Temporal reliability and stability of delay discounting: A 2-year repeated assessments study of the Monetary Choice Questionnaire.

The Monetary Choice Questionnaire (MCQ) is one of the most commonly used measures to assess delay discounting of reward. Reliable measurement by the MCQ is necessary for use in experimental settings or prognostic validity within clinical contexts. The present analysis expands prior work to evaluate temporal reliability and stability over an extended period, including repeated measurements, a larger and more broadly representative sample, and demonstrations of covariation with clinically significant health behaviors (e.g., cigarette use, COVID-19 vaccination, body mass index). Participants (N = 680; 55.6% female) were recruited through crowdsourcing and completed the MCQ approximately quarterly over 2 years. Measures of reliability, stability, and correlations with clinical constructs were determined for each timepoint and pairwise comparison. Test-retest reliabilities were high across all pairwise comparisons (all rxx > .75; range = .78-.86; mean = .83). Stability was also high with within-subject effect size differences all within a less-than-small effect size range (range dz = -0.09 to 0.19; mean = 0.04). Positive associations between smoking status and delay discounting rates were observed consistent with prior clinical studies. These findings of test durability support the use of MCQ administration for repeated measurement of delay-constrained choice as a stable respondent characteristic and illustrate its association with important health behaviors over extended time periods. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Trusted information sources in the early months of the COVID-19 pandemic predict vaccination uptake over one year later.

INTRODUCTION: COVID-19 vaccine uptake has been a major barrier to stopping the pandemic in many countries with vaccine access. This longitudinal study examined the capability to predict vaccine uptake from data collected early in the pandemic before vaccines were available. METHODS: 493 US respondents completed online surveys both at baseline (March 2020) and wave 6 (June 2021), while 390 respondents completed baseline and wave 7 (November 2021) surveys. The baseline survey assessed trust in sources of COVID-19 information, social norms, perceived risk of COVID-19, skepticism about the pandemic, prevention behaviors, and conspiracy beliefs. Multivariable logistic models examined factors associated with the receipt of at least one COVID-19 vaccine dose at the two follow-ups. RESULTS: In the adjusted model of vaccination uptake at wave 6, older age (aOR = 1.02, 95 %CI = 1.00-1.04) and greater income (aOR = 1.69, 95 %CI = 1.04-2.73) was associated with positive vaccination status. High trust in state health departments and mainstream news outlets at baseline were positively associated with vaccination at wave 6, while high trust in the Whitehouse (aOR = 0.42, 95 %CI = 0.24-0.74) and belief that China purposely spread the virus (aOR = 0.66, 95 %CI = 0.46-0.96) at baseline reduced the odds of vaccination. In the adjusted model of vaccination uptake at wave 7, increased age was associated with positive vaccination status, and Black race (compared to white) was associated with negative vaccination status. High trust in the CDC and mainstream news outlets at baseline were both associated with being vaccinated at wave 7, while high trust in the Whitehouse (aOR = 0.24, 95 %CI = 0.11-0.51) and belief that the virus was spread purposefully by China (aOR = 0.60, 95 %CI = 0.39-0.93) were negatively associated with vaccination. CONCLUSIONS: These findings indicated that vaccine uptake could be predicted over a year earlier. Trust in specific sources of COVID-19 information were strong predictors, suggesting that future pandemic preparedness plans should include forums for news media, public health officials, and diverse political leaders to meet and develop coherent plans to communicate to the public early in a pandemic so that antivaccine attitudes do not flourish and become reinforced.

Behavioral and psychosocial factors associated with COVID-19 skepticism in the United States.

