Identifying the determinants of COVID-19 preventative behaviors and vaccine intentions among South Carolina residents

Predicting the intention to receive the COVID-19 booster vaccine based on the health belief model

COVID-19 vaccine boosters are recommended because the protection provided by previous doses eventually decreases, posing a threat to immunity. Some people, however, remain hesitant or unwilling to get vaccinated. The present study sought to investigate factors associated with the intention to receive the COVID-19 booster vaccine based on (1) the constructs of the Health Belief Model, and (2) trust in healthcare workers and science. A sample of 165 adults with two doses of the COVID-19 vaccine were recruited using convenience sampling. Data was collected using an online survey from November 2021 to January 2022. The survey included questions about participants' socio-demographic details, health beliefs, trust, history of COVID-19 vaccination, and the intention to receive a third dose of the COVID-19 vaccine. Ordinal logistic regression analysis showed that higher perceived benefits, severity, and trust in healthcare workers, and lower perceived barriers predicted higher willingness to get a third dose of the vaccine whereas perceived susceptibility and trust in science did not. Understanding the factors and health beliefs that underlie vaccine hesitancy are vital when developing effective interventions with the aim of increasing uptake of COVID-19 booster vaccines.

Psychometric evaluation of the Trust in Science and Scientists Scale

Reliable and valid measurement of trust in science and scientists is important. Assessing levels of such trust is important in determining attitudes and predicting behaviours in response to medical and scientific interventions targeted at managing public crises. However, trust is a complex phenomenon that has to be understood in relation to both distrust and mistrust. The Trust in Science and Scientists Scale has been adopted with increasing frequency in large-scale public health research. Detailed psychometric evaluation of the scale is overdue and makes meaningful comparisons between studies that use the scale difficult. Here, we examine the scale's dimensionality across five separate samples. We find that two factors emerge that are divided by their item polarity. Implications for scale use and trust in science measurement are discussed.

A Scoping Review on Gender/Sex Differences in COVID-19 Vaccine Intentions and Uptake in the United States

OBJECTIVE

To explore the empirical literature on gender/sex differences in vaccine acceptance among U.S.-based adults and adolescents in approximately the first 2 years of the pandemic.

DATA SOURCE

Embase, Medline, PsycINFO, EBSCO, CINAHL, Web of Science.

STUDY INCLUSION AND EXCLUSION CRITERIA

Peer-reviewed studies conducted in the U.S. with those aged 12 and older, published in English before January 12, 2022, examining the relationship between gender/sex on COVID-19 vaccine intentions and/or uptake.

DATA EXTRACTION

Three authors screened studies and extracted data.

DATA SYNTHESIS

Univariate and multivariate results are summarized.

RESULTS

A total of 53 studies met inclusion criteria (48 intentions, 7 uptake), using mostly cross-sectional designs (92.5%) and non-random sampling (83.0%). The majority of studies supported men's greater intentions to vaccinate compared to women, and men's greater vaccine uptake in univariate analyses, but most multivariate analyses supported no gender differences in uptake. Few studies examined gender beyond binary categories (women/men), highlighting a gap in the studies inclusive of transgender or gender-diverse populations in analyses.

CONCLUSION

Women may have been more hesitant to get the vaccine than men early in the pandemic, but these differences may not translate to actual behavior. Future research should include non-binary/transgender populations, explore the gender-specific reasons for hesitancy and differences by sub-populations, utilize more rigorous designs, and test gender-sensitive public health campaigns to mitigate vaccine concerns.

Factors associated with perceived fear of future pandemics and/or epidemics: a cross-sectional study in Cyprus

