Effect of Income Level and Perception of Susceptibility and Severity of COVID-19 on Stay-at-Home Preventive Behavior in a Group of Older Adults in Mexico City

Predictors of older adults' health behaviours to prevent COVID-19 transmission: a multilevel analysis

OBJECTIVES

While older adults showed higher mortality during COVID-19 pandemic, protective behaviours (knowledge regarding coping with COVID-19 symptoms and preventive behaviours) were highlighted to be important to prevent the spread of infection. This study aimed to identify individual and community-level variables influencing deficient knowledge regarding coping with COVID-19 and not-practicing COVID-19 of older adults during the pandemic.

DESIGN

This is a secondary analysis of a cross-sectional study using the 2020 Korea Community Health Survey (KCHS).

SETTING

255 community public health centres nationwide, South Korea.

METHODS AND ANALYSIS

Using 2020 KCHS data, multilevel logistic regression analysis was conducted on 55 005 adults aged 65 years or older.

RESULTS

Older adults who reside alone, as opposed to with their spouse and who lack the support of another individual exhibited insufficient COVID-19 coping-related knowledge (OR: 1.142, p<0.001) and poor preventive behaviours (OR: 1.177, p<0.001). Furthermore, lower municipal social welfare budget levels were associated with worse health behaviours (OR: 0.062, p<0.001). Specifically, older adults living in rural areas were less likely to engage in COVID-19 preventive behaviours compared with those in urban areas (OR: 1.247, p<0.001). Additionally, the effectiveness of mass media as a motivating factor for adopting preventive measures was only significant in rural populations (OR: 0.944, p<0.05).

CONCLUSIONS

Both individual-level and community-level approaches are necessary as an initial response during the pandemic. Since elderly people living alone with low socioeconomic status are vulnerable groups with poor health behaviours, it is helpful to provide social support on how to respond to infectious diseases and manage symptoms. In addition, it is important to expand the municipal social welfare budget to promote health equity between regions through appropriate health behaviour education and the strengthening of public medical services.

Knowledge and awareness on vector-borne diseases: a pending subject for the Spanish society?

BACKGROUND

To evaluate the level of knowledge and risk perception regarding vector-borne diseases in the Spanish society and identify the risk factors associated with the level of understanding.

METHODOLOGY

An online survey was conducted between January and May 2021, targeting Spanish adults. The survey consisted of 11 questions assessing knowledge and risk perception related to vector-borne diseases. Sociodemographic variables predicting the outcome variable (objective level of knowledge, determined by correctly naming two vector-borne diseases) were analyzed using multiple logistic regression. The outcome variable was then compared with the self-reported knowledge declared by the participants (kappa coefficient),k.

RESULTS

Out of the 1,646 respondents who completed the survey, 72.2% were female and 59.8% were >40 years old). Additionally, 87.3% showed a high risk perception and 61.7% understood what is a vector; however, only 36.3% had an objective level of knowledge (k= 0.353). The variables being >40 years (p <0.0001), having a monthly income >1,500 € (p <0.0001), and owning pets (p= 0.0423) were positively related with an objective level of knowledge on vector-borne diseases (adjusted effects).

CONCLUSIONS

Both knowledge and perception of the risk on vector-borne diseases need to be strengthened in Spain, especially in regions where vector-borne diseases are endemic, emerging, or re-emerging. These preliminary results underscore the necessity of enhancing institutional efforts to build a robust knowledge base within the Spanish society, extending beyond scientific forums.

Associations Between Risk Perception and HPV Knowledge and Vaccine Uptake: Highlighting the LGBTQ+ Population

INTRODUCTION

Gay and bisexual males and other LGBTQ+ communities are more frequently exposed to factors associated with an increased risk of human papillomavirus (HPV) acquisition. Vaccination is critical to protect against HPV+ head and neck cancer (HNC). We characterized the association of perceived level of risk of contraction with HPV knowledge, and vaccine decision-making.

STUDY DESIGN

Cross-sectional cohort.

SETTING

LGBTQ and general survey Reddit forums (control).

METHODS

A survey was shared amongst the online forums. Descriptive statistics characterized the data. Multivariable logistic regression was used to understand factors associated with vaccination, self-perceived high risk, and knowledge of HPV + HNC.

RESULTS

Of 718 respondents, most were female (41.09%), Caucasian (59.89%), college-educated (33.01%), and insured (77.15%) with a mean age of 30.75 years. Half were vaccinated (49.16%), with most unvaccinated endorsing interest (60.58%). Few dependents were vaccinated (25.91%), with interest in vaccination among parents of unvaccinated children (38.58%). Knowledge of HIV's association with HPV (62.95%), HPV causing HNC (55.57%), and the vaccine's efficacy against HNC (55.57%) was also moderate. Identifying female (P = .042), a self-perceived high-risk (P < .001), and having vaccinated children (P < .001) increased vaccination likelihood; transgender (P = .021), or lesbian or gay sexual identity (P < .001) decreased likelihood. Personal HNC diagnosis (P < .001), self-vaccination (P < .001), having vaccinated children (P < .001), having anal sex (P = .001) or no knowledge of past HPV status (P < .001) increased likelihood of high self-perceived risk.

CONCLUSION

Efforts to improve public education regarding the association between HPV and HNC and vaccination efficacy are required to better inform vaccine decision-making among individuals at risk for HPV infection.

Gap in protective behaviors between Han and minority ethnicities during COVID-19 pandemic in rural western China: A decomposition analysis

Understanding the ethnic gap in protective behavior and its explanatory factors is a promising step for reducing pandemic-induced disparities. However, no studies have endeavored to identify the factors contributing to a gap in protective behaviors between Han and minority ethnicities during COVID-19 pandemic in rural China. We aimed to analyze the gap in protective behaviors between Han and minority residents in rural China. We conducted cross-sectional studies in multi-ethnic rural China in 2020. A total of 1640 participants from Han and minority groups were invited to participate. The decomposition method was applied to analyze the gap in protective behaviors and its associated factors between the Han and minority groups. Participants in the Han group had a higher protective behavioral score (9.26 ± 1.20) than the minority group (8.97 ± 1.50), yielding a significant gap in protective behaviors between Han and minority ethnicities of 0.29. Socio-demographic characteristics, health status, the degree of knowledge held about COVID-19, and psychological responses to COVID-19 explained 79.3 % (0.23/0.29) of the behavioral gap between the Han and minority groups. The difference in household asset levels was the largest explained contributor to the behavioral gap (52.17 %) (0.12/0.23), followed by fear felt for COVID-19 (-21.74 %) (-0.05/0.23). Differences in educational attainment, degree of knowledge held about COVID-19, and self-efficacy in response to COVID-19 each explained 17.4 % (0.04/0.23) of the behavioral gap. In conclusion, Han group show greater protective behaviors than minority ethnic groups. To drive better protective behavior in the most vulnerable communities, targeted, group-specific COVID-19 preventative messages deployed in public health communication strategies is suggested to enhance individual confidence in coping with the pandemic while creating a healthy amount of fear for public health crisis.

Knowledge, attitudes and practices of patients with chronic pharyngitis toward laryngopharyngeal reflux in Suzhou, China

BACKGROUND

This study aimed to investigate the knowledge, attitudes and practices (KAP) of patients with chronic pharyngitis in Suzhou, China toward laryngopharyngeal reflux (LPR).

METHODS

This cross-sectional study was conducted in patients with chronic pharyngitis in Suzhou, China at the otolaryngology outpatient clinic of the First Affiliated Hospital of Soochow University between November, 2022, and May, 2023. Data was collected through a self-designed online questionnaire encompassing the sociodemographic characteristics and three dimensions of KAP. The questionnaire was administered using SoJump, and data were exported from this platform. Subsequently, statistical analysis, including Structural Equation Modeling, was performed using SPSS 22 software to evaluate the KAP scores.

RESULTS

A total of 487 valid questionnaires were collected, with 275 (56.35%) female patients. The mean score of KAP were 4.76 ± 2.93 (possible range: 0-11), 33.10 ± 4.46 (possible range: 8-40), 31.29 ± 6.04 (possible range: 8-40), respectively. Pearson's correlation analysis showed significant positive correlations between knowledge and attitude dimensions (r = 0.413, P < 0.001), knowledge and practice dimensions (r = 0.355, P < 0.001), and attitude and practice dimensions (r = 0.481, P < 0.001). Structural equation modeling revealed that education exhibited positive effect on knowledge (β = 0.476, P < 0.001) and attitude (β = 0.600, P < 0.001), and having family history of chronic pharyngitis showed positive effect on knowledge (β = 0.580, P = 0.047), experienced with reflux symptoms showed positive effect on knowledge (β = 0.838, P = 0.001) and attitude (β = 0.631, P = 0.085). Moreover, knowledge showed positive effect on attitude (β = 0.555, P < 0.001) and practice (β = 0.351, P < 0.001). Attitude, in turn, showed positive effect on practice (β = 0.511, P < 0.001).

