Public Trust and Compliance with the Precautionary Measures Against COVID-19 Employed by Authorities in Saudi Arabia

Trust as a catalyst: revealing the impact of government trust and professional trust on public health policy compliance during a pandemic

BACKGROUND

Existing research has extensively explored the relationship between government trust and compliance behaviour, but significant controversies exist. Some studies suggest a strong positive correlation between the two. Other studies have found that government trust hinders compliance behaviour. However, during the pandemic, the effectiveness of public health policies largely depends on the public's compliance with these policies. To examine the aforementioned controversies, this study utilizes survey data on the Chinese population during the COVID-19 period to explore the relationship between compliance with public health policies and government trust.

METHODS

The study conducted a questionnaire survey of 1,395 individuals from 25 provinces in China from mid-November to mid-December 2022. Firstly, we categorized the public's compliance behaviour with public health policies based on the results of factor analysis. Subsequently, we examined the impact of government trust and professional trust on compliance behaviour with public health policies by constructing a structural equation model.

RESULTS

Based on the results of factor analysis, we classified public adherence to public health policies into protective compliance and restrictive compliance. Results from the structural equation model show a positive correlation between the public's trust in the government and both protective and restrictive compliance, with a stronger influence on protective compliance. Government trust also exerts a positive impact on restrictive compliance behaviour through professional trust. Additionally, the study indicates a significant positive correlation between the public's professional trust and restrictive compliance, while it does not significantly affect protective compliance. Moreover, the public from rural areas demonstrates a greater willingness to adhere to both types of public health policies. Married individuals exhibit a stronger inclination toward protective compliance, while females show a stronger tendency toward restrictive compliance.

CONCLUSION

The study revealed a significant positive impact of government trust and professional trust on compliance behaviour with public health policies during the COVID-19 pandemic, refuting any negative correlation between government trust and compliance behaviour. Normative motivations for compliance behaviour had a substantial impact on adherence. These findings offer valuable insights for future public health crisis management and public policy formulation.

Disinfection and hand hygiene knowledge, attitude, and practices among childcare facilities staff during the COVID-19 pandemic in Anhui, China: a cross-sectional study

Objective

This study aimed to investigate the knowledge, attitude, and practice (KAP) regarding disinfection and hand hygiene, along with associated influencing factors among childcare facilities staff during the COVID-19 pandemic in Anhui, and to provide information for developing disinfection and hand hygiene strategies for childcare facilities.

Methods

A web-based cross-sectional study was conducted among Anhui Province residents in China in September 2020. In this study, 60 childcare facilities in two cities of Anhui Province were selected using the convenient sampling method for questionnaires. The questionnaires were distributed through a web-based platform. The disinfection and hand hygiene KAP scores among childcare facilities staff were calculated, and their influencing factors were analyzed. The accuracy rates of knowledge, attitude, and practice of behavior were calculated and analyzed.

Results

A total of 1,029 participants were included in the study. The disinfection and hand hygiene knowledge, attitude and practice ranged from approximately 5 to 23, 1 to 5, 3 to 13, respectively. The score of urban areas was higher than that of rural areas. Higher education levels and more years of working were associated with higher scores. Additionally, staff who received training or supervision had higher scores than those without. The categories with the lowest knowledge accuracy rate (46.3%), lowest attitude accuracy rate (4.2%), and "always" practice rate (5.3%) among childcare facility staff were all related to the question categories concerning the appropriate range of disinfectants for use. The accuracy rates of hand hygiene knowledge and attitude among the childcare facility staff were high (83.7%-99.6%), but the "always" practice rate was in the middle range (63.0%).

Conclusion

The disinfection and hand hygiene knowledge among childcare facilities staff was inadequate during the COVID-19 pandemic in Anhui. Continuous implementation of education and training, particularly in rural areas, is essential. Establishing a monitoring system to assess usage effectiveness and adverse reactions in China is critical. Interventions should focus on increasing compliance with hand hygiene practices. Further research should explore the training and intervention of disinfection and hand hygiene, the safety of disinfection measures, and more operational hand hygiene methods in childcare facilities.

A national nudge study of differently framed messages to increase COVID-19 vaccine uptake in Saudi Arabia: A randomized controlled trial

Background

During the COVID-19 pandemic, Saudi Arabia witnessed hesitancy from a proportion of the population toward taking the vaccine; thus, it was necessary to nudge them to uptake it. This study was conducted to assess the impact of using different types of messages to nudge the public to increase the proportion of vaccinated individuals.

Methods

This study is a multi-arm randomized controlled trial aiming to assess the efficacy of using differently framed messages that appear as pop-notifications in Sehatty application. Of those who preregistered to receive a COVID-19 vaccine but didn't take it according to the Saudi national vaccine registry (n = 1,291,686), 12,000 individuals were randomly recruited and randomly assigned to one of five intervention groups (commitment, loss aversion, salience, social norms, and ego) or a control group. To ensure the exposure occurred in the intervention groups, we included only those who received the notification, which was confirmed by checking the information technology system. We used the Chi-square test to compare each intervention group against the control group separately. Also, we used the same test to investigate whether sex and age influenced the percentage of booked appointments in the intervention groups.

Results

Social norms, ego, salience and loss aversion groups had higher percentages of booked appointments when compared to the control group (21.0%, p = 0.001; 19.1%, p = 0.011; 19.0%, p = 0.013; 18.4%, p = 0.034, respectively). Moreover, when combining the intervention groups, the percentage was higher than the control group (p < 0.001). The percentages of booked appointments made by Young adults (18-35 years old) were higher than that of adults over 35 years old in the social norms (22.6%, p = 0.016) and ego groups (21.0%, p = 0.010). At the same time, sex didn't affect the percentages of booked appointments in any group.

Conclusion

Using different framings of messages to nudge the public to take vaccines can help increase the percentage of immunized individuals in a community. Nudges can boost the public health of a population during an unusual spread of vaccine-preventable diseases. Findings might also inspire governmental responses to other public health situations.

Cross-language validation of COVID-19 Compliance Scale in 28 languages

Although compliance scales have been used to assess compliance with health guidelines to reduce the spread of COVID-19, no scale known to us has shown content validity regarding global guidelines and reliability across an international sample. We assessed the validity and reliability of a Compliance Scale developed by a group of over 150 international researchers. Exploratory factor analysis determined reliable items on the English version. Confirmatory factor analysis confirmed the reliability of the six-item scale and convergent validity was found. After invariance testing and alignment, we employed a novel R code to run a Monte Carlo simulation for alignment validation. This scale can be employed to measure compliance across multiple languages, and our alignment validation method can be conducted with future cross-language surveys.

Sociodemographic and clinical predictors for COVID-19 preventive measures compliance among pregnant women in Saudi Arabia: a multicenter study

OBJECTIVE

To assess the levels of adherence among pregnant women to the basic COVID-19 preventive measures, and to analyze the effect of risk perception and sociodemographic and clinical factors on adherence.

METHOD

A multicenter, cross-sectional study was conducted at the obstetrics clinics of 50 primary care centers selected using a multistage sampling method. An online-administered, structured questionnaire was used to collect self-reported levels of adherence to four basic preventive measures against COVID-19, along with perceived COVID-19 severity, infectiousness, and harmfulness to the baby, besides sociodemographic and clinical data including obstetrical and other medical history.

RESULTS

A total of 2460 pregnant women were included with a mean (SD) age of 30.21 (6.11) years. Levels of self-reported compliance were highest for hand hygiene (95.7%), followed by social distancing (92.3%), masking (90.0%), and avoidance of contact with a COVID-19 infected person (70.3%). Perceived COVID-19 severity and infectiousness, and harmfulness to the baby were observed in 89.2%, 70.7%, and 85.0% of the participants, respectively, and were variably associated with compliance to preventive measures. Analysis of sociodemographic factors highlighted the significance of education and economic status in determining adherence to preventive measures, which represents a potential inequity in the risk of COVID-19 infection.

CONCLUSION

This study highlights the importance of patients' education to enable functional perception of COVID-19 that promotes self-efficacy, besides investigating the specific social determinants of health to tackle inequalities in terms of prevention efficiency and the subsequent health outcomes.

