COVID-19 Vaccine Hesitancy: Disadvantaged Groups' Experience with Perceived Barriers, Cues to Action, and Attitudes.

PURPOSE: Drawing from the Health Belief Model, we explored how disadvantaged groups in the U.S., including Black, Hispanic, less educated and wealthy individuals, experienced perceived barriers and cues to action in the context of the COVID-19 vaccination. DESIGN: A cross-sectional survey administered in March 2021. SETTING: USA. SUBJECTS: A national sample of U.S. residents (n = 795) recruited from Prolific. MEASURES: Perceived barriers (clinical, access, trust, religion/spiritual), cues to action (authorities, social circles), attitudes toward COVID-19 vaccination. ANALYSIS: Factor analysis and Structural Equation Model (SEM) were performed in STATA 16. RESULTS: Black and less educated individuals experienced higher clinical barriers (CI [.012, .33]; CI [.027, .10]), trust barriers (CI [.49, .92]; CI [.057, .16]), and religious/spiritual barriers (CI [.28, .66]; CI [.026, .11]). Hispanics experienced lower levels of clinical barriers (CI [-.42, .0001]). Clinical, trust, and religious/spiritual barriers were negatively related to attitudes toward vaccination (CI [-.45, -.15]; CI [-.79, -.51]; CI [-.43, -.13]). Black and less educated individuals experienced fewer cues to action by authority (CI [-.47, -.083]; CI [-.093, -.002]) and social ties (CI [-.75, -.33]; CI [-.18, -.080]). Lower-income individuals experienced fewer cues to action by social ties (CI [-.097, -.032]). Cues from social ties were positively associated with vaccination attitudes (CI [.065, .26]). CONCLUSION: Communication should be personalized to address perceived barriers disadvantaged groups differentially experience and use sources who exert influences on these groups.

Humor in the age of coronavirus: A recapitulation and a call to action

This article discusses the special issue of Humor: International Journal of Humor Research. This special issue reflects numerous opportunities presented by the pandemic for research spanning different cultures, outcomes, and disciplines/methodologies. The studies presented in this special issue include populations and material from the United States, the United Kingdom, the Netherlands, Poland, Belarus, Australia, and Israel. These articles examine humor in the form of memes, late-night comedy, and other media messages. In addition to instances of humor, the role of sense of humor was also discussed. The humor was discussed in various disciplines such as psychology, linguistics, communication studies, and folklore, and employs the many methods that accompany those disciplines. Currently, the research team is working to make this enormous data set available to interested researchers to explore the wealth of research questions, new and old, that can be addressed with this unprecedented global exchange of humor. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Preventive Health Behaviours among Adolescents and Their Parents during the COVID-19 Outbreak in the Light of the Health Beliefs Model.

This article analysed the relationship between the preventive health behaviours of parents and teenagers during the COVID-19 outbreak, taking the Health Beliefs Model (HBM) as a point of reference. We assumed that parents' behaviours may be a cue to action for adolescents, looking at their preventive health behaviours regarding vaccination against COVID-19, as well as vaccination intention (among unvaccinated people); wearing protective masks where it is compulsory and where it is not obligatory; and maintaining physical distance and disinfecting hands in public places. The collected data were statistically analysed using the Statistica version 13.3 software package for advanced statistical data analysis. Descriptive statistics and correlation for non-parametric data (Spearman's correlation) were used. Research on a sample of 201 parents and their children revealed that young people engage in preventive behaviour less frequently than parents, but that the likelihood of such behaviour increases if they have a parent's cue to action. When formulating recommendations, we considered the gender of the surveyed parents, as the questionnaire was mainly completed by women, which may be an indicator of the unequal involvement in addressing the topic of the pandemic and preventive health behaviours, including attitudes towards vaccines.

THE IMPLEMENTATION GAP IN EMERGING DISEASE RISK MANAGEMENT IN THE WILDLIFE TRADE.

