A Multidimensional Model of Public Health Approaches Against COVID-19

The effects of mass media messages, perceived susceptibility and self-rated health on public attitude towards COVID-19 in South Africa

OBJECTIVES

South Africa was the worst affected country in Africa by the COVID-19 pandemic and it is important to interrogate the attitude of the populace towards the pandemic for future interventions. Therefore, this study examined effects of mass media messages, susceptibility to COVID-19 and self-rated health on the attitudes of South Africans towards the COVID-19 pandemic.

METHODS

Data was from the National Income Dynamics Study - Coronavirus Rapid Mobile Survey (NIDS-CRAM) of 2021 which is a nationally representative panel survey of about 7,000 South African individuals in all the nine provinces. Analyses of data were through descriptive statistics, chi square test and logistic regression models.

RESULTS

The results showed that 61.28% of the resondents did not take COVID-19 test while 91.09% of them engaged in behavioral changes such as social distancing and wearing of face masks. In addition, 74.27% of the respondents had access to mass media information, 70.44% believed they have good physical health while 32.43% felt they were not susceptible to COVID-19. The chi-square results of attitude towards COVID-19 showed significant differences in access to mass media messages on COVID-19, race, and province of residence. Furthermore, respondents who had access to mass media information on COVID-19 (OR = 1.469; p = 0.001) and respondents who believed that they were susceptible to COVID-19 infection (OR = 1.443; p = 0.001) were significantly associated with increased likelihood of engagement in behavioral changes to avoid the COVID-19.

CONCLUSION

These findings therefore emphasize the need for increased awareness and sensitization of the people about the susceptibility and adverse effects of diseases to ensure that they adopt the appropriate attitudes that will safeguard them from such diseases outbreak.

Community centered public safety resilience under public emergencies: A case study of COVID-19

During public emergencies, the level of public safety will be resilient and follow a process from decline to rise. Regarding the concept and influencing factors of public safety resilience, a three-level public safety resilience framework that includes personal, community, and government levels was proposed in this study. It provided the overall metrics that used the resistance and recovery ability to describe the dynamic characteristics of public safety resilience as well as the resilience assessment indexes on three levels. In the context of the Coronavirus Disease 2019 (COVID-19) pandemic, this study applied the proposed framework in a case study on public safety resilience at the Beihang community, Beijing, China through descriptive statistics, structural equation model, and principal component regression analysis of questionnaire data. The data analysis results showed that community resilience was the most important of the three levels of public safety resilience. In addition, community resilience could improve personal resilience, and government resilience had a positive effect on community and personal resilience. Compared with the resistance ability, the recovery ability was influenced more by the operation and improvement of the community. This study is conducive to understanding and improving public safety resilience on the personal, community, and government levels and can help relevant parties improve their ability to respond to the COVID-19 pandemic. Furthermore, the methods used in this study can be extended to other studies on public emergencies.

Emergency preparedness during the COVID-19 pandemic: Modelling the roles of social media with fuzzy DEMATEL and analytic network process

While the utility of social media has been widely recognized in the current literature, minimal effort has been made to further the analysis of their roles on disruptive events, such as the COVID-19 pandemic. To address this gap, this work comprehensively identifies the 16 prevalent social media roles in disaster preparedness during the COVID-19 pandemic. Furthermore, an integrated fuzzy decision-making trial and evaluation laboratory (FDEMATEL) and analytic network process (ANP), hereby termed the FDANP methodology, is used to perform the causal analysis of social media roles and to systemically measure the priority of these roles in emergency preparedness. Among the identified roles, those considered top priority are social media roles concerned with the facilitation of public health policy development, prevention of misinformation, and management of public behavior and response. These results were found to be robust, as evidenced by the sensitivity analysis. The implications of these findings were also detailed in this work in the context of a developing country.

The Assessment of Fear of COVID-19 among the Elderly Population: A Cross-Sectional Study

The prevailing COVID-19 pandemic has dramatically affected the mental health and well-being of individuals. This cross-sectional study aimed to assess the perceived fear of COVID-19 among older adults in Poland and identify subpopulations with the highest risk of potential mental health disorders. The study was conducted in November–December 2020 on 500 people aged ≥60 years (mean M = 67.9, standard deviation SD = 4.2). In order to collect information on participants’ characteristics and COVID-19-related information, they were asked to complete a questionnaire based on recorded telephone calls. Perceived fear of COVID-19 was measured using Fear of COVID-19 Scale (FCV-19S), which ranges from 7 to 35. Multiple linear regression was performed to identify factors associated with the perceived fear of COVID-19. Our results showed that the highest level of fear of COVID-19 infection was observed among women (p = 0.025) and patients taking anticoagulants (p = 0.004). Moreover, older adults with higher anxiety levels were more likely to be fearful of COVID-19 (according to the GAS-10 scale; p < 0.001). These findings may help policy makers and healthcare workers to adapt and implement better mental health strategies to help the elderly fight fear and anxiety during the prevailing pandemic.