This study aims to understand the levels of fear experienced by individuals regarding future pandemics and/or epidemics among the general population of Cyprus and comprehensively examine the diverse factors that influence this perceived fear. The cross-sectional study was conducted from October 1st, 2022, to February 19th, 2023. A proportionate quota sampling method was used for the recruitment, by recruiting a fixed number of participants from each age group, sex, and place of residence. The study collected information on sociodemographic and health-related characteristics, health literacy, trust, COVID-19 vaccination information, and perceived fear of future epidemics and/or pandemics using a self-administered questionnaire. The survey included 1075 participants, with 53.7% of them reporting fear of future pandemics. Logistic regression analysis revealed that women (OR = 2.37, 95% CI 1.78, 3.16) and individuals vaccinated against COVID-19 (OR = 1.57, 95% CI 1.02, 2.43) were significantly more likely to experience fear of future pandemics. Moreover, higher levels of trust (OR = 1.04, 95% CI 1.02, 1.06) and higher health literacy (OR = 1.05, 95% CI 1.03, 1.08) were associated with an increased likelihood of fearing future pandemics. Conversely, unemployment (OR = 0.30, 95% CI 0.13, 0.65) and having a postgraduate education decreased the likelihood of fearing future pandemics (OR = 0.56, 95% CI 0.34, 0.90). The linear regression model revealed that older age (β = - 0.10, 95% CI - 0.14, - 0.05) was negatively associated with a higher score of fear regarding future pandemics. Conversely, being in a vulnerable group (β = 2.02, 95% CI 0.75, 3.28) and having at least one chronic disease (β = 1.76, 95% CI 0.68, 2.84) showed positive associations with increased fear of future epidemics and/or pandemics. The findings emphasize the need for relevant authorities to prioritize mental health and disseminate information in a manner that avoids spreading fear and panic, particularly among vulnerable population groups.

Trust and COVID-19 vaccine hesitancy

This article uses novel data collected on a weekly basis covering more than 35,000 individuals in the EU to analyze the relationship between trust in various dimensions and COVID-19 vaccine hesitancy. We found that trust in science is negatively correlated, while trust in social media and the use of social media as the main source of information are positively associated with vaccine hesitancy. High trust in social media is found among adults aged 65+, financially distressed and unemployed individuals, and hesitancy is largely explained by conspiracy beliefs among them. Finally, we found that the temporary suspension of the AstraZeneca vaccine in March 2021 significantly increased vaccine hesitancy and especially among people with low trust in science, living in rural areas, females, and financially distressed. Our findings suggest that trust is a key determinant of vaccine hesitancy and that pro-vaccine campaigns could be successfully targeted toward groups at high risk of hesitancy.

Knowledge and identity antecedents of COVID-19 vaccine status: a study of South Carolina residents

Introduction

Despite over three years of learning about SARS-CoV-2 and extensive work to develop vaccines, vaccination rates remain suboptimal, thereby preventing our society from reaching herd immunity.

Purpose

Extant literature on vaccine hesitancy led us to hypothesize that specific socio/political variables may be contributing to low vaccination rates, particularly in South Carolina.

Methods

By use of Qualtrics surveys, we collected data from people across all counties in South Carolina regarding vaccine status, plans to vaccinate, and a host of demographics.

Results

Findings revealed that those less likely to be vaccinated against COVID-19 tended to be younger, female, republican. Interestingly, COVID-19 knowledge did not appear to differ between vaccination status groups, although COVID-19 vaccine and general vaccine knowledge did differ.

Conclusions

Our results suggest that while understanding of COVID-19 was relatively similar across groups, targeted and tailored interventions aimed at enhancing the public's general and COVID-19-specific vaccine knowledge may aid efforts to reach herd immunity.

Canadian public perceptions and experiences with information during the COVID-19 pandemic: strategies to optimize future risk communications

BACKGROUND

The COVID-19 pandemic accelerated the spread of misinformation worldwide. The purpose of this study was to explore perceptions of misinformation and preferred sources of obtaining COVID-19 information from those living in Canada. In particular, we sought to explore the perceptions of East Asian individuals in Canada, who experienced stigma related to COVID-19 messaging.

METHODS

We conducted a qualitative thematic analysis study. Interviews were offered in English, Mandarin and Cantonese. Interviewers probed for domains related to knowledge about COVID-19, preferred sources of information, perceived barriers and facilitators of misinformation, and preferences for communication during a health emergency. Interviews were recorded, translated, transcribed verbatim and analyzed using a framework approach. Transcripts were independently double-coded until > 60% agreement was reached. This study received research ethics approval.

RESULTS

Fifty-five interviews were conducted. The majority of participants were women (67%); median age was 52 years. 55% of participants were of East-Asian descent. Participants obtained information about COVID-19 from diverse English and non-English sources including news media, government agencies or representatives, social media, and personal networks. Challenges to seeking and understanding information included: encountering misinformation, making sense of evolving or conflicting public health guidance, and limited information on topics of interest. 65% of participants reported encountering COVID-19  misinformation. East Asian participants called on government officials to champion messaging to reduce stigmatizing and racist rhetoric and highlighted the importance of having accessible, non-English language information sources. Participants provided recommendations for future public health communications guidance during health emergencies, including preferences for message content, information messengers, dissemination platforms and format of messages. Almost all participants preferred receiving information from the Canadian government and found it helpful to utilize various mediums and platforms such as social media and news media for future risk communication, urging for consistency across all platforms.

