Parsing susceptibility and severity dimensions of health risk perceptions

Quantitatively Identifying Messaging Topics to Encourage West Virginia nurses' COVID-19 Vaccination

Nurses are particularly influential to others as it relates to COVID-19 vaccination decision-making and are at higher risk of COVID-19 themselves. Yet, nurses' COVID-19 vaccination remains suboptimal. This study combines communication science frameworks with a novel conceptualize of identity-identity fusion-to explore why nurses may not vaccinate and what strategies might encourage them to protect themselves from COVID-19. Practicing nurses recruited from the West Virginia Nurses Association (N = 328) were asked about their nursing identity, COVID-19 threat perceptions, vaccination efficacy perceptions, vaccination social norms, and both vaccination and information seeking plans. Findings show that social norms may have particular influence over nurses' vaccination intentions, though this is unique to nurses who do not view themselves as completely "fused" with the nursing identity. "Fully fused" nurses, on the other hand, may respond well to information conveying their particular risk for COVID-19. Data suggest information on one's self-efficacy or ability to get vaccinated should be avoided, as it might discourage some nurses'vaccination. Findings are discussed in terms of how identity may influence vaccination.

Predicting mobility using limited data during early stages of a pandemic

The COVID-19 pandemic has changed consumer behavior substantially. In this study, we explore the drivers of consumer mobility in several metropolitan areas in the United States under the perceived risks of COVID-19. We capture multiple dimensions of perceived risk using local and national cases and death counts of COVID-19, along with real-time Google Trends data for personal protective equipment (PPE). While Google Trends data are popular inputs in many studies, the risk of multicollinearity escalates with the addition of more relevant terms. Therefore, multicollinearity-alleviating methods are needed to appropriately leverage information provided by Google Trends data. We develop and utilize a novel optimization scheme to induce linear models containing strictly significant covariates and minimal multicollinearity. We find that there are a variety of unique factors that drive mobility in different geographic locations, as well as several factors that are common to all locations.

Get Vaccinated for Loved Ones: Effects of Self-Other Appeal and Message Framing in Promoting HPV Vaccination among Heterosexual Young Men

HPV has long been constructed as a sex-specific virus. Boys and men largely perceive the virus as not related to themselves and thus develop a female-specific schema on HPV. The present study investigates message strategies for promoting HPV vaccination among heterosexual young men in the United States. Through an online experiment, this study examined the effects of reference point (self, other, vs. self-other) and message framing (gain vs. loss) on processing fluency, optimistic bias, and behavioral intentions. The findings showed a schema-matching pattern in facilitating information processing, and a schema-mismatching pattern in attenuating optimistic bias. Specifically, other-referencing messages that related the outcomes of getting vaccinated for HPV to the message recipients' sexual partners promoted processing fluency and widened the self-other gap in perceived susceptibility to HPV, regardless of the message frame. By contrast, self-other-referencing messages that highlighted the outcomes regarding themselves and their sex partners enhanced processing fluency and mitigated optimistic bias. Moreover, the attenuation in optimistic bias increased the participants' information seeking intentions and the likelihood that they would share the messages on social media. The implications for health message design are discussed from a schema-based, message-tailoring perspective.

What Drives People Away from COVID-19 Information?: Uncovering the Influences of Personal Networks on Information Avoidance

The pervasive of COVID-19 information has driven some to escape daily conversations or media coverage. A rich set of theoretical discussions and empirical studies help explain why individuals avoid health risk information, but few studies have explored social network antecedents to information avoidance. This study investigates how personal discussion networks about COVID-19 shape individuals' information avoidance behaviors. Using a nationally representative sample (N = 1,304), we examined the effects of network size, heterogeneity, ego-alter dissimilarity, and social norms. Our results suggest that the four network variables had varying effects on different forms of information avoidance. Notably, social norms significantly predicted individuals' information avoidance. The theoretical and methodological implications of our findings are discussed.

Perceived COVID-19 susceptibility and preventive behaviors: moderating effects of social support in Italy and South Korea

BACKGROUND

The COVID-19 pandemic hit Italy much harder than South Korea. As a way of explaining the different impact in the two countries, this study examines the moderating role of social support on the relationship between perceived susceptibility and preventive behaviors in the two countries.

METHODS

Surveys were conducted in South Korea (n = 1396) and Italy (n = 487) of participants aged 50 to 89 years.

RESULTS

South Koreans felt higher levels of perceived social support than their Italian counterparts. As would be expected, greater perceived susceptibility was associated with increased preventive behavior. Furthermore, a significant three-way interaction effect was found for perceived susceptibility, social support, and country. For Italians, a person who feels him/herself highly susceptible will increase preventive behaviors, if there is a lot of social support. On the other hand, for South Koreans, those with a low level of susceptibility perform more preventive measures than people with a high level of susceptibility if there is a lot of social support.

