ABSTRACT
Abstract Background The COVID-19 vaccine is an essential means to establish group immunity and prevent the spread of the pandemic. However, the public's hesitation has created major difficulties to the promotion of the vaccine. By investigating the relationship between health literacy and COVID-19 vaccine hesitancy, as well as the potential moderating role of stress, the present study would provide critical insights for tailoring vaccine-promotion strategies. Objective The two-fold research purpose is: i) address the effect of health literacy on people's attitude toward COVID-19 vaccine, ii) clarify the role of stress in this effect. Method With structured questionnaires, an online survey was conducted to evaluate general public's COVID-19 vaccine hesitancy, health literacy, and perceived stress. In total, 560 responses were collected, and moderated regression analysis was conducted to test the effect of health literacy on vaccine hesitancy among people with different levels of stress. Results A total of 560 participants aged over 18 years were included in this study. About 39.8% of the respondents reported vaccine hesitancy, and this rate is higher among those aged 20-30 years old (83%) and female (71.3%). The results showed people with higher level of health literacy are less likely to have vaccine hesitancy . However, this effect was only among those with lower to moderate level of stress , among the people with high stress, no significant effect of health literacy was found . Conclusions By focusing on the effect of health literacy on COVID-19 vaccine hesitancy, the findings showed education program increasing individual's health literacy may also effectively reduce the public's vaccine hesitancy and promote accepting attitude. However, for people with high level of stress, other health programs need to be developed to enhance their positive attitude toward the COVID-19 vaccine. In conclusion, promotion strategies should be tailored for different populations, with considering individual factors such as health literacy and stress. Keywords vaccine hesitancy; health literacy; stress; moderation
Subject(s)
COVID-19ABSTRACT
Objective: This prospective observational study examined changing trends of mental responses and prevention patterns, and their impact from uncertainty stress during the transition in China from the COVID 19 epidemic to sporadic infection. Setting: A prospective longitudinal observation design was utilized in this study. Participants: We recruited participants for an online panel survey from chat groups on Chinese social media platforms. Data collection: There were 7 waves of interviews. Data were obtained by an online survey. A special administrative WeChat group was established to manage the follow up data collection. Measures: Several mental responses and prevention patterns were each measured by single questionnaire items. Uncertainty stress was measured by 5-point scale. An irrational beliefs about prevention variable was comprised 5 common misconceptions, which manifested during the COVID 19 epidemic in China. Analysis: Sixty two participants completed all observation points and were included in the study. The Mann Kendall Test was used to assess changing trends across the seven observation points. The nonparametric linear mixed effects model was used to examine the association between uncertainty stress and mental and behavioral responses. Results: The mean uncertainty stress did not change significantly over the observation period (T:-0.911, P>0.05). This trend was also true for perceived risk (T: -0.141, P>0.05), perceived severity (T: 1.010, P>0.05), self efficacy for prevention (T: 0.129, P>0.05), and prevention behavior (T: 0.728, P>0.05). There was a statistically significant downwards trend in irrational beliefs about prevention (T: -4.993, p < 0.01), sleep (T: -2.499, p < 0.05), emotions (T: -5.650, p < 0.01), and lifestyle (T: -5.978, p < 0.01). The results showed that uncertainty stress was positively associated with irrational beliefs (beta: 0.16298, p<0.01). The more uncertainty stress, the worse was their sleep (beta: 0.02070, p<0.05), emotions (beta: 0.03462, p<0.01), and lifestyle(beta: 0.02056, p<0.05). High levels of uncertainty stress was negatively associated with self-efficacy for prevention and prevention behavior, beta value was =-1.33210 (p<0.01) and -0.82742 (p<0.01), respectively. Conclusion: As the COVID-19 virus spreads around the globe, it is currently in epidemic status in some countries, in sporadic status in another countries, and it will eventually transition to sporadic infection status. This study provides new information on changing trends of mental responses and prevention patterns from the COVID-19 epidemic as the transition to a sporadic infection period takes place. These results may have important policy and disease prevention in post-epidemic times.
Subject(s)
COVID-19ABSTRACT
Objective To examine changing trends of uncertainty stress, and its impact on disease fear and prevention behaviors during the Chinese COVID-19 epidemic using a prospective observational study. Methods The study employed a longitudinal design. Participants were recruited for an online panel survey from chat groups on social media platforms. There were 5 waves of interviews. Information on uncertainty stress and related variables were collected via the online survey. Descriptive statistics and the GIM program were used for data analysis. Results Participants numbered 150 for the linkable baseline survey and 102 (68%) for the final survey. Uncertainty stress({beta}: -0.047, S.E: 0.118, p>0.05) did not show a statistically significant temporal change trend over the observation period. Disease fear manifested a statistically significant downwards trend ({beta}: -0.342, S.E: 0.157, p<0.05), and prevention behaviors indicated an upwards trend ({beta}: 0.048, S.E: 0.021, p<0.05) during the observation period. Uncertainty stress was positively associated with disease fear ({beta}: 0.45046, S.E: 0.05964, p<0.0001), and negatively associated with self-efficacy ({beta}: -0.6698, S.E: 0.01035, p<0.0001), and prevention behaviors ({beta}: -0.02029, S.E: 0.00876, p: 0.0209). Conclusion This study yielded new information about uncertainty stress among Chinese people during the COVID-19 epidemic. Policy changes and public education are essential for minimizing the negative effects of uncertainty stress in disease prevention.
Subject(s)
COVID-19ABSTRACT
Abstract Objective This prospective observational study examined changing trends of excess self-protective behavior (EPB), and its association with perceived risk, severity and belief in prevention myths during the Chinese COVID-19 epidemic. Methods The study employed a longitudinal design. Participants were recruited for an online panel survey from chat groups on social media platforms. Descriptive statistics and the CATMOD program were used for data analysis. Findings Participants numbered 150 for the linkable baseline survey and 102 for the final survey. There were 5 waves of interviews. The prevalence of participants perceiving a personal risk of contracting COVID-19, and severe consequences of the disease, was 18.6% and 25.5%, respectively. Their prevalence had declined to 4.9% and 17.6%, respectively, by the last observation point. The 5 selected EPBs also manifested a decreasing trend. Belief in COVID-19 prevention myths trended upwards. Perceived risk was positively associated with each EPB, and perceived severity with disinfection of clothes and hoarding of products. Myth adherence was positively associated with disinfection of clothes and both hand washing and sanitization. Conclusion This study yielded new information about EPB among the public during the COVID-19 epidemic. Policy and health education modifications are essential for minimizing the adverse health effects of subscribing to prevention myths.