that, despite our bleak beginnings, there is always hope for the future and that we must act with foresight to improve things for future generations.

Communication of COVID-19 Misinformation on Social Media by Physicians in the US

Importance

Approximately one-third of the more than 1 100 000 confirmed COVID-19-related deaths as of January 18, 2023, were considered preventable if public health recommendations had been followed. Physicians' propagation of misinformation about COVID-19 on social media and other internet-based platforms has raised professional, public health, and ethical concerns.

Objective

To characterize (1) the types of COVID-19 misinformation propagated by US physicians after vaccines became available, (2) the online platforms used, and (3) the characteristics of the physicians spreading misinformation.

Design, Setting, and Participants

Using US Centers for Disease Control and Prevention guidelines for the prevention and treatment of COVID-19 infection during the study window to define misinformation, structured searches of high-use social media platforms (Twitter, Facebook, Instagram, Parler, and YouTube) and news sources (The New York Times, National Public Radio) were conducted to identify COVID-19 misinformation communicated by US-based physicians between January 2021 and December 2022. Physicians' state of licensure and medical specialty were identified. The number of followers for each physician on 4 major platforms was extracted to estimate reach and qualitative content analysis of the messages was performed.

Main Outcomes and Measures

Outcome measures included categories of COVID-19 misinformation propagated, the number and traits of physicians engaged in misinformation propagation, and the type of online media channels used to propagate misinformation and potential reach.

Results

The propagation of COVID-19 misinformation was attributed to 52 physicians in 28 different specialties across all regions of the country. General misinformation categories included vaccines, medication, masks, and other (ie, conspiracy theories). Forty-two physicians (80.8%) posted vaccine misinformation, 40 (76.9%) propagated information in more than 1 category, and 20 (38.5%) posted misinformation on 5 or more platforms. Major themes identified included (1) disputing vaccine safety and effectiveness, (2) promoting medical treatments lacking scientific evidence and/or US Food and Drug Administration approval, (3) disputing mask-wearing effectiveness, and (4) other (unsubstantiated claims, eg, virus origin, government lies, and other conspiracy theories).

Conclusions and Relevance

In this mixed-methods study of US physician propagation of COVID-19 misinformation on social media, results suggest widespread, inaccurate, and potentially harmful assertions made by physicians across the country who represented a range of subspecialties. Further research is needed to assess the extent of the potential harms associated with physician propagation of misinformation, the motivations for these behaviors, and potential legal and professional recourse to improve accountability for misinformation propagation.

Behind closed doors: Protective social behavior during the COVID-19 pandemic

The success of personal non-pharmaceutical interventions as a public health strategy requires a high level of compliance from individuals in private social settings. Strategies to increase compliance in these hard-to-reach settings depend upon a comprehensive understanding of the patterns and predictors of protective social behavior. Social cognitive models of protective behavior emphasize the contribution of individual-level factors while social-ecological models emphasize the contribution of environmental factors. This study draws on 28 waves of survey data from the Understanding Coronavirus in America survey to measure patterns of adherence to two protective social behaviors-private social-distancing behavior and private masking behavior-during the COVID-19 pandemic and to assess the role individual and environmental factors play in predicting adherence. Results show that patterns of adherence fall into three categories marked by high, moderate, and low levels of adherence, with just under half of respondents exhibiting a high level of adherence. Health beliefs emerge as the single strongest predictor of adherence. All other environmental and individual-level predictors have relatively poor predictive power or primarily indirect effects.

Who do we trust and how do we cope with COVID-19? A mixed-methods sequential exploratory approach to understanding supportive messages across 35 cultures

Based upon a mixed-methods follow-up exploratory model, we examined the link between trust and coping during the early outbreak of the COVID-19 pandemic at the society level. Qualitative data were collected from the supportive messages written by 10,072 community adults across 35 societies. Trust and coping were used as the two pre-defined themes in the conceptual content analysis. Five subthemes emerged from the theme trust, depicting five distinct trusted targets: God, a larger us, country/government, science/healthcare, and the affected. Six subthemes emerged from the theme coping, depicting six distinct coping strategies: interpersonal/social coping, religious/spiritual coping, acceptance, blame, wishful thinking, and strength-based coping. A follow-up quantitative investigation also showed that four society-level factors (viz., individualism, cultural tightness, globalization, and severity of pandemic) had differential effects on people's trusted targets and ways of coping with the pandemic. Our study made both methodological and practical contributions to cross-cultural research on COVID-19 by using a mixed-methods approach in a multinational study and demonstrating the importance of making meaningful virtual connection during a time of physical distancing.

