Tracking the Impact of the Covid-19 Pandemic with the Use of High-Frequency Geo-Located Bank Transaction Data

Using geo-located transaction data from 2 million customers of ABN AMRO bank in the Netherlands, this paper distinguishes the economic effects of consumers responses to the Covid-19 pandemic from those attributable to non-pharmaceutical interventions (NPIs). We compare municipalities that experienced large Covid-19 outbreaks with municipalities that had few or no cases and find that during the first Covid-19 wave the scale of the outbreak in a municipality has a strong negative effect on physical transactions by consumers in that municipality. This behavioral response function of consumers towards the virus is however not constant over time. During the second Covid-19 wave, the behavioural effect of consumers towards the virus has no real impact on consumption. © 2022 IEEE Computer Society. All rights reserved.

Extending the servicescape conceptualization: accounting for perceptions of crowding and risks under the pandemic

Purpose: Though many conceptual and empirical studies have been conducted on the servicescape, limited research has focused on how the COVID-19 pandemic has reshaped factors influencing the servicescape. This paper aims to propose an extension of Bitner's original conceptualization, including pandemic-induced physical and social constraints on servicescape in the form of crowding, consumer risk perception during the crisis and their impact on consumers' and employees' behavioral changes in retail and hospitality sectors. Design/methodology/approach: This paper critically reviewed the past and emerging servicescape and risk literature. It then examines and delineates the concepts of crowding, density and associated risk perceptions to offer an extended servicescape framework. Alongside, scales were proposed to measure the constructs and guidelines given to conduct future empirical studies. Findings: This paper discussed the major impact on servicescape during a pandemic situation, to what extent risk is perceived during consumption and the impact of crowding and store density on employee and customer behavioral responses. Research limitations/implications: This paper principally contributes by explicitly including specific risk dimensions and crowding and proposes the scales to measure consumers' understanding of pandemic-induced perceptions of risk, crowding and density within servicescapes for further empirical testing. Alongside this, the identification and concretization of different types of perceived risks under COVID-19 provide critical and useful marketing implications. Originality/value: This study identifies relevant risk dimensions, proposes crowding as an independent construct apart from servicescape physicality and proposes relevant measures for empirical verification. © 2023, Emerald Publishing Limited.

Interacting With COVID-19: How Population Behavior, Feedback and Memory Shaped Recurrent Waves of the Epidemic

Until the approval of vaccines at the end of 2020, societies relied on non-pharmaceutical interventions (NPIs) in order to control the COVID-19 pandemic. Spontaneous changes in individual behavior might have contributed to or counteracted epidemic control due to NPIs. For example, the population compliance to NPIs may have varied over time as people developed 'epidemic fatigue' or altered their perception of the risk and severity of COVID-19. Whereas official measures are well documented, the behavioral response of the citizens is harder to capture. We propose a mathematical model of the societal response, taking into account three main effects: the citizen response dynamics, the authorities' NPIs, and the occurrence of unpreventable events that significantly alter the virus transmission rate. A key assumption is that a society has a waning memory of the epidemic effects, which reflects on both the severity of the authorities' NPIs and on the citizens' compliance to the prescribed rules. This, in turn, feeds back onto the transmission rate of the disease, such that a higher number of hospitalizations decreases the probability of transmission. We show that the model is able to reproduce the COVID-19 dynamics in terms of hospital admissions for several European countries during 2020 over surprisingly long time scales. Also, it is capable of capturing the effects of disturbances (for example the emergence of new virus variants) and can be exploited for implementing control actions to limit such effects. A possible application, illustrated in this letter, consists of exploiting the estimations based on the data of one country, to predict and control the evolution in another country, where the virus spreading is still in an earlier phase. © 2017 IEEE.

