Preventive behaviors adults report using to avoid catching or spreading influenza, United States, 2015-16 influenza season

University students' willingness to receive a COVID-19 vaccine in the United States

The disproportionate number of COVID-19 cases and deaths in the United States (US) requires understanding of health behaviors that contributed to low acceptance of public health guidelines. University students were at low risk for complications from COVID-19 infections but at high-risk for infecting others. It is important to understand which characteristics influenced willingness to receive the COVID-19 vaccine. The purpose of this cross-sectional study was to explore the social factors and identities that predicted university students' willingness to receive COVID-19 vaccines before one was available. This study used a stratified random sample from a Midwestern public university in 2020 (N = 614). Results suggest hesitancy toward childhood vaccinations, noncompliance with mask-wearing and large-group-avoidance guidelines, and conservative political ideology increased the odds of being unwilling to receive a COVID-19 vaccination. However, higher subjective social status and male gender increased the odds of being willing to be vaccinated.

Promoting influenza prevention for older adults using the Health Action Process Approach: A randomized controlled trial

Older adults are at greater risk of complications from seasonal influenza, and promoting uptake and adherence to preventive behaviors is key to attenuating this risk. The current study examined the efficacy of a theory-based telephone-delivered intervention to promote uptake and maintenance of influenza preventive behaviors in a sample of Hong Kong residents 65 years and older. The intervention adopted a three-group randomized controlled design (n = 312) with two intervention conditions, motivational and motivational + volitional, and a measurement-only control condition. The primary outcome variable was self-reported compliance with influenza preventive behaviors, including washing hands, avoiding touching eyes, nose, or mouth, and wearing face masks. Secondary outcomes were theory-based psychological variables. Influenza preventive behaviors in participants in the motivational + volitional intervention group were significantly improved 3 months post-intervention relative to those in the control condition. However, participants in the intervention group demonstrated no difference in behavior at 6 and 12 months post-intervention relative to the participants in the control group. Intervention effects were observed on the theory-based social support, action planning, and coping planning variables. Although short-term benefits of the intervention were observed, effects appeared to be short-lived and future research should investigate more intensive interventions that lead to greater behavioral maintenance.

Agricultural Producers' and Stakeholders' Perceived Effectiveness and Participation in COVID-19 Protective Behaviors

This study was designed to identify the perceived effectiveness of COVID-19 protective behaviors and participation in COVID-19 protective behaviors among agricultural producers and stakeholders in the Midwest, United States. A questionnaire was disseminated online to agricultural producers and stakeholders in April-July 2020. Respondents (N = 1,876) shared their perceptions of the effectiveness of COVID-19 protective behaviors and participation in those behaviors. Respondents were primarily agricultural producers (85.5%), aged 64 or younger (66.4%), male (81.2%), white (98.3%), and rural residents (88.7%). About three-quarters of respondents thought washing hands with soap and water and covering a cough or sneeze is very effective at preventing the spread of COVID-19, however, only 30% thought wearing a face mask when in contact with others or in public is very effective. Similarly, over 80% reported washing hands with soap regularly every day and covering their cough or sneeze every day in the past two weeks. In contrast, less than 40% reported staying home as much as possible and wearing a face mask when in public every day in the past two weeks. Rural residents were less likely than urban or suburban residents to report wearing a face mask when in public or with people outside their household. Agricultural producers and stakeholders were found to be at risk of getting COVID-19 due to the perceptions and practices, especially those related to protective social measures. Understanding engagement in protective behaviors and perceptions of their effectiveness is critical to developing effective public health interventions for agricultural communities.

Influência de Fatores Psicológicos e Sociais nos Comportamentos Preventivos de Saúde dos Homens

Introdução: Homens tendem a retardar a procura por serviços de saúde e têm baixa adesão a tratamentos, causando piores indicadores de saúde. Objetivou-se analisar a influência de fatores psicológicos e sociais nos comportamentos preventivos de saúde adotados por homens. Métodos: Utilizaram-se um questionário sociodemográfico, o Inventário de Conformidade com Normas Masculinas (CMNI), o Self-Reporting Questionnaire (SRQ) e o Questionário de Atitudes e Comportamentos de Saúde (QACS). Participaram da análise 315 homens adultos de todo o Brasil. Resultados: Uma regressão linear revelou que eram preditores de menor prevenção: pontuar alto em traços que indicavam desejo por admiração e respeito e comportamentos sexuais arriscados, bem como a maior probabilidade de presença de transtorno mental, ter cor de pele preta e menor nível educacional. Discussão: Foram mapeados fatores de risco para a menor conduta preventiva em homens. Conclusão: Conclui-se que variáveis psicológicas e sociais exercem forte influência sobre os comportamentos de saúde dos homens, sendo necessárias ações de promoção da saúde masculina para além das políticas públicas existentes, na busca pela elaboração de novas ações focadas neste grupo e temática específicos.