Invincible honor: masculine honor, perceived invulnerability, and risky decision-making

Masculine honor ideology is characterized by the cultivation, maintenance, and defense of reputations for toughness, bravery, and strength. The link between masculine honor endorsement and increased risk-taking - especially an increased tolerance for and even expectation of violence - is well-established in the literature. However, little empirical research has examined what factors might explain this relationship. This study investigates perceived invulnerability, the cognitive bias that one is immune to threats, as a mediator in the relationship between masculine honor ideology and risky decision-making. Results show moderate support for this relationship's existence. These findings elaborate on previous research between honor and specific risky decisions by demonstrating honor to instill cognitive biases in its adherents that make them more tolerant of risk, and thus more likely to decide to engage in risky behaviors. The implications of these findings for interpreting previous research, guiding future research, and pursuing specific educational and policy-based efforts are discussed.

Effect of short-term use of FFP2 (N95) masks on the salivary metabolome of young healthy volunteers: a pilot study

The use of face masks has become an integral part of public life in the post-pandemic era. However, the understanding of the effect of wearing masks on physiology remains incomplete and is required for informing public health policies. For the first time, we report the effects of wearing FFP2 masks on the metabolic composition of saliva, a proximal matrix to breath, along with cardiopulmonary parameters. Un-induced saliva was collected from young (31.2 ± 6.3 years) healthy volunteers (n = 10) before and after wearing FFP2 (N95) masks for 30 minutes and analyzed using GCMS. The results showed that such short-term mask use did not cause any significant change in heart rate, pulse rate or SpO₂. Three independent data normalization approaches were used to analyze the changes in metabolomic signature. The individuality of the overall salivary metabotype was found to be unaffected by mask use. However, a trend of an increase in the salivary abundance of L-fucose, 5-aminovaleric acid, putrescine and phloretic acid was indicated irrespective of the method of data normalization. Quantitative analysis confirmed increases in concentrations of these metabolites in saliva of paired samples amid high inter-individual variability. The results showed that while there was no significant change in measured physiological parameters and individual salivary metabotypes, mask use was associated with correlated changes in these metabolites plausibly originating from altered microbial metabolic activity. These results might also explain the change in odour perception reported to be associated with mask use. Potential implications of these changes on mucosal health and immunity warrants further investigation to evolve more prudent mask use policies.

Understanding self-protective behaviors during COVID-19 Pandemic: Integrating the theory of planned behavior and O-S-O-R model

Adopting health preventive actions is one of the most effective ways to combat the COVID-19 pandemic. Based on the theory of planned behavior and the orientation-stimulus-orientation-response model, this study investigated the mechanisms by which health information exposure influenced individuals to adopt self-protective behaviors in the context of infectious disease. In this research, a convenience sampling was used and 2265 valid samples (Male = 843, 68.9% of participants aged range from 18 to 24) were collected in China. Structural equation modeling analysis was performed, and the analysis showed that health consciousness positively influenced the subsequent variables through interpersonal discussions and social media exposure to COVID-19-related information. The interaction between interpersonal discussion and social media exposure was found to be positively associated with the elements of the theory of planned behavior and risk perception. The findings also revealed that self-protective behavior was positively predicted by the components of the theory of planned behavior and risk perceptions, with subjective norms serving as the main predictor, followed by attitudes and self-efficacy.