The wildlife trade has been characterized as one of the biggest risk factors in the emergence of new infectious diseases. In the shadow of COVID-19, there is growing political and scientific urgency to manage this risk. Existing studies and experiences make it clear that something must be done but are less clear on how to get it done. It is a quite different task to accumulate evidence on the presence of pathogens, their locations in the supply chain, and their spillover to new hosts than to identify effective ways to prevent and mitigate emerging disease under real-world conditions. This study sought peer-reviewed evidence on the effectiveness, acceptability, feasibility, and sustainability of risk reduction interventions for zoonotic and nonzoonotic disease emergence in the wildlife trade. An environmental scan triangulated information from a scoping review following a Preferred Reporting Items for Systematic Reviews and Meta-analysis extension for scoping review protocol, two narrative literature reviews, and key informant interviews of 26 international wildlife health experts. Existing literature has been inattentive to program implementation or evaluation studies. There was insufficient evidence to identify effective and sustainable risk management actions. Studies on the effects of social, epidemiologic, and ecologic context on intervention success was lacking, as was research using a complex systems perspective. The lack of systematic program evaluations or implementation studies leaves decision makers with insufficient evidence to select interventions likely to be acceptable, effective, and sustainable within and across the disparate context of the wildlife trade. This necessitates adaptive risk management and innovations in program implementation and evaluation to ensure evidence-based risk management.

Self-care behavior prevention of COVID-19 in the general population based on Pender Health Promotion Model: A cross-sectional study.

Background and Aims: Coronavirus with its sudden and widespread outbreak has obviously imposed devastating consequences in various aspects of human life. The purpose of this study was to determine the predictive value of Pender's Health Promotion Model (HPM) structures in self-care preventive behavior against coronavirus disease 2019 (COVID-19) among the general population of Ardabil, Iran. Methods: The present retrospective descriptive-correlational study was conducted on citizens of Ardabil aged 18 years and over in 2021. After dividing the city of Ardabil into four parts, 50 people from each area of the city and a total of 200 people were selected through the available sampling method through social media. Data collection tools included a demographic profile, perceived self-efficacy scale, perceived emotional questionnaire, perceived social support questionnaire, perceived benefits and barriers questionnaire, researcher-made COVID-19 self-care questionnaire, and commitment to action questionnaire based on Pender's HPM structures in an online manner. Data were analyzed by Amos 22 software and using structural equation modeling. Results: According to the results, direct path analysis to COVID-19 self-care behavior indicated that the variables of perceived self-efficacy (ß = 0.18, p < 0.01), interpersonal effects (ß = 0.19, p < 0.01), positive emotion (ß = 0.15, p < 0.05) and perceived benefits (ß = 0.20, p < 0.01) are able to significantly predict self-care behaviors. Moreover, the bootstrapping test results in the indirect path analysis demonstrated that the variables of perceived self-efficacy (95% confidence interval [CI], 0.012, 0.066), perceived social support (95% CI, 0.002, 0.026), and perceived barriers (95% CI, -0.019, -0.002) and benefits (95% CI, 0.001, 0. 015) through the mediator variable of commitment to action are able to significantly predict COVID-19 self-care behavior. Conclusions: Based on the findings of the present study, it can be claimed that the proposed model of COVID-19 self-care behavior has an acceptable fitness in the general population. This model can be used in developing educational programs and intervention techniques to modify people's attitudes and behaviors.

Panic Purchasing: Food Hoarding in a City under Lockdown during the COVID-19 Pandemic

This research aimed to investigate the determinants of panic purchasing to hoard food in Ho Chi Minh City during the lockdown caused by the COVID-19 pandemic. Pragma-tism and the deduction approach were used for the research. During the lockdown period in Ho Chi Minh City, the purposive sampling technique was the first method used to reach the popula- tion that needed to be measured. Then, simple sampling was the second technique to collect data in the city in July and August 2021. Data were collected from 584 participants-higher than the required minimum sample size-who fulfilled the essential criteria to be included in the sample's population. Multi-quantitative methods, including descriptive statistics, reliability tests for items, exploratory factor analysis, and linear regression analysis, were used to analyze the data obtained. The main findings are that perceived scarcity, susceptibility, severity, cues to action, and self -ef- ficacy impacted panic purchasing to hoard foods. The results of this study are compared to the literature review in order to discuss panic buying behaviour, and recommendations are offered to policymakers and researchers in the future.