Behavioral responses for facemask use messages to prevent COVID-19 among residents of Bahir Dar City, Ethiopia: an application of extended parallel process model.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic causes major morbidity and mortality in the world. Timely behavioral response assessment of the community is important to shape the next effective interventions and risk communication strategies to adopt preventive behavior. Hence, this study aimed to assess behavioral responses for facemask-use messages to prevent COVID-19 and its predictors among residents of Bahir Dar City, Ethiopia, 2021 by using the Extended Parallel Process Model.  METHODS: A community-based cross-sectional study was conducted with the guide of the Extended Parallel Process Model in Bahir Dar city from March 9 to April 9, 2021. A multistage sampling technique was used, and data was collected through a face-to-face interviewer-administered questionnaire using Epicollect5. Descriptive statistics and Binary logistic regression were computed using SPSS V.25. Variable with P < 0.25 in the bivariable analysis was a candidate for multivariable analysis to control confounding effect. In multivariable analysis, variables with P < 0.05 were considered statistically significant and the result was presented using an adjusted odd ratio (AOR) with a 95% confidence interval (CI). RESULTS: A total of 616 participants with a response rate of 97.1% were included. Of the total participants, 229(37.2%) were in the danger control response. The behavioral response was affected by Occupational status [AOR (95%CI) 3.53(1.67-7.46)], the number of people living together [AOR (95%CI) 2.62(1.28-5.39)], self-control [AOR (95%CI) 1.14(1.05-1.25)], a friend for the preferred source of information [AOR (95%CI) 5.18(3.22-8.33)] and printed materials for the preferred channel [AOR (95%CI) 2.14(1.35-3.43)]. CONCLUSION: Above one-third of the participants were in the danger control response. Occupational status, number of people living together, self-control, a friend for the preferred source of information, and printed materials for the preferred channel were independent predictors of resident behavioral response to the use of facemasks. Policymakers should consider students and people who live alone. Message developers should use a friendly person to transmit messages and should prepare printed materials. Activities and strategies should also focus on self-control and perceived efficacy without ignoring the perceived threat.

Quarantine and demographic characteristics as predictors of perceived stress and stress responses during the third year of COVID-19 in China.

Background: Quarantine as one of the most effective epidemic prevention measures, significantly increased people's stress levels. Ongoing monitoring of the stress status of people under quarantine during the pandemic is an important part of assessing the long-term impact of COVID-19 on mental health. This study aimed to gain a more comprehensive understanding of the stress status of people under quarantine, including perceived stress and stress responses, during the third year of the COVID-19 pandemic in China. Methods: An anonymous online survey was conducted among 464 participants from 39 cities in China from March 31 to April 12, 2022. The survey included three questionnaires: a self-designed questionnaire collecting demographic information and quarantine characteristics, the Perceived Stress Scale (PSS-10) and the Stress Response Questionnaire (SRQ). The t-test or one-way ANOVA or the Welch F-test were used to examine the differences among demographic and quarantine variables of perceived stress and stress responses, then multiple linear regressions were performed to identify the predictors of perceived stress and stress responses. Results: 428 valid respondents were finally included. The average scores of perceived stress, total stress response, emotional response, physical response, and behavioral response were 14.70 ± 7.02, 50.24 ± 22.48, 20.35 ± 9.99, 15.23 ± 7.25, and 11.39 ± 5.27, respectively. The regression analysis showed that the degree of financial worries and days of continuous quarantine were the predictors of perceived stress. The degree of financial worries was a vital factor in predicting total stress response, emotional response, physical response and behavioral response, and in predicting emotional response, age was also a significant predictor. Conclusion: The stress status of individuals under quarantine was generally stable but still needs further attention during the third year of the COVID-19 pandemic. People who are young, have a high degree of financial worries and have been quarantined for a long time may be at a higher risk of perceived stress and stress responses. Relevant authorities should pay closer attention to the risk groups, and additional support and assistance might be required for those mostly worried about their financial situations under quarantine.

Clear Roads and Dirty Air? Indirect effects of reduced private traffic congestion on emissions from heavy traffic

Traffic and transportation are a major source of CO2 emissions. As the volume of heavy goods vehicle (HGV) transportation is difficult to reduce, many governments target private traffic. Next to the direct effect of fewer private vehicles on the roads, an indirect effect may be very important: The less congestion, the more fuel-efficient the remaining drivers may be able to drive because there would be less need to speed up, brake, and maneuver, for example while overtaking. On the other hand, clear roads may be tempting for drivers to speed and thus result in a negative impact of less private traffic. The direction and size of this indirect effect is difficult to measure for two reasons: First, we usually have no real-time driving data from heavy trucks. Second, traffic density usually does not vary to a large extent. We set out to assess the margins of this indirect effect using a unique data set from a large German logistics fleet. We measured truck drivers’ driving behavior as well as emissions from their trucks between January and May 2020. During that time, the COVID-19-related policy measures led to a significant decline in private traffic on highways. We find that less private traffic volume results in improved fuel-efficient driving behavior, resulting in reduced overall CO2 emissions. The effect is u-shaped;too little private traffic density leads to less fuel-efficient driving by the remaining heavy goods vehicle drivers. Moreover, removing the worst drivers from the roads has the same effect in terms of magnitude as reducing private traffic congestion to the medium-density optimum.