CONCLUSION

Patients with chronic pharyngitis had inadequate knowledge, positive attitudes and suboptimal practices toward LPR. Education, family history of chronic pharyngitis, experienced with reflux symptoms might have effect on their KAP.

Exploring the Lived Experiences of Vulnerable Females from a Low-Resource Setting during the COVID-19 Pandemic

The onset of the Coronavirus disease 2019 (COVID-19) pandemic has affected the mental health and well-being of women in vulnerable settings. Currently, there is limited evidence that explores the wellness of elderly women under the associated restrictions. This study explores the lived experiences of elderly women in a vulnerable community in Durban, South Africa. A face-to-face, in-depth qualitative approach was implemented to interview 12 women aged 50 years and over. Thematic analysis was used to analyse the data. The findings suggest that social interactions, the effect of a high death rate, and financial strain predominantly affect stress and anxiety levels. Despite the women being in receipt of pensions and/or other grants, their supplementary income was reduced. This, together with the additional expenses incurred during the lockdown, resulted in anxiety over finances. The lack of social interaction, with limits on visiting family and other loved ones when they were ill, along with the limit on the number of people attending the funerals of loved ones were also stressful. This study also reports on the resulting coping mechanisms, which included using hobbies such as baking and sewing as a means of self-care. Religious beliefs also relieved stress while home remedies were used as preventative measures during the lockdown restrictions due to COVID-19.

Correlates of COVID-19 Preventative Behaviors before and after Vaccination Availability

As the COVID-19 pandemic progressed, various preventative behaviors and eventually vaccinations became available to decrease the spread of the virus. The current study examined a variety of variables (i.e., age, COVID-19-related economic hardship, interpersonal concern, personality, fear of COVID-19, normative beliefs, political beliefs, and vaccine hesitancy) to better understand predictors of preventative behaviors and vaccination status at different points throughout the pandemic. Online questionnaires, administered through Qualtrics, were used to collect data using two convenience samples. One was a small sample (N = 44) of non-student participants before the vaccine was readily available. The other sample (N = 274) included college student participants and occurred after the vaccine had been available to all participants. Results suggest that several variables (i.e., fear of COVID-19, normative beliefs, interpersonal concern, and openness) were consistent predictors of public health behaviors at both points in time and across differently aged samples. Other variables (i.e., agreeableness, extraversion, conscientiousness, and economic hardship) were less consistent with their relationships with public health behaviors. Implications related to both research and public health are discussed.

The Impact of Japan's Soft Lockdown on Depressive Symptoms among Community-Dwelling Older Adults

This study investigated the impact of stay-at-home orders on depressive symptoms among community-dwelling older adults during the early stages of the COVID-19 pandemic. A questionnaire was administered to older adults living in Ayase City, Kanagawa Prefecture, in July 2020, after the Japanese government declared its first COVID-19 state of emergency and stay-at-home order. In a sample of 1056 people, 69.1% were stay-at-home, and 30.9% were not. Those in the first group were more likely to be women, young-old, or non-workers. In addition, the patients tended to have more diseases. Of the participants, 39.3% had depressive symptoms and 60.7% did not. Multivariate analysis revealed that depressive symptoms were associated with increased frequency of being alone during the daytime (OR = 1.27; 95% CI = 1.07, 1.51), less face-to-face contact with friends or acquaintances (OR = 0.78; 95% CI = 0.65, 0.94), increased contact with friends or acquaintances through email/LINE app (OR = 1.29; 95% CI = 1.03, 1.60), and refraining from going out (OR = 1.54; 95% CI = 1.12, 2.09). These results suggest that quarantine measures related to soft lockdowns may aggravate the mental health of community-dwelling older adults. Therefore, it is necessary to consider macro-level policies.

Determinants of proper disposal of single-use masks: knowledge, perception, behavior, and intervention measures

Background

Although many studies testify to consumer behavior's role in the context of waste-related sustainability objectives, little research examined what people know, think, and feel about the environmental impacts of their personal protective equipment (PPE) or their behavior towards them, in general. Therefore, the present article complements existing information about the public perceptions, knowledge, and behavior of single-use masks in a context where the pandemic has put increasing pressure on waste management public services. From February to June 2020, municipal solid waste increased ten times in Romania. The study identified the factors that predicted the proper disposal of single-use masks and the measures preferred to prevent or minimize the negative impact of single-use mask waste.

Method

Data from a representative sample of 705 Romanians were collected using a structured questionnaire. The data were analyzed with SPSS and SmartPLS. The Cochran's Q test was run to determine the existence of differences between percentages of people who preferred various measures. Dunn's test with a Bonferroni correction was used to identify the exact pair of groups where the differences were located. The study utilized structural equation models (SEM) based on at least partial squares with SmartPLS software (3.2.8) to investigate causal links between constructs. The model considered that the dependent variable (environmentally friendly behavior: proper disposal of single-use masks) could be influenced by the knowledge, perception, behavior, and demographics variables.

Results

The findings indicated that knowledge of the type of material of single-use masks had a direct positive (β = 0.173) and significant effect on their proper disposal. The perception of mask waste impact has a negative and significant (β = -0.153, p < 0.001) impact on the proper disposal of single-use masks. This path coefficient illustrates that the worse the perceived impact of single-use masks on waste management activity, the higher the proper disposal of single-use masks. Gender has a positive (β = 0.115) and significant (p < 0.001) effect on the proper disposal of single-use masks.

Conclusions

It was concluded that the 5Rs waste management approach should be reconsidered for single-use mask waste. For example, "Reuse" and the classic "Recycle" have limited applications since they may lead to virus transmission and possible infection. "Reducing" the use of single-use masks could have repercussions on one's health. Summing up, the study outlined recommendations for effective interventions for the proper disposal of single-use masks from the perspective of behavioral studies.

Vulnerabilities and risk perceptions of contracting COVID-19 among Nepali migrant workers

Social, economic, and demographic characteristics influence public disaster risk perception, including the risk of COVID-19. Migrant workers are one the most vulnerable groups to disasters. More than four million Nepali migrant workers are employed abroad, and millions are working in cities and towns in the country. This study analyzes how the social, economic, and demographic conditions of returning Nepali migrant workers determine their risk perceptions of COVID-19. An online national survey was administered from May 10 to July 30, 2020, targeting returning Nepali migrant workers nationwide. A total of 782 responses from migrant workers were recorded, covering 67 of 74 districts. Using descriptive statistics and binary logistic regression models, the results show that migrant workers in blue-collar jobs, female, older than 29 years, with pre-existing health conditions, from low-income families, and from larger families are more likely to perceive higher risks of COVID-19. The migrant workers who believe in non-pharmaceutical COVID-19 control measures, including awareness campaigns and stay-at-home orders, have higher risk perceptions of the virus than other groups. The research contributes to identifying the program and policy priority areas to address the needs and COVID-19 vulnerabilities of returning Nepali migrant workers during and after the pandemic.

Communication inequalities and health disparities among vulnerable groups during the COVID-19 pandemic - a scoping review of qualitative and quantitative evidence

BACKGROUND

The COVID-19 pandemic has exacerbated health disparities in vulnerable groups (e.g., increased infection, hospitalization, and mortality rates in people with lower income, lower education, or ethnic minorities). Communication inequalities can act as mediating factors in this relationship. Understanding this link is vital to prevent communication inequalities and health disparities in public health crises. This study aims to map and summarize the current literature on communication inequalities linked with health disparities (CIHD) in vulnerable groups during the COVID-19 pandemic and to identify research gaps.

METHODS

A scoping review of quantitative and qualitative evidence was conducted. The literature search followed the guidelines of PRISMA extension for scoping reviews and was performed on PubMed and PsycInfo. Findings were summarized using a conceptual framework based on the Structural Influence Model by Viswanath et al. RESULTS: The search yielded 92 studies, mainly assessing low education as a social determinant and knowledge as an indicator for communication inequalities. CIHD in vulnerable groups were identified in 45 studies. The association of low education with insufficient knowledge and inadequate preventive behavior was the most frequently observed. Other studies only found part of the link: communication inequalities (n = 25) or health disparities (n = 5). In 17 studies, neither inequalities nor disparities were found.

CONCLUSIONS

This review supports the findings of studies on past public health crises. Public health institutions should specifically target their communication to people with low education to reduce communication inequalities. More research about CIHD is needed on groups with migrant status, financial hardship, not speaking the language in the country of residence, sexual minorities, and living in deprived neighborhoods. Future research should also assess communication input factors to derive specific communication strategies for public health institutions to overcome CIHD in public health crises.

