Fear control and danger control amid COVID-19 dental crisis: Application of the Extended Parallel Process Model

Educational intervention based on the Extended Parallel Process Model in promoting preventive behaviors of arteriosclerosis in female high-school students

BACKGROUND

Atherosclerosis can develop gradually from early life and remain asymptomatic for a long time; this research was conducted with the aim of determining the effect of educational intervention based on the Extended Parallel Process Model (EPPM) on the promotion of preventive behaviors of atherosclerosis in female students of a high school in Sabzevar city.

MATERIAL AND METHODS

This quasi-experimental study was conducted on female high-school students in Sabzevar city, northeastern Iran, from September 2021 to June 2022. In this study, 170 participants (85 people for the intervention group and 85 people for the control group) were selected using a multi-stage cluster random sampling approach. The tool used was a researcher-made questionnaire with three sections, whose validity and reliability were confirmed. The educational intervention was conducted offline and virtual in "Shad system" in three sessions for the intervention group by sending educational content designed with the methods of lectures, questions and answers, group discussions, sharing vicarious experiences, use of cues to action, and showing educational videos. Before the intervention and 2 months after the intervention, the questionnaire was completed by both intervention and control groups. The obtained data were analyzed by Stata software version 14.

RESULTS

After the educational intervention, there was a significant difference between the intervention and control groups in all the EPPM constructs. Self-efficacy, perceived response efficacy, and knowledge were the most potent predictors of behavior (P < 0.05).

CONCLUSION

This study showed that the educational intervention based on the EPPM is effective in promoting the preventive behaviors of arteriosclerosis in female students through improving knowledge, perceived susceptibility, perceived severity, perceived response efficacy, and self-efficacy constructs. It is suggested to pay serious attention to the self-efficacy construct in planning educational interventions based on fear and threat for adolescent girls.

Challenges in Media Attention toward COVID-19-Preventive Behaviors: Dual Roles of Threat and Perceived Capability for Information Systems and Health Care

Based on the extended parallel process model, this study investigated the relationship between young adults' media exposure to COVID-19 and their adoption of protective behaviors. This study surveyed 141 college students and found that increased risk perceptions led to greater intentions to engage in COVID-19-preventive behaviors and that these intentions were mediated by normative beliefs. There was no significant difference in risk perceptions between traditional media and social media. The results showed that college students took precautions against COVID-19 because they perceived themselves to be both vulnerable and capable.

Infection Concerns and Economic Burden: Dentists' Cancellations During COVID-19

OBJECTIVES

During the COVID-19 pandemic, dental appointments were cancelled or postponed by both patients and dentists. This study investigated the associations between German dentists' concerns on cross infection and their emotional burden due to personal economic impact on dentist-initiated appointment cancellations.

METHODS

Data were collected using an anonymous cross-sectional online survey of outpatient physicians in Germany from March through April 2020. Dental treatments were divided into 3 treatment categories (plannable treatments, acute treatments without COVID-19-like symptoms, and acute treatments with COVID-19-like symptoms). Descriptive analyses and multivariate logistic regression models were performed.

RESULTS

A sample of 269 self-employed dentists was considered. Cancellations of prophylaxis appointments were reported by 82% of dentists, whilst 49% reported cancellations of appointments for acute complaints with simultaneous patient-side COVID-19-like symptoms. Further, 58% of respondents stated high or very high concerns about COVID-19 self-infection; 81% stated to be emotionally burdened by the personal economic impact. Dentists' concern of infecting themselves significantly decreased the likelihood of maintaining appointments, with odds ratios of 0.635 (95% confidence interval [CI], 0.426 to 0.932) for plannable treatments and 0.587 (95% CI, 0.367 to 0.916) for treatments of patients with acute complaints and simultaneous COVID-19-like symptoms. In addition, there was a significant negative association between dentists who reported emotional distress due to personal economic impact and the likelihood to maintain appointments, with odds ratios of 0.291 (95% CI, 0.123 to 0.695) for plannable treatments and 0.231 (95% CI, 0.053; 0.706) for treatments of patients without acute complaints and simultaneous COVID-19-like symptoms.

CONCLUSION

Dentists' fear of infecting themselves with COVID-19 played a role in terms of practice-related appointment cancellations. Dentists differentiated their appointment cancellations according to different treatment categories and patient needs. If dental care is to be maintained in pandemic times, physicians' personal factors such as concerns about infection and perceived pandemic-related personal economic impact need to be considered.

