Sociodemographic, Cognitive, and Emotional Determinants of Two Health Behaviors during SARS-CoV-2 Outbreak: An Online Study among French-Speaking Belgian Responders during the Spring Lockdown

Predicting health behaviors during the COVID-19 pandemic: A longitudinal study

We investigated the social, emotional, and cognitive predictors of adherence to four health behaviors (handwashing, mask wearing, social contact limitations, and physical distancing) during one critical phase of the COVID-19 pandemic. We collected data (N = 5803, mean age = 53; 57% women) in Belgium at five time points between April and July 2021, a time during which infections evolved from high (third wave of the pandemic) to low numbers of COVID-19 cases. The results show that the social, emotional, and cognitive predictors achieved high levels of explained variance (R2 > .60). In particular, the central components of behavioral change (attitudes, intentions, control, habits, norms, and risk) were the strongest and most consistent predictors of health behaviors over time. Likewise, autonomous motivation and empathetic emotions (e.g., attentive, compassionate) had a positive impact on health behavior adherence, whereas it was the opposite for lively emotions (e.g., active, enthusiastic). These results offer policymakers actionable insights into the most potent and stable factors associated with health behaviors, equipping them with effective strategies to curtail the spread of future infectious diseases.

The role of self-compassion in loneliness during the COVID-19 pandemic: a group-based trajectory modelling approach

Research has suggested an increase in loneliness during the COVID-19 pandemic, but much of this work has been cross-sectional, making causal inferences difficult. In the present research, we employed a longitudinal design to identify loneliness trajectories within a period of twelve months during the COVID-19 pandemic in Belgium (N = 2106). We were particularly interested in the potential protective role of self-compassion in these temporal dynamics. Using a group-based trajectory modelling approach, we identified trajectory groups of individuals following low (11.0%), moderate-low (22.4%), moderate (25.7%), moderate-high (31.3%), and high (9.6%) levels of loneliness. Findings indicated that younger people, women, and individuals with poor quality relationships, high levels of health anxiety, and stress related to COVID-19, all had a higher probability of belonging to the highest loneliness trajectory groups. Importantly, we also found that people high in two of the three facets of self-compassion (self-kindness and common humanity) had a lower probability of belonging to the highest loneliness trajectory groups. Ultimately, we demonstrated that trajectory groups reflecting higher levels of loneliness were associated with lower life satisfaction and greater depressive symptoms. We discuss the possibility that increasing self-compassion may be used to promote better mental health in similarly challenging situations.

Trajectories of health behaviors during the COVID-19 pandemic: a longitudinal analysis of handwashing, mask wearing, social contact limitations, and physical distancing

AIM

This study aimed to investigate the associations between health behavior adherence and psychological factors during the COVID-19 pandemic, with a particular focus on identifying trajectories of handwashing, mask wearing, social contact limitations, and physical distancing.

METHODS

We employed a multi-trajectory group-based approach to analyze data from 6026 Belgian residents, including 60% women, with an average age of 52.65. Data were collected over six waves spanning from April 2021 to December 2021.

RESULTS

Participants were categorized into trajectory groups based on persistently low (11.9%), moderate-low (20.9%), moderate-high (39.1%), and high (28.1%) levels of adherence to the specified health behaviors. Our findings indicate a declining trend in health behavior adherence over the study period. Additionally, we observed that females, older individuals, and those with prior COVID-19 infection had a higher likelihood of belonging to trajectory groups characterized by the highest levels of health behavior adherence. Similarly, individuals with positive vaccination intentions, a heightened perception of consequences, and increased health anxiety demonstrated greater adherence to health behaviors over time. Furthermore, our investigation into the relationship between health behaviors and mental health revealed that participants in trajectory groups with higher levels of adherence to social contact limitations and physical distancing reported increased feelings of loneliness and decreased life satisfaction.

CONCLUSIONS

The COVID-19 pandemic has reshaped our lives, and while vaccines have marked progress, maintaining health behaviors is crucial for virus prevention. To address potential mental health challenges from sanitary measures, policies and communication should promote health behaviors while acknowledging their psychological impact.

