The effect of cognition and affect on preventive behaviors during the COVID-19 pandemic: a cross-sectional study in China

Cognition, affect, and behavioural changes among university students after 10 new guidelines were issued in China: An exploratory study

Objectives

Since late 2019, the coronavirus disease 2019 (COVID-19) epidemic has become a common public health concern globally. China has entered a new phase of prevention and control with the implementation of the 10 new guidelines epidemic prevention policy in early December 2022. The resurgence of the outbreak may cause negative consequences on the behaviour of university students. This study aimed to assess the relationship between cognition, affect, and behavioural changes among university students and the related influencing factors after 10 new guidelines were issued, as well as the difficulties or concerns encountered in the current epidemic prevention process. It also provides a reference for the government to formulate targeted epidemic prevention strategies.

Methods

This study is a cross-sectional investigation. Self-designed questionnaires were distributed to students of a university in Hangzhou between December 25, 2022, and March 13, 2023, using convenience and snowball sampling methods for online surveys. Data analysis involved descriptive analysis, non-parametric tests, correlation, multiple linear regression, and content analyses.

Results

University students had a moderate to high level of cognition about COVID-19 and a medium level of affect. However, the level of behavioural changes was low and the average score was 2.33 (2.00, 3.00). Multiple linear regression analysis revealed that female sex, higher grade, medical specialty, affective factor, and cognitive factor were influencing factors of behavioural changes, which accounted for 35.7% of the variance in behavioural change. Difficulties or concerns included apprehension (84.8%), lack of information (39.3%), and uncertainty about the future (55.1%).

Conclusions

The prevention behaviour of university students has slackened. Evidence-based tailored policy development is indicated. This study suggested that schools and the government can improve the effectiveness of epidemic prevention among university students by adjusting the strategy of epidemic prevention policy formulation, broadening the channels of epidemic prevention information dissemination, and improving the mechanism of "government-community-school-family" collaborative governance.

Protective behaviors against COVID-19 and their association with psychological factors in China and South Korea during the Omicron wave: a comparative study

OBJECTIVES

We aimed to explore the level of protective behaviors against COVID-19 and its association with psychological factors in China and South Korea during the Omicron wave.

STUDY DESIGN

Cross-sectional study.

METHODS

We conducted a population-based cross-sectional survey from March 15 to 30, 2023 in China and South Korea. Demographic characteristics, health status, protective behaviors, and psychological factors (including perceived risks, efficacy belief, attribution of disease, fear of COVID-19, trust and evaluation, fatalism, resilience, and pandemic fatigue) were investigated. After adjusting for sociodemographic and health-related factors, multivariable regression models were constructed to explore the psychological influencing factors of protective behavior.

RESULTS

A total of 3000 participants from China and 1000 participants from Korea were included in the final analysis. The mean performance score for protective behaviors among all respondents was 2.885 in China and 3.139 in Korea, with scores ranging from 1 to 4. In China, performance scores were higher in those who were female, aged 30-39, employed, married, living in urban areas, having the highest income level, having the best subjective health status, and having a history of chronic disease (P-value <0.05). In Korea, performance scores were higher for individuals who were female, over 50 years old, educated to high school or below, unemployed, married, had a history of chronic disease, and had never been infected with SARS-CoV-2 (P-value <0.05). In the multivariable regression model, perceived severity (β = 0.067), attribution of disease (β = 0.121), fear of COVID-19 (β = 0.128), trust and evaluation (β = 0.097), psychological resilience (β = 0.068), and efficacy belief (β = 0.216) were positively associated with the performance scores, pandemic fatigue (β = -0.089) was negatively associated with performance scores in China (P-value <0.05). However, in Korea, perceived susceptibility (β = 0.075), fear of COVID-19 (β = 0.107), and efficacy belief (β = 0.357) were positively associated with protective behaviors (P-value <0.05), trust and evaluation (β = -0.078) and pandemic fatigue (β = -0.063) were negatively associated with performance scores (P-value <0.05).