Does Background Music Affect Silent Dining Emotions? An Empirical Study of Restaurants during COVID-19.

The music environment of a restaurant is an important factor that affects consumer behaviors during the dining experience, especially silent dining behaviors among people who are not encouraged to talk in the context of COVID-19. This study empirically analyzed the influence of consumers' background music preferences on their emotions and behavioral responses during their dining experience at a high-end Chinese restaurant. A total of 393 valid samples were obtained through purposive sampling and snowball sampling. The research tools used in this study included a personal background information questionnaire, four Oriental and Western music conditions, a background music preference scale, a scale for evaluating emotions during the dining experience, and a behavioral response scale. The results showed that the subjects preferred the Chinese classical music-the Butterfly Lovers&nbsp;Concerto. Background music affected the participants' emotions during their dining experience, and different background music conditions resulted in significant differences in emotions and behaviors. The consumers' emotions, during their dining experience significantly predicted their behaviors under all four music conditions. The greatest contribution and value of this study stem from the finding that the background music at a restaurant can arouse specific positive emotions in consumers during their dining experience and thus affect their eating behavior.

Assessment of perceived risk and precautionary behavior toward COVID-19 pandemic using the health belief model, Saudi Arabia.

BACKGROUND: The global threat of the COVID-19 pandemic continues to evolve forming the most impactful health crises in modern history, necessities of individuals adhering to mandatory behavior change that limits the spread of the pandemic. The purpose of the current study is to identify behavioral responses of the health sciences university students during the period of the COVID-19 pandemic and determine risk perceptions using the health belief model (HBM). METHODS: A cross-sectional study using an online survey distributed among health sciences female university students in Riyadh, KSA. The questionnaire was used to assess sociodemographic characteristics; knowledge about COVID-19 and its preventive measures, risk perceptions, and beliefs using the HBM; and their actual adoption of precautionary measures. RESULTS: The mean age of 286 respondents was 21.6 years (SD 2.5). They had good knowledge, positive risk perception, and good practice. Fifty-seven percent of the respondents adhere satisfactorily to COVID-19 precautionary behavior. Respondents with positive overall risk perception had around 6 times significantly higher adherence compared to those with negative risk perception. Perceived benefits have higher odds of adherence to COVID-19 precautionary behavior. Similarly, cues to action were a significant determinant of adherence to COVID-19 precautionary behavior. CONCLUSIONS: The constructs of the HBM provided good measurement of risk perception and the respondent students had good knowledge. Yet, significant gaps were shown between COVID-19 perceived risks and the students' actual practice of personal hygienic measures, particularly hand hygiene. To put an end to the present COVID-19 and its upcoming waves, it is highly recommended to direct COVID-19 training programs specifically tailored towards university students.

Stress Response on Behavioral Response of University Students During the Peak Period of COVID-19.

Background: This study aimed to explore the underlying mechanisms of the relationship between stress response and behavioral response and to develop a moderated mediation model with stress management and risk cognition. Methods: We developed 4 novel questionnaires, namely, stress response questionnaire, behavioral response questionnaire, stress management questionnaire, and risk cognition questionnaire. A total of 5896 university students in China were investigated during the peak period of the coronavirus disease 2019. Results: The results showed that stress response had a significant negative predictive effect on behavioral response (r = -0.489, P < .001). Moreover, stress management had a partial mediating effect between stress response and behavioral response. Risk cognition plays a moderating effect on the mediation model (ß = -0.109, P = .030), and the effect of high-risk cognition is more significant. Conclusion: During the coronavirus disease 2019 period, improving the risk awareness of university students will help to enhance the buffering effect of stress management on behavioral response and indirectly reduce their behavioral response.