Gender Differences in Knowledge, Attitudes, and Practices toward COVID-19 in Saudi Arabia: A Cross-Sectional Study

Days after the World Health Organization (WHO) declared that COVID-19 was a pandemic, Saudi Arabia took preventative and precautionary measures to avoid its spread and to safeguard its citizens. In this study, we investigated the knowledge, attitudes, and practices (KAP) of both men and women toward COVID-19 as well as associated factors. A cross-sectional study was conducted using an online, self-report questionnaire distributed via Google Forms. The overall percentage of correct answers for the knowledge statements was 80.2%, with a higher rate among the female respondents (82.4% vs. 78.5%, p = 0.005). Slightly more than half (i.e., 165: 51.6%) of the participants showed that they did not go to crowded places during the pandemic; however, more female respondents recorded that they avoided crowded places than male respondents (57.7% vs. 46.2%, p = 0.04). Most participants (i.e., 272: 85.0%) reported that they had worn a mask in recent days, and more than two-thirds (84.4%) said that they still follow the strategies recommended by government authorities to prevent the spread of the virus. Again, more female respondents reported this than males (89.9% vs. 79.5%; p = 0.01). Significant correlations (p < 001) were noted between knowledge and practices (r = 0.31), knowledge and attitudes (r = 0.37), and attitudes and practices (r = 0.29). In the multivariate logistic regression analysis, occupation and education were independently associated with knowledge among both the male and female respondents (adjusted odds ratio [aOR]: 2.9; 95% confidence interval [CI]: 1.2-7.2; aOR: 5.9; 95% CI: 2.2-15.9). Residence was independently associated with attitudes, but only among the male respondents (aOR: 2.3; 95% CI: 1.1-4.9), and COVID-19 was independently associated with practices among both the male and female respondents (aOR: 4.5; 95% CI: 1.4-14.2; aOR: 9.8; 95% CI: 1.2-81.2). There were significant gender differences in both knowledge and practices toward COVID-19, with the female respondents achieving better scores than the male respondents. Thus, we recommend that health education campaigns are tailored to specifically target males.

Of primary health care reforms and pandemic responses: understanding perspectives of health system actors in Kerala before and during COVID-19

BACKGROUND

In 2016, the Government of the southern Indian state of Kerala launched the Aardram mission, a set of reforms in the state's health sector with the support of Local Self Governments (LSG). Primary Health Centres (PHCs) were slated for transformation into Family Health Centres (FHCs), with extended hours of operation as well as improved quality and range of services. With the COVID-19 pandemic emerging soon after their introduction, we studied the outcomes of the transformation from PHC to FHC and how they related to primary healthcare service delivery during COVID-19.

METHODS

A qualitative study was conducted using In-depth interviews with 80 health system actors (male n = 32, female n = 48) aged between 30-63 years in eight primary care facilities of four districts in Kerala from July to October 2021. Participants included LSG members, medical and public health staff, as well as community leaders. Questions about the need for primary healthcare reforms, their implementation, challenges, achievements, and the impact of COVID-19 on service delivery were asked. Written informed consent was obtained and interview transcripts - transliterated into English-were thematically analysed by a team of four researchers using ATLAS.ti 9 software.

RESULTS

LSG members and health staff felt that the PHC was an institution that guarantees preventive, promotive, and curative care to the poorest section of society and can help in reducing the high cost of care. Post-transformation to FHCs, improved timings, additional human resources, new services, fully functioning laboratories, and well stocked pharmacies were observed and linked to improved service utilization and reduced cost of care. Challenges of geographical access remained, along with concerns about the lack of attention to public health functions, and sustainability in low-revenue LSGs. COVID-19 pandemic restrictions disrupted promotive services, awareness sessions and outreach activities; newly introduced services were stopped, and outpatient numbers were reduced drastically. Essential health delivery and COVID-19 management increased the workload of health workers and LSG members, as the emphasis was placed on managing the COVID-19 pandemic and delivering essential health services.

CONCLUSION

Most of the health system actors expressed their belief in and commitment to primary health care reforms and noted positive impacts on the clinical side with remaining challenges of access, outreach, and sustainability. COVID-19 reduced service coverage and utilisation, but motivated greater efforts on the part of both health workers and community representatives. Primary health care is a shared priority now, with a need for greater focus on systems strengthening, collaboration, and primary prevention.

Public conformism with health regulation is crumbling as COVID-19 becomes a chronic threat: Repeated Cross-sectional Studies

BACKGROUND

The purpose of this study is to analyze the long terms trends in public attitudes toward the COVID-19 pandemic and compliance with self-quarantine regulations.

METHODS

Repeated cross-sectional studies looking into data collected from nationally representative samples (N = 2568) of the adult population in Israel at five points in time representing the five morbidity waves of the COVID-19 pandemic. This study examined public trust in Israeli health regulations, levels of public panic, feelings of personal worry, and compliance with health regulations, specifically self-quarantine.

RESULTS

Public trust in health regulations in January 2022 is at an all-time low (25%) compared to the maximum value of nearly 75% measured in March 2020. While reported worry is steadily reducing, the perception of public panic is increasing. In earlier rounds, public compliance with self-quarantine was reported close to 100%; however, it has dropped to 38% by January 2022 when compensation is not assumed. Regression analysis suggests that trust is a major predictor of compliance with health regulations.

CONCLUSIONS

The "fifth wave" of the COVID-19 pandemic brought about an all-time low in public trust in health regulations. The Israeli public, normally a highly compliant one, is showing signs of crumbling conformity.

Application of Public Health Precautionary Guidelines Before Contracting COVID-19: Lessons Learned from a Qualitative Descriptive Study

Background

The COVID-19 pandemic has affected the Saudi population despite early efforts taken by officials. This study aimed to describe the precautionary measures taken by patients prior to their diagnosis with COVID-19.

Methods

A qualitative descriptive design was employed to collect data from a convenience sample of 26 participants who had COVID-19 and recovered. Data was collected through conducting telephone interviews and was then transcribed and analyzed using inductive content analysis methods adapted from grounded theory.

Results

Data analysis yielded six categories of precautionary measures participants reported using to minimize their risk of contracting COVID-19: (1) wearing a mask, (2) staying at home and avoiding crowds, (3) washing hands and wearing gloves, (4) following social distancing, (5) using sanitizers, and (6) not interacting with anyone.

Conclusion

The discrepancy found between the participants' reported precautionary measures and their actual behavior, as well as the consistency and specificity with which they implemented some and not all measures raise concerns about existing public health messages. The study findings support the importance of well-structured and detailed communication when designing future public health campaigns and data-driven policies.

Perceptions, precautions, and vaccine acceptance related to monkeypox in the public in China: A cross-sectional survey

BACKGROUND

The World Health Organization declared monkeypox as a Public Health Emergency of International Concern. A cross-sectional online survey was conducted to understand beliefs, attitudes, perceived preventive measures, and vaccination acceptance related to monkeypox in the public in China.

METHODS

Between August 30 and September 15, 2022, we recruited adults through an online survey platform. Demographic characteristics, perceptions, common knowledge, concerns, attitudes, willingness to adopt preventive measures (including hygiene practices, social distancing, and travel avoidance), and vaccination acceptance related to monkeypox were collected. Logistic regression was used to assess correlates of concerns about monkeypox, willingness to adopt preventive measures, and vaccination acceptance.