COVID-19 skepticism can be conceptualized as the denial of the seriousness of the illness and the perception that the pandemic is overblown or a hoax. In the current study, we examined the association between COVID-19 skepticism and frequency of engaging in COVID-19 prevention behaviors, political ideology, social norms about distancing, COVID-19 information-seeking behaviors, and COVID-19 conspiracy theories. A survey was administered from May 5th-14th. At that time, there were over 1 million COVID-19 cases in the US. Participants were recruited online through MTurk. The three outcome variables were handwashing, mask wearing, and social distancing. Injunctive and descriptive norms were assessed as well as measures of perceived risk to self and others. There were 683 participants in the analyses. In the multiple logistic regression model, those who were of younger age (aOR = 0.97, p < 0.05), better health (aOR = 0.56, p < 0.01), and more politically conservative (aOR = 1.32, p < 0.01) were more likely to endorse COVID-19 skepticism statements. People who reported higher Skepticism were also less likely to that believe people close to them would die from COVID-19 (aOR = 4.2, p < 0.01), engage in COVID-19 prevention behaviors, including spending time inside to prevent coronavirus (aOR = 0.33, p < 0.01) and frequently wear a mask outside (aOR = 0.44, p < 0.01). Those who were more skeptical about COVID-19 were also more likely to believe the conspiracy theory that China purposefully spread the virus (aOR = 6.38 p < 0.01). COVID-19 Skepticism was strongly associated with reduced engagement in COVID-19 prevention behaviors. These findings bolster the arguments for making these public health recommendations mandatory.

Behavioral economic methods predict future COVID-19 vaccination.

Increasing vaccine utilization is critical for numerous diseases, including COVID-19, necessitating novel methods to forecast uptake. Behavioral economic methods have been developed as rapid, scalable means of identifying mechanisms of health behavior engagement. However, most research using these procedures is cross-sectional and evaluates prediction of behaviors with already well-established repertories. Evaluation of the validity of hypothetical tasks that measure behaviors not yet experienced is important for the use of these procedures in behavioral health. We use vaccination during the COVID-19 pandemic to test whether responses regarding a novel, hypothetical behavior (COVID-19 vaccination) are predictive of later real-world response. Participants (N = 333) completed a behavioral economic hypothetical purchase task to evaluate willingness to receive a hypothetical COVID-19 vaccine based on efficacy. This was completed in August 2020, before clinical trial data on COVID-19 vaccines. Participants completed follow-up assessments approximately 1 year later when the COVID-19 vaccines were widely available in June 2021 and November 2021 with vaccination status measured. Prediction of vaccination was made based on data collected in August 2020. Vaccine demand was a significant predictor of vaccination after controlling for other significant predictors including political orientation, delay discounting, history of flu vaccination, and a single-item intent to vaccinate. These findings show predictive validity of a behavioral economic procedure explicitly designed to measure a behavior for which a participant has limited-to-no direct prior experience or exposure. Positive correspondence supports the validity of these hypothetical arrangements for predicting vaccination utilization and advances behavioral economic methods.

A goal of behavioral science is to develop methods that can predict future behavior to inform preventive health efforts and identify ways people engage in positive health behaviors. Behavioral economic methods apply easy to use and rapid assessment tools to evaluate these mechanisms of health behavior engagement. Here, we show how similar methods can be applied to novel behaviors yet experienced like intentions to vaccinate against COVID-19. We find that responses on a behavioral economic task designed to measure vaccination likelihood closely corresponded to the likelihood of being vaccinated 1 year later. This prediction was above and beyond common predictors of vaccination including demographics like political orientation and age. These findings provide support for these novel methods in the context of the COVID-19 pandemic, specifically, and behavioral health, broadly.

The (Mis)Understanding of the Symbol Associated with Recycling on Plastic Containers in the US: A Brief Report

Plastic containers are a major source of pollution and contribute to greenhouse gases. Many plastic containers are embossed with a small symbol of three arrows forming a triangle and a number in the middle of the triangle. As part of a US online study, we assessed the meaning of this symbol. Of the 808 respondents presented with a visual image of the three-arrow symbol, 81.3% reported (incorrectly) that the symbol indicated that the item could definitely be recycled and 16.3% reported that it could probably be recycled. The findings suggest that a large proportion of individuals have an inaccurate understanding of the symbol on plastics purported to indicate recycling. Plastic manufacturers should revise labels about recycling and not disseminate potentially deceptive information about the ability to recycle their products, and more effective methods such as extended producer responsibility legislation are needed to reduce plastic pollution.

A socio-ecological perspective on parents' intentions to vaccinate their children against COVID-19.