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.

Social Media Use, Self-Efficacy, Perceived Threat, and Preventive Behavior in Times of COVID-19: Results of a Cross-Sectional Study in Pakistan

Although the role of social media in infectious disease outbreaks is receiving increasing attention, little is known about the mechanisms by which social media use affects risk perception and preventive behaviors during such outbreaks. This study aims to determine whether there are any relationships between social media use, preventive behavior, perceived threat of coronavirus, self-efficacy, and socio-demographic characteristics. The data were collected from 310 respondents across Pakistan using an online cross-sectional survey. Reliability analyses were performed for all scales and structural equational modeling was used to identify the relationships between study variables. We found that: (i) social media use predicts self-efficacy (β = 0.25, p < 0.05) and perceived threat of coronavirus (β = 0.54, p < 0.05, R 2 = 0.06), and (ii) preventive behavior is predicted by self-efficacy and perceived threat of coronavirus (R = 0.10, p < 0.05). Therefore, these results indicate the importance of social media's influence on health-related behaviors. These findings are valuable for health administrators, governments, policymakers, and social scientists, specifically for individuals whose situations are similar to those in Pakistan.

Negative Impact of Fear of COVID-19 on Health-Related Quality of Life Was Modified by Health Literacy, eHealth Literacy, and Digital Healthy Diet Literacy: A Multi-Hospital Survey

Background: The COVID-19 pandemic has been disseminating fear in the community, which has affected people’s quality of life, especially those with health problems. Health literacy (HL), eHealth literacy (eHEAL), and digital healthy diet literacy (DDL) may have potential impacts on containing the pandemic and its consequences. This study aimed to examine the association between the fear of COVID-19 scale (FCoV-19S) and the health-related quality of life (HRQoL), and to examine the effect modification by HL, eHEAL, and DDL on this association. Methods: A cross-sectional study was conducted in 11 hospitals across Vietnam from 7 April to 31 May 2020. Data were collected on 4348 outpatients, including demographic characteristics, HL, eHEAL, DDL, FCoV-19S, and HRQoL. Multiple linear regression and interaction models were used to explore associations. Results: Patients with higher FCoV-19S scores had lower HRQoL scores (unstandardized coefficient, B = −0.78, p < 0.001). HL (B = 0.20, p < 0.001), eHEAL (B = 0.24, p < 0.001), and DDL (B = 0.20, p < 0.001) were positively associated with higher HRQoL scores. The negative impact of FCoV-19S on HRQoL was significantly attenuated by higher eHEAL score groups (from one standard deviation (SD) below the mean, B = −0.93, p < 0.001; to the mean, B = −0.85, p < 0.001; and one SD above the mean, B = −0.77, p < 0.001); and by higher DDL score groups (from one SD below the mean, B = −0.92, p < 0.001; to the mean, B = −0.82, p < 0.001; and one SD above the mean, B = −0.72, p < 0.001). Conclusions: eHealth literacy and digital healthy diet literacy could help to protect patients’ health-related quality of life from the negative impact of the fear of COVID-19 during the pandemic.

Health Literacy Regarding Infectious Disease Predicts COVID-19 Preventive Behaviors: A Pathway Analysis

Health literacy has been identified as one vital determinant of public health and healthy behaviors, but very few studies regarding infectious disease prevention have been found. This descriptive cross-sectional study aimed to validate the pathway of infectious disease-specific health literacy (IDSHL), COVID-19 (coronavirus disease 2019) preventive behaviors, and their determinants. A sample of 1459 casino workers in Macao was eligible for analysis. The concept model was verified with a comparative fit index of 0.937 and goodness-of-fit index of 0.971. Government responses was a significant determinant of situational factors (helpfulness of health information, resource accessibility, and organizational training adequacy), while situational factors showed a direct effect on COVID-19 preventive behaviors. Education and organization training adequacy was the strongest influencing factor of IDSHL, which should be a key target of intervention programs for COVID-19.

