Risk perception, knowledge, information sources and emotional states among COVID-19 patients in Wuhan, China

Factors influencing risk perception during Public Health Emergencies of International Concern (PHEIC): a scoping review

The unknownness and dread potential of a risk event shapes its perceived risk. A public health emergency of international concern (PHEIC) declaration by the World Health Organisation (WHO) is a signal for such an event. Understanding perceived risk then shapes risk-avoiding behaviours, important for health prevention. The review aims to consolidate the determinants of risk perception during a PHEIC, underscoring the need for grounding in context and theory. Studies published from 2010 until end-2020, searching PubMed, PsycINFO, MedlinePlus, PubPsych, and CINAHL, were included. Studies with only biological conceptualisations of risk, or no association to risk perception, were excluded. A total of 65 studies were included. Quality of the cross-sectional studies was assessed using Newcastle Ottawa Scale (NOS), yielding an average of 5.4 stars (out of 10). Factors were classified into three broad categories - individual, contextual, and media. Individual risk factors include emotions; beliefs, trust, and perceptions; immutable physical traits (sex, age, ethnicity); mutable traits (education, income, etc.); and knowledge, with no definitive correlation to risk perception. Contextual traits include pandemic experience, time, and location, with only time negatively correlated to risk perception. Media traits include exposure, attention, and framing of media, with no clear association to risk perception. One limitation is excluding a portion of COVID-19 studies due to censoring. Still, this lack of consensus highlights the need to better conceptualise "risk perception". Specifying the context and timing is also important since jurisdictions experience different outbreaks depending on outbreak histories. Using theories to ground risk perception research assists with these tasks.

A Social Media Blueprint - Understanding What Makes the Optimal Social Media Account for Paediatric Surgical Families

BACKGROUND

Social media is one of the most common sources of information for parents seeking information on their child's health. The purpose of this study was to better understand the social media habits of parents of paediatric surgery patients through surveys and focus groups.

METHODS

An online survey was distributed to parents visiting paediatric surgery clinics at a tertiary care hospital. Surveys were distributed via QR code and social media. Two virtual focus groups were conducted with parents of paediatric patients. Descriptive statistics were used for survey analysis and focus group transcripts were thematically analyzed.

RESULTS

A total of 107 respondents completed the online survey. Median age of respondents was 36 (interquartile range: 32-41). 81.3% of the respondents were female. Facebook was the preferred social media platform (47.2%), followed by Instagram (41.5%) then other platforms (4.7%). Respondents indicated that their preferred length of video was 30 s (41.2%). When asked which type of video content they prefer, participants indicated animated video as most popular (66.0%) followed by a physician speaking (60.0%), and slides with voiceover (45.0%). The focus groups revealed themes of: (1) functionality and content; (2) branding, aesthetic and legitimacy; (3) unmasking of physicians; (4) peer and community support.

CONCLUSION

Creating a successful social media account for parents must take into consideration their social media habits. A Facebook account that features brief videos may be most likely to engage parents. Additionally, physicians need to establish credibility and legitimacy of their content to attract their target audience.

LEVEL OF EVIDENCE

III.

Cognition, affect, and behavioural changes among university students after 10 new guidelines were issued in China: An exploratory study

Objectives

Since late 2019, the coronavirus disease 2019 (COVID-19) epidemic has become a common public health concern globally. China has entered a new phase of prevention and control with the implementation of the 10 new guidelines epidemic prevention policy in early December 2022. The resurgence of the outbreak may cause negative consequences on the behaviour of university students. This study aimed to assess the relationship between cognition, affect, and behavioural changes among university students and the related influencing factors after 10 new guidelines were issued, as well as the difficulties or concerns encountered in the current epidemic prevention process. It also provides a reference for the government to formulate targeted epidemic prevention strategies.

Methods

This study is a cross-sectional investigation. Self-designed questionnaires were distributed to students of a university in Hangzhou between December 25, 2022, and March 13, 2023, using convenience and snowball sampling methods for online surveys. Data analysis involved descriptive analysis, non-parametric tests, correlation, multiple linear regression, and content analyses.

Results

University students had a moderate to high level of cognition about COVID-19 and a medium level of affect. However, the level of behavioural changes was low and the average score was 2.33 (2.00, 3.00). Multiple linear regression analysis revealed that female sex, higher grade, medical specialty, affective factor, and cognitive factor were influencing factors of behavioural changes, which accounted for 35.7% of the variance in behavioural change. Difficulties or concerns included apprehension (84.8%), lack of information (39.3%), and uncertainty about the future (55.1%).

Conclusions

The prevention behaviour of university students has slackened. Evidence-based tailored policy development is indicated. This study suggested that schools and the government can improve the effectiveness of epidemic prevention among university students by adjusting the strategy of epidemic prevention policy formulation, broadening the channels of epidemic prevention information dissemination, and improving the mechanism of "government-community-school-family" collaborative governance.

Awareness, Attitude, and Fertility Desire in Elective Oocyte Cryopreservation of Adults in Four Areas of China

Purpose

Controversy exists on whether or not elective oocyte cryopreservation (eOC) can be conducted in public hospitals in China. Policymakers should take into account the benefits and risks in the Chinese population. This study explored basic data concerning the awareness, attitudes of eOC, and fertility desire of eOC in China to offer evidence for policy making.

Methods

A total of 442 people in four areas of China responded to a survey. The questionnaire was divided into three parts: awareness, attitude, and fertility desire of eOC. Descriptive analysis and multivariable regression analysis were used in the study.

Results

Generally, the respondents had a positive or neutral attitude towards eOC. However, about 90% of respondents did not know the cost of eOC. In general, a more positive attitude was found towards eOC among participants who had heard of the procedure compared with those who had not. Most women did not desire to reproduce by eOC. After adjusting for access to information, we found that female, older age groups, and singles were more likely to have increased awareness than their counterparts. The awareness of participants who accessed information from any source had a higher relative probability of having good awareness levels compared to participants who had not accessed the information. Undergraduates exhibited significantly higher levels of cognitive understanding, as indicated by their increased familiarity and comprehension, compared to high school students (relative risk ratio = 1.44, confidence interval = 0.48,4.29).

Conclusion

Continued discussion is needed regarding the ethical, legal, and social aspects of performing eOC in public hospitals. Furthermore, policies are needed to regulate eOC to protect the reproductive freedom of healthy women.

Implementation of community health care services to counter the SARS-CoV2 pandemic

BACKGROUND

The COVID-19 pandemic has ravaged many countries worldwide since December 2019. The high infection rates, and the need for health care assistance for individuals with comorbidities, strained the national health care systems around the world. Outbreak peaks increased the burden on hospitals that where perceived as high-risk places by people, who often decided to cancel or defer hospital visits. Thus, Italian Local Health Authorities had to develop new organizational models to meet the increased health care needs of the population. The aim of this study is to assess the impact of strengthened community health services on the hospital burden.

METHODS

We analysed the number of Emergency Department access at the Hospital De Lellis covered by the Local Health Authority in Rieti, from March 2020 to November 2021. We then assessed the effects of community health services: the Special District Continuing Care Units (SDCUs) and the the COVID hub, on the COVID-19-related ED access, admission and mortality rates. A Chi-squared test for trend and three multivariable logistic regression models were used to investigate the trends and the possible predictors of COVID ED access, COVID hospital admissions, and deaths.

RESULTS

Being male (OR = 1.41, CI95% 1.05-1.90; p = 0.022) and older age (OR = 1.03, CI95% 1.02-1.04; p < 0.0001) increase the likelihood of hospitalisation for Sars-CoV-2. The implementation of the nursing and medical SDCUs contributed to reducing COVID-19-related deaths (OR = 0.09, CI95% 0.03-0.29; p < 0.0001). The simultaneous implementation of the COVID hub and of the nursing SDCUs had a synergistic effect in reducing the likelihood of hospitalisation (OR = 0.24, CI95% 0.09-0.65; p = 0.005). The subsequent implementation of the medical SDCUS has further contributed to lowering the admission rates. These protective effects persisted also after potential cofounders, such as age, sex, clinical condition on admission, and the immunisation status, were adjusted.

CONCLUSIONS

These measures have helped in the management of patients in a complex context such as that of a pandemic by reducing the hospital load and playing an important role in the management of the pandemic. Further studies could assess the transferability of this model in a non-pandemic context.