INTRODUCTION: Vaccinating children against COVID-19 protects children's health and can mitigate the spread of the virus to other community members. OBJECTIVE: The primary objective of this study was to use a socio-ecological perspective to identify multi-level factors associated with US parents' intention to vaccinate their children. METHODS: This study used a longitudinal online cohort. Multinomial logistic regression models assessed socio-ecological predictors of negative and uncertain child COVID-19 vaccination intentions compared to positive intentions. RESULTS: In June 2021, 297 parents were surveyed and 44% reported that they intended to vaccinate their children while 25% expressed uncertainty and 31% did not intend to vaccinate their children. The likelihood of reporting uncertain or negative intention, compared to positive intention to vaccinate their children was higher among parents who had not received a COVID-19 vaccination and those who did not have trusted information sources. Parents who talked to others at least weekly about the COVID-19 vaccine were less likely to endorse uncertain compared to positive vaccine intentions (aRRR: 0.44; 95% CI: 0.20-0.93). A sub-analysis identified that parents had significantly higher odds of intending to vaccinate older children compared to younger children (children ages 16-17 years v. 0-4 years OR: 2.01, 95% CI: 1.05-3.84). An additional sub-analysis assessed the stability of parents' intention to vaccinate their children between March 2021 and June 2021 (N=166). There was transition within each intention group between the study periods; however, symmetry and marginal homogeneity test results indicated that the shift was not statistically significant. Parents expressing uncertainty in March 2021 were the most likely to change their intention, with 24% transitioning to positive intention and 23% to negative intention in June 2021. CONCLUSION: Study findings suggest that programs to promote vaccination uptake should be dyadic and work to promote child and parent vaccination. Peer diffusion strategies may be particularly effective at promoting child vaccination uptake among parents expressing uncertainty.

A longitudinal study of vaccine hesitancy attitudes and social influence as predictors of COVID-19 vaccine uptake in the US.

BACKGROUND: In many countries with high levels of COVID-19 vaccine access, uptake remains a major issue. We examined prospective predictors of COVID-19 vaccine uptake in a United States longitudinal study. METHODS: An online longitudinal study on COVID-19 and well-being assessed vaccine hesitancy attitudes, social norms, and uptake among 444 respondents who had completed both survey waves in March and June 2021. RESULTS: The mean sample age was 41, with 55% female, 71% white, 13% Black, and 6% Latinx. In March 2021, 14% had received at least one COVID-19 vaccine dose. By June 2021, 64% reported receiving at least one dose. In prospectively assessing predictors of vaccine uptake, we found strong correlations among five different vaccine hesitancy questions. In multivariable logistic regression models, family and friends discouraging vaccination (adjusted odds ratios [aOR] = .26, 95% CI = .07, .98), not knowing whom to believe about vaccine safety (aOR = .51, 95% CI = .27, .95), and concerns that shortcuts were taken with vaccine development (aOR = .43, 95% CI = .23, .81) were all independent predictors of lower vaccine uptake. Political conservatism, gender, education, and income were also independent predictors of reduced uptake. Vaccine hesitancy items were also modeled as a scale, and the scale was found to be strongly predictive of vaccine uptake. CONCLUSIONS: The findings highlight the importance of social norm interventions and suggest general and specific vaccine hesitancy attitudes, especially trust, should be considered in developing vaccine uptake programs.

The association between climate change attitudes and COVID-19 attitudes: The link is more than political ideology✰,✰✰,☠.

