A Psychological Network Approach to Attitudes and Preventive Behaviors During Pandemics: A COVID-19 Study in the United Kingdom and the Netherlands

Public attitudes towards COVID-19 vaccine mandates and vaccine certificates in Canada: a time series study

INTRODUCTION

Since the beginning of the pandemic, numerous public health measures such as COVID-19 vaccines, vaccine mandates and vaccination certificates have been introduced to mitigate the spread of COVID-19. Public opinion and attitudes towards these measures have fluctuated in response to the dynamic political, social, and cultural landscape of the pandemic.

METHODS

We conducted a time-series study consisting of national cross-sectional surveys between November 2021 to March 2022 to evaluate the Canadian public's attitudes towards COVID-19 vaccine mandates and vaccine certificates.

RESULTS

When examining public sentiment towards COVID-19 vaccine certificates and proof of vaccination measures, there was a shift in responses over time. The proportion of participants "strongly supporting" these measures decreased from 66.0 to 43.1% between W25(Capacity Limits), -W32 (Mask Mandate Removed), whereas "strongly oppose" was the second most common response and rose from 15.9 to 20.6% during this same time period. Concurrently, when examining participants views surrounding mandates, many participants believed that their province was reopening at "about the right pace", which remained relatively stable over time (33.0-35.4%) between W28 (Emergency Act)-W32 (Mask Mandate Removed).

CONCLUSION

Our study's findings on the public's attitudes towards COVID-19 vaccine mandates and vaccine certificates in Canada may aid to guide and streamline the implementation of future similar public health interventions. Future research should include extended follow-up and a more comprehensive examination of trust in government institutions and polarized perspectives on vaccine mandates.

Understanding public perceptions toward sustainable healthcare through psychological network analysis of material preference and attitudes toward plastic medical devices

Recent and potential future health-care users (i.e., the public) are important stakeholders in the transition toward environmentally sustainable healthcare. However, it remains unclear whether, according to the public, there is room for sustainable innovations in materials for plastic medical devices (PMD). This study explores preferences regarding conventional or bio-based PMD, and psychological mechanisms underlying these preferences. We administered two surveys among Dutch adults from a research panel. Results from the first survey (i.e., open-text survey on attitude elements; NStudy1 = 66) served as input for the second survey (i.e., Likert-scale survey on beliefs, emotions, perceived control, social norms, trust, related to current and bio-based PMD, and health and age; NStudy2 = 1001; Mage = 47.35; 54.4% female). The second survey was completed by 501 participants who, in the last two years, received care in which PMD were used, and 500 participants who did not. Cross-sectional psychological networks were estimated with data from the second study using the EBICglasso method. Results showed that participants preferred bio-based over conventional PMD, and this applied regardless of whether devices are used inside or outside of the body. Results also showed emotions play an important role, with emotions regarding bio-based PMD being strongly related to preference. Furthermore, comparing recent and potential future receivers of PMD revealed differences in preference but comparable relations between preference and other psychological variables. This study shows that receivers' perspectives should not be seen as potential barriers, but as additional motivation for transitioning toward sustainable healthcare. Recommendations for implementation are discussed.

Correlates of COVID-19 Preventative Behaviors before and after Vaccination Availability

As the COVID-19 pandemic progressed, various preventative behaviors and eventually vaccinations became available to decrease the spread of the virus. The current study examined a variety of variables (i.e., age, COVID-19-related economic hardship, interpersonal concern, personality, fear of COVID-19, normative beliefs, political beliefs, and vaccine hesitancy) to better understand predictors of preventative behaviors and vaccination status at different points throughout the pandemic. Online questionnaires, administered through Qualtrics, were used to collect data using two convenience samples. One was a small sample (N = 44) of non-student participants before the vaccine was readily available. The other sample (N = 274) included college student participants and occurred after the vaccine had been available to all participants. Results suggest that several variables (i.e., fear of COVID-19, normative beliefs, interpersonal concern, and openness) were consistent predictors of public health behaviors at both points in time and across differently aged samples. Other variables (i.e., agreeableness, extraversion, conscientiousness, and economic hardship) were less consistent with their relationships with public health behaviors. Implications related to both research and public health are discussed.

How compliance with behavioural measures during the initial phase of a pandemic develops over time: A longitudinal COVID-19 study

In this longitudinal research, we adopt a complexity approach to examine the temporal dynamics of variables related to compliance with behavioural measures during the COVID-19 pandemic. Dutch participants (N = 2399) completed surveys with COVID-19-related variables five times over a period of 10 weeks (23 April-30 June 2020). With these data, we estimated within-person COVID-19 attitude networks containing a broad set of psychological variables and their relations. These networks display variables' predictive effects over time between measurements and contemporaneous effects during measurements. Results show (1) bidirectional effects between multiple variables relevant for compliance, forming potential feedback loops, and (2) a positive reinforcing structure between compliance, support for behavioural measures, involvement in the pandemic and vaccination intention. These results can explain why levels of these variables decreased throughout the course of the study. The reinforcing structure points towards potentially amplifying effects of interventions on these variables and might inform processes of polarization. We conclude that adopting a complexity approach might contribute to understanding protective behaviour in the initial phase of pandemics by combining different theoretical models and modelling bidirectional effects between variables. Future research could build upon this research by studying causality with interventions and including additional variables in the networks.

