Personal infection prevention behaviors and campaign to encourage travel during COVID-19: A cross-sectional study.

Introduction: The Go To Travel campaign in Japan was launched to subsidize travel and accommodation costs for tourists through vouchers that could be used at domestic destinations. Infection prevention behavior can lead to refraining from travel owing to infection concerns; conversely, taking preventive action can promote travel. There is a lack of information about the association between infection prevention behaviors and desire to travel. During a pandemic of infection, there is the difficult challenge of balancing the promotion of infection prevention behavior with economic revitalization. Thus, we examined the relationship between personal infection prevention behaviors and using Go To Travel. Methods: We conducted a cross-sectional study of 26,637 workers who responded to a large-scale questionnaire survey about COVID-19 in Japan. We built multilevel logistic regression models adjusted for confounders to assess the association between each personal infection prevention behavior and using Go To Travel. We analyzed the seven infection prevention behavior individually: wearing a mask when among other people; disinfecting hands with alcohol before going indoors; washing hands after using the toilet; gargling upon returning home; opening a window to ventilate a room; carrying an alcohol sanitizer; and disinfecting hands after touching objects outside. Results: Among the 26,637 participants, 7,959 (30%) used Go To Travel. For "wearing a mask in the presence of others" and "washing hands after using the toilet," the majority of respondents answered "almost always: 86.5 and 85.6% respectively. Action "carrying alcohol disinfectant" was the least implemented, with 36.9% of respondents saying "almost never." Two of the seven preventive behaviors ("disinfecting hands with alcohol before going indoors" and "carrying alcohol disinfectant") were positively related to using Go To Travel, that is, the more of these actions they took, the more they used Go To Travel (p for trend <0.001). Conclusions: To balance pandemic preparedness with economic preparedness, it is also necessary to promote travel when the infection situation is calm. However, since human mobility can be a factor that exacerbates the infection situation, it is necessary to promote more infection prevention behaviors among individuals. We confirmed that Go To Travel users were basically doing a good infection prevention behaviors, but they tended not to wash their hands after touching things or carry alcohol sanitizer. It is necessary to encourage these measures to be taken when traveling.

Association between preventive measures against workplace infection and preventive behavior against personal infection.

To prevent the spread of infection, it is necessary for each individual to adopt infection prevention behavior. We investigated the effect of infection control measures implemented in the workplace on personal infection prevention behavior. We conducted a self-administered questionnaire survey through the Internet from December 22 to 25, 2020, during which period coronavirus disease 2019 (COVID-19) was spreading. Among respondents aged 20 to 65 years (n=27,036), 21,915 workers were included in the analysis. The results showed that as the number of infection control measures in the workplace increased, implementation of infection prevention behavior by individuals also significantly increased. However, the relationship differed depending on the type of personal infection prevention behavior. Specifically, infection control measures against COVID-19 in the workplace may affect personal infection prevention behavior. Implementation of infection control measures in the workplace increases awareness of the importance of individual infection prevention behavior and its implementation by all individuals. These findings may be applicable not only to COVID-19 measures but also to responses to other emerging infections and seasonal influenza.

Effect of COVID-19 infection related experiences on social behaviors when a state of emergency is declared: a cohort study.