CONCLUSIONS

This study provides insights into how cognitive factors, such as susceptibility and severity, as well as social and environmental factors can be taken into account, and the public be told the real risk and given behavioral guidelines when a pandemic is approaching. Given the critical role of social support as a coping mechanism in crisis situations, societies should mull over ways to increase emotional and instrumental support.

Generational differences in the relationship between media exposure and health behaviors during COVID-19 pandemic

Based on a questionnaire survey (N = 857), this study analyzed generational differences in the public health behaviors of COVID-19 and provided an explanation for generational differences from the perspective of media exposure. There are significant differences in media exposure and health behaviors between the Mesozoic generation (35-55) and the young generation (18-34) during the lull. The Mesozoic generation paid greater attention to information on pandemics. Consequently, their health behaviors surpass that of the young generation. On the basis of social cognitive theory and protection motivation theory, this study develops a mediating model of media exposure on health behaviors, demonstrating that media exposure can influence health behaviors through the mediating effects of perceived severity, self-efficacy, and response efficacy, but not via perceived susceptibility. Moreover, a moderated mediation study found that generation moderates the indirect effect of media exposure on health behaviors via perceived susceptibility. Media exposure influences Mesozoic healthy behaviors positively by decreasing their perceived susceptibility. The implication of this study is that the development of health communication theory must account for generational differences and disease-specific characteristics.

How health beliefs and sense of control predict adherence to COVID-19 prevention guidelines among young adults in South Korea

This study defined adherence to COVID-19 prevention guidelines as health behavior and examined whether the two constructs of the health belief model (i.e., perceived susceptibility and perceived severity) and sense of control predict the level of adherence among young adults in South Korea. An online survey (N = 200) conducted in June 2021, showed that perceived susceptibility, perceived severity, and sense of control positively predict adherence behavior. Sense of control significantly moderated the relationship between perceived susceptibility and adherence even after controlling for depression and perceived health status. Specifically, individuals with a lower level of perceived susceptibility still adhered to COVID-19 prevention guidelines if they had a higher level of sense of control. The finding demonstrates the key role of sense of control in promoting adherence to COVID-19 prevention guidelines and the relationship between sense of control and two constructs of the health belief model. Implication for public messaging targeted at young adults during pandemic situations is also discussed.

Research on older people's health information search behavior based on risk perception in social networks-A case study in China during COVID-19

Objective

COVID-19 has caused great loss of human life and livelihoods. The dissemination of health information in online social networks increased during the pandemic's quarantine. Older people are the most vulnerable group in sudden public health emergencies, and they have the disadvantage of infection rates and online search for health information. This study explores the relationship between the health risk perception and health information search behavior of older people in social networks, to help them make better use of the positive role of social networks in public health emergencies.

Method

Based on the Risk Information Search and Processing model, and in the specific context of COVID-19, this study redefines health risk perception as a second-order construct of four first-order factors (perceived probability, perceived severity, perceived controllability, and perceived familiarity), and constructs a research model of the health risk perception and health information search behavior of older people. An online survey of people over 55 years old was conducted through convenience sampling in China from February 2020 to March 2020.

Results

A total of 646 older adults completed the survey. The structural equation model showed that health risk perception is a second-order factor (H1), that health risk perception has significant positive effects on health information search behavior (H2: β = 0.470, T = 11.577, P < 0.001), and that health risk perception has significant positive effects on affective response (H3: β = 0.536, T = 17.356, P < 0.001). In addition, affective response has a significant positive mediating effect on information sufficiency (H4: β = 0.435, T = 12.231, P < 0.001), and information sufficiency has a significant positive mediating effect on health information search behavior (H5: β = 0.136, T = 3.081, P = 0.002).

Conclusion

The study results indicate that the health risk perception of older people during the COVID-19 outbreak not only directly affected their health information search behavior, but also had an indirect impact on their health information search behavior by affecting affective response and information sufficiency.

Modeling Electronic-Cigarette Users' Risk Information Avoidance

The current study examined e-cigarette users' risk information avoidance (i.e., RIA), which is a significant challenge to e-cigarette risk communication. Applying and extending previous RIA studies and the risk information seeking and processing (RISP) model, this study identified the predictors of e-cigarette users' RIA with a comprehensive model that incorporated new roles for scientific uncertainty and relevant channel beliefs. Responses collected from an online survey were analyzed (N = 593) and support was found for two pathways that explain e-cigarette users' motivation for RIA. One suggests heightened risk perceptions were associated with strong negative affective responses that include fear, anger, sadness, and guilt. These affective responses, in turn, were positively associated with RIA intentions. The second was a direct, positive association between scientific uncertainty and RIA as well as an indirect path mediated by relevant channel beliefs. More specifically, scientific uncertainty was negatively associated with quality perceptions of e-cigarette information making it more likely e-cigarette users would avoid it. Suggestions for how to prevent or mitigate these processes that result in e-cigarette users' maladaptive response of RIA are discussed.