Formative Research to Inform College Health Communication Campaigns About COVID-19 Prevention Behaviors

This research aimed to inform the development of a health communication campaign to increase the uptake of COVID-19 prevention behaviors among university students. Twenty-eight students attending a mid-sized public university in the southeastern United States and 84 parents or guardians of university students were recruited. The study included an online survey assessing COVID-19 prevention behaviors, perceived susceptibility to COVID-19, perceived severity of COVID-19, and semi-structured interviews to elicit beliefs on COVID-19 prevention behaviors. Students and parents/guardians reported that getting COVID-19 was possible but not necessarily likely. COVID-19 was seen as serious and at least somewhat severe. Dominant interview themes for benefits, barriers, response efficacy, and self-efficacy related to prevention behaviors are reported. Overall, perceptions of behavioral benefits, barriers, and response efficacy were often shared by parents and students but varied across behaviors. These data provide insights for future campaign development for the control of infectious diseases among college students.

Determinants of COVID-19 preventive health behaviors in Iranian adults based on extended parallel process model

Performing preventive behaviors by individuals has been recognized as one of the important strategies for the prevention and control of Coronavirus Disease 2019 (COVID-19). This study aimed to assess the determinants of adopting preventive behaviors of COVID-19 in a sample of Iranian adults based on Extended Parallel Process Model (EPPM) variables. In this cross-sectional study, 300 adults from Tehran, Iran were selected using cluster sampling method from five areas of the city: north, south, west, east, and center. The participants completed a study instrument developed to assess demographic information and EPPM variables. Finally, the data were analyzed using SPSS software. The mean age of the participants was 40.11 (± 15.158) years. The results showed that 88.3% (n = 265) of the participants were in the process of danger control. Perceived self-efficacy, attitude, response efficiency, behavioral intention, and the number of hours of activity outside home were determinants of performing COVID-19 preventive behaviors among the participants. These predictors might be used to develop theory-based educational efforts based on EPPM variables due to encouraging people to adopt COVID-19 preventive behaviors. Our results suggest that because many participants were engaged in danger control, health professionals should focus on increasing perceived efficacy.

Enhancing a Willingness to Respond to Disasters and Public Health Emergencies Among Health Care Workers, Using mHealth Intervention: A Multidisciplinary Approach

Health care workers (HCWs) are increasingly faced with the continuous threat of confronting acute disasters, extreme weather-related events, and protracted public health emergencies. One of the major factors that determines emergency-department-based HCWs' willingness to respond during public health emergencies and disasters is self-efficacy. Despite increased public awareness of the threat of disasters and heightened possibility of future public health emergencies, the emphasis on preparing the health care workforce for such disasters is inadequate in low-and-middle-income countries (LMICs). Interventions for boosting self-efficacy and response willingness in public health emergencies and disasters have yet to be implemented or examined among emergency HCWs in LMICs. Mobile health (mHealth) technology seems to be a promising platform for such interventions, especially in a resource-constrained setting. This paper introduces an mHealth-focused project that demonstrates a model of multi-institutional and multidisciplinary collaboration for research and training to enhance disaster response willingness among emergency department workers in Pakistan.

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

Introduction

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

Method

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

Results

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

Conclusion

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

Survey on public awareness, attitudes and self-protective behavior adoption in different periods of COVID-19

Introduction

The outbreak and spread of the pandemics have been an issue of critical concern globally, posing a significant threat to the health sector globally. This study aimed to examine the basic knowledge and attitudes toward the recommended protective measures at different times, respond to the COVID-19 pandemic, and provide recommendations for developing targeted strategies and measures for preventing and controlling public health emergencies.

Methods

The study used self-filled questionnaires to examine the public's knowledge, attitudes, and practices on COVID-19 at two different period, from 20 to 31 March 2020 (the beginning period) and 22-27 April 2022 (the regular epidemic prevention and control period). Descriptive and quantitative analyses were used for statistical analysis.

Results and discussion

The survey collected 2375 valid questionnaires. A comparison of the two periods reveals that as the epidemic continued over a long period, the level of knowledge, attitudes toward preventive measures, risk perceptions, and adoption behavior of the respondents at the beginning of the epidemic were significantly higher than during the regular epidemic prevention and control period. With the upsurge in the spread of the epidemic, the public needs a multi-channel, targeted, and all-round guidance and information on prevention and control of the COVID-19, and internalizes knowledge into individual's behavior of actively responding to diseases.When the epidemic lasts for a long time, the relevant agencies should strengthen their monitoring role to promote public compliance with the recommended measures.

Application of behavioral change theory and models on COVID-19 preventive behaviors, worldwide: A systematic review

Objective:

This systematic review aimed to assess the global application of behavioral change theory and models on COVID-19 preventive behaviors.

Methods:

This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses procedure. Databases such as PubMed/MIDLINE, Web of Science, Scopus, EMB ASE, World Health Organization libraries, and Google Scholar were used to search all published articles in the area of application of behavioral change theory and model on COVID-19 preventive behavior until October 1, 2022. Studies published in another language other than English were excluded. Two independent reviewers did the article selection and quality check. A third reviewer asked if any disagreement were found.