The balance between traffic control and economic development in tourist cities under the context of COVID-19: A case study of Xi'an, China

Selecting an appropriate intensity of epidemic prevention and control measures is of vital significance to promoting the two-way dynamic coordination of epidemic prevention and control and economic development. In order to balance epidemic control and economic development and suggest scientific and reasonable traffic control measures, this paper proposes a SEIQR model considering population migration and the propagation characteristics of the exposed and the asymptomatic, based on the data of COVID-19 cases, Baidu Migration, and the tourist economy. Further, the factor traffic control intensity is included in the model. After determining the functional relationship between the control intensity and the number of tourists and the cumulative number of confirmed cases, the NSGA-II algorithm is employed to perform multi-objective optimization with consideration of the requirements for epidemic prevention and control and for economic development to get an appropriate traffic control intensity and suggest scientific traffic control measures. With Xi'an City as an example. The results show that the Pearson correlation coefficient between the predicted data of this improved model and the actual data is 0.996, the R-square in the regression analysis is 0.993, with a significance level of below 0.001, suggesting that the predicted data of the model are more accurate. With the continuous rise of traffic control intensity in different simulation scenarios, the cumulative number of cases decreases by a significant amplitude. While balancing the requirements for epidemic prevention and control and for tourist economy development, the model works out the control intensity to be 0.68, under which some traffic control measures are suggested. The model presented in this paper can be used to analyze the impacts of different traffic control intensities on epidemic transmission. The research results in this paper reveal the traffic control measures balancing the requirements for epidemic prevention and control and for economic development.

Factors associated with Medicare beneficiaries' perceptions of COVID-19 and preventive health behaviors: results from winter 2021 MCBS survey

This study evaluates the impact of preferred information sources on Medicare beneficiaries' perception of COVID-19 severity compared with flu and examines factors influencing preventive health behaviors using the Medicare Current Beneficiary Survey (MCBS) winter 2021. Medicare beneficiaries who primarily relied on traditional news, guidance from government officials, and healthcare providers, beneficiaries who were female, older than 65 years, metro residence, or living in the West were more likely to believe that the COVID-19 is more severe than flu and take vaccine than their counterparts. Compared to White, Black and Hispanic were more likely to agree with COVID-19 severity, but less likely to take vaccine. Factors associated with preventive health behavior utilization included perceived severity of COVID-19, primary information source, gender, race, language, annual income, and chronic health conditions. It is crucial to provide accurate information in lay terms to help people understand the importance of taking preventative actions against COVID-19.  .

Periodontists' perceptions and attitudes toward the use of social media for professional purposes in Saudi Arabia

BACKGROUND

There is a notable increase in the usage of social media platforms, especially for health communication, as more clinicians and patients count on this kind of technology. Therefore, this research aimed to investigate the perception and attitude toward social media (SM) use for professionalism and dental practice promotion among periodontal specialists working in Saudi Arabia (KSA).

METHODS

Electronic surveys were distributed in person or online using WhatsApp, Snapchat or Email from October 2022 until March 2023. The questionnaire was targeting periodontists in KSA, and it consists of three parts: the first part includes sociodemographic and professional data; the second part asks about the daily usage of SM in dental practice; and the third part asks about the periodontist's opinion about SM usage. Descriptive data were presented as numbers and percentages. The association between the demographic variables and the means of periodontists' opinions was tested using Pearson's chi-square test. Any value equal to or less than 0.05 was considered statistically significant.

RESULTS

A total of 121 responses were received from the periodontists. Most of the participants were in the 36-45 age group, with a percentage of 40.5%. In terms of gender, males made up 52.9% of the population, while females made up 47.1%, and the majority of the participants were consultants. The most common SM platform used by periodontists for daily using and dental practice promotion was Snapchat (56.2%), followed by Instagram and Twitter (54.5% and 49.6%, respectively). There was a significant difference in proportions among Twitter, Snapchat and TikTok between older and younger periodontists, with a p value < 0.05. There was no significant difference between the gender of the participants and their opinions regarding the usage of SM.

CONCLUSIONS

This study highlighted the effectiveness of SM in the promotion of dental practices and the discipline of periodontics, as more clinicians and patients rely on this kind of technology. These online platforms can improve periodontal practice in terms of dental health education, counseling, advertising, and oral health services.

Assessing psychometric challenges and fatigue during the COVID-19 pandemic

Environmental hazards and/or pandemics may push humans to use different protective methods to maintain their well-being. This study aimed to identify populations vulnerable to psychometric challenges and fatigue during the Coronavirus Disease (COVID-19) pandemic in Kazakhstan. A total of 1,592 participants were recruited and asked to complete the Multidimensional Fatigue Inventory-20 (MFI-20). Participants were classified according to gender and age. Data were analyzed using the Chi-square test (x2) and MedCalc to detect the odds of MFI-scales with a score ≥12 in women compared to men. Young women had significantly higher odds (OR) of reduced activity (OR 2.4, p<0.0001), physical (OR 2.5, p<0.0001), and mental fatigue (OR 3.4, p<0.0001) than young men. Middle-aged women had significantly higher odds of general fatigue (OR 2.1; p<0.0001), reduced motivation (OR 2.1, p<0.0001), physical (OR 2.1, p<0.0001), and mental fatigue (OR 1.9, p<0.0001) than did middle-aged men. Elderly women had significantly higher odds of general fatigue (OR 3.6, p<0.0001), reduced motivation (OR 3.5, p<0.0001), and physical fatigue (OR 3.5, p<0.0001) than men in the same age category. The study highlights that women were more susceptible, with significantly increased odds of experiencing various aspects of fatigue syndrome compared to men during the COVID-19 pandemic in Kazakhstan. Therefore, it is necessary to investigate individual behavioral changes to help identify vulnerable populations and provide relevant evidence for developing protocols and guidelines during pandemics and/or outbreaks.

Fun with Frustration? TikTok Influencers' Emotional Expression Predicts User Engagement with COVID-19 Vaccination Messages

This study examined what kinds of TikTok video and message features are associated with user engagement in the context of COVID-19 vaccination. Content analysis was applied to study a sample of 223 COVID-19 vaccination-related videos from creators with at least 10,000 followers. The content analysis involved coding themes, video formats, the valence of attitude toward vaccination, and emotional expressions from the influencers. A majority of videos showcased personal vaccination experiences, followed by fictitious dramas and instructional information. More fictitious dramas expressed unclear attitudes, neither explicitly supporting nor opposing the COVID-19 vaccine, compared to personal vaccination stories and instructional videos. Some imaginative and dramatic scenes, such as zombie transformation or dramatic spasms after taking the vaccines, were widely imitated across influencers, perhaps humorously, and raised concerns about diminishing positive images of vaccine uptake. Videos with simultaneous expression of humor and frustration significantly predicted engagement when the video content opposed or was uncertain about taking the vaccine, implying the effectiveness of mixed emotional attributes within a message. This study provides insight into how social context and message choices by creators interact to influence audience engagement.

Complementary, alternative, and integrative medicine-specific COVID-19 misinformation on social media: A scoping review

Background

The sharing of health-related information has become increasingly popular on social media. Unregulated information sharing has led to the spread of misinformation, especially regarding complementary, alternative, and integrative medicine (CAIM). This scoping review synthesized evidence surrounding the spread of CAIM-related misinformation on social media during the COVID-19 pandemic.

Methods

This review was informed by a modified version of the Arksey and O'Malley scoping review framework. AMED, EMBASE, PsycINFO and MEDLINE databases were searched systematically from inception to January 2022. Eligible articles explored COVID-19 misinformation on social media and contained sufficient information on CAIM therapies. Common themes were identified using an inductive thematic analysis approach.

Results

Twenty-eight articles were included. The following themes were synthesized: 1) misinformation prompts unsafe and harmful behaviours, 2) misinformation can be separated into different categories, 3) individuals are capable of identifying and refuting CAIM misinformation, and 4) studies argue governments and social media companies have a responsibility to resolve the spread of COVID-19 misinformation.

Conclusions

Misinformation can spread more easily when shared on social media. Our review suggests that misinformation about COVID-19 related to CAIM that is disseminated online contributes to unsafe health behaviours, however, this may be remedied via public education initiatives and stricter media guidelines. The results of this scoping review are crucial to understanding the behavioural impacts of the spread of COVID-19 misinformation about CAIM therapies, and can inform the development of public health policies to mitigate these issues.

[Sources used to obtain information on COVID-19 and its impact on mental health.]