Mask Adherence to Mask Mandate: College Campus Versus the Surrounding Community

Adherence to masking recommendations and requirements continues to have a wide variety of impacts in terms of viral spread during the ongoing pandemic. As governments, schools, and private sector businesses formulate decisions around mask requirements, it is important to observe real-life adherence to policies and discern subsequent implications. The CDC MASCUP! observational study tracked mask-wearing habits of students on higher-education campuses across the country to collect stratified data about mask typologies, correct mask usage, and differences in behaviors at locations on a college campus and in the surrounding community. Our findings from a single institution include a significant adherence difference between on-campus (86%) and off-campus sites (72%) across the course of this study as well as a notable change in adherence at the on-campus sites with the expiration of a county-wide governmental mandate, despite continuance of a university-wide mandate. This study, completed on and around the campus of East Tennessee State University in Washington County TN, was able to pivotally extract information regarding increased adherence on campus versus the surrounding community. Changes were also seen when mask mandates were implemented and when they expired.

Lay theories about emotion recognition explain cultural differences in willingness to wear facial masks during the COVID-19 pandemic

Given that mask-wearing proved to be an important tool to slow the spread of infection during the COVID-19 pandemic, investigating the psychological and cultural factors that influence norms for mask wearing across cultures is exceptionally important. One factor that may influence mask wearing behavior is the degree to which people believe masks potentially impair emotion recognition. Based on previous research suggesting that there may be cultural differences in facial regions that people in Japan and the United States attend to when inferring a target's emotional state, we predicted that Americans would perceive masks (which cover the mouth) as more likely to impair emotion recognition, whereas Japanese would perceive facial coverings that conceal the eye region (sunglasses) to be more likely to impair emotion recognition. The results showed that Japanese participants reported wearing masks more than Americans. Americans also reported higher expected difficulty in interpreting emotions of individuals wearing masks (vs. sunglasses), while Japanese reported the reverse effect. Importantly, expectations about the negative impact of facial masks on emotion recognition explained cultural differences in mask-wearing behavior, even accounting for existing social norms.

Trans and Gender Diverse People's Experience Wearing Face Masks During the COVID-19 Pandemic: Findings from Data Across 4 States in the USA

Introduction

Social isolation and reduced access to public life in response to SARS-CoV-2 (COVID-19) challenges health and well-being for many. Marginalized communities, including transgender and gender diverse (TGD) people, have been disproportionally impacted. Experiences of TGD people should be centered in pandemic-related research to better inform policy.

Methods

A diverse sample of TGD people (N = 158) were recruited from Michigan, Nebraska, Oregon, and Tennessee to participate in the Trans Resilience and Health Study. Participants ranged from 19 to 70 years old (M = 33.06; SD = 12.88) with 27.2% identifying as trans men/men, 26% identifying as trans women/women, and remaining identifying with terms like genderqueer and nonbinary. Thirty percent identified as people of color. Participants completed a monthly COVID-19-related questionnaire April 2020-March 2021 including open-ended questions to learn what contributed to resilience during this time. Thematic analyses of responses enabled identification of salient themes.

Results

Analyses revealed pandemic-related changes in social experiences of marginalization and mask-wearing. Twenty-six participants mentioned face masks as contributing to resilience while also elaborating the influence of masks on experiences of misgendering. Participants identifying as trans women reported decreased misgendering while trans men and nonbinary participants reported increased misgendering.

Conclusions and Policy Implications

Mask-wearing helps reduce transmission of COVID-19. For some trans women, masks also reduce the threat of misgendering and possibly other forms of enacted stigma. However, increased risk for misgendering, as noted by trans men in our study, should be considered and increased supports should be provided.

The role of honour in interpersonal, intrapersonal and intergroup processes

In this article, we review research in psychology and other related social science fields that has adopted an honor framework to examine intrapersonal, interpersonal, and intergroup processes taking a culture-comparative or individual differences approach. In the sections below, we will first review research on the role of honor in interpersonal processes focusing primarily on interpersonal aggression including in close relationships, non-aggressive ways of responding to threats (e.g., forgiveness), and reciprocity. Next, we move onto reviewing research on the role of honor in intrapersonal processes, specifically in the domains of emotional responses to honor-threatening situations, mental, and physical health. Finally, we review research emerging from social and political psychology and political science that have utilized the honor framework to understand and explain group processes and intergroup relations at different level of analyses (e.g., social groups, nations). Given the limited space, our goal was to emphasize major and emerging areas of research on honor and provide food for thought for future research.

