Health risk perceptions in the era of the new coronavirus: are the Italian people ready for a novel virus? A cross-sectional study on perceived personal and comparative susceptibility for infectious diseases

The use of fear appeals for pandemic compliance: A systematic review of empirical measurement, fear appeal strategies and effectiveness

Interventions to pandemic outbreaks are often associated with the use of fear-appeal to trigger behavioral change, especially in public health issues. However, no systematic review exists in the literature on the effectiveness of fear appeal strategies in the context of pandemic compliance. This paper aims at providing systematic literature review that answers the following thought-provoking research questions: (1) What is the standard measurement of fear in relation to pandemics in the existing literature? (2) What are the fear appeal strategies used in the empirical literature? (3) How effective are fear appeal strategies in changing behavior toward adopting pandemic preventive measures? A total of 22 studies were selected from 455 potential studies, following a comprehensive literature search and assessment in accordance with the PRISMA guidelines. The findings show that nearly all the available studies on fear measurement used the Likert scale (as the standard approach) with different points of degree and fear appeal strategies such as fear triggers in media channels, print advertisements, and verbal descriptions. Furthermore, most studies conclude that fear appeal is effective in making participants adopt pandemic preventive measures; hence, it is effective for positive behavioral change (the degree of effectiveness depends on gender, population group, etc.), especially when combined with self-efficacy and socio-cultural considerations. Very few studies, however, find an insignificant association, arguably due to the kind and intensity of the fear appeal messages and strategies used.

Factors influencing psychological concerns about COVID-19 in South Korea: direct and indirect damage during the early stages of pandemic

BACKGROUND

COVID-19 pandemic has led to psychological concerns, the distribution of which across populations may differ depending on whether pandemic-related damage is direct or indirect. This study aims to investigate concerns associated with direct and indirect damage according to population characteristics, and identify relatively vulnerable groups that are particularly affected by concerns.

METHOD

This cross-sectional study used data from the 2020 Korea Community Health Survey, which collected data based on a complex sampling design. A total of 208,106 responses from individuals aged ≥ 19 were collected via in-person interviews. The items related to COVID-19 concerns were measured by Likert scales ranging from 1 to 5 and categorized into two types: direct concerns, which pertained to infection or death, and indirect concerns, which pertained to criticism, vulnerability, and economic damage, through factor analysis. We compared the means and effect size of direct concerns, indirect concerns, and overall concerns using weighted mean, ANOVA, and multiple regression analysis.

RESULTS

Exploratory and confirmatory factor analyses supported a two-factor structure for psychological concerns about COVID-19 (CFI = 0.99, TLI = 0.97, SRMR = 0.02, RMSEA = 0.06), which were divided into direct and indirect concerns. Mean scores were 3.62 for direct concerns and 4.07 for indirect concerns. Direct concerns were higher in females (B = .26); the elderly (B = .15); those diagnosed with hypertension or diabetes (B = .04; B = .06); those with few assistants during quarantine (B = .15); and those whose neighbors responded inappropriately to COVID-19 (B = .07). Indirect concerns were lower among the elderly (B = -.04), and higher among young; married (B = .25); pink- or blue-collar workers (B = .08; B = .06); and those who felt that the city responded inappropriately to COVID-19 (B = .02).

CONCLUSION

The prevalence of concerns regarding direct and indirect damage caused by the COVID-19 pandemic differed according to population characteristics. Some factors had a marked influence on direct and indirect concerns. Our findings could inform psychological interventions and policies for future pandemics. Customized interventions are needed to prevent negative psychological concerns and improve mental health.

Behavioral intentions and perceived stress under isolated environment

BACKGROUND

Isolation is a special environment that will affect the mental health and behavior of individuals. The current study was to explore the relationship between behavior intention (BI) and perceived stress in isolated environment during Shanghai Omicron pandemic.

METHODS

A cross-sectional study was conducted between April 8 and 14, 2022. Three self-reported questionnaires were used to evaluate quarantine duration, stress perception, and BI. A total of 1042 participants in Shanghai under quarantine at home were included by random sampling. Logistic regression and one-way variance analysis were used to determine the risk factors related to BI.

RESULTS

The finding implicated negative BI was more reported by the population of males, with lower educational background, with jobs, and youngers. A negative association existed between perceived stress and BI (B = -1.004, p = .003, OR = 0.367, 95% CI = .191-.703). The proportion of positive BI decreased with quarantined duration, whereas the negative BI seemed vibrate upward then downward.

CONCLUSION

There existed a significant effect of quarantined days on perceived stress with different BIs. High perceived stress was a risk factor of positive BI. This preliminary study has significance to understand the effect of compulsory measures on BI and for policies makers to take a psychosocial perspective to consider the effective pandemic intervention strategies.

Association between the risk perception of contracting COVID-19 and sociodemographic characteristics in a Peruvian population

Background: The perception of risk regarding coronavirus disease 2019 (COVID-19) has been widely researched due to its association with the adoption of preventive measures. In addition, since the onset of vaccination, it has been reported that the population perceives a lower risk of getting infected. However, few studies have analyzed the factors associated with risk perception in low- and middle-income countries. The aim of this study was to determine the association between the risk perception of contracting COVID-19 and sociodemographic characteristics in Peruvian population. Methods: An analytical and cross-sectional study was conducted in four cities in Peru from October to December, 2021. The sample consisted of 821 individuals aged 18 years and older. A virtual questionnaire was used to collect sociodemographic data and assess the risk perception of contracting coronavirus based on the Health Belief Model. The process of back-translation, expert judgment, and reliability analysis using split-half correlation was conducted. Student's t-tests, analysis of variance with post hoc Tukey's test, and Spearman's correlation were employed. Results: Of the participants, 53.71% were women and 73.3% had a higher education level, 45.55% are self-employed, and 40.44% did not have a family member infected with COVID-19. The risk perception of COVID-19 infection was associated with participants' family antecedent of COVID-19 (p < 0.05). Regarding the factors analyzed, perceived susceptibility to COVID-19 was associated with age (p=0.002), occupation (p<0.05), and a history of COVID-19 (p<0.05), while the perceived benefits of adopting preventive measures against this disease were associated with educational level (p < 0.001). Conclusions: The risk perception of contracting COVID-19 was higher among whose had multiple infected relatives.. Furthermore, the perception of susceptibility and the perceived benefits of using preventive measures were associated with sociodemographic characteristics.

Role of Trust, Risk Perception, and Perceived Benefit in COVID-19 Vaccination Intention of the Public

COVID-19 vaccination is an effective method for dealing with the COVID-19 pandemic. This study proposed and validated a theoretical intention model for explaining the COVID-19 vaccination intention (CVI) of the public. The theoretical intention model incorporated trust in vaccines, two types of risk perception (risk perception of COVID-19 and risk perception of COVID-19 vaccination), and perceived benefit into a theory of planned behavior (TPB). Structural equation modeling was utilized to test the theoretical intention model with data collected from 816 Chinese adults in China. The results confirmed the crucial role of trust in vaccines, risk perception, and perceived benefit in shaping the CVI of the public. In addition, TPB was found to be applicable in a research context. The theoretical intention model accounted for 78.8% of the variance in CVI. Based on the findings, several practical recommendations for improving COVID-19 vaccination rates were discussed.

Social support for overcoming fear of contagion at the start of the COVID-19 pandemic. Cross-sectional study in Latin America

Background

The psychological impact of the COVID-19 pandemic on healthcare professionals has been widely studied, along with different strategies to minimize it. However, professionals' assessment of the social support received and the factors that mitigated their fear of contagion have not been described. This study aimed to assess healthcare professionals' satisfaction with the social support and information received and their efforts to self-isolate to avoid infecting loved ones in Chile, Colombia, and Ecuador.

Methods

A cross-sectional online survey, conducted from July to September 2020 in three Latin American countries, elicited healthcare professionals' satisfaction with social support from colleagues, their community, the media, and scientific societies; as well as the information received about the evolution of the pandemic and measures to avoid contagion. The EASE scale was used to measure acute stress.