Behavioral SIR models with incidence-based social-distancing

Most available behavioral epidemiology models have linked the behavioral responses of individuals to infection prevalence. However, this is a crude approximation of reality because prevalence is typically an unobserved quantity. This work considers a general endemic SIR epidemiological model where behavioral responses are incidence-based i.e., the agents perceptions of risks are based on available information on infection incidence. The differences of this modeling approach with respect to the standard ‘prevalence-based’ formulations are discussed and its dynamical implications are investigated. Both current and delayed behavioral responses are considered. We show that depending on the form of the ‘memory’ (i.e., in mathematical language, of the information delaying kernel), the endemic equilibrium can either be globally stable or destabilized via Hopf bifurcations yielding to stable recurrent oscillations. These oscillations can have a very long inter-epidemic periods and a very wide amplitude. Finally, a numerical investigation of the interplay between these behavior-related oscillations and seasonality of the contact rate reveals a strong synergic effect yielding to a dramatic amplification of oscillations. © 2021 Elsevier Ltd

Epidemic proximity and imitation dynamics drive infodemic waves during the COVID-19 pandemic

An infodemic - an outpouring of information, including misleading and also fake news - is accompanying the current pandemic caused by SARS-CoV-2. In the absence of valid therapeutic approaches, behavioral responses may seriously affect the social dynamics of contagion, so the infodemic may cause confusion and disorientation in the public, leading to possible individually and socially harmful choices. This new phenomenon requires specific modeling efforts to better understand the complex intertwining of the epidemic and infodemic components of a pandemic crisis, with a view to building an integrative public health approach. We propose three models, from epidemiology to game theory, as potential candidates for the onset of the infodemics and statistically assess their accuracy in reproducing real infodemic waves observed in a data set of 390 million tweets collected worldwide. Our results show that evolutionary game-theory models are the most suitable ones to reproduce the observed infodemic modulations around the onset of the local epidemic wave. Furthermore, we find that the number of confirmed COVID-19 reported cases in each country and worldwide are driving the modeling dynamics with opposite effects. © 2022 authors. Published by the American Physical Society.

Epidemic spreading in populations of mobile agents with adaptive behavioral response

Despite the advanced stage of epidemic modeling, there is a major demand for methods to incorporate behavioral responses to the spread of a disease, such as social distancing and adoption of prevention methods. Mobility plays an important role on epidemic dynamics and is also affected by behavioral changes, but there are many situations in which real mobility data is incomplete or inaccessible. We present a model for epidemic spreading in temporal networks of mobile agents that incorporates local behavioral responses. Susceptible agents are allowed to move towards the opposite direction of infected agents in their neighborhood. We show that this mechanism considerably decreases the stationary prevalence when the spatial density of agents is low. However, for higher densities, the mechanism causes an abrupt phase transition, where a new bistable phase appears. We develop a semi-analytic approach for the case when the mobility is fast compared to the disease dynamics, and use it to argue that the bistability is caused by the emergence of spatial clusters of susceptible agents. Finally, we characterize the temporal networks formed in the fast mobility regime, showing how the degree distributions and other metrics are affected by the behavioral mechanism. Our work incorporates results previously known from adaptive networks into population of mobile agents, which can be further developed to be used in mobility-driven models. © 2022

Mobility in China, 2020: a tale of four phases.

2020 was an unprecedented year, with rapid and drastic changes in human mobility due to the COVID-19 pandemic. To understand the variation in commuting patterns among the Chinese population across stable and unstable periods, we used nationwide mobility data from 318 million mobile phone users in China to examine the extreme fluctuations of population movements in 2020, ranging from the Lunar New Year travel season (chunyun), to the exceptional calm of COVID-19 lockdown, and then to the recovery period. We observed that cross-city movements, which increased substantially in chunyun and then dropped sharply during the lockdown, are primarily dependent on travel distance and the socio-economic development of cities. Following the Lunar New Year holiday, national mobility remained low until mid-February, and COVID-19 interventions delayed more than 72.89 million people returning to large cities. Mobility network analysis revealed clusters of highly connected cities, conforming to the social-economic division of urban agglomerations in China. While the mass migration back to large cities was delayed, smaller cities connected more densely to form new clusters. During the recovery period after travel restrictions were lifted, the netflows of over 55% city pairs reversed in direction compared to before the lockdown. These findings offer the most comprehensive picture of Chinese mobility at fine resolution across various scenarios in China and are of critical importance for decision making regarding future public-health-emergency response, transportation planning and regional economic development, among others.