Result:

Seventeen thousand four hundred thirty-six total articles were retrieved from all sources after the removal of duplicated articles and those not evaluating the outcome of interest were excluded. Finally, 82 articles done using behavioral change theory and model on COVID-19 preventive behaviors were included. The health belief model (HBM) and theory of planned behavior (TPB) were most commonly used in COVID-19 preventive behaviors. The constructs of most behavioral theories and models were significantly associated with COVID-19 preventive behaviors such as hand washing, face mask use, vaccine uptake, social isolation, self-quarantine, social distance, and use of sanitizers.

Conclusion:

This systematic review summarizes comprehensive evidence on the application of behavioral change theory and model on COVID-19 preventive behaviors globally. A total of seven behavioral change theories and models were included. The HBM and TPBs were most commonly used for COVID-19 preventive behaviors. Therefore, the application of behavioral change theory and models is recommended for developing behavioral change interventional strategies.

Behavioral responses for facemask use messages to prevent COVID-19 among residents of Bahir Dar City, Ethiopia: an application of extended parallel process model

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic causes major morbidity and mortality in the world. Timely behavioral response assessment of the community is important to shape the next effective interventions and risk communication strategies to adopt preventive behavior. Hence, this study aimed to assess behavioral responses for facemask-use messages to prevent COVID-19 and its predictors among residents of Bahir Dar City, Ethiopia, 2021 by using the Extended Parallel Process Model.  METHODS: A community-based cross-sectional study was conducted with the guide of the Extended Parallel Process Model in Bahir Dar city from March 9 to April 9, 2021. A multistage sampling technique was used, and data was collected through a face-to-face interviewer-administered questionnaire using Epicollect5. Descriptive statistics and Binary logistic regression were computed using SPSS V.25. Variable with P < 0.25 in the bivariable analysis was a candidate for multivariable analysis to control confounding effect. In multivariable analysis, variables with P < 0.05 were considered statistically significant and the result was presented using an adjusted odd ratio (AOR) with a 95% confidence interval (CI).

RESULTS

A total of 616 participants with a response rate of 97.1% were included. Of the total participants, 229(37.2%) were in the danger control response. The behavioral response was affected by Occupational status [AOR (95%CI) 3.53(1.67-7.46)], the number of people living together [AOR (95%CI) 2.62(1.28-5.39)], self-control [AOR (95%CI) 1.14(1.05-1.25)], a friend for the preferred source of information [AOR (95%CI) 5.18(3.22-8.33)] and printed materials for the preferred channel [AOR (95%CI) 2.14(1.35-3.43)].

CONCLUSION

Above one-third of the participants were in the danger control response. Occupational status, number of people living together, self-control, a friend for the preferred source of information, and printed materials for the preferred channel were independent predictors of resident behavioral response to the use of facemasks. Policymakers should consider students and people who live alone. Message developers should use a friendly person to transmit messages and should prepare printed materials. Activities and strategies should also focus on self-control and perceived efficacy without ignoring the perceived threat.

COVID-19 Protective Behaviors of Iranian Healthcare Workers: A Psychological Theoretical Design Analysis

Background: This study aimed to investigate COVID-19 protective behaviors of Iranian healthcare workers (HCWs) using an extended parallel process model (EPPM). Methods: This cross-sectional study was conducted online on a convenience sample of 418 Iranian HCWs in 2020. Data were gathered using a standardized electronic questionnaire published on the Porsline website, designed based on the EPPM, to assess the relationships between different constructs of EPPM and COVID-19 protective behaviors. For data analysis, statistical tests, such as descriptive tests, independent t-test, ANOVA, Pearson's correlation test, and multiple regression analysis, were performed in SPSS version 18. Results: Most participants (40.4%) were in the age group of 30-40 years, and most were female (70.6%). Significant associations were found between COVID-19 protective behaviors and EPPM constructs of perceived self-efficacy (r = 0.373, P = 0.000), perceived response efficacy (r = 0.120, P = 0.014), and intention (r = 0.462, P = 0.000). Perceived self-efficacy (P = 0.000, beta = 0.398) and behavioral intention (P = 0.000; Beta = 0.283) were predictors of protective behaviors. Also, 34.4% of the HCWs were involved in the danger control process. Conclusions: Only one-third of the HCWs contributed to the process of COVID-19 danger control. The HCWs' motivation for protection against COVID-19 depended on their perception of self-efficacy and their perceived efficacy of COVID-19 preventive behaviors. The present results can be used to design and implement training programs to improve the protective behaviors of HCWs.