Risk-Likelihood Perceptions and Preventive Behaviors Against Infectious Diseases: Testing Different Types of Risk-Likelihood Perceptions in the Context of MERS and COVID-19

Effective public health communication should take into the consideration how communicated risk perceptions might influence the public. Although many health behavior theories claim that high perceived risk likelihood motivates preventive health behaviors, this general prediction is complicated by different ways of estimating risk likelihood. Our review of 14 previous studies on perceived risk of infectious diseases revealed different measures of risk likelihood and inconsistent findings regarding the relationship between perceived risk likelihood and behavioral intention. Drawn from the review, we examined the predictive power of different types of risk likelihood on intention to prevent infectious diseases. Using two separate data sets, collected during the 2015 outbreak of the Middle East respiratory syndrome (N = 557) and the COVID-19 pandemic of 2021 (N = 1,001), we demonstrated that perceived risk likelihood that specifies future inaction on health behaviors (i.e., conditional absolute risk perception) better predicted behavioral intention than did other types of risk perceptions. When the effect of conditional absolute risk perception was controlled, the behavioral intention and unconditional absolute risk perception showed a negative relationship. The findings have theoretical and practical implications that can inform strategic communication during future outbreaks.

Cognitive and Affective Routes to the Adoption of Protective Behaviors Against Health Risks of PM2.5 in China

The current research examines how risk appraisals of PM2.5 influence Chinese people's behavioral intentions to adopt government-recommended protective behaviors through negative affect. In testing the appraisal-based protective behavior model, this research also takes institutional trust and media sensationalism into account. An online survey is conducted with participants (N = 1,569) randomly drawn from heavily polluted Chinese regions. As predicted, negative affect mediates the effects of perceived susceptibility and perceived severity on individuals' intentions to take preventive measures against the PM2.5 risk. Institutional trust appears to increase people's behavioral intentions. However, media sensationalism decreases people's behavioral intentions.

A Shot in the Arm for Vaccination Intention: The Media and the Health Belief Model in Three Chinese Societies

This large-sample study of three Chinese societies—Mainland China, Taiwan, and Hong Kong—demonstrates the importance of media exposure for people’s vaccination intentions during the COVID-19 pandemic. By employing two constructs (i.e., perceived susceptibility and severity) in the health belief model (HBM), the study identifies significant indirect effects of media exposure on individuals’ vaccination intention in all three Chinese societies. That said, media trust negatively moderated the path from perceived severity to vaccination intention in Mainland China and Taiwan. In these two societies, the higher an individual’s trust in media, the less influence of perceived severity on his/her vaccination intention. It suggests that the level of trust in media is a contextual factor in explaining individuals’ decision-making on health issues. Generally, the combination of the HBM and media trust has been proven to be useful for understanding individuals’ vaccination intentions. These findings provide practical considerations for governmental agencies, public institutions, and health campaign designers to promote vaccination in the pandemic.

The Swedish gamble: trust in the government and self-efficacy in the battle to combat COVID-19

Governments around the world have issued movement restrictions and quarantines to combat the SARS-CoV-2 (COVID-19) pandemic. However, the Swedish government has not implemented such measures but has depended on individual responsibility. The extent to which individuals have been encouraged to trust in and be satisfied with government strategies and adopt personal health measures, such as social isolation, remains unclear. This study examines the direct effects of trust in the government and risk perception on self-efficacy. Most importantly, this study intends to explore whether satisfaction with government measures strengthens the relationships between 1) trust in the government and self-efficacy and 2) risk perception and self-efficacy. We test our suggested hypotheses using survey data obtained from 403 Swedish citizens living in Sweden. As predicted, the findings indicate that trust in the government and risk perception positively impact individual self-efficacy. Additionally, the findings reveal that satisfaction with government measures strengthens these relationships; more precisely, the impact of trust in the government and risk perception under a high level of individual satisfaction with government measures is much more positive than that under a low satisfaction level. In practice, a focus on implementing successful policies and excellent individual self-efficacy is required to halt the pandemic, and the findings indicate that combining strictly attentive and adaptive individual strategies with government strategies can minimize the spread of infection.