The Determinants of Adherence to Public Health and Social Measures Against COVID-19 Among the General Population in South Korea: National Survey Study

BACKGROUND

The COVID-19 pandemic has created devastating health, social, economic, and political effects that will have long-lasting impacts. Public health efforts to reduce the spread of COVID-19 are the priority of national policies for responding to the pandemic globally. Public health and social measures (PHSMs) have been shown to be effective when used alone or in combination with other measures, reducing the risk of spreading COVID-19. However, there is insufficient evidence on the status of compliance with PHSMs in the general population for the prevention of COVID-19 in public areas, including Korea.

OBJECTIVE

The aim of this study was to assess levels of compliance with the recommended PHSMs against SARS-CoV-2 infection and their predictors among the general population by using national data.

METHODS

This study was a secondary data analysis of the National Survey of Infectious Disease Preventive Behaviors in Community, which was conducted by the Korea Centers for Disease Control and Prevention Agency (KDCA) between October 12 and October 30, 2020. The primary study was cross-sectional, using stratified sampling via an adjusted proportional allocation method to select representative samples and ensure the stability of samples. The data were collected through phone interviews conducted by trained enumerators using a structured questionnaire. PHSM adherence was measured using a 10-item comprehensive infectious disease prevention behavior (CIDPB) scale, and each sociocognitive factor, including perceived susceptibility to SARS-CoV-2 infection, perceived severity of SARS-CoV-2 infection, perceived confidence in performing preventive behaviors related to COVID-19, information comprehension ability, and trust in information from the KDCA, was measured. A total of 4003 participants were included in the final analysis. Tobit regression and a decision tree analysis were performed to identify the predictors of preventive measures and the target groups for intervention.

RESULTS

We discovered that women scored 1.34 points higher on the CIDPB scale than men (P<.001). Compared to the group aged 19 to 29 years, those aged 50 to 59 years and those older than 60 years scored 1.89 and 2.48 points higher on the CIDPB scale (P<.001), respectively. The perceived severity of infection, confidence in preventive behaviors, information comprehension ability, and trust in information from the KDCA were significant positive determinants of CIDPBs (P<.001). The perceived susceptibility to infection showed a significant negative relationship with CIDPBs (P<.001).

CONCLUSIONS

Female sex, older age, lower income, and sociocognitive factors were found to be significant determinants of adhering to PHSMs. The findings suggest the need for tailored interventions for target groups; specifically, the age group that was the most active at work indicated the highest potential to spread infection. Adequate public health education and health communication for promoting adherence to PHSMs should be emphasized, and behavior change strategies for those with low perceived confidence in performing PHSMs should be prioritized.

Effects of negative emotions and information perceived value on residents' risk perception during the COVID-19 pandemic: An empirical survey from China

Background

The COVID-19 pandemic has spread rapidly and heavily hit the globe, and the mutation and transmission speed of the coronavirus have accelerated so that the world is still in danger. Thus, this study aims to investigate the participants' risk perception and explore the associations of risk perception of COVID-19 with negative emotions, information value perception and other related dimensions.

Methods

A cross-sectional, population-based online survey was conducted from April 4 to 15, 2020, in China. A total of 3,552 participants were included in this study. A descriptive measure of demographic information was used in this study. Multiple regression models and moderating effect analysis were used to estimate the effect of potential associations of risk perceptions.

Results

Those who showed negative emotions (depressed, helplessness, loneliness) and perceived video information in social media to be useful were positively correlated with risk perception, whereas individuals who perceived experts' advice to be useful, shared risk information with friends and thought that their community made adequate emergency preparation reported lower risk perception. The moderating effect of information perceived value (β = 0.020, p < 0.001) on the relationship between negative emotion and perception of risk was significant.

Conclusions

Individual differences in risk cognition during the COVID-19 pandemic were observed in subgroups of age level. Furthermore, the role of negative emotional states, the perceived usefulness of risk information and the sense of security also contributed to improving the public's risk perception. It is crucial for authorities to focus on residents' negative emotions and to clarify misinformation in accessible and effective ways in a timely manner.

Predisposing, Enabling, and Reinforcing Factors of COVID-19 Prevention Behavior in Indonesia: A Mixed-methods Study

OBJECTIVES

To prevent the spread of coronavirus disease 2019 (COVID-19), behaviors such as mask-wearing, social distancing, decreasing mobility, and avoiding crowds have been suggested, especially in high-risk countries such as Indonesia. Unfortunately, the level of compliance with those practices has been low. This study was conducted to determine the predisposing, enabling, and reinforcing factors of COVID-19 prevention behavior in Indonesia.

METHODS

This cross-sectional study used a mixed-methods approach. The participants were 264 adults from 21 provinces in Indonesia recruited through convenience sampling. Data were collected using a Google Form and in-depth interviews. Statistical analysis included univariate, bivariate, and multivariate logistic regression. Furthermore, qualitative data analysis was done through content analysis and qualitative data management using Atlas.ti software.

RESULTS

Overall, 44.32% of respondents were non-compliant with recommended COVID-19 prevention behaviors. In multivariate logistic regression analysis, low-to-medium education level, poor attitude, insufficient involvement of leaders, and insufficient regulation were also associated with decreased community compliance. Based on in-depth interviews with informants, the negligence of the Indonesian government in the initial stages of the COVID-19 pandemic may have contributed to the unpreparedness of the community to face the pandemic, as people were not aware of the importance of preventive practices.

CONCLUSIONS

Education level is not the only factor influencing community compliance with recommended COVID-19 prevention behaviors. Changing attitudes through health promotion to increase public awareness and encouraging voluntary community participation through active risk communication are necessary. Regulations and role leaders are also required to improve COVID-19 prevention behavior.

Relationship between attitudes toward COVID-19 infection, depression and anxiety: a cross-sectional survey in Japan

BACKGROUND

Although negative attitudes are known to develop with experiences of COVID-19 infection, it remains unclear whether such attitudes contribute to depression and anxiety as sequelae of COVID-19. We aimed to investigate the relationships between attitude towards COVID-19 infection and post-COVID-19 depression and anxiety.

METHODS

A cross-sectional survey of COVID-19 recovered patients was conducted from July to September 2021 in Japan. Outcome variables, depression and anxiety were assessed using the Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7); scores of 10 and above were identified as having symptoms of depression and anxiety, respectively. Exposure variables were whether participants were experiencing the following attitude strongly: threat to life due to COVID-19 infection, helplessness regarding COVID-19 infection, blaming a third party who did not restrain from going outside, blaming themselves for their COVID-19 infection, worry about spreading the infection to others, and self-stigma (Self-Stigma Scale-Short). Modified Poisson regression analyses were performed to analyze the findings.

RESULTS

A total of 6016 responses were included in the analyses. The proportion of depression was 19.88%, and anxiety was 11.47%. The threat of life due to COVID-19 infection, helplessness regarding COVID-19 infection, blaming oneself for their COVID-19 infection, and self-stigma were significantly associated with depression and anxiety after adjusting covariates. Blaming the third party who did not restrain from going outside was associated with anxiety. There was no association between the worry about spreading infection to others and depression or anxiety.

CONCLUSION

Negative attitudes, including self-stigma with the experience of COVID-19 infection, were related to depression and anxiety. Further studies confirming whether countermeasures for preventing or decreasing the negative attitude towards COVID-19 infection mitigate these symptoms are needed.

Impact of Personal Experience of COVID-19 Disease on Recreational Anglers' Attitudes and Behaviors

BACKGROUND

Anglers are a large social group with access to a "relatively safe" form of recreation, that allows the opportunity to relieve stress. An important question, however, is how they did so, and to what extent their perceived COVID-19 transition status influenced decisions both in life and at the fishing site.

AIM

Our study aimed to determine the dynamics of anglers' attitudes and behaviors during the COVID-19 pandemic as a result of the different statuses of their exposure to the SARS-CoV-2 virus. We assumed that the behavior of anglers who have not experienced the disease (were not ill and not sure if ill) will be similar and, on the other hand, different from the behavior of those who have experienced COVID-19.

METHODS

The web-assisted interviews survey was used among 586 anglers with different COVID-19 disease experience statuses. Their pandemic behavior and activities by four age groups were studied using non-metric multidimensional scaling. Redundancy analysis has been used to identify the relationship between anglers' life attitudes and socioeconomic and demographic factors, taking into account their preferences and involvement in fishing.

RESULTS

We have demonstrated that the behavior of anglers who have not experienced COVID-19 disease and do not present a reckless attitude toward pandemic threats, do not show significant differences from the life attitudes of the group experienced by the SARS-CoV-2 virus. These two groups comprise more than 70% of anglers. However, the rest show a lack of interest in an aware diagnosis of their health and a low level of acceptance of self-restraint in the area of direct social contact.

CONCLUSIONS

Unawareness, combined with ignorance, could be a potential factor in the transmission of the virus while fishing. The behaviors of almost 30% of anglers are particularly risky when combined with a strong need to fish in the company of friends and familiar people. Anglers' social identity should be tapped by fishery managers. Targeted educational campaigns should be aimed at groups around specific fishing spots. The need for self-limitation under the pandemic should be promoted for the benefit of the general public and to maintain the reputation of angling as a safe recreational activity.