Results

Survey responses were received from 700 professionals. The response rate per country exceeded the estimated sample size except in the case of Colombia, which was 81.4%. In general, peer support was highly valued, though satisfaction was lower in high-risk units (p < 0.001). Those who directly assisted COVID-19 patients perceived the least community support (p = 0.023). Professionals from high-risk units (p = 0.013) and those who experienced greater acute stress (p = 0.05) assigned the lowest rating to the information offered by the centre on the pandemic. Men perceived more support from colleagues and better information from the centre than women (p < 0.05). Just 10.7% of professionals changed their residence during the pandemic, but those who worked in high-risk areas self-isolated more frequently (p = 0.026).

Conclusion

In the early stages of the COVID-19 pandemic, healthcare professionals in Chile, Colombia, and Ecuador greatly valued the support received from their peers. Being infected with COVID-19, working in high-risk areas, experiencing higher self-reported acute stress, and having an infected co-worker were predictors for self-isolation to protect their relatives. These results point to the appropriateness of putting in place institutional resources based on peer support and specific communication strategies and action protocols to build resilience and responsiveness to future health crises.

Sexual self-efficacy and sexual communication among adolescent girls: moderated mediation results from a randomized controlled trial

OBJECTIVE

Guided by the Operating Conditions Framework, the goal of this study was to identify how and for whom an online sexual health program called Health Education and Relationship Training (HEART) worked.

DESIGN

Data come from a randomized controlled trial among 198 U.S. high school girls who completed HEART or an attention-matched control. We conducted mediation and moderated mediation models to determine if sexual self-efficacy was a mediator and if program acceptability and sexual activity status were moderators of HEART efficacy.

MAIN OUTCOME MEASURE

Sexual communication skills were assessed with a behavioral role-play task.

RESULTS

HEART significantly improved sexual communication skills. These effects were fully mediated through sexual self-efficacy. Specifically, HEART improved sexual self-efficacy which in turn increased sexual communication skills. Also, when participants liked the program more, the effect of HEART on sexual self-efficacy was stronger. Further, among girls who had engaged in sexual activity, sexual self-efficacy was significantly associated with sexual communication skills.

CONCLUSION

This study provides insights into the mechanisms of behavior change underlying HEART. Results highlight the need to further 'unpack' the effects of other sexual health programs, as we showed that programs may work better under certain conditions.

University Experience during the First Two Waves of COVID-19: Students' Experiences and Psychological Wellbeing

BACKGROUND

This study aimed to analyze Italian university students' psychological needs, learning experiences, and wellbeing during the first two waves of the COVID-19 pandemic.

METHODS

The study was carried out during the first wave of the pandemic, and then during the second. A total of 1230 university students (654 in stage 1 and 576 in stage 2) completed a battery of validated questionnaires exploring students' experiences in distance learning, perceived health risks related to COVID-19, and psychological wellbeing.

RESULTS

MANOVA showed a significant main effect of the pandemic stage on students' learning experience and wellbeing. In particular, students were more distracted and concerned about their academic careers during the second phase of the pandemic than in the first. Furthermore, the pandemic stage also significantly affected health risk perceptions and fear of COVID-19, which were higher during the second wave of the pandemic. Female gender and concern for a university career were significant risk factors for high levels of negative affectivity and low levels of positive affectivity during the pandemic. In contrast, adherence to COVID-19 restriction measures and good family support were protective factors.

CONCLUSIONS

It is essential to promote adequate university psychological services to support university students who have experienced the adverse psychological effects of the pandemic and enhance the resilience factors needed to improve their wellbeing in the post-pandemic period.

Self-perception and COVID-19 vaccination self-efficacy among Chinese adults: A moderated mediation model of mental health and trust

BACKGROUND

Optimal COVID-19 vaccination coverage is necessary to achieve community protection, and self-efficacy independently predict vaccination behavior. The current study examined the effect of self-perception on COVID-19 vaccination self-efficacy as well as potential mechanisms among Chinese adults.

METHODS

A cross-sectional survey was conducted from four cities in China (n = 6781). Models 4 and 8 in Hayes' PROCESS macro were used to test models.

RESULTS

Self-perception (β = 0.128, 95 % CI: 0.093-0.163) and self-perception ∗ mental health (β = 0.009, 95 % CI: 0.003-0.014) were positively associated with trust in doctors and vaccine developers, while mental health was negatively related to trust in doctors and vaccine developers (β = -0.483, 95 % CI: -0.629-0.337). Self-perception (β = 0.149, 95 % CI: 0.138-0.161), trust in doctors and vaccine developers (β = 0.185, 95 % CI: 0.177-0.194) and self-perception ∗ mental health (β = 0.003, 95 % CI: 0.002-0.005) were positively associated with COVID-19 vaccination self-efficacy. Mental health was negatively related to COVID-19 vaccination self-efficacy (β = -0.101, 95 % CI: -0.151-0.051).

LIMITATIONS

This cross-sectional study collected data through online questionnaires.

CONCLUSIONS

Our results demonstrated that the relationship between self-perception and COVID-19 vaccination self-efficacy was partially mediated by trust in doctors and vaccine developers. Both the correlation between self-perception and COVID-19 vaccination self-efficacy, and the relationship between self-perception and trust in doctors and vaccine developers were moderated by mental health. Findings confirm that increasing COVID-19 vaccination self-efficacy would be facilitated by improvements in self-perception, mental health, and trust in doctors and vaccine developers.

Cross-cultural investigation from nine countries on the associations of antisocial traits and the WHO's containment measures for the COVID-19 pandemic

Personality traits play a role in prosocial behavior in relation to containment measures intended to tackle the COVID-19 pandemic. Empirical findings indicated that individuals high in socially aversive traits such as callousness are less compliant with containment measures. This study aimed to add cross-cultural data on the relationship between antisocial traits and adherence to COVID-19 containment measures. The sample consisted of 4,538 adults recruited by convenience in nine countries (Australia, Brazil, England, Iraq, Iran, Italy, Jordan, Saudi Arabia, and the United States). Statistical analyses indicated two latent profiles from our sample, empathic and antisocial, and six COVID-19 containment-measure-related factors using measures covering antisocial traits (PID-5), empathy (ACME), global personality pathology (LPFS-BF), and COVID-19 behaviors and beliefs. Through MANCOVA, the antisocial profile consistently showed less compliance and concern about the COVID-19 containment measures, even when controlling for demographics and local pandemic covariables. The network analysis indicated a lack of empathy and callousness as crucial traits of the predisposition to non-compliant behavior. In elaborating on prosocial campaigns in community emergencies, our cross-cultural findings would need to consider personality traits that focus on antisociality, anticipating similar associations and potential impacts in future disease outbreaks.

Psychological impact of COVID-19 Pandemic on dentists

BACKGROUND

The Covid-19 pandemic seems to have an incessant out-turn on the people in every field in some or the other way. It has been reported that maximum number of deaths in the countries during this pandemic are caused due to a term called death anxiety or phobia. There are certain parameters such as anxiety, apprehension, depression which if influence a person can alter one's well-being.

OBJECTIVE

The steadfast intent of this review article is to narrate the psychological impact of this pandemic on dentists. The eloquence and emergence of this topic will alarm all the medicos and paramedics to have a check on this scenario.

METHODS

The article consists of detailed study from several articles from PubMed publications. Articles written only in English language were referred. Various keywords such as "Covid-19 pandemic" or "Psychological Impact" were used.

RESULTS

The Covid-19 Pandemic has adversely affected all of us physically as well as psychologically. This article signifies the psychological impact of this pandemic on dentists.

CONCLUSION

The current studies that are carried out till date show an extensive impact on the psychology of the dental professionals. The following review article elaborates the importance of the same.

Risk communication and risk perception along with its influencing factors in Covid-19 disease: Focusing on the Extended Parallel Process Model

INTRODUCTION

Following the global spread of the Covid-19 infection, the Iranian government adopted measures to control the spread of the disease, but they were not applicable without the acceptance and interaction of the general population. This study used the Extended Parallel Process Model (EPPM) components to attempt to determine risk communication and risk perception along with its influencing factors in Covid-19 disease among the population of northwestern Iran.