RESULTS

2135 participants were recruited (median age: 31.4 years). 62.7% were concerned about monkeypox. 33.2% were more concerned about monkeypox compared to COVID-19. Males (aOR 0.61, 95%CI 0.50-0.74), accessing monkeypox information from the Internet (0.77, 0.61-0.98), and willingness to adopt monkeypox vaccine (2.9, 2.38-3.53) were associated with concerns about monkeypox. Most participants were willing to adopt precautions (76.3% hygiene practices, 68.2% social distancing, 85.9% travel avoidance). Individuals who were concerned about monkeypox (hygiene practices: 2.09, 1.69-2.59; social distancing: 1.78, 1.46-2.16; travel avoidance: 1.74, 1.34-2.26) and had better knowledge about monkeypox (hygiene practices: 1.85, 1.48-2.31; social distancing: 2.17, 1.77-2.66; travel avoidance: 1.74, 1.34-2.26) were more likely to adopt precautions. 68.8% were willing to adopt monkeypox vaccine. Participants with older age (aged 40-49: 0.57, 0.38-0.85; aged 50 +: 0.50, 0.31-0.81), and higher income (¥6000-10,000: 0.61, 0.39-0.95; ≥¥10,000: 0.48, 0.30-0.77) were less likely to adopt the monkeypox vaccine. Being concerned more about monkeypox compared to COVID-19 (1.63, 1.31-2.02), and having better knowledge about monkeypox (1.34, 1.09-1.66) were associated with willingness to adopt vaccination.

CONCLUSIONS

Compared with COVID-19, monkeypox attracted significantly less attention in the public in China, who currently have insufficient monkeypox knowledge. Interventions aimed at improving monkeypox knowledge and precautions among different groups of individuals in China are needed.

Knowledge, Attitudes and Practices of the General Population in Yemen Regarding COVID-19: A Cross-Sectional Study

BACKGROUND

Following the World Health Organization declaration of COVID-19 as a pandemic, Yemen has taken preventive and precautionary measures against COVID-19 to control its spread. This study evaluated the knowledge, attitudes, and practices (KAP) of the Yemeni public regarding COVID-19.

METHODS

A cross-sectional study using an online survey was conducted during the period from September 2021 to October 2021.

RESULTS

The mean total knowledge score was 9.50 ± 2.12. The majority of the participants (93.4%) were aware that to prevent infection by the COVID-19 virus, going to crowded places and gatherings should be avoided. Approximately two thirds of the participants (69.4%) believed COVID-19 is a health threat to their community. However, in terms of actual behavior, only 23.1% of the participants reported that they did not go to any crowded places during the pandemic, and only 23.8% had worn a mask in recent days. Moreover, only about half (49.9%) reported that they were following the strategies recommended by the authorities to prevent the spread of the virus.

CONCLUSION

The findings suggest that the general public has good knowledge and positive attitudes regarding COVID-19, but that their practices are poor.

Can Trust Bring Satisfaction to the Festival Under Pandemic?

In existing festival research, trust is often placed at the post-experience stage by scholars, and there is no research to explore the relationship between festivalscape, trust, and experience. In addition, the main function of trust is to reduce uncertainty and risk perception. Existing festival-related research scenarios do not have typical risks, which will limit the findings of the research. This research focuses on festivals under covid-19 pandemic, which is a typical risky scenario. Exploring the antecedent variables and the consequences of the trust of the festival participants in this context may therefore make up the deficiency of existing research. Several interesting findings have been made: the perception of the festivalscape during the pandemic has been significantly simplified. Epidemic prevention measures and staff may increase trust, but trust cannot have a direct and significant impact on festival satisfaction. While staff positively strengthen trust, they will have a significant negative impact on satisfaction.

Compliance with COVID-19 public health guidelines: an attitude-behaviour gap bridged by personal concern and distance to conspiracy ideation

OBJECTIVE

This study examined predictors of compliance with public health guidelines to curb transmission of COVID-19.

DESIGN

Applying an exploratory longitudinal design, participants (N = 431) from Germany and Austria completed surveys in April/May 2020 (T1) and July/August 2020 (T2).

MEASURES

Three outcome measures operationalised compliance with public health guidelines at T2: self-reported adherence (behavioural), agreement and opposition (attitudinal). At T1, demographics, perceived distress (PHQ-4, crisis of meaning), resources (self-control, meaningfulness), locus of control, conspiracy mentality and social media use were assessed. At T2, situational variables were added (person at risk, infection of close person, fear of infection, COVID-19 stress). Temporal shifts from T1 to T2 were examined as complementary information.

RESULTS

An attitude-behaviour gap at T2 was identified, as agreement with and opposition to the guidelines were only modestly correlated with adherence to them. Measures of personal concern (fear of infection, person at risk) were associated with both adherence and positive attitudes towards the measures. COVID-19 stress and conspiracy mentality predicted negative attitudes, but not adherence. Age predicted adherence positively, social media use negatively.

CONCLUSION

The findings support the significance of personal concern for compliance with public health guidelines and suggest a critical impact of social media use and conspiracy mentality.

Development and cross-national investigation of a model explaining participation in WHO-recommended and placebo behaviours to prevent COVID-19 infection

To protect themselves from COVID-19, people follow the recommendations of the authorities, but they also resort to placebos. To stop the virus, it is important to understand the factors underlying both types of preventive behaviour. This study examined whether our model (developed based on the Health Belief Model and the Transactional Model of Stress) can explain participation in WHO-recommended and placebo actions during the pandemic. Model was tested on a sample of 3346 participants from Italy, Japan, Poland, Korea, Sweden, and the US. It was broadly supported: objective risk and cues to action showed both direct and indirect (through perceived threat) associations with preventive behaviours. Moreover, locus of control, decision balance, health anxiety and preventive coping moderated these relationships. Numerous differences were also found between countries. We conclude that beliefs about control over health and perceived benefits of actions are critical to the development of interventions to improve adherence to recommendations.

Assessing the impact of the COVID-19 pandemic among Venezuelan refugees and migrants in Colombia using respondent-driven sampling (RDS)

OBJECTIVES

To determine factors associated with adherence to COVID-19 mitigation measures, related symptoms and testing, as well as pandemic-related income loss among Venezuelan refugee and migrant adults in urban and border areas of Colombia.

DESIGN

Phone-based respondent-driven sampling SETTING: Bogotá and Norte de Santander, Colombia.

PARTICIPANTS

605 adult Venezuelan refugees and migrants residing in Bogotá (n=305) and Norte de Santander (n=300), who arrived in Colombia after 2014 and completed the survey in August and September 2020.

PRIMARY AND SECONDARY OUTCOME MEASURES

Full COVID-19 compliance (vs incomplete or no compliance), any COVID-19-related symptoms (vs none) and income loss due to isolation measures in Colombia (vs no income change or increase in income).

RESULTS

Older age was associated with lower odds of compliance with physical distancing measures (0.94, 0.90-0.99; p=0.01) for those in Bogotá. Nearly 15% of refugees and migrants in both locations (81 of 605) experienced at least one symptom consistent with COVID-19. Having a health condition was associated with higher odds of experiencing COVID-19-related symptoms in Bogotá (4.00, 1.22-13.06; p=0.02) and Norte de Santander (6.99, 1.95-24.99; p=0.003). Around 8% in both locations (48 of 605) were tested for COVID-19. Around 90% in both locations (537 of 605) had trouble earning an income after the introduction of isolation measures, and the median reported monthly income decreased by half in Bogotá and by 30% in Norte de Santander. A higher level of education (3.46, 1.02-11.75; p=0.05) was associated with higher odds of income loss among participants in Norte de Santander.

CONCLUSIONS

Results indicate high compliance with COVID-19 mitigation measures, low testing rates and high pandemic-related income loss among Venezuelan refugees and migrants in Colombia. This study provides insights into a hard-to-reach refugee and migrant population in Colombia; additional study on the effects of the pandemic on hidden populations is warranted.

Predictors of Self-Reported Compliance with COVID-19 Preventive Guidelines: A Quantile Regression Model

The research used an online, convenience cross-sectional sample of adults aged ≥18 years old recruited from Shahroud County, Northeast of Iran. We measured the contribution of multiple determinants for association with behavioral compliance, at the time of the COVID-19 pandemic. The compliance score measured with this questionnaire can be within a range of 5 and 100. Compliance was bounded between 19 and 80 that has been distributed J-shape, so quantile logistic regression model has been fitted for that. Variables related to people's knowledge, including self-reported knowledge and following the news related to COVID-19, were the two main factors that accompanied behavioral compliance at all of its levels in the period of pandemic.

