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Shea L, Cooper D, Ventimiglia J, Frisbie S, Carlton C, Song W, Salzer M, Lee B, Hotez E, Vanness DJ. Self-Reported COVID-19 Vaccine and Booster Acceptance and Hesitancy Among Autistic Adults in Pennsylvania: Cross-Sectional Analysis of Survey Data. JMIR Public Health Surveill 2024; 10:e51054. [PMID: 39196609 PMCID: PMC11391151 DOI: 10.2196/51054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 01/30/2024] [Accepted: 06/21/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND The autistic population is rapidly increasing; meanwhile, autistic adults face disproportionate risks for adverse COVID-19 outcomes. Limited research indicates that autistic individuals have been accepting of initial vaccination, but research has yet to document this population's perceptions and acceptance of COVID-19 boosters. OBJECTIVE This study aims to identify person-level and community characteristics associated with COVID-19 vaccination and booster acceptance among autistic adults, along with self-reported reasons for their stated preferences. Understanding this information is crucial in supporting this vulnerable population given evolving booster guidelines and the ending of the public health emergency for the COVID-19 pandemic. METHODS Data are from a survey conducted in Pennsylvania from April 11 to September 12, 2022. Demographic characteristics, COVID-19 experiences, and COVID-19 vaccine decisions were compared across vaccination status groups. Chi-square analyses and 1-way ANOVA were conducted to test for significant differences. Vaccination reasons were ranked by frequency; co-occurrence was identified using phi coefficient correlation plots. RESULTS Most autistic adults (193/266, 72.6%) intended to receive or received the vaccine and booster, 15% (40/266) did not receive or intend to receive any vaccine, and 12.4% (33/266) received or intended to receive the initial dose but were hesitant to accept booster doses. Reasons for vaccine acceptance or hesitancy varied by demographic factors and COVID-19 experiences. The most significant were previously contracting COVID-19, desire to access information about COVID-19, and discomfort with others not wearing a mask (all P=.001). County-level factors, including population density (P=.02) and percentage of the county that voted for President Biden (P=.001) were also significantly associated with differing vaccination acceptance levels. Reasons for accepting the initial COVID-19 vaccine differed among those who were or were not hesitant to accept a booster. Those who accepted a booster were more likely to endorse protecting others and trusting the vaccine as the basis for their acceptance, whereas those who were hesitant about the booster indicated that their initial vaccine acceptance came from encouragement from someone they trusted. Among the minority of those hesitant to any vaccination, believing that the vaccine was unsafe and would make them feel unwell were the most often reported reasons. CONCLUSIONS Intention to receive or receiving the COVID-19 vaccination and booster was higher among autistic adults than the population that received vaccines in Pennsylvania. Autistic individuals who accepted vaccines prioritized protecting others, while autistic individuals who were vaccine hesitant had safety concerns about vaccines. These findings inform public health opportunities and strategies to further increase vaccination and booster rates among generally accepting autistic adults, to better support the already strained autism services and support system landscape. Vaccination uptake could be improved by leveraging passive information diffusion to combat vaccination misinformation among those not actively seeking COVID-19 information to better alleviate safety concerns.
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Affiliation(s)
- Lindsay Shea
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Dylan Cooper
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Jonas Ventimiglia
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Shelby Frisbie
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Conner Carlton
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Wei Song
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Mark Salzer
- College of Public Health, Temple University, Philadelphia, PA, United States
| | - Brian Lee
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, United States
| | - Emily Hotez
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States
| | - David J Vanness
- College of Health and Human Development, Pennsylvania State University, University Park, PA, United States
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Adams DR, Ratcliff CL, Pokharel M, Jensen JD, Liao Y. Communicating scientific uncertainty in the early stages of the COVID-19 pandemic: A message experiment. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2024; 44:1700-1715. [PMID: 37963681 PMCID: PMC11090995 DOI: 10.1111/risa.14256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Revised: 10/01/2023] [Accepted: 10/25/2023] [Indexed: 11/16/2023]
Abstract
The World Health Organization (WHO) officially declared COVID-19 a pandemic on March 11, 2020. It was a time of significant uncertainty as experts were not yet certain whether social distancing behaviors were necessary to slow the spread of the virus. Some public communicators opted to acknowledge uncertainty based on the limited evidence, whereas others downplayed uncertainty. This situation provided researchers with an opportunity to advance theory by explicating and testing cognitive responses to message uncertainty. Immediately following the WHO declaration (March 13-19, 2020), U.S. adults (N = 1186) were randomly assigned to one of six conditions in a 2 (message uncertainty: low, high) × 3 (argument support: expert, threat, precedent) between-participants experiment. Overall, perceived uncertainty negatively mediated the impact of message uncertainty on intentions. However, participant education was a key moderator. For those with more than a high school education, uncertain messages were related to higher intentions to social distance through increased critical reflection. For those with a high school education or less, uncertain messages were related to lower intentions through decreased message credibility.