Prevalence of Long-COVID Among Low-Income and Marginalized Groups: Evidence From Israel

Objective: To identify the socioeconomic and demographic factors associated with the prevalence of self-reported long-COVID symptoms. Method: We examined the association between acute-COVID (SARS-CoV-2) and long-COVID symptoms, by a cross-sectional analysis of data obtained on a prospective online-survey, conducted from November to December 2021 on a nationally-representative sample of the Israeli population (N = 2,246). Results: Findings suggest that there is a greater likelihood of experiencing long-COVID symptoms among low-income and among marginalized groups. After controlling for demographic and socioeconomic attributes, those who had moderate/severe acute-COVID were 1.3 (p < 0.05) times more likely to experience a long-term symptom and also reported more long-term symptoms (2.2 symptoms) than those who have not been infected (1.4 symptoms; p < 0.01). Among the low-income group, a larger gap in symptom count was found between those who had moderate/severe acute-COVID (3.3 symptoms) and those who had not been infected (1.8 symptoms, p < 0.05). Conclusion: Our findings highlight the importance of raising awareness of long-COVID among marginalized population groups, and to the therapeutic options available. Such efforts should be tailored and should consider the unique socioeconomic and cultural characteristics, as well as the preexisting low access to healthcare services among these groups.

Health Literacy, Misinformation, Self-Perceived Risk and Fear, and Preventive Measures Related to COVID-19 in Spanish University Students

The "infodemic" is one of the main obstacles in the fight against the COVID-19 pandemic. In order to face it, health literacy (HL) is essential since it allows for knowledge about COVID-19 and the practice of preventive measures to be fostered. This is especially relevant in university students due to their idiosyncrasy. This study aims to evaluate the level of HL related to COVID-19 (HLC), risk perception, misinformation, and the attitudes and behaviors adopted to prevent the spread of coronavirus in Spanish university students. An online questionnaire was administered to 499 Spanish university students. The HLC index presented a mean of 33.89 out of 50; a total of 63.8% had an inadequate level of HLC. They practiced a mean of 7.54 out of 9 preventive behaviors, and the mean knowledge score was 10.40 out of 13. The HLC showed significantly different scores for the degree, the practice of preventive measures, and some sources of information. The level of HL correlates with the adoption of preventive measures. The higher the severity and perceived susceptibility, the more preventive measures are taken by the students. Therefore, there is a need to strengthen the HL skills of university students and address the dissemination of misinformation. Although caution should be taken when generalizing these results due to the limitations inherent within a cross-sectional study and the convenience sampling, our results can guide the establishment of health education strategies and policies for the management of the infodemic in pandemic situations, according to this target population.

Epidemiological Profile and Social Welfare Index as Factors Associated with COVID-19 Hospitalization and Severity in Mexico City: A Retrospective Analysis

Epidemiological data indicate that Mexico holds the 19th place in cumulative cases (5506.53 per 100,000 inhabitants) of COVID-19 and the 5th place in cumulative deaths (256.14 per 100,000 inhabitants) globally and holds the 4th and 3rd place in cumulative cases and deaths in the Americas region, respectively, with Mexico City being the most affected area. Several modifiable and non-modifiable risk factors have been linked to a poor clinical outcome in COVID-19 infection; however, whether socioeconomic and welfare factors are associated with clinical outcome has been scanty addressed. This study tried to investigate the association of Social Welfare Index (SWI) with hospitalization and severity due to COVID-19. A retrospective analysis was conducted at the Centro Médico Nacional "20 de Noviembre"-ISSSTE, based in Mexico City, Mexico. A total of 3963 patients with confirmed or suspected COVID-19, registered from March to July 2020, were included, retrieved information from the Virology Analysis and Reference Unit Database. Demographic, symptoms and clinical data were analyzed, as well as the SWI, a multidimensional parameter based on living and household conditions. An adjusted binary logistic regression model was performed in order to compare the outcomes of hospitalization, mechanical ventilation requirement (MVR) and mortality between SWI categories: Very high (VHi), high (Hi), medium (M) and low (L). The main findings show that lower SWI were independently associated with higher probability for hospital entry: VHi vs. Hi vs. M vs. L-SWI (0 vs. +0.24 [OR = 1.24, CI95% 1.01-1.53] vs. +0.90 [OR = 1.90, CI95% 1.56-2.32] vs. 0.73 [OR = 1.73, CI95% 1.36-2.19], respectively); Mechanical Ventilation Requirement: VHi vs. M vs. L-SWI (0 vs. +0.45 [OR = 1.45, CI95% 1.11-1.87] vs. +0.35 [OR = 1.35, CI95% 1.00-1.82]) and mortality: VHi vs. Hi vs. M (0 vs. +0.54 [OR = 1.54, CI95% 1.22-1.94] vs. +0.41 [OR = 1.41, CI95% 1.13-1.76]). We concluded that SWI was independently associated with the poor clinical outcomes in COVID-19, beyond demographic, epidemiological and clinical characteristics.

An empirical study of the effect of a flooding event caused by extreme rainfall on preventive behaviors against COVID-19

Since the outbreak of COVID-19, wearing masks, vaccinations, and maintaining a safe distance has become social behaviors advocated by the government and widely adopted by the public. At the same time, unpredictable natural disaster risks brought by extreme climate change compound difficulties during epidemics and cause systemic risks that influence the existing pattern of epidemic prevention. Therefore, it is necessary to explore the effect of natural disaster risk caused by climate change on the response to outbreaks in the context of the COVID-19 epidemic. This study will focus on individual-level epidemic prevention behaviors, taking as an example the significant risk of severe destructive flooding caused by heavy rains in Henan, China, on July 20, 2021, which claimed 398 lives, to explore the effect of floods on the preventive behaviors of residents in the hardest hit areas against COVID-19. Through the multi-stage stratified random sampling of the affected residents in Zhengzhou, Xinxiang, Hebi, Luoyang, Anyang, and other cities in Henan Province, 2,744 affected people were surveyed via questionnaires. Through the linear regression model and moderating effect analysis, the study found that after floods, the individual's flood risk perception and response behaviors significantly correlated with the individual's prevention behaviors against COVID-19. Specifically, both flood risk perception and response behaviors strengthened the individual's prevention behaviors. Furthermore, the study also found that community risk preparation behavior and social capital can moderate the above relationship to a certain extent. The research can guide risk communication under the compound risk scenario and prevent risky public behavior under the consistent presence of COVID-19 in the community.

Influence of the level of education on women's knowledge, attitude, and practices to control the transmission of COVID-19 in the Democratic Republic of the Congo

Adequate knowledge, attitude, and practices (KAP) towards the novel coronavirus (COVID-19) can reduce its spread and may also be useful in preventing and controlling the transmission of severe acute respiratory syndrome coronavirus 2 (ARS-CoV-2) in the community. This study examines the influence of women's education level on COVID-19 KAP behaviour in the Democratic Republic of the Congo (DRC). This study uses COVID-19 data obtained from the Performance Monitoring for Action (PMA) in Kinshasa, the DRC's capital city. Data were collected through telephone interviews held in June 2020 with a representative sample of 1773 women aged 15–49 years. Data were then analysed using multiple probit regression and marginal effects techniques. To address possible sample selection bias due to the use of a telephone to recruit participants, the data were adjusted to account for the selectivity due to telephone number ownership through inverse probability weighting. In general, the results of this study indicate no statistically significant difference in the influence of the level of education on women's KAP to control the transmission of COVID-19 in the DRC, women with higher levels of education are not found to always exhibit improved knowledge, attitude, or practices of appropriate strategies for the prevention and control of COVID-19 in the DRC. The results also indicate that education can have both positive and negative influences in alleviating the burden of COVID-19.