With the rise of COVID-19, the society has had the need to search for information about the pandemic and the sources used to obtain information have been very diverse, with a greater predominance of social media, traditional media and consultation with loved ones. In addition, an excess of information has been observed in the media that made access and understanding difficult, as well as a constant concern and anxiety about health that caused a need to search excessively or repeatedly for information on health and disease. This information was not always endorsed by the scientific community and during the pandemic there has been the spread of misinformation, fake news and conspiracy theories about COVID-19 disseminated, mainly through social media. In this sense, both the knowledge and the beliefs apprehended have been able to impact the mental health of the population.

A Study of Reasons for Self-Disclosure on Social Media among Chinese COVID-19 Patients: Based on the Theory of Planned Behavior Model

BACKGROUND

With a massive population of internet users, China has witnessed a shift in the behavior of social media users towards the COVID-19 pandemic, transitioning from reticence to frequent sharing of information in response to changing circumstances and policy adjustments of the disease. This study aims to explore how perceived benefits, perceived risks, subjective norms, and self-efficacy influence the intentions of Chinese COVID-19 patients to disclose their medical history on social media, and thus to examine their actual disclosure behaviors.

METHODS

Based on the Theory of Planned Behavior (TPB) and Privacy Calculus Theory (PCT), a structural equation model was constructed to analyze the influence paths among perceived benefits, perceived risks, subjective norms, self-efficacy, and behavioral intentions to disclose medical history on social media among Chinese COVID-19 patients. A total of 593 valid surveys were collected via a randomized internet-based survey, which constituted a representative sample. Firstly, we used SPSS 26.0 to conduct reliability and validity analyses of the questionnaire, as well as the tests of demographic differences and correlations between variables. Next, Amos 26.0 was employed to construct and test the model fit degree, identify the relationships among latent variables, and conduct path tests.

RESULTS

Our findings revealed the following: (1) There were significant gender differences in the self-disclosure behaviors of medical history on social media among Chinese COVID-19 patients. (2) Perceived benefits had a positive effect on self-disclosure behavioral intentions (β = 0.412, p < 0.001); perceived risks had a positive effect on self-disclosure behavioral intentions (β = 0.097, p < 0.05); subjective norms had a positive effect on self-disclosure behavioral intentions (β = 0.218, p < 0.001); self-efficacy had a positive effect on self-disclosure behavioral intentions (β = 0.136, p < 0.001). (3) Self-disclosure behavioral intentions had a positive effect on disclosure behaviors (β = 0.356, p < 0.001).

CONCLUSIONS

Our study, by integrating TPB and PCT to examine the influencing factors of the self-disclosure behaviors among Chinese COVID-19 patients on social media, found that perceived risks, perceived benefits, subjective norms, and self-efficacy had a positive influence on the self-disclosure intentions of Chinese COVID-19 patients. We also found that self-disclosure intentions, in turn, positively influenced disclosure behaviors. However, we did not observe a direct influence of self-efficacy on disclosure behaviors. Our study provides a sample of the application of TPB in the context of social media self-disclosure behavior among patients. It also introduces a novel perspective and potential approach for individuals to address the feelings of fear and shame related to illness, particularly within the context of collectivist cultural values.

Social Media and Apps in Urology

Purpose of Review

In this study, we aimed to review the common social media (SoMe) apps used and how they have impacted the practice and exchange of information, as well as the challenges of using SoMe in urology.

Recent Findings

SoMe has become increasingly popular in the urology community. Lay users often turn to SoMe to learn about urological health and share their own experiences, while medical professionals may use it for career development, networking, education, and research purposes.

Summary

It is important to recognize the power of SoMe and to use it responsibly and ethically, particularly given the potential risks of encountering low-quality or misleading information.

No going back: COVID-19 disease threat perception and male migrants' willingness to return to work in India

This paper explores the causal link between the likelihood of re-migration to cities and the perceived threat of contracting COVID-19 using novel data on male reverse migrant workers in India. We find that reverse-migrants who believe there is a significant chance of contracting COVID-19 display a significantly lower likelihood of returning to their urban workplaces, regardless of their duration of migration. On the other hand, longer-duration migrants display a lower perceived chance of contracting COVID-19 than shorter-duration migrants. We also contribute to the migration literature by linking behavioural attributes to the decision to migrate. We find that more impatient individuals display a heightened belief regarding contracting COVID-19 and a higher projected likelihood of returning to work. Finally, we find that while both loss and risk-averse individuals have a lower projected likelihood of returning to urban workplaces, only loss-averse individuals perceive that their chance of contracting COVID-19 is lower.

Gender Differences in the Nonspecific and Health-Specific Use of Social Media Before and During the COVID-19 Pandemic: Trend Analysis Using HINTS 2017-2020 Data

The use of social media has changed since the outbreak of coronavirus disease 2019 (COVID-19). However, little is known about the gender disparity in social media use for nonspecific and health-specific issues before and during the COVID-19 pandemic. Based on a gender difference perspective, this study aimed to examine how the nonspecific and health-specific uses of social media changed in 2017-2020. The data came from the Health Information National Trends Survey Wave 5 Cycle 1-4. This study included 10,426 participants with complete data. Compared to 2017, there were higher levels of general use in 2019 and 2020, and an increased likelihood of health-related use in 2020 was reported among the general population. Female participants were more likely to be nonspecific and health-specific users than males. Moreover, the relationship of gender with general use increased in 2019 and 2020; however, concerning health-related use, it expanded in 2019 but narrowed in 2020. The COVID-19 global pandemic led to increased use of social media, especially for health-related issues among males. These findings further our understanding of the gender gap in health communication through social media, and contribute to targeted messaging to promote health and reduce disparities between different groups during the pandemic.

The Early Warning Mechanism of Public Health Emergencies Through Whistleblowing: A Perspective Based on Considering the Uncertainty of Risk Perception

Purpose

During the early warning period of public health emergencies, the information released by whistleblowers on the risk posed by the given event can reduce uncertainty in the public's risk perception and help governments take timely actions to contain the large-scale dissemination of risk. The purpose of this study is to give full play to whistleblowers and draw attention to the risk events, forming a pluralistic model of the risk governance during the early warning period of public health emergencies.

Methods

We construct an evolutionary game model of the early warning of public health emergencies through whistleblowing that involves the government, whistleblowers, and the public, discussing the mechanism of interaction between these subjects under the uncertainty of risk perception. Furthermore, we use numerical simulations to analyze the influence of changes in the relevant parameters on the evolutionary trajectory of the subjects' behaviors.

Results

The results of the research are obtained by numerical simulation of the evolutionary game model. The results show that the public's cooperation with the government encourages the latter to take a positive guidance strategy. Increasing the reward for whistleblowers within an acceptable cost, strengthening the propaganda of the mechanism and the higher level of risk perception of the government and whistleblowers will promote whistleblowers' vocalization actively. When the government's reward for whistleblowers is lower, the whistleblowers choose negative vocalization with the improvement of the public's risk perception. If there is no mandatory guidance from the government at this point, the public is prone to passively cooperating with the government owing to a lack of risk-related information.

Conclusion

Establishing an early warning mechanism through whistleblowing is important for containing risk in the early warning period of public health emergencies. Building the whistleblowing mechanism in daily work can improve the effectiveness of the mechanism and enhance the public's risk perception better when the public health emergencies arise.

Perceived COVID-19 Severity, Risk of Infection, and Prevention Self-Efficacy in Saudi Arabia During Lockdown: A Population-Based National Study

Evidence shows that the risk perception of humans can significantly affect their response to a threat. This population-based, cross-sectional study explored the determinants of perceived disease seriousness, perceived disease infectiveness, and perceived prevention self-efficacy of coronavirus disease (COVID-19), during the lockdown period, using the health belief model for preventive behavior (HBMPB) among 4423 adults in Saudi Arabia from 13 provinces. Multivariate binary regression was used to analyze the independent factors of three risk perception variables and to measure their effect on adherence to preventive measures. Overall, COVID-19 seriousness was perceived to be higher than that of diabetes and lower than that of a heart attack, while its infectiousness was perceived to be high by 75.3% of the participants. Furthermore, 66.6% had a low perception of their prevention self-efficacy. The HBMPB showed independent effects of all three risk perception parameters on adherence to the preventive measures, including perceived seriousness (Odd's ratio [OR] = 1.26; 95% confidence interval [95% CI] = 1.01-1.56), infectiousness (OR = 1.90; 95% CI = 1.52-2.38), and prevention self-efficacy (OR = 1.51; 95% CI = 1.20-1.91). Authorities should maintain an optimal level of communication on the COVID-19 risk, communicate more about the virus' cycle and the disease to demystify the rationale of the preventive measures, and enhance confidence in their efficiency.