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Affiliation(s)
| | | | | | | | - Yi Liao
- Department of Communication, University of Utah
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3
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Sinha J, Serin N. Online Health Information Seeking and Preventative Health Actions: Cross-Generational Online Survey Study. J Med Internet Res 2024; 26:e48977. [PMID: 38466985 DOI: 10.2196/48977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 07/31/2023] [Accepted: 02/08/2024] [Indexed: 03/13/2024] Open
Abstract
BACKGROUND The popularity of online health information seeking (OHIS) has increased significantly owing to its accessibility and affordability. To facilitate better health management, it is essential to comprehend the generational differences in OHIS behavior and preventative health actions after seeking online health information (OHI). OBJECTIVE This study investigates the variations in OHIS and engagement in preventative health actions between 2 generations based on their technology use (digital natives [aged 18-42 years] and digital immigrants [aged ≥43 years]). Additionally, this research explores the mediating role of OHIS types on the generational effect on preventative health actions and the moderating role of OHI search frequency, gender, and the presence of chronic diseases on the generational effect on OHIS types and preventative health actions. METHODS A preregistered online survey was conducted on the Prolific online data collection platform using stratified sampling of 2 generations (digital natives and digital immigrants) from the United States in November 2023. Overall, 3 types of OHIS were collected: health wellness information search, health guidance information search, and health management information search. A 1-way analysis of covariance tested the generational differences in types of OHIS and preventative health actions, and a 2-way analysis of covariance tested the moderating role of OHIS search frequency, gender, and the presence of chronic diseases using 7 control variables. The PROCESS Macro Model 4 was used to conduct mediation analyses, testing OHI search types as mediators. Linear regression analyses tested age as a predictor of OHIS and preventative health actions. RESULTS The analysis of 1137 responses revealed generational differences in OHIS. Digital natives searched for health wellness information more frequently (P<.001), whereas digital immigrants searched for health guidance (P<.001) and health management information (P=.001) more frequently. There were no significant differences between the 2 generations regarding preventative health actions (P=.85). Moreover, all 3 types of OHIS mediated the relationship between generational differences and preventative health actions. Furthermore, as people aged, they searched for significantly less health wellness information (P<.001) and more health guidance (P<.001), and health management information (P=.003). Age was not a significant predictor of preventative health actions (P=.48). The frequency of OHI searches did not moderate the effect of generations on OHIS types and preventative health actions. Gender only moderated the relationship between generation and health guidance information search (P=.02), and chronic diseases only moderated the relationship between generation and health wellness information search (P=.03). CONCLUSIONS To the best of our knowledge, this study is the first to explore how 2 digital generations vary in terms of searching for OHI and preventative health behaviors. As the older adult population grows, it is crucial to understand their OHIS behavior and how they engage in preventative health actions to enhance their quality of life.
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Affiliation(s)
- Jayati Sinha
- Department of Marketing & Logistics, College of Business, Florida International University, Miami, FL, United States
| | - Nuket Serin
- W. Fielding Rubel School of Business, Bellarmine University, Louisville, KY, United States
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Sileo KM, Hirani IM, Luttinen RL, Hayward M, Fleming PJ. A Scoping Review on Gender/Sex Differences in COVID-19 Vaccine Intentions and Uptake in the United States. Am J Health Promot 2024; 38:242-274. [PMID: 37847250 PMCID: PMC10802093 DOI: 10.1177/08901171231200778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Abstract
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.
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Affiliation(s)
- Katelyn M. Sileo
- The Department of Public Health, College of Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Inara M. Hirani
- The Department of Public Health, College of Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Rebecca L. Luttinen
- The Department of Demography, College of Health, Community, and Policy, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Matt Hayward
- The John Peace Library, The University of Texas at San Antonio, San Antonio, TX, USA
| | - Paul J. Fleming
- The Department of Health Behavior and Health Education, The School of Public Health at the University of Michigan, Ann Arbor, MI, USA
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Cahill ME, Lozoya SB, Griffin MA, Blackstock A, Stockdale K, Cowman S, Graff R, Spear C, Carter K. Observed face mask use outside retail chain stores during the COVID-19 pandemic in two cities in the state of Idaho, USA. J Community Health 2024; 49:26-33. [PMID: 37314630 PMCID: PMC10719412 DOI: 10.1007/s10900-023-01241-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 06/15/2023]
Abstract
During the COVID-19 pandemic, public health authorities have encouraged the use of face masks to minimize transmission within the community. To assess mask wear during a COVID-19 surge and guide public health response efforts, including public messaging on mask recommendations, we compared observed mask use in the largest city in each of Idaho's 2 most populous counties, both without a current mask mandate. We recorded mask usage by every third person exiting stores of 5 retail chains in Boise and Nampa during November 8-December 5, 2021. Observations were conducted during three time periods (morning, afternoon, and evening) on weekday and weekend days. A multivariable model with city, retail chain, and city-chain interaction was used to assess mask wear differences by city for each chain. Of 3021 observed persons, 22.0% wore masks. In Boise, 31.3% (430/1376) of observed persons wore masks; in Nampa, 14.3% (236/1645) wore masks. Among all persons wearing masks, > 94% wore masks correctly; cloth and surgical masks were most common. By retail chain, observed individuals at Boise locations were 2.3-5.7 times as likely to wear masks than persons at respective Nampa locations. This study provided a rapid, nonconfrontational assessment of public use of mitigation measures in 2 Idaho cities during a COVID-19 surge.