Airborne transmission of biological agents within the indoor built environment: a multidisciplinary review

The nature and airborne dispersion of the underestimated biological agents, monitoring, analysis and transmission among the human occupants into building environment is a major challenge of today. Those agents play a crucial role in ensuring comfortable, healthy and risk-free conditions into indoor working and leaving spaces. It is known that ventilation systems influence strongly the transmission of indoor air pollutants, with scarce information although to have been reported for biological agents until 2019. The biological agents' source release and the trajectory of airborne transmission are both important in terms of optimising the design of the heating, ventilation and air conditioning systems of the future. In addition, modelling via computational fluid dynamics (CFD) will become a more valuable tool in foreseeing risks and tackle hazards when pollutants and biological agents released into closed spaces. Promising results on the prediction of their dispersion routes and concentration levels, as well as the selection of the appropriate ventilation strategy, provide crucial information on risk minimisation of the airborne transmission among humans. Under this context, the present multidisciplinary review considers four interrelated aspects of the dispersion of biological agents in closed spaces, (a) the nature and airborne transmission route of the examined agents, (b) the biological origin and health effects of the major microbial pathogens on the human respiratory system, (c) the role of heating, ventilation and air-conditioning systems in the airborne transmission and (d) the associated computer modelling approaches. This adopted methodology allows the discussion of the existing findings, on-going research, identification of the main research gaps and future directions from a multidisciplinary point of view which will be helpful for substantial innovations in the field.

From believers to skeptics: Latent class analysis of COVID-19 protective practices and perceptions among agricultural community members

PURPOSE

This cross-sectional study aimed to identify homogenous groups of agricultural producers and stakeholders based on their perceptions of effectiveness and use of COVID-19 protective behaviors.

METHODS

We conducted an online survey of agricultural producers and stakeholders through Qualtrics. Participants responded to 7 statements about COVID-19 protective behavior effectiveness and 7 statements about participation in COVID-19 protective behaviors in the previous 2 weeks. These statements included handwashing, disinfecting, refraining from touching one's face, covering one's face when coughing/sneezing, staying at home, social distancing, and wearing a face mask. Additional survey sections included demographics and health history. We performed separate latent class analysis (LCA) to identify clusters of agricultural producers' and stakeholders' perceptions and participation in COVID-19-related protective behaviors based on their pattern of responses.

FINDINGS

Based on LCA, participants were distributed as universal believers (33%), social believers (16%), personal believers (26%), moderate believers (17%), and social skeptics (85%) of effectiveness and as low (15%), moderate (40%), and high (45%) adherents of COVID-19 protective behaviors. Those who were female, older, or had underlying health conditions were more likely to be universal believers and highly adherent. High adherence was also more likely among those who lived in urban areas or were not self-employed.

CONCLUSIONS

Results suggest that groups of agricultural producers and stakeholders based on perception of effectiveness and participation in COVID-19 protective behaviors are associated with demographic and health characteristics. Public health campaigns that increase or maintain motivation to comply with protective behaviors should be developed and implemented specific for agricultural populations.

COVID-19 Prevention Practices and Associated Factors among Diabetes and HIV/AIDS Clients in South-Wollo Zone, Ethiopia: A Health Facility-Based Cross-Sectional Study

Background

Coronavirus-2019 (COVID-19) is affecting many people. Chronic patients are highly vulnerable to contracting an infection. Most people recover within a week, but chronic patients can face severe illness or death. The increasing of cases, complications, and mortality demands compulsory preventive measures. Therefore, this study was designed to identify major preventive practices and associated factors.

Methods

A facility-based cross-sectional study was employed from November to December 2020 among diabetics and HIV/AIDS follow-up clients in Dessie referral hospital. Data were entered into EpiData manager 4.6.0 version and exported to Statistical Package for Social Science (SPSS) version 25.0 for data cleaning and analysis. Logistic regression analysis was done and an adjusted odds ratio (AOR) with its 95% confidence interval (CI) was used for determining the strength of association.