Knowledge acquisition and precautionary behaviors for individual resilience to the COVID-19 pandemic: A study of rural Latin America

The concept of resilience gains prominence as human society faces more frequent and impactful shocks and disturbances. This study seeks to investigate how rural populations build resilience amid the COVID-19 pandemic. A simple theoretical model is presented to illustrate the determinants of knowledge acquisition and precautionary behaviors among rural residents. Based on a High Frequency Phone Survey of 10,583 Latin American adults, this study found that rural residents were less capable of using informal channels (e.g., the internet) to collect COVID-19 information. Younger generations were generally less likely to adopt precautionary behaviors than the elderly. The age disparity, however, was relatively minor for rural populations. Costly preventive measures such as staying at home are less affordable for rural residents. Meanwhile, confidence in government ensures better compliance to ensure public health guidelines. We argue that internet skills, prosociality, and political confidence are necessary to build rural residents' resilience during the pandemic.

The impact of inspection policies on reducing disease prevalence in public buildings: A systems dynamics approach

The occurrence of the COVID-19 pandemic revealed new dimensions of urban resilience to communities. Failure to implement health protocols in public buildings has had a significant impact on the spread of the disease, and inspection has become necessary to enforce the rules. This study presents different inspection policies of public buildings to reduce disease prevalence. It evaluates and compares the implementation of these policies in the long run based on the systems dynamics approach. First, baseline modeling was performed without inspection to analyze the proposed policies, and disease prevalence was investigated. Then various proposed inspection and fines policies, including fixed inspection and fines rate (FIFF), fixed inspection rate with the variable fine rate (FIVF), and variable inspection and fines rate (VIVF), are introduced, and their system dynamics models are presented. The impact of each inspection policy on the violations rate and disease prevalence in public buildings has been investigated using long-term simulation. Based on the results, regulatory agencies can significantly reduce the rate of violations in public buildings and improve urban resilience to the epidemic by adopting proper inspection policies. The results can help city managers to adopt appropriate inspection policies.

Policy capacity during COVID-19 in Asia: A systematic literature review

COVID-19 has revealed the policy capacity of some governance institutions, both resilience and vulnerability. Hence, this circumstance has demanded public administration scholars and practitioners to rethink the existing governance practices, particularly in making effective crisis-related policies. This paper reviewed primary and secondary studies exploring the application of policy capacity competencies in facilitating COVID-19 handling in Asia. In achieving so, we did a systematic literature review of relevant studies published between January and October 2020. Applying the agreed search term to several databases, we found 2541 studies, while merely 30 were included for review. Findings from the studies are predominantly closely linked to operational capacity (n = 21). Other studies are related to political and analytical capacity (n = 14 and 7, retrospectively). We found that there are some dilemmas and inadequacy of understanding concerning the role of features in certain capacities (such as technology use versus individual privacy, the paradox of trust and legitimacy, or centralisation versus decentralisation), particularly in the time of crisis, which is a calling for future research.

"Apples and Oranges": Examining Different Social Groups' Compliance With Government Health Instructions During the COVID-19 Pandemic

BACKGROUND

The coronavirus outbreak has demonstrated the crucial effect of the public's compliance with the government's health instructions on the population's health. However, evidence shows that some communities are less likely to comply with such instructions than others. This study highlights the factors related to intentions to comply with newly issued health directives during an ongoing extreme crisis, such as the current pandemic. In addition, it compares the impact of these factors on different minority groups and the general population in Israel.

METHODS

Using an online survey (N=1005), we examined the impact of compliance-related factors on compliance intentions with newly issued health directives in two minority groups in Israel: the ultra-Orthodox Jewish community (N=323) and the Arab community (N=361), as well as in the general population (N=321), during the first outbreak of coronavirus disease 2019 (COVID-19). Participants were presented with a new made-up COVID-19-related instruction simulated to be issued by the Israeli Ministry of Health. Compliance intentions and compliance-related factors were measured.

RESULTS

The Arab minority expressed greater intentions of complying with the instructions than the other groups. Perceptions on risk and the effectiveness of the instruction were the only two significantly associated factors with compliance intentions in all of the social groups. Additional factors affected different groups to different extents. Trust in government was related to compliance intentions only in the Arab minority.

CONCLUSION

Intentions to comply with health instructions during a crisis differ in various minority groups and in comparison to the general population, both in their levels and in the factors related to them. Policy-makers and health authorities should consider providing information about the risks and negative outcomes of the crisis as well as the expected effectiveness of the recommended behaviors. Future research should examine other minority groups and other types of instructions in different stages of a crisis.

Attitudes toward COVID-19 Pandemic among Fully Vaccinated Individuals: Evidence from Greece Two Years after the Pandemic

Background

Considering the major effects of COVID-19 pandemic on health, social, economic, and political dimensions of all countries, positive attitudes toward COVID-19 pandemic are essential to control the pandemic. In our study, we investigated attitudes toward COVID-19 pandemic among fully COVID-19 vaccinated individuals two years after the pandemic and we identified predictors of attitudes.

Materials and Methods

We conducted an on-line cross-sectional study with 815 fully COVID-19 vaccinated individuals in Greece during May 2022. A self-administered and valid questionnaire was disseminated through social media platforms. We measured socio-demographic variables and COVID-19-related variables as potential predictors of attitudes toward COVID-19 pandemic. The outcome variable was attitudes toward COVID-19 pandemic (compliance with hygiene measures, trust in COVID-19 vaccination, fear of COVID-19, and information regarding the COVID-19 pandemic and vaccination).

Results

We found a very high level of compliance with hygiene measures, a high level of trust and information about the COVID-19 pandemic and vaccination, and a moderate level of fear of COVID-19. Also, we identified that females, participants with a higher educational level, those with a chronic disease, those with a better self-perceived physical health, and those without a previous COVID-19 diagnosis adhered more in hygiene measures. Trust in COVID-19 vaccination was higher among females, older participants, those with a higher educational level, those with a better self-perceived physical health, and those without a previous COVID-19 diagnosis. Moreover, females, older participants, those with a higher educational level, those with a chronic disease, those with a better self-perceived physical health, those that received a flu vaccine in previous season, and those without a previous COVID-19 diagnosis experienced more fear of COVID-19. Finally, level of information regarding COVID-19 pandemic and vaccination was higher for participants with a higher educational level, those without a chronic disease, those with a better self-perceived physical health, and those that received a flu vaccine in previous season.

Conclusions

Understanding predictors of attitudes toward COVID-19 pandemic among fully vaccinated individuals is crucial for developing appropriate public health campaigns in the future. Vaccination should be accompanied by positive attitudes in order to decrease the frequency of negative outcomes of COVID-19, such as hospitalization, complications and mortality.

The Impact of COVID-19 on the Mental Well-Being of College Students

The COVID-19 pandemic has caused an overall increase in stress and depression in society. The aim of the present research was to evaluate the psychological condition of college students during the COVID-19 pandemic and explore factors influencing their daily functioning. The study focused on four main aspects such as mental well-being, sexuality, concern about financial status, and trust in medical authorities. The study was based on a specially designed survey. The questionnaire was created using Google Forms and shared on social media sites. A total of 630 students participated in the survey, 17 surveys were excluded due to incomplete data and 613 surveys (97.30%) were considered for the final analysis. During isolation, 68.0% of students experienced fear of missing out (FOMO). A total of 73.4% were frustrated due to spending a lot of time in front of a computer. A significant decrease in motivation to study was reported by 78.1% of the respondents. Students showed significantly different attitudes towards sexuality. Concern about the financial situation was reported by 48.7% of respondents. The state of the Polish economy was of concern to 86.4% of respondents. A total of 74.5% of students declared concern about their career development. During the pandemic, 59.0% of respondents became concerned about their health. The attitude towards vaccination was described as positive by 82.5% of the respondents. The percentage of respondents experiencing negative psychological effects relative to the overall epidemiological situation of COVID-19 is troubling. Given the unexpected length and severity of the pandemic, we suggest that students’ concerns be more thoroughly understood and addressed.