Insight into the mechanisms of olfactory dysfunction by COVID-19

One of the unique symptoms of COVID-19 is chemosensory dysfunction. Almost three years since the beginning of the pandemic of COVID-19, there have been many studies on the symptoms, progress, and possible causes, and also studies on methods that may facilitate recovery of the senses. Studies have shown that some people recover their senses even within a couple of weeks whereas there are other patients that fail to recover chemosensory functions fully for several months and some never fully recover. Here we summarize the symptoms and the progress, and then review the papers on the causation as well as the treatments that may help facilitate the recovery of the symptoms. Depending on the differences in the levels of severity and the locations where the main pathological venues are, what is most effective in facilitating recovery can vary largely across patients and thus may require individualized strategies for each patient. The goal of this paper is to provide some thoughts on these choices depending on the differences in the causes and severity.

Masking Behaviors in the Absence of Local Mandate-An Observational Study from Hillsborough County, Florida

The purpose of this study was to understand the predictors of masking-especially age, race/ethnicity and gender-in Hillsborough County Florida, a region without mask mandates. Masking and social distancing behaviors of individuals were observed in Hillsborough County during one-week intervals in July 2021, August 2021 and Late September-early October 2021. Demographic and behavioral observations were recorded and logistic regression was utilized to determine the odds ratio of wearing a mask amongst various groups. Overall, masking ranged from 36.80% to 48.64%, peaking during the second observation period. Masking rates were highest amongst people of color, women and seniors. Establishments posting mask-negative language, such as "masks NOT required," saw a 46% decrease in the odds of masking compared to establishments without mask-related signage (thereby defaulting to no mandate). Understanding who engaged in masking and social distancing behaviors will provide local public health officials with a deeper understanding of the effectiveness of previously used strategies, which can be leveraged in future surges of COVID-19 and other emergencies to create maximum impact. Lessons learned regarding policy implementation and understanding patterns of uptake of health guidelines are important for the continuous improvement of public health practice.

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

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

Exploration of the impact of political ideology disparity on COVID-19 transmission in the United States

BACKGROUND

Based on individual-level studies, previous literature suggested that conservatives and liberals in the United States had different perceptions and behaviors when facing the COVID-19 threat. From a state-level perspective, this study further explored the impact of personal political ideology disparity on COVID-19 transmission before and after the emergence of Omicron.

METHODS

A new index was established, which depended on the daily cumulative number of confirmed cases in each state and the corresponding population size. Then, by using the 2020 United States presidential election results, the values of the built index were further divided into two groups concerning the political party affiliation of the winner in each state. In addition, each group was further separated into two parts, corresponding to the time before and after Omicron predominated. Three methods, i.e., functional principal component analysis, functional analysis of variance, and function-on-scalar linear regression, were implemented to statistically analyze and quantify the impact.

RESULTS

Findings reveal that the disparity of personal political ideology has caused a significant discrepancy in the COVID-19 crisis in the United States. Specifically, the findings show that at the very early stage before the emergence of Omicron, Democratic-leaning states suffered from a much greater severity of the COVID-19 threat but, after July 2020, the severity of COVID-19 transmission in Republican-leaning states was much higher than that in Democratic-leaning states. Situations were reversed when the Omicron predominated. Most of the time, states with Democrat preferences were more vulnerable to the threat of COVID-19 than those with Republican preferences, even though the differences decreased over time.

CONCLUSIONS

The individual-level disparity of political ideology has impacted the nationwide COVID-19 transmission and such findings are meaningful for the government and policymakers when taking action against the COVID-19 crisis in the United States.

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.

Factors associated with COVID-19 masking behavior: an application of the Health Belief Model

Wearing a face mask is effective in minimizing the spread of coronavirus disease 2019 (COVID-19) among unvaccinated individuals and preventing severe illness among the vaccinated. Country, state and local guidelines promote, and at times mandate, mask-wearing despite it being publicly perceived as an individual's choice. Guided by the Health Belief Model (HBM), structural equation modeling was used to analyze longitudinal data in a sample of US adults aged 18-49 years to identify constructs that contribute to face mask-wearing. Results indicated that perceived COVID-19 severity, perceived masking benefits and self-efficacy were positively associated with masking behavior, and masking barriers were negatively associated with masking behavior. Perceived susceptibility to COVID-19 and cues to action were nonsignificant correlates of masking behavior. These results' theoretical and practical implications contribute to the literature on the HBM and the COVID-19 pandemic. Future directions and limitations are discussed.