Design and evaluation of two educational media in the form of animation and games to promote the cutaneous leishmaniasis prevention behaviors in adolescent female

BACKGROUND

Cutaneous leishmaniasis (CL) has social and psychological effects on different groups, especially adolescents and young girls in 98 countries of the world, in addition to the economic burden. Therefore, it is necessary to apply effective methods for CL prevention. In this study, educational messages were designed based on Extended Parallel Process Model in both forms of animation and game, whose effect on the cutaneous leishmaniasis prevention behaviors was evaluated in adolescent female students.  METHODS: This experimental study was carried out from January to September 2021 on 275 adolescent female students in Isfahan province, Iran. Cluster sampling method was used, and then the students were randomly divided into three groups, namely animation education, game education, and control groups. The educational intervention was performed with two new media in the form of animation and games. The data collected before and two months after the education through a valid and reliable researcher-made questionnaire were analyzed in SPSS24 software using statistical tests of ANOVA, Chi-square, paired t and analysis of covariance (ANCOVA).

RESULTS

The mean age of the participants was 14.07 ± 0.94. The mean scores of behavior in the animation group (60.60 ± 23.00), the game group (61.70 ± 22.05), and the control group (66.13 ± 24.62) were not significantly different prior to the education. However, after the education, there was a significant difference between the animation (80.66 ± 17.62) and game groups (82.58 ± 19.07) and the control group (69.79 ± 23.29) (P < 0.001). The mean scores of model constructs following the intervention (susceptibility, severity, response efficacy, and perceived self-efficacy) significantly increased in the animation and game groups compared to that in the control group (P < 0.05).

CONCLUSION

The results showed that if educational programs contain a combination of threat and efficiency messages, CL-preventive behaviors in adolescents increase. Providing similar educational content with both game and animation methods indicated that both methods had an almost same effect. Although animation production is more costly, it has the advantage of being used in periods and for other adolescents.

Stress, anxiety and depression in dental students: Impact of severe acute respiratory syndrome-coronavirus 2 pandemic

INTRODUCTION

With the emergence of COVID-19, dental medicine students were faced with a new reality, as a modification of the learning methods in Dentistry colleges happened. The aim of this study was to characterise the possible effects of Covid-19 pandemic in terms of anxiety, depression, and stress among students of dentistry.

MATHERIALS AND METHODS

This cross-sectional study was conducted between October 2020 and May 2021. A total of 1115 participants from a total of approximately 3000 students from the seven university institutions that teach the master's degree in dentistry in Portugal, agreed to participate. An online self-reported questionnaire was applied through Google Forms® platform. The questionnaire was divided in three sections: the students' sociodemographic characterisation, pedagogical aspects, and questions about anxiety, depression, and stress using the Depression, Anxiety, and Stress-21 Scale.

RESULTS

Normal levels of anxiety, depression, and stress, were found in 41%, 36.7%, and 22.7% of the participants, respectively. Being female was the most significant and strong predictor of anxiety and stress, and for depression, not feeling fulfilled in the course they were in was the most significant variable.

CONCLUSION

The participants presented high values of anxiety, depression, and stress, during the pandemic state. Gender and not feeling fulfilled in the course were important predictors.

Development and psychometric assessment of cutaneous leishmaniasis prevention behaviors questionnaire in adolescent female students: Application of integration of cultural model and extended parallel process model

BACKGROUND

Cutaneous Leishmaniasis (CL) is an important public health issue in at least 83 countries, including Iran. Individuals' behavior modification is believed to be one of the best ways for CL prevention. However, no comprehensive questionnaires have been psychoanalyzed for identification of CL prevention behaviors and its numerous associated factors, as well as the impact of educational messages. Thus, the present study was conducted to develop and psychometrically assess CL prevention behaviors questionnaire in female students.

METHODS

The present study was performed from October 2020 to May 2021 by developing a preliminary questionnaire based on integration of Cultural Model and Extended Parallel Process Model. The questionnaire was completed online by 460 adolescent female students living in endemic areas of Isfahan, Iran. Exploratory factor analysis was performed using SPSS 24 to ensure the construct validity. Internal reliability was assessed via Cronbach's alpha and external reliability was determined using the test-retest method based on the intraclass correlation coefficient (ICC) index.

RESULTS

The first version of the questionnaire contains 110 items, out of which 82 remained according to content validity ratio (CVR) and content validity index (CVI) criteria. Afterwards, 11 items were removed due to low factor load in the construct validity process using the factor analysis technique. Ultimately, a 71-items questionnaire was developed and 12 factors were extracted from it. According to Cronbach's alpha index, the internal reliability for the questionnaire was 0.877 and the ICC index calculated the external reliability as 0.833.

CONCLUSIONS

Integration of a Cultural Model with individual model was used for the first time to measure the factors related to CL prevention behaviors in this questionnaire; owing to the strength of the factor structure and appropriate psychometric properties, the questionnaire is applicable in the evaluation process of educational interventions concerning CL prevention, especially in female students.

