Preferred Information Source Correlates to COVID-19 Risk Misperception.

Inaccurate perceptions of COVID-19 (coronavirus disease 2019) risk may decrease compliance with public health mitigation practices, in turn increasing disease burden. The extent to which public perceptions of COVID-19 risk are inaccurate is not well studied. This study investigates the relationship between preferred information sources and inaccurate COVID-19 risk perception. A cross-sectional online survey of adults in the United States using online snowball techniques was administered between April 9, 2020 and July 12, 2020. Raking techniques were used to generate a representative U.S. sample from 10,650 respondents. Respondents who did not provide an answer to key questions were excluded. The remaining sample included 1,785 health care workers (HCW) and 4,843 non-HCW. Subjective risk was measured as the product of perceived likelihood of COVID-19 infection and perceived harm from infection. Objective risk was measured as a function of the presence of known COVID-19 risk factors. Discrepancies between subjective and objective risk were compared between respondents with different preferred information sources. Chi Square contingency tables and pair-wise correlation were used to evaluate differences to 95% confidence. For HCW and non-HCW, the greatest overestimation of personal COVID-19 risk assessment (p < .05 for all differences) were found in those whose preferred source of information was social media (HCW: 62.1%; non-HCW: 64.5%), followed by internet news sources (HCW: 59.6%, non-HCW%: 59.1%), government websites (HCW: 54%, non-HCW = 51.8%), other sources (HCW: 50.7%, non-HCW = 51.4%), and television news (HCW: 46.1%, non-HCW: 47.6%). Preferred information sources correlate with inaccuracies in personal COVID-19 risk assessment. Public health information campaigns should consider targeting groups whose preferred information sources correlate to higher inaccuracies in COVID-19 risk perceptions. [HLRP: Health Literacy Research and Practice. 2023;7(2):e105-e110.].

Race, employment, and the pandemic: An exploration of covariate explanations of COVID-19 case fatality rate variance.

We derive a simple asymptotic approximation for the long-run case fatality rate of COVID-19 (alpha and delta variants) and show that these estimations are highly correlated to the interaction between US State median age and projected US unemployment rate (Adj. r2 = 60%). We contrast this to the high level of correlation between point (instantaneous) estimates of per state case fatality rates and the interaction of median age, population density and current unemployment rates (Adj. r2 = 50.2%). To determine whether this is caused by a "race effect," we then analyze unemployment, race, median age and population density across US states and show that adding the interaction of African American population and unemployment explains 53.5% of the variance in COVID case fatality rates for the alpha and delta variants when considering instantaneous case fatality rate. Interestingly, when the asymptotic case fatality rate is used, the dependence on the African American population disappears, which is consistent with the fact that in the long-run COVID does not discriminate on race, but may discriminate on access to medical care which is highly correlated to employment in the US. The results provide further evidence of the impact inequality can have on case fatality rates in COVID-19 and the impact complex social, health and economic factors can have on patient survival.

Perceived risk, political polarization, and the willingness to follow COVID-19 mitigation guidelines.

OBJECTIVE: Risk assessment and response is important for understanding human behavior. The divisive context surrounding the coronavirus pandemic inspires our exploration of risk perceptions and the polarization of mitigation practices (i.e., the degree to which the behaviors of people on the political "Left" diverge from those on the "Right"). Specifically, we investigate the extent to which the political polarization of willingness to comply with mitigation behaviors changes with risk perceptions. METHOD: Analyses use data from two sources: an original dataset of Twitter posts and a nationally-representative survey. In the Twitter data, negative binomial regression models are used to predict mitigation intent measured using tweet counts. In the survey data, logit models predict self-reported mitigation behavior (vaccination, masking, and social distancing). RESULTS: Findings converged across both datasets, supporting the idea that the links between political orientation and willingness to follow mitigation guidelines depend on perceived risk. People on the Left are more inclined than their Right-oriented colleagues to follow guidelines, but this polarization tends to decrease as the perceived risk of COVID-19 intensifies. Additionally, we find evidence that exposure to COVID-19 infections sends ambiguous signals about the risk of the virus while COVID-19 related deaths have a more consistent impact on mitigation behaviors. CONCLUSIONS: Pandemic-related risks can create opportunities for perceived "common ground," between the political "Right" and "Left." Risk perceptions and politics interact in their links to intended COVID-19 mitigation behavior (as measured both on Twitter and in a national survey). Our results invite a more complex interpretation of political polarization than those stemming from simplistic analyses of partisanship and ideology.