The COVID-19 pandemic and climate change are two current global threats. This study examined the relationship between climate change attitudes and COVID-19 behaviors and risk perceptions. Drivers of climate change attitudes and COVID-19 behaviors were also assessed. Study participants were an online sample of 520 respondents from a longitudinal study of COVID-19 and well-being in the US. Logistic regression models were used to examine the outcomes of climate change opinions and COVID-19 perceptions and prevention behaviors (perceived COVID-19 risk, mask wearing, social distancing, and vaccine intentions). Covariates included political ideology, conspiracy beliefs, and trust in scientific information about COVID-19. In the multivariable models of COVID-19 perceptions and prevention behaviors, climate change opinions were also included as a covariate. In these models, climate change attitudes were significantly associated with perceived risk of COVID-19, always wearing masks, decreased time spent with others due to COVID-19, and intention to get a COVID-19 vaccine. In adjusted models, the odds of wearing a mask increased 41% (CI: 1.11-1.78) for every 1-point increase on the climate attitude scale and decreased 13% (CI: 0.79-0.96) if the participant distrusted COVID-19 information. Those who reported distrust of COVID-19 information (aOR: 1.61, CI: 1.40-1.85), politically conservative ideology (aOR: 1.24, CI: 1.04-1.47), lower concern about climate change (aOR: 0.71, CI: 0.53-0.97), female sex (aOR: 2.39 CI: 1.38-4.13), and lower disbelief in conspiracy theories (aOR: 0.63, CI: 0.51-0.80) had higher odds of not intending to be vaccinated. These findings suggest that climate change attitudes are linked to COVID-19 behaviors and perceptions, which are not completely driven by political ideology or trust in scientific information.

Implications of attitudes and beliefs about COVID-19 vaccines for vaccination campaigns in the United States: A latent class analysis.

Unprecedented global efforts in vaccine development have resulted in effective vaccines for COVID-19. The pandemic response in the US has been highly politicized, resulting in significant opposition to public health efforts, including vaccines. We aimed to understand patterns of attitudes and beliefs about the COVID-19 vaccine to inform vaccination campaigns. 583 English speaking United States adults were surveyed November 18-29, 2020. Participants answered 11 questions about their attitudes and beliefs about a COVID-19 vaccine, including perceived vaccine effectiveness, likelihood of getting vaccinated, and concerns that vaccine development was rushed/influenced by politics. We conducted a latent class analysis to identify profiles of attitudes/beliefs about a COVID-19 vaccine. We identified four classes of COVID-19 vaccine beliefs. The pro-vaccine class (28.8%) was willing to get vaccinated and had broadly positive beliefs about the vaccine. The development concerns class (27.8%) was willing to get vaccinated but was concerned about the development process. The third class (22.6%) was largely unsure if they would get vaccinated and if their peer groups would be vaccinated. The forth class (anti-vaccine, 20.8%) was dominated by an unwillingness to get vaccinated, vaccine distrust, vaccine development concerns, and peers groups with negative vaccine intentions. Given the large proportion of individuals who were concerned about the COVID-19 vaccine development process, messaging about rigor and approval processes may be critical to securing this group's commitment to vaccination. Having scientific and cultural leaders endorse vaccination may also be influential.

Behavioral economic methods to inform infectious disease response: Prevention, testing, and vaccination in the COVID-19 pandemic.

The role of human behavior to thwart transmission of infectious diseases like COVID-19 is evident. Psychological and behavioral science are key areas to understand decision-making processes underlying engagement in preventive health behaviors. Here we adapt well validated methods from behavioral economic discounting and demand frameworks to evaluate variables (e.g., delay, cost, probability) known to impact health behavior engagement. We examine the contribution of these mechanisms within a broader response class of behaviors reflecting adherence to public health recommendations made during the COVID-19 pandemic. Four crowdsourced samples (total N = 1,366) completed individual experiments probing a response class including social (physical) distancing, facemask wearing, COVID-19 testing, and COVID-19 vaccination. We also measure the extent to which choice architecture manipulations (e.g., framing, opt-in/opt-out) may promote (or discourage) behavior engagement. We find that people are more likely to socially distance when specified activities are framed as high risk, that facemask use during social interaction decreases systematically with greater social relationship, that describing delay until testing (rather than delay until results) increases testing likelihood, and that framing vaccine safety in a positive valence improves vaccine acceptance. These findings collectively emphasize the flexibility of methods from diverse areas of behavioral science for informing public health crisis management.

Social norms and prevention behaviors in the United States early in the COVID-19 pandemic.