Impact of Social Media, Extended Parallel Process Model (EPPM) on the Intention to Stay at Home during the COVID-19 Pandemic

Considering how communities perceive the threat and risks of COVID-19, it is essential to examine how emotional regulation stimulated through intrinsic and extrinsic incentive mechanisms via social media can reinforce ‘Stay at home’ intentions. The conceptual framework was developed using the elements of the Extended Parallel Process Model (EPPM). A self-reported questionnaire was used to measure individuals’ intention to stay at home during the pandemic based on the perceived locus of causality as a part of self-determination theory. The empirical research was conducted on a sample of 306 USA respondents. The study results indicate that both components of the EPPM—efficacy and threat—positively affect ‘stay at home’ intentions. Moreover, a positive effect of efficacy on threats was found, as was a moderating effect of threats on the relationship between efficacy and the intention to stay at home. Meanwhile, the influence of social media exposure on threats and behavioral intentions was not significant. People are likely to stay at home as a preventive measure during COVID-19 if there is enough threats and efficacy. However, the abundance of information and opinions in social media can lead to a decreased perceived threat and might disrupt the acceptance of preventive actions.

Evaluation of fear, anxiety, and knowledge among dental providers during the COVID 19 pandemic

Background/purpose

COVID-19 has caused a global public health crisis with a major impact on the dental community. The unknown nature of the disease, close and prolonged contact between the patient and provider, aerosol-generating dental procedures in dental settings, guidelines that kept evolving are some of the factors that have alarmed the dental community. The purpose of this study was to evaluate the fear/anxiety among dental providers and assess the knowledge and related practice modification in a post-doctoral dental institution in Upstate New York.

Materials and methods

An online, anonymous, validated survey was sent to all dental faculty and trainees (n = 358) including general dentists and specialists from various departments between August and October 2020. Descriptive statistics and Chi-square goodness-of-fit test were performed.

Results

A total of 144 responded to the survey. It was reported that the majority of the dental providers (faculty (80%) and trainees (90%)) were afraid of getting infected with COVID-19 from the patient. Approximately 90% in both groups reported fear of carrying the infection home to their family and about reports of people dying. The majority of dental providers were well-versed with the Centers for Disease Control and Prevention guidelines. There was difference in knowledge about using N-95 and level 3 masks with face shields for various dental procedures.

Conclusion

The study concluded that COVID-19 related fear/anxiety among dental providers was immediate and needed to be addressed.

The fear of COVID-19 and job insecurity impact on depression and anxiety: An empirical study in China in the COVID-19 pandemic aftermath

The employees' psychological health and resilience in times of emergency and general uncertainty was chosen due to the immense implications for economics, entrepreneurs, psychologists and psychiatrists, and policymakers. This study aims to provide an insight into uncertainty-induced anxiety and depression among Chinese employees in the aftermath of the COVID-19 outbreak. Analysis performed in the context of China in the COVID-19 pandemic aftermath is significant due to the universal nature of external shock impact on psychological welfare, applicable across nations and business sectors and in similar contexts. The statistical analysis was performed with SEM software AMOS version 23. The research model consisting of fear of COVID-19, job insecurity, anxiety, depression, was empirically tested. A purposive sampling technique was applied with the online questionnaire shared with employees in companies located in China. Respondents were working in educational services, information technology, engineering, electronics, and other sectors on white-collar jobs. The data collection was conducted from May to August 2020, in the aftermath of the COVID-19 pandemic in China. The research sample consisting of 283 respondents was used for analysis. Path analysis was performed, and standardized parameter estimates, standard errors, and p-values were calculated. The results indicate a positive and significant impact of job insecurity on depression and anxiety. Furthermore, results indicate that the fear of COVID-19 significantly impacts anxiety and depression but does not impact job insecurity. The findings can be used in a multidisciplinary effort to mitigate the psychological damage. Furthermore, they complement the ongoing epidemiological and scientific discourse on people's personal health and choice of coping.

An Integrated Model of Compliance with COVID-19 Prescriptions: Instrumental, Normative, and Affective Factors Associated with Health-Protective Behaviors

Background

The efficacy of public measures for reducing the transmission of the COVID-19 infection relies on citizens’ voluntary adherence with prescribed actions. Drawing on prior literature about compliant behavior, this study aimed to identify factors associated with people engagement in health-protective behaviors by including a conjoint complement of instrumental/self-oriented, normative/community-based, and affective variables.

Method

A cross-sectional study involving a non-representative sample of 4045 Italian citizens was carried out during the first stage of the pandemic (April–May 2020). Variables associated with health-protective behaviors were perceived personal and societal concerns and perceived effectiveness of the institutional response to the outbreak (instrumental dimensions), and family and friends perceived norms and sense of community responsibility (normative dimensions). Two negative emotions (anxiety and fear) were included as mediators between personal and societal concerns and outcome behaviors.

Results

Results showed the importance of both self-interest and community-based factors. Indeed, self-interest concerns, family perceived norms, and sense of community responsibility were significant predictors of people’s decisions to engage in health-protective behaviors.

