The Adoption of Preventive Behaviors during the COVID-19 Pandemic in China and Israel

Preventive behaviors of COVID-19 in the Iranian adult population during the pandemic: Integrated effect of the health belief model and the planned behavior intention using causal path analysis

Background

This study aimed to investigate the integration of the health belief model (HBM) and the theory of intention to plan preventive behavior for COVID-19 during the pandemic.

Methods

In a cross-sectional study, a sample of 480 adult participants from different outpatient clinics were recruited in the study. The participant responded by self-report; the health belief model (HBM) scale, preventive behavior scale, subjective norms scale, the intention of planned behavior scale, and perceived control behavior scale were measured. The hypothesized causal path models were examined using SEM analysis.

Results

The HBM had significant effects on perceived behavior control (β=0.60, P=0.001), the intended preventive behavior (β=0.32, P=0.001), and subjective norm (β=0.53, P=0.001). Subsequently, the intention of preventive behavior (β==0.39, P=0.001) and subjective norms (β=0.27, P=0.001) significantly affected the performance of preventive behaviors. The estimated fitting criteria showed that the hypothesized model fits relatively well.

Conclusion

The health belief model with the integration of subjective norms, perceived control behavior and mediation by the intention of planned behavior in a pathway relationship explains well the preventive behavior of COVID-19. The findings present a deeper understanding of how integrating HBM and intended planned behavior enhances people's preventive behavior against COVID-19.

COVID-19 Vaccine Hesitancy Among Patients Recovered From COVID-19 Infection in Wuhan, China: Cross-Sectional Questionnaire Study

BACKGROUND

Although patients recovered from COVID-19 already have immunity gained from natural infection, they are still at risk of reinfection due to the emergence of new variants of COVID-19 and the diminishing of naturally acquired immunity over time. Vaccination is associated with efficacious protection against COVID-19 infection and could boost infection-acquired immunity; however, various COVID-19 survivors have not been vaccinated due to vaccine hesitancy.

OBJECTIVE

The aim of this study was to investigate COVID-19 vaccine hesitancy and related factors among COVID-19 survivors.

METHODS

A cross-sectional questionnaire survey was conducted among patients who recovered from COVID-19 infection in Wuhan, China, between June 10 and July 25, 2021. The questionnaire included sociodemographic information, items on COVID-19 infection, the COVID-19 vaccine hesitancy scale based on the 3Cs (complacency, convenience, and confidence) model, trust in vaccine manufacturers and health facilities, and reasons for the decision to accept COVID-19 vaccination. Multivariate logistic regression analysis was used to assess the factors influencing COVID-19 vaccine hesitancy.

RESULTS

Among the 1422 participants, 538 (37.8%) were not vaccinated against COVID-19. The COVID-19-recovered patients who self-reported having a current unhealthy status expressed more hesitancy about the COVID-19 vaccine than those who perceived themselves to be healthy (odds ratio [OR] 0.45, 95% CI 0.28-0.71). Compared to the asymptomatic patients, patients with mild symptoms were more likely to receive a COVID-19 vaccine (OR 1.67, 95% CI 1.02-2.82). Regarding the 3Cs model, high complacency (P=.005) and low convenience (P=.004) were significant negative factors for COVID-19 vaccination. Trust in vaccine manufacturers and health facilities was a significant positive factor for COVID-19 vaccination (OR 1.14, 95% CI 1.09-1.19). "Self-needs" was the main reason for patients to receive the COVID-19 vaccine, whereas "already have antibodies and do not need vaccination" was the main reason for patients to not receive the COVID-19 vaccine.

CONCLUSIONS

Among the three major factors of vaccine hesitancy, complacency proved to be the most notable among COVID-19-recovered patients. Therefore, educational campaigns can focus on raising the awareness of risk of infection and the benefits of vaccination to reduce complacency toward vaccination among this population. In particular, for individuals who have recovered from COVID-19, improving factors related to convenience such as transportation, the environment of vaccination, and providing door-to-door service was also deemed necessary to facilitate their vaccination. In addition, addressing the concerns about vaccination of COVID-19-recovered patients could foster trust and promote their uptake of vaccination.