The role of risk perception and affective response in the COVID-19 preventive behaviours of young adults: a mixed methods study of university students in the Netherlands

OBJECTIVES

Due to an increased infection rate among young adults, they need to adhere to the preventive guidelines to stop the spread of COVID-19 and protect vulnerable others. The purpose of this mixed methods study was to explore the role of risk perception and affective response in the preventive behaviours of young adults during the COVID-19 outbreak.

SETTING

This study followed a convergent mixed methods design, in which a quantitative online survey (n=1081) and 10 qualitative in-depth semistructured video interviews were conducted separately in the Netherlands during April-August 2020.

PARTICIPANTS

1081 participants filled in the online survey, and 10 participants participated in the interviews. Eligibility criteria included being a university student.

PRIMARY AND SECONDARY OUTCOME MEASURES

Data on risk perception, affective response, that is, worry, and adherence to preventive guidelines were combined and analysed during this study. There were no secondary outcome measures.

RESULTS

The results showed that young adults perceived their risk as low. Their affective response for their own well-being was also low; however, their affective response was high with regards to vulnerable others in their surroundings. Due to their high impersonal risk perception (ie, perceived risk to others) and high affective response, young adults adhered to most preventive guidelines relatively frequently. However, young adults sometimes neglected social distancing due to the negative effects on mental health and the uncertainty of the duration of the situation.

CONCLUSIONS

In conclusion, high impersonal risk perception and high affective response regarding others are key motivators in young adults' preventive behaviour. To maximise adherence to the preventive guidelines, risk communication should put emphasis on the benefits to vulnerable others' health when young adults adhere to the preventive guidelines.

Evaluating the Extended Parallel Process Model's Danger Control Predictions in the Context of Dense Breast Notification Laws

This study evaluates predictions central to the extended parallel process model (EPPM) in the context of dense breast notifications. Many EPPM propositions have gone untested and competing predictions to the model have been evaluated to an even lesser extent. Also left as an open question is exactly how perceived threat and efficacy constructs should be treated in health communication research. Using experimental data collected from women likely to receive dense breast notification letters (i.e., aged 40 to 50 years) in states with and without dense breast notification legislation, this study explicitly tests EPPM predictions regarding danger control responses. These data were largely unsupportive of the EPPM's predictions and instead finds that negative affect is more of a direct predictor of intention than expected. These data also provide evidence supporting the separate treatment of the perceived severity, susceptibility, self-efficacy, and response efficacy variables, contrary to convention in EPPM research. Implications for breast density research and EPPM theorizing are discussed in light of these findings.

Psychological Impact of Ambiguous Health Messages about COVID-19

Perceiving ambiguity in health information-that is, uncertainty elicited from believing information lacks credibility, reliability, or adequacy-is typically associated with pessimistic appraisals (e.g., high perceived disease risk) and behavioral avoidance. We examined the effect of ambiguous health information about COVID-19 on health cognitions and vaccination intentions, and tested a "normalized-uncertainty" intervention. Two studies with identical methodology (online adult sample: n = 299, undergraduate sample: n = 150) were conducted in March to April 2020. Participants were randomly assigned to read one of three health messages about COVID-19 that emphasized what was currently unknown (ambiguity condition), what was currently unknown but that scientific uncertainty is expected (intervention condition), or what was currently known (control condition). The ambiguity condition led to greater perceived ambiguity than the control condition and perceived ambiguity in the intervention condition was comparable to the ambiguity condition. There were few differences in health cognitions, and no differences in vaccination intentions, when examining pairwise comparisons across the three conditions. Correlational analyses collapsing across condition indicated evidence of pessimistic appraisal but not behavioral avoidance among individuals who perceived greater ambiguity. Future research should examine longer, more detailed normalized-uncertainty interventions.

Behavioral Correlates of COVID-19 Worry: Stigma, Knowledge, and News Source

Non-adherence to COVID-19 guidelines may be attributable to low levels of worry. This study assessed whether endorsing COVID-19-stigmatizing restrictions, COVID-19 knowledge, and preferred news source were associated with being 'very worried' versus 'not at all' or 'somewhat' worried about contracting COVID-19. Survey data were collected in July-August 2020 from N = 547 New York State (NYS) and N = 504 national Amazon MTurk workers. Respondents who endorsed COVID-19 stigmatizing restrictions (NYS OR 1.96; 95% CI 1.31, 2.92; national OR 1.80; 95% CI 1.06, 3.08) and consumed commercial news (NYS OR 1.89; 95% CI 1.21, 2.96; national OR 1.93; 95% CI 1.24, 3.00) were more likely to be very worried. National respondents who consumed The New York Times (OR 1.52; 95% CI 1.00, 2.29) were more likely to be very worried, while those with little knowledge (OR 0.24; 95% CI 0.13, 0.43) were less likely to be very worried. NYS (OR 2.66; 95% CI 1.77, 4.00) and national (OR 3.17; 95% CI 1.95, 5.16) respondents with probable depression were also more likely to be very worried. These characteristics can help identify those requiring intervention to maximize perceived threat to COVID-19 and encourage uptake of protective behaviors while protecting psychological wellbeing.