Sociodemographic Differences in COVID-19 Self-Reported Symptoms by Ethnicity and Older Adults in Bolivia

The effects of COVID-19 revealed the fragility of health systems in the LAC region, with greater risk of death in older people than in younger people, as well as greater vulnerability to infection due to living with people aged 30–59 years, who have a higher prevalence of COVID-19. On the other hand, there is not much information on inequalities in the incidence of COVID-19 in indigenous people, a population with lower immunological resistance. The objectives are: 1) To determine the association between sociodemographic variables with self-reported COVID-19 symptoms. 2) To investigate whether this relationship shows inequalities by ethnicity and age. For that purpose I conducted a cross-sectional analysis using the 2020 Household Survey and investigated the association between sociodemographic variables and self -reported COVID-19 symptoms and explore the contribution of factors such as employment type, household living arrangements, years of education, age, ethnicity, gender, current status of working and residence area. I performed bivariate analysis to establish trends. Subsequently using logistic regressions to establish the risks to self-reported COVID-19 symptoms. A fully interacted model is analysed by ethnicity. I found those who were living alone were less likely than those living in a Couple with/without relatives’ household arrangement to self-reported COVID-19 symptoms (OR = 0.79, 95% CI: 0.66–0.94, p < .01). Odds of the older persons aged 45–59 (OR = 1.44, 95% CI: 1.27–1.62, p < .05) were relatively more likely than younger people (OR = 1.19, 95% CI: 1.05–1.35, p < .01). Indigenous living in a couple with/without children household arrangement were less likely than non-Indigenous (OR = 0.75, 95% CI: 0.62–0.90, p < .01). Odds of Indigenous people of age 30–44 (OR = 1.26, 95% CI: 1.04–1.53, p < .01) were more likely than non-Indigenous. Odds of Indigenous persons of age 45–59 (OR = 1.59, 95% CI: 1.32–1.91, p < .05) were more likely than non-Indigenous (OR = 1.32, 95% CI: 1.12–1.55, p < .01). As conclusions, 45–59 age group shows higher risk factors and those aged 60 + show lower risks. These are increased in people working in managerial, administrative and professional, and technical positions, those living in a household with/without relatives, men, those living in urban areas, and/or non-indigenous people.

Determinants of COVID-19 testing among late middle-aged and older adults: Applying the health belief model

Objectives

The purpose of this study was to examine correlates of taking a COVID-19 test among late middle-aged and older adults using nationally representative data.

Methods

Data were obtained from the 2020 Health and Retirement Study midway release COVID-19 module. Our sample was representative of community residing adults aged 51 and over in the United States (n = 2,870).

Measurements

We regressed taking a COVID-19 test on demographic characteristics, medical comorbidities, and measures related to the health belief model (i.e., perceived severity, perceived susceptibility, cues to action, and perceived barriers) using logistic regression, stratifying the model by 10-year age categories.

Results

Concern about the pandemic was associated with an increase in the likelihood of taking a test among late middle-aged adults. Knowing someone who was diagnosed with COVID-19 was associated with taking a test in most age categories. Financial barriers and knowing someone who died of COVID-19 were not associated with taking a test.

Conclusions

How late middle-aged and older adults perceive the COVID-19 pandemic may significantly influence their likelihood of taking a COVID-19 test.

Perceived Self Efficacy in Implementing COVID-19 Preventive Measures Among Residents of Harari Regional State, Eastern Ethiopia: A Community-Based Cross-Sectional Study

Background

The COVID-19 outbreak has now become a major international public health concern and a major challenge for the entire world. Poor adherence to COVID-19 prevention measures continues to be a challenge in managing COVID-19 pandemics, including in Ethiopia. As a result, the current study sought to identify the determinants of community adherence to COVID-19 preventive measures among the adult population of Harari Regional State in Eastern Ethiopia.

Methods

A community-based cross-sectional study was conducted in Harari Regional State, Eastern Ethiopia from January 5 to 30, 2021. All adults above the age of 18 who lived in Harari Regional State's selected kebeles were eligible to participate in the study. A systematic random sampling method was used to select the study participants. The study included a total of 1,320 participants. Pre-tested, structured, and self-administered questionnaires were used to collect data, which was then analyzed using STATA version 16 software. The consent was obtained from each individual and concerned body. Binary logistic regression was used to find the correlation between community adherence to COVID-19 preventive measures and sociodemographic, knowledge, self-efficacy, and risk perception. A P-value of 0.05 was used as the statistical significance cut-off point.

Results

One thousand two hundred fifty-five (1,255) people took the survey, yielding a 95.1 % response rate. Adherence to COVID-19 preventive measures resulted in a mean cumulative score of 29.8. Six hundred eight (48.5%) of the participants had good adherence to COVID-19 preventive measures, whereas 647 (51.5%) did not. The researchers also discovered a statistically significant link between participants' residence, educational status, risk perception, income, and adherence to COVID-19 preventive measures.

Conclusion

Appropriate implementation of COVID-19 preventive measures among community members is required to manage or control pandemics and reduce health-related consequences associated with COVID-19 pandemics. The current study, on the other hand, discovered that nearly half of the study participants had poor adherence. As a result, in order to manage this pandemic, the relevant organizations, including the government and non-governmental organizations, must take appropriate and timely measures.

Individual and group level risk factors in preventive health and panic buying behaviors during COVID-19 pandemic in India

The present research explored individual and group level risk factors in preventive health and panic buying behaviors during the COVID-19 pandemic in India. Perceived susceptibility, perceived severity, COVID-19 anxiety, and personal identity were considered individual-level risk factors. Group based identities such as family, religious groups, and identification with one's nation were considered as group level risk factors. Standardized scales have been used to measure all the constructs under study. Data were collected electronically from 305 Indian respondents. Hierarchical regression analysis in SPSS Version 22 was used to test the hypotheses. Results showed that personal identity and identification with the nation predicted preventive health behavior. Panic buying behavior was predicted by the location of the respondents (containment versus non-containment zones), perceived severity, and one's personal identity. The interplay of individual and social factors is reflective of both individual and collective agencies in the adoption of preventive health behaviors, while only individual-level factors led to panic buying behavior. The findings of this study have implications for curbing, managing, and reinforcing desirable and non-desirable behavior during the present pandemic as well as in the future as well.

Factors Associated with an Outbreak of COVID-19 in Oilfield Workers, Kazakhstan, 2020

From March to May 2020, 1306 oilfield workers in Kazakhstan tested positive for SARS-CoV-2. We conducted a case-control study to assess factors associated with SARS-CoV-2 transmission. The cases were PCR-positive for SARS-CoV-2 during June–September 2020. Controls lived at the same camp and were randomly selected from the workers who were PCR-negative for SARS-CoV-2. Data was collected telephonically by interviewing the oil workers. The study had 296 cases and 536 controls with 627 (75%) men, and 527 (63%) were below 40 years of age. Individual factors were the main drivers of transmission, with little contribution by environmental factors. Of the twenty individual factors, rare hand sanitizer use, travel before shift work, and social interactions outside of work increased SARS-CoV-2 transmission. Of the twenty-two environmental factors, only working in air-conditioned spaces was associated with SARS-CoV-2 transmission. Communication messages may enhance workers’ individual responsibility and responsibility for the safety of others to reduce SARS-CoV-2 transmission.

Employee Perceptions About Participation in Decision-Making in the COVID Era and Its Impact on the Psychological Outcomes: A Case Study of a Cooperative in MONDRAGON (Basque Country, Spain)

This research aims to study possible effects or impacts of COVID-19 in the context of a democratic organizational system analyzing how COVID-19 has influenced employees' perception of their participation in decision-making and its impact on some psychological outcomes and emotions. COVID-19 has accelerated the process of implementation of new frameworks at work (digitalization, teleworking, new skills, and abilities) that have generated the modification of culture and employee management practices. Our hypothesis are, on the one hand, that COVID-19 has generated changes in participation structures and internal communication mechanisms, having to make modifications not to deteriorate the perception of employees about their participation in decision making. On the other hand, COVID-19 has generated changes in the psychological outcomes and emotions of the employees. In the study, we analyze a cooperative belonging to the MONDRAGON cooperative group, where participation in decision-making and ownership is in its DNA. Through qualitative (5 focus groups) and quantitative (short questionnaire) methodologies, involving 42 employees, we investigate firstly, how COVID-19 has affected perceptions about participation in decision-making analyzing what role has played internal communication in these perceptions. Secondly, we investigate how COVID-19 has affected psychological outcomes and emotions. In this case, the perceptions arising from participation in decision-making focus on the assessment that participators make of the governance channels and the day-to-day meetings. Therefore, their appropriateness seems to be a key factor in the perception of participation in the COVID-19 era. Differences have been detected between the perceptions of blue and white collar employees. Such differences have also been founded in the psychological outcomes and emotions. Although this is a single case study, the analysis carried out provides elements of reflection to modify and restructure the decision-making and participation mechanisms, adapting them to the needs of blue and white collar employees in order to "guarantee" the expected outcomes.

Investigating the Adoption of Precautionary Behaviors Among Young Rural Adults in South Iran During COVID-19

COVID-19 is an unprecedented challenge for public health worldwide. Reducing the incidence of the disease requires protective measures to prevent virus transmission. Understanding those factors influencing preventive behavior is the first step in preventing the spread of the disease. This study investigates factors affecting youth intention and preventive behaviors in the face of COVID-19 through the health belief model by using a cross-sectional survey collected through an online questionnaire. The sample comprises 304 rural youth in South Iran who were selected through a random sampling technique. The results reveal that perceived severity, perceived benefits, public health beliefs, perceived self-efficacy, and the cue to act positively and significantly affect preventive behaviors. The model explains 59% of variance changes in rural youth preventive behaviors during COVID-19. Cue to action is the strongest and self-efficacy was the weakest determinant of youth's preventive behavior. This study confirms that the HBM framework has appropriate predictive power and is an effective tool for investigating preventive behaviors during COVID-19. These results provide important policy implications for the development of policies that aim to avoid the further spread of COVID-19 between young citizens.