Compliance with Ministry of Health Regulations among Israeli Nurses during the COVID-19 Pandemic: The Mediating Role of Risk Perception

The COVID-19 pandemic has created a sustained state of emergency, causing uncertainty and risk taking. Israeli nurses were required to follow new regulations and safety measures issued by the Israeli Ministry of Health (MOH). This study aimed to examine nurses' compliance with MOH regulations and its association with their risk and threat perceptions and their positive and negative emotions. A cross-sectional online survey was conducted among 346 Israeli nurses. The study model was examined with path analysis. Most nurses reported complying with MOH regulations either fully (49%) or very often (30%). Negative emotions were positively associated with perceptions of both threat and risk, yet only risk perception was positively associated with nurses' compliance. A significant mediated relationship was found between negative emotions and nurses' compliance, with the possible mediator being risk perception. Hence, higher negative emotions were associated with a greater risk perception, which was associated with higher compliance. Health systems leaders must strategize to deal with the wave-like character of the pandemic. Solutions to nursing teams' negative emotions must be provided to keep the balance between feelings of complacency and a situation of high-level, intense negative feelings, which might lead to abstention, burnout, or emotional injury.

Risk perception of COVID-19 and its related factors among centralized medical isolation groups in China

Objective

Medical isolation is one of the most effective measures to slow the spread of the virus when dealing with a pandemic. Millions of people in China have undergone centralized medical isolation (CMI) during the COVID-19 pandemic. This study aims to assess the centralized medical isolation group's COVID-19 risk perception and to explore the influencing factors.

Methods

A total of 400 participants (200 who had experienced CMI and 200 who had not experienced) completed a questionnaire related to COVID-19 risk perceptions. The questionnaire was designed with the Cognitive-Experiential Self-Theory (CEST) and the Common Sense Model of Risk Perception (CSM). It adopted nine questions to measure risk perception in terms of Emotional feelings, Cognitive judgment, and Mental representation of unusual severity. Descriptive statistical analysis, correlation analysis, and multiple linear regression analysis were conducted with SPSS 26.0 software.

Results

The mean risk perception score for the CMI group was 30.75, with a standard deviation of 7.503, which was significantly higher than that in the non-centralized medical isolation (NCMI) group (risk perception score was 28.2, and the standard deviation was 7.129). The results show that risk perceptions were higher for older age, risk perceptions were higher for higher education, risk perceptions were higher for those who had received the COVID-19 vaccination, and risk perceptions were higher for those who lived in a family with children.

Conclusion

Risk perception is significantly higher in CMI groups than in NCMI groups. The government should draw more care to the risk perception and psychological wellbeing of the CMI group and provide extra support and assistance to the elderly and those raising younger children. In dealing with future pandemics like the COVID-19 outbreak, the government should actively guide the public to properly isolate at home and cautiously implement a CMI policy.

The perception and attitude of Turkish ophthalmologists related with COVID-19 pandemic

Türk göz hekimlerinin COVID-19 pandemisi ile ilgili algı ve tutumları. Öz Amaç: Üçüncü basamak bir referans göz hastalıkları hastanesinde görev yapan Türk göz hekimleri arasında, COVID-19 ile ilgili algı ve tutum düzeylerini araştırmak. Gereç ve Yöntem: Mart 2021'de, sosyodemografik form ve 52 çoktan seçmeli soru içeren ankete dayalı kesitsel bir çalışma yapılmıştır. Sorular, üç kavramın algısını ayrı ayrı değerlendirmeye yönelikti: Hastalık, COVID-19'un nedenleri ve COVID-19'un kontrolü. Yanısıra, COVID-19'dan kaçınma tutumlarını ve COVID-19 aşısına yönelik tutumları değerlendirmeyi hedefleyen sorulara da yer verildi. Bulgular: Toplam 43 (15 erkek ve 28 kadın) göz hekimi çevrimiçi anketi tamamladı. Göz hekimleri arasında tehlikelilik ve bulaşıcılık algısı güçlüydü. COVID-19'un nedenlerine ilişkin algı alt boyutlarındaki puanlar orta-ılımlı düzeydeydi. Aşağıdakiler arasında istatistiksel olarak anlamlı farklar ortaya çıktı: Asistan hekimler ve öğretim üyeleri arasında Makro Kontrol’de (p=0.02), Kontrol Edilebilirlik’te (p=0.38) ve COVID-19 Kontrolü Algısı’nda (p=0.022); erkekler ve kadınlar (p=0,009) ile asistan hekimler ve öğretim üyeleri (p=0,023) arasında COVID-19'dan Davranışsal Kaçınma Tutumları’nda; asistan hekimler ve öğretim üyeleri arasında COVID-19 Aşısına Yönelik Tutumlar’da (p=0.034). Sonuç: COVID-19, göz hekimlerince tehlikeli ve bulaşıcı olarak algılandı. COVID-19'un Kontrolü Algısı, öğretim üyelerinde, asistan hekimlere göre daha güçlüydü. Kadın ve öğretim üyesi katılımcılarda, COVID-19'dan Davranışsal Kaçınma tutumları daha yüksekti. Öğretim üyeleri, COVID-19 aşısına karşı asistan doktorlardan daha az olumsuz tutum sergiledi. Bu değerlendirmeler, hem COVID-19 pandemisinde hem de gelecekteki salgınlarda, hastalıkla mücadelede, yolumuza ışık tutabilir. Anahtar Kelimeler: Algı, COVID-19, oftalmologlar, pandemi, tutum.

Ethical principles for infodemiology and infoveillance studies concerning infodemic management on social media

Big data originating from user interactions on social media play an essential role in infodemiology and infoveillance outcomes, supporting the planning and implementation of public health actions. Notably, the extrapolation of these data requires an awareness of different ethical elements. Previous studies have investigated and discussed the adoption of conventional ethical approaches in the contemporary public health digital surveillance space. However, there is a lack of specific ethical guidelines to orient infodemiology and infoveillance studies concerning infodemic on social media, making it challenging to design digital strategies to combat this phenomenon. Hence, it is necessary to explore if traditional ethical pillars can support digital purposes or whether new ones must be proposed since we are confronted with a complex online misinformation scenario. Therefore, this perspective provides an overview of the current scenario of ethics-related issues of infodemiology and infoveillance on social media for infodemic studies.

Investors' confidence in the crowdlending platform and the impact of Covid-19

Crowdlending platforms have gained importance in recent years due to digitalization. The Covid-19 pandemic has severely impacted the entire economy, including repercussions on digital transactions. Investors considering transactions on these platforms require confidence in both the platform and the project in order to make the right decision. For this reason, this study analyzes the links between the parties involved in the process. A survey was sent to 135 investors on the Colectual platform in January 2022, and the research method adopted is Fuzzy Set Qualitative Comparative Analysis (fsQCA). The study examines the connections between the platform, the investors, and the project developers, to assess the influence exerted by the platform on the confidence of the parties seeking and providing investment. The main result is that Covid-19 has been a key factor in the confidence of investors in the platform, and it has had a significant influence on the investments made.

Associations between COVID-19 Risk Perceptions and Mental Health, Wellbeing, and Risk Behaviours

Background

Mental health has worsened, and substance use has increased for some people during the coronavirus (COVID-19) pandemic. Some cross-sectional studies suggest that higher COVID-19 risk perceptions are related to poorer mental health and greater risk behaviours (e.g., substance use). However, longitudinal and genetic data are needed to help to reduce the likelihood of reverse causality.

Methods

We used cross-sectional, longitudinal, and polygenic risk score (PRS; for anxiety, depression, wellbeing) data from the Avon Longitudinal Study of Parents and Children (ALSPAC). We examined cross-sectional and prospective longitudinal associations between COVID-19 risk perceptions (i.e., cognitive, affective, self, other, and a combined 'holistic' measure) and mental health (i.e., anxiety, depression), wellbeing, and risk behaviours. Pandemic (April-July 2020) and pre-pandemic (2003-2017) data (ns = 233-5,115) were included.

Results

Higher COVID-19 risk perceptions (holistic) were associated with anxiety (OR 2.78, 95% confidence interval [CI] 2.20 to 3.52), depression (OR 1.65, 95% CI 1.24 to 2.18), low wellbeing (OR 1.76, 95% CI 1.45 to 2.13), and increased alcohol use (OR 1.46, 95% CI 1.24 to 1.72). Higher COVID-19 risk perceptions were also associated with self-isolating given a suspected COVID-19 infection (OR 1.74, 95% CI 1.13 to 2.68), and less face-to-face contact (OR 0.83, 95% CI 0.70 to 0.98) and physical contact (OR 0.83, 95% CI 0.68 to 1.00). Pre-pandemic anxiety (OR 1.64, 95% CI 1.29 to 2.09) and low wellbeing (OR 1.41, 95% CI 1.15 to 1.74) were associated with higher COVID-19 risk perceptions. The depression PRS (b 0.21, 95% CI 0.02 to 0.40) and wellbeing PRS (b -0.29, 95% CI -0.48 to -0.09) were associated with higher and lower COVID-19 risk perceptions, respectively.

