Your health vs. my liberty: Philosophical beliefs dominated reflection and identifiable victim effects when predicting public health recommendation compliance during the COVID-19 pandemic

The role of collectivism, liberty, COVID fatigue, and fatalism in public support for the zero-COVID policy and relaxing restrictions in China

BACKGROUND

China was the last country in the world to relax COVID-19 restrictions. A successful public health policy requires public support. This analysis examined the factors associated with Chinese support for zero-COVID and relaxing COVID-19 restrictions in China.

METHOD

Two online surveys were conducted among Chinese participants in mainland China on June 10-13 (N = 460) and December 2, 2022 (N = 450). These two samples were similar based on the participants' demographics.

RESULTS

The results revealed that the perceived health consequences of a COVID-19 policy, perceived norms of approving a COVID-19 policy, and hope positively predicted the participants' support for the COVID-19 policy. The results further showed that collectivism and fatalism positively predicted support for zero-COVID and negatively predicted support for relaxing restrictions. COVID fatigue was negatively associated with support for zero-COVID and positively associated with support for relaxing restrictions. Liberty positively predicted support for relaxing restrictions in June and negatively predicted zero-COVID in December 2023. It did not positively or negatively predict support for the policy adopted by the government.

CONCLUSION

Collectivism, liberty, COVID fatigue, and fatalistic beliefs are important considerations connected to public support for a COVID-19 policy. The role of liberty was more nuanced and depended on the survey's time and whether the government adopted the policy.

Anticipated and Experienced Stigma After Testing Positive for SARS-CoV-2: A Qualitative Study

INTRODUCTION

Stigma has inhibited public health practitioners' influence during the COVID-19 pandemic. We explore the experienced and anticipated stigma of people affiliated with a large university in the United States, using the Health Stigma and Discrimination Framework.

METHODS

We conducted a qualitative secondary substudy of 20 people who tested SARS-CoV-2 positive and 10 who tested negative in the summer of 2020, selected from a study of 3,324 university students and employees.

FINDINGS

No participants reported anticipated stigmatization prior to testing positive. However, eight of 20 participants recounted stigma marking (being marked by COVID-19 diagnosis or membership in a "high-risk" group) or manifestations of stigma after testing positive, including feelings of guilt or shame, and concerns about being judged as selfish or irresponsible. Three described being denied services or social interactions as a result of having had COVID-19, long after their infectiousness ended. Participants noted that clear public health messaging must be paired with detailed scientific information, rather than leaving people to resort to non-experts to understand the science.

DISCUSSION

Public health messaging designed to mitigate spread of SARS-CoV-2 and protect the community may perpetuate stigma and exacerbate inequities. As a result, people may avoid testing or treatment, mistrust public health messaging, or even use risk-increasing behavior as coping mechanisms.

IMPLICATIONS FOR PRACTICE

Intentional use of language that promotes equity and deters discrimination must be high priority for any COVID-19-related public health messaging. Partnership with community leaders to co-create programs and disseminate messaging is a critical strategy for reducing stigma, especially for historically mistreated groups.

Effects of portraying an innocent versus non-innocent identified victim on intentions to donate organs post-mortem

The need for more people to register as organ donors is a pressing concern. This preregistered experiment examined whether portraying a patient in need of an organ transplant as leading a healthy lifestyle (an "innocent victim") can serve to increase people's intentions to register as post-mortem organ donors. Participants not previously registered as organ donors (N = 348) were randomly assigned to an innocent identified victim, non-innocent identified victim, or statistical victims condition. The identified victim was a 42 year-old woman in need of a liver transplant. The experimental manipulation produced marginally significant effects on self-reported intentions to register as an organ donor. Moreover, participants in the innocent victim condition were more likely relative to those in the non-innocent victim condition to sign up on an e-mail list to receive additional information about organ donation.

The role of audience favorability in processing (un)familiar messages: a heuristic-systematic model perspective

Several mechanisms of processing (un)familiar messages-processing fluency, message fatigue, interest, and counterarguing-are documented but studied independently, preventing a holistic understanding of how we process (un)familiar messages. This research integrates these mechanisms under a coherent theoretical framework based on heuristic-systematic model and identifies which one becomes dominant as a joint function of message familiarity and audience favorability. Across two studies concerning social distancing (Study 1; N = 412) and smoking (Study 2; N = 300), message fatigue and counterarguing were heightened in unfavorable audiences processing familiar and unfamiliar messages, respectively. Interest was dominant among favorable audiences processing unfamiliar messages in Study 2. Processing fluency was not heightened under any conditions. In models testing mediational capacities of the four mechanisms simultaneously, message fatigue and interest were significant mediators of the effects of audience favorability and message familiarity on persuasion, respectively. This research underscores the importance of considering audience favorability when studying the effects of message familiarity.