METHOD

This cross-sectional study was conducted among the general population of the province. Demographic characteristics and extended parallel process model questionnaires were used to collect data, which was then analyzed based on descriptive (frequency, mean, standard deviation) and inferential statistics (t-test, analysis of variance, regression, chi-square) in SPSS-25 software.

RESULTS

This study showed that 63.8% of the participants continually followed Covid-19 news, and 34% of participants used social media to get the news and warnings related to the Covid-19 pandemic. Among the domains of participants' risk perception for Covid-19 disease, the three domains of self-efficacy, response effectiveness and intention had the highest means compared with other domains. Significant correlations were found between risk perception and the dimensions of age, gender, marriage status, number of family members, place of residence, underlying disease, history of Covid-19, and family history of Covid-19 disease (p < 0.05). Multivariate linear regression analysis revealed that perceived sensitivity, perceived severity, self-efficacy, fear, defensive avoidance, intention, and behaviors were independent predictors of response efficacy (p < 0.001).

CONCLUSION

More than two years after the onset of the spread of Covid-19 disease, the risk perception of the disease among the study population was still insufficient in many areas. Risk of communication refers to the point of interaction between the government and the people, and the need to improve public trust in this issue is strongly felt.

Decision-making process about prenatal genetic screening: how deeply do moms-to-be want to know from Non-Invasive Prenatal Testing?

BACKGROUND

Prenatal information may be obtained through invasive diagnostic procedures and non-invasive screening procedures. Several psychological factors are involved in the decision to undergo a non-invasive prenatal testing (NIPT) but little is known about the decision-making strategies involved in choosing a specific level of in-depth NIPT, considering the increased availability and complexity of NIPT options. The main aim of this work is to assess the impact of psychological factors (anxiety about pregnancy, perception of risk in pregnancy, intolerance to uncertainty), and COVID-19 pandemic on the type of NIPT chosen, in terms of the number of conditions that are tested.

METHODS

A self-administered survey evaluated the decision-making process about NIPT. The final sample comprised 191 women (M_age = 35.53; SD = 4.79) who underwent a NIPT from one private Italian genetic company. Based on the test date, the sample of women was divided between "NIPT before COVID-19" and "NIPT during COVID-19".

RESULTS

Almost all of the participants reported being aware of the existence of different types of NIPT and more than half reported having been informed by their gynecologist. Results showed no significant association between the period in which women underwent NIPT (before COVID-19 or during COVID-19) and the preferences for more expanded screening panel. Furthermore, regarding psychological variables, results showed a significant difference between perceived risk for the fetus based on the NIPT type groups, revealing that pregnant women who underwent the more expanded panel had a significantly higher level of perceived risk for the fetus than that reported by pregnant women who underwent the basic one. There was no statistically significant difference between the other psychological variables and NIPT type.

CONCLUSIONS

Our findings indicate the paramount role of gynecologist and other health care providers, such as geneticists and psychologists, is to support decision-making process in NIPT, in order to overcome people's deficits in genetic knowledge, promote awareness about their preferences, and control anxiety related to the unborn child. Decision-support strategies are critical during the onset of prenatal care, according to the advances in prenatal genomics and to parent's needs.

The Intention of Retail Stores in Taiwan to Cooperate with the Government in the Establishment of IT Measures for Pandemic Prevention

This study focuses on the cooperative attitude and intention of retail stores in Taiwan to cooperate with the government's related pandemic prevention measures. The study is based on the Theory of Planned Behavior (TPB). The study includes factors such as perceived risk of infection, job stress, pandemic prevention IT (information technology) convenience, pandemic prevention attitude, and pandemic prevention intention. Pandemic prevention attitude is used as a mediating variable to establish the research framework. This study collected research data through a questionnaire survey. A total of 457 valid questionnaires were collected through an electronic questionnaire platform. The findings showed that perceived risk of infection and pandemic prevention IT convenience had a positive and significant effect on pandemic prevention attitude (β = 0.567; β = 0.422) and pandemic prevention intention (β = 0.424; β = 0.296). Job stress has a significant negative effect on attitude (β = -0.173). In addition, job stress influenced intention through attitudes. Finally, perceived risk, job stress, and IT convenience had high explanatory power (R² = 0.706) on attitudes. Perceived risk, IT convenience, and attitude also had moderate explanatory power (R² = 0.588) on prevention intention. The study also suggests practical recommendations to improve and cooperate with pandemic prevention intention.

How does risk perception of the COVID-19 pandemic affect the consumption behavior of green food?

Attention to health is on the rise with the global pandemic of COVID-19, especially in food security. Green food is viewed as a healthy, safe, and nutritious food, which plays a significant role in enhancing immunity. This study aimed to investigate how risk perception affects the consumption behavior of green food. Risk perception and health awareness were added to the original model based on the extended theory of planned behavior. And an online survey about the influence of COVID-19 on consumers' green food consumption behavior was conducted with 612 valid respondents recruited. The results indicate that risk perception has a positive effect on both consumption intention and behavior. The mediating effect analysis shows that risk perception influences green food consumption intention by improving people's attitudes, subjective norms, and health awareness. These findings can not only help clarify the relationship between green food consumption behavior and the risk perception of COVID-19 but also provide some valuable implications for policymakers and marketers in promoting green food.

COVID-19 pandemic and adolescent mental health in China: Micro evidence and socioeconomic mechanisms

Although the impact of the COVID-19 pandemic on adolescent mental health has received sufficient attention in the medical and public health fields, analysis from the social science perspective is still lacking. By regarding the shock of COVID-19 pandemic as a quasi-natural experiment, this study adopts the Difference-in-Differences (DID) model and large microdata from Shandong Province, China, to identify the causal effect of the COVID-19 pandemic on the mental health of senior high school students. We find that the COVID-19 pandemic results in an increase of 2.5677 points in adolescent psychological problem scores, equivalent to an average decrease of 29.93% in mental health. Furthermore, results of mechanism tests show that this negative impact of the COVID-19 pandemic on adolescent mental health can be explained by a reduction in social trust, as well as widening inequalities caused by the digital divide and family income gap. Moreover, the estimates suggest that the COVID-19 pandemic has a greater negative influence on the mental health of boys and urban adolescents. Our study complements the research field on the impact of the COVID-19 pandemic on adolescent mental health and the potential socioeconomic mechanisms from a new perspective. These findings provide insights into how to safeguard adolescent mental health in China and other countries in the pandemic prevention and post-pandemic era.

The development of coronaphobia scale and psychometric effect among UAE people

The effects of the COVID-19 pandemic on mental health are likely to worsen as the epidemic progresses and will last long even after the pandemic has passed. The present study developed a coronaphobia scale during the pandemic to measure its psychological effects such as fear, anxiety, and depression in the majority of the cases in the United Arab Emirates (UAE). It is a 35-item scale that measures anxiety symptoms connected with COVID-19 and may be used to identify people who require mental health treatment. Based on 618 adults, the reliability and validity of these items were appropriate. The scales were distributed via social media using a Google form. Internal consistency, reliability analysis, and structural equation models, particularly confirmatory factor analysis, were carried out. The elevated scores on the coronaphobia scale were associated with social phobia, anxiety, stress, and depression. The coronaphobia score distinguishes well between those with and without dysfunctional anxiety (85% specificity and 90% sensitivity). These results support the coronaphobia scale as a valid and effective tool for clinical practice and research.

Association between perceived risk of COVID-19 and support for transportation policies

The association between perceived risk of COVID-19 at the individual level and support for transportation policies designed to mitigate coronavirus transmission has received little attention. We surveyed a nationally representative sample of U.S. adults (N = 2,011) in June 2020 to examine how support for public policy varied according to perceived risk. We used logistic regression models to control for demographic factors and identify the effect of perceived risk, defined as a combination of self-reported perceptions of personal risk of acquiring the disease and the severity of the illness if infected, on support for a range of policies related to transportation. We found that perceived risk did not vary significantly by sex, race, urbanicity, income, or age. Support for policies aimed at mitigating COVID-19 transmission was consistently higher among those with higher perceived risk of the disease.