Face mask use as a categorical dimension in social perception

Prevention measures aimed at combating COVID-19 pandemic strongly impact several aspects of social life. In particular, interpersonal perception is affected as a function of whether the persons perceived wear or not face masks. In two experimental studies, we here explored whether people rely on the presence vs. absence of face masks when encoding information in memory about other individuals. In a memory confusion paradigm, participants were initially presented with individuals either wearing a face mask or not, each conveying a series of sentences. Next, participants were probed about the identity of the speaker of each sentence. Results showed that it was more likely to erroneously attribute a sentence to a speaker who also was wearing a face mask (or not) as the original speaker, demonstrating that the cue about wearing or not a face mask was spontaneously used to encode information. Study 2 ruled out an alternative explanation based on perceptual processes, suggesting that face masks represent meaningful social objects. Overall, it emerged that participants spontaneously categorize others as a function of whether they wear a mask or not. Findings also confirmed previous research evidence about the more positive evaluation of mask wearers as compared to non-wearers, and the overall detrimental impact that face masks may have on the correct identification of social targets.

Development and cross-national investigation of a model explaining participation in WHO-recommended and placebo behaviours to prevent COVID-19 infection

To protect themselves from COVID-19, people follow the recommendations of the authorities, but they also resort to placebos. To stop the virus, it is important to understand the factors underlying both types of preventive behaviour. This study examined whether our model (developed based on the Health Belief Model and the Transactional Model of Stress) can explain participation in WHO-recommended and placebo actions during the pandemic. Model was tested on a sample of 3346 participants from Italy, Japan, Poland, Korea, Sweden, and the US. It was broadly supported: objective risk and cues to action showed both direct and indirect (through perceived threat) associations with preventive behaviours. Moreover, locus of control, decision balance, health anxiety and preventive coping moderated these relationships. Numerous differences were also found between countries. We conclude that beliefs about control over health and perceived benefits of actions are critical to the development of interventions to improve adherence to recommendations.

To mask or not to mask: Debunking the myths of mask-wearing during COVID-19 across cultures

Mask-wearing is the simplest yet most effective preventive behavior during COVID-19. However, it has sparked great controversy, particularly in America. Little is known about what psychosocial factors predict people’s decision to mask. This research challenges three myths about mask-wearing. First, does mask-wearing provide a false sense of security? Second, is knowledge of COVID-19 a more robust predictor than political ideology of mask-wearing behavior? Third, does resistance to masks reflect anti-authoritarianism or a lack of trust in government? With nationally representative samples across two cultures (N = 1,121), findings reveal a significant positive correlation between mask-wearing and other preventive behaviors. Moreover, knowledge of COVID-19 and trust in government significantly predicted mask-wearing. Implications of the results are also discussed in the cross-cultural context. Critically, findings could provide practical implications for public education and policymaking by uncovering how to more effectively promote compliance with recommended preventive behaviors during our ongoing struggle with COVID-19.

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.

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.

The COVID-19 Health Protocol among University Students: Case Studies in Three Cities in Indonesia

The COVID-19 pandemic has caused lifestyle changes for everyone and led to the practice of regulated health protocols for preventing the spreading or severity of the COVID-19 pandemic. This study examines the differences in health protocols and health practices among university students. The designed online survey was conducted among 292 university students in three cities in Indonesia, i.e., Yogyakarta, Semarang, and Surakarta. A forced-entry multivariate regression was conducted using all RANAS (risk, attitude, norms, ability-self-regulation) sub-factors as independent variables and health protocol obtained from PCA as the dependent variable. The results showed that the students' health protocol and health practices were practiced with varying frequency. A face mask covering the chin and nose was the most practiced health protocol, while reducing mobilization by maintaining distance was the most violated health protocol among students. We also found that four health protocol practices are highly correlated, i.e., handwashing in public spaces, physical distancing, frequency of using the mask, and avoiding crowded places. In addition, three significant psychological factors were identified, which were positively associated with the student's health protocol practice, i.e., belief about time (attitude) (OR: 0.119; CI: -0.054-0.136; p ≤ 0.05), personal norm (norm) (OR: 0.232; CI: 0.149-0.539; p ≤ 0.01), and action control (self-regulation) (OR: 0.173; CI: 0.046-0.427; p ≤ 0.05), where the personal norm is the most significant one. Finally, to minimize the COVID-19 transmission among students, especially when they back to onsite learning, it was important to create students' sense of ethical self-obligation to follow and practice standard health hygiene correctly and regularly.