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Affiliation(s)
- Megan E Cahill
- Division of Public Health, Idaho Department of Health Welfare, Boise, ID, USA.
- Epidemic Intelligence Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Sujeith Barraza Lozoya
- Division of Public Health, Idaho Department of Health Welfare, Boise, ID, USA
- Public Health Associate Program, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Michelle A Griffin
- Division of Public Health, Idaho Department of Health Welfare, Boise, ID, USA
| | - Anna Blackstock
- Epidemiology Workforce Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Robert Graff
- Division of Public Health, Idaho Department of Health Welfare, Boise, ID, USA
| | | | - Kris Carter
- Division of Public Health, Idaho Department of Health Welfare, Boise, ID, USA
- Center for Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Jo H, Baek EM. The sound of safety: exploring the determinants of prevention intention in noisy industrial workplaces. BMC Public Health 2024; 24:90. [PMID: 38178066 PMCID: PMC10768458 DOI: 10.1186/s12889-023-17618-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/30/2023] [Indexed: 01/06/2024] Open
Abstract
Occupational noise exposure is a pervasive issue in many industries, leading to a range of health issues and sleep disturbances among workers. Additionally, there is a strong desire among these workers to prevent industrial accidents. This study, aimed at enhancing worker health and well-being, utilized a survey distributed by the Korean Confederation of Trade Unions to field workers. Data from 1285 workers were collected and analyzed using partial least squares structural equation modeling (PLS-SEM) to identify and understand the factors affecting prevention intention in noisy work environments. Our findings indicate that health problems resulting from occupational noise exposure significantly influence insomnia, perceived severity of potential accidents, perceived benefits of preventive measures, and perceived barriers. Perceived severity was significantly correlated with prevention intention, emphasizing the role of risk perception in motivating preventive behaviors. Perceived benefits were also significantly associated with prevention intention, highlighting the importance of positive outcomes in influencing workers' behaviors. Additionally, perceived barriers showed a significant relationship with prevention intention, suggesting that overcoming these barriers is crucial in promoting preventive behaviors. Demographic factors such as gender displayed a significant association with prevention intention, while age did not. This study provides valuable insights into the multifaceted factors influencing workers' intention to prevent industrial accidents in noisy environments, underlining the importance of comprehensive data collection tools in understanding these dynamics.
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Affiliation(s)
- Hyeon Jo
- Headquarters, HJ Institute of Technology and Management, 71 Jungdong-ro 39, 14721, Bucheon-si, Gyeonggi-do, Republic of Korea
| | - Eun-Mi Baek
- Department of Preventive Medicine, College of Medicine, Catholic University of Korea, 222 Banpo-daero, Seocho-gu, 06591, Seoul, Republic of Korea.
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7
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Alba C, An R. Using Mobile Phone Data to Assess Socio-Economic Disparities in Unhealthy Food Reliance during the COVID-19 Pandemic. HEALTH DATA SCIENCE 2023; 3:0101. [PMID: 38487207 PMCID: PMC10904071 DOI: 10.34133/hds.0101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 11/20/2023] [Indexed: 03/17/2024]
Abstract
Background: Although COVID-19 has disproportionately affected socio-economically vulnerable populations, research on its impact on socio-economic disparities in unhealthy food reliance remains scarce. Methods: This study uses mobile phone data to evaluate the impact of COVID-19 on socio-economic disparities in reliance on convenience stores and fast food. Reliance is defined in terms of the proportion of visits to convenience stores out of the total visits to both convenience and grocery stores, and the proportion of visits to fast food restaurants out of the total visits to both fast food and full-service restaurants. Visits to each type of food outlet at the county level were traced and aggregated using mobile phone data before being analyzed with socio-economic demographics and COVID-19 incidence data. Results: Our findings suggest that a new COVID-19 case per 1,000 population decreased a county's odds of relying on convenience stores by 3.41% and increased its odds of fast food reliance by 0.72%. As a county's COVID-19 incidence rate rises by an additional case per 1,000 population, the odds of relying on convenience stores increased by 0.01%, 0.02%, and 0.06% for each additional percentage of Hispanics, college-educated residents, and every additional year in median age, respectively. For fast food reliance, as a county's COVID-19 incidence rate increases by one case per 1,000 population, the odds decreased by 0.003% for every additional percentage of Hispanics but increased by 0.02% for every additional year in the county's median age. Conclusion: These results complement existing literature to promote equitable food environments.
