Longitudinal study of theory-based predictors of COVID-19 vaccination.

Efforts to mitigate the impact of COVID-19 now focus primarily on encouraging vaccination. These efforts have been hampered, however, by vaccine hesitancy. A better understanding of the factors associated with vaccination may help identify those most likely to experience hesitancy and inform the content of public health outreach efforts. The aims of this study were to evaluate whether two theory-based factors (perceived vaccine efficacy and vaccination intention) and political party affiliation were associated with vaccination in the United States (US) and to provide descriptive analysis of factors shaping vaccination decisions. A longitudinal online survey was conducted with 108 adults in the US. Participants completed surveys in July 2020 (Time 1) and October 2021 (Time 2). As hypothesized, greater vaccination intention and perceived vaccine efficacy were significant predictors of vaccine uptake. The second hypothesis was also supported as political party affiliation was associated with vaccination (i.e. Democrats were more likely to vaccinate than Republicans). Descriptive data indicated that vaccinated participants (including those reluctant to vaccinate at Time 1) had been motivated by a desire to protect themselves and others from COVID-19. Participants who had chosen not to vaccinate were influenced by a variety of factors including concerns about vaccine safety and efficacy. Understanding the predictors of vaccination is critical to identifying those unlikely to vaccinate and creating effective interventions to encourage the uptake of this essential public health strategy. Messaging should emphasize the efficacy of COVID-19 vaccines and be delivered by those seen as trustworthy in communities prone to vaccine hesitancy.

The roles of risk perception, negative emotions and perceived efficacy in the association between COVID-19 infection cues and preventive behaviors: a moderated mediation model.

Preventive behaviors during the COVID-19 pandemic are especially critical to the protection of individuals whose family members or acquaintances have been infected. However, limited research has explored the influence of infection cues on preventive behaviors. This study proposed an interaction model of environment-cognitive/affective-behavior to elucidate the mechanism by which infection cues influence preventive behaviors and the roles of risk perception, negative emotions, and perceived efficacy in that influence. To explore the relationships among these factors, we conducted a cross-sectional online survey in 34 provinces in China during the first wave of the COVID-19 pandemic. A total of 26,511 participants responded to the survey, and 20,205 valid responses (76.2%) were obtained for further analysis. The moderated mediation results show that infection cues positively predicted preventive behaviors in a manner mediated by risk perception and negative emotions. Moreover, perceived efficacy moderated the influence of infection cues not only on preventive behaviors but also on risk perception and negative emotions. The higher the perceived efficacy, the stronger these influences were. These findings validated our model, which elucidates the mechanisms underlying the promoting effect of infection cues on preventive behaviors during the initial stage of the COVID-19 pandemic. The implications of these results for the COVID-19 pandemic and beyond are discussed.

The mechanism of governments' and individuals' influence on protective behaviours during the second wave of COVID-19: a multiple mediation model.

Background: The SARS-CoV-2 virus continues to spread and resurge globally with signs of a second wave, despite actions by governments to curb the COVID-19 pandemic. However, evidence-based strategies to combat COVID-19 recurrence are poorly documented. Objective: To reveal how governments and individuals should act to effectively cope with future waves, this study proposed a preventive model of COVID-19 resurgence. Method: A questionnaire survey was conducted among 1,137 residents of Beijing, where the epidemic reoccurred. Structural equation model was used to explore the mechanism among government intervention, perceived efficacy, positive emotions, posttraumatic growth (PTG) and protective behaviours. Results: Data analysis revealed that during COVID-19 resurgence, government intervention could directly and indirectly influence protective behaviours through individual factors (i.e. perceived efficacy, positive emotions), and PTG could mediate the indirect pathway to protective behaviours. Conclusions: These findings implied that government intervention needs to be integrated with individual factors to effectively control repeated COVID-19 outbreaks.

Antecedentes: El virus SARS-CoV-2 continúa propagándose y resurgiendo a nivel mundial con signos de una segunda ola, a pesar de las acciones de los gobiernos para frenar la pandemia de COVID-19. Sin embargo, las estrategias basadas en evidencia para combatir la recurrencia de COVID-19 están pobremente documentadas.Objetivo: Para revelar cómo deben actuar los gobiernos y las personas para hacer frente de manera efectiva a futuras olas, este estudio propuso un modelo preventivo del resurgimiento de COVID-19.Método: Se realizó una encuesta entre 1.137 residentes de Beijing, donde la epidemia volvió a ocurrir. Se utilizó un modelo de ecuación estructural para explorar el mecanismo entre la intervención del gobierno, la eficacia percibida, las emociones positivas, el crecimiento postraumático (CPT) y las conductas protectoras.Resultados: El análisis de datos reveló que durante el resurgimiento de COVID-19, la intervención del gobierno podría influir directa e indirectamente en los comportamientos de protección a través de factores individuales (es decir, eficacia percibida, emociones positivas), y CPT podría mediar en el camino indirecto hacia los comportamientos de protección.Conclusiones: Estos hallazgos implicaron que la intervención del gobierno debe integrarse con factores individuales para controlar de manera efectiva los brotes repetidos de COVID-19.