CONCLUSIONS

Populations in both China and Korea demonstrated great compliance with protective behaviors during the Omicron wave. Because of the sociocultural, economic, and political differences, there were differences in the association between psychological factors and protective behaviors in the two countries. This study, from the perspective of psychological factors in different cultural contexts, would provide references for increasing adherence to protective guidelines in future outbreaks of emerging infectious diseases.

Social participation and risk of developing dementia

The increasing number of people with dementia globally illustrates the urgent need to reduce dementia's scale and impact. Lifetime social participation may affect dementia risk by increasing cognitive reserve, and through brain maintenance by reducing stress and improving cerebrovascular health. It may therefore have important implications for individual behavior and public health policy aimed at reducing dementia burden. Observational study evidence indicates that greater social participation in midlife and late life is associated with 30-50% lower subsequent dementia risk, although some of this may not be causal. Social participation interventions have led to improved cognition but, partly due to short follow-up and small numbers of participants, no reduction in risk of dementia. We summarize the evidence linking social participation with dementia, discuss potential mechanisms by which social participation is likely to reduce and mitigate the impact of neuropathology in the brain, and consider the implications for future clinical and policy dementia prevention interventions.

Mediating Effects of Attitudes, Risk Perceptions, and Negative Emotions on Coping Behaviors

Based on the perspectives of social risk amplification and the knowledge-attitudes-practice model, this study aimed to test how the level of knowledge about COVID-19 and information sources can predict people's behavioral changes and to examine the effect mechanisms through the mediating roles of attitude, risk perception, and negative emotions in a survey of 498 older Chinese adults. The results showed that (1) older people had a lower level of factual knowledge regarding the variant strains and vaccines; (2) in the information sources-behavior, information sources had a critical influence on elderly individuals' coping behaviors; and (3) in the knowledge-behavior, factual knowledge had a significant effect on elderly individuals' coping behaviors. Specifically, for prevention behaviors, both risk perception and negative emotions played full mediating roles. The findings have significant implications for the development of an effective COVID-19 prevention program to older adults coping with pandemic conditions.

The Asymmetric Influence of Emotion in the Sharing of COVID-19 Science on Social Media: Observational Study

BACKGROUND

Unlike past pandemics, COVID-19 is different to the extent that there is an unprecedented surge in both peer-reviewed and preprint research publications, and important scientific conversations about it are rampant on online social networks, even among laypeople. Clearly, this new phenomenon of scientific discourse is not well understood in that we do not know the diffusion patterns of peer-reviewed publications vis-à-vis preprints and what makes them viral.

OBJECTIVE

This paper aimed to examine how the emotionality of messages about preprint and peer-reviewed publications shapes their diffusion through online social networks in order to inform health science communicators' and policy makers' decisions on how to promote reliable sharing of crucial pandemic science on social media.

METHODS

We collected a large sample of Twitter discussions of early (January to May 2020) COVID-19 medical research outputs, which were tracked by Altmetric, in both preprint servers and peer-reviewed journals, and conducted statistical analyses to examine emotional valence, specific emotions, and the role of scientists as content creators in influencing the retweet rate.

RESULTS

Our large-scale analyses (n=243,567) revealed that scientific publication tweets with positive emotions were transmitted faster than those with negative emotions, especially for messages about preprints. Our results also showed that scientists' participation in social media as content creators could accentuate the positive emotion effects on the sharing of peer-reviewed publications.

CONCLUSIONS

Clear communication of critical science is crucial in the nascent stage of a pandemic. By revealing the emotional dynamics in the social media sharing of COVID-19 scientific outputs, our study offers scientists and policy makers an avenue to shape the discussion and diffusion of emerging scientific publications through manipulation of the emotionality of tweets. Scientists could use emotional language to promote the diffusion of more reliable peer-reviewed articles, while avoiding using too much positive emotional language in social media messages about preprints if they think that it is too early to widely communicate the preprint (not peer reviewed) data to the public.