Results

Data were collected from 426 participants with a mean age of 46.54 years. The overall poor prevention practice rate of COVID-19 among diabetic and HIV/AIDS follow-up clients was 68.8% 95% CI (64.6–72.8%). Factors significantly associated with poor prevention practice were femaleness (AOR; 1.61; 95% CI; 1.03–2.51), illiterate [AOR; 2.59; 95% CI; 1.33–5.09]), family size greater than four (AOR; 2.06; 95% CI; 1.32–3.23), absence of health professional in the household (AOR; 1.79; 95% CI; 1.13–2.84), not having health insurance (AOR; 1.85; 95% CI; 1.18–2.89) and urban residence (AOR; 0.38; 95% CI; 0.18–0.79).

Conclusion

The overall proportion of prevention practice towards COVID-19 among diabetic and HIV/AIDS follow-up clients was poor. Illiteracy, having a family size greater than four, not having health professionals in the household, not having health insurance and urban residency were associated with poor prevention practices. Therefore, continuous health educations about good preventive behavioral practice should be enhanced by the health professionals.

Policy liberalism and source of news predict pandemic-related health behaviors and trust in the scientific community

In March of 2020, the United States was confronted with a major public health crisis caused by the coronavirus disease (COVID-19). This study aimed to identify what factors influence adherence to recently implemented public health measures such as mask-wearing and social distancing, trust of scientific organizations like the Centers for Disease Control and Prevention (CDC) and the World Health Organization (WHO) on information pertaining to the pandemic, and level of perceived risk. Data were collected from June 30, 2020 to July 22, 2020 on 951 adult residents of the United States using an online survey through Microsoft Forms. Multiple linear regression was used to identify the strongest predictors for compliance to pandemic-related health measures, trust in the scientific community, and perceived risk. Results showed that the strongest predictor of all variables of interest was degree of policy liberalism. Additionally, participants who consumed more conservative news media conformed less to the pandemic health guidelines and had less trust in the scientific community. Degree of policy liberalism was found to have a significant moderating effect on the relationship between gender and conformity to pandemic-related health behaviors. These findings have concerning implications that factors like degree of policy liberalism and source of news are more influential in predicting adherence to life-saving health measures than established risk factors like pre-existing health conditions.

Structural Racism and the COVID-19 Experience in the United States

The long, fallacious history of attributing racial disparities in public health outcomes to biological inferiority or poor decision making persists in contemporary conversations about the COVID-19 pandemic. Given the disproportionate impacts of this pandemic on communities of color, it is essential for scholars, practitioners, and policymakers to focus on how structural racism drives these disparate outcomes. In May and June 2020, we conducted a 6-state online survey to examine racial/ethnic differences in exposure to COVID-19, risk mitigation behaviors, risk perceptions, and COVID-19 impacts. Results show that Black and Hispanic individuals were more likely than White respondents to experience factors associated with structural racism (eg, living in larger households, going to work in person, using public transportation) that, by their very nature, increase the likelihood of exposure to COVID-19. Controlling for other demographic and socioeconomic characteristics, non-White respondents were equally or more likely than White respondents to take protective actions against COVID-19, including keeping distance from others and wearing masks. Black and Hispanic respondents also perceived higher risks of dying of the disease and of running out of money due to the pandemic, and 40% of Black respondents reported knowing someone who had died of COVID-19 at a time when the US death toll had just surpassed 100,000 people. To manage the current pandemic and prepare to combat future health crises in an effective, equitable, and antiracist manner, it is imperative to understand the structural factors perpetuating racial inequalities in the COVID-19 experience.