The current study assessed how social norms were associated with the three effective Covid-19 prevention behaviors of social distancing, handwashing, and wearing protective face masks during the early stages of the pandemic in the US. Study participants were recruited online. Data from the present study was from a baseline quantitative survey administered from March 25th-27th, 2020. The 808 study participants were recruited for a longitudinal study online. Eligibility requirements included age 18 or older, living in the United States, English speaking and reading had heard of the Coronavirus or Covid-19, and provided informed consent. The three outcome variables were handwashing, mask wearing, and social distancing. Injunctive and descriptive norms were assessed. The injunctive norm of perceiving friends would find them rude if they did not affiliate with them because Covid-19 was associated with all three outcomes in both the bivariate and multivariate logistic regression models with adjusted odds ratios ranging from (aOR) = .80 for handwashing to aOR = .63 for social distancing and aOR = .77 for mask wearing. The descriptive cognitive norm of friends worrying about becoming infected was associated with all three outcomes in the bivariate analysis but only mask wearing in the multivariate models (aOR = 1.74). The study findings suggest there are strong social factors that correlate with behaviors to prevent the transmission of SARS-CoV-2. These findings also suggest that public health communication campaigns should focus on more than heightening risk perceptions. They should include attention to social norms and perceptions of social risks to significant others.

Implications of Attitudes and Beliefs about COVID-19 vaccines for Vaccination Campaigns in the United States: a Latent Class Analysis

Unprecedented global efforts in vaccine development have resulted in effective vaccines for COVID-19. The pandemic response in the US has been highly politicized, resulting in significant opposition to public health efforts, including vaccines. We aimed to understand patterns of attitudes and beliefs about the COVID-19 vaccine to inform vaccination campaigns. 583 English speaking United States adults were surveyed November 18-29, 2020. Participants answered 11 questions about their attitudes and beliefs about a COVID-19 vaccine, including perceived vaccine effectiveness, likelihood of getting vaccinated, and concerns that vaccine development was rushed/influenced by politics. We conducted a latent class analysis to identify profiles of attitudes/beliefs about a COVID-19 vaccine. We identified four classes of COVID-19 vaccine beliefs. The pro-vaccine class (28.8%) was willing to get vaccinated and had broadly positive beliefs about the vaccine. The development concerns class (27.8%) was willing to get vaccinated but was concerned about the development process. The third class (22.6%) was largely unsure if they would get vaccinated and if their peer groups would be vaccinated. The forth class (anti-vaccine, 20.8%) was dominated by an unwillingness to get vaccinated, vaccine distrust, vaccine development concerns, and peers groups with negative vaccine intentions. Given the large proportion of individuals who were concerned about the COVID-19 vaccine development process, messaging about rigor and approval processes may be critical to securing this group’s commitment to vaccination. Having scientific and cultural leaders endorse vaccination may also be influential.

Correlates of Levels of Willingness to Engage in Climate Change Actions in the United States.

While the majority of the American public believe climate change is occurring and are worried, few are engaged in climate change action. In this study, we assessed factors associated with the level of willingness to engage in climate change actions using an online, longitudinal US study of adults. Climate change action outcomes included the level of willingness to post materials online, take political actions, talk with peers about climate change, and donate to or help an organization. Predictors included climate change attitudes, environmental attitudes, political ideology, political party affiliation, and demographic variables. Most (72%) of the 644 respondents only talked about climate change with peers a few times a year or less, though 65% were very or extremely worried about climate change. Many respondents indicated a willingness to do somewhat or a lot more, from 38% willing to talk to peers to 25% for willing to take political actions. In multinomial regression models, the Climate Change Concern scale was strongly and consistently associated with willingness to engage in climate change action. These findings indicate a need to both identify those who are willing to act and finding activities that fit with their interests and availability.

Distress in the time of COVID-19: Understanding the distinction between COVID-19 specific mental distress and depression among United States adults.