COVID-19 Vaccination Acceptance in the Context of the Health Belief Model: Comparative Cross-Sectional Study in Punjab, Pakistan.

One of the models that could be used to understand the adoption of vaccine uptake is the Health Belief Model (HBM). The aim of this study is to assess the role of HBM constructs and Perceived Health Status (PHS) on the vaccination status of individuals and to understand the role of socio-demographic variables on HBM scoring. A comparative cross-sectional telephone survey was conducted among 1325 vaccinated (60.0%) and non-vaccinated (40.0%) individuals aged 40 years and above in July 2021 in Punjab province, Pakistan. A higher level of education was the strongest predictor of positive HBM. All constructs of HBM, PHS and cues-to-action were significant predictors of COVID-19 vaccination uptake, with perceived benefits as the strongest predictor. In order to expand the vaccination coverage, double-pronged interventions utilizing both information and communication technology and human resources should be designed that address each barrier perceived by individuals and understandably communicate the benefits of COVID-19 vaccination to the broader population.

The Health Belief Model Applied to COVID-19 Vaccine Hesitancy: A Systematic Review.

This study systematically analyzes the research that used the Health Belief Model (HBM) as a theoretical basis to examine the influence of HBM constructs on COVID-19 vaccine hesitancy. Following PRISMA guidelines, PubMed, Web of Science, Google Scholar, and Scopus were searched for quantitative studies. Sixteen studies with 30,242 participants met inclusion criteria. The prevalence of COVID-19 vaccine hesitancy was 33.23% (95% CI 24.71-41.39%). Perceived barriers and perceived benefits were the most common HBM constructs that were significantly associated with vaccine hesitancy. While perceived benefits was inversely associated, a positive association was found between perceived barriers and vaccine hesitancy. Other HBM constructs that were frequently examined and inversely associated were perceived susceptibility, cues to action, perceived severity, and self-efficacy. The most common HBM modifying factor that was directly associated with COVID-19 vaccine hesitancy was gender, followed by education, age, geographical locations, occupation, income, employment, marital status, race, and ethnicity; however, a few studies report inconsistent results. Other modifying variables that influenced vaccine hesitancy were knowledge of COVID-19, prior diagnosis of COVID-19, history of flu vaccination, religion, nationality, and political affiliation. The results show that HBM is useful in predicting COVID-19 vaccine hesitancy.

Using Health Belief Model for predicting COVID-19 prevention practices among university student and staff

Large-scale social restriction (PSBB-Pembatasan Sosial Berkala Besar) is a policy aimed at reducing the spread of coronavirus disease 2019 (COVID-19). The purpose of this study was to determine the respondents' compliance behaviors towards the PSBB regulations according to the Health Belief Model. This cross-sectional study was conducted at a private university in Jakarta using quantitative methods. Data collection was carried out on July 2020, where 116 respondents were selected and recruited in the study using convenience non-probability sampling. Online self-administered questionnaire was used to collect data. The independent variables were adopted from Health Belief Model theory. These included;perceived susceptibility, perceived severity, health motivation, perceived benefit, perceived barrier and cues to action. The dependent variable was COVID-19 prevention behavior. Results showed that variables of health motivation (p-value=0.001), perceived benefits (p-value=0.008), and perceived barriers (p-value=0.007), advertising (p-value=0.027), counseling (p-value=0.001), and media access (p-value=0.000) had significant effects on the respondents' compliance to COVID-19 prevention behaviors. Multivariate analysis showed significant association of health motivation and perceived benefits with COVID-19 prevention behavior. An intervention is required to improve the community’s perception and belief towards the benefits and effectiveness of COVID-19 prevention behavior in preventing the COVID-19 pandemic. © 2022, Intelektual Pustaka Media Utama. All rights reserved.