Preventive Behaviors During the COVID-19 Pandemic: Associations With Perceived Behavioral Control, Attitudes, and Subjective Norm

Background: The coronavirus disease 2019 (COVID-19) is a highly contagious and potentially fatal infectious disease that has swept the globe. To reduce the spread, it is important to engage in preventive behaviors recommended by health authorities, such as washing your hands, wearing a face mask, and social distancing. Aim: In the present study, we draw from the Theory of Planned Behavior (TPB) to examine the associations between perceived behavioral control, attitudes, and subjective norm and whether people engage in eight different preventive behaviors. Methods: For each of the preventive behaviors (washing hands; using hand sanitizer; not touching your face; social distancing; wearing a face mask; disinfecting surfaces; coughing in your elbow; staying home if sick), we conducted separate logistic regressions predicting whether the participants (N = 2,256; age range = 1898 years) reported engaging in the behavior from their perceived behavioral control, attitudes, and subjective norm. Results: We found that perceived behavioral control, attitudes, and subjective norm had independent significant associations with each preventive behavior. Moderation analyses revealed that for most behaviors the associations with perceived behavioral control were stronger for older adults than for younger adults. Limitation: The present study was cross-sectional; future longitudinal studies and interventions are needed to disentangle directionality. Conclusion: Our findings suggest several ways to increase adherence to health behaviors that reduce the spread of coronavirus and other infectious diseases.

Behavioral changes and hygiene practices of older adults in Japan during the first wave of COVID-19 emergency

BACKGROUND

On April 7, 2020, Japan declared a state of emergency due to the first wave of coronavirus disease 2019 (COVID-19) with the associated social distancing likely to have had a great impact on older adults' lifestyle and health. This study aimed to explore the behavioral changes and personal hygiene practices in relation with background psychosocial and health characteristics of older adults during the COVID-19 emergency.

METHODS

A cross-sectional telephonic survey was conducted with the participants of the Kawasaki Aging and Wellbeing Project (KAWP), an on-going longitudinal cohort study of older adults aged 85 or older. The interviews were conducted using a structured questionnaire consisting of 11 closed questions regarding behavioral changes and personal hygiene practices during the state of emergency. Sociodemographic and health data were obtained from the KAWP baseline survey conducted 2.2 years before the telephonic survey.

RESULTS

Overall, 487 participants from the KAWP responded to the telephonic survey (response rate: 89.2%). 94.5% of the respondents reported no changes in basic lifestyle habits, such as eating, sleeping, smoking, and drinking, whereas 28.1% reported a decrease in physical activity, and 54.6% reported going out less frequently. One-third of the respondents reported a decrease in the number of people to converse with, as well as the amount of time to converse. For personal hygiene practices, 93.8% reported wearing a mask when they went out, and 50.3% reported an increased frequency of handwashing. Multiple logistic regression analysis revealed that engagement in physical activity at baseline (odds ratio [OR] = 1.95, 95% confidence interval [CI] = 1.23-3.08), smartphone ownership (OR = 2.15, 95% CI = 1.33-3.47), and visual impairment (OR = 1.79; 95% CI = 1.10-2.91) were independently associated with decreased physical activity during the COVID-19 emergency. Female respondents and smartphone ownership were significantly associated with more frequent handwashing.

CONCLUSIONS

The study revealed that older adults in an urban setting responded to the COVID-19 emergency with behavioral changes. The findings of this study have implications for the design of preventive strategies to maintain the health and wellbeing of at-risk older adults.

Factors associated with admission to intensive care units in COVID-19 patients in Lyon-France

INTRODUCTION

A new respiratory virus, SARS-CoV-2, has emerged and spread worldwide since late 2019. This study aims at analysing clinical presentation on admission and the determinants associated with admission in intensive care units (ICUs) in hospitalized COVID-19 patients.

PATIENTS AND METHODS

In this prospective hospital-based study, socio-demographic, clinical and biological characteristics, on admission, of adult COVID-19 hospitalized patients presenting from the community for their first admission were prospectively collected and analysed. Characteristics of patients hospitalized in medical ward to those admitted in ICU were compared using Mann-Whitney and Chi-square or Fisher exact test when appropriate. Univariate logistic regression was first used to identify variables on admission that were associated with the outcome i.e. admission to an ICU versus total hospital stay in a medical ward. Forward selection was then applied beginning with sex, age and temperature in the multivariable logistic regression model.

RESULTS

Of the 412 patients included, 325 were discharged and 87 died in hospital. Multivariable regression showed increasing odds of ICU hospitalization with temperature (OR, 1.56 [95% CI, 1.06-2.28] per degree Celsius increase), oxygen saturation <90% (OR, 12.45 [95% CI, 5.27-29.4]), abnormal lung auscultation on admission (OR, 3.58 [95% CI, 1.58-8.11]), elevated level of CRP (OR, 2.7 [95% CI, 1.29-5.66for CRP>100mg/L vs CRP<10mg/L). and monocytopenia (OR, 3.28 [95% CI, 1.4-7.68]) were also associated with increasing odds of ICU hospitalization. Older patients were less likely to be hospitalized in ICU (OR, 0.17 [95%CI, 0.05-0.51].