CONCLUSIONS

We provide insights on Canadian experiences navigating COVID-19 information, where more than half perceived encountering misinformation on platforms when seeking COVID-19 information . We provide recommendations to inform public health communications during future health emergencies.

Association between the COVID-19 Vaccine and Preventive Behaviors: Panel Data Analysis from Japan

The coronavirus (COVID-19) vaccine is key to reducing the probability of contracting COVID-19. The vaccine is generally known to prevent severe illness, death, and hospitalization as a result of the disease and for considerably reduce COVID-19 infection risk. Accordingly, this might significantly change an individual's perceived risk of altering everyday behaviors. For instance, the proliferation of vaccination is anticipated to reduce preventive behaviors such as staying at home, handwashing, and wearing a mask. We corresponded with the same individuals monthly for 18 months from March 2020 (early stage of COVID-19) to September 2021 in Japan to independently construct large sample panel data (N = 54,007), with a participation rate of 54.7%. We used a fixed effects model, controlling for key confounders, to determine whether vaccination was associated with a change in preventive behaviors. The major findings are as follows. Contrary to the prediction, (1) based on the whole sample, being vaccinated against COVID-19 led people to stay at home; however, it did not change the habit of handwashing and wearing a mask. Especially after the second shot, respondents were likelier to stay at home by 0.107 (95% CIs: 0.059-0.154) points on a 5-point scale compared to before the vaccination. Dividing the entire sample into young and old, (2) those aged ≤ 40 years were more likely to go out after being vaccinated, and (3) people over 40 years of age were more likely to stay at home (similar to the first result). Preventive behaviors impact all individuals during the current pandemic. Informal social norms motivate people to increase or maintain preventive behaviors even after being vaccinated in societies where these behaviors are not enforced.

Scientific reasoning is associated with rejection of unfounded health beliefs and adherence to evidence-based regulations during the Covid-19 pandemic

Scientific reasoning and trust in science are two facets of science understanding. This paper examines the contribution of science understanding, over and above analytic thinking, to the endorsement of conspiracy and pseudoscientific beliefs about COVID-19 and behavioral intentions to engage in the recommended preventive behavior. We examined the direct and indirect effects of science understanding on normative health behavior in a representative sample of the Slovak population (N = 1024). The results showed more support for the indirect pathway: individuals with a better understanding of science generally had fewer epistemically suspect beliefs and as a consequence tended to behave more in line with the evidence-based guidelines and get vaccinated. Neither scientific reasoning nor trust in science directly predicted non-compliance with preventive measures, but analytic thinking correlated positively with non-compliance with preventive measures. The strongest predictor of epistemically suspect beliefs was trust in science, which also directly predicted the intention to get vaccinated against COVID-19. Therefore, reasoning about which experts or sources to believe (second-order scientific reasoning) has become more important than directly evaluating the original evidence (first-order scientific reasoning).

Supplementary information

The online version contains supplementary material available at 10.1007/s12144-023-04284-y.

Psychological factors responsible for low adherence to mask-wearing measures during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic has led to >6 million deaths. Anti-mask movements may decrease the effects of preventive measures. Psychological factors that may be related to anti-mask behaviour are not well researched.

AIMS

This study aims to determine the psychological correlates of anti-mask attitudes and behaviour in an online general population sample, focusing on the possible role of claustrophobia.

METHOD

Data on attitudes and behaviour toward mask-wearing were collected from an online sample of 3709 people. Predictors of both anti-mask attitudes and behaviour were assessed with linear and logistic regression analyses.

RESULTS

Few people (3.3%) were overtly opposed to mask-wearing; mask opposition was more common in men than women. Predictors of negative attitude toward mask-wearing and low adherence to mask-related measures were similar and included male gender, lower education, lower income, being employed, having had COVID-19 and lower COVID-19-related anxiety. Psychopathology measures did not show a prediction, whereas claustrophobia had a significant prediction that was over and above those of other predictors. Avoidance behaviour had similar predictors, except for higher COVID-19-related anxiety.