Closer to or further from the new normal? business approach through social media analysis

The outbreak of COVID-19 has led to radical change in all social and economic spheres and, even today, the scope of the pandemic cannot be detailed. This unprecedent situation is challenging the global world but particularly for business. The packages of measures internationally imposed as restrictions on commercial activity, isolation and social distancing mean that business should face a transformation in order to survive in each stage of the crisis. For this purpose, a content analysis with an initial dataset with 2,610 tweets of the most representative Spanish entrepreneurial organizations was carried out in key periods of the pandemic. The findings highlight that there are collective concerns with emotional burden in the business sector that encourage action despite confusion and uncertainty. Generalized distrust of policies led business organizations to insist on innovation and adaptation as the best tools to overcome the economic effect of the crisis.

Attitude Toward Protective Behavior Engagement During COVID-19 Pandemic in Malaysia: The Role of E-government and Social Media

The coronavirus disease 2019 (COVID-19) pandemic is still evolving and affecting millions of lives. E-government and social media have been used widely during this unprecedented time to spread awareness and educate the public on preventive measures. However, the extent to which the 2 digital platforms bring to improve public health awareness and prevention during a health crisis is unknown. In this study, we examined the influence of e-government and social media on the public's attitude to adopt protective behavior. For this purpose, a Web survey was conducted among 404 Malaysian residents during the Recovery Movement Control Order (RMCO) period in the country. Descriptive and multiple regression analyses were conducted using IBM SPSS software. Social media was chosen by most of the respondents (n = 331 or 81.9%) as the source to get information related to COVID-19. Multiple regression analysis suggests the roles of e-government and social media to be significantly related to people's attitudes to engage in protective behavior. In conclusion, during the COVID-19 outbreak, public health decision makers may use e-government and social media platforms as effective tools to improve public engagement on protective behavior. This, in turn, will help the country to contain the transmission of the virus.

The Impact of Education, COVID-19 and Risk Factors on the Quality of Life in Patients with Type 2 Diabetes

BACKGROUND

The aim of this study was to examine the impact of education, coronavirus disease 2019 (COVID-19), and risk factors on the quality of life in patients with type 2 diabetes.

METHODS

A prospective study was conducted in three phases: before education, after education, and in the period of pandemic coronavirus disease 2019 (COVID-19). The subjects were diabetics on oral therapy. To determine the quality of life index, a standardized Ferrans and Powers survey questionnaire was used.

RESULTS

A total of 205 participants took part in the study, of which 111 (54.1%) were men and 94 (46%) women. Participants were enrolled in the study between January 2019 and September 2020. Glycated hemoglobin values were significantly higher before education compared to post-education and at the time of COVID-19 (Friedman test, p = 0.002), and body mass index was significantly lower after education compared to values before education (Friedman test, p = 0.008). The quality of life was significantly lower in all domains in the COVID-19 period (Friedman test, p < 0.001).

CONCLUSIONS

A significant predictor of worse assessment of overall quality of life was male gender and rural place of residence. Disease duration of up to 5 years was a significant predictor of worse assessment in the psychological/spiritual domain, while being married was a predictor of better assessment of the quality of life in the family domain. The education of diabetics brought an increase in the health and quality of life while the coronavirus disease pandemic had negative consequences on the same parameters. We consider it necessary to systematically educate diabetics about the comorbidity of COVID-19.

Exploring the Mechanisms of Influence on COVID-19 Preventive Behaviors in China's Social Media Users

The outbreak of Coronavirus Disease 2019 (COVID-19) posed a powerful threat to human life. The preventive behaviors of individuals (e.g., home quarantine, disinfection, and wearing masks) play a key role in preserving and controlling the disease. In this case, as a motivational psychological system oriented toward avoiding infection, the behavioral immune system (BIS) may be activated and link to preventive behaviors. This study investigated the mechanisms through which emotional and cognitive processes resulted by BIS have promoted preventive behaviors in relation to COVID-19. We collected data on 22,005 active Sina Weibo users from 31 December 2019 to 8 February 2020 to measure their emotions (including disgust, happiness, and fear), cultural values (individualism and collectivism), moral concern (including purity vice, fairness vice, and authority virtue), and behavioral intentions (including isolation intention, protection intention, and aid intention) using Text Mind software and related dictionaries. Multiple regression and mediation analyses were performed to explore the relationships among variables. The results showed seven complete mediation paths (such as disgust-purity vice-protection intention). Each of these paths describes the effects of cognitive processes caused by BIS on preventive behaviors. We inferred that there may be path mechanisms such as disgust-cognitive processes-preventive behaviors. Using these results, policy makers can take appropriate measures to intervene in preventive behaviors (e.g., by posting disgusting images on social media to evoke disgust). The results can be used to explain differences in preventive behaviors among populations even in the face of similar thread levels. Furthermore, our research provides empirical evidence for the hypothesis of pathogen prevalence.