Did Mindful People Do Better during the COVID-19 Pandemic? Mindfulness Is Associated with Well-Being and Compliance with Prophylactic Measures

This paper investigates the relationship between mindfulness and well-being within the context of compliance with prophylactic measures in the time of COVID-19. We conducted a large-scale survey among a representative sample of the French population. We measured mindfulness, using the Mindful Attention Awareness Scale, and the extent to which respondents were impacted by COVID-19 in terms of their mood and quality of sleep, as well as how they complied with prophylactic measures. Our results suggest that more mindful individuals were less negatively impacted by COVID-19 with regard to their sleep and mood. Concerning the prophylactic measures, we obtained mixed results: more mindful participants were more likely to respect lockdowns, physical distancing and to cough in their sleeves, but did not wash their hands, wear masks or avoid touching their face more often than less mindful individuals.

Lockdown Efficacy in Controlling the Spread of COVID-19 May Be Waning Due to Decline in Public Compliance, Especially among Unvaccinated Individuals: A Cross-Sectional Study in Israel

Public compliance is paramount for the success of public health measures and decision making, such as lockdowns, in controlling the spread of diseases. The aim of this population-based cross-sectional study was to investigate the level of reported compliance with home isolation among the adult Israeli population (n = 940) during the first three national lockdowns, compliance with a potential fourth national lockdown if enacted, risk perception of COVID-19, vaccination uptake status, perceived effectiveness of the vaccine, and compliance with additional protective health behaviors (e.g., mask wearing and social distancing). Following widespread compliance with initial lockdowns (90.7% reported "high" or "very high" compliance), as few as 60.1% of participants indicated that they would comply with a fourth lockdown if the government decides to enact it. Non-vaccinated individuals reported the lowest levels of compliance with previous lockdowns, compared to participants who received one or two vaccines and participants vaccinated with three doses. Adjusted for gender and age, the results suggest that fearing being infected with COVID-19, perceiving the vaccine to be effective, and reporting being compliant with other health behaviors-such as mask wearing and maintaining social distance from others-are predictors of lockdown compliance. Considering the effect of pandemic lockdown fatigue, there is little support for additional lockdowns among the Israeli public, unless dramatic changes occur in the characteristics of the COVID-19 pandemic. Compliance with lockdowns is reduced among individuals who are at higher risk of contracting COVID-19, therefore rendering this non-pharmaceutical intervention even less effective in reducing the spread of the disease.

Travel decision determinants during and after COVID-19: The role of tourist trust, travel constraints, and attitudinal factors

The COVID-19 pandemic has forced tourism practitioners to create efficient strategies to attract travelers. Using three theoretical frameworks, such as tourist trust (political, destination, and interactional trust), travel constraint (intrapersonal, interpersonal, and "social distancing" structural constraint), and extended theory of planned behavior (travel attitude, perceived behavioral control, subjective norm, perceived health risk, past travel experience), we develop a comprehensive framework to explain the impact of travel promoting, restricting, and attitudinal factors on travel decision during and after the pandemic. Data was obtained through an extensive survey conducted on 1451 Korean travelers and was analyzed using probabilistic choice models and count models. The results show the specific factors that determine travel decisions during the pandemic (whether to travel and frequency) and travel intention after the pandemic. This study provides important theoretical and practical insights into how to develop successful COVID-19 recovery strategies in the tourism industry.

COVID-19: Mathematical growth vs. precautionary measures in China, KSA, and the USA

This paper aims to study the relation between precautionary measures that were taken by countries to prevent the spread of COVID-19 and its impact on its mathematical growth. In this paper, we study the development and growth of the epidemic during the first fifty days since its appearance in three countries: China, the Kingdom of Saudi Arabia (KSA), and the United States of America (USA). An optimization process is used to determine the parameters of the closest model that simulates the data during the specified period by using one of the evolutionary computation techniques, the grasshopper optimization algorithm (GOA). The study reveals that the strict precautionary measures of applying isolation and quarantine, preventing all gatherings, and a total curfew are the only way to prevent the spread of the epidemic exponentially as China did. Also, without any measures to slow its growth, COVID-19 will continue to spread steadily for months.

Compliance Toward Protective Precautions During and After the Lockdown Among Citizens of Riyadh

Objective: The emergence of the novel coronavirus disease 2019 (COVID-19) has resulted in precautionary measures by governments worldwide to contain the spread of the virus. However, the degree of compliance toward personal precautionary measures has varied, despite the urgent need to contain the pandemic. This study aimed to assess the level of compliance toward personal protective precautions during and after the lockdown among residents of Riyadh, Saudi Arabia.

Methods: We conducted a cross-sectional study with 1,108 residents using an online survey to collect sociodemographic data, compliance with personal protective measures, and other factors during and after the lockdown. Statistical Package for Social Sciences (SPSS) version 26 (IBM SPSS Statistics, Armonk, NY) was used for data analysis.

Results: During the lockdown, 35.5% of respondents were “very compliant,” whereas 30.1% were “less compliant.” Additionally, compliance levels in those who depended on official sites as their primary source of information were significantly higher than those who depended on their family, friends, and social media. Approximately 39.76% of those who were “very compliant” intended on getting vaccinated against COVID-19, while 28% of those with high compliance did not intend on getting vaccinated. Further, compliance levels were high in participants who were not in direct contact with COVID-19 cases as well.

Conclusion: This study highlights the importance of maintaining the level of compliance toward personal precautionary measures against COVID-19 even after lockdown release to prevent further waves. This study showed that compliance toward personal protective measures was high for those who did not have direct contact with COVID-19 positive people after lockdown, those planning for inoculation, and those insuring applications of precautionary measures by their children. Additionally, higher compliance was noted in participants who sought information from official sites.

Effect of non-pharmacological interventions on the COVID-19 epidemic in Saudi Arabia

We quantified the potential impact of different social distancing and self-isolation scenarios on the coronavirus disease 2019 (COVID-19) pandemic trajectory in Saudi Arabia and compared the modelling results to the confirmed epidemic trajectory. Using the susceptible, exposed, infected, quarantined and self-isolated, requiring hospitalisation, recovered/immune individuals, fatalities model, we assessed the impact of a non-pharmacological interventions' subset. An unmitigated scenario (baseline), mitigation scenarios (25% reduction in social contact/twofold increase in self-isolation) and enhanced mitigation scenarios (50% reduction in social contact/twofold increase in self-isolation) were assessed and compared to the actual epidemic trajectory. For the unmitigated scenario, mitigation scenarios, enhanced mitigation scenarios and actual observed epidemic, the peak daily incidence rates (per 10 000 population) were 77.00, 16.00, 9.00 and 1.14 on days 71, 54, 35 and 136, respectively. The peak fatality rates were 35.00, 13.00, 5.00 and 0.016 on days 150, 125, 60 and 155, respectively. The R0 was 1.15, 1.14, 1.22 and 2.50, respectively. Aggressive implementation of social distancing and self-isolation contributed to the downward trend of the disease. We recommend using extensive models that comprehensively consider the natural history of COVID-19, social and behavioural patterns, age-specific data, actual network topology and population to elucidate the epidemic's magnitude and trajectory.

Public Trust in COVID-19 Prevention and Responses Between January and May 2020 in Bangladesh

BACKGROUND AND AIMS

Although the Government of Bangladesh (GoB) developed some policy initiatives during the first phase of COVID-19, their efforts were questioned due to indecision, late policy decisions and implementation, and a proliferation of fake testing and fake news. As such, this research aims to examine public trust in preparedness and response measures undertaken by both the GoB and private sector organisations in Bangladesh between January and May 2020.

METHODS

A cross-sectional survey method was applied to a sample of Bangladeshi residents using a questionnaire distributed between April and June 2020. Three hundred and seven respondents participated in an online questionnaire that was disseminated on online outlets, such as e-mail, Facebook Messenger, and WhatsApp. The survey questionnaire was distributed to potential respondents, and continuous-chain messages were provided. Data were analyzed using exploratory factor analysis (EFA).