Predicting Compliance with Sanitary Behaviors among Students in Higher Education During the Second COVID-19 Wave: The Role of Health Anxiety and Risk Perception

To limit the spread of COVID-19, public authorities have recommended sanitary behaviors such as handwashing, mask-wearing, physical distancing, and social distancing. We recruited a large sample of higher education students in Belgium (N = 3201-3441) to investigate the role of sociodemographic variables, mental health, previous COVID-19 infections, academic involvement, and risk perception on adherence to these sanitary behaviors. This cross-sectional study took place during the second COVID-19 wave in Belgium, between February and March 2021. Analyses showed that living alone, being female, later in the academic curriculum, having higher general and health anxiety, higher academic involvement, and higher risk perception were positively associated with adherence to the four aforementioned sanitary behaviors. Conversely, previous infection with COVID-19 and having been quarantined were negative predictors. Our results show a set of predictors highly similar for the four sanitary behaviors. We discuss potential initiatives to increase adherence to sanitary behaviors in this group of highly educated youngsters.

A cross-national and longitudinal analysis of handwashing and its predictors during the COVID-19 pandemic in France and Belgium

Background: Using a longitudinal design, we investigate how the adherence to handwashing and its underlying socio-psychological predictors evolved over time during the COVID-19 pandemic and under distinct circumstances (e.g. when the crisis was more acute or chronic). Method: We collected data (N = 753) in Belgium and France at the onset of the COVID-19 pandemic when the crisis was at its peak (April 2020), and almost a year later (February 2021), when the outbreak was more manageable. Results: Regression models suggest that the compliance with handwashing and its pattern of underlying predictors remained remarkably stable over time despite the variations in contextual factors such as the severity of the health crisis and the stringency of health measures. As such, the findings also highlight the robustness of the models that predict it, namely the Theory of Planned Behavior. The intentions to perform the behavior, the perceived control over it, and being part of the (para)medical field were among the strongest predictors. Conclusions: In practice, the stability of the underlying factors suggests a set of action levers that can be used in communication campaigns aimed at fostering its adherence throughout the pandemic.

Predicting health behaviors across Belgium and France during the first wave of COVID-19 pandemic

The objective of the current research was to investigate how a series of psychological factors may underlie two COVID-19 health behaviors, and how a contextual factor (country of residence) could shape their influence. Cross-sectional results from the first pandemic wave (N_Belgium = 4878, N_France = 1071) showed that handwashing and social contacts limitation are predicted by a unique set of psychological variables that holds across Belgium and France, despite their distinct lockdown-policies strictness. In practice, policy-makers could leverage on these unique predictors and fine-tune their strategies accordingly to promote adherence to each measure while generalizing it across similar nations.

Group-based trajectories and predictors of adherence to physical distancing during the COVID-19 pandemic

Objective: This study sought to identify psychosocial predictors of trajectories of adherence to physical distancing alongside changes in public health measures during the COVID-19 pandemic. Design: A three-time point longitudinal survey during the first two waves of the COVID-19 pandemic. Methods: Participants (N = 1003) completed self-report measures of adherence to physical distancing over an 8-month period at the start (T1) and end (T2) of the first wave of the pandemic, and the start of the second wave of the pandemic (T3). Participants also completed measures of their health beliefs related to the self and others, social norms, emotional distress, and sociodemographic characteristics. Results: Using group-based trajectory modeling, four trajectories of adherence to physical distancing emerged: a high-adherence trajectory, a slow-declining trajectory, a fluctuating trajectory, and a fast-declining trajectory. The most important psychosocial predictors of poorer adherence trajectories included perceptions of lower self-efficacy and higher barriers to adherence, as well as lower prosocial attitudes towards physical distancing. Conclusion: Public health messages targeting these factors may be most relevant to promote sustained adherence to physical distancing over time in the context of a pandemic.

Cognitive predictors of COVID-19 mitigation behaviors in vaccinated and unvaccinated general population members

BACKGROUND

Given the long-term threat posed by COVID-19, predictors of mitigation behaviors are critical to identify. Prior studies have found that cognitive factors are associated with some COVID-19 mitigation behaviors, but few studies employ representative samples and no prior studies have examined cognitive predictors of vaccination status. The purpose of the present study was to examine associations between cognitive variables (executive function, delay discounting, and future orientation) and COVID-19 mitigation behaviors (mask wearing, social distancing, hand hygiene and vaccination) in a population representative sample.

METHODS

A population representative sample of 2,002 adults completed validated measures of delay discounting, future orientation, and executive function. Participants also reported frequency of mitigation behaviors, vaccination status, and demographics.