Protective and Overprotective Behaviors against COVID-19 Outbreak: Media Impact and Mediating Roles of Institutional Trust and Anxiety

This study aims to explore how pandemic-related media use relates to both protective and overprotective behaviors and to probe the underlying mechanisms. The data were collected online during the early outbreak of COVID-19 in China, and a total of 1118 valid cases, which covered the 30 provincial administrative divisions in mainland China, were collected. Results showed that official government media use was positively associated with protective behaviors and institutional trust was an important mediator. Commercial media use was also found to be positively associated with overprotective behavior, and anxiety mediated this relationship. Findings of this study suggested that different media sources could play completely different roles. Institutional trust in government institutions and medical care systems were equally critical in translating the media effect into public compliance with the preventive measures advocated by the relevant departments. Media outlets and practitioners should also be responsible in order to avoid causing unnecessary anxiety among the public so as to reduce irrational overprotective behaviors.

Acceptability of contact management and care of simple cases of COVID-19 at home: a cross-sectional study in Senegal

BACKGROUND

COVID-19 is a major public health problem. In mid-2020, due to the health system challenges from increased COVID-19 cases, the Ministry of Health and Social Action in Senegal opted for contact management and care of simple cases at home. The objective of the study was to determine the acceptability of contact and simple case management of COVID-19 at home and its associated factors in Senegal.

METHODS

This was a descriptive and analytical cross-sectional study. We collected data from 11 June to 10 July 2020. We used a marginal quota sampling strategy. A total of 813 individuals took part in the survey. We collected data using a telephone interview.

RESULTS

The care of simple cases of COVID-19 at home was well accepted (78.5%). The use of home contact management was less accepted (51.4%). Knowledge of the modes of transmission of the virus and confidence in institutional information were associated with the acceptability of home care for simple cases. Regularly searching for information on COVID-19 and confidence in the government's control of the epidemic were associated with the acceptability of managing contacts at home.

CONCLUSIONS

Authorities should take these factors into account for better communication to improve the acceptability and confidence in home-based care for COVID-19 and future epidemics.

Financial hardship and mental health among cancer survivors during the COVID-19 pandemic: An analysis of the US COVID-19 Household Impact Survey

Purpose

Our objective was to (1) identify associated characteristics of financial hardship (FH), and (2) evaluate associations of FH with mental health symptoms among cancer survivors during the COVID-19 pandemic.

Methods

Using data from the nationally representative COVID-19 Impact Survey, we defined cancer survivors as those with a self-reported diagnosis of cancer (n = 854,7.6%). We defined FH using the following question: "Based on your current financial situation, how would you pay for an unexpected $400 expense?" Multivariable Poisson regression was used to estimate adjusted prevalence ratios (aPR) with 95% confidence intervals (95%CI) to identify associated characteristics of FH and associations of FH with mental health symptoms among cancer survivors overall and by age (18-59 years/60+ years).

Results

Forty-one percent of cancer survivors reported FH, with 58% in 18-59 and 33% in 60+ year old respondents. Compared to cancer survivors aged 60+ years, those aged 30-44 (aPR:1.74,95% CI:1.35-2.24), and 45-59 years (aPR:1.60,95% CI:1.27-1.99) were more likely to report FH. Compared to non-Hispanic(NH)-White cancer survivors, NH-Black cancer survivors had a 56% higher prevalence of FH (aPR:1.56; 95% CI: 1.23-1.97). Among 60+ years aged cancer survivors, NH-Black (aPR:1.80; 95% CI: 1.32-2.45) and NH-Asian cancer survivors (aPR:10.70,95% CI:5.6-20.7) were more likely to experience FH compared to their NH-White counterparts. FH was associated with feeling anxious (aPR:1.51,95% CI:1.11-2.05), depressed (aPR:1.66,95% CI:1.25-2.22), and hopeless (aPR:1.84,95% CI:1.38-2.44).