A COVID-19 disruption: The great acceleration of digitally planned and transformed behaviors in Thailand

The Coronavirus Disease 2019 (COVID-19) pandemic has reshaped human behaviors and switched communication systems from face-to-face to digital communication technologies. This study aimed to examine how digital transformation practices affect human behavioral change digitally, and how perceived COVID-19 severity affects digital transformation practices and behavioral decisions. We use the traditional theory of planned behavior (TPB) to determine new behavioral roles in the digital era, namely digitally planned and transformed behavior. The quantitative survey method was designed to collect cross-sectional data from 550 Thai citizens to provide the conceptual evidence of key proximal measures of digital attitude, digital social norms, digital behavioral control perception, and the digital behavioral decision to predict digitally planned and transformed behavior. The results show that people are more likely to digitalize than before, which predicts the decision to behave digitally at 93.9% of the variability, more than 75% of the predictive power of the total variance suggested by Hair, Ringle, and Sarstedt [1]. However, the higher the COVID-19 severity, the more likely digital transformation is impactful (β = 0.481). This study provides interesting evidence that people struggle to transform their digital behavior during the pandemic. We demonstrate that digital transformation can offer the desired consequences by cultivating digital attitudes, promoting digital social norms, increasing digital behavioral control perception, and enhancing digital behavioral decisions.

Media, Trust in Government, and Risk Perception of COVID-19 in the Early Stage of Epidemic: An Analysis Based on Moderating Effect

Previous research has revealed that environmental, social, and cultural factors affect people's risk perception of COVID-19, especially the influence of media and trust, while the dynamics of how they affect it is still not clear. Through the analysis of online survey data, this article shows that there are two opposed paths of action. Trust in the government will enhance people's confidence in controlling COVID-19. It then moderates and decreases the effects of people's level and frequency of concernon the risk perception (both cognition and worries) of COVID-19, on the contrary, obtaining information from unofficial channels also moderates and increases the effects of the people's level and frequency of concern on the second dimension (worries) of risk perception of COVID-19 rather than the first dimension (cognition). These conclusions have important policy implications for the control of the COVID-19 epidemic all over the world.

Predictive Model of Preventive Behaviors against COVID-19 in the Older Adult: The PREASOC-COVID-19 Study

Background: The purpose of this study was to analyze the relationship between COVID-19 preventive behaviors, as the dependent variable, with risk perception, coping style and sense of coherence, as independent variables, in older people living in the community. Methods: An observational design for predictive model development. This study was reported following the STROBE statement. The subjects were people over 65 years of age living in the community. Data collection included sociodemographic variables related to COVID-19, risk perception and types, coping styles in the face of contagion, sense of coherence, and preventive behaviors in the face of COVID-19. The data collection period was from November 2020 to January 2021. Results: A total of 305 people participated in this study (71.5% women, mean age 71.34 years; 6.9% suffered from COVID-19 and 44.3% knew someone close to them who suffered from the virus). The coping style variables problem-focused, emotion-focused, and sense of coherence subscales Significance and manageability explained 17% of the variable preventive behaviors against COVID-19. There were statistically significant differences by gender in all subscales, with women scoring higher in all of them; Conclusions: Men with low risk perception, extrinsic risk perception, and low sense of coherence presented worse COVID-19 preventive behaviors. It would be interesting to develop specific prevention and health education campaigns for this population.

The Health Belief Model as an explanatory framework for COVID-19 prevention practices

Background

The COVID-19 government public health measures are necessary to prevent the spread of COVID-19, however, their efficacy is largely dependent on adherence. This study utilized the Health Belief Model (HBM) to explain the public’s adopted prevention practices during the COVID-19 outbreak in Saudi Arabia.

Methods

This study used “COVID-19 Snapshot MOnitoring (COSMO): monitoring knowledge, risk perceptions, preventive behaviours, and public trust in the current coronavirus outbreak” research protocol which is developed by the WHO Regional Office for Europe and the COSMO group. The COSMO questionnaire was translated into Arabic and distributed as an online survey via WhatsApp instant messaging application from May 2nd to May 26th, 2020. The dependent variable was the mean of adopting ten COVID-19 preventive practices. These practices were hand washing, avoiding touching eyes, nose and mouth, use of hand sanitizer, covering mouth and nose when coughing/sneezing, staying home when sick, avoiding close contact with infected persons, social distancing, wearing masks, home isolation, and lockdown. The independent variables included the HBM constructs (susceptibility to and severity of COVID-19, benefits of and barriers to adopting preventive behaviors, cues to action, health motivation, and self-efficacy), sociodemographic factors, presence of chronic illness, and perceived and actual knowledge. We conducted bivariate and multivariate analyses and reported significant findings (P ≤ 0.05).

Results

We analyzed 1027 surveys. About 38% adhered to all COVID-19 preventive behaviors and the mean for adherence was 9. The HBM perceived benefits (p = 0.001), perceived barriers (p = 0.004), and cues to action (p = 0.046) were associated with adherence to COVID-19 preventive behaviors after adjusting for all other factors. Respondents with the highest levels of education and income were less likely to adopt COVID-19 preventive behaviors compared to those in the lower ranks of education and income.

Conclusion

Our findings suggest that the HBM can be applied to understand adherence to COVID-19 prevention practices. The recognition of perceived health beliefs and practices is important for developing effective COVID-19 health intervention strategies.

COVID-19-related stigma and its influencing factors: a nationwide cross-sectional study during the early stage of the pandemic in China

OBJECTIVES

To describe the situation of COVID-19-related stigma towards patients with COVID-19 and people from the city of Wuhan in China and to assess the associations between COVID-19-related stigma, health literacy and sociodemographic characteristics during March 2020, the early stage of the pandemic.

DESIGN

A cross-sectional online survey.

SETTING

The study surveyed 31 provinces in China.

PARTICIPANTS

This study surveyed 5039 respondents in China.

OUTCOME MEASURES

Public stigma towards both patients with COVID-19 and Wuhan residents was measured. Binary logistic regression was used to identify the factors associated with public COVID-19-related stigma.

RESULTS

Among the participants, 122 (2.4%) reported themselves and 254 (5.0%) reported the communities they lived in as holding a stigmatising attitude towards patients with COVID-19, respectively. Additionally, 114 (2.5%) and 475 (10.3%) reported that themselves and the communities they lived in, respectively, held a stigma against people from Wuhan, which was the most severely affected area in China. People aged over 40, lived in areas with severe epidemics (adjusted OR (aOR)=2.03, 95% CI (1.05 to 3.92)) and who felt it difficult to find and understand information about COVID-19 (aOR=1.91, 95% CI (1.08 to 3.37); aOR=1.88, 95% CI (1.08 to 3.29)) were more likely to stigmatise patients with COVID-19. People who were male, aged 41-50 and had difficulty understanding information (aOR=2.08, 95% CI (1.17 to 3.69)) were more likely to stigmatise people from Wuhan.

CONCLUSIONS

Patients with COVID-19 and Wuhan residents suffered stigma at both the individual and the community levels. Those who had low health literacy, who lived in areas with a large number of COVID-19 cases and who were of ethnic minorities were more likely to stigmatise others. Tailored interventions are encouraged to improve health literacy and consequently to reduce public COVID-19-related stigma.

Factors associated with COVID-19 preventive health behaviors among the general public in Mexico City and the State of Mexico

Objective

To evaluate factors associated with COVID-19 preventive health behaviors among adults in Mexico City and the State of Mexico.

Methods and findings

We conducted a cross-sectional survey from June to October 2020 through a structured, internet-based questionnaire in a non-probabilistic sample of adults >18 years living in Mexico City and the State of Mexico. The independent variables included sociodemographic and clinical factors; health literacy; access to COVID-19 information; and perception of COVID-19 risk and of preventive measures’ effectiveness. The dependent variable was COVID-19 preventive health behaviors, defined as the number of preventive actions adopted by participants. The data were analyzed through multivariate negative binomial regression analysis. The survey was completed by 1,030 participants. Most participants were women (70.7%), had a high school or above level of education (98.8%), and had adequate health literacy and access to COVID-19 information. Only 18% perceived having a high susceptibility to COVID-19, though 83.8% recognized the disease’s severity and 87.1% the effectiveness of preventive measures. The median number of COVID-19 preventive actions was 13.5 (range 0–19). The factors associated with preventive health behavior were being female, of older age, a professional worker, a homemaker, or a retiree; engaging in regular physical exercise; having high health literacy and access to COVID-19 information sources; and perceiving COVID-19 as severe and preventive measures as effective.

Conclusion

People with high education and internet access in Mexico City and the State of Mexico reported significant engagement in COVID-19 preventive actions during the first wave of the COVID-19 pandemic.