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Affiliation(s)
- Charles Alba
- Division of Computational & Data Sciences,
Washington University in St Louis, St Louis, MO, USA
| | - Ruopeng An
- Division of Computational & Data Sciences,
Washington University in St Louis, St Louis, MO, USA
- Brown School,
Washington University in St Louis, St Louis, MO, USA
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8
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Holbein J, Crabtree C. Do sleep disruptions promote social fragmentation? Politics Life Sci 2023; 42:205-233. [PMID: 37987569 DOI: 10.1017/pls.2023.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Sleep changes predate shifts in mood/affect, thought processing, mental and physical health, civic engagement, and contextual circumstances, among other things. Theory predicts that these changes may lead to shifts in political and social beliefs. Do sleep disruptions shape how individuals see the world, the people around them, and themselves in relation to others? In this article, we use daily survey data from the 77 waves (N ≈ 460,000) of the University of California, Los Angeles's 2019-2021 Nationscape Survey-a nationally representative political survey-to examine the effect of an exogenous short-term sleep disruption on measures of political views, polarization, and discriminatory beliefs. Using this data set, we leverage the modest sleep disruption that occurs at the start (and end) of Daylight Saving Time (DST) and employ a regression discontinuity in time design around the precise DST cutoff (which we supplement with event study models). Despite strong theoretical expectations and correlational connection between measures of sleep and many outcomes related to social fragmentation, we find that the DST change has little to no causal effect on citizens' levels of polarization or their discriminatory attitudes. These effects are precise enough to rule out small effects, robust to a host of specification checks, and consistent across potential subgroups of interest. Our work adds to a small but growing body of research on the social and political effects of sleep disruptions.
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Affiliation(s)
- John Holbein
- University of Virginia, Charlottesville, VA, USA,
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9
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Kimbler KJ, Gromer C, Ayala M, Casey B. Correlates of COVID-19 Preventative Behaviors before and after Vaccination Availability. Behav Sci (Basel) 2023; 13:501. [PMID: 37366753 PMCID: PMC10295163 DOI: 10.3390/bs13060501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 06/09/2023] [Accepted: 06/09/2023] [Indexed: 06/28/2023] Open
Abstract
As the COVID-19 pandemic progressed, various preventative behaviors and eventually vaccinations became available to decrease the spread of the virus. The current study examined a variety of variables (i.e., age, COVID-19-related economic hardship, interpersonal concern, personality, fear of COVID-19, normative beliefs, political beliefs, and vaccine hesitancy) to better understand predictors of preventative behaviors and vaccination status at different points throughout the pandemic. Online questionnaires, administered through Qualtrics, were used to collect data using two convenience samples. One was a small sample (N = 44) of non-student participants before the vaccine was readily available. The other sample (N = 274) included college student participants and occurred after the vaccine had been available to all participants. Results suggest that several variables (i.e., fear of COVID-19, normative beliefs, interpersonal concern, and openness) were consistent predictors of public health behaviors at both points in time and across differently aged samples. Other variables (i.e., agreeableness, extraversion, conscientiousness, and economic hardship) were less consistent with their relationships with public health behaviors. Implications related to both research and public health are discussed.
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Ladis I, Gao C, Scullin MK. COVID-19-Related News Consumption Linked with Stress and Worry, but Not Sleep Quality, Early in the Pandemic. PSYCHOL HEALTH MED 2023; 28:980-994. [PMID: 36322027 DOI: 10.1080/13548506.2022.2141281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Beginning in early 2020, the novel coronavirus was the subject of frequent and sustained news coverage. Building on prior literature on the stress-inducing effects of consuming news during a large-scale crisis, we used network analysis to investigate the association between coronavirus disease 2019 (COVID-19) news consumption, COVID-19-related psychological stress, worries about oneself and one's loved ones getting COVID-19, and sleep quality. Data were collected in March 2020 from 586 adults (45.2% female; 72.9% White) recruited via Amazon Mechanical Turk in the U.S. Participants completed online surveys assessing attitudes and behaviors related to COVID-19 and a questionnaire assessing seven domains of sleep quality. Networks were constructed using partial regularized correlation matrices. As hypothesized, COVID-19 news consumption was positively associated with COVID-19-related psychological stress and concerns about one's loved ones getting COVID-19. However, there were very few associations between COVID-19 news consumption and sleep quality indices, and gender did not moderate any of the observed relationships. This study replicates and extends previous findings that COVID-19-news consumption is linked with psychological stress related to the pandemic, but even under such conditions, sleep quality can be spared due to the pandemic allowing for flexibility in morning work/school schedules.
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Affiliation(s)
- Ilana Ladis
- Department of Psychology, University of Virginia, Charlottesville, VA USA
| | - Chenlu Gao
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA USA.,Division of Sleep Medicine, Harvard Medical School, Boston, MA USA.,Broad Institute of MIT and Harvard, Cambridge, MA USA
| | - Michael K Scullin
- Department of Psychology and Neuroscience, Baylor University, Waco, TX USA
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Lin X, Kernell G, Groeling T, Joo J, Luo J, Steinert-Threlkeld ZC. Mask images on Twitter increase during COVID-19 mandates, especially in Republican counties. Sci Rep 2022; 12:21331. [PMID: 36494380 PMCID: PMC9734103 DOI: 10.1038/s41598-022-23368-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Accepted: 10/31/2022] [Indexed: 12/13/2022] Open
Abstract
Wearing masks reduces the spread of COVID-19, but compliance with mask mandates varies across individuals, time, and space. Accurate and continuous measures of mask wearing, as well as other health-related behaviors, are important for public health policies. This article presents a novel approach to estimate mask wearing using geotagged Twitter image data from March through September, 2020 in the United States. We validate our measure using public opinion survey data and extend the analysis to investigate county-level differences in mask wearing. We find a strong association between mask mandates and mask wearing-an average increase of 20%. Moreover, this association is greatest in Republican-leaning counties. The findings have important implications for understanding how governmental policies shape and monitor citizen responses to public health crises.