Bridging the Inferential Gaps in Healthcare

Inferential gaps are the combined effect of reading-to-cognition gaps as well as the knowledge-to-action gaps. Misdiagnoses, medical errors, prescription errors, surgical errors, under-treatments, over-treatments, unnecessary lab tests, etc. – are all caused by inferential gaps. Late diagnosis of cancer is also due to the inferential gaps at the primary care. Even the medical climate crisis caused by misuse, underuse, or overuse of antibiotics are the result of serious inferential gaps. Electronic health records (EHR) had some success in mitigating the wrong site, wrong side, wrong procedure, wrong person (WSWP) errors, and the general medical errors;however, these errors continue to be quite significant. In the last few decades the disease demography has changed from quick onset infectious diseases to slow onset non-communicable diseases (NCD). This changed the healthcare sector in terms of both training and practice. In 2020 the COVID-19 pandemic disrupted the entire healthcare system further with change in focus from NCD back to quick onset infectious disease. During COVID-19 pandemic misinformation in social media increased. In addition, COVID-19 made virtual healthcare a preferred mode of patient-physician encounter. Virtual healthcare requires higher level of audit, accuracy, and technology reliance. All these events in medical practice widened the inferential gaps further. In this position paper, we propose an architecture of digital health combined with artificial intelligence that can mitigate these challenges and increase patient safety in the post-COVID healthcare delivery. We propose this architecture in conjunction with diseasomics, patholomics, resistomics, oncolomics, allergomics, and drugomics machine interpretable knowledge graphs that will minimize the inferential gaps. Unless we pay our attention to this critical issue immediately, medical ecosystem crisis that includes medical errors, caregiver shortage, misinformation, and the inferential gaps will become the second, if not the first leading cause of death by 2050. © 2021, Springer Nature Switzerland AG.

Suicide attempts among college students hospitalized for COVID-19.

BACKGROUND: Suicide is the second leading cause of death among U.S. college students. Past pandemics have been linked to increases in suicide risk, but little is known about how suicide risk relates to COVID-19 symptoms or hospitalizations. METHODS: We analyzed data from the Fall cohort of the 2020-2021 Healthy Minds Study, a cross-sectional, web-based survey of undergraduate and graduate students in the U.S. (N = 16,315). Logistic regression was used to test for associations between COVID-19 infections, hospitalizations, and symptoms severity, and suicide-related outcomes. RESULTS: Suicidal ideation was reported by n = 2190 (13.4%), plans by n = 885 (5.4%), and attempts by n = 209 (1.3%). The prevalence of each suicide-related outcome measure was greater among those reporting COVID-19 symptoms/diagnosis and among those with greater COVID-19 symptom severity, with a drastically greater prevalence of suicide attempts among those who were hospitalized for COVID-19, odds ratio (95% confidence interval) = 9.43 (3.87-22.95). Among respondents with suicidal ideation, 53.8% of those hospitalized for COVID-19 also made a suicide attempt, compared to 8.9% of non-infected respondents with past-year ideation. LIMITATIONS: Limitations include the use of cross-sectional data and retrospective self-report measures, which may be subject to recall biases. The response rate was low but typical of online surveys conducted during the COVID-19 pandemic. CONCLUSIONS: Hospitalization for COVID-19 may be an underestimated risk factor for suicide attempts. While mechanisms remain unclear, these data suggest that college students hospitalized for COVID should be screened for suicidal thoughts and behaviors subsequent to discharge, particularly if they have pre-existing suicidal ideation.

Perceived Benefits Matter the Most in COVID-19 Preventive Behaviors: Empirical Evidence from Okara District, Pakistan.