FINDINGS

Of the 307 participants, 77% were male and 23% were female. Findings suggest that the participants showed greater approval of private sector responses than of governmental preparedness and response activities. For preparedness activities, participants were negative about both the GoB efforts to organize and provide personal protective equipment (PPE) for doctors in time as a safeguard against COVID-19, and also the lack of coordination and informed decision-making in relation to facing COVID-19. Respondents were asked to share their perception of the suitability of GoB pandemic management plans, as evidenced by plan effectiveness during the COVID-19 pandemic.

CONCLUSION

A lower level of trust was demonstrated by the Bangladeshis with regard to preparedness and response measures taken in Bangladesh. Based on participants' concerns and suggestions and a review of drawback of policy responses in the early stage, a set of recommendations are provided for future pandemics like public health emergency risk management in Bangladesh.

Short-term psychological consequences of the COVID-19 pandemic: Results of the first wave of an ecological daily study in the Italian population

COVID-19 pandemic involved several psychosocial consequences. We aimed at monitoring the mental health of Italian adults during the lockdown imposed by the government. We present here results from the baseline assessment of the "EmotionalThermometer [TermometroEmotivo] project on a sample of 1548 Italian adults. We assessed the socio-demographic conditions of participants, individuals' perception of the COVID-19-situation, psychological distress, emotion regulation strategies, and perceived social support. Having a worse representation of COVID-19 and consulting news more frequently, with higher anxiety and less credibility of different sources of information, were positively associated with psychological distress and post-traumatic responses. Being female, younger age, living in high-risk regions, having symptoms of COVID-19, and having relatives/friends with such symptoms represented risk factors for a worse perception of COVID-19 and distress. Social support and cognitive reappraisal represented protective factors for mental health.

How Do People Cope During the COVID-19 Pandemic and Stay Well? A Salutogenic Longitudinal Study in Israel

Employing the salutogenic approach, this longitudinal study explored the effects of coping with the COVID-19 pandemic in Israel, as it evolved from an acute to a chronic stress situation, during the first year. We examined the role of individual [sense of coherence (SOC)], social (perceived social support), and national [sense of national coherence (SONC)] coping resources, as well as situational and demographic factors, in predicting mental health and anxiety. Data was collected in five phases between March 2020 and February 2021 via a repeated panel sample and included 198 Jewish Israelis (52% males) age 18-64 (M = 43.5). The results confirmed the expected pattern of moving from acute to chronic stressful situation: levels of general anxiety were higher in the first phase of the pandemic outbreak as compared to the other phases. Levels of social and national coping resources significantly decreased over time. However, as expected, the salutogenic resource of the individual sense of coherence remained stable and was also found as the main predictor of both anxiety and mental health in the 5 phases of the study. Beyond the explanatory factor of SOC, mental health was better explained by the social and national coping resources, while anxiety was explained by situational factors (level of financial risk and gender). The discussion delineates the longitudinal effects of individual, social, and national coping resources on mental health and anxiety during the dynamic process of the long period of 1 year of the pandemic, evolving from acute to chronic phases of the complicated health, economic, social, and political crisis.

Indoor and outdoor noise changes due to the COVID-19 lockdown and their effects on individuals' expectations and preferences

The COVID-19 pandemic significantly modified our urban territories. One of the most strongly affected parameters was outdoor noise, caused by traffic and human activity in general, all of which were forced to stop during the spring of 2020. This caused an indubitable noise reduction both inside and outside the home. This study investigates how people reacted to this new unexpected, unwanted and unpredictable situation. Using field measurements, it was possible to demonstrate how the outdoor sound pressure level clearly decreased. Furthermore, by means of an international survey, it was discovered that people had positive reaction to the lower noise level. This preference was generally not related to home typology or location in the city, but rather to a generalized wish to live in a quieter urban environment.

Coping during COVID-19 Pandemic in Saudi Community: Religious Attitudes, Practices and Associated Factors

The COVID-19 pandemic has affected many societies’ life aspects and activities including social and Islamic practices; more attention should be given to investigate the interaction between Islamic worships and the spread of the disease. Here, we performed a cross-sectional study using an online questionnaire to assess the preventive Islamic attitudes and practices during the COVID-19 lockdown period from the Saudi publics’ perspectives. Mann-Whitney, Kruskal and logistic regression tests were used to analyze the data. The results revealed that most participants had positive Islamic attitudes and practices. However, elders and males were less obeyed to preventive measures during performing worship (p < 0.05). While younger, females and not married were less obeyed when dealing with COVID-19 related death (p < 0.05). Even though, elders were less likely to have poor social and Islamic practices concerning adherence to preventive measures during the pandemic (OR = 0.38; 95% CI: 0.176–0.816) than younger. Furthermore, males, Saudi participants, lower education level, lower Islamic attitudes scores were more likely to have poor social and Islamic practices concerning adherence to preventive measures during the pandemic (OR = 1.65; 95% CI: 1.126–2.421; OR = 1.57; 95% CI: 1.067–2.322; OR = 3.09; 95% CI: 1.721–5.563; and OR = 1.89; 95% CI: 1.309–2.753, respectively), than their corresponding targeted counterparts. Thus, despite the high preventative perceptions of Islamic attitudes and practices of the Saudi community, our study highlighted some risk groups with less preventative practices. Thus, targeted health education interventions are highly recommended for these risk groups to enhance the commitment to government instructions.

Analyzing the Perceived Utility of Covid-19 Countermeasures: The Role of Pronominalization, Moral Foundations, Moral Disengagement, Fake News Embracing, and Health Anxiety

An online survey (N = 210) is presented on how the perceived utility of correct and exaggerated countermeasures against Covid-19 is affected by different pronominalization strategies (impersonal form, you, we). In evaluating the pronominalization effect, we have statistically controlled for the roles of several personal characteristics: Moral Disengagement, Moral Foundations, Health Anxiety, and Embracing of Fake News. Results indicate that, net of personal proclivities, the you form decreases the perceived utility of exaggerated countermeasures, possibly due to simulation processes. As a second point, through a Structural Equation Model, we show that binding moral values (Authority, Ingroup, and Purity) positively predict both fake news embracing and perceived utility of exaggerated countermeasures, while individualizing moral values (Harm and Fairness) negatively predict fake news embracing and positively predict the perceived utility of correct countermeasures. Lastly, fake news embracing showed a doubly bad effect: not only does it lead people to judge exaggerated countermeasures as more useful; but, more dangerously, it brings them to consider correct countermeasures as less useful in the struggle against the pandemic.

Perceptions towards COVID-19 and adoption of preventive measures among the public in Saudi Arabia: a cross sectional study

BACKGROUND

Effective management of the spread of a novel infectious disease, such as the COVID-19 virus can be achieved through influencing people's behavior to adopt preventive measures. The public's perceptions and attitudes towards the virus, governmental guidance and preventive measures were unknown in Saudi Arabia.

OBJECTIVES

1) investigate the public perception of COVID-19, anxiety level, the COVID-19 information sources sought, adoption of preventive measures, and ability and willingness to self-isolate during and post-lockdown periods of the COVID-19 pandemic in Saudi Arabia; 2) investigate socio-demographic factors associated with adoption of preventive measures against COVID-19 and self-isolation practices.

METHOD

Between April 22nd and June 21st 2020, Saudi adults aged ≥18 years voluntarily completed a self-administered web-based cross-sectional survey, distributed through social media (WhatsApp) and emails to representatives in education, health, business, and social sectors across all Saudi Arabian regions. The survey included questions on anxiety level, COVID-19 risk perceptions and adoption of preventive measures. Weighted percentages, Pearson's chi-square tests, and multiple logistic regression were applied to evaluate associations between these factors and socio-demographic variables.

RESULTS

A total of 2393 respondents completed the survey. A majority (74%) were worried about the COVID-19 outbreak and of those, 27% reported that it was likely that they would be infected with COVID-19; 16% believed it would be life-threatening or severe. However, only 11% of respondents reported high anxiety level. Adoption of hygiene practices and social distancing were lower among older (> 65 years) compared to younger (18-24 years) respondents (OR: 0.06; 95% CI: 0.01, 0.28 and OR 0.06; 95% CI: 0.01, 0.27 respectively). High percentages of respondents reported being able to (88%) and were willing to (82%) self-isolate. Those with the lowest gross household income and those with at least one flu symptom were less able and willing to self-isolate. A significant increase in levels of anxiety, perceived effectiveness of social distancing and hygiene practices was reported in the post-lockdown compared to during the lockdown.

