Pathways Improving Compliance with Preventive Behaviors during the Remission Period of the COVID-19 Pandemic

Mixed methods examination of risk perception on vaccination intentions: The perspective of doctor-patient communication

AIM

From the perspective of doctor-patient communication, this research used multiple methods combined natural language processing (NLP), a cross-sectional survey and an online experiment to investigated how risk perception influenced people's vaccination intention.

METHODS

In Study 1, we used Python to crawl 335,045 comments about COVID-19 vaccine published in a social media platform Sina Weibo (equivalent of Twitter in China) from 31 December 2020 to 31 December 2021. Text analysis and sentiment analysis was used to examine how vaccination intention, as measured by linguistic features from the LIWC dictionary, changed with individuals' perceptions of pandemic risk. In Study 2, we adopted a cross-sectional questionnaire survey to further test the relation of risk perception, vaccination intention, trust in physicians, and perceived medical recommendations in a Chinese sample (n = 386). In Study 3, we conducted an online experiment where we recruited 127 participants with high trust in physicians and 127 participants with low trust, and subsequently randomly allocated them into one of three conditions: control, rational recommendation, or perceptual recommendation.

RESULTS

Text and sentiment analysis revealed that the use of negative words towards COVID-19 vaccine had a significant decrease at high (vs. low) risk perception level time (Study 1). Trust in physicians mediated the effect of risk perception on vaccination intention and this effect was reinforced for participants with low (vs. high) level of perceived medical recommendation (Study 2), especially for the rational (vs. perceptual) recommendation condition (Study 3).

CONCLUSION

Risk perception increased vaccination intention through the mediating effect of trust in physicians and the moderating effect of perceived medical recommendations. Rational (vs. perceptual) recommendation is more effective in increasing intention to get vaccinated in people with low trust in physicians.

Mapping the association between mental health and people's perceived and actual ability to practice hygiene-related behaviours in humanitarian and pandemic crises: A scoping review

Humanitarian crises such as disease outbreaks, conflict and displacement and natural disasters affect millions of people primarily in low- and middle-income countries. Here, they often reside in areas with poor environmental health conditions leading to an increased burden of infectious diseases such as gastrointestinal and respiratory infections. Water, sanitation, and hygiene behaviours are critical to prevent such infections and deaths. A scoping review was conducted to map out what is known about the association between three mental health disorders and people's perceived and actual ability to practice hygiene-related behaviours, particularly handwashing, in humanitarian and pandemic crises. Published and grey literature was identified through database searches, humanitarian-relevant portals, and consultations with key stakeholders in the humanitarian sector. 25 publications were included, 21 were peer-reviewed published articles and four were grey literature publications. Most of the studies were conducted in mainland China (n = 12) and most were conducted in an outbreak setting (n = 20). Six studies found a positive correlation between handwashing and anxiety where participants with higher rates of anxiety were more likely to practice handwashing with soap. Four studies found an inverse relationship where those with higher rates of anxiety were less likely to wash their hands with soap. The review found mixed results for the association between handwashing and depression, with four of the seven studies reporting those with higher rates of depression were less likely to wash their hands, while the remaining studies found that higher depression scores resulted in more handwashing. Mixed results were also found between post-traumatic stress disorder (PTSD) and handwashing. Two studies found that lower scores of PTSD were associated with better hygiene practices, including handwashing with soap. The contradictory patterns suggest that researchers and practitioners need to explore this association further, in a wider range of crises, and need to standardize tools to do so.

Diet Quality of Older African Americans: Impact of Knowledge and Perceived Threat of COVID-19

Confusing health messages and environmental changes intended to prevent the spread of the COVID-19 virus have affected the dietary behavior of older African Americans. We investigated the impact of COVID-19-related factors on diet quality and the relationship between food access and diet quality. We surveyed 150 African Americans aged 55 years and above during the COVID-19 pandemic. The data obtained included socio-demographic and health information, and COVID-19-related knowledge and perceptions. Dietary intake data was obtained using the Diet History Questionnaire III. Analyses included bivariate and multivariable statistics. Overall, based on United States Department of Agriculture guidelines, the diet quality of older African Americans was poor. Lower knowledge and a lower perceived threat of COVID-19 were significantly associated with poor diet quality. Additionally, older African Americans with chronic diseases and food insecurity had poor diet quality. The COVID-19 pandemic has highlighted the fragility of diet quality. The combined impact of poor knowledge and perceived threat of COVID-19, chronic disease, and food insecurity contribute to poor diet quality in this population. This study adds to the well-known need for strategies to support the right to a healthy diet, particularly during COVID-19 and future pandemics. Proactive interventions to counteract the potential consequences of poor diets are needed.