Why we should care about moral foundations when preparing for the next pandemic: Insights from Canada, the UK and the US

Health behaviors that do not effectively prevent disease can negatively impact psychological wellbeing and potentially drain motivations to engage in more effective behavior, potentially creating higher health risk. Despite this, studies linking "moral foundations" (i.e., concerns about harm, fairness, purity, authority, ingroup, and/or liberty) to health behaviors have generally been limited to a narrow range of behaviors, specifically effective ones. We therefore explored the degree to which moral foundations predicted a wider range of not only effective but ineffective (overreactive) preventative behaviors during the COVID-19 pandemic. In Study 1, participants from Canada, the United Kingdom, and the United States reported their engagement in these preventative behaviors and completed a COVID-specific adaptation of the Moral Foundations Questionnaire during the pandemic peak. While differences occurred across countries, authority considerations consistently predicted increased engagement in both effective preventative behaviors but also ineffective overreactions, even when controlling for political ideology. By contrast, purity and liberty considerations reduced intentions to engage in effective behaviors like vaccination but had no effect on ineffective behaviors. Study 2 revealed that the influence of moral foundations on U.S participants' behavior remained stable 5-months later, after the pandemic peak. These findings demonstrate that the impact of moral foundations on preventative behaviors is similar across a range of western democracies, and that recommendations by authorities can have unexpected consequences in terms of promoting ineffective-and potentially damaging-overreactive behaviors. The findings underscore the importance of moral concerns for the design of health interventions that selectively promote effective preventative behavior.

Demographic, structural, and psychological predictors of risk-increasing and mask wearing behaviors among US adults between December 2020-March 2021

OBJECTIVES

To assess demographic, structural, and psychological predictors of risk-increasing and risk-decreasing behaviors METHODS: This study used data from an online longitudinal, three-wave COVID-19 survey (12/20-03/21) regarding the behaviors, attitudes, and experiences of US Veteran (n = 584) and non-Veteran (n = 346) adults.

RESULTS

Inability to get groceries delivered emerged as the strongest predictor of more frequent risk-increasing behavior across all timepoints. Other consistent predictors of more frequent risk-increasing behavior and less frequent mask wearing included less worry about getting COVID-19, disbelief in science, belief in COVID-19 conspiracies, and negative perceptions of the state response. No demographic factor consistently predicted risk-increasing behavior or mask wearing, though different demographic predictors emerged for more frequent risk-increasing behaviors (e.g., lower health literacy) and mask-wearing (e.g., older age and urban residence) at certain timepoints. The most frequently endorsed reasons for having contact with others concerned health-related (food, medical care, and exercise) and social needs (seeing friends/family and boredom).

CONCLUSIONS

These findings highlight key individual-level determinants of risk-increasing behaviors and mask wearing which encompass demographic, structural, and psychological factors.

PRACTICE IMPLICATIONS

Findings can support public health experts and health communicators promote engagement with risk-reducing behaviors and address key barriers to engaging in these behaviors.

Give me liberty or give me COVID-19: How social dominance orientation, right-wing authoritarianism, and libertarianism explain Americans' reactions to COVID-19

While previous research has revealed an ideological divide in Americans' perceptions of COVID-19, specific ideological components can additionally explain public reactions to the pandemic. With two surveys-one sample of crowdsourced workers (N = 482) and a nationally representative sample of American adults (N = 7449)-this research investigates how multiple ideological facets simultaneously predict individuals' reactions to COVID-19. Results demonstrate that social dominance orientation and libertarianism are two important ideological sources that predict more dismissal of COVID-19 and less support for government measures. Right-wing authoritarianism was negatively correlated with COVID-19 concern and support for government actions, but suppression effects could exist. The effects of ideological variables were largely consistent when trust in science was considered. This study highlights the role of specific ideological components in contributing to the political divide regarding attitudes toward the COVID-19 pandemic beyond the liberal-conservative identification.

Communicating about COVID-19 vaccine development and safety

Purpose

Beliefs that the risks from a COVID-19 vaccine outweigh the risks from getting COVID-19 and concerns that the vaccine development process was rushed and lacking rigor have been identified as important drivers of hesitancy and refusal to get a COVID-19 vaccine. We tested whether messages designed to address these beliefs and concerns might promote intentions to get a COVID-19 vaccine.

Method

We conducted an online survey fielded between March 8–23, 2021 with US Veteran (n = 688) and non-Veteran (n = 387) respondents. In a between-subjects experiment, respondents were randomly assigned to a control group (with no message) or to read one of two intervention messages: 1. a fact-box styled message comparing the risks of getting COVID-19 compared to the vaccine, and 2. a timeline styled message describing the development process of the COVID-19 mRNA vaccines.

Results

Most respondents (60%) wanted a COVID-19 vaccine. However, 17% expressed hesitancy and 23% did not want to get a COVID-19 vaccine. The fact-box styled message and the timeline message did not significantly improve vaccination intentions, F(2,358) = 0.86, p = .425, ηP2 = .005, or reduce the time respondents wanted to wait before getting vaccinated, F(2,306) = 0.79, p = .453, ηP2 = .005, compared to no messages.

Discussion

In this experimental study, we did not find that providing messages about vaccine risks and the development process had an impact on respondents’ vaccine intentions. Further research is needed to identify how to effectively address concerns about the risks associated with COVID-19 vaccines and the development process and to understand additional factors that influence vaccine intentions.