BACKGROUND: Restricting the movement of the public to gathering places and limiting close physical contact are effective measures against COVID-19 infection. In Japan, states of emergency have been declared in specific prefectures to reduce public movement and control COVID-19 transmission. We investigated how COVID-19 infection related experiences including people with a history of infection, people with a history of close contact, and people whose acquaintances have been infected, affected self-restraint from social behaviors during the second state of emergency in Japan. METHODS: A prospective cohort study was conducted among workers aged 20-65 years using data from an internet survey. The baseline survey was conducted on December 22-25, 2020, and a follow-up survey was on February 18-19, 2021. There were 19,051 participants who completed both surveys and were included in the final analysis. We identified eight social behaviors: (1) eating out (4 people or fewer); (2) eating out (5 people or more); (3) gathering with friends and colleagues; (4) day trip; (5) overnight trip (excluding visiting home); (6) visiting home; (7) shopping for daily necessities; and (8) shopping for other than daily necessities. We set self-restraint regarding each social behavior after the second state of emergency was declared in January 2021 as the dependent variable, and COVID-19 infection related experiences as independent variables. Odds ratios were estimated using multilevel logistic regression analyses nested in the prefecture of residence. RESULTS: Significant differences by COVID-19 infection related experiences were identified: compared to people without COVID-19 related experiences, people with a history of COVID-19 were less likely self-restraint from most social behaviors. People whose acquaintance had been diagnosed with COVID-19 were significantly more likely to refrain from most social behaviors. There was no significant difference in any social behaviors for people with a history of close contact only. CONCLUSION: To maximize the effect of a state of emergency, health authorities should disseminate information for each person in the target population, taking into account potential differences related to the infection related experiences.

Corporate health culture promotes infection control measures against COVID-19 in the workplace.

OBJECTIVES: The present study examined the relationship between health culture evaluated by the Health and Productivity Survey Sheets and the implementation status of infection control measures against COVID-19 in the workplace. METHODS: This was a cross-sectional study using the corporate data (2518 companies) collected for the purpose of selecting the excellent company of health and productivity management by the Japanese government. The explanatory variable was the overall evaluation score, and the outcome was whether or not infection control measures against COVID-19 in the workplace. We used logistic regression analysis and calculated the odds ratio adjusted for the industry sector, the corporation size, and the operating profit ratio by the overall evaluation score category. RESULTS: The odds ratio of all infection control measurements in the workplace increased as the evaluation score increased. CONCLUSIONS: This study revealed a new finding that the presence of a healthy culture in the workplace will lead to the appropriate implementation of infection control measures during a pandemic. The company's ordinary commitment to employee health will be effective even in times of health crisis, such as during the outbreak of the pandemic.

Association between Perceived Organizational Support for Infection Prevention and Work Engagement during the COVID-19 Pandemic among Japanese Workers: A Prospective Cohort Study.

Although the correlation between perceived organizational support (POS) and work engagement has been investigated in several studies, the relationship between health-focused POS and work engagement has not been clarified. We prospectively evaluated the influence of workers' POS for infection prevention (POS-IP) on employees' work engagement. This prospective cohort study was conducted from December 2020 (baseline) to December 2021 (1-year follow-up) using a self-administered internet questionnaire. At follow-up, there were 18,560 respondents, and after excluding 6677 respondents who had changed jobs or retired since baseline or who were self-employed; thus, 11,883 participants were included in the analysis. We asked participants a single question on POS-IP and the three-item Utrecht Work Engagement Scale (UWES-3), and then analyzed the relationship between POS-IP at baseline and UWES-3 at follow-up using multilevel regression analysis. Work engagement at follow-up was significantly higher in the groups with "low", "high", and "very high" POS-IP at baseline as compared with the "very low" group (all, p < 0.001). A dose-response relationship was also observed between the POS-IP categories at baseline and work engagement at follow-up (p for trend < 0.001). During the COVID-19 pandemic, POS-IP can increase work engagement after 1 year.

Workplace Infection Control Measures and Perceived Organizational Support During the COVID-19 Pandemic in Japan: A Prospective Cohort Study.

OBJECTIVE: We investigated whether workplace infection control measures during the COVID-19 pandemic could increase perceived organizational support (POS). METHODS: This prospective cohort study was conducted in Japan from December 2020 to December 2021 using a questionnaire survey. There were 18,560 respondents at follow-up; we investigated 4971 who rated low POS at baseline. The participants were asked a single question about POS and nine about workplace infection control measures. We determined the odds ratios (ORs) of high POS at follow-up using multilevel logistic regression analysis. RESULTS: The groups of 5 to 6 (OR = 1.29, 95% confidence interval = 1.05-1.57, P = 0.014) and 7 to 9 workplace infection control measures (OR = 1.54, 95% confidence interval, 1.28-1.85, P < 0.001) had significantly higher ORs than the group with 0 to 2 measures. CONCLUSIONS: Health support for employees through workplace infection control measures can increase POS.