RESULTS

Future orientation was associated with more mask wearing (β = 0.160, 95 % CI [0.090, 0.220], p < 0.001), social distancing (β = 0.150, 95 % CI [0.070, 0.240], p < 0.001), hand hygiene behaviors (β = 0.090, 95 % CI [0.000, 0.190], p = 0.054), and a higher likelihood of being fully vaccinated (OR = 0.80, 95 % CI [0.670, 0.970], p = 0.020). Lower delay discounting predicted more consistent mask wearing (β = -0.060, 95 % CI[-0.120, -0.010], p = 0.032) and being fully vaccinated (OR = 1.28, 95 % CI [1.13, 1.44], p < 0.001), while more symptoms of executive dysfunction predicted less mask wearing (β = -0.240, 95 % CI [-0.320, -0.150] p < 0.001) and hand hygiene (β = -0.220, 95 % CI [-0.320, -0.130], p < 0.001), but not vaccination status (OR = 0.96, 95 % CI [0.80, 1.16], p = 0.690) or social distancing behaviors (β = -0.080, 95 % CI [-0.180, 0.020], p = 0.097). Overall, social distancing was the least well-predicted outcome from cognitive factors, while mask wearing was most well-predicted. Vaccination status was not a significant moderator of these effects of cognitive predictors on mitigation behaviors.

CONCLUSIONS

Cognitive variables predict significant variability in mitigation behaviors. regardless of vaccination status. In particular, thinking about the future and discounting it less may encourage more consistent implementation of mitigating behaviors.

Applying the Reasoned Action Approach and Planning to Understand Diabetes Self-Management Behaviors

Individuals managing diabetes are required to adhere to self-management behaviors to ensure the optimal regulation of their blood glucose levels. This study examined the psychological determinants underlying three important diabetes self-management behaviors (e.g., physical activity, diet, and blood glucose monitoring) using the reasoned action approach (RAA) and planning. A cross-sectional design was used, with participants (N = 273) completing measures of RAA constructs (e.g., experiential and instrumental attitude, descriptive and injunctive norm, and capacity and autonomy) and planning (e.g., action and control planning) at time 1 and participation in the behaviors one week later at time 2. Regressions showed that RAA constructs accounted for good variance in intention and behavior in all behaviors. Intention towards diet and blood glucose monitoring was significantly predicted by instrumental attitude, injunctive norm, and capacity. Intention towards physical activity was significantly predicted by instrumental attitude, experiential attitude, injunctive norm, capacity, and autonomy. All behaviors were significantly predicted by intention, action planning, and coping planning. Additionally, capacity significantly predicted physical activity and autonomy significantly predicted diet and blood glucose monitoring. Successfully intervening in the influential psychological constructs identified in the study could ensure optimal blood glucose regulation in those managing diabetes.

At the Peak of the Second Wave of COVID-19, Did Millennials Show Different Emotional Responses from Older Adults?

The COVID-19 pandemic disturbs mental health. Indeed, higher levels of negative emotions and anxiety, along with lower levels of positive emotions and well-being, have been highlighted. As a result, individuals need to regulate these psychological states in a context of uncertainty and daily restrictions (e.g., access to leisure activities, social contacts) or modifications of livelihood (e.g., working modalities). Overall, psychological reactions to the pandemic have been shown to differ based on one's age. The purpose of this research is to compare psychological reactions to the pandemic between Millennials (born between 1981 and 1996) and Older Adults. The generation's prism seems relevant as members of specific generations are shaped (e.g., views of the world, the future) by their similar experiences. Ninety-four Millennials and 129 Older Adults, recruited in the general population, participated to an online survey assessing emotions, emotion regulation strategies, environmental satisfaction, and intolerance of uncertainty. Results show that Millennials experience higher levels of negative emotions along with higher levels of worry and rumination than Older Adults. Millennials also report a higher level of joy. Nonetheless, more Older Adults engage themselves in novel activities. Overall, findings confirm previous ones and indicate the need to offer effective clinicals tool to prevent mental health worsening.

Home Quarantine Behavior in College Students: The Internal Mechanism and Cross-National Differences

Background

The COVID-19 pandemic motivated people to stay at home to reduce the risk of COVID-19 infection and community transmission, but limited research has investigated the behavioral mechanisms underlying home quarantine.

Methods

Based on the theory of planned behavior (TPB), this study explored the mediating role of intention toward home quarantine and the moderating role of nationality among attitude, subjective norms, and perceived behavioral control. A total of 827 college students from the United States and China were recruited to complete an online survey.