The More Insufficient, the More Avoidance? Cognitive and Affective Factors that Relates to Information Behaviours in Acute Risks

This study examines the relationship between cognitive and affective factors and people's information-seeking and -avoiding behaviours in acute risks with a 1,946-sample online survey conducted in February 2020, during the outbreak of the COVID-19 pandemic in mainland China. Multiple linear regression analysis showed that perceived information insufficiency correlates negatively with information-seeking behaviour and there was an inverted U-shaped relationship between information insufficiency and avoidance behaviour. As for the risk-related cognitive factors, information seeking increases as perceived severity of risks rises, while information avoiding increases as perceived susceptibility rises. Perceived response efficacy positively correlates with information-seeking and negatively with information-avoidance behaviours. Preliminary results also indicated that different affective factors relate to information-seeking and avoidance behaviours differently.

Information avoidance during health crises: Predictors of avoiding information about the COVID-19 pandemic among german news consumers

This study investigates the prevalence of source-specific information avoidance among German consumers and predictors of information-avoidance behavior in the context of the COVID-19 pandemic. Guided by the Risk Information Seeking and Processing Model (RISP), we propose that the perceived social norms, information insufficiency, risk perception, affective risk response, and attitudes toward seeking predict information avoidance. We supplement the RISP model by considering information overload as the vast volume and the incredulous quality of information in the COVID-19 pandemic challenge individuals' information acquisition and processing. Using a stratified demographic sample of news consumers of a federal German state (N = 1,000), we empirically examined the proposed model, answered the research question, and tested our hypotheses using structural equation modeling. The results reveal information avoidance among one-third of the respondents. They avoided online sources, including online-mediated interpersonal sources, more often than interpersonal sources and traditional mass media. Information avoidance was linked to more negative attitudes toward seeking and negative affective risk responses, more pronounced descriptive and injunctive avoidance norms, and perceived information overload. Attitudes and information overload were the most influential predictors of avoidance. In contrast, risk perception and information insufficiency were not associated with information avoidance. This study provides insights into theory development, contributes to the information behavior literature, and identifies barriers to communication during health crises.

The Effects of Social Media Use on Preventive Behaviors during Infectious Disease Outbreaks: The Mediating Role of Self-relevant Emotions and Public Risk Perception

While there has been increasing attention to the role of social media during infectious disease outbreaks, relatively little is known about the underlying mechanisms by which social media use affects risk perception and preventive behaviors during such outbreaks. Using data collected during the 2015 Middle East Respiratory Syndrome coronavirus (MERS-CoV) outbreak in South Korea, this study explores the relationships among social media use, risk perception, and preventive behaviors by examining the mediating role of two self-relevant emotions: fear and anger. The findings demonstrate that social media use is positively related to both of these emotions, which are also positively related to the public's risk perception. The findings also indicate that social media use can significantly increase preventive behaviors via the two self-relevant emotions and the public's risk perception.

Contactless channel for shopping and delivery in the context of social distancing in response to COVID-19 pandemic

Arising from the global COVID-19 pandemic, social distancing has become the new norm that shapes consumers' shopping and consumption activities. In response, the contactless channel (i.e., shopping online, self-collecting and returning parcels via delivery lockers) is ideally positioned to fulfil consumers' shopping/logistics needs while avoiding all unnecessary social interactions. Thus, this study examines the factors that motivate consumers' migration to the contactless channel by viewing consumers' channel choice as both health-related and shopping behaviours. Anchored on the synthesised insights of protection motivation theory and automation acceptance theory, the conceptual framework and a series of hypotheses are proposed. A survey instrument is used for data collection, and the data are analysed using structural equation modelling. Our findings reveal that perceived channel characteristics such as compatibility and trust directly contribute to the relative value of the contactless channel; these characteristics are also correlated where trust perception reinforces compatibility perception. The channel characteristics are further influenced by consumers' perceived susceptibility of COVID-19; that is, susceptibility perception enhances channel compatibility but decreases consumers' trust in the contactless channel. However, the impacts of susceptibility become insignificant with a low level of severity perception, confirming the stage-based conceptualisation of severity. Furthermore, the severity perception of COVID-19 is found to amplify the positive impacts of susceptibility perception but attenuate its negative impact. Our study promotes a deeper integration between the health and service literature and encourages more interdisciplinary studies in this nexus. Considering the practical context of social distancing, our findings suggest a struggle between compatibility perception and trust concern that shapes consumers' behaviours.