Healthy Dietary Intake Behavior Potentially Modifies the Negative Effect of COVID-19 Lockdown on Depression: A Hospital and Health Center Survey

Background: The COVID-19 pandemic causes a huge burden for affected countries. Several public health interventions were applied to contain the infection. However, the pandemic itself and the lockdown measure negatively influence people's lifestyles and psychological health. Purpose: To explore determinants of healthy dietary intake and depression, and examine the interaction between healthy dietary intake and COVID-19 lockdown on depression. Methods: A cross-sectional study was conducted at 18 hospitals and health centers from February 14 to May 31, 2020. Data of 8,291 outpatients were collected including patients' characteristics, clinical parameters, health literacy, healthy dietary intake (using the healthy eating score, HES), other health-related behaviors, and depression (using the patient health questionnaire, PHQ). Depression was defined as PHQ score ≥ 10. Results: Protective factors of healthy dietary intake and depression were higher education, better medication payment ability, higher social status, more physical activity, and higher health literacy, whereas older age, ever married, own business or other types of occupation, lockdown, suspected COVID-19 symptoms, and comorbidity were associated with lower HES scores and a higher depression likelihood. Besides, overweight/obesity and alcohol drinking were associated with lower HES scores. As compared with patients not under lockdown and with lowest HES score, those who were under lockdown and with lowest HES score had 10.6 times higher depression likelihood (odds ratio, OR, 10.60; 95% CI 6.88, 16.32; p < 0.001), whereas people with higher HES score had 15% lower depression likelihood (OR 0.85; 95% CI 0.82, 0.89; p < 0.001). Conclusions: Healthy dietary intake and depression were determined by several sociodemographic, clinical, and behavioral factors. Lockdown measure affects people's dietary intake behavior and depression. Importantly, healthy dietary intake potentially modifies the negative effect of lockdown on depression.

Health Literacy, eHealth Literacy, Adherence to Infection Prevention and Control Procedures, Lifestyle Changes, and Suspected COVID-19 Symptoms Among Health Care Workers During Lockdown: Online Survey

Background

The COVID-19 pandemic has imposed a heavy burden on health care systems and governments. Health literacy (HL) and eHealth literacy (as measured by the eHealth Literacy Scale [eHEALS]) are recognized as strategic public health elements but they have been underestimated during the pandemic. HL, eHEALS score, practices, lifestyles, and the health status of health care workers (HCWs) play crucial roles in containing the COVID-19 pandemic.

Objective

The aim of this study is to evaluate the psychometric properties of the eHEALS and examine associations of HL and eHEALS scores with adherence to infection prevention and control (IPC) procedures, lifestyle changes, and suspected COVID-19 symptoms among HCWs during lockdown.

Methods

We conducted an online survey of 5209 HCWs from 15 hospitals and health centers across Vietnam from April 6 to April 19, 2020. Participants answered questions related to sociodemographics, HL, eHEALS, adherence to IPC procedures, behavior changes in eating, smoking, drinking, and physical activity, and suspected COVID-19 symptoms. Principal component analysis, correlation analysis, and bivariate and multivariate linear and logistic regression models were used to validate the eHEALS and examine associations.