COVID-19 Risk Factors and Predictors for Handwashing, Masking, and Social Distancing Among a National Prospective Cohort of U.S. Older Adults

Objectives

Older adults have a disproportionately higher COVID-19 risk; however, there is limited research investigating adherence to the major COVID-19 mitigation behaviors (handwashing, masking, social distancing) for older populations. We examined COVID-19 risk factors and predictors for adherence to COVID-19 mitigation behaviors among a national sample of US older adults.

Study design

Data were retrieved for 3257 respondents from a nationally representative prospective sample of US Medicare beneficiaries aged ≥65 years. COVID-19 variables were collected in 2020, whereas all other data were collected in 2019.

Methods

We used multiple logistic regression to analyze COVID-19 risk factors and predictors for handwashing, masking, and social distancing to minimize COVID-19 spread. All models applied survey sampling weights.

Results

Factors significantly associated with increased odds of COVID-19 diagnosis among US older adults were Hispanic ethnicity (adjusted odds ratio [aOR] = 2.83, P = .01), income (aOR = 0.71, P = .04), residential care or nursing home (aOR = 2.62, P = .01), and generalized anxiety disorder (aOR = 2.38, P = .04). We identified multiple factors significantly associated with adherence to handwashing, masking, and social distancing. Most notably, older males had a significantly lower odds of practicing all three COVID-19 mitigation behaviors, and Black older adults had a significantly higher odds of masking (aOR = 7.94, P < .001) and social distancing (aOR = 2.33, P = .01).

Conclusions

When prioritizing COVID-19 prevention efforts for older adults, risk factors that should be considered are race and ethnicity, income, residential setting, and anxiety. To effectively mitigate COVID-19 disease spread, public health professionals must also recognize sociodemographic and health factors may influence whether older adults adhere to handwashing, masking, and social distancing.

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.

Queer Politics of a Pandemic: LGBTQ + People's Conceptions of COVID-19's Politicization

Introduction

Lesbian, gay, bisexual, transgender, and/or queer (LGBTQ+) people have historically been at the center of contentious political debates in the United States. The pandemic's divisive politicization has created societal stress in both hindering mitigation efforts and exacerbating social marginalization. Research has examined relatively privileged groups' COVID beliefs; however, explorations are needed into ideological processes among those marginalized by COVID, such as LGBTQ+ people, to provide a holistic framework of queer politics.

Methods

Data come from in-depth interviews conducted with 43 LGBTQ+ people collected between October 2020 and January 2021. Purposive sampling was used to recruit participants from a larger survey on pandemic experiences.

Results

Through the "underdog" framework," LGBTQ+ people held strong convictions to science-informed political beliefs, which informed their critiques of inadequate government leadership. Participants also engaged in ideological resistance to harmful individualistic rhetoric through an emphasis on collectivism. The divisive politicization of the pandemic shaped numerous social stressors that LGBTQ+ people adapted to using various strategies to maintain their mental health.

Conclusions

Participants viewed American individualism and Christian nationalism as a public health threat that led to resistance to health and safety measures putting other people at risk. Findings support the underdog theory, with LGBTQ+ people elevating evidence-based science and disadvantaged groups' wellbeing by emphasizing social empathy as a collective good that supports community health.

Policy Implications

Findings can inform policies and community programming that promotes equity across all social identities through the depoliticization of public health and centering LGBTQ+ people's capacity for resistance and resilience.