Conclusion

Minoritized communities, younger adults, and cancer survivors with low socioeconomic status had a higher burden of FH, which was associated with feelings of anxiety, depression, and hopelessness.

Interpersonal risk communication matters more than media risk communication in its impact on individuals' trust and preventive behaviors during COVID-19

A cross-sectional survey study from 1496 respondents was conducted to investigate how interpersonal risk communication and media risk communication foster individuals' interpersonal trust and trust in scientists during the ongoing COVID-19 pandemic. Findings reveal that interpersonal risk communication is significantly related to interpersonal trust and trust in scientists, but have no direct association with preventive behaviors. Media risk communication is significantly associated with preventive behaviors and increases individuals' trust in scientists while having no effect on interpersonal trust. Preventive behaviors are significantly influenced by both interpersonal trust and trust in scientists. In addition, trust mediated the association between risk communication and preventive behaviors.

What drives people’s protective behaviors during the early stage of the COVID-19 pandemic in China

This study systematically examined people’s protective behaviors against COVID-19 in China, and particular attention was given to people’s perceived threat and information-processing strategies. This study constructed a conceptual model and used structural equation modeling to explore this issue, and a questionnaire survey was conducted to collect data involving 4,605 participants during the early stage of the COVID-19 pandemic in China. The results showed that people’s initial information acquisition played an essential role in their behavioral responses; acquiring more initial information about COVID-19 would make them perceive a higher threat and present a higher demand for information, then making them more likely to seek and process information, and subsequently motivating their protective behaviors. In addition to increasing people’s information needs, the perceived threat could also strengthen the analytical assessment and affect protective behavior positively but failed to predict the experiential assessment. Driven by information need, information seeking significantly influenced protective behavior; it also facilitated analytical assessment and decreased experiential assessment, thus predicting people’s protective behaviors. Protective behaviors were spurred by analytical assessment but negatively influenced by the experiential assessment.

Infection preventive behaviors and its association with perceived threat and perceived social factors during the COVID-19 pandemic in South Korea: 2020 community health survey

BACKGROUND

This study examined why some individuals have not properly performed health prevention behavior during the coronavirus disease 2019 (COVID-19) pandemic. We used data from a community health survey conducted by public health centers in South Korea to identify factors affecting COVID-19 prevention behavior in urban and rural areas. Also, we examined whether individual-level demographic, socio-psychological, and structural variables affected COVID-19 prevention behavior by referring to a model explaining individuals' health prevention behavior. In particular, the study is significant as not many other measures were suggested besides compliance with personal quarantine rules during the early phase of the pandemic in 2020. We hope that the results of this study will be considered in further analysis of infection preventive behavior and in future health crises.

METHODS

Probability proportional and systematic sampling were used to collect data in 2020 from 229,269 individuals. After exclusion, the valid data from 141,902 adults (86,163 urban and 44,739 rural) were analyzed. We performed t-tests and analyses of variance to ascertain the differences in COVID-19 preventive behaviors according to demographic characteristics, and a post-hoc analysis was conducted using Scheffé's test. Factors that affected participants' COVID-19 preventive behaviors were analyzed using multiple regression analyses.

RESULTS

The variables significantly influencing COVID-19 preventive behaviors in urban areas were age, gender, living with two or more people, educational level, monthly household income, working status, influenza vaccination, daily life stress, and perceived threat. In rural areas, age, gender, living with two or more people, education level, influenza vaccination, daily life stress, perceived threat, and perceived social factors were significantly associated with increased COVID-19 preventive behaviors.