CONCLUSIONS

Although low adherence to mask-wearing during the pandemic was not related to having a mental disorder, it may partly be caused by psychological factors. Those who had a negative attitude also reported lower adherence behaviour, and were characterised by being male, having lower education, being employed and having lower COVID-19-related anxiety; claustrophobia was a strong predictor of attitude. Understanding psychological factors responsible for low adherence may help to decrease morbidity and mortality in future pandemics.

Political ideology and pandemic lifestyles: the indirect effects of empathy, authoritarianism, and threat

Background

In this paper, we integrate theory and research from sociology, psychology, and political science to develop and test a mediation model that helps to explain why political conservatism is often associated with pandemic behaviors and lifestyles that are inconsistent with public health recommendations for COVID-19.

Methods

Using national data from the 2021 Crime, Health, and Politics Survey (n = 1743), we formally test the indirect effects of political conservatism (an index of Republican party identification, conservative political orientation, right-wing news media consumption, and 2020 Trump vote) on pandemic lifestyles (an index of social distancing, hand sanitizing, mask usage, and vaccination) through the mechanisms of empathy (concern about the welfare of others), authoritarian beliefs (authoritarian aggressiveness and acquiescence to authority), and pandemic threat perceptions (threats to self and to the broader society).

Result

Our results confirm that political conservatism is associated with riskier pandemic lifestyles. We also find that this association is partially mediated by lower levels of empathy, higher levels of authoritarian beliefs, and lower levels of perceived pandemic threat.

Conclusions

Understanding why political conservatism is associated with riskier pandemic lifestyles may eventually lead us to ways of identifying and overcoming widespread cultural barriers to critical pandemic responses.

COVID-19 health practices and attitudes in the United States: the role of trust in healthcare

Aim

Individual-level COVID-19 vaccination and related preventive health behaviors is politically polarized in the United States. We examined whether the current polarization in COVID-19 health behavior may be explained by differences in trust in healthcare, locus of control, or insurance status.

Subject and methods

Our sample includes 553 US adults recruited on Amazon MTurk. We assessed odds ratios of currently vaccinated, or willing to be vaccinated if unvaccinated using logistic regression. We assessed count of routine changes and positive attitudes toward facemasks using negative binomial regression.

Results

Trust in healthcare was found to be an important determinant of all COVID-19 related health behavior measured in our study. Further, the effects on COVID-related attitudes/behavior from trust in healthcare are large in magnitude. For instance, our results suggest that individuals at or above the upper quartile of trust in healthcare are around 20 percentage points more likely to be vaccinated than those at or below the lower quartile. Further, we find that the effect of trust in healthcare on adherence or endorsement of COVID-19 mitigation strategies is distinct from political affiliation, i.e., the effect on COVID-19 related health behavior is independent of the polarization across political party lines. Locus of control was not associated with adherence/attitude toward COVID-19 mitigation strategies. Insurance status was only found to be positively associated with odds of being vaccinated.

Conclusion

Our study highlights the importance of increasing trust in healthcare as a means to protect public health in the wake of major public health crises.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10389-022-01737-9.

Brain and behavior in health communication: The Canadian COVID-19 Experiences Project

Background

Methods

Discussion

Predicting attitudes towards easing COVID-19 restrictions in the United States of America: The role of health concerns, demographic, political, and individual difference factors

Despite rising cases of COVID-19 in the United States of America, several states are easing restrictions (e.g., relaxing physical distancing requirements, reopening businesses) that were imposed to limit community transmission of the virus. Individuals hold differing opinions regarding whether restrictions should continue to be imposed or lifted, evidenced, for example, by debate and protests regarding reopening of businesses and venues. Health and social psychological research suggest that perceptions of COVID-19related risk, experiences of the virus, and individual difference factors can help explain individuals’ attitudes towards health initiatives and their tendency to be persuaded towards a specific course of action. The purpose of this study was to investigate what factors influence support or opposition to easing COVID-19-related restrictions. A sample of 350 United States citizens, responding to an anonymous survey, were asked about the extent to which they support/oppose easing of COVID-19-related restrictions, both generally and in relation to specific restrictions. Respondents completed measures of their experiences of COVID-19, individual difference factors, and demographic variables, including political affiliation and degree of social and economic conservatism. In a series of regression analyses, significant demographic predictors of support or opposition for easing restrictions were gender, age, ethnicity, and education, with political affiliation and degree of social and economic conservatism also predicting attitudes. Experiences related to COVID-19 that predicted attitudes were concerns for self and family, perceptions of threat posed by the virus, perceived ability to adhere to restrictions, willingness to take government direction, and belief in COVID-19-related conspiracy theories. At an individual differences level, uncertainty avoidance, collectivism, long-term orientation, masculinity, empathic concern, personal distress, reactance, and general conspiracy theory beliefs all significantly precited attitudes to easing restrictions. Understanding the factors that help explain attitudes towards COVID-19 restrictions can inform how best to position health messaging and initiatives going forward, particularly as states or countries open borders.