Tailored interventions into broad attitude networks towards the COVID-19 pandemic

This study examines how broad attitude networks are affected by tailored interventions aimed at variables selected based on their connectiveness with other variables. We first computed a broad attitude network based on a large-scale cross-sectional COVID-19 survey (N = 6,093). Over a period of approximately 10 weeks, participants were invited five times to complete this survey, with the third and fifth wave including interventions aimed at manipulating specific variables in the broad COVID-19 attitude network. Results suggest that targeted interventions that yield relatively strong effects on variables central to a broad attitude network have downstream effects on connected variables, which can be partially explained by the variables the interventions were aimed at. We conclude that broad attitude network structures can reveal important relations between variables that can help to design new interventions.

Psychological network analysis of the relations between beliefs about smoking for smokers with and without a recent quit attempt

OBJECTIVE

Psychological network analysis was used to evaluate the relations between beliefs about cigarette smoking in current smokers with and without a recent quit attempt and determine if these networks differed in global strength (how strongly beliefs are related) or global structure (which beliefs are related).

DESIGN

Using two publicly available datasets, the California Smokers' Cohort (CSC; N = 933) and Wave 1 of the Population Assessment of Tobacco and Health (PATH; N = 7855), we evaluated differences in global strength and global structure of the beliefs held by current smokers with and without a recent quit attempt.

MAIN OUTCOME MEASURES

Strength and structure of networks generated for current smokers with and without a recent quit attempt.

RESULTS

In the CSC dataset there were differences between smokers with and without a recent quit attempt in global structure and marginal differences in global strength; the PATH dataset suggested small differences in global strength and structure.

CONCLUSION

The present study suggests that consideration of relations among smoking beliefs may be a valuable contribution to characterizing smoking beliefs when assessing smoking quit attempts.

Interaction between Health and Financial Status on Coping Behaviors during the COVID-19 Pandemic

BACKGROUND

The year 2022 started with protests against COVID-19 restrictions throughout North America. These events manifest the fact that some segments of the population are not compliant with the preventive measures of COVID-19, and the reasons of the disobedience against public health regulation remain unclear. The current paper examined the joint effect of financial and health status on people's likelihood of pursuing active coping efforts (i.e., following preventive measures) and giving up coping with the COVID-19 pandemic.

METHOD

We conducted a large-scale survey study in China (N = 3834) in May 2020.

RESULTS

Our results showed that people with low financial status were less likely to manifest active coping behavior and more likely to give up coping with the pandemic. People's self-confidence in coping with the pandemic mediated this effect. We showed that one's health status could interact with their financial status in a way that healthy people with low financial status would have less confidence in their coping abilities and thus become less likely to pursue active coping efforts and more likely to give up coping with the pandemic.

CONCLUSIONS

Our results call for policymakers to find more effective solutions for noncompliant groups so that they can abide by the general guidelines in the COVID-19 context and other social crises that may emerge in the future. We suggest that governments should concentrate their support efforts on healthy populations of low financial segments to prevent COVID-19 and other infectious diseases in the future from spreading further.

Understanding change in COVID-19 vaccination intention with network analysis of longitudinal data from Dutch adults

Prior research into the relationship between attitudes and vaccination intention is predominantly cross-sectional and therefore does not provide insight into directions of relations. During the COVID-19 vaccines development and enrollment phase, we studied the temporal dynamics of COVID-19 vaccination intention in relation to attitudes toward COVID-19 vaccines and the pandemic, vaccination in general, social norms and trust. The data are derived from a longitudinal survey study with Dutch participants from a research panel (N = 744; six measurements between December 2020 and May 2021; age 18–84 years [M = 53.32]) and analyzed with vector-autoregression network analyses. While cross-sectional results indicated that vaccination intention was relatively strongly related to attitudes toward the vaccines, results from temporal analyses showed that vaccination intention mainly predicted other vaccination-related variables and to a lesser extent was predicted by variables. We found a weak predictive effect from social norm to vaccination intention that was not robust. This study underlines the challenge of stimulating uptake of new vaccines developed during pandemics, and the importance of examining directions of effects in research into vaccination intention.