Risky business: A mixed methods study of decision-making regarding COVID-19 risk at a public university in the United States

Introduction

Until vaccines became available in late 2020, our ability to prevent the spread of COVID-19 within countries depended largely on voluntary adherence to mitigation measures. However, individual decision-making regarding acceptable COVID-19 risk is complex. To better understand decision-making regarding COVID-19 risk, we conducted a qualitative substudy within a larger Berkeley COVID-19 Safe Campus Initiative (BCSCI) during the summer of 2020, and completed a mixed-methods analysis of factors influencing decision-making.

Materials and methods

We interviewed 20 participants who tested positive for SARS-CoV-2 and 10 who remained negative, and analyzed quantitative survey data from 3,324 BCSCI participants. The BCSCI study enrolled university-affiliated people living in the local area during summer of 2020, collected data on behaviors and attitudes toward COVID-19, and conducted SARS-CoV-2 testing at baseline and endline.

Results

At baseline, 1362 students (57.5%) and 285 non-students (35.1%) said it had been somewhat or very difficult to comply with COVID-19-related mandates. Most-cited reasons were the need to go out for food/essentials, difficulty of being away from family/friends, and loneliness. Eight interviewees explicitly noted they made decisions partially because of others who may be at high risk. We did not find significant differences between the behaviors of students and non-students.

Discussion

Despite prevailing attitudes about irresponsibility of college students during the COVID-19 pandemic, students in our study demonstrated a commitment to making rational choices about risk behavior, not unlike non-students around them. Decision-making was driven by perceived susceptibility to severe disease, need for social interaction, and concern about risk to others. A harm reduction public health approach may be beneficial.

Political orientation, moral foundations, and COVID-19 social distancing

During the COVID-19 pandemic, governments have advocated numerous social distancing measures, and compliance with these has likely saved millions of lives globally. In an online sample drawn from the U.S. and Canada (N = 209), participants completed measures of political orientation, moral foundations, and COVID-19 social distancing attitudes and behaviours. A more left-wing political orientation, and greater endorsement of the individualizing moral foundations were significantly related to more positive social distancing attitudes, and greater self-reported compliance with relevant restrictions. A more right-wing political orientation, and greater endorsement of the binding and economic liberty foundations were associated with less positive attitudes and reduced compliance. In a series of mediation analyses, the relationships between political orientation and various social distancing measures were significantly mediated by variations in participants' moral foundations, particularly their endorsement of economic liberty and the individualizing foundations. Further data indicated that the perceived persuasiveness of messages based on each moral foundation advocating for continued social distancing was significantly related to both participants' moral values and their political orientation. Findings are discussed in terms of understanding politicized differences around social distancing as partly reflecting differential valuation of the moral foundations, and in creating effective public health messaging regarding compliance.

Indonesian Islamic Students’ Fear of Demographic Changes: The Nexus of Arabic Education, Religiosity, and Political Preferences

Demographic changes have sparked several debates on the interconnected identities of citizens, with some transitions observed in previous studies to be smooth as indicated by the continuous emergence of conflicts. The fear of within-boundary demographic changes also drives potential tensions among native people. Therefore, this study posited that the basic knowledge of the Arabic language has the ability to contribute to the formation of religiosity, political preference, and fear of demographic changes. This was determined quantitatively by distributing questionnaires to 496 students of Islamic state universities, and the findings confirmed nearly all the direct relationships aside from religiosity and political preference. This also shows the complex formation of fear due to demographic changes. The possession of the Arabic language is observed to be causing an increase in discomfort while being religious decreases it. Additionally, further discussions and implications are presented.

Public perceptions of psychiatric, justice-involved, and elderly populations during the COVID-19 pandemic

The novel coronavirus disease (COVID-19) has had a significant global impact, with all countries facing the challenge of mitigating its spread. An unprecedented shortage of medical resources has raised concerns regarding allocation and prioritization of supplies, which may exacerbate social discrepancies for already vulnerable populations. As public opinion can impact healthcare policies, we aimed to characterize perceptions of psychiatric, forensic psychiatry, correctional, and elderly populations regarding COVID-19-related issues. This web-based study recruited participants (n = 583) from the general population in North America. The survey included perceptions of the pandemic, hypothetical scenarios on resource prioritization, and Likert scale questions. The majority of participants were cisgender female (72.7%), aged 31-74 years (80.0%), married (48.0%), retired (52.7%), resided in Canada (73.9%), had a college/university degree (50.9%) and had never worked in healthcare (66.21%). Most respondents reported not having a criminal history (95.88%), or a psychiatric disorder (78.73%). Perceptions of vulnerable populations were significantly different for resource allocation and prioritization (e.g., ventilator and vaccine resources, all p < 0.001). Healthcare workers and the elderly were commonly ranked the highest priority for resources, while forensic psychiatry and correctional populations were given the lowest priority. A high rate of disagreement was found for the more stigmatizing questions in the survey (all p < 0.0001). Our results suggest that perception from members of the general public in North America is aligned with current practices for resource allocation. However, individuals that already face social and health disparities may face additional opposition in decision-making for COVID-19 resources.