Factors influencing the coping abilities in clinic nursing students under public health emergency (COVID-19): a cross-sectional study.

BACKGROUND: Public health emergencies are serious social problems, threatening people's lives, causing considerable economic losses, and related to all mankind life and health and safety. Nurses are essential in the fight against the public health emergency, corona virus disease 2019 (COVID-19). clinic nursing students are considered as backup health care providers for licensed nurses, the coping abilities and crisis management of nursing students at present deserve attention all around the world. METHODS: 2035 clinic nursing students were invited to participate in mobile phone app-based survey from Feb 6 to 20, 2020. The demographic items, psychological and behavioral responses, and the coping abilities were conducted. Multiple linear regression was used to identify the independent factors to clinic nursing students' coping abilities under COVID-19. RESULTS: 1992 submitted were valid. Multiple linear regression analysis showed that Confidence to overcome difficulties, Optimism, Active coping, Help seeking and Practice hospital as designated treatment unit were independently associated with the positive coping of clinic nursing students. Fear of COVID-19, Optimism, Avoidance, Help seeking and Severity of epidemic around were independently associated with the negative coping of clinic nursing students. CONCLUSION: Under COVID-19, nursing students' coping level is superior to the Chinese norm, which is also affected by many factors. As the most direct backup resources of professional nurses, the way clinic nursing students respond to public health emergencies and its influencing factors deserve attention.

State and trait anxiety among medical staff during the first month of COVID-19 pandemic: A sample from Turkey.

OBJECTIVES: During the COVID-19 pandemic, excessive workload, a rapidly changing workplace environment, the danger of carrying the virus and transmitting the disease to their families, relatives and those they live with creates stress for the medical workers. In our study, we aimed to evaluate the state and trait anxiety levels of healthcare professionals who encounter patients with suspected COVID-19 infection and related factors. METHOD: Data were collected from healthcare professionals working with patients diagnosed or suspected with COVID-19 via online self-report questionnaire between 9-19 April 2020. The state (STAI-S) and trait anxiety (STAI-T) scale was used to measure anxiety. RESULTS: A total of 291 healthcare professionals, 216 women and 75 men, participated in the study. Women's state and trait anxiety were significantly higher than men's. 11 participants without any lifetime psychiatric illness experienced psychiatric symptoms and consulted to a psychiatrist. The state anxiety of those who have children, nurses and those working in branches directly related to the pandemic (Infectious Diseases, Respiratory Diseases, Emergency Medicine, Internal Medicine, Radiology, Anesthesiology and Reanimation) was higher than others. The state anxiety of those who thought they were not protected with personal protective equipment and those who did not stay in their own home was higher than others. CONCLUSIONS: At the forefront of the fight against COVID-19, there are medical personnel who pay a serious psychological cost. Especially in terms of anxiety, we should pay attention to women, workers with children, nurses and people working in branches that are directly related to pandemics.

Public Psychosocial and Behavioral Responses in the First Wave of COVID-19 Pandemic: A Large Survey in China.

Background: The COVID-19 has grown into a global pandemic. This study investigated the public psychosocial and behavioral responses through different time periods of the pandemic, and assessed whether these changes are different in age, gender, and region. Methods: A three-phase survey was conducted through the DaDui Social Q&A Software for COVID-19. A total of 13,214 effective responses of COVID-19 were collected. Statistical analysis was performed based on their basic information and psychosocial responses. Results: The degree of attention, understanding, and cooperation with preventive and control measures of the disease increased and then decreased. The panic level gradually increased with the epidemic process. The degree of satisfaction with management measures and of confidence in defeating COVID-19 increased throughout the survey. Compared with residents in other areas, respondents from the COVID-19 epicenter (Wuhan) reported a higher degree of self-protection during the outbreak and a significantly lower degree of satisfaction with respect to government prevention and control measures during all phases. Shortages of medical supplies and low testing capacity were reported as the biggest shortcoming in the prevention and control strategies during COVID-19, and an abundance of disorderly and inaccurate information from different sources was the primary cause of panic. Conclusions and Relevance: Major public health events elicit psychosocial and behavioral changes that reflect the different phases of the biologic curve. Sufficient medical supplies and improved organization and accurate information during epidemics may reduce panic and improve compliance with requested changes in behavior. We need to recognize this natural phenomenon and our public policy preparedness should attempt to move the social/psychological curve to the left in order to minimize and flatten the biologic curve.