Conclusions

The research findings show that compliance with public health prescriptions is a multimodal phenomenon and integrating self-interest and community-based factors can offer a better understanding of people’s decision to engage in health-protective behaviors. Further, this study unveils that a shared sense of community is effective in encouraging adherence to recommended behaviors so as behavioral changes can be sustained by targeting the recommendations not only on risk minimization for oneself but also on the allocation of personal responsibility toward the belonging community.

Knowledge and anxiety for dental treatments due to COVID-19 among general public

Introduction:

The fears, anxiety, and worries created among general population by COVID-19 are severe. The procedures which generate aerosols transmit most of COVID-19 transmission and we know one such procedure is dental treatment. After the COVID-19 pandemic, there is a change in health-care services; hence, this droplet transmission in dentistry became an issue which needs to be addressed.

Methodology:

A descriptive, online questionnaire survey was conducted among adults above 20 years. The questionnaire consisted of demographic details and questions related to anxiety and fear of considering dental treatment during this pandemic situation.

Results:

680 people responded for the study, among which 32% had COVID symptoms. 27% of them said that they are afraid of dental treatment during the pandemic whereas 47% said that they will accept if there is an emergency. The main reason for this fear was droplet infection in dental clinics.

Conclusion:

The fear of dental treatment during pandemic is moderate. This may be due to the self-care, positive behavior toward oral care by the people, and fear of cross-contamination due to airborne infections though the personal protective measures were followed.

Testing Extended Parallel Processing Model in the Korean COVID-19 Context: Effect of Moral Intuitions as Moderators

Despite the possible social implications of the coronavirus disease 2019 (COVID-19), previous studies of the extended parallel processing model (EPPM) in the context of COVID-19 overlooked the emotional aspects when processing fear-inducing COVID-19-related messages. Drawing upon the moral foundation theory (MFT), this study aimed to (a) apply EPPM in the Korean COVID-19 context, (b) introduce MFT and explain why moral intuitions can be related to the processing of COVID-19 messages, and (c) examine the moderating role of moral intuitions in the EPPM model. Based on the theoretical backgrounds, this study tested EPPM hypotheses and also tested whether moral intuition can moderate the relationship between perceived self-efficacy, perceived threat, fear of COVID-19, and health compliance behavioral intention. This study conducted an online survey using measurements of perceived self-efficacy, perceived threat, MFQ-20, fear of COVID, and health compliance. Our study showed three main findings. First, our study found the main effects of (a) self-efficacy on health compliance behavioral intention and (b) perceived threat on health compliance behavioral intention. Second, our study found that morality moderated the main effects of self-efficacy or perceived threat and also moderated EPPM interaction on fear of COVID. Third, the moderation of morality in the relationship between self-efficacy and health compliance behavioral intention showed that health compliance intention decreased as morality increased. Our findings suggest that people can consider COVID-19 as a social and moral issue that involves protecting others.

COVID19 vaccine intentions in South Africa: health communication strategy to address vaccine hesitancy

BACKGROUND

Vaccine hesitancy is emerging as a significant challenge in many parts of the world in the fight against the COVID19 pandemic. The continued infection amongst the unvaccinated can lead to a heightened risk of further virus mutation, exposing even those vaccinated to new virus strains. Therefore, there are social benefits in minimising vaccine hesitancy. The objective of this study is to assess the level of COVID19 vaccine hesitancy in South Africa, identify the socio-economic patterns in vaccine hesitancy and highlight insights from the national survey that can inform the development of a COVID-19 vaccination acceptance communication campaign.

METHODS

The study uses the nationally representative National Income Dynamics Study - Coronavirus Rapid Mobile Survey (NIDS-CRAM) survey. The analysis combines univariate and bivariate statistics, as well as multivariate regression models like binomial/ordinal and multinomial logit.

RESULTS

The study finds that vaccine acceptance is lower than that of non-pharmaceutical intervention like face-mask use. Only 55% fully accept the vaccine, while a further 16% are moderately accepting of vaccines. Together, vaccine acceptance is estimated at 70.8%, and vaccine hesitancy against COVID19 is estimated at 29.2% amongst the adult South African population. The study has identified the perceived risk of infection with the mediating role of efficacy as a key predictor of vaccine intention. Higher awareness of COVID19 related information and higher household income are correlated with lower vaccine hesitancy. The non-black African population group has significantly high vaccine hesitancy compared to black Africans.

CONCLUSIONS

There are other significant differences across socio-economic and demographic variables in vaccine hesitancy. From a communication perspective, it is imperative to continue risk messaging, hand in hand with clearer information on the efficacy of the vaccines.

Comparison of Compliance with Infection Control Practices Among Dental Students in Saudi Arabia Before and During the COVID-19 Pandemic

Background

With the emergence of the COVID-19 pandemic, professional organizations issued new guidelines for infection control standards in dental clinics. The objective of this study was to compare dental students' compliance with those standards before the COVID-19 outbreak and during the pandemic.