Risk Perception among Psychiatric Patients during the COVID-19 Pandemic

The fear of the new coronavirus infection has driven many non-COVID-19 patients away from essential healthcare. Our study aimed to investigate the perception of risk and feelings of danger for the contagion in a sample of Italian psychiatric patients. We conducted a cross-sectional observational study during the second wave of the COVID-19 pandemic and the lockdown in Italy. The risk perception and risk-related variables were assessed in a sample of 150 consecutive patients with a previous diagnosis of major depression (50), bipolar I disorder (50), and schizophrenia seeking ambulatory care using a questionnaire previously administered to the general Italian population. Our results showed that patients were more concerned about economic, psychological, and interpersonal consequences of COVID-19 pandemic, rather than about their own health. At the multiple regression analysis, the likelihood of COVID-19 resolution was positively influenced by the diagnosis of schizophrenia, the increased perceived effectiveness, and the presence of positive emotions. Indeed, positive emotions and uncertainty positively influenced interpersonal risk. Our study highlights the need to provide more support to psychiatric patients during emergency events to prevent them from engaging in risky behaviors.

The Impact of the Implementation of Preventive Measures Due to COVID-19 on Work Design and Early Childhood Professionals' Well-Being-A Qualitative Study

The reopening of child-care programs during COVID-19 demanded comprehensive preventive measures. Research to date has overlooked this reopening process as well as early childhood professionals’ (ECPs) implementation efforts and resulting changes in their work practices and well-being. As a result, this study sought insights into (1) the practical implementation of measures, (2) perceptions and evaluations of measures, (3) changes in work characteristics, and (4) its impact on well-being. Qualitative interviews were conducted with German child-care managers (N = 27) between June and August 2020. The semi-structured interviews were audio-recorded, transcribed, and content-analyzed using MAXQDA. ECPs, through a combination of high effort and engagement, ensured the feasibility of most preventive measures. This included practices which were perceived to be unreasonable or ones which were stricter than practices required for the public. This exacerbated the critical work characteristics (e.g., high workload, overtime, and multitasking) from pre-pandemic scenarios and led to new work demands (e.g., changes in work content and social interactions). ECPs maintained intensive work demands and consequently suffered from broad strain outcomes (e.g., worry, exhaustion, anger, fear of infection, and reduced psychological sense of community). This study highlights the adverse psychosocial work environment of ECPs despite the necessity of ensuring health and safety at work.

Social cognitive factors outweigh negative emotionality in predicting COVID-19 related safety behaviors

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Health-related behaviors can either be driven by emotions or socio-structural factors.

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These variables were assessed in the context of the COVID-19 pandemic (N = 4134)

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The pandemic negatively influences emotional responses in young adults.

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Compliance with safety measures was largely unrelated to negative emotionality.

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Political strategies should focus on socio-structural instead of emotional aspects.

Emotion-motivation models propose that behaviors, including health behaviors, should be predicted by the same variables that also predict negative affect since emotional reactions should induce a motivation to avoid threatening situations. In contrast, social cognitive models propose that safety behaviors are predicted by a different set of variables that mainly reflect cognitive and socio-structural aspects. Here, we directly tested these opposing hypotheses in young adults (N = 4134) in the context of COVID-19-related safety behaviors to prevent infections. In each participant, we collected measures of negative affect as well as cognitive and socio-structural variables during the lockdown in the first infection wave in Germany. We found a negative effect of the pandemic on emotional responses. However, this was not the main predictor for young adults’ willingness to comply with COVID-19-related safety measures. Instead, individual differences in compliance were mainly predicted by cognitive and socio-structural variables. These results were confirmed in an independent data set. This study shows that individuals scoring high on negative affect during the pandemic are not necessarily more likely to comply with safety regulations. Instead, political measures should focus on cognitive interventions and the societal relevance of the health issue. These findings provide important insights into the basis of health-related concerns and feelings as well as behavioral adaptations.