BACKGROUND: During the COVID-19 pandemic, many Americans have experienced mental distress, which may be partially characterized by a rise in mental illnesses. However, COVID-19 specific psychological distress may also be separate from diagnosable conditions, a distinction that has not been well established in the context of the pandemic. METHODS: Data came from an online survey of US adults collected in March 2020. We used factor analysis to assess the relationship between COVID-19 related mental distress and depressive symptoms. Using four questions on psychological distress modified for COVID-19 and eight depressive symptoms, we conducted an exploratory factor analysis (EFA) to identify the factor structure and then estimated a confirmatory factor analysis (CFA). RESULTS: The EFA model indicated a two-factor solution, where the COVID-19 distress items loaded onto the first factor and depression items loaded onto the second. Only two items cross-loaded between factors: feeling fearful and being bothered by things that do not usually bother the participant. The CFA indicated that this factor structure fit the data adequately (RMSEA=0.106, SRMR=0.046, CFI=0.915, TLI=0.890). LIMITATIONS: It is possible that there are additional important symptoms of COVID-19 distress that were not included. Depression symptoms were measured via the CES-D-10, which while validated is not equivalent to a clinician diagnosis. CONCLUSIONS: As COVID-19 related mental distress appears to be distinct from, though related to, depression, public health responses must consider what aspects of depression treatment may apply to this phenomenon. For COVID-related distress, it may be more appropriate to treat symptomatically and with supportive psychotherapy.

Socioeconomic Factors Associated With an Intention to Work While Sick From COVID-19.

OBJECTIVE: We sought to understand barriers to staying home from work when sick from COVID-19 (COVID-19 presenteeism) to understand COVID-19 health disparities and transmission and guide workplace and social policy. METHODS: We used logistic regression models to assess which socioeconomic factors were associated with intended COVID-19 presenteeism among an online study population working outside their home in March 2020 (N = 220). RESULTS: Overall, 34.5% of participants reported intended COVID-19 presenteeism. Younger individuals and individuals making over $90,000 per year were less likely to report COVID-19 presenteeism. Individuals who were worried about having enough food had 3-fold higher odds of intended COVID-19 presenteeism. CONCLUSION: Current policies around food access, paid sick leave, and other workplace protections need to be expanded and made more accessible to reduce health disparities as well as the transmission of COVID-19 and other infections.

COVID-19 vaccine prioritization of incarcerated people relative to other vulnerable groups: An analysis of state plans.

BACKGROUND: Carceral facilities are epicenters of the COVID-19 pandemic, placing incarcerated people at an elevated risk of COVID-19 infection. Due to the initial limited availability of COVID-19 vaccines in the United States, all states have developed allocation plans that outline a phased distribution. This study uses document analysis to compare the relative prioritization of incarcerated people, correctional staff, and other groups at increased risk of COVID-19 infection and morbidity. METHODS AND FINDINGS: We conducted a document analysis of the vaccine dissemination plans of all 50 US states and the District of Columbia using a triple-coding method. Documents included state COVID-19 vaccination plans and supplemental materials on vaccine prioritization from state health department websites as of December 31, 2020. We found that 22% of states prioritized incarcerated people in Phase 1, 29% of states in Phase 2, and 2% in Phase 3, while 47% of states did not explicitly specify in which phase people who are incarcerated will be eligible for vaccination. Incarcerated people were consistently not prioritized in Phase 1, while other vulnerable groups who shared similar environmental risk received this early prioritization. States' plans prioritized in Phase 1: prison and jail workers (49%), law enforcement (63%), seniors (65+ years, 59%), and long-term care facility residents (100%). CONCLUSIONS: This study demonstrates that states' COVID-19 vaccine allocation plans do not prioritize incarcerated people and provide little to no guidance on vaccination protocols if they fall under other high-risk categories that receive earlier priority. Deprioritizing incarcerated people for vaccination misses a crucial opportunity for COVID-19 mitigation. It also raises ethical and equity concerns. As states move forward with their vaccine distribution, further work must be done to prioritize ethical allocation and distribution of COVID-19 vaccines to incarcerated people.

An Assessment of the Rapid Decline of Trust in US Sources of Public Information about COVID-19.

We conducted a longitidinal assessment of 806 respondents in March, 2020 in the US to examine the trustworthiness of sources of information about COVID-19. Respondents were recontacted after four months. Information sources included mainstream media, state health departments, the CDC, the White House, and a well-known university. We also examined how demographics, political partisanship, and skepticism about COVID-19 were associated with the perceived trustworthiness of information sources and decreased trustworthiness over time. At baseline, the majority of respondants reported high trust in COVID-19 information from state health departments (75.6%), the CDC (80.9%), and a university (Johns Hopkins, 81.1%). Mainstream media was trusted by less than half the respondents (41.2%), and the White House was the least trusted source (30.9%). At the 4-month follow-up, a significant decrease in trustworthiness in all five sources of COVID-19 information was observed. The most pronounced reductions were from the CDC and the White House. In multivariate analyses, factors associated with rating the CDC, state health department, and a university as trustworthy sources of COVID-19 information were political party affiliation, level of education, and skepticism about COVID-19. The most consistent predictor of decreased trust was political party affiliation, with Democrats as compared to Republicans less likely to report decreased trust across all sources.