Intrapersonal and interpersonal level factors influencing self-care practices among Hong Kong individuals with COVID-19-A qualitative study

Background

The unprecedented crisis during the fifth wave of the COVID-19 pandemic in Hong Kong placed a significant burden on the health care system. Therefore, the Hong Kong government advocated that individuals with no or mild COVID-19 symptoms should self-care at home. This study aimed to understand intrapersonal and interpersonal level factors that shaped self-care practices among home-quarantined individuals with COVID-19 during the peak of the pandemic.

Methods

This study used convenience and snowball sampling whereby a total of 30 semi-structured telephone interviews were conducted between March and April 2022. Inductive content analysis was used to analyze the data.

Results

Factors reported at the intrapersonal level included socioeconomic status and housing conditions, information and knowledge about COVID-19, long COVID, and psychological adjustments brought about by home quarantine. Factors identified at the interpersonal level included caregiving responsibilities, family relationships, and social support.

Conclusions

Findings from this study identified a combination of intra and interpersonal level factors influenced an individual's self-care practices as a result of pandemic-induced quarantine. It was particularly concerning for those individuals in socially and economically deprived groups, where access to services was challenging. This study also raised awareness of the ineffectual and insufficient knowledge individuals held of self-medication and overall COVID-19 management. A key recommendation is developing family-based resilience programmes to support and empower vulnerable families to better cope with the realities of self-quarantine.

Measuring the Intention in Favour and Against Getting Vaccinated from COVID-19 Using the Health Belief Model: Cross-Sectional Study of Pakistan

Vaccination is without a doubt one of the most efficient ways to stop the COVID-19 pandemic from spreading. The goal of this study was to look into the acceptance and resistance to COVID-19 vaccination and its associated components using the Health Belief Model, which is a framework for changing health behaviours (HBM). The current study is quantitative; hence data was collected from attendants of patients admitted to hospitals in Pakistan's top-tier cities using a survey-based self-administered questionnaire. Nonprobability convenient sampling was utilised to approach the respondents. The model was tested in two stages using partial least squares (variance-based structural equation modelling). The measurement model's reliability and validity imply that the data is reliable and valid. Except for the impact of benefits on accepting behaviour, all of the study postulated relationships are supported by the results. The study agenda adds to our understanding of health care, immunisation, consumer behaviour, and behavioural research. It adds to the body of knowledge in the fields of immunisation and behavioural research by examining people's behaviours and changes during the worldwide mass vaccination period.

Examining the Influence of Housing Conditions and Daily Greenspace Exposure on People’s Perceived COVID-19 Risk and Distress

Many people have worried about COVID-19 infection, job loss, income reduction, and family conflict during the COVID-19 pandemic. Some social groups may be particularly vulnerable due to their residential neighborhoods and daily activities. On the other hand, people’s daily exposure to greenspace offers promising pathways for reducing these worries associated with COVID-19. Using data collected with a questionnaire and a two-day activity diary from two typical neighborhoods in Hong Kong, this study examines how people’s housing conditions and daily greenspace exposure affect their perceived COVID-19 risk and distress (i.e., worries about job loss, income reduction, and family conflict) during the pandemic. First, the study compares people’s perceived COVID-19 risk and distress based on their residential neighborhoods. Further, it examines the associations between people’s perceived COVID-19 risk and distress with their housing conditions and daily greenspace exposure using ordinal logistic regression models. The results indicate that living in a high-risk neighborhood, being married, renting a residential unit, and living in a large household are significantly associated with a higher neighborhood-based perceived COVID-19 risk and distress during the pandemic. In addition, people also reported lower mobility-based perceived COVID-19 risk when compared to their neighborhood-based perceived COVID-19 risk, while they still have a high perceived COVID-19 risk in their occupational venues if they have to work in a high-risk district (e.g., Kowloon). Lastly, daily greenspace exposure (i.e., woodland) could reduce people’s perceived COVID-19 risk and distress. These results have important implications for the public health authority when formulating the measures during the COVID-19 pandemic.

Prevalence of Post-traumatic Stress Disorder Status Among Healthcare Workers and Its Impact on Their Mental Health During the Crisis of COVID-19: A Cross-Sectional Study

Objective

After the unprecedented coronavirus disease 2019 (COVID-19) outbreak, the health status of the general population has suffered a huge threat, and the mental health of front-line healthcare providers has also encountered great challenges. Therefore, this study aims to: (1) investigate the prevalence and influencing factors of post-traumatic stress disorder (PTSD) among healthcare providers, and (2) verify the moderating role of self-efficacy in the influence of PTSD on mental health.

Methods

A cross-sectional study was conducted using an online survey of 1993 participants. The presence of depression, anxiety, self-efficacy, and PTSD was evaluated using screening tests from March 1. Sociodemographic and COVID-19-related data were also collected. A data analysis was performed using descriptive statistics, Pearson's correlation coefficient, and multiple linear regression.

Results

The prevalence of PTSD among healthcare providers was 9.3%. PTSD was negatively correlated with self-efficacy (r = -0.265, P < 0.01), anxiety (r = -0.453, P < 0.01), and depression (r = 0.708, P < 0.01). Profession, daily working hours, maximum continuous working days, and daily sleep time were influencing factors of PTSD. A binary logistic regression analysis showed that physicians (OR = 2.254, 95% CI = 1.298, 3.914) and nurses (OR = 2.176, 95% CI = 1.337, 3.541) were more likely to experience PTSD than other healthcare providers.

Conclusion

Self-efficacy has a moderating effect on the influence of PTSD on anxiety and depression. This suggests that health managers need to respond to the current psychological crisis of healthcare providers, implement appropriate psychological interventions, and minimize the psychological harm caused by COVID-19.

Flow Experience and Emotional Well-Being among Italian Adolescents during the COVID-19 Pandemic

Research highlighted the negative consequences of the COVID-19 pandemic on adolescents' emotional well-being worldwide. In the attempt to identify resources which could facilitate adolescents' adjustment, this study examined the occurrence of flow experience and related activities, and the association between flow and emotional well-being among Italian teenagers. In Spring 2021, 150 students (40.7% girls) aged 15-19 completed instruments assessing flow and related activities before and during the pandemic, and current positive and negative affect. Findings revealed that only 24.7% of the participants currently reported flow; over half of those reporting flow before the pandemic did not experience it subsequently, and only 6.5% of those not reporting flow before the pandemic currently experienced it. Participants with flow both before and during the pandemic reported higher positive affect than teens who never experienced flow (p = .011), or lost it (p = .006). No group differences were detected for negative affect. Learning, structured leisure, and interpersonal relations were the domains most frequently associated with flow before and during the pandemic, but after the pandemic onset a reduction in the variety of flow activities and limited identification of new flow domains were observed. The association of flow with higher emotional well-being even in pandemic times suggests the potential usefulness of interventions promoting flow retrieval under adverse circumstances.

Psychological wellbeing and associated factors among nurses exposed to COVID 19: Findings from a cross sectional study

BACKGROUND

The coronavirus pandemic known as COVID-2019 poses a global concern. The psychological well-being of front-line nurses and other healthcare providers is a major concern.

AIMS

This study evaluated the psychological well-being and the associated factors among nurses in Dr. Soliman Fakeeh Hospital during the COVID-19 pandemic.

METHODS

The cross-sectional survey was conducted during the peak period of COVID 19 among 367 nurses recruited from Dr. Soliman Fakeeh Hospital. The online survey was used with the snowballing sampling technique to collect the participants' socio-demographic data and assess their psychological status using DASS-21; in addition, the major traumatic event was assessed by Impact of Event Scale-Revised, and self-efficacy was evaluated.

RESULTS

67.7% of the 367 respondents experienced moderate or severe psychological problem; 46.1% reported moderate to severe depressive symptoms; 48.0% moderate to severe anxiety symptoms; and 48.4% moderate to severe stress levels. The psychological status and influence of a major traumatic event and self-efficacy were statistically significant different among nurses according to age, gender, working experience, marital status, working in a COVID 19 unit or with suspected cases.