Methods

This cross-sectional study entailed observing 622 dental students during their clinical sessions to assess compliance with the infection control protocol. The compliance checklist used was adopted from the Centers for Disease Control and Prevention Infection Control Checklist for Dental Settings. Observations took place during two consecutive years: once in 2019 before the COVID-19 outbreak and once in 2020 during the pandemic.

Results

The dental students audited in 2019 were 1.4 times more likely to violate infection control measures compared with those in 2020. The two most common violations in both audits were not wearing eye protection and not following hand hygiene recommendations immediately after they removed their gloves. During both audits, male students violated infection controls significantly less often than female students.

Conclusion

Dental students' adherence to infection control measures improved during the COVID-19 pandemic compared with before the COVID-19 pandemic. Compliance with personal protective equipment standards was higher than with hand hygiene practices. Our findings have important clinical implications in designing strategies to improve dental students' compliance with infection control standards, particularly hand hygiene practices.

The Threat of COVID-19 and Job Insecurity Impact on Depression and Anxiety: An Empirical Study in the USA

As the coronavirus disease 2019 pandemic causes a general concern regarding the overall mental health of employees worldwide, policymakers across nations are taking precautions for curtailing and scaling down dispersion of the coronavirus. In this study, we conceptualized a framework capturing recurring troublesome elements of mental states such as depression and general anxiety, assessing them by applying standard clinical inventory. The study explores the extent to which danger control and fear control under the Extended Parallel Processing Model (EPPM) threat impact job insecurity, with uncertainty phenomenon causing afflicting effect on the experiential nature of depression heightened by anxiety. With the aim to explore the job insecurity relationship with anxiety and depression, and measure the impact of EPPM threat, an empirical study was conducted in the United States on a sample of 347 white collar employees. Demographic data, EPPM threat, job insecurity, anxiety, and depression data were collected via a standardized questionnaire during the coronavirus disease 2019 (COVID-19) pandemic. The questionnaire consisting of multi-item scales was distributed online. All the scale items were evaluated on a 5-point Likert scale. SEM software AMOS version 23 was used to perform confirmatory factor analysis with maximum likelihood estimation. In the structural model, relationships between the threat of COVID-19, job insecurity, anxiety, and depression were assessed. The findings of the study suggest that job insecurity has a significant impact on depression and anxiety, whereas the threat of COVID-19 has a significant impact on depression. Mediating effects of job insecurity and EPPM threat impact on anxiety were not established in the study. The study contributes to the apprehension of the repercussions of major environmental disruptions on normal human functioning, and it investigates the effects of self-reported protective behaviors on risk perception. The study also explains the underlying mechanisms of coping behavior as possible antecedents to mental disorders. When subjected to stressful events, heightened psychological arousal causes physical and psychological challenges of affected employees to manifest as behavioral issues.

Delivery of Health Care by Spanish Dental Hygienists in Private and Public Dental Services during the COVID-19 De-Escalation Phase (June 2020): A Cross-Sectional Study

Background: The first wave of the COVID-19 pandemic in Spain posed a major challenge for Spanish dental professionals. The objective of this work is to describe the dental hygienists’ work status and employment patterns during the de-escalation phase in order to analyse the standards of knowledge, compliance with official recommendations, and dental activities both in the public health service and in the private sector. Material and Methods: A cross-sectional questionnaire was answered by Spanish dental hygienists via WhatsApp, Facebook, and Instagram. The questionnaire was piloted before it was distributed and carried out during June 2020. Results: Here, 517 dental hygienists were surveyed, of which 86.2% followed the official recommendations to avoid contagion and 63.8% agreed with the gradual return to work by limiting the use of aerosols. Private dental hygienists identified more with returning to work without restrictions (14.5%) versus those working for the public service (1.2%) (p < 0.005). Conclusions: Dental hygienists’ return to work has involved different strategies, aimed at controlling infection and guaranteeing the safety of patients and the rest of the dental team. The availability of personal protective equipment, the adaptation of clinical infrastructure, and patient care management have differed between professionals working in the private and public sectors.

Role of Threat and Coping Appraisal in Protection Motivation for Adoption of Preventive Behavior During COVID-19 Pandemic