Who complies with coronavirus disease 2019 precautions and who does not?

PURPOSE OF REVIEW

Severe acute respiratory syndrome (SARS)-coronavirus disease 2019 (COVID-19) virus imposes a higher risk of complications and mortality among people with mental disorders. Until widely available vaccines, adherence to preventive behaviours remains the most crucial tool to prevent SARS/COVID-19 virus transmission. Our review focuses on the determinants of adherence behaviours.

RECENT FINDINGS

Adherence behaviours include the use of a face mask and protective gloves, personal hygienic behaviours (handwashing or using hand sanitiser), and keeping physical distance and avoiding social gatherings. In almost all studies, males and younger people show less adherence. Risk perception and health beliefs (especially perceived severity of COVID-19 related conditions) can explain the sex and age differences in adherence. Studies covering the impact of mental disorders on adherence are surprisingly missing, with the exception of smoking.

SUMMARY

Engaging men and young people in adopting preventive behaviours is crucial in protecting the whole community and specific vulnerable populations. There is a lack of studies investigating preventive behaviours among people living with mental disorders and addiction problems. Furthermore, descriptive and intervention studies are needed to understand and improve the adherence of this population to preventive behaviours.

Habitability, Resilience, and Satisfaction in Mexican Homes to COVID-19 Pandemic

Following the 2020 confinement due to the COVID-19 pandemic, housing has become the only safe place and this has exposed inequity in habitability. This research on the reality of confined households and the perception of their homes in the Mexican republic is based on a mixed participatory study, combining quantitative and qualitative approaches. The online questionnaire consisted of 58 questions in the quantitative approximation. The qualitative part required the provision of an image of the workspace, with testimonies and personal reflections. During the lockdown, all participants saw an increase in overall energy consumption; more than half reported not being in thermal comfort; and a third declared deficiencies in noise insulation. Regarding the perception of the telework/tele-study space, we found the following categories: bedrooms, living/dining rooms, studies and others. In addition, respondents had often adapted the workspace for both individual and shared use. In general, the households were satisfied with the size of their houses but would like landscaped spaces or better views outside. Confinement made housing the protective element against the pandemic. The consequences will have an effect globally, so new architectural design paradigms need to be rethought.

Perceptions towards COVID-19 and adoption of preventive measures among the public in Saudi Arabia: a cross sectional study

BACKGROUND

Effective management of the spread of a novel infectious disease, such as the COVID-19 virus can be achieved through influencing people's behavior to adopt preventive measures. The public's perceptions and attitudes towards the virus, governmental guidance and preventive measures were unknown in Saudi Arabia.

OBJECTIVES

1) investigate the public perception of COVID-19, anxiety level, the COVID-19 information sources sought, adoption of preventive measures, and ability and willingness to self-isolate during and post-lockdown periods of the COVID-19 pandemic in Saudi Arabia; 2) investigate socio-demographic factors associated with adoption of preventive measures against COVID-19 and self-isolation practices.

METHOD

Between April 22nd and June 21st 2020, Saudi adults aged ≥18 years voluntarily completed a self-administered web-based cross-sectional survey, distributed through social media (WhatsApp) and emails to representatives in education, health, business, and social sectors across all Saudi Arabian regions. The survey included questions on anxiety level, COVID-19 risk perceptions and adoption of preventive measures. Weighted percentages, Pearson's chi-square tests, and multiple logistic regression were applied to evaluate associations between these factors and socio-demographic variables.

RESULTS

A total of 2393 respondents completed the survey. A majority (74%) were worried about the COVID-19 outbreak and of those, 27% reported that it was likely that they would be infected with COVID-19; 16% believed it would be life-threatening or severe. However, only 11% of respondents reported high anxiety level. Adoption of hygiene practices and social distancing were lower among older (> 65 years) compared to younger (18-24 years) respondents (OR: 0.06; 95% CI: 0.01, 0.28 and OR 0.06; 95% CI: 0.01, 0.27 respectively). High percentages of respondents reported being able to (88%) and were willing to (82%) self-isolate. Those with the lowest gross household income and those with at least one flu symptom were less able and willing to self-isolate. A significant increase in levels of anxiety, perceived effectiveness of social distancing and hygiene practices was reported in the post-lockdown compared to during the lockdown.

CONCLUSIONS

The study reported high levels of adoption of preventive measures, willingness and perceived ability to self-isolate during the early phase of the pandemic. Vulnerable groups such as the elderly, and those with low socio-economic status reported lower adoption of preventive measures or ability and willingness to self-isolate. Tailored public health messages and interventions are needed to achieve high adherence to these preventive measures in these groups.

Resilience in the Storm: Impacts of Changed Daily Lifestyles on Mental Health in Persons with Chronic Illnesses under the COVID-19 Pandemic

Studies have shown individuals with chronic illnesses tend to experience poorer mental health compared to their counterparts without a chronic illness under the COVID-19 pandemic. The pervasive disruption on daily lifestyles due to social distancing could be a contributing factor. In this study, we collaborated with local patient support groups to explore the psychological adjustment among a group of community-dwelling individuals with chronic illnesses under the COVID-19 pandemic in Hong Kong. We collected responses from 408 adults with one or more chronic illnesses using an online survey. Results show that about one in four participants experienced moderate to high levels of depression (26.0%), anxiety (26.2%) and stress (20.1%) symptoms measured by the Depression, Anxiety and Stress Scale and the World Health Organisation-Five Well-Being Index. While 62.3% (gatherings) to 91.9% (contact with others) of participants reported changes in their daily lifestyles, these changes—both an increase and a decrease—were related to poorer mental health. The relationship was mediated by psychological resilience, measured by the Connor–Davidson Resilience Scale, with an estimate of indirect effect of −0.28 (95% confidence interval −0.44 to −0.10). In light of our findings, we urge social and healthcare professionals to support chronic illness patients to continue their daily lifestyles such as exercises and social contacts as much as possible by educating the public on feasible and practical preventive measures and enhance the psychological resilience of community-dwelling patients with scalable and efficacious psychological interventions.

Knowledge, Emotions and Stressors in Front-Line Healthcare Workers during the COVID-19 Outbreak in Mexico

The aim of this study was to explore the knowledge, emotions and perceived stressors by healthcare workers who were in contact with infected patients during the COVID-19 outbreak. An online cross-sectional survey was applied. Data were collected from N = 263 healthcare workers in Tabasco State, Mexico. We developed and administered a questionnaire, which consisted of sociodemographic characteristics, plus four sections. The sections evaluated were (1) knowledge of COVID-19; (2) feelings/emotions during the COVID-19 outbreak; (3) factors that caused stress and (4) factors that helped to reduce stress. Surveyed individuals were divided into three groups: physicians, nurses and other healthcare workers. When we evaluated their knowledge of COVID-19 we observed that the majority of healthcare workers in the three groups reported that they knew about COVID-19. Physicians indicated that they felt insecure about practicing their profession (62.5%) due to the high risk of being in contact with SARS-CoV-2. With regards to stressor factors, the risk of transmitting COVID-19 to their families was the main factor causing moderate to high stress (95.4%). Finally, we found that "your profession puts your life at risk" was the only factor associated with feeling nervous and scared (PR: 3.15; 95% CI: 1.54-6.43). We recommended health education campaigns, introductory courses on COVID-19 and other infectious diseases, management protocols and the provision of protection equipment to health workers in order to reduce personal and professional fears of contagion and to improve the health system in Mexico when facing epidemics.

It's Not the Flu: Popular Perceptions of the Impact of COVID-19 in the U.S

Messaging from U.S. authorities about COVID-19 has been widely divergent. This research aims to clarify popular perceptions of the COVID-19 threat and its effects on victims. In four studies with over 4,100 U.S. participants, we consistently found that people perceive the threat of COVID-19 to be substantially greater than that of several other causes of death to which it has recently been compared, including the seasonal flu and automobile accidents. Participants were less willing to help COVID-19 victims, who they considered riskier to help, more contaminated, and more responsible for their condition. Additionally, politics and demographic factors predicted attitudes about victims of COVID-19 above and beyond moral values; whereas attitudes about the other kinds of victims were primarily predicted by moral values. The results indicate that people perceive COVID-19 as an exceptionally severe disease threat, and despite prosocial inclinations, do not feel safe offering assistance to COVID-19 sufferers. This research has urgent applied significance: the findings are relevant to public health efforts and related marketing campaigns working to address extended damage to society and the economy from the pandemic. In particular, efforts to educate the public about the health impacts of COVID-19, encourage compliance with testing protocols and contact tracing, and support safe, prosocial decision-making and risk assessment, will all benefit from awareness of these findings. The results also suggest approaches, such as engaging people's stable values rather than their politicized perspectives on COVID-19, that may reduce stigma and promote cooperation in response to pandemic threats.