The Social Meanings of Artifacts: Face Masks in the COVID-19 Pandemic

Since the beginning of the COVID-19 pandemic, research has explored various aspects of face mask use. While most of the research explores their effectiveness to prevent the spread of the virus, a growing body of literature has found that using face masks also has social meaning. But what social meaning does it have, and how does this meaning express itself in people's practice? Based on 413 qualitative interviews with residents in five European countries (Austria, Belgium, Germany, Ireland, and Switzerland), we found that the meanings of face masks have changed drastically during the first months of the pandemic. While in spring 2020 people wearing them had to fear stigmatization, in autumn of 2020 not wearing masks was more likely to be stigmatized. Throughout the first year of the pandemic, we found that mask wearing had multiple and partly seemingly contradictory meanings for people. They were perceived as obstacles for non-verbal communication, but also a way to affirm friendships and maintain social contacts. They also signaled specific moral or political stances on the side of face mask wearers and non-wearers alike, expressed their belonging to certain communities, or articulated concern. In sum, our findings show how face masks serve as scripts for people to navigate their lives during the COVID-19 pandemic. We conclude that public and political discussions concerning face masks should include not only evidence on the epidemiological and infectiological effects of face masks, but also on their social meanings and their social effects.

Citizen Compliance with Pandemic Rules in China: Exploring the Effects of Emotional States, Peer Influence, and Policing

In December 2019, the SARS-CoV-2 virus was first detected in Wuhan, China. Soon after, China became the first country in the world to enforce strict restrictions in an effort to mitigate the spread of the disease. Relying on survey data from 600 Chinese citizens in urban China, this study assessed the extent of citizen compliance and factors related to public compliance to pandemic lockdown and mitigation rules during the initial peak of the pandemic in January, 2020. Using multivariate regressions, we explored the effects of three sets of factors on Chinese citizens’ compliance to pandemic mitigation rules: negative emotions during the pandemic, peer modeling of compliance, and the prevalence of formal social control in the forms of police presence and performance. Our regression analyses suggest that all three mechanisms influence Chinese citizens’ level of compliance with counter-pandemic rules. Nevertheless, the strengths of their effects varied, with peer influence showing the strongest effect on compliance, followed by police presence and fear of contracting COVID-19.

Effect of Information Framing on Wearing Masks During the COVID-19 Pandemic: Interaction With Social Norms and Information Credibility

Objective

The main objectives of this study were to use the effect of information framing (different expressions of the same issue, e.g., positive messages and negative messages) to explore key factors that influence the attitude of and intention of the public toward wearing masks and to understand the internal and external factors of intervention on information framing perception.

Methods

This study performed an online questionnaire survey to explore the influence of demographic characteristics, information framing, social norms, and information credibility on the attitude of the public toward masks and their intention to wear them.

Results

(1) Information framing had a significant impact on the attitudes of people toward masks and their intention to wear them, and the persuasion effect of gain-framed messages was higher than that of loss-framed messages. (2) Gender, income, occupation, educational background, and residence have no significant difference in attitude and intention to wear masks. There was a significant correlation between age and wearing of masks (p = 0.041 < 0.05). (3) Social norms affected people's perception of information framing and their attitude toward wearing masks, but only the impact of loss-framed messages on intention was significant. (4) Information framing affected people's perception of information credibility, which had a positive impact on their intention to wear masks; however, information credibility only had a significant impact on attitude toward wearing masks under the gain-framed messages and played an intermediary role.

Conclusion

The impact of information framing on the attitude of people toward masks and their intention to wear them varies. Individuals involved in the publicity of health information related to this issue should pay attention to the influence of information framing and content on the public wearing masks as a means of enhancing public health awareness.

Perceived COVID-19 Threat and Reactions to Noncompliant Health-Protective Behaviors: The Mediating Role of Desired Cultural Tightness and the Moderating Role of Age