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Affiliation(s)
- Xiaofeng Lin
- Department of Statistics, University of California - Los Angeles, Los Angeles, CA, 90024, USA
| | - Georgia Kernell
- Department of Communication, University of California - Los Angeles, Los Angeles, CA, 90024, USA.
- Department of Political Science, University of California - Los Angeles, Los Angeles, CA, 90024, USA.
| | - Tim Groeling
- Department of Communication, University of California - Los Angeles, Los Angeles, CA, 90024, USA
| | - Jungseock Joo
- Department of Communication, University of California - Los Angeles, Los Angeles, CA, 90024, USA
| | - Jun Luo
- Department of Communication, University of California - Los Angeles, Los Angeles, CA, 90024, USA
| | - Zachary C Steinert-Threlkeld
- Department of Political Science, University of California - Los Angeles, Los Angeles, CA, 90024, USA
- Department of Public Policy, Luskin School of Public Affairs, University of California - Los Angeles, Los Angeles, CA, 90024, USA
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12
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Seifarth J, Pinaire M, Zicker J, Singh I, Bloch D. Circulating Illness and Changes in Thermometer Use Behavior: Series of Cross-sectional Analyses. JMIR Form Res 2022; 6:e37509. [PMID: 35998174 PMCID: PMC9506504 DOI: 10.2196/37509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/27/2022] [Accepted: 08/19/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Temperature-taking behaviors vary with levels of circulating infectious illness; however, little is known about how these behaviors differ by demographic characteristics. Populations with higher perceived risks of illness are more likely to adopt protective health behaviors. OBJECTIVE We investigated differences in temperature-taking frequency and the proportion of readings that were feverish among demographic groups (age, gender, urban/rural status) over influenza offseason; influenza season; and waves 1, 2, and 3 of the COVID-19 pandemic. METHODS Using data from smart thermometers collected from May 1, 2019, to February 28, 2021, across the United States, we calculated the frequency of temperature-taking and the proportion of temperature readings that were feverish. Mixed-effects negative binomial and mixed-effects logistic regression analyses were performed to identify demographic characteristics associated with temperature-taking frequency and the proportion of feverish readings, respectively. Separate models were fit over five study periods: influenza offseason (n=122,480), influenza season (n=174,191), wave 1 of COVID-19 (n=350,385), wave 2 (n=366,489), and wave 3 (n=391,578). RESULTS Both temperature-taking frequency and the proportion of feverish readings differed by study period (ANOVA P<.001) and were the highest during influenza season. During all periods, children aged 2-5 years and 6-11 years had significantly higher frequencies of temperature-taking than users aged 19-30 years, and children had the highest proportion of feverish readings of all age groups, after adjusting for covariates. During wave 1 of COVID-19, users over the age of 60 years had 1.79 times (95% CI 1.76-1.83) the rate of temperature-taking as users aged 19-30 years and 74% lower odds (95% CI 72%-75%) of a reading being feverish. Across all periods, men had significantly lower temperature-taking frequency and significantly higher odds of having a feverish reading compared to women. Users living in urban areas had significantly higher frequencies of temperature-taking than rural users during all periods, except wave 2 of COVID-19, and urban users had higher odds of a reading being feverish in all study periods except wave 1 of COVID-19. CONCLUSIONS Temperature-taking behavior and the proportion of readings that were feverish are associated with both population disease levels and individual demographic characteristics. Differences in the health behavior of temperature-taking may reflect changes in both perceived and actual illness risk. Specifically, older adults may have experienced an increase in perceived risk during the first three waves of COVID-19, leading to increased rates of temperature monitoring, even when their odds of fever were lower than those of younger adults. Men's perceived risk of circulating infectious illnesses such as influenza and COVID-19 may be lower than that of women, since men took their temperature less frequently and each temperature had a higher odds of being feverish across all study periods. Infectious disease surveillance should recognize and incorporate how behavior impacts illness monitoring and testing.
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Affiliation(s)
- Jack Seifarth
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
- Kinsa Inc, San Francisco, CA, United States
| | - Megan Pinaire
- Kinsa Inc, San Francisco, CA, United States
- Department of Biostatistics, Yale School of Public Health, New Haven, CT, United States
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Swisher R, Garcia-Alexander G, Cossman L, Schaefer D. Explaining racial/ethnic and socioeconomic differences in COVID protective behavior. SSM Popul Health 2022; 19:101147. [PMID: 35721250 PMCID: PMC9197562 DOI: 10.1016/j.ssmph.2022.101147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 06/10/2022] [Accepted: 06/10/2022] [Indexed: 12/02/2022] Open
Abstract
COVID-19 has had a disproportionate impact on Black, Hispanic, and lower socioeconomic status communities. Using data from the Community, Health and Politics Study (CHAPS 2021), collected in the midst of the pandemic, we examine differences in COVID-19 health promotion behavior (i.e., avoiding large gatherings, mask wearing, and vaccination status) across racial, ethnic, and socioeconomic status subgroups of the population. Moreover, we examine the degree to which observed differences are robust to controls for other health-related disparities, such as access to health insurance, underlying health conditions, personal exposure to COVID-19 (i.e., own diagnoses, knowing persons who have died from COVID-19), and perceived COVID-19 threat. Findings are consistent with arguments proposed by fundamental cause theory and disease stage theory as they indicate fewer differences on the basis of socioeconomic status or race and ethnicity for masking and social distancing, which may be thought of as less effective measures. In contrast, disparities were prominent in vaccination outcomes. Specifically, racial and ethnic minorities, those with lower levels of education, and those with lower incomes had lower odds of vaccination, after controlling for covariates. Private insurance and older age were also associated with higher odds of vaccination. Higher perceived threat of COVID-19 increased the likelihood of all protective behaviors. Our findings suggest that the need for ongoing efforts to increase vaccination uptake in socially disadvantaged communities.