LGB Tobacco Control: Do Health Belief Model Constructs Predict Tobacco Use Intentions Differently between LGB and Heterosexual Individuals?

This research includes two studies testing whether the Health Belief Model (HBM) constructs predict tobacco use intentions differently between heterosexual and lesbian, gay, and bisexual (LGB) people. Focusing on cigarette smoking, Study 1 (n = 1808 U.S. adult current smokers) found that the perceived health threat and perceived benefits of smoking differently predicted intentions to continue smoking between heterosexual and LGB smokers. The perceived health threat of smoking had a weaker negative relationship and perceived benefits of smoking had a stronger positive relationship with smoking intentions among LGB smokers than heterosexual smokers. Focusing on vaping, Study 2 (n = 2801 U.S. adults) found that the perceived health threat and perceived barriers of vaping differentially predicted vaping intentions between heterosexual and LGB individuals. The perceived health threat of vaping only negatively predicted vaping intentions among heterosexual people. Perceived barriers to vaping had a stronger negative relationship with intentions to vape among LGB people than among heterosexual people. Our finding suggests that compared to perceptions of tobacco-related health consequences (perceived heath threat), behavioral perceptions (perceived benefits and barriers) may have stronger impacts on tobacco use intentions among LGB people. Thus, efforts focusing on reducing tobacco-related disparities among the LGB community should address perceived benefits and barriers of tobacco use.

Psychobehavioral Responses and Likelihood of Receiving COVID-19 Vaccines during the Pandemic, Hong Kong

To access temporal changes in psychobehavioral responses to the coronavirus disease (COVID-19) pandemic, we conducted a 5-round (R1–R5) longitudinal population-based online survey in Hong Kong during January–September 2020. Most respondents reported wearing masks (R1 99.0% to R5 99.8%) and performing hand hygiene (R1 95.8% to R5 97.7%). Perceived COVID-19 severity decreased significantly, from 97.4% (R1) to 77.2% (R5), but perceived self-susceptibility remained high (87.2%–92.8%). Female sex and anxiety were associated with greater adoption of social distancing. Intention to receive COVID-19 vaccines decreased significantly (R4 48.7% to R5 37.6%). Greater anxiety, confidence in vaccine, and collective responsibility and weaker complacency were associated with higher tendency to receive COVID-19 vaccines. Although its generalizability should be assumed with caution, this study helps to formulate health communication strategies and foretells the initial low uptake rate of COVID-19 vaccines, suggesting that social distancing should be maintained in the medium term.

Emotional and Cognitive Responses to COVID-19 Information Overload under Lockdown Predict Media Attention and Risk Perceptions of COVID-19

The present study examined positive and negative effects of health communication on the fight against the COVID-19 under lockdown, during the first wave of the pandemic in Greece. An online survey (N = 1,199) examined the relationships among media trust, emotional and cognitive reactions to COVID-19 information overload, media attention, and risk perceptions regarding COVID-19. Participants' media attention (exposure and attention combined) to information about the pandemic was positively related to their risk perceptions (perceived susceptibility and severity) about the disease. Media attention was dependent on participants' trust in the media as valid sources of information, but also on their cognitive and emotional reactions to COVID-19 information overload. In response to this overload, they produced negative thoughts and more negative (fear and anger) than positive (protection) emotions. These distinct reactions had differential effects on media attention and risk perceptions. Fear and protection were positively related to media attention and risk perceptions, while anger and negative thinking undermined attention and perceptions. Furthermore, all reactions depended on media trust, which mediated the effect on media attention. These findings highlighted desirable and some undesirable effects of health communication in the fight against COVID-19, which can be used to improve health communication in the future.

Intentions to Seek Information about E-Cigarettes: Perceived Risk, Efficacy, and Smoking Identity

While e-cigarette use increases in the US., people's knowledge about e-cigarettes is limited. Information seeking may influence people's knowledge about e-cigarettes. Using the risk perception attitude framework and the identity theory, this study examined if U.S. adult current smokers (n = 1,841) differing in perceived efficacy of switching completely to e-cigarettes, perceived risk of cigarette smoking, and smoking identity report different levels of intentions to seek information about e-cigarettes. Results revealed that smokers with high perceived risk of smoking and perceived efficacy about switching completely to e-cigarettes (responsive group) reported strongest intentions to seek information about e-cigarettes (M = 5.41 on a 1-7 scale), followed by the group having low smoking risk perceptions and high e-cigarette efficacy beliefs (proactive group; M = 4.58), the group having high smoking risk perceptions and low e-cigarette efficacy beliefs (avoidance group; M = 3.18), and the group low on both factors (indifference group; M = 2.76). The differences between responsive group and proactive, avoidance, and indifference groups were greater among smokers with high (M_diff = 6.14) vs. low (M_diff = 5.27) smoking identity. Theoretical and practical implications of the findings are discussed.