CONCLUSIONS

Nurses had a significantly increased risk of developing psychological problems, negatively impacted by the major traumatic event and poor self-efficacy.

Adolescents' adherence to Centers for Disease Control and Prevention guidelines during the COVID-19 pandemic

BACKGROUND

The outbreak of the coronavirus (COVID-19) pandemic in the United States resulted in safety guidelines from the Centers for Disease Control and Prevention (CDC) intended to curb the spread of the virus. Adolescents are potentially at risk for disregarding these guidelines due to their reduced psychosocial maturity compared with adults. The current study examined the relationship between adolescents' psychosocial maturity, perceived importance of the CDC guidelines and adherence to the CDC guidelines within some of the highest risk groups for contracting COVID-19 in a county particularly impacted by the pandemic (i.e., Hispanic and low-SES youth in El Paso, Texas).

METHODS

Participants completed a phone interview with a research assistant regarding their thoughts and behaviours in the initial months of the COVID-19 pandemic. Adolescents (N = 68) were 15.38 years old on average (SD = 1.05, range = 13, 17), predominantly male (60.3%) and nearly exclusively Hispanic/Latino (94.1%).

RESULTS

Results indicated that although more psychosocially mature adolescents reported greater adherence to the CDC guidelines than less psychosocially mature adolescents, the association between psychosocial maturity and adherence was fully mediated by how important adolescents felt it was to follow the guidelines. Specifically, greater perceived importance was associated with greater adherence to the guidelines.

CONCLUSIONS

The current study found that more psychosocially mature adolescents adhere to CDC's safety guidelines better than less psychosocially mature adolescents because they are more likely to view the guidelines as important. Information that attempts to increase adolescent adherence to the guidelines should therefore emphasize not only that following the guidelines is important, but why following the guidelines is so important. Less psychosocially mature adolescents may benefit most from interventions efforts and targeted messages regarding the importance of following the CDC's guidelines, as more psychosocially mature adolescents already recognize this importance.

Maternal Anxiety Symptoms and Chinese Adolescents' Mental Health During the COVID-19 Pandemic: The Protective Role of Adolescents' Self-Compassion

The COVID-19 outbreak triggered dramatic changes to family life. Parents, especially mothers, were found to experience more psychological distress during the pandemic, which may have had an impact on their children's mental health. The primary goal of this study was to examine the potential protective role of adolescents' self-compassion in the relationship between maternal anxiety and adolescents' mental health during the COVID-19 pandemic. Participants included 5,720 adolescents (48.9% girls; M age = 11.60, SD age = 1.36) and their mothers from Zhengzhou city, Henan province, in Mainland China. Adolescents reported their level of self-compassion, PTSD symptoms, and negative affect during the COVID-19 pandemic. Mothers reported their own anxiety symptoms and their children's depression and anxiety symptoms. Results indicated that older female adolescents reported higher levels of PTSD symptoms and negative affect and lower levels of self-compassion than their counterparts. Maternal anxiety during the COVID-19 pandemic was consistently positively associated with adolescents' psychological maladjustment. These associations were buffered by adolescents' self-compassion. Specifically, adolescents with higher levels of self-compassion were found to be less psychologically affected by their mothers' anxiety during the COVID-19 pandemic. Findings highlighted the possibility of improving adolescents' mental health through fostering their self-compassion during the COVID-19 pandemic.

Activating Self-Transcendence Values to Promote Prosocial Behaviors among Adolescents during the COVID-19 Pandemic: The Moderating Role of Positive Orientation

The COVID-19 pandemic has severely affected people's health, daily routine, and behaviors. Its effects have been most pronounced for the youngest and oldest generations. Their daily lives have completely changed throughout the pandemic. Self-transcendence values and positive orientation could facilitate optimal adjustment to this situation by promoting prosociality. The present study aimed to discover if applying a new, web-based intervention could activate self-transcendence values in a group of Italian adolescents, fostering COVID-19 prosocial behaviors while also considering the role of positive orientation. The study adopted a longitudinal, web-based, and quasi-experimental design. One hundred and forty adolescents between 15 and 19 years of age were involved in the study two times (T1-T2). Participants were assigned to an intervention or control group. All participants completed the self-transcendence subscale extracted from the 21-item Portrait Values Questionnaire, the Positive Orientation Scale, and the COVID-19 Prosocial Experiences Scale. The results showed that adolescents' self-transcendence values and positive orientation were positively associated with COVID-19 prosociality. However, the relationship between self-transcendence values and COVID-19 prosocial behaviors was significantly more robust in the intervention group. Finally, a three-way interaction (self-transcendence*group*positive orientation) emerged as significant. For the intervention group, the effect of self-transcendence values on COVID-19 prosocial behaviors was significant only for adolescents who reported a strong positive orientation. Limitations of the study, future research developments, and practical implications are discussed.

Health anxiety model of cyberchondria, fears, obsessions, sleep quality, and negative affect during COVID-19

The aim of the study was to explore the relationships among cyberchondria, fear of COVID-19, health anxiety, obsessions, sleep quality, and negative affect in a national community sample of Turkish participants. A sample of 8,276 volunteers, aged between 18 and 65, were recruited via an online platform. The Perceived Vulnerability about Diseases Questionnaire, Fear of COVID-19 Scale, Cyberchondria Severity Scale, Short Health Anxiety Inventory, Depression Stress Anxiety Scale-21, Obsessive-Compulsive Inventory-Revised, and Pittsburgh Sleep Quality Index were completed by participants. Data were analyzed using mixture structural equation modelling approach. Results revealed that perceived vulnerability to disease was found to be positively related with cyberchondria, poor sleep quality, health anxiety, and obsessive-compulsive symptoms. Negative affect was positively associated with obsessive-compulsive symptoms, fears of COVID-19, cyberchondria severity, and poor sleep quality. Additionally, fear of COVID-19 was positively related to health anxiety. Also, cyberchondria severity was found to be positively associated with poor sleep quality and obsessive-compulsive symptoms. Mixture analysis classified participants into six latent classes: 1) Risk-Aversive Healthy Group, 2) Incautious Healthy Group, 3) Infection Obsessions Group, 4) Health Anxiety Group, 5) Negative Affect Group, and 6) General Psychopathology Group. The national survey data showed that perceived vulnerability to diseases, negative affect, fear of COVID-19, cyberchondria, health anxiety, obsessive-compulsive symptoms, and sleep quality appeared to be at the center of pandemic health anxiety.

Risk Perception among Psychiatric Patients during the COVID-19 Pandemic

The fear of the new coronavirus infection has driven many non-COVID-19 patients away from essential healthcare. Our study aimed to investigate the perception of risk and feelings of danger for the contagion in a sample of Italian psychiatric patients. We conducted a cross-sectional observational study during the second wave of the COVID-19 pandemic and the lockdown in Italy. The risk perception and risk-related variables were assessed in a sample of 150 consecutive patients with a previous diagnosis of major depression (50), bipolar I disorder (50), and schizophrenia seeking ambulatory care using a questionnaire previously administered to the general Italian population. Our results showed that patients were more concerned about economic, psychological, and interpersonal consequences of COVID-19 pandemic, rather than about their own health. At the multiple regression analysis, the likelihood of COVID-19 resolution was positively influenced by the diagnosis of schizophrenia, the increased perceived effectiveness, and the presence of positive emotions. Indeed, positive emotions and uncertainty positively influenced interpersonal risk. Our study highlights the need to provide more support to psychiatric patients during emergency events to prevent them from engaging in risky behaviors.