CONCLUSIONS

Age and delay between onset of symptoms and hospital admission were associated with the risk of hospitalisation in ICU. Age being a fixed variable, interventions that shorten this delay would improve the prognosis of Covid-19 patients.

Guidelines: Discharge Instructions for Covid-19 Patients

INTRODUCTION/OBJECTIVES

Clinicians treating COVID-19 patients face a major challenge in providing an effective relationship with patients who are discharged to return to home in order to optimize patient self-management after discharge. The purpose of these discharge instructions is to assist and provide guidance for physicians, nurses, and other health care personnel involved in discharging COVID-19 patients to home after encounters at hospitals, emergency departments, urgent care settings, and medical offices.

METHODS

A systematic literature-search of studies evaluating both symptoms and signs of COVID-19 was performed in order to establish specific optimal performance criteria in monitoring a patient's status with regard to disease safety. These optimal performance criteria parameters were considered with regard to the severity of morbidity and mortality. Strategies used to develop the discharge instructions included review of a broad spectrum of literature to develop the discharge criteria.

RESULTS

These guidelines are presented for patient education and should achieve the essential goals including: enabling patients to understand their medical situation, preventing complications, supporting patients by providing instructions, helping patients make more effective use of available health services, and managing patient stress by giving patients comfort through the knowledge of specific recommendations including how to respond to situations.

CONCLUSION

The COVID-19 pandemic requires clinicians to efficiently teach their patients self-management strategies and to provide a safe educated response to the patient and the surrounding community environment. The primary goal of the patient education discharge-instructions (PEDI) is to provide self-management strategies for preventing complications and disease transmission.

Psychological and Behavioural Responses to Coronavirus Disease 2019: The Role of Personality

This study examined the associations between personality traits and psychological and behavioural responses to the coronavirus disease 2019 (COVID-19) pandemic. Personality was assessed in January/February 2020 when the public was not aware of the spread of coronavirus in the USA. Participants were reassessed in late March 2020 with four sets of questions about the pandemic: concerns, precautions, preparatory behaviours, and duration estimates. The sample consisted of N = 2066 participants (mean age = 51.42; range = 18-98; 48.5% women). Regression models were used to analyse the data with age, gender, education, race, and ethnicity as covariates. Consistent with the preregistered hypotheses, higher neuroticism was related to more concerns and longer duration estimates related to COVID-19, higher extraversion was related to shorter duration estimates, and higher conscientiousness was associated with more precautions. In contrast to the preregistered hypotheses, higher neuroticism was associated with fewer precautions and unrelated to preparatory behaviours. Age moderated several trait-response associations, suggesting that some of the responses were associated more strongly in older adults, a group at risk for complications of COVID-19. For example, older adults high in conscientiousness prepared more. The present findings provide insights into how personality predicts concerns and behaviours related to the COVID-19 pandemic. © 2020 European Association of Personality Psychology.

Psychological and Behavioural Responses to Coronavirus Disease 2019: The Role of Personality

This study examined the associations between personality traits and psychological and behavioural responses to the coronavirus disease 2019 (COVID-19) pandemic. Personality was assessed in January/February 2020 when the public was not aware of the spread of coronavirus in the USA. Participants were reassessed in late March 2020 with four sets of questions about the pandemic: concerns, precautions, preparatory behaviours, and duration estimates. The sample consisted of N = 2066 participants (mean age = 51.42; range = 18-98; 48.5% women). Regression models were used to analyse the data with age, gender, education, race, and ethnicity as covariates. Consistent with the preregistered hypotheses, higher neuroticism was related to more concerns and longer duration estimates related to COVID-19, higher extraversion was related to shorter duration estimates, and higher conscientiousness was associated with more precautions. In contrast to the preregistered hypotheses, higher neuroticism was associated with fewer precautions and unrelated to preparatory behaviours. Age moderated several trait-response associations, suggesting that some of the responses were associated more strongly in older adults, a group at risk for complications of COVID-19. For example, older adults high in conscientiousness prepared more. The present findings provide insights into how personality predicts concerns and behaviours related to the COVID-19 pandemic. © 2020 European Association of Personality Psychology.