With more than 100 million cases and over 2 million deaths globally, the COVID-19 pandemic continues to remain a major threat. Identifying the behavioral factors influencing preventive behaviors for COVID-19 are crucial in devising public health policies to promote essential strategies to combat the pandemic in an efficient manner. The current study was therefore conducted to estimate the prevalence of COVID-19 preventive behaviors and measure their association with behavioral constructs like threat perception, response efficacy, and self-efficacy, as per socio-demographic background. A region-stratified online survey focusing on the constructs of protection motivation theory, for example, threat and coping appraisal for preventive health practices against COVID-19, was carried out among adult users of social media in India. Generalized linear models with cluster-adjusted-robust standard errors were used to analyze the responses and model the preventive practices among the study population. Analysis of a total 2,646 responses revealed that proper perceptions regarding cause, symptoms, and transmission of COVID-19 were prevalent in the majority of the respondents. The majority of the participants reported frequent use of face masks (93.20%), followed by frequent washing of hands with soap and water (84.90%). The majority of the respondents affirmed that, though not frequently but sometimes, they avoid touching the face with unclean hands. Frequently covering mouth with the crook of the elbow while sneezing and coughing, and maintaining physical distance when outside was noted among 74.14 and 83.84%, respectively. The proportion of participants frequently using sanitizers to clean hands and those infrequently practicing the same were comparable. Self-efficacy for preventive practices and threat-appraisal of COVID-19 illness were identified as important determinants of the selected COVID-19 preventive behaviors, independently. The analysis confirmed that practices of the behaviors were mostly synergistic to each other. Current findings highlight that formulation of precise risk communication strategies to improve perceptions regarding threat appraisal and self-efficacy could facilitate desirable practices, which are also effective in the prevention of airborne infections and, hence, may contribute toward broader policy directions. The evidence urges the implementation of precision-driven risk communication and diffusion of these practices to attain behavioral herd immunity.

Factors Related to COVID-19 Preventive Behaviors: A Structural Equation Model

Background: While COVID-19 has rapidly spread around the world, and vaccines are not widely available to the general population, the World Health Organization outlines preventive behavior as the most effective way to limit the rapid spread of the virus. Preventive behavior is associated with a number of factors that both encourage and discourage prevention. Aim: The aim of this research was to study COVID-19 threat appraisal, fear of COVID-19, trust in COVID-19 information sources, COVID-19 conspiracy beliefs and the relationship of socio-demographic variables (gender, age, level of education, place of residence, and employment status) to COVID-19 preventive behavior. Methods: The data originate from a national cross-sectional online survey (N = 2,608) undertaken in July 2020. The data were analyzed using structural equation modeling. Results: COVID-19 threat appraisal, trust in COVID-19 information sources, and fear of COVID-19 are all significant predictors of COVID-19 preventive behaviors. Together they explain 26.7% of the variance of this variable. COVID-19 conspiracy beliefs significantly negatively predict COVID-19 threat appraisal (R 2 = 0.206) and trust in COVID-19 information sources (R 2 = 0.190). COVID-19 threat appraisal contributes significantly and directly to the explanation of the fear of COVID-19 (R 2 = 0.134). Directly, as well as mediated by COVID-19 conspiracy beliefs, threat appraisal predicts trust in COVID-19 information sources (R 2 = 0.190). The relationship between COVID-19 threat appraisal and COVID-19 preventive behaviors is partially mediated by fear of COVID-19 (indirect effect 28.6%) and trust in information sources (15.8%). Socio-demographic variables add very little in prediction of COVID-19 preventive behavior. Conclusions: The study results demonstrate that COVID-19 threat appraisal is the most important factor associated with COVID-19 preventive behavior. Those Latvian residents with higher COVID-19 threat appraisal, experienced higher levels of fear of COVID-19, had more trust in COVID-19 information sources, and were more actively involved in following COVID-19 preventive behaviors. COVID-19 conspiracy beliefs negatively predict COVID-19 threat appraisal and trust in COVID-19 information sources, but not the COVID-19 preventive behaviors. Socio-demographic factors do not play an important role here.

Implementation of COVID-19 Infection Control Measures by German Dentists: A Qualitative Study to Identify Enablers and Barriers

OBJECTIVES

COVID-19 infection control measures have been recommended for dental practices worldwide. This qualitative study explored barriers and enablers for the implementation of these measures in German dental practices.

METHODS

Semi-structured phone interviews were conducted in November/December 2020 (purposive/snowball sampling). The Theoretical Domains Framework (TDF) and the Capabilities, Opportunities and Motivations influencing Behaviors model (COM-B) were used to guide interviews. Mayring's content analysis was employed to analyze interviews.

RESULTS

All dentists (28-71 years, 4/8 female/male) had implemented infection control measures. Measures most frequently not adopted were FFP2 masks, face shields (impractical), the rotation of teams (insufficient staffing) and the avoidance of aerosol-generating treatments. Dentists with personal COVID-19 experience or those seeing themselves as a role model were more eager to adopt measures. We identified 34 enablers and 20 barriers. Major barriers were the lack of knowledge, guidelines and recommendations as well as limited availability and high costs of equipment. Pressure by staff and patients to ensure infection control was an enabler.

CONCLUSIONS

Dentists are motivated to implement infection control measures, but lacking opportunities limited the adoption of certain measures. Policy makers and equipment manufacturers should address these points to increase the implementation of infection control measures against COVID-19 and potential future pandemics.