The COVID-19 pandemic is a health crisis that requires individuals to comply with many health-protective behaviors. Following the previous literature, cultural tightness has been found to be a key mechanism to increase coordination in order to mitigate collective threats (e.g., COVID-19). In this study, we test a moderated mediation model to examine whether the perceived COVID-19 threat could intensify the extent of desired tightness (i.e., a personal desire for cultural tightness), moderated by age. Subsequently, we test whether this could intensify individuals' emotional reactions to non-compliance with COVID-19 health protective behaviors. The study relies on a cross-sectional design, with a sample of 624 participants residing in central Italy (i.e., Lazio). The data were collected from February to October 2021. Questionnaires contained self-reporting measures of the perceived COVID-19 threat, desired tightness, and personal emotional reactions to non-compliance with COVID-19 preventive measures (e.g., wearing a mask). The results confirm that the perceived COVID-19 threat is associated with an increase in the desire for cultural tightness-and that this relationship was moderated by age-and, consequently, with intolerance for noncompliance with preventive behaviors. Additionally, both direct and indirect effects of the perceived COVID-19 threat on negative emotional reactions to noncompliance were significant; this indirect effect was larger at high (+1 SD) age than at low (-1 SD) age. Overall, this research provides some insight into how people can respond to the current pandemic threat, and how this may have implications for violating rules and regulations to keep contagion under control.

The impact of mask-wearing in mitigating the spread of COVID-19 during the early phases of the pandemic

Masks have been widely recommended as a precaution against COVID-19 transmission. Several studies have shown the efficacy of masks at reducing droplet dispersion in lab settings. However, during the early phases of the pandemic, the usage of masks varied widely across countries. Using individual response data from the Imperial College London-YouGov personal measures survey, this study investigates the effect of mask use within a country on the spread of COVID-19. The survey shows that mask-wearing exhibits substantial variations across countries and over time during the pandemic's early phase. We use a reduced form econometric model to relate population-wide variation in mask-wearing to the growth rate of confirmed COVID-19 cases. The results indicate that mask-wearing plays an important role in mitigating the spread of COVID-19. Widespread mask-wearing associates with an expected 7% (95% CI: 3.94%-9.99%) decline in the growth rate of daily active cases of COVID-19 in the country. This daily decline equates to an expected 88.5% drop in daily active cases over 30 days compared to zero percent mask-wearing, all else held equal. The decline in daily growth rate due to the combined effect of mask-wearing, reduced outdoor mobility, and non-pharmaceutical interventions averages 28.1% (95% CI: 24.2%-32%).

Face mask uptake in the absence of mandates during the COVID-19 pandemic: a qualitative interview study with Swiss residents

Background

In the COVID-19 pandemic, Switzerland introduced broad nationwide face mask mandates only by October 2020, later than other Western European countries. This study aims to assess the underlying values and considerations of individuals to wear face masks in the absence of face mask mandates in the COVID-19 pandemic in German-speaking Switzerland.

Methods

As part of the “Solidarity in times of a pandemic” (SolPan) research commons, we interviewed 31 participants living in the German-speaking part of Switzerland in April 2020 and 25 of them again in October 2020. Qualitative inductive thematic analysis was applied for data analysis and interpretation. Public health ethics principles guided the interpretation and organization of findings.

Results

Five themes were identified: Trust and governmental policy; perceived benefits of mask-wearing; perceived risks of mask-wearing; social exclusion and prejudice; and decision-making in the absence of mandates. In light of increasing infection rates in October 2020, many participants started to consider the benefits higher than the risks and were willing to accept face mask mandates in that context, despite earlier reservations.

Conclusions

The absence of face mask mandates underline individual autonomy but may also suppress personal responsibility due to social influence. Face masks are only temporarily acceptable in liberal Western societies and face mask mandates should be enforced only when epidemiologically necessary.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-12215-4.

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.

The social axioms of populism: Investigating the relationship between culture and populist attitudes

Populism is on the rise with various movements having electoral breakthroughs. Most social-science research on populism has focused primarily on party tactics and rhetoric, and a definition for the term itself; only recently has populism emerged as a psychological construct. We contribute to this growing literature with two studies (n = 456 and n = 5,837) that investigated the cultural worldviews underpinned in populist attitudes. Using the social axioms model, an etic framework for assessing people’s generalized social expectations, we linked populist attitudes to universal dimensions of culture. We found that higher levels of social cynicism and social flexibility, and to a lesser extent, lower levels of fate control and reward for application predicted populist attitudes. These findings indicate that people who endorse populist attitudes, across a range of contexts, are cynical regarding the social world, believe in alternative solutions to social dilemmas, but may also perceive a world that is difficult to control and potentially unfair. The discussion focuses on the cultural forces that may drive or facilitate populist attitudes across context and time.