What is the role of occupational physicians in the workplace during the COVID-19 pandemic in Japan? A qualitative interview study.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has had various impacts on businesses and workers worldwide. The spread of infection has been reported through cluster outbreaks in the workplace, and World Health Organization has emphasized workplace infection control measures. Occupational physicians (OPs) are expected to actively support employers' efforts to minimize the damage of the pandemic. However, there is little research on the role of these specialists during a pandemic. Clarification of the contributions of OPs to health and safety at the workplace in the COVID-19 pandemic would be beneficial to ensure that OPs can be effectively deployed in the next pandemic. METHODS: We employed semi-structured interviews and qualitative content analysis of the interview transcripts. Twenty OPs were selected as priority candidates from among 600 OPs certificated of the JSOH, and thirteen who met the eligibility criteria agreed to participate. The online interviews were conducted in November and December 2020 with thirteen OPs. We extracted meaning units (MUs) from interview transcripts according to the research question: "What was the role of OP in the COVID-19 pandemic?" and condensed and abstracted them into codes and categorized them. Validity was confirmed by additional 5 OPs interviews. RESULTS: A total of 503 MUs were extracted from the transcripts. These were abstracted into 10 sub-categories and two categories. Categories 1 and 2 dealt with "Role in confronting the direct effects of the pandemic" and "Role in confronting the indirect effects of the pandemic" and accounted for 434 (86.3%) and 69 (13.7%) MUs, respectively. These results were validated by another 5 interviews. CONCLUSION: This study identified the role of OPs in Japan in the COVID-19 pandemic. The results showed that they made a wide range of contributions to the direct and indirect effects of the pandemic. We hope our findings will help OPs during future pandemics or other long-term emergency situations.

Workplace vaccination opportunity against COVID-19 contributed to high perceived organizational support of employees in Japan: A prospective cohort study.

OBJECTIVES: Perceived organizational support is a broad perception by employees about the extent to which their employer values their contributions and cares about their well-being. We examined the relationship between workplace vaccination opportunities for COVID-19 provided by companies and increases and decreases in perceived organizational support, using a prospective cohort study. METHODS: This study was conducted between December 2020 and December 2021 using a self-administered questionnaire survey in Japan. In total, 18 560 people responded to the follow-up, and were included in this study. The odds ratios (ORs) for the association between company-arranged vaccination opportunities and high perceived organizational support at the follow-up for participants (a) with low perceived organizational support at the baseline (n = 4971), and (b) with high perceived organizational support at the baseline (n = 6912) were separately estimated using a multilevel logistic model. RESULTS: The OR of high perceived organizational support at the follow-up after low baseline levels was significantly higher in participants given a vaccination opportunity than those not given this opportunity (OR 1.49; 95% confidence interval [CI] 1.32-1.67; p < .001). The OR of high perceived organizational support at the follow-up after high baseline levels was also significantly highly in participants given a vaccination opportunity than not (OR 1.38; 95% CI 1.23-1.54; p < .001). These significant differences remained after adjusting for workplace infection control measures. CONCLUSIONS: Employee health support provided through a workplace vaccination program can contribute to high perceived organizational support.

COVID-19 vaccination coverage by company size and the effects of workplace vaccination program in Japan: a cohort study.