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Affiliation(s)
- Raymond Swisher
- Department of Sociology, University of Texas at San Antonio, San Antonio, TX, USA
| | | | - Lynne Cossman
- College for Health, Community and Policy, University of Texas at San Antonio, San Antonio, TX, USA
| | - Drew Schaefer
- Department of Demography, MS Building 4.01.50, One UTSA Circle, San Antonio, TX, 78429, USA
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14
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Williams N, Haines T, Williams C, Bowles KA, Hill KD. Age Differences in Preferred Methods of Obtaining and Understanding Health Related Information During the COVID-19 Pandemic in Australia. Front Public Health 2022; 10:912188. [PMID: 35910912 PMCID: PMC9326317 DOI: 10.3389/fpubh.2022.912188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 06/10/2022] [Indexed: 11/13/2022] Open
Abstract
Methods of communications and the nature of messaging are critically important in influencing public behavior. The COVID-19 pandemic has resulted in major disruptions to all aspects of life globally and has triggered multiple approaches of health messaging to the general public to communicate COVID-19 preventative measures. This study aimed to identify: (1) differences between age groups in the main avenues used by people to obtain COVID-19 related information; and (2) whether age and information sources were associated with correct interpretation of government messaging relating to how people understand or interpret the terms “self-isolation” and “social distancing.” An online survey was conducted in 2020. Participants were aged over 18 years and grouped into age group decades. Differences in sources of COVID-19 information were compared visually between age groups. Logistic regression was used to determine whether age and each of the various methods of communication of COVID-19 information were independently associated with correct response to the self-isolation, or the social distancing statements. There were 3,300 survey respondents 85% female; age sub-groups: 18–29 (7.4%); 30–39 (10.6%); 40–49 (17.6%); 50–59 (22.9%); 60–69 (25.9%); 70–79 (13.9%); and 80+ (1.7%). People accessed public health messaging information from a wide variety of sources that changed as they aged (e.g., older people were more likely to be exposed to COVID-19 information via television news programs and less likely via social media platforms). Age was frequently associated with whether the message key terms were interpreted correctly or incorrectly, but in some cases, it promoted more correct responses whereas in others, fewer correct responses. There was no difference between being exposed to COVID-19 information via mainstream media, compared with social media, or compared with Government sources of information, in terms of whether COVID-19 messages were interpreted correctly. In order to improve future public health messaging, there is a need for multiple avenues of communication to meet the needs and preferences across and within age groups. Further investigation is warranted into the clarity of the content and method of delivery of public health messages, to ensure optimal understanding of public health messages by vulnerable populations and across the community.
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Affiliation(s)
- Nathan Williams
- School of Primary and Allied Health Care & National Centre for Healthy Ageing, Monash University, Frankston, VIC, Australia
- *Correspondence: Nathan Williams
| | - Terry Haines
- School of Primary and Allied Health Care & National Centre for Healthy Ageing, Monash University, Frankston, VIC, Australia
| | - Cylie Williams
- School of Primary and Allied Health Care & National Centre for Healthy Ageing, Monash University, Frankston, VIC, Australia
| | - Kelly-Ann Bowles
- School of Primary and Allied Health Care & National Centre for Healthy Ageing, Monash University, Frankston, VIC, Australia
- Department of Paramedicine, Monash University, Frankston, VIC, Australia
| | - Keith D. Hill
- Rehabilitation Ageing and Independent Living (RAIL) Research Centre, Monash University, Frankston, VIC, Australia
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15
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Takizawa R, Robinson S, Aelenei C, Iacoviello V, Kulich C. A five-nation study of the impact of political leaning and perception of crisis severity on the preference for female and minority leaders during the COVID-19 pandemic. CURRENT RESEARCH IN ECOLOGICAL AND SOCIAL PSYCHOLOGY 2022; 3:100055. [PMID: 35847992 PMCID: PMC9270965 DOI: 10.1016/j.cresp.2022.100055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 05/16/2022] [Accepted: 07/07/2022] [Indexed: 06/15/2023]
Abstract
Research on underrepresented groups in leadership has shown that women and ethnic minorities are preferred as leaders during a crisis. In the present study, we investigated factors that shape voter preferences for minority political leaders in the COVID-19 crisis. We examined participant perceptions of the severity of the COVID-19 crisis in health, social, and economic domains and self-reported political leaning, and their impact on preference for a female (vs male) or minority political leader. We collected survey data in autumn 2020 using online platforms in France, Japan, the United Kingdom, the United States, and a snowball sample in Germany (total N = 1,259). Results showed that female leaders were generally more preferred by politically left- than right-leaning participants independent of severity perceptions of the social or economic crisis. In addition, we found that preference for female leaders amongst right-leaning participants increased when their current regional leader's actions were judged insufficient to manage the health crisis, an effect primarily driven by participants in Germany and the United Kingdom. Left-leaning political orientation also predicted the preference for minority leaders across countries. Moreover, a more severe perception of the social aspects of the crisis increased minority preference, as expected, but mostly in Germany and the United States. We discuss cross-country variation of our results. Overall, our findings affirm and expand prior research showing the importance of political leaning and changing leadership demands in a crisis and their impact on the preference for minority leaders.