The organizational impact of Covid-19 crisis on travel perceived risk across four continents

Purpose

It became a fact, and the world's countries went under confinement due to the pandemic of the Covid19. There are severe impacts on tourism with the supply chain experiencing a full pause. This research investigates the influence of governance, media coverage, crisis severity, former travel practice and Covid-19 incidences on the perceived risk related to travel and tourism during the pandemic and in cross-countries.

Design/methodology/approach

We collected the data from a sample of 1845 individuals from more than 12 countries and four continents representing quarantined and most impacted areas in the world in March and April 2020. A multilevel linear model was applied to predict the perceived risk across countries as a level 2 research unit.

Findings

The finding confirms the clustering in the data with media coverage, governance and crisis growth affecting the outcome. There are cross-level interaction effects, as the growth rate of the pandemic per country and media coverage impact tourists' perception of risk. Finally, there are lower-level direct effects, with lower-level variables affecting tourists' perceived risks.

Research limitations/implications

The survey is randomly administered online due to the nearly complete quarantine implemented in the studied areas. Besides, and considering the latter, the responses might have been subjective due to the non-containment of the crisis by the study's time, directing to possible alteration of feelings and responses from respondents. This leads to suggest a future extension of this research, similarly, post-crisis.

Originality/value

This research pinpointed the impacts of predictors, concerning the countries' level, during the crisis phase on the perceived risk. Therefore, it gives insights into professional bodies on future concerns to be considered during the recovery phase.

Tailoring Temporal Message Frames to Individuals' Time Orientation Strengthens the Relationship between Risk Perception and Behavioral Intention

While health behavior theories conceptualize risk perception as a major factor motivating protective action against risk, empirical support for this widely-assumed proposition has been inconclusive. Given the inherent issue concerning the delay of desired outcomes in most health behaviors, this research proposes the congruence between temporal frame and individuals' trait time orientation (i.e., consideration of future consequences; CFC) as an important moderator in the risk perception-behavioral intention relationship. Findings from two experiments concerning messages promoting adequate sleep (N = 227; Study 1) and plastic bottle recycling (N = 223; Study 2) showed that the relationship between risk perception and behavioral intention was significantly stronger when temporal frames and CFC were more congruent (i.e., tailored). Nuanced differences in the moderating effects of frame-CFC congruence were observed depending on how risk perception was operationalized (i.e., susceptibility only, severity only, or combination of the two). Implications for health communication message design are discussed.

Exploring the Factors Affecting Bitter Melon Peptide Intake Behavior: A Health Belief Model Perspective

Purpose

Diabetes mellitus (DM) patients need to control their blood sugar level in order to achieve a good quality of life. This study was conducted using the health belief model (HBM), to explore the factors behind the bitter melon peptide (BMP) intake behavior and the role of self-efficacy in the model.

Materials and Methods

The subjects were type 2 diabetes mellitus patients in Taiwan. A structured questionnaire was adopted from the theory of health belief model and modified specifically for this study as an instrument to survey 292 DM patients, of whom 51.03% were female, 75.68% were married, and 49.32% were aged 40 to 64 years old. The data were analyzed using t-tests, one-way ANOVA and regression.

Results

Perceived susceptibility was the most sensitive in the response to the various demographic factors, whereas perceived barrier was the least sensitive. The HBM explained 38.0% of BMP intake behavior. Perceived benefits (β= 0.357) and perceived susceptibility (β= 0.348) were the major predictors. Self-efficacy mediated the relationship between perceived benefits and BMP intake behavior, as well as increased the variance explained to 51.30%.

Conclusion

The perceived benefits of taking BMP and perceived susceptibility to DM complications were the two major drivers acting on BMP intake behavior. The power of perceived benefits was mediated by self-efficacy in driving DM patients to take BMP regularly. Several ways of affecting perceived susceptibility and perceived benefits were suggested.

Verbal Quantifiers and Communicating Painkiller Side Effect Risk

The two studies reported here explore the use of verbal quantifiers (e.g., "common") as an alternative to the numerical presentation of risk information about prescription drugs. Guided by work on adverb-adjective pairs (Study 1) and research on fuzzy trace theory (Study 2), predictions are made about participants' risk perceptions after reading verbal presentations of a medication's side effects. Participants report their perceptions about the drug's side effects' occurrence among users. In Study 1, pairs of adverbs and adjectives (e.g., "very rare") are used in contrast to adjectives alone to convey numerical risk information. In Study 2, severity and more general risk perception measures are added to better understand bottom-down schema processing. Findings show that individuals vastly overestimate the likelihood of side effects occurring, compared with the European Union's CIOMS III recommendations (e.g., "rare" side effects affect .01-.1% of users), and demonstrate support for the differences between gist and verbatim processing of risk information.