A Network Approach to Compliance: A Complexity Science Understanding of How Rules Shape Behavior

To understand how compliance develops both in everyday and corporate environments, it is crucial to understand how different mechanisms work together to shape individuals' (non)compliant behavior. Existing compliance studies typically focus on a subset of theories (i.e., rational choice theories, social theories, legitimacy theories, capacity theories, and opportunity theories) to understand how key variables from one or several of these theories shape individual compliance. The present study provides a first integrated understanding of compliance, rooted in complexity science, in which key elements from these theories are considered simultaneously, and their relations to compliance and each other are explored using network analysis. This approach is developed by analyzing online survey data (N = 562) about compliance with COVID-19 mitigation measures. Traditional regression analysis shows that elements from nearly all major compliance theories (except for social theories) are associated with compliance. The network analysis revealed groupings and interconnections of variables that did not track the existing compliance theories and point to a complexity overlooked in existing compliance research. These findings demonstrate a fundamentally different perspective on compliance, which moves away from traditional narrow, non-network approaches. Instead, they showcase a complexity science understanding of compliance, in which compliance is understood as a network of interacting variables derived from different theories that interact with compliance. This points to a new research agenda that is oriented on mapping compliance networks, and testing and modelling how regulatory and management interventions interact with each other and compliance within such networks.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s10551-022-05128-8.

Meating Conflict: Toward a Model of Ambivalence-Motivated Reduction of Meat Consumption

An increasing number of people are concerned about eating meat, despite enjoying doing so. In the present research, we examined whether the desire to resolve this ambivalence about eating meat leads to a reduction in meat consumption. Our model of ambivalence-motivated meat reduction proposes that the pervasive nature of evaluative conflict motivates meat avoidance, and we highlight two potential mechanisms involved: the anticipation of ambivalence reduction through behavioral change, and information seeking for contents that facilitate meat reduction. Study 1 drew on a cross-sectional 6-day food diary with 7485 observations in a quota sample to investigate why meat-related ambivalence arises and to demonstrate the correlation of ambivalence with meat reduction. Two experiments investigated the causal direction of this association by showing that ambivalence-induced discomfort motivated participants to eat less meat when they introspected on their preexisting incongruent evaluations (Study 2 and 3), which was mediated by the aforementioned mechanisms involved (Study 3; preregistered). The studies utilized diverse samples from Germany, England, and the US (total N = 1192) and support the proposed model by indicating that behavioral change is an important coping strategy to resolve ambivalent discomfort in the context of meat consumption. Our model of ambivalence-motivated meat reduction contributes to theorizing on the consequences of ambivalence and the psychology of (not) eating meat.

Intervening on Trust in Science to Reduce Belief in COVID-19 Misinformation and Increase COVID-19 Preventive Behavioral Intentions: Randomized Controlled Trial

Background

Trust in science meaningfully contributes to our understanding of people’s belief in misinformation and their intentions to take actions to prevent COVID-19. However, no experimental research has sought to intervene on this variable to develop a scalable response to the COVID-19 infodemic.

Objective

Our study examined whether brief exposure to an infographic about the scientific process might increase trust in science and thereby affect belief in misinformation and intention to take preventive actions for COVID-19.

Methods

This two-arm, parallel-group, randomized controlled trial aimed to recruit a US representative sample of 1000 adults by age, race/ethnicity, and gender using the Prolific platform. Participants were randomly assigned to view either an intervention infographic about the scientific process or a control infographic. The intervention infographic was designed through a separate pilot study. Primary outcomes were trust in science, COVID-19 narrative belief profile, and COVID-19 preventive behavioral intentions. We also collected 12 covariates and incorporated them into all analyses. All outcomes were collected using web-based assessment.

Results

From January 22, 2021 to January 24, 2021, 1017 participants completed the study. The intervention slightly improved trust in science (difference-in-difference 0.03, SE 0.01, t₁₀₀₀=2.16, P=.031). No direct intervention effect was observed on belief profile membership, but there was some evidence of an indirect intervention effect mediated by trust in science (adjusted odds ratio 1.06, SE 0.03, 95% CI 1.00-1.12, z=2.01, P=.045) on membership in the “scientific” profile compared with the others. No direct nor indirect effects on preventive behaviors were observed.

Conclusions

Briefly viewing an infographic about science appeared to cause a small aggregate increase in trust in science, which may have, in turn, reduced the believability of COVID-19 misinformation. The effect sizes were small but commensurate with our 60-second, highly scalable intervention approach. Researchers should study the potential for truthful messaging about how science works to serve as misinformation inoculation and test how best to do so.

Trial Registration

NCT04557241; https://clinicaltrials.gov/ct2/show/NCT04557241

International Registered Report Identifier (IRRID)

RR2-10.2196/24383

The limitations of polling data in understanding public support for COVID-19 lockdown policies

Opinion polls regarding policies designed to tackle COVID-19 have shown public support has remained high throughout the first year of the pandemic in most places around the world. However, there is a risk that headline support over-simplifies people's views. We carried out a two-wave survey with six-month interval on a public sample (N = 212) in the UK, examining the factors that underpin lockdown policy support. We find that the majority of people support most public health measures introduced, but that they also see significant side effects of these policies, and that they consider many of these side effects as unacceptable in a cost-benefit analysis. We also find that people judged the threat of COVID-19 via the magnitude of the policy response, and that they do not use their perception of the personal threat to themselves or close others to guide their support for policy. Polling data only offer one simple perspective and do not illustrate the ambivalence many people feel around lockdown policies. There is also a meaningful risk of public opinion and government policy forming a symbiotic relationship, which impacts upon how effectively such policies are implemented both now, and in relation to future threats.