Psychological Distress, Early Behavioral Response, and Perception Toward the COVID-19 Pandemic Among Health Care Workers in North Shoa Zone, Oromiya Region.

Background: The coronavirus disease 2019 (COVID-19) pandemic has had a significant psychological impact on health care workers (HCWs). Therefore, this study inspects the mental health status, behavioral response, and perception among HCWs (nurses, physicians, and medical laboratory workers) during the COVID-19 pandemic in public health care facilities. Methods: A facilities-based cross-sectional study was conducted in July 2020. A simple random sampling technique was used to select study participants. Data were collected by self-report administered questionnaires using Patient Health Questionnaire-9 (PHQ-9) for depression, General Anxiety Disorder-7 (GAD-7) for anxiety, Insomnia Severity Index (ISI) for insomnia, Impact of Event Scale-Revised (IES-R) for psychological distress, Perceived Threat Scale for perception, and Behavioral Response Inquiry for the behavioral response. Moreover, bivariable and multivariable logistic regressions analysis was used to identify the association between dependent and independent variables at p-value <0.05. Results: A total of 417 (98.6%) HCWs responded to a self-administered questionnaire. The proportion of HCWs who had moderate to severe symptoms of psychological distress, depression, anxiety, and insomnia during the COVID-19 pandemic were 58, 16.3, 30.7, and 15.9%, respectively. Three-fifth of the nurses, medical laboratory professionals (62.2%), and physicians (59.2%) had reported good behavioral responses toward the COVID-19 pandemic. More than three-fifths of the nurses had reported poor perception toward the COVID-19 pandemic. Conversely, 61.2% of physicians and three-fourths (75.5%) of medical laboratory professionals had reported good perception toward the COVID-19 pandemic. Female and married participants, those working in the emergency unit, those with poor behavioral responses, and those with poor perception toward the COVID-19 pandemic were significantly associated with symptoms of psychological distress, depression, anxiety, and insomnia. Conclusions: Psychological impacts among physicians, nurses, and medical laboratory professionals are high during the COVID-19 pandemic. The Ethiopian Federal Ministry of Health should aim to protect all HCWs' psychological well-being during the COVID-19 pandemic with appropriate interventions and accurate information response.

Community Behavioral and Perceived Responses in the COVID-19 Outbreak in Afghanistan: A Cross-Sectional Study.

OBJECTIVE: Community responses are important for the management of early-phase outbreaks of coronavirus disease 2019 (COVID-19). Perceived susceptibility and severity are considered key elements that motivate people to adopt nonpharmaceutical interventions. This study aimed to (i) explore perceived susceptibility and severity of the COVID-19 pandemic, (ii) examine the practice of nonpharmaceutical interventions, and (iii) assess the potential association of perceived COVID-19 susceptibility and severity with the practice of nonpharmaceutical interventions among people living in Afghanistan. METHODS: A cross-sectional design was used, using online surveys disseminated from April to May 2020. Convenience sampling was used to recruit the participants of this study. The previously developed scales were used to assess the participants' demographic information, perceived risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and perceived severity of COVID-19. Multivariate analyses were conducted to assess the potential association of perceived COVID-19 susceptibility and severity with the practice of nonpharmaceutical interventions. RESULTS: The Internet was the main source for obtaining COVID-19 information among participants in this study. While 45.8% of the participants believed it was "very unlikely" for them to get infected with COVID-19, 76.7% perceived COVID-19 as a severe disease. Similarly, 37.5% believed the chance of being cured if infected with COVID-19 is "unlikely/very unlikely." The majority of participants (95.6%) perceived their health to be in "good" and "very good" status. Overall, 74.2% mentioned that they stopped visiting public places, 49.7% started using gloves, and 70.4% started wearing a mask. Participants who believed they have a low probability of survival if infected with COVID-19 were more likely to wear masks and practice hand washing. CONCLUSIONS: It appears that communities' psychological and behavioral responses were affected by the early phase of the COVID-19 pandemic in Afghanistan, especially among young Internet users. The findings gained from a timely behavioral assessment of the community might be useful to develop interventions and risk communication strategies in epidemics within and beyond COVID-19.

