Health policy perception and health behaviours: a multilevel analysis and implications for public health psychology

How perceived coercion polarizes unvaccinated people: The mediating role of conspiracy beliefs

During the COVID-19 pandemic, different policies were implemented to increase vaccination uptake. Meanwhile, conspiracy theories spread widely, and vaccinated versus unvaccinated people increasingly polarized against each other. This study examined the associations between perceived vaccination coercion, conspiracy beliefs and polarization. We tested the relationship of vaccination status with perceived vaccination coercion, conspiracy beliefs, and polarization, with a total sample size of N = 1202 (n = 400 in China, n = 401 in the US, and n = 401 in the UK), among them n = 603 were vaccinated and n = 599 were unvaccinated. As pre-registered, unvaccinated people perceived more vaccination coercion and endorsed more conspiracy theories. Conspiracy mentality was positively related to perceived coercion. Contrary to our hypotheses, vaccinated people were more polarized toward unvaccinated people than vice versa. Finally, conspiracy beliefs mediated the link between perceived coercion and polarization among unvaccinated people.

The Impact of Student-Teacher Policy Perception on Employment Intentions in Rural Schools for Educational Sustainable Development Based on Push–Pull Theory: An Empirical Study from China

Governments and professional organizations around the world have realized that successful recruitment and retention policies are vital to address the shortage of teachers in rural and remote areas. To the best of our knowledge, despite extensive advocacy of policies and discussions pertaining to their implications, an academic investigation into how student teachers perceive the policies and how their policy perception influences rural employment intentions has rarely been performed. Herein, this study is devoted to investigating the impact of policy perception on student-teacher rural employment intentions. In this study, the participants consist of undergraduate and postgraduate students at Chinese universities who specialize in preparing teachers of all disciplines. A questionnaire survey and quantitative analysis based on commercially available software Questionnaire Star, SPSS 26.0, Amos 26.0 and RMediation package were performed in data acquisition and analysis. It was found that student-teacher perception of the supporting policy Rural Revitalization Strategy was a little below average. High policy perception leads to an increase in the intentions of student teachers to seek employment in rural areas, and social support and positive job perception mediate the linkage between policy perception and rural employment intentions. It was also found that a difference in academic qualifications, census registration, and unpaid teaching satisfaction exists in the intentions to teach in rural schools. Such effects can be explained by the push–pull theory. Finally, this study provides recommendations for governments, universities, rural schools, and families.

Association Between Actual and Perceived U.S. COVID-19 Policies and Preventive Behavior

BACKGROUND

COVID-19 related policies in the USA can be confusing: some states, but not others, implemented mask mandates mid-pandemic, and states reopened their economies to different levels with different timelines after initial shutdowns.

PURPOSE

The current research asks: How well does the public's perception of such policies align with actual policies, and how well do actual versus perceived policies predict the public's mask-wearing and social distancing behaviors during the COVID-19 pandemic?

METHODS

We conducted a preregistered cross-sectional study among 1,073 online participants who were representative of the U.S. population on age, gender, and education on Monday-Tuesday, July 20-21, 2020. We asked participants which locations they visited in the past weekend, and their mask-wearing and social distancing behaviors at each location. We also measured participants' beliefs about their state's policies on mask mandate and business opening and obtained objective measures of these policies from publicly available data.

RESULTS

Perception about the existence of mask mandate was 91% accurate in states with a mask mandate but only 46% accurate in states without one. Perception of state reopening level did not correlate with policy. It was the perceived but not actual state mask mandate that positively predicted both mask-wearing and social distancing, controlling for state COVID-19 cases, demographic factors, and participants' numeracy and COVID-19 history.

CONCLUSIONS

The public's perception of state-level mask mandates erred on the side of assuming there is one. Perception of reopening is almost completely inaccurate. Paradoxically, public perception that a mask mandate exists predicts preventive behaviors better than actual mandates.

Perceived efficacy of COVID-19 restrictions, reactions and their impact on mental health during the early phase of the outbreak in six countries

The COVID-19 pandemic forced millions of people to drastically change their social life habits as governments employed harsh restrictions to reduce the spread of the virus. Although beneficial to physical health, the perception of physical distancing and related restrictions could impact mental health. In a pre-registered online survey, we assessed how effective a range of restrictions were perceived, how severely they affected daily life, general distress and paranoia during the early phase of the outbreak in Brazil, Colombia, Germany, Israel, Norway and USA. Most of our over 2000 respondents rated the restrictions as effective. School closings were perceived as having the strongest effect on daily life. Participants who believed their country reacted too mildly perceived the risk of contracting SARS-CoV-2 to be higher, were more worried and expressed reduced beliefs in the ability to control the outbreak. Relatedly, dissatisfaction with governmental reactions corresponded with increased distress levels. Together, we found that satisfaction with one's governmental reactions and fear appraisal play an important role in assessing the efficacy of restrictions during the pandemic and their related psychological outcomes. These findings inform policy-makers on the psychological factors that strengthen resilience and foster the well-being of citizens in times of global crisis.