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

OBJECTIVES

This study aims to evaluate the impact of psychological and sociodemographic variables on perceived personal and comparative susceptibility to diseases caused by a novel, unknown virus.

STUDY DESIGN

Cross-sectional study.

METHODS

A total of 438 adults (200 male and 238 female) were interviewed in the waiting rooms of three primary care medicine outpatient clinics. The participants completed three validated questionnaires: the Italian Adjustment of Risk Perception of Infectious Diseases questionnaire, the General Self-Efficacy (GSE) scale, and the Italian Version of Personality Inventory (ITAPI).

RESULTS

Only 5% of the respondents believed it likely that they would contract a disease caused by a novel virus in the following months, even though 5.9% considered this probability higher than that of other people of the same age and gender. Gender (P < .04), age (P = .002), and marital status (P = .002) significantly affected the perceived risk of getting a disease caused by a novel virus. Self-efficacy (P < .001), imagination (P < .001), and empathy (P < .001) were significant predictors of perceived personal susceptibility. Self-efficacy (P = .04) and imagination (P = .04) were predictive of perceived comparative susceptibility.

CONCLUSIONS

Adequate psycho-educational interventions are necessary to empower the population in adopting the necessary prevention and containment measures aimed at limiting the spread of novel diseases such as COVID-19 and avoiding disastrous consequences both at the health and economic level.

Valuing Acute Health Risks of Air Pollution in the Jinchuan Mining Area, China: A Choice Experiment with Perceived Exposure and Hazardousness as Co-Determinants

This paper analyzes the choice of illness-cure combinations to estimate people’s willingness to pay (WTP) for the reduction of acute health risks correlated with air pollution caused by mining and smelting in the Jinchuan mining area, China. To improve explaining the power of choice experiment (CE), a random parameter logit model (RPL) was employed and extended by considering rank ordered choice sets and non-linear effects of health risk perception on choice behaviors. The results of this study indicated that the ordered RPL approach produced better results than the unordered alternative after comparing different modeling techniques. Perceived health risk, illness attributes, and the residents’ external characteristics: income, education, age, family health experience, work environment and proximity to pollution source are important determinants of the Jinchuan people’s choice mode for avoiding acute health risks caused by air pollution. Taking all acute illnesses investigated together, the mean Jinchuan household WTP for reducing acute health risk caused by air pollution is 146.69 RMB (abbreviation of Chinese yuan) per year (US$23.38, 0.31% of average yearly household income). On the basis of our findings, we conclude that virtually Jinchuan residents perceive air pollution as a serious health risk. To assist the residents to take appropriate preventive action, the local government should develop counseling and educational campaigns and institutionalize disclosure of air quality conditions.

Self-Determination Theory and Risk Behavior in a Collectivistic Society: Preventing Reckless Driving in Urban Nepal

Traffic road accidents are one of the leading causes of mortality in Nepal and around the world. Drivers in Nepal are not adequately educated about road safety rules. Road conditions are chaotic as traffic regulations are also not strictly enforced. Public safety campaigns may be able to alter drivers' attitudes and behaviors; however, little is known about which persuasive strategies may be most effective. Drawing on self-determination theory and the Health Belief Model, the current study used a post-only experimental design to test the impact of a short video message. The video included collective vs. individual appeals, and messages emphasizing one's ability to make the right choice (autonomy support) vs. directive language. Participants were Nepali college students (mean age 20, N = 199). Using structural equation modeling, the study found that directive messages rather than autonomy support influenced an individual seeing value in the recommended behavior (identified regulation), which in turn influenced perceived susceptibility, perceived severity, and behavioral intention. The study also proposed a behavior change model by incorporating the stage of identification with the message upon exposure. This model aims to expand the model proposed by the Health Belief Model, to include a stage of value identification before cues to action influence perception of threat. Further implications are discussed.

The impact of social media on risk perceptions during the MERS outbreak in South Korea

Analyzing nationally representative online panel survey data during the MERS outbreak in South Korea, this study examined the role of social media exposure in shaping public's risk perceptions of MERS. The present study also investigated the moderating role of heuristic-systematic processing and self-efficacy in the relationship between social media exposure and risk perceptions. The findings of this study showed that social media exposure was positively related to forming risk perceptions. Moreover, heuristic-systematic processing and self-efficacy were found to moderate the impact of social media on risk perceptions. The interaction effects suggested that the role of social media in increasing risk perceptions of MERS was heighted by heuristic-systematic processing and self-efficacy. The results and implications of this study are discussed in greater details.