Your pain, my gain: The relationship between self-report and behavioral measures of everyday sadism and COVID-19 vaccination intention

Vaccination plays a crucial role in containing the spread of the COVID-19 pandemic. However, a significant fraction of the global population is reluctant to take a coronavirus vaccine. A burgeoning literature has considered mainly adaptive personality traits as antecedents of vaccine hesitancy (i.e., Big Five and HEXACO), while maladaptive personality traits (i.e., "Dark Tetrad" of personality) are often a comparatively neglected area. In this research, we examined the relationship between everyday sadism and intention to get vaccinated against COVID-19. We theorized that driven by antisocial tendencies and social indifference, individuals with higher sadism may be less willing to obtain a vaccine. Employing a bug-killing paradigm to capture everyday sadism, we tested this prediction in a Chinese sample of non-student adults (N = 188). Support for this proposition was found in the lab task, which demonstrates that sadism was associated with more vaccine refusal spanning the self-report and behavioral domains. In addition, we showed that the sadistic behavioral choices can be predicted with self-report measure of sadistic personality. These findings highlight the important role of maladaptive personality traits in predicting vaccination attitudes and intentions.

Evaluation of Stigma Related to Perceived Risk for Coronavirus-19 Transmission Relative to the Other Stigmatized Conditions Opioid Use and Depression

BACKGROUND

The coronavirus-19 (COVID-19) pandemic was initially characterized by misinformation and fear related to transmission that has been previously shown to produce stigma toward persons perceived to be at risk for transmission. This study evaluated perceptions toward scenarios with variable levels of perceived risk for COVID-19 acquisition, and compared stigma to COVID-19 to depression and opioid use disorder.

METHODS

Respondents (N = 280) from the United States completed a web-based survey 6 months after pandemic declaration. Questions included demographics and COVID-19 misconceptions, expected response to hypothetical scenarios with variable risk for COVID-19, and the Attribution Questionnaire-9 for COVID-19, depression, and opioid use disorder.

RESULTS

Participants had several COVID-19 misconceptions, including that opioids increased immunity (63.6%), persons were more susceptible based upon racial/ethnic background (63.2%), and underlying health conditions did not influence risk (58.9%). Respondents were highly likely (64/100) to assume someone coughing had COVID-19 and the majority (93.5%) recommended quarantining persons with recent travel. However, the majority of respondents (>70% in all cases) also believed they would not change their COVID-19-related behavior when interacting with persons of different racial, ethnic, and age backgrounds. Finally, persons with COVID-19 engendered greater pity, less fear, less blame, less anger, and more willingness to help from respondents relative to persons with opioid use disorder.

CONCLUSION

Stigma ratings toward persons perceived at risk of transmitting COVID-19, collected soon after the onset of the pandemic, showed less evidence of stigma relative to persons with opioid use disorder despite pronounced misconceptions regarding COVID-19 risk. Data provide a foundation for additional research in this area.

Living Alone or Together During Lockdown: Association with Mood, Immune Fitness and Experiencing COVID-19 Symptoms

Purpose

The aim of this study was to evaluate whether or not living alone or together throughout the lockdown had an impact on mood, perceived immune fitness, as well as the presence and severity of COVID-19 symptoms.

Methods

N = 505 participants completed an online survey, which included questions on living situations, as well as mood, perceived immune fitness and COVID-19 symptom presence and severity. These factors were assessed retrospectively for the time periods before and during the COVID-19 pandemic.

Results

An overall decrease in mood was observed for both those living alone and together during the lockdown period. However, significantly larger increases in feelings of loneliness were observed for the group living alone. Furthermore, both groups reported decreases in perceived immune fitness, whereas only the group living alone reported a significant increase in COVID-19 symptom presence and severity. Moreover, significant correlations were found between perceived immune fitness, anxiety, and loneliness. These correlations were strongest in the group living alone. Lastly, positive correlations were found between perceived immune fitness and mood outcomes with being active, optimistic and the ability to cope with stress. Increased optimism, being more active and the adequate ability to cope with stress were associated with a reduced negative impact on perceived immune fitness.

Conclusion

The first COVID-19 lockdown period in the Netherlands was a challenging period for both people who lived alone and those living together, resulting in decreases in mood and poorer perceived immune fitness. Those living alone were, however, more heavily impacted by the lockdown restrictions. This was further reflected by the increased presence and severity of COVID-19 symptoms in people who lived alone during the first COVID-19 lockdown in The Netherlands.

Insights into the impact on daily life of the COVID-19 pandemic and effective coping strategies from free-text analysis of people's collective experiences

There has been considerable speculation regarding how people cope during the COVID-19 pandemic; however, surveys requiring selection from prespecified answers are limited by researcher views and may overlook the most effective measures. Here, we apply an unbiased approach that learns from people's collective lived experiences through the application of natural-language processing of their free-text reports. At the peak of the first lockdown in the United Kingdom, 51 113 individuals provided free-text responses regarding self-perceived positive and negative impact of the pandemic, as well as the practical measures they had found helpful during this period. Latent Dirichlet Allocation identified, in an unconstrained data-driven manner, the most common impact and advice topics. We report that six negative topics and seven positive topics are optimal for capturing the different ways people reported being affected by the pandemic. Forty-five topics were required to optimally summarize the practical coping strategies that they recommended. General linear modelling showed that the prevalence of these topics covaried substantially with age. We propose that a wealth of coping measures may be distilled from the lived experiences of the general population. These may inform feasible individually tailored digital interventions that have relevance during and beyond the pandemic.

The Impact of the Corona Virus Disease 2019 Pandemic on Chinese Middle School Students' Self-Perceived Emotional States: A Wuhan Perspective

This mixed-methods study examined the impact of the COVID-19 pandemic on 1493 Grades 7, 8, and 9 students’ self-perceived emotional states in Wuhan, China when it was locked down for the pandemic on January 23, 2020 and when the lockdown was lifted on April 8, 2020, as well as the changes of their emotional states over the 1-year period after the lockdown was lifted. A five-point Likert scale survey was administered to the participants between March 1 and April 1, 2020 when Wuhan was blocked down; and three focus group interviews were conducted between May 1 and May 31, 2021, 1 year after the lockdown was lifted. The results showed that these students in Wuhan experienced feelings of loss of control and negative emotions when the city was locked down and they were home quarantined; furthermore, there were significant differences for their self-perceived feelings of loss of control and negative emotions across demographic variables of gender, grade level, physical activity, social economic status, and family cohesion; finally, their emotional states changed substantially at different time nodes during this pandemic. Implications for students, parents, and schools are discussed.

Associations of COVID-19 Knowledge and Risk Perception with the Full Adoption of Preventive Behaviors in Seoul

This study explores the levels of COVID-19 knowledge, risk perception, and preventive behavior practice in Seoul, to determine whether knowledge and risk perception are significantly associated with the full adoption of preventive behaviors, for the delivery of a customized public campaign to Seoul's citizens. A total of 3000 Seoul residents participated in this study through an online questionnaire survey. They had a mean score of 84.6 for COVID-19 knowledge (range: 0-100 points) and 4.2 (range: 1-7 points) for risk perception. Of the participants, 33.4% practiced full adoption of all three preventive behaviors: hand hygiene, wearing a face mask, and social distancing; wearing a face mask was practiced the most (81.0%). Women significantly adopted these three preventive behaviors more often compared with men. Both COVID-19 knowledge and risk perception were found to be significantly associated with the full adoption of preventive behaviors; however, this association differed by the type of preventive behavior. This indicates that city-level information on the levels of COVID-19 knowledge, risk perception, and preventive behaviors should be clearly and periodically communicated among public officers and healthcare professionals to continually raise the public's awareness of the full adoption of non-pharmaceutical preventive behaviors.

Knowledge, acceptance and perception on COVID-19 vaccine among Malaysians: A web-based survey

BACKGROUND

Coronavirus disease 2019 or COVID-19 is caused by a newly discovered coronavirus, SARS-CoV-2. The Malaysian government has planned to procure COVID-19 vaccine through multiple agencies and companies in order to vaccinate at least 70% of the population. This study aimed to determine the knowledge, acceptance and perception of Malaysian adults regarding the COVID-19 vaccine.