Exploring the Psychological Mechanism Underlying the Effect of COVID-19 Information Exposure via Digital Media on COVID-19 Preventive Behavioral Intention1

Despite the increasing use of digital media and their powerful impact on risk management during recent outbreaks of emerging infectious diseases, the question of how digital media exposure influences preventive behaviors has not been fully explained. Using the appraisal tendency framework and protection motivation theory as theoretical frameworks, we theorized the affective and cognitive mechanisms under which the differential roles of three negative emotions (fear, anger, worry) on two cognitive appraisals (perceived threat and perceived efficacy) were examined. Based on data collected from a survey of 1,500 South Koreans during the COVID-19 pandemic, we found that while worry and anger increased perceived efficacy, fear reduced perceived efficacy. The results also showed that although exposure to COVID-19 information via digital formats increased preventive behavioral intention in general, digital media use for COVID-19 information had a negative influence on preventive behavioral intention through the sequential mediation of fear and perceived efficacy. © 2022, Center for Asian Public Opinion Research and Collaboration Initiative. All rights reserved.

What Prompted the Adoption of Self-Protective Behaviors in Response to COVID-19? Evidence From Women Living in the Rural Areas of Western China.

Background: Self-protective behaviors, such as handwashing and mask-wearing, are effective to reduce the spread of coronavirus disease (COVID-19), but few studies have focused on women living in rural areas who bear the brunt of the impacts of the pandemic due to their economic and social vulnerabilities. This study explores what prompted the adoption of self-protective behaviors in response to COVID-19 among women living in rural areas of western China. Methods: The study sample consisted of 1,524 women from 116 townships across 10 counties in rural western China. We collected data in May and August 2020 on women's socioeconomic characteristics, exposure to COVID-19-related information, psychological response to COVID-19, and adoption of self-protective behaviors. Structural equation modeling (SEM) analyses were conducted to analyze the relations among the variables. Results: During the lockdown, 1,221 (80.12%) of the 1,524 women in the study sample reported wearing a mask every time when they went outside and 1,021 (66.99%) reported handwashing with soap every time after they came home. Perceived efficacy had the strongest association with self-protective behaviors (ß = 0.38; p < 0.001). Receiving public health guidance (ß = 0.18; p < 0.001) was indirectly associated with more self-protective behaviors via greater perceived efficacy. Higher socioeconomic status was also directly associated with increased adoption of self-protective behaviors (ß = 0.24; p < 0.001). Other variables, such as receiving surveillance and risk information, communication channels, perceived risks, and fear, were indirectly associated with the adoption of self-protective behaviors with smaller effect sizes (all ß were lower than 0.10). Conclusions: Not all women were able to adopt self-protective behaviors, such as mask-wearing and handwashing, during the COVID-19 pandemic in western China. To further encourage behavioral changes in response to public health crises, the government should develop clear and actionable guidelines and adopt targeted health communication strategies to reach the most disadvantaged groups of society. These findings may inform tailored responses to COVID-19 in other low- and middle-income countries.

What makes people intend to take protective measures against influenza? Perceived risk, efficacy, or trust in authorities.

BACKGROUND: Influenza outbreaks occur annually across the world, causing a global health challenge. This study aims to explore the association between risk perception (perceived severity and perceived probability), perceived efficacy (individual's efficacy and government's efficacy), trust in authorities, and intention to implement influenza protective behaviors. METHODS: The data (N = 1,372) used in this paper comes from the 2013 Taiwan Social Change Survey dataset. Six intentions of protective behaviors (getting vaccinated, wearing a mask, washing hands, avoiding going to public settings, sanitizing home, and eating nutritional supplements) were investigated. Tobit and ordered logistic regressions were used to conduct data analysis. RESULTS: Respondents were most inclined to washing hands, followed by wearing a mask, avoiding going to public settings, getting vaccine, sanitizing their homes, and eating nutritional supplements. Perceived severity and individual's efficacy were positively correlated with all 6 behavioral intentions. Trust in authorities has positive effect on all the protective behaviors except sanitizing home. Moreover, perceived probability has positive relationships with overall intention, intention to wear mask, and intention to wash hands. Government's efficacy was only positively correlated with eating nutritional supplements. CONCLUSIONS: Perceived severity and perceived response efficacy towards flu, as well as trust in authorities were relatively important factors in motivating people's intention to adopt influenza protective behaviors.

Intolerance of COVID-19-Related Uncertainty and Negative Emotions among Chinese Adolescents: A Moderated Mediation Model of Risk Perception, Social Exclusion and Perceived Efficacy.