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Kearney M, Bornstein M, Fall M, Nianogo R, Glik D, Massey P. Cross-sectional study of COVID-19 knowledge, beliefs and prevention behaviours among adults in Senegal. BMJ Open 2022; 12:e057914. [PMID: 35618332 PMCID: PMC9136694 DOI: 10.1136/bmjopen-2021-057914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 04/27/2022] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES The aim of the study was to explore COVID-19 beliefs and prevention behaviours in a francophone West African nation, Senegal. DESIGN This was a cross-sectional analysis of survey data collected via a multimodal observational study. PARTICIPANTS Senegalese adults aged 18 years or older (n=1452). PRIMARY AND SECONDARY OUTCOME MEASURES Primary outcome measures were COVID-19 prevention behaviours. Secondary outcome measures included COVID-19 knowledge and beliefs. Univariate, bivariate and multivariate statistics were generated to describe the sample and explore potential correlations. SETTING Participants from Senegal were recruited online and telephonically between June and August 2020. RESULTS Mask wearing, hand washing and use of hand sanitiser were most frequently reported. Social distancing and staying at home were also reported although to a lower degree. Knowledge and perceived risk of COVID-19 were very high in general, but risk was a stronger and more influential predictor of COVID-19 prevention behaviours. Men, compared with women, had lower odds (adjusted OR (aOR)=0.59, 95% CI 0.46 to 0.75, p<0.001) of reporting prevention behaviours. Rural residents (vs urban; aOR=1.49, 95% CI 1.12 to 1.98, p=0.001) and participants with at least a high school education (vs less than high school education; aOR=1.33, 95% CI 1.01 to 1.76, p=0.006) were more likely to report COVID-19 prevention behaviours. CONCLUSIONS In Senegal, we observed high compliance with recommended COVID-19 prevention behaviours among our sample of respondents, in particular for masking and personal hygiene practice. We also identified a range of psychosocial and demographic predictors for COVID-19 prevention behaviours such as knowledge and perceived risk. Stakeholders and decision makers in Senegal and across Africa can use place-based evidence like ours to address COVID-19 risk factors and intervene effectively with policies and programming. Use of both phone and online surveys enhances representation and study generalisability and should be considered in future research with hard-to-reach populations.
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Affiliation(s)
- Matthew Kearney
- Department Family Medicine and Community Health, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Marta Bornstein
- Department of Epidemiology, Ohio State University College of Public Health, Columbus, Ohio, USA
| | - Marieme Fall
- The African Health and Education Network (NGO RAES), Dakar, Senegal
| | - Roch Nianogo
- Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Deborah Glik
- Department of Community Health Sciences, UCLA Fielding School of Public Health, Los Angeles, California, USA
| | - Philip Massey
- Department of Health, Human Performance and Recreation, University of Arkansas College of Education and Health Professions, Fayetteville, Arkansas, USA
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Powell L, Lavender TM, Reinhard CL, Watson B. Pet Owners' Perceptions of COVID-19, Zoonotic Disease, and Veterinary Medicine: The Impact of Demographic Characteristics. Vet Sci 2022; 9:195. [PMID: 35622723 PMCID: PMC9143664 DOI: 10.3390/vetsci9050195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/11/2022] [Accepted: 04/15/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to investigate the impact of sociodemographic characteristics on pet owners' concern about the transmission of zoonotic disease and SARS-CoV-2, and to describe owners' perceptions of veterinarians and physicians as resources for zoonoses information. Between September and October 2020, 1154 individuals completed an online survey via Qualtrics. Binary logistic regression models were used to examine the associations between owner demographics and perceptions of zoonoses and SARS-CoV-2. Most participants were minimally concerned about their pets contracting or transmitting zoonotic diseases or SARS-CoV-2, although perceptions of risk differed based on age, race, and education. Older participants were typically less concerned about the transmission of zoonotic diseases and SARS-CoV-2. Considering where participants obtained information about zoonoses, pet owners were more likely to contact their veterinarian for advice (43%) than their physician (17%). However, 17% of pet owners struggled to access veterinary care, and 51% said their access to veterinary care had become more difficult during the COVID-19 pandemic. Our findings highlight a need for further education about zoonoses and SARS-CoV-2, and suggest veterinarians may play a key role in these communications. The results also emphasize the need to address access to care issues in veterinary medicine.
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Affiliation(s)
- Lauren Powell
- School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA; (T.M.L.); (C.L.R.); (B.W.)