Conclusions

Poorer mental health and wellbeing are associated with higher COVID-19 risk perceptions, and longitudinal and genetic data suggest that they may play a causal role in COVID-19 risk perceptions.

The mediating effect of Covid-19 risk perception on the correlation between levels of mindfulness and preventive health behavior in nursing students

OBJECTIVE

This study aimed to investigate nursing students' levels of mindfulness and its effect on developing preventive health behaviors, and to examine the mediating role of COVID-19 risk perception on this effect.

DESIGN AND MEASURES

This study used a descriptive and correlational study design.

RESULTS

The level of mindfulness, accompanied by COVID-19 risk perception caused a.104-unit increase in developing preventive health behavior.

CONCLUSIONS

The findings revealed that the indirect effect of the level of mindfulness on developing preventive health behavior was at a significant level; therefore, it is concluded that COVID-19 risk perception mediates the correlation between level of mindfulness.

PRACTICE IMPLICATIONS

The present study is important to investigate nursing students' levels of mindfulness and the effect of these on developing preventive health behaviors.

Risk perception of COVID-19 among college students in China: Latent profile analysis

Background

The outbreak of the new coronavirus-2019 (COVID-19) has had a significant impact on people's mental and physical health. Meanwhile, people's perceptions of risk may influence their emotional states and preventative behavior during an epidemic. Previous research have revealed the diversity and uniqueness of risk perception, and college students may have a different perspective on risk perception. The objective of this study was to describe the subtypes of risk perception for COVID-19 among college students in China, identify the subtypes' traits, and investigate their affecting variables.

Methods

College students from 10 Chinese provinces participated in a cross-sectional study (n = 2,000) that from January 16 to 30, 2022. The latent profiles and influencing factors for risk perception were investigated using latent profile analysis, one-way analysis of variance, and multinomial logistical regression.

Results

The sample group of this survey was 1,946 students, and the response rate was 97.3%. The best model was suggested to consist of three profiles: "neutral risk perception" (20.3%), "perception seriously without susceptible" (52.8%), and "low risk perception" (26.9%). Risk perception of COVID-19 was positively associated with attention to negation information (r = 0.372, p < 0.01), anxiety (r = 0.232, p < 0.01), and depression (r = 0.241, p < 0.01), and negatively associated with perceived social support (r = -0.151, p < 0.01). Logistic-regressions analyses mainly revealed that the risk perception of three profiles related to having chronic diseases (OR = 2.704, p < 0.01), medical major (OR = 0.595, p < 0.01; OR = 0.614, p < 0.05), without having COVID-19 confirmed cases around (OR = 0.539, p < 0.01), attention to negative information (OR = 1.073, p < 0.001; OR = 1.092, p < 0.001), and perceived social support (OR = 0.0.975, p < 0.01).

Conclusions

The level of risk perception for COVID-19 among Chinese college students was unsatisfactory, and the risk perception of COVID-19 had significant group characteristics and heterogeneity. Colleges and public health practitioners could have a theoretical and empirical basis to implement risk perception intervention efforts by identifying latent subgroups during the COVID-19 epidemic.

Excessive and Unreliable Health Information and Its Predictability for Anxiety: A Cross-Sectional Observational Study

INTRODUCTION

Being ignorant or unaware is not expected in a situation like the pandemic of COVID-19 with modern internet connectivity and the era of social media. However, information overload may itself lead to health anxiety.

AIMS AND OBJECTIVES

This study investigated the predictability of health anxiety with information overload and sociodemographic profiles during the COVID-19 pandemic.

MATERIALS AND METHODS

A cross-sectional study was done among 400 caretakers of non-covid patients in a tertiary healthcare medical college. The consenting participants provided their sociodemographic details and responded to the short health anxiety inventory (SHAI), Beck anxiety inventory (BAI) and Information overload scale (IOS) for COVID-19.

RESULTS

A total number of 400 participants aged 35.58 ± 10.57 years participated and out of which 88.2% acknowledged health-related anxiety and 56.8% for excessive use of social media. BAI measured anxiety was mild for 19.8%, moderate for 3.5% and severe for 3%. The linear regression analysis predicted health anxiety by three variables only: total anxiety as measured by the Beck anxiety inventory [β = 0.416, t = 9.318, p = 0.000], information overload (rejection of information) [β = 0.171, t = 3.126, p = 0.002], and excessive use of social media [β = 0.124, t = 2.888, p = 0.004].

CONCLUSION

Information overload, its rejection and excessive use of social media were found to be predictive of health-related anxiety.

Mediating Effects of Attitudes, Risk Perceptions, and Negative Emotions on Coping Behaviors

Based on the perspectives of social risk amplification and the knowledge-attitudes-practice model, this study aimed to test how the level of knowledge about COVID-19 and information sources can predict people's behavioral changes and to examine the effect mechanisms through the mediating roles of attitude, risk perception, and negative emotions in a survey of 498 older Chinese adults. The results showed that (1) older people had a lower level of factual knowledge regarding the variant strains and vaccines; (2) in the information sources-behavior, information sources had a critical influence on elderly individuals' coping behaviors; and (3) in the knowledge-behavior, factual knowledge had a significant effect on elderly individuals' coping behaviors. Specifically, for prevention behaviors, both risk perception and negative emotions played full mediating roles. The findings have significant implications for the development of an effective COVID-19 prevention program to older adults coping with pandemic conditions.

Psychological well-being during the COVID-19 pandemic in Italy assessed in a four-waves survey

COVID-19 pandemic had a negative impact on the mental health and well-being (WB) of citizens. This cross-sectional study included 4 waves of data collection aimed at identifying profiles of individuals with different levels of WB. The study included a representative stratified sample of 10,013 respondents in Italy. The WHO 5-item well-being scale (WHO-5) was used for the assessment of WB. Different supervised machine learning approaches (multinomial logistic regression, partial least-square discriminant analysis-PLS-DA-, classification tree-CT-) were applied to identify individual characteristics with different WB scores, first in waves 1-2 and, subsequently, in waves 3 and 4. Forty-one percent of participants reported "Good WB", 30% "Poor WB", and 28% "Depression". Findings carried out using multinomial logistic regression show that Resilience was the most important variable able for discriminating the WB across all waves. Through the PLS-DA, Increased Unhealthy Behaviours proved to be the more important feature in the first two waves, while Financial Situation gained most relevance in the last two. COVID-19 Perceived Risk was relevant, but less than the other variables, across all waves. Interestingly, using the CT we were able to establish a cut-off for Resilience (equal to 4.5) that discriminated good WB with a probability of 65% in wave 4. Concluding, we found that COVID-19 had negative implications for WB. Governments should support evidence-based strategies considering factors that influence WB (i.e., Resilience, Perceived Risk, Healthy Behaviours, and Financial Situation).

Effects of information sources on public preventive behaviors in health emergencies: Evidence from a digital epidemiologic study during the COVID-19 pandemic

Introduction

It has been approved that information sources would affect public behaviors. However, due to the outbreak of COVID-19, this influence was enhanced and showed a distinctive pattern among different populations, which has been less noticed before. We aimed to investigate the potential roles of different information sources in COVID-19 preventive behaviors of different publics.

Methods

A cross-sectional online survey with 11,190 participants from 33 province-level regions in China was conducted during the COVID-19 pandemic. Sociodemographic characteristics, COVID-19 preventive behaviors, and information sources for COVID-19-related information were assessed. A mixed linear model was used to analyze risk factors of COVID-19 preventive behaviors. The effects of different information sources on COVID-19 prevention behaviors of different publics were analyzed.