Health Communication, Knowledge, Perception and Behavioral Responses to COVID-19 Outbreak in Dessie, Kombolcha and Kemissie Towns, Amhara Region, Northeast Ethiopia: A Mixed-Method Study.

BACKGROUND: Despite the efforts made to mitigate the spread of COVID-19 in Ethiopia, new cases continue to rise. Therefore, to overcome the devastating effects of the outbreak, health communication and the community's knowledge, perception, and behavioral responses towards COVID-19 should be assessed. METHODS: A community-based cross-sectional study design was conducted from June 15 to July 30, 2020, with 827 and 18 participants for the quantitative and qualitative study, respectively. The data were collected using ODK collect and exported to SPSS version 25 for analysis. Multivariate logistic regression was computed, and variables that had a significant association were interpreted at p <0.05 with a 95% CI. Additionally, the qualitative data were collected using in-depth interview and then transcribed, translated, and analyzed using thematic content analysis. RESULTS: The majority (97.8%) of respondents obtained information about COVID-19 through broadcast media, and 58.5% of the participants had good knowledge of COVID-19. Likewise, 51.3%, 60.9%, 73.8%, 35.1%, and 74.2% of participants had high perceived susceptibility, severity, benefit, barrier, and self-efficacy to COVID-19, respectively. Additionally, 54.3% of respondents had good behavioral responses to COVID-19. Kombolcha town residents (AOR: 4.32, 95% CI, 2.02-9.2), aged from 25 to 34, and 35 to 44 years old (AOR: 2.62, 95% CI, 1.37-5.0), and (AOR: 2.23, 95% CI, 1.11-4.46), respectively, secondary or above education (AOR: 2.38, 95% CI, 1.17-4.86), good knowledge of COVID-19 (AOR: 2.07, 95% CI, 1.42-3.02), high perceived self-efficacy (AOR: 4.90, 95% CI, 3.10-7.75), and low perceived barriers (AOR: 3.17, 95% CI, 2.12-4.74) to COVID-19 preventive measures were significantly associated with the behavioral responses to COVID-19. CONCLUSION: In this study, the behavioral responses to COVID-19 were relatively low. Therefore, continuous awareness creation is needed to scale up the community's knowledge and perceived self-efficacy. Furthermore, the general public, especially young people, should follow the government's COVID-19 prevention and control rules and regulations.

Perceived Beliefs, Uncertainty, and Behavioral Responses During the COVID-19 Outbreak in China: Findings From a Convenience Sample.

PURPOSE: To investigate perceived beliefs, uncertainty, and behavioral responses among Chinese residents toward the COVID-19 outbreak, and explore their relationships amid an incipient pandemic. DESIGN: A cross-sectional correlational survey with a combination of a convenience and snowball sampling design. SETTING: This study was conducted online from February 7 to 14, 2020, the third week after the lockdown of Wuhan city on January 23. PARTICIPANTS: A total of 2,654 residents was contacted, 2,534 agreed to participate, and 2,215 completed valid questionnaires. The sample covered 30 provinces, municipalities, autonomous regions of China, and a broader region. MEASURES: The Uncertainty About COVID-19 Scale was applied to assess perceived public uncertainty. Five dimensions of health beliefs about COVID-19 and 12 health-related response behaviors were measured. ANALYSIS: Univariate analysis and multiple linear regression models were used to identify associations. Mediation was assessed by a bootstrapping technique. RESULTS: Five constructs of health beliefs were found to be significant predictors of multiple response behaviors. Uncertainty about COVID-19 has a direct relationship with general response behaviors (ß=-0.119**) and sanitization practices (ß=-0.068**). Emergency coping behaviors aside, uncertainty also partially mediated associations between perceived susceptibility, perceived effectiveness, and perceived barriers influencing general response behaviors and sanitization practices, respectively. CONCLUSION: Findings provide evidence-based information to government and policymakers for designing effective health communication messages and intervention strategies by targeting the key constructs of the health belief model and reducing perceived uncertainty about COVID-19. They support public health-related response behaviors to prevent COVID-19 spread among the population.