CONCLUSIONS

Several demographic characteristics were associated with urban and rural residents' COVID-19-related preventive behaviors. A different approach is needed for the two regions in future policy. Future studies should aim to improve the power of the model and include other factors that may be related to COVID-19 preventive behavior.

Managing Covid-19 pandemic and supply chain disruptions through employee attitude: A cross-country analysis based on the transtheoretical model

In this paper, we examine the attitudinal changes and processes regarding Covid-19 guidelines through the lens of the Transtheoretical Model (TTM) among 932 employees in organisations within the emerging markets of China and Qatar, and the implications for the management of operations and supply chain disruptions. Exploratory and confirmatory factor analysis, and hierarchical multiple regression were conducted to validate our measures, confirm model fit, and verify the proposed hypotheses. Our findings reveal that attitude towards the guidelines differ between Chinese and Qatari samples, significantly stronger among the Chinese sample. The TTM dimensions explain a considerable amount of variance in attitude and self-efficacy. Self-efficacy further explains attitudinal changes. Firms should actively source and provide useful and accurate information about COVID 19, including pathological characteristics, propagation, prevention measures, and treatment. Besides, firms should promote the importance of following the guidelines, leaders should set examples, and encourage and empower employees to do so. With the right employee attitude and behavior, firms can manage pandemic-related disruptions within the organization and the supply chain.

Individual Preferences for COVID-19 Vaccination under the China’s 2021 National Vaccination Policy: A Discrete Choice Experiment Study

(1) Background: Since China’s national vaccination policy announcement in January 2021, individual vaccination preferences related to vaccine characteristics, social relationships, sociodemographic characteristics and cognition remain opaque. This study aims to investigate vaccination preferences regarding these attributes, and to assess changes in individual vaccine preferences since the pre-2021 emergency vaccination phase. (2) Methods: The two-part questionnaire surveyed 849 individuals between May and June 2021 in Qingdao, China. The survey contained eight binary choice tasks that investigated preference trade-offs. Respondents’ sociodemographic characteristics, including age, sex, urban/rural residence, income, education and whether living with the young or old, were also collected. Conditional logit, mixed logit and latent class models were used to quantify preference utility and identify preference heterogeneity. (3) Results: Vaccine effectiveness, vaccine side effects, duration of protection and probability of infection all significantly affected vaccination utility. Preference heterogeneity based on individual social relationships and sociodemographic characteristics were also established. Marginal analysis showed that compared to the pre-2021 phase, individuals’ preferences had shifted towards vaccines with longer protection periods and better accessibility. (4) Conclusion: This study will inform the full rollout of China’s 2021 national vaccination program and provide valuable information for future vaccination policy design to meet resurgent COVID-19 risks.

Field observations and survey evidence to assess predictors of mask wearing across different outdoor activities in an Argentine city during the COVID-19 pandemic

We here studied some potential factors underlying variation in compliance with preventive behaviors against COVID-19 by studying mask wearing during outdoor recreational activities in a midsize city of Argentina in 2020. The originality of present research relies on the complementation of observational (N = 15,507) and survey (N = 578) data and in assessing the determinants of and disposition to the same preventive behavior across activities. In Study 1, we did 8 weeks of unobtrusive systematic observation of mask wearing in outdoor recreational sites as a function of activity (walking, running, and cycling). In Study 2, we ran an online survey (concomitant with the last weeks of the observational study) to measure self-reported mask use and relevant beliefs, including self- and other-regarding motives. Behavioral observations showed that mask wearing declined over time for the three activities as predicted from a social dilemma perspective; nonetheless, compliance significantly differed across activities. Self-reported mask use was predicted by the perceived risk of contagion for the self and for others, perceived comfort costs of wearing masks, and social norms, but not by perceived illness severity or mask effectiveness. We discuss some implications and limitations of present findings for the development of preventive strategies to reduce COVID-19 transmission.