Results

The eHEALS had a satisfactory construct validity with 8 items highly loaded on one component, with factor loadings ranked from 0.78 to 0.92 explaining 76.34% of variance; satisfactory criterion validity as correlated with HL (ρ=0.42); satisfactory convergent validity with high item-scale correlations (ρ=0.80-0.84); and high internal consistency (Cronbach α=.95). HL and eHEALS scores were significantly higher in men (unstandardized coefficient [B]=1.01, 95% CI 0.57-1.45, P<.001; B=0.72, 95% CI 0.43-1.00, P<.001), those with a better ability to pay for medication (B=1.65, 95% CI 1.25-2.05, P<.001; B=0.60, 95% CI 0.34-0.86, P<.001), doctors (B=1.29, 95% CI 0.73-1.84, P<.001; B 0.56, 95% CI 0.20-0.93, P=.003), and those with epidemic containment experience (B=1.96, 95% CI 1.56-2.37, P<.001; B=0.64, 95% CI 0.38-0.91, P<.001), as compared to their counterparts, respectively. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures (B=0.13, 95% CI 0.10-0.15, P<.001; B=0.22, 95% CI 0.19-0.26, P<.001), had a higher likelihood of healthy eating (odds ratio [OR] 1.04, 95% CI 1.01-1.06, P=.001; OR 1.04, 95% CI 1.02-1.07, P=.002), were more physically active (OR 1.03, 95% CI 1.02-1.03, P<.001; OR 1.04, 95% CI 1.03-1.05, P<.001), and had a lower likelihood of suspected COVID-19 symptoms (OR 0.97, 95% CI 0.96-0.98, P<.001; OR 0.96, 95% CI 0.95-0.98, P<.001), respectively.

Conclusions

The eHEALS is a valid and reliable survey tool. Gender, ability to pay for medication, profession, and epidemic containment experience were independent predictors of HL and eHEALS scores. HCWs with higher HL or eHEALS scores had better adherence to IPC procedures, healthier lifestyles, and a lower likelihood of suspected COVID-19 symptoms. Efforts to improve HCWs’ HL and eHEALS scores can help to contain the COVID-19 pandemic and minimize its consequences.

Analysis of the Influence of Psychological Contract on Employee Safety Behaviors against COVID-19

This study explored the influencing factors of safety behavior from the perspective of employees, studied the mechanism of the psychological contract on employees' safety behavior in the context of the Chinese epidemic situation, tested the mediating role of job burnout and perceived insider status in the process of work resumption, and provided preventive suggestions for combating the global spread of COVID-19. A questionnaire survey was utilized to collect data and, combined with the necessary protective measures taken for employees in China, was used to modify the mature safety behavior scale. Finally, through the analysis of 402 employees' questionnaires, the hypotheses were verified; that is, in the process of Chinese enterprises returning to work to cope with COVID-19, the psychological contract has a positive role in promoting employees' safety behavior, while job burnout plays a weakened mediating role, and perceived insider status plays a strengthening mediating role. The psychological contract negatively affects job burnout but positively affects perceived insider status. Job burnout negatively affects employees' safety behavior, but perceived insider status positively affects employees' safety behavior. The results show that employees' conscious participation in safety behavior plays an irreplaceable role in the prevention of COVID-19 and safety of work resumption.

Sentiment Analysis and Emotion Understanding during the COVID-19 Pandemic in Spain and Its Impact on Digital Ecosystems

COVID-19 has changed our lives forever. The world we knew until now has been transformed and nowadays we live in a completely new scenario in a perpetual restructuring transition, in which the way we live, relate, and communicate with others has been altered permanently. Within this context, risk communication is playing a decisive role when informing, transmitting, and channeling the flow of information in society. COVID-19 has posed a real pandemic risk management challenge in terms of impact, preparedness, response, and mitigation by governments, health organizations, non-governmental organizations (NGOs), mass media, and stakeholders. In this study, we monitored the digital ecosystems during March and April 2020, and we obtained a sample of 106,261 communications through the analysis of APIs and Web Scraping techniques. This study examines how social media has affected risk communication in uncertain contexts and its impact on the emotions and sentiments derived from the semantic analysis in Spanish society during the COVID-19 pandemic.

Exploring the Social Media on the Communication Professionals in Public Health. Spanish Official Medical Colleges Case Study

The purpose of the study is to analyze the role that social media have on the practice of health professionals working in information and communication department of Spanish official medical college. Social media in health fields have experienced growing participation of users and are increasingly considered a credible form of communication. This paper examines the use of social media as communication tool by the Official Medical Colleges (OMC) of Spain. According to the National Institute of Statistics, in 2019 there were 267,995 registered medical professionals in the 52 OMC in Spain. This research is based on a qualitative methodological technique through semi-structured interviews, with the aim of identifying the profiles of the people who lead the information in the professional organizations of the OMC. Of the colleges, 73.07% participated. The findings show that information is essential for the OMC and most of them have at least one experienced communication professional. Social media are essential tool in their work and Twitter (87.5%) and Facebook (81.3%) are considered the most relevant social media according to their interests. These tools are believed to be very useful for informing, establishing relationships and listening to users.