Results

Generally, the Chinese public had good COVID-19 preventive behaviors, and the top three COVID-19 preventive behaviors with the higher action rate were avoiding eat bushmeat (76.1%), a healthy diet (74.8%), and avoiding contact with people with symptoms of respiratory diseases (73.0%). About information sources, 12320 telephone (National Public Health Hotline) (-0.62, 95% CI: -0.94 to -0.31) and acquaintances consulting (-1.00, 95% CI: -1.31 to -0.69) were negatively associated with COVID-19 preventive behaviors, while internet resources, family doctors, hospitals, and community health centers were positively associated with COVID-19 preventive behaviors (1.00 vs. 0.47 vs. 0.46 vs. 0.33, P < 0.05). For older adults, accessing to COVID-19-related information through family doctors and community health centers were positively associated with COVID-19 preventive behaviors. For the non-educated, family doctors and community health centers had positive effects on their COVID-19 preventive behaviors. Family doctors and internet resources were positively associated with COVID-19 preventive behaviors among those earning 5,000 yuans and above. The effects of family doctors, hospitals, and internet resources were higher for COVID-19 preventive behaviors of urban publics than for rural publics. Finally, the effect of internet resources on COVID-19 preventive behaviors of females was lower than males.

Conclusions

Obtaining COVID-19-related information through internet resources had the most significant effect on COVID-19 preventive behaviors, but was not significant among publics with old age, low education, low income, and living in rural area.

Knowledge acquisition and precautionary behaviors for individual resilience to the COVID-19 pandemic: A study of rural Latin America

The concept of resilience gains prominence as human society faces more frequent and impactful shocks and disturbances. This study seeks to investigate how rural populations build resilience amid the COVID-19 pandemic. A simple theoretical model is presented to illustrate the determinants of knowledge acquisition and precautionary behaviors among rural residents. Based on a High Frequency Phone Survey of 10,583 Latin American adults, this study found that rural residents were less capable of using informal channels (e.g., the internet) to collect COVID-19 information. Younger generations were generally less likely to adopt precautionary behaviors than the elderly. The age disparity, however, was relatively minor for rural populations. Costly preventive measures such as staying at home are less affordable for rural residents. Meanwhile, confidence in government ensures better compliance to ensure public health guidelines. We argue that internet skills, prosociality, and political confidence are necessary to build rural residents' resilience during the pandemic.

Religiosity and Beliefs toward COVID-19 Vaccination among Adults in Puerto Rico

Religiosity may influence COVID-19 vaccination. However, it remains unclear how religiosity is associated with beliefs toward COVID-19 and vaccination against it, particularly amongst ethnic minorities. This study examined the association between religiosity, vaccination intent, beliefs, and attitudes related to COVID-19 and vaccination among adults in Puerto Rico. Data from an online survey conducted between December 2020-February 2021 among adults (≥18 yr; n = 1895) residing in Puerto Rico were used. Rating of the importance of religiosity was used to capture the level of religiosity ('less important', 'somewhat important', 'important', and 'very important'). The health belief model (HBM) assessed beliefs and attitudes toward COVID-19 and vaccination against it. Adjusted Poisson models with robust error variance estimated prevalence ratios (PR) and 95% confidence intervals for vaccination intent and individual COVID-19 HBM constructs. Compared to individuals rating religiosity as 'less important' to them, those rating it as 'very important' were more likely to be unwilling or uncertain to get the COVID-19 vaccine (PR = 1.51, 95% CI = 1.10-2.05). Higher ratings of importance of religiosity, compared to the lowest level, were associated with significantly lower perceived COVID-19 susceptibility, more vaccine barriers, and lower vaccine benefits (all p < 0.05). Individuals who reported religiosity being very important to them were more likely to report that they will get the COVID-19 vaccine only if given adequate information about it (PR = 1.14, 95% CI = 1.02-1.27) and more likely to get the vaccine if more people decide to receive it (all p < 0.05). In conclusion, our results suggest an association between religiosity and COVID-19 vaccination intent and beliefs and attitudes toward vaccination. The study highlights important guidelines for public health campaigns to increase vaccine uptake among religious communities in Puerto Rico.

COVID-19 Infection among Nursing Students in Spain: The Risk Perception, Perceived Risk Factors, Coping Style, Preventive Knowledge of the Disease and Sense of Coherence as Psychological Predictor Variables: A Cross Sectional Survey

The exploration of patterns of health beliefs about COVID-19 among nursing students may be beneficial to identify behaviors, attitudes and knowledge about contagion risk. We sought to analyze the variables of risk perception, perceived risk factors, coping style, sense of coherence and knowledge of preventive measures as possible predictors of having suffered from COVID-19. Participants were nursing students from 13 universities in Spain. Sociodemographic and health variables were collected. To test the independent variables, the Perception Risk Coping Knowledge (PRCK-COVID-19) scale was created and validated because there was no specific survey for young people adapted to the pandemic situation of COVID-19. It was validated with adequate psychometric properties. A total of 1562 students (87.5% female, mean age 21.5 ± 5.7 years) responded. The high perception of the risk of contagion, the high level of knowledge and a coping style focused on the situation were notable. Significant differences by gender were found in the coping styles, problem-focused, avoidance and knowledge scales, with women scoring higher in all categories. The multiple regression analysis was significant (F = 3.68; p < 0.001). The predictor variables were the coping styles subscale search for support and the intrinsic and extrinsic perceived risk factors. Our model predicts that nursing students with a social support-based coping style are at a higher risk of becoming infected with COVID-19, based on their own health belief model.

Experiences of COVID-19 patients in a Fangcang shelter hospital in China during the first wave of the COVID-19 pandemic: a qualitative descriptive study

OBJECTIVES

This study aimed to examine COVID-19 patients' experiences in a Fangcang shelter hospital in China, to provide insights into the effectiveness of this centralised isolation strategy as a novel solution to patient management during emerging infectious disease outbreaks.

DESIGN

This study adopted a qualitative descriptive design. Data were collected by individual semistructured interviews and analysed using thematic analysis.

SETTING

This study was undertaken in 1 of the 16 Fangcang shelter hospitals in Wuhan, China between 28 February 2020 and 7 March 2020. Fangcang shelter hospitals were temporary healthcare facilities intended for large-scale centralised isolation, treatment and disease monitoring of mild-to-moderate COVID-19 cases. These hospitals were an essential component of China's response to the first wave of the COVID-19 pandemic.

PARTICIPANTS

A total of 27 COVID-19 patients were recruited by purposive sampling. Eligible participants were (1) COVID-19 patients; (2) above 18 years of age and (3) able to communicate effectively. Exclusion criteria were (1) being clinically or emotionally unstable and (2) experiencing communication difficulties.

RESULTS

Three themes and nine subthemes were identified. First, COVID-19 patients experienced a range of psychological reactions during hospitalisation, including fear, uncertainty, helplessness and concerns. Second, there were positive and negative experiences associated with communal living. While COVID-19 patients' evaluation of essential services in the hospital was overall positive, privacy and hygiene issues were highlighted as stressors during their hospital stay. Third, positive peer support and a trusting patient-healthcare professional relationship served as a birthplace for resilience, trust and gratitude in COVID-19 patients.

CONCLUSIONS

Our findings suggest that, while sacrificing privacy, centralised isolation has the potential to mitigate negative psychological impacts of social isolation in COVID-19 patients by promoting meaningful peer connections, companionship and support within the shared living space. To our knowledge, this is the first study bringing patients' perspectives into healthcare service appraisal in emergency shelter hospitals.

Exploring factors that influence COVID-19 vaccination intention in China: Media use preference, knowledge level and risk perception

Vaccine is one of the most effective means to deal with the COVID-19 pandemic in many countries, but vaccine hesitancy has been always widespread among people due to individual differences in access to vaccine information. This research aims to empirically investigate the relationship between media use preference (video-based and text-based), knowledge level, risk perception and willingness to vaccinate among Chinese residents. A cross-sectional survey of a Chinese sample (N = 885) was carried out to explore factors that influence the COVID-19 vaccination intention of Chinese residents. The empirical results show that the knowledge level and risk perception of Chinese residents positively contribute to vaccination intention. People with video-usage preference have lower levels of knowledge about the COVID-19 vaccine than those with text-usage preference. People’s risk perception of the COVID-19 pandemic is not influenced by their media use preference or knowledge level, as COVID-19 is a global pandemic and a significant social risk. The current study yields health-related implications for the role of media use preference in vaccination intention.