Factors Influencing Vaccine Hesitancy in China: A Qualitative Study

Vaccine hesitancy has become a significant issue. We aimed to elucidate the factors influencing vaccine hesitation in Chinese residents and to analyze and recommend promotional strategies and measures. In total, 92 Chinese residents from 10 provinces were interviewed using semi-structured face-to-face interviews following a predetermined survey framework in this qualitative study. We found trust in vaccine safety, access to professional advice, and vaccine price and effectiveness to be the main factors influencing vaccine hesitation. Additionally, residents in areas with a higher per capita GDP tend to receive more social support, believe that vaccination is beneficial and can prevent diseases, pay more attention to whether the vaccine is safe and has undergone various clinical trials, and are more likely to seek advice from individuals with vaccination experience as opposed to their counterparts in areas with a lower per capita GDP. Notably, as per capita GDP rises, individuals become more concerned about the price of vaccines. Measures such as clarifying vaccine safety and effectiveness, reducing self-funded vaccine prices, offering free vaccination for special groups, strengthening the publicity role of medical staff, and taking advantage of network platforms are essential to reduce vaccine hesitancy among Chinese residents.

The role of online news and social media in preventive action in times of infodemic from a social capital perspective: The case of the COVID-19 pandemic in South Korea

Infodemic, the spread of false information during the COVID-19 pandemic, has been raised as one of the major concerns aggravating the confusion in the global society. In this regard, the role of media as an information channel in delivering the reliable information and motivating the active participation of citizens in complying with government's preventive actions becomes much more important. In this study, the role of online news and social media on people's preventive actions considering the role of trust in citizens and government from the perspective of social capital is investigated. For the empirical study, a structural equation modeling is employed by using survey material gathered from South Korea in the early days of the COVID-19 outbreak. South Korea was selected as its COVID-19 prevention strategy focused not only on the provision of medical support, but also on the enhancement of social trust through active engagement with people through media channels. Our results reveal that the perceived characteristics of online news and social media influence preventive actions through the trust in citizens or in government. In addition, while online news media enhances trust in both the citizens and the government, social media only influences trust in citizens. Based on our findings, the role of media in preventing the spread of COVID-19 is dicussed.

Emergency Response and Risk Communication Effects of Local Media during COVID-19 Pandemic in China: A Study Based on a Social Media Network

As the country where the COVID-19 was first reported and initially broke out, China has controlled the spread of the pandemic well. The pandemic prevention process included emergency response and risk communication, both of which could notably increase public participation, people's anxiety has been alleviated, their confidence in the government has been enhanced, and the implementation of prevention and control measures has been understood. This study selected 157,283 articles published by 447 accounts across 326 cities in February 2020 from WeChat, the largest social media application in China, to systematically compare the spatial distributions in the effectiveness of emergency responses and risk communication. The results showed that there were significant regional differences in the effectiveness of emergency response and risk communication during the pandemic period in China. The effectiveness of emergency response and risk communication are related to the exposure risk to the COVID-19, the level of economy, culture, and education of the region, the type of accounts and articles, and the ranking of the articles in posts. The timeliness and distribution types of articles should take into account the psychological changes in communication recipients to avoid the dissemination of homogenized information to the masses and the resulting information receiving fatigue period.

Detection of COVID-19 in Chest X-ray Images: A Big Data Enabled Deep Learning Approach

Coronavirus disease (COVID-19) spreads from one person to another rapidly. A recently discovered coronavirus causes it. COVID-19 has proven to be challenging to detect and cure at an early stage all over the world. Patients showing symptoms of COVID-19 are resulting in hospitals becoming overcrowded, which is becoming a significant challenge. Deep learning's contribution to big data medical research has been enormously beneficial, offering new avenues and possibilities for illness diagnosis techniques. To counteract the COVID-19 outbreak, researchers must create a classifier distinguishing between positive and negative corona-positive X-ray pictures. In this paper, the Apache Spark system has been utilized as an extensive data framework and applied a Deep Transfer Learning (DTL) method using Convolutional Neural Network (CNN) three architectures -InceptionV3, ResNet50, and VGG19-on COVID-19 chest X-ray images. The three models are evaluated in two classes, COVID-19 and normal X-ray images, with 100 percent accuracy. But in COVID/Normal/pneumonia, detection accuracy was 97 percent for the inceptionV3 model, 98.55 percent for the ResNet50 Model, and 98.55 percent for the VGG19 model, respectively.