BACKGROUND: Vaccination is considered the most effective control measure against COVID-19. Vaccine hesitancy and equitable vaccine allocation are important challenges to disseminating developed vaccines. To promote COVID-19 vaccination coverage, the government of Japan established the workplace vaccination program. However, while it appears that the program was effective in overcoming vaccine hesitancy, the program may have hindered the equitable allocation of vaccines because it mainly focused on employees of large companies. We investigated the relationship between company size and COVID-19 vaccination completion status of employees and the impact of the workplace vaccination program on this relationship. METHODS: We conducted an internet-based prospective cohort study from December 2020 (baseline) to December 2021. The data were collected using a self-administered questionnaire survey. Briefly, 27,036 workers completed the questionnaire at baseline and 18,560 at follow-up. After excluding ineligible respondents, we finally analyzed the data from 15,829 participants. At baseline, the participants were asked about the size of the company they worked for, and at follow-up they were asked about the month in which they received their second COVID-19 vaccine dose and the availability of a company-arranged vaccination opportunity. RESULTS: In each month throughout the observation period, the odds of having received a second COVID-19 vaccine dose were significantly lower for small-company employees than for large-company employees in the sex- and age-adjusted model. This difference decreased after adjusting for socioeconomic factors, and there was no significant difference after adjusting for the availability of a company-arranged vaccination opportunity. CONCLUSIONS: The workplace vaccination program implemented in Japan to control the COVID-19 pandemic may have been effective in overcoming vaccine hesitancy in workers; however, it may have caused an inequitable allocation of vaccines between companies of different sizes. Because people who worked for small companies were less likely to be vaccinated, it will be necessary to enhance support of vaccination for this population in the event of future infectious disease outbreaks. TRIAL REGISTRATION: Not applicable.

Prospective Cohort Study of Sociodemographic and Work-Related Factors and Subsequent Unemployment under COVID-19 Pandemic.

The previous studies found that women and low-income households were more likely to experience unemployment prior to the COVID-19 pandemic. However, there is no cohort study to examine the relationship during the COVID-19 pandemic. The aim of this prospective cohort study is to examine the relationship between sociodemographic factors and unemployment during the COVID-19 pandemic in Japan. We surveyed the socioeconomic status, personal characteristics, and occupation of recruited workers at baseline (22-25 December 2020); subsequent unemployment was examined at follow-up (18-19 February 2021). We determined the odds ratio of unemployment by sociodemographic status and occupation. The multivariate model was adjusted for sex and age. Among the 19,941 participants, 725 (3.6%) had experienced unemployment. Multivariate analysis showed significant high unemployment amongst women and participants of younger age, bereaved or divorced, unmarried, of lower income, or with short educational background. By occupation, the unemployment rate of temporary or contract employees and self-employed is high. COVID-19 expelled socially vulnerable groups from employment. This suggests the need for employment and economic support for such individuals.

Sociodemographic factors and self-restraint from social behaviors during the COVID-19 pandemic in Japan: A cross-sectional study.

The control of human flow has led to better control of COVID-19 infections. Japan's state of emergency, unlike other countries, is not legally binding but is rather a request for individual self-restraint; thus, factors must be identified that do not respond to self-restraint, and countermeasures considered for those factors to enhance its efficacy. We examined the relationship between sociodemographic factors and self-restraint toward social behaviors during a pandemic in Japan. This cross-sectional study used data for February 18-19, 2021, obtained from an internet survey; 19,560 participants aged 20-65 were included in the analysis. We identified five relevant behaviors: (1) taking a day trip; (2) eating out with five people or more; (3) gathering with friends and colleagues; (4) shopping for other than daily necessities; (5) shopping for daily necessities. Multilevel logistic regression analyses were used to examine the relationship between sociodemographic factors and self-restraint for each of the behaviors. Results showed that for behaviors other than shopping for daily necessities, women, those aged 60-65, married people, highly educated people, high-income earners, desk workers and those who mainly work with interpersonal communication, and those with underlying disease reported more self-restraint. Older people had less self-restraint than younger people toward shopping for daily necessities; an underlying disease had no effect on the identified behavior. Specialized interventions for these groups that include recommendations for greater self-restraint may improve the efficacy of the implementing measures that request self-restraint.

Prospective cohort study of workers diagnosed with COVID-19 and subsequent unemployment.