Association between Mental Health and Hand Hygiene Practices in Adults with Hypertension and Diabetes during the COVID-19 Pandemic: The 2020 Korea Community Health Survey

The preventive measures against the spread of COVID-19 have negatively impacted the mental health of people with chronic diseases. This cross-sectional study investigated the association between mental health and hand hygiene practices in patients with hypertension (HTN) and diabetes mellitus (DM) (n = 74,296) during the COVID-19 pandemic. Their anxiety about contracting COVID-19 and death, depression, and hand hygiene practices were compared to that of controls. Multiple logistic regression analysis showed that the patients had higher anxiety and depression and poorer hand hygiene practices than controls. Anxiety about contracting COVID-19 was associated with increased handwashing before eating (aOR = 1.59), after using the restroom (aOR = 1.61), after returning from outdoors (aOR = 1.69), for at least 30 s (aOR = 1.45), and with soap or hand sanitizer (aOR = 1.43). However, depression was associated with decreased handwashing before eating (aOR = 0.50), after using the restroom (aOR = 0.51), after returning from outdoors (aOR = 0.51), for at least 30 s (aOR = 0.73), and with soap or hand sanitizer (aOR = 0.63). Anxiety about death showed similar results. Psychological support for people with chronic diseases in crisis situations may promote self-care activities such as hand hygiene for infection control.

A Moderated Mediation Model Explaining the Relationship Between Risk-Group Membership, Threat Perception, Knowledge, and Adherence to COVID-19 Behavioral Measures

Background

COVID-19 is a threat to individual and global health, thus, reducing the disease's spread is of significant importance. However, adherence to behavioral measures against the spread of COVID-19 is not universal, even within vulnerable populations who are at higher risk of exposure to the virus or severe COVID-19 infection. Therefore, this study investigates how risk-group membership relates to adherence to COVID-19 behavioral measures, whether perceived threat of COVID-19 is a mechanism explaining this relationship, and whether knowledge about COVID-19 moderates these effects.

Methods

We conducted a web-based survey (N = 4,096) representative of the adult population in Germany with regard to gender, age (18 to 74), and province. Therein, we assessed risk group membership with two indicators (risk of exposure to COVID-19 and risk of severe COVID-19 infection), perceived COVID-19 threat with the Perceived Coronavirus Threat Questionnaire, knowledge about COVID-19 with a knowledge test; and adherence to six behavioral measures to protect against the spread of COVID-19 (e.g., keeping distance, using mouth-nose protection, and following contact restrictions). We used moderated mediation models to test whether perceived threat mediates the relationship between risk-group membership and adherence and whether knowledge about COVID-19 moderates this relationship.

Results

We found that risk group members had more perceived COVID-19 threat and that knowledge about COVID-19 increased perceived threat. Moreover, risk group membership had a positive direct effect on adherence to most behavioral measures and risk group members with less knowledge about COVID-19 violated measures more frequently. Risk-group membership also had positive indirect effects on adherence via perceived COVID-19 threat. The moderated indirect effects of threat indicate that threat led to more adherence when knowledge was low, but lost relevance as knowledge increased.

Conclusion

The results may help to evaluate disease-regulation measures and to combat the pandemic more effectively. For example, increasing COVID-19 knowledge in the general population could increase adherence to COVID-19 behavioral measures. However, policy makers should be mindful that this could also have negative mental health implications as knowledge increases perceived COVID-19 threat.

Identifying Predictive Factors in Compliance with the COVID-19 Containment Measures: A Mediation Analysis

INTRODUCTION

The outbreak of the COVID-19 pandemic has led governments to implement some containment measures to flatten the curve of the diffusion of the virus. The current study aims to investigate individual differences in compliance with these restrictive behaviors. In a sample of Italian individuals (N = 300), we examined whether sociodemographic factors, personality traits, fatalism, and fear could be considered as possible predictors.

METHODS

We performed a series of standard multiple regression analyses and proposed a mediation analysis to test the associations among variables.

RESULTS

Overall, our results suggested that men are less likely to engage in preventive behaviors, younger individuals are more reluctant to adhere to social distancing mandates, and fear has a functional role in predicting positive outcomes.

CONCLUSION

The results of our analyses are discussed and suggestions for future research are provided.