The 2019 coronavirus disease (COVID-19), caused by the SARS-CoV-2 virus has affected the social determinants of health, worsening health inequities and deteriorating healthcare capacities around the globe. The objective of this study is to investigate the COVID-19 prevention behaviors within the framework of the Health Belief Model in the city of Depalpur in the Okara District of Pakistan in May 2020. Using an observational, cross-sectional, and quantitative study design, a face-to-face field survey was conducted during the epidemic of COVID-19 in district Okara, Pakistan. A sample of 500 adults was selected from the city of Depalpur the in Okara district of Pakistan, using a two-stage sampling design with cluster sampling in stage one and systematic random sampling at stage two. A COVID-19 prevention behavior scale was computed based on twelve dichotomous items. Descriptive statistics, analysis of variance (ANOVA), and negative binomial regression analyses were performed. The most common prevention behavior among study participants was avoiding going for walks in the parks (81.0%), followed by not leaving home during the lockdown (72.6%), and washing hands every day with soap and water for 20 s after going out of their home (64.0%). Fewer people exhibited prevention behaviors such as social distancing (e.g., staying at least six feet away from other people) which in the EU was recommended to be a minimum of 1.5-2 m (44.4%) and following all of the basic protective measures (e.g., hand washing, use of a face covering in public, social distancing) in order to protect against COVID-19 (33.0%). The results from the negative binomial regression analysis showed that after controlling for the other HBM constructs and sociodemographic factors, only the perceived benefits of preventative actions showed significant association with the prevention behavior scale (IRR, 1.16; CI, 1.061-1.276; p < 0.001). The study findings show that public health interventions attempting to control the spread of COVID-19 in Pakistan may want to affect a change in people's perceived benefits of preventative actions through mass awareness-raising campaigns.

Tracking Environmental and Health Disparities to Strengthen Resilience Before the Next Crisis.

The COVID-19 pandemic has underscored how underlying disparities in environmental and health conditions exacerbate vulnerability during public health emergencies in low-income and communities of color. Neglected epidemics-high rates of pollution, chronic disease, and racial and socioeconomic health disparities-have continued amid persistent systemic racism and declining investment in public health. Recognized too late due to shortcomings in public health data tracking, COVID-19 has surged through vulnerable communities. Improved public health tracking is critical for informing the country's recovery from COVID-19, and it can be leveraged to measure and reduce health disparities and strengthen community resilience to respond more effectively to the next public health crisis. We emphasize how public health tracking agencies can engage communities in data collection and reporting; we also discuss the complementary role that communities can take to mobilize data to change policies and institutions, strengthening resilience through increased information and capacity driven by community priorities. Success requires the continuous collection of timely data at a community scale, and public health agencies partnering with communities to use the information in decision making and evaluation to ensure progress over time. We highlight community-engaged data collection and reporting-community air monitoring in Imperial County, CA-as an example of working with communities to improve public health data collection and reporting, increase community dialogue and engagement in governmental decision making, and inform public health tracking to reduce health disparities and strengthen community resilience.

Digital Health Management During and Beyond the COVID-19 Pandemic: Opportunities, Barriers, and Recommendations.

During the coronavirus disease (COVID-19) crisis, digital technologies have become a major route for accessing remote care. Therefore, the need to ensure that these tools are safe and effective has never been greater. We raise five calls to action to ensure the safety, availability, and long-term sustainability of these technologies: (1) due diligence: remove harmful health apps from app stores; (2) data insights: use relevant health data insights from high-quality digital tools to inform the greater response to COVID-19; (3) freely available resources: make high-quality digital health tools available without charge, where possible, and for as long as possible, especially to those who are most vulnerable; (4) digital transitioning: transform conventional offline mental health services to make them digitally available; and (5) population self-management: encourage governments and insurers to work with developers to look at how digital health management could be subsidized or funded. We believe this should be carried out at the population level, rather than at a prescription level.