METHODOLOGY

An online survey was conducted for two weeks in December 2020. A bilingual, semi-structured questionnaire was set up using Google Forms and the generated link was shared on social media (i.e., Facebook and WhatsApp). The questionnaire consisted of questions on knowledge, acceptance and perception of COVID-19 vaccine. The association between demographic factors with scores on knowledge about COVID-19 vaccine were analysed using the Mann-Whitney test for two categorical variables, and the Kruskal-Wallis test used for more than two categorical variables.

RESULTS

A total of 1406 respondents participated, with the mean age of 37.07 years (SD = 16.05) years, and among them 926 (65.9%) were female. Sixty two percent of respondents had poor knowledge about COVID-19 vaccine (mean knowledge score 4.65; SD = 2.32) and 64.5% were willing to get a COVID-19 vaccine. High knowledge scores associated with higher education background, higher-income category and living with who is at higher risk of getting severe COVID-19. They were more likely to be willing to get vaccinated if they were in a lower age group, have higher education levels and were female.

CONCLUSION

Even though knowledge about vaccine COVID-19 is inadequate, the majority of the respondents were willing to get vaccinated. This finding can help the Ministry of Health plan for future efforts to increase vaccine uptake that may eventually lead to herd immunity against COVID-19.

Attachment, Personality and Locus of Control: Psychological Determinants of Risk Perception and Preventive Behaviors for COVID-19

Background: The understanding of factors that shape risk perception is crucial to modulate the perceived threat and, in turn, to promote optimal engagement in preventive actions. Methods: An on-line, cross-sectional, survey was conducted in Italy between May and July 2020 to investigate risk perception for COVID-19 and the adoption of preventive measures. A total of 964 volunteers participated in the study. Possible predictors of risk perception were identified through a hierarchical multiple linear regression analysis, including sociodemographic, epidemiological and, most of all, psychological factors. A path analysis was adopted to probe the possible mediating role of risk perception on the relationship between the independent variables considered and the adoption of preventive measures. Results: Focusing on the psychological predictors of risk perception, high levels of anxiety, an anxious attachment, and an external locus of control predicted higher perceived risk. Conversely, high levels of openness personality and of avoidant attachment predicted a lower perception of risk. In turn, the higher was the perceived risk the higher was the adoption of precautionary measures. Furthermore, psychological factors influenced the adoption of preventive behaviors both directly and indirectly through their effect on risk perception. Conclusions: Our findings might be taken into high consideration by stakeholders, who are responsible for promoting a truthful perception of risk and proper compliance with precautionary measures.

The Psychological Impact of Coronavirus Pandemic Restrictions in Italy. The Mediating Role of the Fear of COVID-19 in the Relationship between Positive and Negative Affect with Positive and Negative Outcomes

Italy was quickly hit hard by the coronavirus. 'Lockdown' has significantly impacted the psychological health, personal wellbeing and quality of life of the people. The study aims to explore the relationship between positive and negative affect, as well as positive (spiritual well-being and flourishing) and negative outcomes (psychological distress caused by a traumatic life event in terms of perception of PTSD symptoms) on Italian adults during the lockdown period. Data was collected between April and May 2020. The participants were 281 Italian adults aged between 18 and 73 years. The survey was composed of the following measures: Flourishing Scale, Jarel Spiritual Well-Being scale, Positive and Negative Affect Schedule, Impact of Event Scale-Revised, Fear of COVID-19. The mediational analysis shows that fear of COVID-19 fully mediates the relationship between negative affect and spiritual well-being and flourishing; fear of COVID-19 partially mediates the relationship between negative affect and PTSD symptoms; the positive affect shows only direct effects on positive outcomes. Therefore, fear of COVID-19 does not play any mediation role. Implications for psychological interventions and future research will be discussed.

Risk-Aversion for Negative Health Outcomes May Promote Individual Compliance to Containment Measures in Covid-19 Pandemic

First-person experience of stressful life events can change individuals' risk attitudes, driving to increased or decreased risk perception. This shift to more risk-averse or risk-loving behaviors may find a correlate in the individual psycho-socio-emotional profile. To this purpose, we aimed to estimate the relationship between differences in risk-taking attitudes toward possible negative health outcomes and psycho-socio-emotional dimensions modulating the experience of life-threatening situations, in the context of the Covid-19 pandemic. In March 2020, we launched the PsyCovid Study (https://wprn.org/item/428452) to assess psycho-socio-emotional changes due to Covid-19 pandemic in the Italian population. Additionally, we distributed to 130 participants the Covid-19 Risk Task, including monetary and health-related stimuli, estimating a measure of risk-aversion toward health and classifying participants on the basis of their risk-attitude profiles. The set of psycho-socio-emotional variables was reduced to three PCA components: Proactivity, Isolation, Inactivity. The individual degree of risk-aversion toward negative health outcomes was directly related to Proactivity, encasing empathic, social support and positive coping strategies, which may prompt individuals to put in place self-protection strategies toward possible negative health consequences. These findings indicate that a risk-averse profile toward possible negative health outcomes may be associated to higher levels of individual prosocial and proactive dispositions, possibly making individuals' more compliant with the social and hygienic guidelines and, thus, reducing their exposure to the SARS-CoV-2 infection.

Latent trait models for perceived risk assessment using a Covid-19 data survey

Aim of the contribution is analyzing potential events that may negatively impact individuals, assets, and/or the environment, and making judgments about the perceived personal and social riskiness of Covid-19 compared to other hazards belonging to health (AIDS, cancer, infarction), environmental (climate change), behavioral (serious car accidents), and technological (nuclear weapons) domains. The comparative risk analysis has been performed on a survey data collected during the first Italian Covid-19 lockdown. An item response theory model for polytomously scored items has been implemented for the analysis of the positioning of Covid-19 with respect to the other hazards in terms of perceived risk. Among the attributes determining the hazard's perceived risk, Covid-19 distinguishes for the knowledge of risks from the hazard, media attention, and fear caused by the hazard in the peers. Besides, through a latent regression analysis, the role of some individual characteristics on the perceived risk for Covid-19 has been examined. Our contribution allows us to disentangle among several aspects of hazards and describe the main factors affecting the perceived risk. It also contributes to determine if existing control measures are perceived as adequate and the interest for new media with related impact on a person's reaction.

Prevalence of COVID-19 Anxiety in Division I Student-Athletes

Anxiety and depressive symptoms are prevalent in athletes. The pandemic of novel coronavirus (COVID-19) may increase risk for symptoms due to fear of exposure during competition or uncertainty regarding participation. The current study examined the prevalence of COVID-19 anxiety in 437 National Collegiate Athletic Association Division I student-athletes and its association with psychological symptoms. Only 0.2% of participants endorsed COVID-19 anxiety symptoms above cutoff. COVID-19 anxiety did not change after postponement of fall sports or differ between persons competing in different seasons. However, higher levels of COVID-19 anxiety were significantly associated with depression, anxiety, and stress. Though student-athletes generally reported low levels of psychological symptoms, females endorsed significantly higher levels than males. Low levels of COVID-19 anxiety in student-athletes may reflect protective factors (e.g., health knowledge, emotion regulation) or the tendency for this population to minimize psychological symptoms. Further investigations on the psychological impact of COVID-19 in athletes is needed.

Psychological Well-Being in Chinese College Students During the COVID-19 Pandemic: Roles of Resilience and Environmental Stress

Psychological well-being is an important indicator of well-being and has been found to be associated with a multitude of positive life outcomes. Using data collected from 1,871 Chinese college students from September 23 to October 5, 2020, this study examined students' psychological well-being during the COVID-19 pandemic and investigated how resilience and pandemic-related environmental stress may affect psychological well-being. Results showed that resilience had strong positive effects on psychological well-being during the pandemic. Meanwhile, environmental stress had a moderate effect and marginally reduced psychological well-being. The magnitudes of the estimates suggested that increasing resilience can effectively buffer the negative effect of environmental stress on psychological well-being.

Psychological Distress Among Chinese College Students During the COVID-19 Pandemic: Does Attitude Toward Online Courses Matter?