Parental COVID-19 Vaccine Hesitancy in Diverse Communities: A National Survey.

OBJECTIVE: We surveyed a diverse group of US participants to understand parental coronavirus disease 2019 (COVID-19) vaccine hesitancy. METHODS: We administered a telephone and online survey from May 7 to June 7, 2021 using stratified sampling to ensure robust sample sizes of racial and ethnic minorities. Of the 20,280 contacted, 12,288 respondents completed the survey (response rate 61%). We used chi-square tests and adjusted risk ratios to compare results by racial/ethnic group. RESULTS: Overall, 23% of parents stated that they plan to (or have) vaccinated their children; 30% said that they would not vaccinate their children, and 25% were unsure. Latino/a, Native American, and Asian American-Pacific Islander (AAPI) parents were generally more likely to vaccinate their children than Black or White parents. After adjusting for demographic factors, AAPI parents were significantly more likely to vaccinate their children than were others. Of parents who said that they would not vaccinate their child, 55% stated it was due to insufficient research. However, over half of parents stated that they would follow their child's health care provider's recommendations. After adjusting for demographic factors, trust in their primary care doctor was significantly lower among AAPI, Black, and Native American parents than White parents. CONCLUSIONS: Parental vaccine hesitancy was similar overall, but drivers of hesitancy varied by racial/ethnic groups. While the perception that vaccines had been "insufficiently researched" was a major concern among all groups, we found that parents are generally inclined to follow health providers' recommendations. Health professionals can play an important role in COVID-19 vaccine education and should provide access to vaccines.

The Self-Appraisal of Masking Instrument

We explore mask-wearing behavior during the coronavirus pandemic using the Self-Appraisal of Masking Instrument (SAMI). We situate this survey-based instrument within a theory in which the decision to mask reflects social identity, an associated identity standard, and appraisals that generate feelings about oneself. Analyses of SAMI’s empirical properties reveal that masking-specific emotional reactions are distinct from emotional reports related to current events and politics (discriminant validity). We also uncover evidence of predictive validity: expressed feelings about masking predict future voting more than 6 months later. We recommend SAMI to researchers interested in studying mask resistance in an increasingly polarized political climate, and the intuition behind SAMI could prove useful in other research contexts in which health decisions reflect a conscious comparison to standards held by those who share an identity or will otherwise pass judgment. Supplementary Information The online version contains supplementary material available at 10.1186/s42409-022-00032-3.

Underserved population acceptance of combination influenza-COVID-19 booster vaccines.

Recent data indicates increasing hesitancy towards both COVID-19 and influenza vaccination. We studied attitudes towards COVID-19 booster, influenza, and combination influenza-COVID-19 booster vaccines in a nationally representative sample of US adults between May and June 2021 (n = 12,887). We used pre-qualification quotes to ensure adequate sample sizes for minority populations. Overall vaccine acceptance was 45% for a COVID-19 booster alone, 58% for an influenza vaccine alone, and 50% for a combination vaccine. Logistic regression showed lower acceptance among female, Black/African American, Native American/American Indian, and rural respondents. Higher acceptance was found among those with college and post-graduate degrees. Despite these differences, our results suggest that a combination vaccine may provide a convenient method of dual vaccination that may increase COVID-19 vaccination coverage.

African American Adherence to COVID-19 Public Health Recommendations.

By mid-May 2020, most of the United States had been under shelter-in-place orders for several weeks to decrease the spread of coronavirus 2019 (COVID-19). As states begin to lift these orders to reopen the economy, the risk of a resurgence of COVID-19 may be related to the public's voluntary adherence to public health recommendations. We conducted a nationally representative survey of 604 African Americans to generate a risk assessment based on African Americans' compliance with public health recommendations to frequently wash hands, maintain social distancing, avoid touching face, and wear a mask in public. This is, to our knowledge, the most comprehensive study of African Americans and public health adherence specific to COVID-19. The percent of respondents reporting that they always comply with these recommendations was 72%, 67%, 55%, and 65%, respectively. Based on this threshold, African Americans' level of adherence with COVID-19 public health recommendations suggests they may be at high risk of a resurgence of COVID-19 during reopening, and there is an urgent need for targeted, culturally responsive public health messaging that is accessible to communities of color to help address racial disparities in COVID-19 risk. [HLRP: Health Literacy Research and Practice. 2020;4(3):e166-e170.].