Results

The results of structural equation modeling showed that antecedents (ie, attitude, subjective norms, and perceived behavioral control) could predict actual home-quarantine behavior through the role of intention. Notably, the relation between both attitude and intention and perceived behavioral control and intention were moderated by nationality. Specifically, attitude was a stronger predictor of intention for American participants than for Chinese participants; however, perceived behavioral control was a stronger predictor of intention for Chinese participants.

Conclusion

These findings reveal the internal mechanism of home-quarantine behavior and the heterogeneous explanations attributed to cultural diversity during the pandemic, which not only expands the application of TPB but also provides a reference for infectious disease mitigation in the field of public health policy.

The Theory of Planned Behavior during the COVID-19 pandemic: A comparison of health behaviors between Belgian and French residents

The COVID-19 pandemic presents a global crisis and authorities have encouraged the population to promote preventive health behaviors to slow the spread of the virus. While the literature on psychological factors influencing health behaviors during the COVID-19 is flourishing, there is a lack of cross-national research focusing on multiple health behaviors. The present study overcomes this limitation and affords a validation of the Theory of Planned Behavior (TPB) as a conceptual framework for explaining the adoption of handwashing and limitation of social contacts, two health behaviors that highly differ in their nature. Specifically, we compare TPB model on these two protective behaviors among people living in Belgium (N = 3744) and France (N = 1060) during the COVID-19 sanitary crisis. Data were collected from March 18 until April 19, 2020, which corresponds to the spring lockdown and the first peak of the pandemic in these countries. Results indicated that more positive attitudes, greater social norms, increased perceived control and higher intentions were related to higher adherence to handwashing and limitation of social contacts, for both Belgian and French residents. Ultimately, we argued that the TPB model tends to manifest similarly across countries in explaining health behaviors, when comparing handwashing and limitation of social contacts among individuals living in different national contexts.

Anxiety, Compassion and Pride. How Emotions Elicited by the Government's Handling of Covid-19 Influences Health-Promoting Behavior

This article explores how emotions connected to the Government's handling of the Covid-19 outbreak in Sweden relates to behaviors to stop the spread of the virus, and which emotions functions as mediators in this relationship. The Swedish approach to handling the outbreak greatly differed from how many other Western European countries handled the situation and thus makes an important case to study. In a large representative survey (N = 2449), we found that satisfaction with how the Government handled the situation was related to more positive and less negative emotions. Anxiety, compassion and pride mediated the effect of satisfaction on compliance with the national recommendations such that anxiety and compassion increased compliance, while pride decreased it. Importantly though, satisfaction increased compassion and pride, but only compassion led to more compliant behaviors. In fact, satisfaction was indirectly related to less compliant behaviors via anxiety and pride. Shame mediated the effect on the tendency to wear face masks, a behavior that was explicitly not endorsed by the Swedish Public Health Agency. We speculate if the face mask, which was intensely debated, became a politicized symbol of dissatisfaction with the Swedish approach. In sum, it seems that individuals who were dissatisfied with how the government handled the Covid-19 outbreak were in fact engaging more in health-promotional behaviors to stop the spread of the virus.

Determinants of adherence to COVID-19 measures among the Belgian population: an application of the protection motivation theory

Background

Since the start of the COVID-19 outbreak, the Belgian government has implemented various infection prevention and control measures. This study assessed the extent to which the general population in Belgium adhered to these measures, and which determinants were associated with adherence.

Methods

We undertook an internet survey among a sample of the Belgian population, representative for sex, age, socio-economic status and province. The questionnaire included various demographic, socio-economic and health-related questions, and also drew upon the Protection Motivation Theory as a theoretical framework to measure levels of perceived severity, vulnerability, perceived usefulness of the measures (response efficacy), perceived personal capacity to adhere (self-efficacy), and past and future adherence. Data were collected in Dutch and French, the main languages of Belgium.

Results

Our study was carried out in September 2020, and the number of respondents was 2008. On average, respondents provided high scores for each of the measures in place in September in terms of response efficacy (range of 3.54–4.32 on 1 to 5 Likert-scale), self-efficacy (range of 3.00–4.00), past adherence (4.00–4.68) and future adherence (3.99–4.61). The measure that overall received the highest scores was wearing a face mask in public spaces, while ‘the social bubble of 5’ generally received the lowest scores. There was a statistically significant relationship between response efficacy and self-efficacy on the one hand and (past and future) adherence on the other hand, in a multivariate model corrected for confounders. Vulnerability and severity did not show statistical significance.

Conclusion

Risk communication regarding COVID-19 should place a stronger emphasis on helping people understand why implemented measures are useful and how they can be put into practice, more than on increasing fear appeals.