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18
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Myerson J, Strube MJ, Green L, Hale S. Individual differences in COVID-19 mitigation behaviors: The roles of age, gender, psychological state, and financial status. PLoS One 2021; 16:e0257658. [PMID: 34547057 PMCID: PMC8454939 DOI: 10.1371/journal.pone.0257658] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 09/07/2021] [Indexed: 12/02/2022] Open
Abstract
The present study examined individual characteristics potentially associated with changes in mitigation behaviors (social distancing and hygiene) recommended by the Centers for Disease Control and Prevention. Analysis of online survey responses from 361 adults, ages 20-78, with US IP addresses, identified significant correlates of adaptive behavioral changes, with implications for preventive strategies and mental health needs. The extent to which individuals changed their mitigation behaviors was unrelated to self-rated health or concern regarding the personal effects of COVID-19 but was related to concern regarding the effects of the pandemic on others. Thus, mitigation behaviors do not appear to be primarily motivated by self-protection. Importantly, adaptive changes in mitigation behaviors increased with age. However, these changes, particularly those related to the frequency of close proximity encounters, appear to be due to age-related decreases in anxiety and depression. Taken together, the present results argue against over-reliance on 'fear appeals' in public health messages as they may increase anxiety and depression. Instead, the present findings argue for more appeals to people's concern for others to motivate mitigation as well as indicating an immediate need to address individual mental health concerns for the sake of society as a whole.
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Affiliation(s)
- Joel Myerson
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States of America
| | - Michael J. Strube
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States of America
| | - Leonard Green
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States of America
| | - Sandra Hale
- Department of Psychological & Brain Sciences, Washington University in St. Louis, St. Louis, MO, United States of America
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19
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Jiang J, Ren X, Ferrara E. Social Media Polarization and Echo Chambers in the Context of COVID-19: Case Study. ACTA ACUST UNITED AC 2021; 2:e29570. [PMID: 34459833 PMCID: PMC8371575 DOI: 10.2196/29570] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/08/2021] [Accepted: 06/24/2021] [Indexed: 01/02/2023]
Abstract
Background Social media chatter in 2020 has been largely dominated by the COVID-19 pandemic. Existing research shows that COVID-19 discourse is highly politicized, with political preferences linked to beliefs and disbeliefs about the virus. As it happens with topics that become politicized, people may fall into echo chambers, which is the idea that one is only presented with information they already agree with, thereby reinforcing one’s confirmation bias. Understanding the relationship between information dissemination and political preference is crucial for effective public health communication. Objective We aimed to study the extent of polarization and examine the structure of echo chambers related to COVID-19 discourse on Twitter in the United States. Methods First, we presented Retweet-BERT, a scalable and highly accurate model for estimating user polarity by leveraging language features and network structures. Then, by analyzing the user polarity predicted by Retweet-BERT, we provided new insights into the characterization of partisan users. Results We observed that right-leaning users were noticeably more vocal and active in the production and consumption of COVID-19 information. We also found that most of the highly influential users were partisan, which may contribute to further polarization. Importantly, while echo chambers exist in both the right- and left-leaning communities, the right-leaning community was by far more densely connected within their echo chamber and isolated from the rest. Conclusions We provided empirical evidence that political echo chambers are prevalent, especially in the right-leaning community, which can exacerbate the exposure to information in line with pre-existing users’ views. Our findings have broader implications in developing effective public health campaigns and promoting the circulation of factual information online.
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Affiliation(s)
- Julie Jiang
- Information Sciences Institute University of Southern California Marina Del Rey, CA United States.,Department of Computer Science Viterbi School of Engineering University of Southern California Los Angeles, CA United States
| | - Xiang Ren
- Department of Computer Science Viterbi School of Engineering University of Southern California Los Angeles, CA United States
| | - Emilio Ferrara
- Information Sciences Institute University of Southern California Marina Del Rey, CA United States.,Department of Computer Science Viterbi School of Engineering University of Southern California Los Angeles, CA United States.,Annenberg School of Communication University of Southern California Los Angeles, CA United States
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20
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Bohnhoff J, Davis A, Bruine de Bruin W, Krishnamurti T. COVID-19 Information Sources and Health Behaviors During Pregnancy: Results From a Prenatal App-Embedded Survey. JMIR INFODEMIOLOGY 2021; 1:e31774. [PMID: 34926994 PMCID: PMC8664132 DOI: 10.2196/31774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 10/27/2021] [Accepted: 11/08/2021] [Indexed: 01/11/2023]
Abstract
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.
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Affiliation(s)
- James Bohnhoff
- Division of General Pediatrics University of Pittsburgh School of Medicine Pittsburgh, PA United States
| | - Alexander Davis
- Department of Engineering and Public Policy Carnegie Mellon University Pittsburgh, PA United States
| | - Wändi Bruine de Bruin
- Sol Price School of Public Policy University of Southern California Los Angeles, CA United States.,Schaeffer Center for Health Policy and Economics University of Southern California Los Angeles, CA United States
| | - Tamar Krishnamurti
- Division of General Internal Medicine University of Pittsburgh School of Medicine Pittsburgh, PA United States
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