COVID-19 preventive behavior among university students in Southeast Asia: Effects of knowledge, concern, awareness, and perceived risk

The persistent rise of pandemics across the globe in recent times has led to the prescription of several collaborative preventive strategies to reduce the effect that the pandemic has on public health. Consistent monitoring and surveillance appear to be the only available approach to detecting and classifying the issues of public health threats. Global pandemic threats demand public co-operation to take preventive actions at a personal level so that the risk of infectious diseases can be contained. Said that, this study explored the influence of awareness of precaution measures (APM), concerns about coronavirus disease 2019 (COVID-19) (CAC), knowledge of COVID-19 (KOC), and perceived risk (PRK) on preventive behavior (PRB), as well as the effect of age and gender on the relationships among the studied variables. Quantitative data were collected from 551 university students across Malaysia and Vietnam through field survey and online survey, respectively. The data collection was performed from 13 March to 23 March 2020. Partial least square structural equation modeling (PLS-SEM) was employed for data analysis. The multiple group analysis (MGA) technique was applied to compare the data retrieved from the respondents based on age and gender. The results revealed that APM, CAC, KOC, and PRK on PRB significantly influenced PRB toward COVID-19. In light of the two personal factors, age and gender, significant variances were noted for age and KOC, while PRK on PRB on the PRB toward COVID-19. Based on the study outcomes, APM emerged as the most significant predictor of PRB, followed by PRK on PRB, and CAC. Since a large fraction of the world reside in rural areas and have high-level interaction with animals, the provision of education at all level can harness the attitude to adopt PRB toward COVID-19. As such, policymakers need to work with the young generation so that the latter may serve as change agents to spread the message of taking precautions and adopting effective PRB toward COVID-19.

Relationship of Societal Adaptation with Vaccine Worries among Healthcare Workers during the COVID-19 Pandemic: The Mediating Effects of Posttraumatic Stress Disorder

Vaccine hesitancy has become a major public health problem among healthcare workers (HCWs) in this coronavirus disease 2019 (COVID-19) pandemic. The aim of this study was to examine the relationship between societal adaptation and vaccine worries and the mediating effects of posttraumatic stress disorder (PTSD) indicators in HCWs. A total of 435 HCWs (327 women and 108 men) were recruited. Their levels of societal adaptation were evaluated using the Societal Influences Survey Questionnaire (SISQ). Their severity and frequency of PTSD symptoms were examined using the Disaster-Related Psychological Screening Test (DRPST). The severity of vaccine worries was assessed using the Vaccination Attitudes Examination (VAX) Scale. The relationships among societal adaptation, PTSD, and vaccine worries were examined using structural equation modeling. The severity of societal adaptation was positively associated with both the severity of PTSD and the severity of vaccine worries. In addition, the severity of PTSD indicators was positively associated with the severity of vaccine worries. These results demonstrated that the severity of societal adaptation was related to the severity of vaccine worries, either directly or indirectly. The indirect relationship was mediated by the severity of PTSD. Societal adaptation and PTSD should be taken into consideration by the community of professionals working on vaccine hesitancy. Early detection and intervention of PTSD should be the objectives for programs aiming to lower vaccine hesitancy among HCWs.

Religion, politics and COVID-19 risk perception among urban residents in Malawi

INTRODUCTION

Majority of Malawians have not yet adopted COVID-19 mitigation measures despite having knowledge about its infectivity, morbidity, and fatality. Understanding drivers of hesitancy to adoption of COVID-19 mitigation measures is critical as it can inform prevention programs. This study explores Malawians' COVID-19 risk perception, and the associated constraints in the adoption of mitigation efforts. A Health Belief Model (HBM) approach was used to understand perceived factors that undermine public health COVID-19 messages to reduce the spread of the pandemic in Malawi.

METHODS

The study applied rapid appraisal and photovoice qualitative inquiry to comprehend risk perception regarding COVID-19. We purposively selected 52 participants from three major cities in Malawi. Audio and video interviews were transcribed verbatim, and transcripts were coded manually to derive key themes and concepts.

RESULTS

The study identified that social factors particularly religious and political beliefs influenced COVID-19 risk perception. Specific religious beliefs pertaining to individuals recognizing signs of the 'Christian apocalypse' were particularly associated with lower risk perceptions. Politically, participants believed COVID-19 lockdown measures were a ploy by the then-ruling party to remain in power.

CONCLUSION

The study suggests that religious beliefs and political environment undermine self -perceived risk of contracting COVID-19 among urban dwellers in Malawi. We recommend that diverse actors in Malawi should collaborate to promote the dissemination of accurate COVID-19 discourses and reduce the severity of the pandemic's impact in Malawi.

Air pollution and perception-based averting behaviour in the Jinchuan mining area, China

This paper presents a simultaneous equation, knowledge and perception-based averting behavior model of health risk caused by air pollution, with application to the Jinchuan mining area, China. Three types of averting behavior are distinguished: (a) purchases of purifying equipment, plants, or masks; (b) purchases of preventive or curing medication or food; and (c) adjustment of daily outdoor activities. Two types of perceived health risk are distinguished: (a) risk due to the intensity of exposure and (b) risk caused by the hazardousness of pollutants. The estimations show that an increase in perceived air pollution of two or more days a week leads to a restriction of outdoor activities of approximately 90 min per person per week. Another result is that the average annual household expenditure on air filters, foods, or medicines is 206.25 CNY (US$ 31.73) to prevent the hazardousness of air pollution. The total willingness to pay for air quality improvement is 2.95% of annual net household income. Because air quality improving investments can only be implemented in the medium or long run, daily disclosure of air quality is an adequate short-run policy handle to assist residents to take the right kind and level of risk-reducing actions.

Communication, information, and knowledge in the pandemic by COVID-19 in Brazil

As coronavirus disease 2019 (COVID-19) is asserting itself as a health crisis, it is necessary to assess the knowledge and perceptions of people about the disease. The aim of this study is to assess the knowledge of the general population about COVID-19 and how the media influence this knowledge. This is a cross-sectional study with 5066 participants who answered an online questionnaire between April and May 2020. Data analysis was performed using descriptive statistics and logistic regression models. Over 75% have obtained a high degree of knowledge regarding signs, symptoms, and transmission, 95% stated to check the veracity of the information received, and also showed that the total knowledge about COVID-19 was associated with the level of instruction, with the perception of the quality of information disseminated by the media, and with the risk perception. Despite the high level of knowledge of participants, the results pointed to the need to reinforce information for individuals with less education and the importance of avoiding denialism that reduces the risk perception about COVID-19.

Analyzing Risk Communication, Trust, Risk Perception, Negative Emotions, and Behavioral Coping Strategies During the COVID-19 Pandemic in China Using a Structural Equation Model

Objective

Risk communication and the degree of trust are major factors that affect the public's behavioral coping strategies and play an important role in emergency risk management. However, the internal formation mechanism involved in the public's psychological behavior remains unclear. This study aimed to investigate the association among risk communication, trust, risk perception, negative emotions, and behavioral coping strategies during the coronavirus disease 2019 (COVID-19) pandemic, and to identify and quantify the factors that influence public behavior.

Methods

We launched an online survey through social media from April to July 2020 in China. Relevant data were elicited using a self-designed questionnaire that mainly examined respondent characteristics, risk communication, trust, risk perception, negative emotions, protective coping behavior, and excessive coping behavior in the context of the COVID-19 pandemic. A total of 735 valid responses were obtained. A structural equation model was then used to explore relationship pathways among the components.

Results

The higher the degree of risk communication (β = -0.10, p < 0.05) and trust (β = -0.22, p < 0.001), the lower the public risk perception. Risk communication and trust had a direct effect on public behavioral coping strategies during the COVID-19 pandemic. The higher the level of risk communication (β = 0.14, p < 0.001) or trust (β = 0.48, p < 0.001), the more likely it was that this would encourage the public to adopt protective coping behaviors, while the public was less likely to engage in excessive coping behaviors as the degree of trust increased (β = -0.12, p < 0.01). Risk perception influenced by poor risk communication and trust generated negative emotions (β = 0.31, p < 0.001), and such negative emotions further positively influenced public behavioral coping strategies (whether protective [β = 0.09, p < 0.05] or excessive [β = 0.24, p < 0.001] behaviors).

Conclusion

Risk communication, trust, risk perception, and negative emotions were significantly directly or indirectly related to public behavior. The findings provide useful information for emergency risk management and a theoretical basis for follow-up research on public coping behavior during the COVID-19 pandemic.