CONCLUSIONS

The study reported high levels of adoption of preventive measures, willingness and perceived ability to self-isolate during the early phase of the pandemic. Vulnerable groups such as the elderly, and those with low socio-economic status reported lower adoption of preventive measures or ability and willingness to self-isolate. Tailored public health messages and interventions are needed to achieve high adherence to these preventive measures in these groups.

Impact of COVID-19 lockdown on psychosocial factors, health, and lifestyle in Scottish octogenarians: The Lothian Birth Cohort 1936 study

Background

Little is known about effects of COVID-19 lockdown on psychosocial factors, health and lifestyle in older adults, particularly those aged over 80 years, despite the risks posed by COVID-19 to this age group.

Methods

Lothian Birth Cohort 1936 members, residing mostly in Edinburgh and the surrounding Lothians regions in Scotland, mean age 84 years (SD = 0.3), responded to an online questionnaire in May 2020 (n = 190). We examined responses (experience and knowledge of COVID-19; adherence to guidance; impact on day-to-day living; social contact; self-reported physical and mental health; loneliness; and lifestyle) and relationships between previously-measured characteristics and questionnaire outcomes.

Results

Four respondents experienced COVID-19; most had good COVID-19 knowledge (94.7%) and found guidance easy to understand (86.3%). There were modest declines in self-reported physical and mental health, and 48.2% did less physical activity. In multivariable regression models, adherence to guidance by leaving the house less often associated with less professional occupational class (OR = 0.71, 95%CI 0.51–0.98) and poorer self-rated general health (OR = 0.62, 95%CI 0.42–0.92). Increased internet use associated with female sex (OR = 2.32, 95%CI 1.12–4.86) and higher general cognitive ability (OR = 1.53, 95%CI 1.03–2.33). Loneliness associated with living alone (OR = 0.15, 95%CI 0.07–0.31) and greater anxiety symptoms (OR = 1.76, 95%CI 0.45–1.24). COVID-19 related stress associated with lower emotional stability scores (OR = 0.40, 95%CI 0.24–0.62). Decreased physical activity associated with less professional occupational class (OR = 1.43, 95%CI 1.04–1.96), and lower general cognitive ability (OR = 0.679, 95%CI 0.491–0.931).

Conclusions

Characteristics including cognitive function, occupational class, self-rated health, anxiety, and emotional stability, may be related to risk of poorer lockdown-related psychosocial and physical outcomes.

Public willingness to adhere to COVID-19 precautionary measures in Sudan: an application of the Health Belief Model

INTRODUCTION

coronavirus disease (COVID-19) is a highly infectious disease caused by the novel coronavirus (SARS-CoV-2). Several public health and social protective measures that may prevent or slow down the transmission of COVID-19 were introduced. However, these measures are unfortunately being neglected or deliberately ignored by some individuals.

METHODS

a cross sectional online based survey was conducted to identify possible factors influencing public willingness to adhere to precautionary measures and preventive guidelines against COVID-19 during the lockdown periods in Sudan. The questionnaire was used to collect socio-demographic data of study participants, their health beliefs and willingness regarding adherence to precautionary measures against COVID-19 based on the constructs of the Health Belief Model.

RESULTS

a total of 680 respondents completed and returned the online questionnaire. Significant predictors of the willingness to adhere to the precautionary measures against COVID-19 were gender (β= 3.34, P<0.001), self-efficacy (β= 0.476, P<0.001), perceived benefits (β= 0.349, P<0.001) and perceived severity (β= 0.113, P=0.005). These factors explained 43% of the variance in respondents' willingness to adhere to COVID-19 precautionary measures. Participants who were female, confident in their ability to adhere to the protective measures when available, believing in the benefits of the protective measures against COVID-19 and perceiving that the disease could have serious consequences were more likely to be willing to adhere to the protective measures.

CONCLUSION

female respondents and respondents having higher self-efficacy, higher perceived benefits and higher perceived severity were more likely to be willing to adhere to the protective measures against COVID-19 in Sudan.

Life-Changing Experiences of Mothers with School-Age Children during the COVID-19 Pandemic: Focusing on Their Health Risk Perceptions and Health-Related Behaviors

This study aimed to explore health risk perceptions, changes in health-related behaviors, and life experiences of mothers with school-age children during the early coronavirus disease (COVID-19) pandemic. Data were collected between 16 July and 10 September 2020, by individual interviews and analyzed through qualitative content analysis. After the twelve participants' experiences were analyzed, four themes and ten sub-themes were derived. The four themes were: "Struggling to identify the substance of COVID-19," "Taking the initiative to protect the health of the family," "Frustrated by the brutal reality of no end in sight," and "Trying to adjust wisely to an inevitable new lifestyle." The findings suggest that while the world remains in an ongoing battle with COVID-19, national health institutions should prepare a health education system for specific infection prevention methods that can be practiced by individuals in daily life.

Behavior Responses and Attitude of the Public to COVID-19 Pandemic During Movement Restrictions in Saudi Arabia

BACKGROUND

The behavior of the general public and the adoption of precautionary measures during a pandemic determine the fate of the country in the absence of any specific cure. This study aimed to determine the public attitude and behavior responses to the COVID-19 pandemic in Saudi Arabia during movement restrictions, and the predictors of behavioral responses.

METHODS

A community-based cross-sectional study of 2470 adult individuals in Saudi Arabia, 17-29 April 2020 was conducted via Survey Monkey, using an anonymous validated e-questionnaire. Data were collected on demographic characteristics, COVID-19-related attitudes, and behavioral responses in terms of; precautionary measures, preparedness, and self-quarantine activities, to be responded to by 4-point Likert scales. Multiple linear regression analyses were performed to identify the significant predictors of compliance with different behaviors. Significance was considered at p<0.05.

RESULTS

Participants reported positive attitudes towards governmental actions (95%), self-hygiene (93.2%), social distancing (97.1%) and choice of healthy food (89.6%), and negative attitudes towards the current worldwide situation of the pandemic (81.0%) and hearing someone tested positive (77.8%) or died from COVID-19 (83.7%). High rates of compliance to behavior were reported by only 55.8% of participants in terms of precautionary measures (71.3%), preparedness (38.4%), and self-quarantine activities (46.1%). After adjusting for all possible confounders, the total attitude score was a significant predictor of the total scores of precautionary measures (t=12.01, p<0.001), preparedness (t=9.29, p<0.001), self-quarantine activities (t=12.05, p<0.001), and overall behavior response (t=14.09, p<0.001). Other significant predictors of higher overall behavior response scores were female gender (t=7.22, p<0.001) and non-Saudi nationality (t=3.40, p<0.001).

CONCLUSION

This study provides baseline data on the behavioral response to the national COVID-19 pandemic in Saudi Arabia. The levels of compliance to behavior response and attitude to COVID-19 pandemic were less than satisfactory. Socio-demographics influence public behavior and protective health measures. COVID-19 awareness programs are recommended.

Knowledge, Attitude and Practice About Coronavirus Disease (COVID-19) Pandemic and Its Psychological Impact on Students and Their Studies: A Cross-Sectional Study Among Pharmacy Students in Saudi Arabia

Background

Individuals’ knowledge, attitude and practice towards preventive and precautionary measures of COVID-19 are essential to control the spread of the disease. Consequently, the aims of the study were to evaluate knowledge, attitude and practice of pharmacy students towards the pandemic and to assess its psychological impact on them to provide future guidance.

Methods

A cross-sectional, questionnaire-based study was conducted via a web-based survey in May 2020. All pharmacy students enrolled at Unaizah College of Pharmacy, Qassim University, were invited to take part in the study.