The uncertainty caused by the COVID-19 pandemic has exacerbated negative emotions, especially among adolescents, who feel unable to tolerate the uncertainty of the epidemic. However, the mechanism by which the intolerance of COVID-19-related uncertainty (COVID-19 IU) affects negative emotions in adolescents remains unclear. This study explored the underlying mechanism from COVID-19 IU to negative emotions using a moderated mediation model in adolescents. In total, 3037 teenagers completed a cross-sectional survey including measures of COVID-19 IU, risk perception, social exclusion, perceived efficacy, and negative emotions. The results showed that COVID-19 IU positively predicted negative emotions and that risk perception and social exclusion mediated this relationship. In addition, both the direct effect of COVID-19 IU on negative emotions and the mediating effect of risk perception on this relationship were moderated by perceived efficacy; in particular, COVID-19 IU had a greater impact on negative emotions among adolescents with lower levels of perceived efficacy. These findings suggest that COVID-19 IU is closely associated with negative emotions among adolescents and that effective measures should be taken to enable adolescents to improve their perceived efficacy and develop a reasonable perception of risk, help them eliminate the stigma of the disease, and strengthen their connections with society.

Disease Prevention Behavior During the COVID-19 Pandemic and the Role of Self-Esteem: An Extended Parallel Process Model.

OBJECTIVE: The COVID-19 outbreak has become a serious public health problem worldwide. The purpose of this study was to use an extended parallel process model (EPPM) to understand factors in COVID-19 prevention behaviors. METHODS: This cross-sectional and analytical study was conducted on 1012 participants in Taiwan. A structured questionnaire and an online survey were used to collect data. RESULTS: The EPPM revealed that the severity of the COVID-19 threat perceived by respondents directly affected the arousal of fear in the respondents (ß=0.268, t=9.007, p<0.001), but perceived efficacy did not (ß=-0.019, t=-0.619, p>0.05); additionally, fear arousal was significantly associated with COVID-19 prevention behaviors (ß=0.119, t=4.603, p<0.001). Regarding personal characteristics, self-esteem moderated the relationship between perceived threat and fear arousal. However, the moderating effect of self-esteem was stronger in people with low self-esteem compared to those with high self-esteem (ß=0.606, -0.472; t=26.303, -17.694; p<0.001, p<0.001; respectively). The results of this study also indicated that two demographic characteristics (age and gender) affect COVID-19 prevention behaviors. CONCLUSION: When developing healthcare policies and community interventions for improving COVID-19 prevention behaviors during an outbreak, healthcare administrators should carefully consider the main constructs of the EPPM, particularly personal characteristics (ie, self-esteem) and demographic characteristics (ie, age and gender).

Intention to Receive the COVID-19 Vaccination in China: Application of the Diffusion of Innovations Theory and the Moderating Role of Openness to Experience.

COVID-19 has caused a devastating impact on public health and made the development of the COVID-19 vaccination a top priority. Herd immunity through vaccination requires a sufficient number of the population to be vaccinated. Research on factors that promote intention to receive the COVID-19 vaccination is warranted. Based on Diffusion of Innovations Theory, this study examines the association between the perceived efficacy of the COVID-19 vaccination, use of social media for COVID-19 vaccine-related information, openness to experience and descriptive norm with the intention to receive the COVID-19 vaccination, and the moderating role of openness to experience among 6922 university students in mainland China. The intention to receive the free and self-paid COVID-19 vaccination is 78.9% and 60.2%, respectively. Results from path analyses show that perceived efficacy of the COVID-19 vaccination, use of social media for COVID-19 vaccine-related information, and openness to experience and descriptive norm are all positively associated with the intention to receive COVID-19 free and self-paid vaccination. The association between the perceived efficacy of the COVID-19 vaccination and descriptive norm with the intention to receive the COVID-19 vaccination is stronger among those with a lower level of openness to experience. Our findings support the usefulness of Diffusion of Innovations Theory and the moderating role of openness of experience in explaining intention to receive the COVID-19 vaccination.

Personality and perceived stress during COVID-19 pandemic: Testing the mediating role of perceived threat and efficacy.

Prolonged stress is associated with poor physical and mental health outcomes. Understanding the mediators between personality and stress is critical for developing effective stress management interventions during a pandemic. Our study explored whether perceptions of threat from COVID-19 and efficacy to follow government recommendations for preventing COVID-19 would mediate the relationships between personality traits (e.g., neuroticism, conscientiousness-goal-striving, extroversion-activity and sociability) and perceived stress. In an online survey of a representative sample of Canadian adults (n = 1055), we found that higher neuroticism and extroversion were associated with higher levels of stress during the pandemic and a greater increase in stress levels compared to levels before the pandemic. Perceived threat and efficacy significantly mediated the relationship between neuroticism and stress, which suggested that individuals with higher neuroticism experienced higher levels of stress due to higher levels of perceived threat and lower levels of efficacy. Perceived threat did not mediate the relationship between extroverts and stress, which suggested that the source of stress may stem from elsewhere (e.g., inability to socialize). Our findings highlighted that personality traits could be an important factor in identifying stress-prone individuals during a pandemic and that stress management interventions need to be personality specific.