Public anxiety through various stages of COVID-19 coping: Evidence from China

As countries underwent the initiation, peak, post-peak, and early vaccination stages of COVID-19, the changing risk perception, coping behaviors and corresponding psychological stress experienced by the public over time was rarely reported. We conducted a national scale panel study using social-psychological data collected from 5,983 questionnaires to investigate the interactions between anxiety level, risk perception and coping behavior during different stages of COVID-19 in China. We found that sustained perceiving worries of being infected, first due to domestic and then global pandemic, contributed to the persistent high proportion of respondents with anxiety disorders which even gradually increased over time (56.1% during initiation to 60.4% during early vaccination). Gender was the strongest predictor of anxiety at all stages, with females having less confidence in COVID-19 control and always suffering from much higher anxiety levels than males even during the post peak stage. Excessive protective behavior and frequency of access to COVID-related news also contributed to public anxiety. Additionally, public risk perception was significantly associated with their willingness to vaccinate. The findings verify the feasibility of taking stage-specific and gender-based risk communication strategies to alleviate the pandemic-related public anxiety and promote vaccination by influencing public risk perception and guiding coping behaviors.

Impact of Social Media, Extended Parallel Process Model (EPPM) on the Intention to Stay at Home during the COVID-19 Pandemic

Considering how communities perceive the threat and risks of COVID-19, it is essential to examine how emotional regulation stimulated through intrinsic and extrinsic incentive mechanisms via social media can reinforce ‘Stay at home’ intentions. The conceptual framework was developed using the elements of the Extended Parallel Process Model (EPPM). A self-reported questionnaire was used to measure individuals’ intention to stay at home during the pandemic based on the perceived locus of causality as a part of self-determination theory. The empirical research was conducted on a sample of 306 USA respondents. The study results indicate that both components of the EPPM—efficacy and threat—positively affect ‘stay at home’ intentions. Moreover, a positive effect of efficacy on threats was found, as was a moderating effect of threats on the relationship between efficacy and the intention to stay at home. Meanwhile, the influence of social media exposure on threats and behavioral intentions was not significant. People are likely to stay at home as a preventive measure during COVID-19 if there is enough threats and efficacy. However, the abundance of information and opinions in social media can lead to a decreased perceived threat and might disrupt the acceptance of preventive actions.

Association between Self-Classification of COVID-19 Risk Levels and Adverse Lifestyle Changes among Physically Active Older Adults Following the Coronavirus Outbreak

The COVID-19 pandemic has imposed barriers to a healthy lifestyle, especially for older adults who are considered to be at a high-risk of infection. This study examined the associations between negative changes and the self-classification to COVID-19 risk level among physically active older adults who are members of a nationwide health club chain. A cross-sectional digital survey was sent to 19,160 older adults (age ≥ 65). The data collected included information on the subjects’ self-classification to the COVID-19 high-risk group (HRG) and changes in physical activity (PA), body weight, and smoking habits since the outbreak. Logistic regression models were used to investigate the associations between the dependent variables of ‘experienced a negative change’ and the independent variables. Of the 1670 survey respondents, 78.3% classified themselves as COVID-19 HRG. Over half of the respondents reported a reduction in PA hours, 26.6% reported weight gain, and 17.7% of smokers increased their amount of smoking. A self-classification to the HRG was associated with 1.46 (95%CI 1.10−1.93, p < 0.009) and 1.67 (95%CI 1.21−2.31, p < 0.002) greater odds for reduced hours of exercise and weight gain compared to the not high-risk group, respectively. Decision makers should consider how policies may cause barriers to a healthy lifestyle and develop risk communication strategies to encourage positive health-related behaviors, even during a pandemic.

Determinants of adherence to personal preventive behaviours based on the health belief model: a cross-sectional study in South Korea during the initial stage of the COVID-19 pandemic

Background

Along with the rapid transmission of COVID-19, adherence to preventive behaviours plays a crucial role with respect to the control of COVID-19. However, different individuals’ psychological characteristics and risk perception result in various forms of response to preventive behaviours. Based on the Health Belief Model, this study identifies the factors associated with preventive behaviours towards COVID-19 in South Korea during the initial stage of the COVID-19 pandemic.

Methods

A cross-sectional study was conducted in April 2020 through an anonymous online survey. A total of 1207 people in the age bracket of 20–59 years participated in the survey. Single and multiple linear regression analyses were conducted to identify the determinants of preventive behaviours against COVID-19.

Results

The following factors were associated with preventive behaviours towards COVID-19: female gender (β = .124, p < 0.001), has a master’s degree or above (β = 0.065, p = 0.010), perceived susceptibility (β = .197, p < 0.001), self-efficacy (β = .404, p < 0.001), trust in radio (β = −.080, p = .006), trust in official government website (β = .057, p = .045), trust in social networks (β = .054, p = .033), and trust in family and friends (β = .068, p = .009), with an explanatory power of 41.5% (R² = 0.415).

Conclusions

To flatten the epidemic curve, it is important to understand the public’s risk perception and the motivation behind behavioural responses that aim to promote preventive behaviours among the public. Thus, this study calls for the provision of accessible and credible information sources and demonstrates a public health campaign that encourages the public’s engagement in preventive behaviours towards COVID-19.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-022-13355-x.

Walking a tightrope: A meta-synthesis from frontline nurses during the COVID-19 pandemic

Nursing staff plays a key role in the public health response to the COVID‐19 pandemic, being in the front line of care. This study sought to synthesise the qualitative literature on care experiences of frontline nurses during the COVID‐19 pandemic. A search was conducted on five databases in January 2021. Fifteen qualitative studies met the inclusion criteria and were included in the research, being submitted to interpretive meta‐synthesis according to the eMERGe guide. The final synthesis included a line of argument that shows the experiences of frontline nurses during the COVID‐19 pandemic, divided into three major themes: ‘Instability on the edge of a cliff: unpredictable and unknown context,’ ‘The price of walking the tightrope: the uncertainty surrounding care,’ and ‘Finding the balance to reach the other side: dealing with the emotional demands of care.’ Although essential in the health response to the COVID‐19 pandemic, nurses experienced an emotional impact arising from the hampered care provision. Our results point to need for strengthening the training of nurses and future nurses, creating and promoting measures that contribute to their psycho‐emotional well‐being, ensuring a safe environment for their clinical practice, and promoting their participation in decision‐making processes.

The relationship between adolescent risk perception and emotions during the COVID-19: a short-term longitudinal study

This study explores the relationship between adolescents' perceptions of epidemic risk and their emotions through three follow-up surveys during the early stages of the COVID-19 pandemic on February 11th (T1), 18th (T2), and 25th (T3), 2020. Three hundred and four adolescents in different academic stages (junior high middle school, senior high middle school, and university) participated in the online survey, and cross-lag analysis was used to examine the causal relationship between epidemic risk perceptions and positive and negative emotions. The results found that the individual's positive emotions were significantly higher than the negative emotions in T1, T2 and T3. Cross-lag analysis found that for positive emotions, T2 positive emotions could negatively predict T3 epidemic risk perceptions, and T2 epidemic risk perceptions could negatively predict the individual's T3 positive emotions. For negative emotions, risk perceptions at T1 could positively predict negative emotions at T2, and at the same time, negative emotions at T1 could also positively predict epidemic risk perceptions at T2. This indicates that during the early stages of the COVID-19 pandemic, there was a causal relationship between the perceptions of epidemic risk and the emotions of adolescents, and this relationship had high stability among groups of different genders and academic stages.

Official social media and its impact on public behavior during the first wave of COVID-19 in China

BACKGROUND

During the COVID-19 pandemic, official social media became a critical channel for the public to obtain pandemic information. No matter the positive function or negative effect of information dissemination, it involves the public's risk perception and behavior. This study was designed to contribute to the existing research on how official social media information quality (IQ) and risk perception (RP) affect preventive behavior (PB) and continued use behavior (CB) of official social media during the first wave of COVID-19.

METHODS

The required data were extracted from a national online survey of the Chinese Mainland during March 24-30 2020, a random sample was asked to participate in the survey (n = 666). Data analysis was performed using regression analysis, structural equation modeling, mediating effect analysis, and one-way ANOVA analysis.

RESULTS

The results show that IQ (10.010 ± 3.568) has direct and indirect positive impact on PB (9.475 ± 3.571), and has a low significant positive indirect impact on CB (3.739 ± 1.566). The IQ has a significant positive impact on RP (β = 0.548), which show that there is no "risk perception paradox" in COVID-19. Furth more, this study also provides new evidence indicating that RP mediates the relationship between IQ and PB. According to the region, gender, age and annual income, and there are significant differences in PB and CB.

CONCLUSION

The study findings have remarkable implications for improving the information quality and public behaviors. Too high or too low level of risk perception is not conducive to pandemic prevention and control. Official social media should indirectly affect information flow through the reasonable supply of pandemic information and constantly improve the quality of pandemic information to avoid public's undue panic and excessive health concerns during this ongoing outbreak and subsequent national public emergency events.