Non-EPI Vaccine Hesitancy among Chinese Adults: A Cross-Sectional Study

Vaccination against coronavirus disease 2019 (COVID-19) is paramount to curtailing the pandemic. However, the impact of the Non-Expanded Program on Immunization (non-EPI) and COVID-19 vaccine hesitancy on vaccine uptake among Chinese adults remain unclear. This study was an online survey performed in Eastern, Central, and Western China between February 2021 and March 2021 using proportional sampling (n = 7381). Adults aged ≥ 18 years were included, especially younger people (aged < 65). Vaccine hesitancy was assessed using the 3C model and relative scales; logistic regression was used to explore the factors affecting vaccination uptake; structural equation modeling was used to evaluate the correlations between variables. Overall, 67.6% and 24.7% of adults reported vaccine hesitancy toward the non-EPI and COVID-19 vaccines, respectively. Participants (66.3%) reported taking the vaccine mainly based on recommendations from medical staff. Vaccine-hesitant participants (60.5%) reported a fear of side effects as the deciding factor in vaccine rejection. Vaccine hesitancy interacted negatively with confidence (β = −0.349, p < 0.001) and convenience (β = −0.232, p < 0.001), and positively with complacence (β = 0.838, p < 0.001). Nonmedical personnel, adults who had previously received the influenza vaccine, and older people had lower vaccine hesitancy than their counterparts. Most Chinese adults have non-EPI but not COVID-19 vaccine hesitancy. Vaccine safety remains a concern.

From Isolation to Containment: Perceived Fear of Infectivity and Protective Behavioral Changes during the COVID-19 Vaccination Campaign

In the ongoing COVID-19 pandemic, maintenance of protective behavior is a continued challenge in the effort to contain the spread of the virus. A cross-sectional study via an internet questionnaire was utilized to elucidate changes in compliance to protective behavior among the Israeli population (n = 1120), after the beginning of the vaccination campaign. Comparison was made between individuals who were previously infected with the virus, those who received one dose of inoculation with the vaccine, and individuals that were neither infected or vaccinated. The study results indicate that those who were previously infected with the COVID-19 virus were less careful about mask wearing (18.8%) and social distancing (29.7%), as compared to the other examined groups (regarding mask wearing, 8.2% and 11.6% respectively, and with regard to social distancing 12.8% and 19.2%), and may require targeted risk communication campaigns to address this population. Furthermore, the study revealed that those that were non-Jewish (as compared to Jewish study counterparts) or that were older (19+) were more vigilant in their protective behavior (29.6% vs. 11.2% respectively for social distancing and 29.6% vs. 11.1% respectively for mask wearing). Despite a successful initial vaccination campaign in Israel, public health officials need to engage all members of the public to unremittingly observe compliance to directed health guidelines, to ensure that the results of previous governmental efforts in fighting the pandemic (such as lockdowns) will be effectively sustained, and the road to containment will be hastened.