An anchor in troubled times: Trust in science before and within the COVID-19 pandemic

Researchers, policy makers and science communicators have become increasingly been interested in factors that affect public’s trust in science. Recently, one such potentially important driving factor has emerged, the COVID-19 pandemic. Have trust in science and other science-related beliefs changed in Germany from before to during the pandemic? To investigate this, we re-analyzed data from a set of representative surveys conducted in April, May, and November 2020, which were obtained as part of the German survey Science Barometer, and compared it to data from the last annual Science Barometer survey that took place before the pandemic, (in September 2019). Results indicate that German’s trust in science increased substantially after the pandemic began and slightly declined in the months thereafter, still being higher in November 2020 than in September 2019. Moreover, trust was closely related to expectations about how politics should handle the pandemic. We also find that increases of trust were most pronounced among the higher-educated. But as the pandemic unfolded, decreases of trust were more likely among supporters of the populist right-wing party AfD. We discuss the sustainability of these dynamics as well as implications for science communication.

Barriers and facilitators of willingness to vaccinate against COVID-19: Role of prosociality, authoritarianism and conspiracy mentality. A four-wave longitudinal study

Aim

We investigated longitudinal relations between individual willingness to undergo vaccination against COVID-19 and three social factors: conspiracy mentality, prosociality, and authoritarianism.

Method

This longitudinal study comprised four measurement points. The first wave sample included 1130 responses and was representative of the Polish population in terms of gender, age, and place of residence. Analyses were performed using random intercept cross-lagged panel models.

Results

We observed bidirectional positive cross-lagged relationships between prosociality and willingness to undergo vaccination in the first three waves of measurement. Authoritarianism and conspiracy mentality translated into a lower willingness to vaccinate between the third and fourth points of measurement when the vaccination became a near-term possibility.

Conclusions

Eliciting prosocial motivation to vaccinate can be paramount in overcoming vaccine hesitancy. Because conspiracy thinking may be a crucial barrier to willingness to be vaccinated, it is critical to focus on planning interventions and campaigns undermining conspiracy theories about COVID-19.

COVID-19 Information Sources and Health Behaviors During Pregnancy: Results From a Prenatal App-Embedded Survey

BACKGROUND

Pregnancy is a time of heightened COVID-19 risk. Pregnant individuals' choice of specific protective health behaviors during pregnancy may be affected by information sources.

OBJECTIVE

This study examined the association between COVID-19 information sources and engagement in protective health behaviors among a pregnant population in a large academic medical system.

METHODS

Pregnant patients completed an app-based questionnaire about their sources of COVID-19 information and engagement in protective health behaviors. The voluntary questionnaire was made available to patients using a pregnancy app as part of their routine prenatal care between April 21 and November 27, 2020.

RESULTS

In total, 637 pregnant responders routinely accessed a median of 5 sources for COVID-19 information. The most cited source (79%) was the Centers for Disease Control and Prevention (CDC). Self-reporting evidence-based protective actions was relatively common, although 14% self-reported potentially harmful behaviors to avoid COVID-19 infection. The CDC and other sources were positively associated with engaging in protective behaviors while others (eg, US president Donald Trump) were negatively associated with protective behaviors. Participation in protective behaviors was not associated with refraining from potentially harmful behaviors (P=.93). Moreover, participation in protective behaviors decreased (P=.03) and participation in potentially harmful actions increased (P=.001) over the course of the pandemic.

CONCLUSIONS

Pregnant patients were highly engaged in COVID-19-related information-seeking and health behaviors. Clear, targeted, and regular communication from commonly accessed health organizations about which actions may be harmful, in addition to which actions offer protection, may offer needed support to the pregnant population.