The Impact of COVID-19 Restrictions on Mental Well-Being and Working Life among Faroese Employees

The societal changes caused by COVID-19 have been far-reaching, causing challenges for employees around the world. The aim of this study was to assess the effect of the COVID-19 restrictions on mental well-being, working life, family life and social life among Faroese employees within a broad range of professions. A total of 1328 Faroese employees answered an anonymous self-report survey from 13 April to 4 May 2020. Employee mental well-being was only modestly affected by the restrictions and the respondents had a mean score of 50.7 on the Warwick-Edinburgh Mental Wellbeing Scale where a score between 41-44 is found to correspond with possible depression. Work commitment, work and family life, work satisfaction and work ability were all rated significantly worse after the COVID-19 outbreak than before (all p values < 0.005). Contrary to previous research, employees in health services assessed their work ability significantly higher than employees in teaching, and child and youth care (p < 0.05). Working parents had higher levels of stress and assessed their work ability significantly lower than employees without children (p < 0.05), and women tended to be more worried than men because of the pandemic. In conclusion, the overall mental well-being of Faroese employees was on an average level during lock-down in April and May 2020. Their working life seemed, however, to be worse than usual.

The Collateral Damage of the COVID-19 Outbreak on Mental Health and Psychiatry

The potential consequences of the COVID-19 outbreak are multifarious and remain largely unknown. Deaths as a direct result of the condition are already in the millions, and the number of indirect deaths is likely to be even higher. Pre-existing historical inequalities are compounded by the virus, driving increased rates of infection and deaths amongst people who use drugs and alcohol, those belonging to racial-ethnic minority groups, poorer communities, LBGTQ+ populations, healthcare workers, and other members of the care economy; all of whom are already at increased risk of adverse mental health effects. In this paper we suggest that a central role of mental health practitioners is advocacy: both for people who use psychiatric services and for those who, due to the effects of the pandemic, are at an increased risk of needing to do so.

Increased COVID-19 Vaccination Hesitancy and Health Awareness amid COVID-19 Vaccinations Programs in Israel

In January 2021, Israel started vaccinating healthcare workers (HCWs) and individuals older than 65 years with COVID-19 vaccines. Scientific literature points to vaccine hesitancy as being a major health concern. During time of pandemics, increased consciousness of health behaviors may be encountered. The current study aimed to assess attitudes to general vaccines and to COVID-19 vaccines in particular among adult (>18) Israeli general public, and among Israeli dentists and dental hygienists. Cross-sectional surveys were filled out by a total of 501 participants (361 Israeli adults >18 years, 73 dental hygienists, and 67 dentists). Along with basic demographics, participants responded to the Hebrew VAX, COVID-VAX and HCS scales. Group comparisons were analyzed using t tests and ANOVAs with Scheffe's test used for post hoc comparisons. Dental hygienists demonstrated significantly higher anti-vaccinations approaches than both dentists (p < 0.01) and the general public (p < 0.05). In all groups, attitudes towards the COVID-19 vaccines were more negative compared to attitudes towards general vaccines, with hygienists demonstrating significant negative attitudes compared to dentists (p < 0.05). The general public (p = 0.56) and hygienists demonstrated increased health awareness compared to dentists (p < 0.05). As health awareness has increased during the COVID-19 pandemic primary strategies to combat vaccine hesitancy should be implemented in the general public, and in particular, an dental teams.

Fear of COVID-19 for Individuals and Family Members: Indications from the National Cross-Sectional Study of the EPICOVID19 Web-Based Survey

The study analyzed the association of the fear of contagion for oneself and for family members (FMs) during the first wave of the COVID-19 pandemic, with demographic and socioeconomic status (SES) and health factors. The study was performed within the EPICOVID19 web-based Italian survey, involving adults from April-June 2020. Out of 207,341 respondents, 95.9% completed the questionnaire (60% women with an average age of 47.3 vs. 48.9 years among men). The association between fear and demographic and SES characteristics, contacts with COVID-19 cases, nasopharyngeal swab, self-perceived health, flu vaccination, chronic diseases and specific symptoms was analyzed by logistic regression model; odds ratios adjusted for sex, age, education and occupation were calculated (aORs). Fear for FMs prevailed over fear for oneself and was higher among women than men. Fear for oneself decreased with higher levels of education and in those who perceived good health. Among those vaccinated for the flu, 40.8% responded they had feelings of fear for themselves vs. 34.2% of the not vaccinated. Fear increased when diseases were declared and it was higher when associated with symptoms such as chest pain, olfactory/taste disorders, heart palpitations (aORs > 1.5), lung or kidney diseases, hypertension, depression and/or anxiety. Trends in fear by region showed the highest percentage of positive responses in the southern regions. The knowledge gained from these results should be used to produce tailored messages and shared public health decisions.

Sources of COVID-19-Related Information in People with Various Levels of Risk Perception and Preventive Behaviors in Taiwan: A Latent Profile Analysis

The present study aimed to identify the distinct levels of risk perception and preventive behaviors during the coronavirus disease 2019 (COVID-19) outbreak among people in Taiwan and to examine the roles of information sources in various levels of risk perception and preventive behavior. The online survey recruited 1984 participants through a Facebook advertisement. Their self-reported risk perception, adopted preventive behaviors and COVID-19-related information were collected. We analyzed individuals’ risk perception and adopted preventive behaviors by using latent profile analysis and conducted multinomial logistic regression of latent class membership on COVID-19-related information sources. Four latent classes were identified, including the risk neutrals with high preventive behaviors, the risk exaggerators with high preventive behaviors, the risk deniers with moderate preventive behaviors, and the risk deniers with low preventive behaviors. Compared with the risk neutrals, the risk exaggerators with high preventive behaviors were more likely to obtain COVID-19 information from multiple sources, whereas the risk deniers with moderate preventive behaviors and risk deniers with low preventive behaviors were less likely to obtain COVID-19 information compared with the risk neutrals. Governments and health professions should take the variety of risk perception and adopted preventive behaviors into consideration when disseminating information on COVID-19 to the general public.

The Moderating Effects of Perceived Severity on the Generational Gap in Preventive Behaviors during the COVID-19 Pandemic in the U.S

During the COVID-19 pandemic, older adults appear to be more susceptible to the coronavirus disease. Although the health stakes are higher for older adults, individuals of all ages should adopt preventive measures to contain the human-to-human transmission of the virus. This study conducted a national online survey of 1843 adults at the early stage of the COVID-19 pandemic in the U.S. to examine age disparities in preventive behaviors against the virus. The results show that older generations, motivated by a higher perceived severity of the disease, were more likely to take the precautionary actions recommended by the U.S. Centers for Disease Control and Prevention (CDC) than younger generations. This thus suggests that persuasive health messages addressing the severity of COVID-19 might reduce the generational gap and promote preventive behaviors among young people, to protect themselves and the elderly.

Well-Being and Fear of Missing Out (FOMO) on Digital Content in the Time of COVID-19: A Correlational Analysis among University Students

The majority of research on the fear of missing out (FOMO) has focused on understanding how social media posts about attractive unattended experiences taking place in the physical world (e.g., a friend's vacation) influence individuals' affective states. With quarantine measures in place, and in the absence of travel and party photos on social media, do individuals feel they are missing out on enjoyable experiences? The current work shows that FOMO has not disappeared during the pandemic, even when socially distancing at home, but has been replaced by feelings towards new online activities (e.g., online concerts, virtual gatherings). As a consequence, we find that FOMO threatens well-being by causing important psychological and health issues, such as sleep deprivation, loss of focus, declined productivity, and finding relief in knowing that others have difficulty keeping up with abundant digital content. Importantly, we find these consequential effects both during the initial (May 2020) and late stages (December 2020) of the pandemic. With excessive Internet use and virtual FOMO likely to be a continuing reality of life, questions remain as to how one can refrain from its negative effects and stay healthy during the pandemic and in the post-pandemic era. We discuss remedies and suggest new research avenues that may help elevate the negative consequences of FOMO on well-being.

The Role of Employee Relations in Shaping Job Satisfaction as an Element Promoting Positive Mental Health at Work in the Era of COVID-19

The COVID-19 pandemic is affecting the mental health of employees. Deterioration of the well-being of workers is also caused by changes in the working environment. Remote working can affect both social interactions and job satisfaction. The purpose of the study is to examine what factors influence job satisfaction in the context of remote work caused by a pandemic. The study analyses whether employee relations and interpersonal trust are related to the level of perceived job satisfaction. The investigation started with a literature review and then research hypotheses have been formulated. Based on an empirical study, carried out on a sample of 220 IT employees during the pandemic, an analysis of the mediating role of trust in links between employee relations and perceived job satisfaction was conducted. The current study found that positive employee relations contribute to the level of job satisfaction. Additionally, trust is an important factor that mediates these relationships. Based on the results of the research, it was possible to describe the mechanism of shaping a supportive work environment during a pandemic.