Impacto del COVID-19 en población adulta mexicana: conductas de salud pública y salud mental

La crisis de salud pública del COVID-19 ha implicado que se lleven a cabo conductas para su prevención y a su vez ha acarreado consecuencias psicológicas en los ciudadanos. El objetivo de esta investigación es comparar las relaciones existentes entre las variables sociodemográficas y las variables de salud mental y de salud pública contra el coronavirus en población mexicana. El estudio se desarrolló mediante un diseño transversal de una sola etapa. Participaron 7,693 adultos quienes contestaron el cuestionario en línea PSY-COVID diseñado ad hoc durante junio de 2020. Los resultados indican que existe una relación positiva entre todas las variables de salud pública: expectativas de resultados, autoeficacia, norma social subjetiva, barreras/facilitadores, experiencia en conductas de prevención e intención de conductas de prevención post-confinamiento y las variables de salud mental: ansiedad, depresión y resiliencia. Por el contrario, hay una correlación negativa de estas últimas. Existen más síntomas de estrés y de depresión entre las mujeres y las personas de 16-26 años. Además, los hallazgos indican que los comportamientos de salud pública difieren de acuerdo con el género, nivel educativo, tener personas al cargo, nivel de información y haberse contagiado. A partir de nuestros hallazgos, consideramos importante el promover intervenciones desde la psicología de la salud, sensibles a los distintos grupos de personas que contribuyan al desarrollo de la resiliencia y, a partir de ello, aminorar el impacto psicológico por la pandemia.

Keep Calm and Stay Safe: The Relationship between Anxiety and Other Psychological Factors, Media Exposure and Compliance with COVID-19 Regulations

The COVID-19 pandemic has led many countries to employ public health regulations to achieve behavioral change and stop the transmission of the virus. The factors influencing compliance with these regulations may differ from "classic" predictors for medical compliance. This study attempted to assess the effect of social communication and psychological factors on intention to comply. A cross-sectional online survey was conducted on healthy adults living in Israel (n = 697). The survey assessed the intention to comply with the state COVID-19 regulations and explored possible correlations with demographic and psychosocial factors. Data were collected during May 2020 using a Qualtrics online survey. Data were analyzed to find correlations between anxiety, uncertainty, media exposure and other variables and the level of intention to comply as self-reported. Moderation and mediation effects were studied by an integrative model of influencing factors. We found that media exposure change, trust in responsible agencies and anxiety were positively correlated with compliance, while uncertainty was correlated with noncompliance. The effect of media exposure on compliance had two components. First, media exposure was positively correlated with compliance. On the other hand, media exposure was positively correlated with uncertainty, and uncertainty was negatively correlated with compliance. Interestingly, anxiety, which was positively correlated with media exposure, also moderated the negative correlation between uncertainty and compliance. Our results highlight the important role of uncertainty and anxiety as moderators between media exposure and compliance. To increase public compliance with COVID-19 regulations, efforts should be directed at decreasing uncertainty and anxiety.

Disease Prevention Behavior During the COVID-19 Pandemic and the Role of Self-Esteem: An Extended Parallel Process Model

Objective

The COVID-19 outbreak has become a serious public health problem worldwide. The purpose of this study was to use an extended parallel process model (EPPM) to understand factors in COVID-19 prevention behaviors.

Methods

This cross-sectional and analytical study was conducted on 1012 participants in Taiwan. A structured questionnaire and an online survey were used to collect data.

Results

The EPPM revealed that the severity of the COVID-19 threat perceived by respondents directly affected the arousal of fear in the respondents (β=0.268, t=9.007, p<0.001), but perceived efficacy did not (β=−0.019, t=−0.619, p>0.05); additionally, fear arousal was significantly associated with COVID-19 prevention behaviors (β=0.119, t=4.603, p<0.001). Regarding personal characteristics, self-esteem moderated the relationship between perceived threat and fear arousal. However, the moderating effect of self-esteem was stronger in people with low self-esteem compared to those with high self-esteem (β=0.606, −0.472; t=26.303, −17.694; p<0.001, p<0.001; respectively). The results of this study also indicated that two demographic characteristics (age and gender) affect COVID-19 prevention behaviors.

Conclusion

When developing healthcare policies and community interventions for improving COVID-19 prevention behaviors during an outbreak, healthcare administrators should carefully consider the main constructs of the EPPM, particularly personal characteristics (ie, self-esteem) and demographic characteristics (ie, age and gender).