Is nutritional labeling associated with individual health? The effects of labeling-based awareness on dyslipidemia risk in a South Korean population

Background

In 1995, the South Korean government made nutrition labeling compulsory, which has positively impacted patients with certain chronic diseases, such as dyslipidemia. We investigated the association between nutrition labeling-based awareness and the risk of dyslipidemia among individuals not yet diagnosed.

Methods

Our study used data from the fifth Korea National Health and Nutrition Examination Surveys administered during 2010–2014 (n = 17,687). We performed multiple or logistic regression analysis to examine the association between nutritional analysis and various outcome variables.

Results

Approximately 70 % of the respondents (n = 11,513) were familiar with nutrition labeling, of which 20 % (n = 3172) decided what food to buy based on that information. This awareness yielded mostly positive results on outcome indicators, such as triglyceride and high-density lipoprotein cholesterol levels. In general, individuals who used nutritional labels to make decisions regarding food purchases had a lower risk of dyslipidemia than individuals who did not (OR: 0.806, 95 % CI: 0.709–0.917).

Conclusion

Utilizing nutrition labels for making food choices correlated with a lower risk of dyslipidemia in certain subgroups. Based on our findings, we recommend that health policymakers and medical professionals consider promoting nutrition labeling as an alternative method for managing certain chronic diseases in South Korean patients.

Complexity and Team Dynamics in Multiple Intervention Programmes

Psychologists engaged in public health research and intervention will become more involved in multiple intervention programming approaches. Managing innovation and complexity is a challenge when the team members come from different disciplines, organizational cultures and research perspectives. This report captures some of those challenges with a participatory, capacity-building, community-based intervention over research stages. We detail successful and less successful attempts to manage the challenges within changing public health contexts and end with concrete suggestions for teams with mixed intervention and research goals. Insights from this project should inform similar programmes with multi-level, participatory, community-based approaches.

Habit, custom, and power: a multi-level theory of population health

In multi-level theory, individual behavior flows from cognitive habits, either directly through social referencing, rules of thumb, or automatic behaviors; or indirectly through the shaping of rationality itself by framing or heuristics. Although behavior does not arise from individually rational optimization, it generally appears to be rational, because the cognitive habits that guide behavior evolve toward optimality. However, power imbalances shaped by particular social, political, and economic structures can distort this evolution, leading to individual behavior that fails to maximize individual or social well-being. Replacing the dominant rational-choice paradigm with a multi-level theoretical paradigm involving habit, custom, and power will enable public health to engage in rigorous new areas of research.

Promoting HIV testing and condom use among Filipina commercial sex workers: findings from a quasi-experimental intervention study

This study examines the effects of a multi-level social action-based theory (SABT) intervention to increase HIV testing and consistent condom use among female commercial sex workers (FCSWs). Respondents in four socio-demographically similar Philippine cities received an SABT intervention based on: (1) peer influence; (2) manager training; (3) combined peer/manager influence; or (4) usual care (control condition). HIV testing increased 86% from baseline (N = 980) to follow-up (N = 903), and was significantly associated with higher HIV/AIDS knowledge, lower probability of contracting HIV and increased condom use. After adjusting for socio-demographic, HIV knowledge and perceived control variables, FCSWs in the manager training and combined peer/manager conditions were significantly more likely to engage in consistent condom use. Mediational analyses revealed higher HIV/AIDS risk perceptions and a supportive work environment related to increased condom use. These findings support a growing body of research suggesting the need for multi-level sexual risk reduction interventions among FCSWs.

Readiness for Community-based Bicycle Helmet Use Programs

Understanding community context is as important to develop effective community-based injury prevention programs as assessing attitudes and behaviors among individuals. Readiness of a community toward community efforts to promote bicycle helmet use and of individuals to use bicycle helmets were examined in a northern Colorado town in the United States, using a semi-qualitative approach. Community readiness and individual readiness to prevent injuries through use of bicycle helmets differed across groups. The findings provide a better understanding of interactions between community perceptions and individual attitudes and behaviors. Further, target groups for improving bicycle helmet use were identified.

Public health is an interdiscipline, and about wholes and parts: indeed, critical health psychology needs to join forces

Hepworth's assessment of critical health psychology's capacity to contribute to public health promotion (this issue) is commented on and supplemented by selected issues relevant to Hepworth's timely call for interdisciplinary research and action in this context. Drawing on eco-epidemiology, multilevel research strategies are suggested that comprehensively account for individual/psychological and population/sociological factors. It is delineated how health promotion policies may be backed by psychologically informed policy analysis. Regarding health, it is argued to keep scrutinizing ill-health and to resist simplistic notions of quality of life or wellness but also to enhance these by incorporating concepts from positive psychology. Finally, it is considered whether trans disciplinarity may be in aid of fully realizing the potentials of blending the merits of health psychology and public health.