COVID-19 vaccine delay: An examination of United States residents' intention to delay vaccine uptake.

The current study examines differences between COVID-19 vaccine intention and delay. A survey was administered to 585 US respondents in late November 2020 as part of an online longitudinal study. Respondents provided information on whether they would obtain a COVID-19 vaccine, once available, and how long they intended to wait before obtaining it. In the negative intention group, 3.4% reported waiting a few weeks, 34.0% waiting a few months, and 62.6% never getting vaccinated. In multivariable models, social norms were a significant and independent predictor of all vaccine delay and intention models. Vaccine delay was associated with low levels of worry about becoming infected with COVID-19, political conservatism, concerns about vaccine side effects, and low levels of believing a vaccine would be effective. Negative vaccine intentions were associated with worries about becoming infected with COVID-19, concerns about vaccine side effects, beliefs that the vaccines were developed too quickly, and low endorsement of the altruistic belief that older people should have vaccination priority. The study results highlight the importance of a multifactorial approach to assessing vaccine attitudes. The findings suggest that uptake programs should focus on enhancing pro-vaccine norms.

Political partisanship and stigma against people who use drugs in opinions about allocating COVID-19 prevention resources to vulnerable populations.

BACKGROUND: The distribution of resources during the COVID-19 pandemic has been politicized and contentious in the United States. Vulnerable populations, such as those living in poverty, experiencing homelessness, or who use drugs, are particularly susceptible to becoming infected with COVID-19 and often have limited access to protective supplies, such as masks and hand sanitizer. Our aim was to understand public opinion on increasing the allocation of COVID-19 prevention resources to vulnerable populations. METHODS: Data were from an online survey of 680 United States adults. Participants' opinions on the allocation of COVID-19 prevention resources to people with low income, experiencing homelessness, or who use drugs were assessed using a five-item Likert scale. We examined the prevalence of these opinions and their relationship to sociodemographic characteristics, COVID-19 beliefs, and drug-related experiences. RESULTS: Most participants supported increasing resources for individuals with low incomes (79.6%) and experiencing homelessness (74.6%), while a minority supported increasing resources for people who use drugs (33.5%). Politically conservative participants were less likely to support increasing resources for all three populations than those who were politically liberal. Skepticism about the severity of COVID-19 was also associated with less support for increasing resources across groups. DISCUSSION: Our results demonstrate that people who use drugs continue to be stigmatized in the context of the COVID-19 pandemic, resulting in popular opinion not supporting people who use drugs with potentially lifesaving resources. Overcoming this stigma is essential to prevent COVID-19 among people who use drugs, a population which experiences elevated risk of COVID-19 infection.

Determinants of worry using the SARS-CoV-19 worry (CoV-Wo) scale among United States residents.

We sought to develop a brief Severe Acute Respiratory Syndrome Coronavirus 2-related worry (CoV-Wo) scale to understand COVID-19-related worry among adults in the United States. We also aimed to model key determinants of worry in the early stage of the COVID-19 pandemic in the United States. A total of 806 participants completed an online survey in late March 2020. Exploratory and confirmatory factor analyses assessed scale structure. Factor analysis stratified by depression was used to assess measurement invariance. Linear regression models examined COVID-19-related worry determinants. The CoV-Wo scale exhibited good reliability (α = 0.80) and a two-factor structure: health (α = 0.83) and resources (α = 0.71). The full scale and both subscales were higher among participants who stopped working due to COVID-19 and those with depression. Perception of quality medical care if infected with COVID-19 was associated with reduced worry. The CoV-Wo scale is a low burden assessment of COVID-19-related worry, that captures common worries in domains affected by COVID-19 and can be used to develop psychosocial resources.