Due to the pandemic of coronavirus disease 2019 (COVID-19), taking online courses has become a "new normality" for college students. This study paid particular attention to the role of college students' attitude toward online courses (ATOC) in shaping their psychological distress during the COVID-19 epidemic in China. Participants were from a national panel survey that has been administered before and during the COVID-19 epidemic. Besides bivariate analysis, a multivariate regression model while adjusting for a lagged dependent variable (i.e., pre-COVID distress) was estimated to show the association between ATOC and during-COVID distress. We found that respondents from a disadvantaged family background (i.e., below-college parental education, below-average family economic condition, and rural residence) were more likely to have an "unsupportive" ATOC. Moreover, both bivariate and multivariate analyses confirmed that respondents with a "neutral" or "unsupportive" ATOC had greater during-COVID psychological distress, compared to their counterparts with a "supportive" ATOC. Given the persistent spread of the COVID-19 worldwide and the profound onsite-online transition in course delivery in higher education, students' perceptions and evaluations of the massive online courses should be carefully considered and integrated into curriculum reforms in both present and post COVID-19 situations.

Prioritizing the Mental Health and Well-Being of Healthcare Workers: An Urgent Global Public Health Priority

The COVID-19 pandemic has had an unprecedented impact on health systems in most countries, and in particular, on the mental health and well-being of health workers on the frontlines of pandemic response efforts. The purpose of this article is to provide an evidence-based overview of the adverse mental health impacts on healthcare workers during times of crisis and other challenging working conditions and to highlight the importance of prioritizing and protecting the mental health and well-being of the healthcare workforce, particularly in the context of the COVID-19 pandemic. First, we provide a broad overview of the elevated risk of stress, burnout, moral injury, depression, trauma, and other mental health challenges among healthcare workers. Second, we consider how public health emergencies exacerbate these concerns, as reflected in emerging research on the negative mental health impacts of the COVID-19 pandemic on healthcare workers. Further, we consider potential approaches for overcoming these threats to mental health by exploring the value of practicing self-care strategies, and implementing evidence based interventions and organizational measures to help protect and support the mental health and well-being of the healthcare workforce. Lastly, we highlight systemic changes to empower healthcare workers and protect their mental health and well-being in the long run, and propose policy recommendations to guide healthcare leaders and health systems in this endeavor. This paper acknowledges the stressors, burdens, and psychological needs of the healthcare workforce across health systems and disciplines, and calls for renewed efforts to mitigate these challenges among those working on the frontlines during public health emergencies such as the COVID-19 pandemic.

Individual and community psychological experiences of the COVID-19 pandemic: The state of emergency in Portugal

Individuals have different ways of coping with crisis. Individual factors, family and contextual features, and community support may influence how individuals feel, think and act during a crisis. COVID-19 was an unexpected pandemic that forced many European countries to take confinement measures and restrict social face to face interactions. This study is an effort to understand how Portuguese residents dealt with the pandemic during the first confinement period, considering different sociodemographic characteristics and trauma exposure perceptions. Five hundred and five adults, between 18 and 79 years old participated in this study via an online self-report assessment protocol. Sociodemographic characteristics such as gender, age, marital status, employment status, and caring responsibilities had an impact on individuals' perceptions regarding their exposure to the pandemic and their quality of life. Perceived exposure to the pandemic was found to predict quality of life in the physical, psychological, and environmental domains. Results have practical implications for European and local policy-making, as well as for targeting psychological interventions for those whose mental health has been negatively affected by the pandemic and for those who may become more affected if confinement measures are implemented again.

Psychosocial Framework of Resilience: Navigating Needs and Adversities During the Pandemic, A Qualitative Exploration in the Indian Frontline Physicians

Introduction

Frontline healthcare workers (HCW) have faced significant plight during the ongoing Coronavirus disease 2019 (COVID-19) pandemic. Studies have shown their vulnerabilities to depression, anxiety disorders, post-traumatic stress, and insomnia. In a developing country like India, with a rising caseload, resource limitations, and stigma, the adversities faced by the physicians are more significant. We attempted to hear their "voices" to understand their adversities and conceptualize their resilience framework.

Methods

A qualitative approach was used with a constructivist paradigm. After an initial pilot, a socio-demographically heterogeneous population of 172 physicians working in COVID-designated centers were purposively sampled from all over India. Following in-depth virtual interviews using a pre-formed semi-structured guide, the data was transcribed and translated verbatim. The interview was focused on their challenges, needs, and processes of coping and support. Charmaz's grounded theory was used for analysis supplemented by NVivo 10 software.

Results

Fear of infection, uncertainty, stigma, guilt, and social isolation emerged as the main challenges. Simultaneously, their "unmet needs" were flexible work policies, administrative measures for better medical protection, the sensitivity of media toward the image of HCW, effective risk communication for their health, and finally, social inclusion. Their resilience "framework" emerged as a process while navigating these adversities and consisted of three facets: forming a "resilient identity," managing the resilience, and working through the socio-occupational distress. The role of mental well-being, social network, peer support, problem negotiation, and self-care emerged as the key coping strategies.

Conclusion

The study findings support the global call for better psychosocial health and quality of life of the frontline HCWs. Their "unheard voices" explored in the study can anchor subsequent resilience-enhancing interventions and policies. Guidelines focusing on the psychological wellbeing of frontline HCWs need to be grounded in their unmet needs and lived experiences.

Positive Environments and Precautionary Behaviors During the COVID-19 Outbreak

Theoretically, a positive environment (PE) includes (a) tangible and intangible resources that satisfy human needs, (b) enablers of healthy, pro-social, and pro-environmental behaviors that guarantee socio-environmental quality and wellbeing, and (c) environmental challenges that must be faced and solved. One of the most salient challenges is the global COVID-19 pandemic. This study sought to investigate whether PEs can stimulate responsible actions (i.e., self-care and precautionary behaviors against COVID-19), while maintaining personal wellbeing. Nine hundred and forty-nine Mexicans participated in an online survey encompassing five primary factors: resources, enablers, challenges, responsible health behaviors, and wellbeing. The first three factors examine "resources" such as physical infrastructure as well as family and social support, "enablers" which include information about protective health practices and perceived legitimacy of authorities in handling the pandemic, and "challenges" encompassing threat perception and social pressure to not engage in precautionary measures. Participants also self-reported hedonic wellbeing as well as self-care and precautionary behaviors, which formed the "responsible (health) behavior" factor. Structural equations model (n = 714 after list-wise deletion) showed that "resources," "challenges," and "enablers" form a second-order factor, "positive environments," and this factor strongly covaries with "responsible behavior" and "wellbeing." These results suggest that PEs are not only buffers against the negative impact of the COVID-19 pandemic but can also stimulate effective responses against a threat while maintaining individual wellbeing. These results can be used to inform the development and maintenance of PE frameworks aimed at minimizing the spread of COVID-19 and encouraging mental and physical health.

Race and ethnicity, gender, and age on perceived threats and fear of COVID-19: Evidence from two national data sources

Previous studies find preventative behaviors designed to reduce the number of infections during emerging disease outbreaks are associated with perceived risk of disease susceptibility. Few studies have attempted to identify underlying factors that explain differences in perceptions of risk during an infectious disease outbreak. Drawing from two early waves of American Trends Panel (n=7,441), as well as a National Science Foundation funded, Qualtrics national panel survey from the early stages of the pandemic (n=10,368), we test whether race and ethnicity, gender, and age were associated with six perceived threat and fear outcomes related to COVID-19. Results demonstrate race and ethnicity, gender, and age play a significant role in shaping threat and fear perceptions of COVID-19, but depending on the outcome, relationships vary in direction and magnitude. In some cases, historically marginalized racial and ethnic groups were more likely to report high fear and perceive coronavirus as a major threat to population and individual health, whereas, in others cases, the same marginalized racial and ethnic groups were less likely to perceive coronavirus to be a serious threat to the immune-comprised and the elderly population. We also find women were generally more likely to report high levels of threat and fear of COVID-19. Finally, we observe a clear age difference, whereby adults in older age groups report high-risk perceptions of COVID-19. Findings can inform public health programs designed to educate communities on the benefits of engaging in effective preventative practices during emerging infectious disease outbreaks.