OBJECTIVES: The purpose of this study was to investigate the relationships of workers being diagnosed with coronavirus disease 2019 (COVID-19) and being identified as close contacts of infected persons with unemployment in Japan. METHODS: This was a prospective cohort study using questionnaires about COVID-19 administered to Japanese workers. A baseline survey conducted on December 22-25, 2020, was used to determine history of being diagnosed with COVID-19 or being identified as a close contact of an infected person. Unemployment since the baseline survey was ascertained with a follow-up survey on February 18 and 19, 2021. The odds ratios (ORs) of unemployment were estimated using a multilevel logistic model with adjusted covariates nested in prefecture of residence. RESULTS: Women (n = 8771) accounted for 44% of the total sample (n = 19 941), and the mean age was 48.0 years. In terms of unemployment because of negative reasons, the multivariate analysis showed that the OR of unemployment associated with being diagnosed with COVID-19 was 2.40 (95% CI: 1.15-5.01) and that the OR associated with being identified as a close contact was 0.98 (95% CI: 0.31-3.11). CONCLUSIONS: There is an association between workers being diagnosed with COVID-19 and unemployment. The reason is not clear, but if the unemployment is unwanted by the individual, workplace adjustment may help prevent unwilling unemployment.

Association between perceived organizational support and COVID-19 vaccination intention: A cross-sectional study.

OBJECTIVES: We examined the association between perceived organizational support (POS) and COVID-19 vaccination intention as well as the influence of the implementation of workplace infection prevention measures. METHODS: We analyzed data from an Internet survey of workers aged 20-65 years conducted in December 2020, during a period of widespread COVID-19 infection in Japan. RESULTS: Of the 23 846 participants in this survey, 1958 (8%) reported very high POS. In the group with very high POS, 836 (43%) workers wanted the COVID-19 vaccination; in contrast 1382 (36%) workers in the group with very low POS wanted the vaccination. POS was associated with COVID-19 vaccination intention (odds ratio [OR] = 1.11). The OR decreased after additional adjustment for the number of workplace infection control measures (OR = 1.06). In the analysis with POS as a categorical variable, very high POS was associated with COVID-19 vaccination intention (reference: very low POS) (OR = 1.34). The OR decreased after additional adjustment for the number of workplace infection control measures (OR = 1.17). High POS was associated with COVID-19 vaccination intention (OR = 1.17) but not with vaccination intention after additional adjustment for the number of workplace infection control measures (OR = 1.05). CONCLUSIONS: High POS during the COVID-19 pandemic increased employees' vaccination intention. The relationship between POS and vaccination intention was strongly influenced by implementation of workplace infection prevention measures. Implementing appropriate workplace infection prevention measures in the event of an emerging infectious disease outbreak may influence the vaccination behavior of employees, which may contribute to the acquisition of herd immunity in the community.

Worries About COVID-19 Infection and Psychological Distress at Work and While Commuting.

OBJECTIVE: This study examined the relationship between worry about COVID-19 infection in the workplace and while commuting to work and psychological distress in Japan. METHODS: An internet monitor study was conducted. Out of a total of 33,302 participants, 26,841 people were included. The subjects were asked single-item questions about whether they were worried about COVID-19 infection in general, at work and while commuting to work. K6 was used to assess psychological distress. RESULTS: The OR was significantly higher in association with worry about infection in the workplace at 1.71 (95%CI 1.53 to 1.92) and worry about infection while commuting at 1.49 (95%CI 1.32 to 1.67). CONCLUSIONS: This study suggests the need for psychological intervention to reduce worry about infection in response to public mental health challenges associated with the COVID-19 pandemic.

Intensity of Home-Based Telework and Work Engagement During the COVID-19 Pandemic.

OBJECTIVE: The present study examined the relationship between the intensity of home-based telework and work engagement. METHODS: This cross-sectional study using a self-administrated questionnaire survey was conducted from December 22 to 25, 2020, in Japan. The subjects were asked single-item questions about the intensity of telework and three-item questions about work engagement using the Utrecht Work Engagement Scale. Coefficients were estimated using a multilevel regression model nested by the prefecture of residence and adjusted for covariates. RESULTS: High-intensity (4 or more days per week) telework was not associated with high work engagement for men or women. In contrast, low and moderate intensity (3 days per week to once per month) were associated with high work engagement. The results were consistent when stratified by sex. CONCLUSIONS: Reasonable-intensity telework may have beneficial effects on work engagement.