Results

A total of 232 out of 460 students took part in the study, giving a response rate of 50.43%. The mean total knowledge score was 9.87 ± 2.04 (maximum attainable score, 12). The majority of the participants (n=163; 70.3%) believed COVID-19 is a health threat to their community in the early months of the pandemic. Moreover, the majority (93%) also believed that the lockdown at the beginning of the pandemic was necessary to contain the pandemic. Encouragingly, 86.6% reported that they did not go to any crowded places during the pandemic with more female students avoiding crowded places compared to male students (91.6% versus 78.7%, respectively, P = 0.005). The majority (91%) also reported that they were following the strategies recommended by the authorities to prevent the spread of the virus. Encouragingly, 54.3% reported that the pandemic either had no effect or just a limited effect on their studies. However, 38.5% reported that they always felt or frequently felt nervous or anxious during the pandemic.

Conclusion

The study showed that pharmacy students had good knowledge as well as positive attitudes and good practices towards COVID-19 and the preventive measures. However, during the early months, the pandemic did have a negative psychological impact on a number of students. Consequently, proactive psychological and social support services to the students should be considered during the current and future pandemics. In addition, it is important to consider and proactively address key issues that could cause stress and anxiety among students when shifting to distance learning and assessments.

Multistakeholder Participation in Disaster Management-The Case of the COVID-19 Pandemic

The coronavirus disease 2019 (COVID-19) pandemic is affecting society's health, economy, environment and development. COVID-19 has claimed many lives across the globe and severely impacted the livelihood of a considerable section of the world's population. We are still in the process of finding optimal and effective solutions to control the pandemic and minimise its negative impacts. In the process of developing effective strategies to combat COVID-19, different countries have adapted diverse policies, strategies and activities and yet there are no universal or comprehensive solutions to the problem. In this context, this paper brings out a conceptual model of multistakeholder participation governance as an effective model to fight against COVID-19. Accordingly, the current study conducted a scientific review by examining multi-stakeholder disaster response strategies, particularly in relation to COVID-19. The study then presents a conceptual framework for multistakeholder participation governance as one of the effective models to fight against COVID-19. Subsequently, the article offers strategies for rebuilding the economy and healthcare system through multi-stakeholder participation, and gives policy directions/decisions based on evidence to save lives and protect livelihoods. The current study also provides evidence about multidimensional approaches and multi-diplomatic mechanisms during the COVID-19 crisis, in order to examine dimensions of multi-stakeholder participation in disaster management and to document innovative, collaborative strategic directions across the globe. The current research findings highlight the need for global collaboration by working together to put an end to this pandemic situation through the application of a Multi-Stakeholder Spatial Decision Support System (MS-SDSS).

Public Trust and Policy Compliance during the COVID-19 Pandemic: The Role of Professional Trust

Previous research has shown that public trust is vital for promoting policy compliance, particularly in times of crisis. However, the literature supporting this notion remains scarce, especially in countries which have successfully contained a pandemic despite showing a generally low level of public trust in the government. To address this topic, we conducted a cross-sectional study between February and March of 2020 to examine the relationship between public trust and the compliance of the general public in adopting personal protective measures introduced during the early phase of the coronavirus disease 2019 (COVID-19) outbreak in Thailand. We report our result from a hierarchical regression. We find a positive and significant relationship between public trust in the government and the likelihood of respondents adopting these precautions, more importantly, this relationship was fully mediated by the professional trust as the effect of public trust in the government on policy compliance was reduced by 0.118, namely from (β = 0.133, p < 0.001) to (β = 0.015, p > 0.05). Married respondents residing in the capital city, with a higher degree of worry were also more likely to comply with these safety measures. In conclusion, the finding sheds light on the dynamic relationship between public trust and policy compliance and offers some implications in times of a global health crisis.

Does High Public Trust Amplify Compliance with Stringent COVID-19 Government Health Guidelines? A Multi-country Analysis Using Data from 102,627 Individuals

PURPOSE

To examine how public trust mediates the people's adherence to levels of stringent government health policies and to establish if these effects vary across the political regimes.

METHODS

This study utilizes data from two large-scale surveys: the global behaviors and perceptions at the onset of COVID-19 pandemic and the Oxford COVID-19 Government Response Tracker (OxCGRT). Linear regression models were used to estimate the effects of public trust and strictness of restriction measures on people's compliance level. The model accounted for individual and daily variations in country-level stringency of preventative measures. Differences in the dynamics between public trust, the stringent level of government health guidelines and policy compliance were also examined among countries based on political regimes.

RESULTS

We find strong evidence of the increase in compliance due to the imposition of stricter government restrictions. The examination of heterogeneous effects suggests that high public trust in government and the perception of its truthfulness double the impact of policy restrictions on public compliance. Among political regimes, higher levels of public trust significantly increase the predicted compliance as stringency level rises in authoritarian and democratic countries.

CONCLUSION

This study highlights the importance of public trust in government and its institutions during public health emergencies such as the COVID-19 pandemic. Our results are relevant and help understand why governments need to address the risks of non-compliance among low trusting individuals to achieve the success of the containment policies.

Hand Hygiene Knowledge, Perception, and Practices among Domestic Visitors to the Prophet's Mosque in Al Madinah City Amid the COVID-19 Pandemic: A Cross-Sectional Study

This study aimed to assess hand hygiene knowledge, perception, and practices of visitors to the Prophet’s Mosque in Al Madinah City, Saudi Arabia. Using a self-administered electronic questionnaire, a cross-sectional survey was conducted among domestic residents, who visited the mosque between 31 July and 3 August 2020. Participants’ demographic data, hand hygiene knowledge, perception, and practices were collected. Four hundred participants aged 18–65 (median 36) years completed the survey, of which 215 (53.8%) were female. The visitors’ mean knowledge score about hand hygiene was 6.4 (± standard deviation (SD) 1.35) of total 12. Most participants (392, 98%) were aware of the role of hand hygiene in preventing Coronavirus Disease 2019 (COVID-19); nevertheless, 384 (96%) said hand hygiene lowers body immunity and 316 (79%) thought <60% alcohol is sufficient for hand disinfection. Males had a higher knowledge score than females (6.46 (±1.41) vs. 6.14 (±1.27), p = 0.02) and, visitors who had no formal education scored higher than those with post-graduate education (6.88 (±1.45) vs 5.73 (±1.12), p = 0.01). Washing hands with soap and water was the predominant method practiced after a meal (365, 91.7%), after toilet visit (354, 88.5%), after touching a surface (262, 65.7%), after waste disposal (332, 83.2%), and when hands were visibly dirty (357, 89.5%). Al Madinah visitors had moderate knowledge about hand hygiene, but demonstrated some knowledge gaps and negligence in practice that are crucial to curb the spread of COVID-19.

Community-based observational assessment of compliance by the public with COVID19 preventive measures in the south of Saudi Arabia

Background

At the end of August 2020, a surge in the number of cases in the Jazan region has been observed. The number of reported cases by 19th of August in the Jazan region was more than 300, which exceeded the number of reported cases in larger regions such as Riyadh, and Makkah. This study aims to measure compliance by the public with COVID-19 preventive measures.

Methods

This study was a cross-sectional, field-based observational assessment of compliance by individuals in public settings with COVID-19 preventive measures in the Jazan region of Saudi Arabia. The assessment was performed in the last week of July 2020. The assessment was based on observing the actual compliance of individuals and different establishments in the Jazan region with COVID-19 preventive measures. To perform the field observations, a standardised check-list was adopted from COVID-19 preventive measures in the community, which was developed by the Saudi Centre for Disease Prevention and Control (CDC).

Results

A total of 1096 individuals were observed in 69 different locations in the Jazan region. Compliance by the observed individuals was variable depending on the age group, the setting and the recommended preventive practice. The findings indicate very low compliance of specific precautionary measures within public parks in comparison to other measured settings. Proportions of individuals not compliant with mask-wearing instructions varied according to settings and age group from 5% in malls and shopping areas to nearly 83% in public parks. Additionally, Proportions of children not compliant with mask-wearing instructions was higher in comparison to adults in all observed settings.

Conclusions

The findings of this study identified variability in the levels of compliance with specific preventive measures against COVID-19. Further assessment is needed to explore factors associated with the limited observed compliance, in particular with regard to limited compliance to precautionary measures applied in specific settings and compliance of children to mask-wearing instructions.