Access to Information and Degree of Community Awareness of Preventive Health Measures in the Face of COVID-19 in Spain

The COVID-19 pandemic is posing a major health crisis. Spanish legislation establishes the mandatory use of masks and the implementation of hygienic measures such as hand washing and physical distancing. The aim of this study is to describe access to information and the level of community knowledge/adoption about the preventive measures proposed by the Spanish health authorities in response to the COVID-19 pandemic and to analyze the influence of socio-demographic factors in compliance among people over 18 years of age resident in Spain. An observational, descriptive and transversal study was conducted. Data was collected on sociodemographic variables, access to information and the degree of knowledge/adoption about the preventive measures: use of masks, hand hygiene and physical distancing. A total of 1811 people participated. The average age was 45.1 ± 15.1 years, predominantly female (69.3%), from an urban geographical area (74%), with a higher education level of 53.2%. Most of the respondents (57.5%) are or live with people at risk. The main access to information on preventive measures was from secondary sources (49.2%), with television being the main medium; 72.3% think that there are some difficulties in accessing information, while 8.7% of the participants do not consider the use of masks to be useful. As regards the choice of type of mask, the majority of people (44.8%) opt for the surgical variety; 88.5% of respondents believe that the physical distancing established is at least 1.5 m. This study confirmed that socio-demographic factors influence compliance with or the degree of knowledge/adoption of the preventive measures proposed to combat the COVID-19 pandemic and has made it possible to ascertain the sectors of the population with the greatest deficiencies in this respect. It shows the importance of implementing health information and education systems in the community, and it is advisable to promote specific programs aimed at men, people living in rural areas and people with a low level of education.

Confidence and Receptivity for COVID-19 Vaccines: A Rapid Systematic Review

While COVID-19 continues raging worldwide, effective vaccines are highly anticipated. However, vaccine hesitancy is widespread. Survey results on uptake intentions vary and continue to change. This review compared trends and synthesized findings in vaccination receptivity over time across US and international polls, assessing survey design influences and evaluating context to inform policies and practices. Data sources included academic literature (PubMed, Embase, and PsycINFO following PRISMA guidelines), news and official reports published by 20 October 2020. Two researchers independently screened potential peer-reviewed articles and syndicated polls for eligibility; 126 studies and surveys were selected. Declining vaccine acceptance (from >70% in March to <50% in October) with demographic, socioeconomic, and partisan divides was observed. Perceived risk, concerns over vaccine safety and effectiveness, doctors' recommendations, and inoculation history were common factors. Impacts of regional infection rates, gender, and personal COVID-19 experience were inconclusive. Unique COVID-19 factors included political party orientation, doubts toward expedited development/approval process, and perceived political interference. Many receptive participants preferred to wait until others have taken the vaccine; mandates could increase resistance. Survey wording and answer options showed influence on responses. To achieve herd immunity, communication campaigns are immediately needed, focusing on transparency and restoring trust in health authorities.

Confidence in social institutions, perceived vulnerability and the adoption of recommended protective behaviors in Brazil during the COVID-19 pandemic

The current worldwide COVID19 pandemic has required the rapid and drastic adoption of social distancing and protective measures as the leading method for reducing the spread of the disease and death. The purpose of this study is to investigate the factors associated with the adoption of such measures in a large sample of the Brazilian population. We relied on recreancy theory, which argues that confidence in the ability of social institutions and perceived vulnerability to the disease are central factors predicting the adoption of these behaviors. Our results, drawn from 7554 respondents, indicate that self-confidence in the ability to carry out these behaviors, confidence in the ability of social institutions such as the government, hospitals, health workers and the media to cope with the pandemic crisis, and risk perceptions are associated with the adoption of preventive behaviors. Our results expand the recreancy theory and show that beyond the main effects, the effect of perceived vulnerability depends on the values of self-confidence and confidence in social institutions. The theoretical implications of the findings are discussed.