Disparities and Temporal Trends in COVID-19 Exposures and Mitigating Behaviors Among Black and Hispanic Adults in an Urban Setting.

Importance: COVID-19, caused by SARS-CoV-2 virus, has disproportionately affected Black and Hispanic communities in the US, which can be attributed to social factors including inconsistent public health messaging and suboptimal adoption of prevention efforts. Objectives: To identify behaviors and evaluate trends in COVID-19-mitigating practices in a predominantly Black and Hispanic population, to identify differences in practices by self-reported ethnicity, and to evaluate whether federal emergency financial assistance was associated with SARS-CoV-2 acquisition. Design, Setting, and Participants: This survey study was conducted by telephone from July 1 through August 30, 2020, on a random sample of adults who underwent SARS-CoV-2 testing at a safety-net health care system in Chicago during the surge in COVID-19 cases in the spring of 2020. Behaviors and receipt of a stimulus check were compared between participants testing positive and negative for SARS-CoV-2. Differences in behaviors and temporal trends were assessed by race and ethnicity. Main Outcomes and Measures: SARS-CoV-2 infection was assessed using nasopharyngeal quantitative reverse transcriptase-polymerase chain reaction testing. Mitigating behaviors and federal emergency financial assistance were assessed by survey. Race and ethnicity data were collected from electronic health records. Results: Of 750 randomly sampled individuals, 314 (41.9%) consented to participate (169 [53.8%] women). Of those, 159 (51%) self-reported as Hispanic and 155 (49%) as non-Hispanic (120 [38.2%] Black), of whom 133 (84%) and 76 (49%) tested positive for SARS-CoV-2, respectively. For all participants, consistent mask use (public transport: adjusted odds ratio [aOR], 0.00; 95% CI, 0.00-0.34; social gatherings: aOR, 0.10; 95% CI, 0.00-0.50; running errands: aOR, 0.18; 95% CI, 0.07-0.42; at work: aOR, 0.23; 95% CI, 0.07-0.79) and hand sanitizer use (aOR, 0.26; 95% CI, 0.13-0.52) were associated with lower odds of infection. During 3 sampled weeks, mitigation practices were less frequent among Hispanic compared with non-Hispanic participants (eg, mask use while running errands: aOR, 0.26; 95% CI, 0.15-0.46). Hispanic participants were at high risk of infection (aOR, 5.52; 95% CI, 4.30-7.08) and more likely to work outside the home (aOR, 2.05; 95% CI, 1.27-3.30) compared with non-Hispanic participants, possibly because of limited receipt of stimulus checks (aOR, 0.03; 95% CI, 0.02-0.07) or unemployment benefits (aOR, 0.36; 95% CI, 0.16-0.74). Conclusions and Relevance: In this survey study of adults in a large US city, public health messaging improved preventive behaviors over time but lagged among Hispanic participants; messaging tailored to Hispanic communities, especially for mask use, should be prioritized. Hispanic individuals were at higher risk for infection, more often worked outside the home, and were less likely to have received a stimulus check; this suggests larger studies are needed to evaluate the provision of economic support on SARS-CoV-2 transmission dynamics in low-income populations.

An Investigation of Low COVID-19 Vaccination Intentions among Black Americans: The Role of Behavioral Beliefs and Trust in COVID-19 Information Sources.

Developing a COVID-19 vaccine is a critical strategy for combatting the pandemic. However, for vaccination efforts to succeed, there must be widespread willingness to vaccinate. Prior research has found that Black Americans, who are disproportionately impacted by COVID-19, report lower intentions to get a vaccine than do other populations. We investigate two potential contributors to this disparity: COVID-19 vaccine-related behavioral beliefs and trust in four COVID-19 information sources (mainstream media, social media, President Trump, and public health officials and agencies). Using a nationally-representative survey (n= 889), we demonstrate that differences in vaccination beliefs explain the lower vaccination intentions reported by Black participants, compared to non-Black participants. However, while trust in information sources is associated with vaccination beliefs, differences in trust do not account for the observed differences in vaccination beliefs by race. Furthermore, we find that race moderates the relationships between trust in two sources (Trump and public health officials and agencies) and vaccination beliefs. The effects of trusting these sources on COVID-19 vaccine-related beliefs are smaller among Black participants; thus trust in these sources is less consequential to their pro-vaccination beliefs. Our results suggest that trust in information sources alone does not explain the observed relationship between race and vaccination beliefs.

Utilizing the ACCESS Model to Understand Communication With the Ultraorthodox Community in Beit Shemesh During the First Wave of COVID-19.

INTRODUCTION: The coronavirus pandemic has disproportionately negatively affected the ultraorthodox in Israel. Their unique characteristics and slow adoption of preventative health guidelines resulted in a significant increase in morbidity and mortality. To lower these rates, health and government authority figures employed methods to change the ultraorthodox community health behaviors. METHODOLOGY: This study utilizes the ACCESS model for transcultural nursing to analyze the response by authorities to high infection rates in the large ultraorthodox community in city of Beit Shemesh during the first wave of the outbreak (through early May). RESULTS: The authorities employed all model components to varying degrees and found moderate success in changing health behaviors of the ultraorthodox. DISCUSSION: Employing the ACCESS model as a response to the health care crisis among the ultraorthodox community in Beit Shemesh led to some success in increased compliance, thus lowering morbidity rates. However, not establishing strong respect and rapport hindered the process.

Travel health seeking behaviours, masks, vaccines and outbreak awareness of Australian Chinese travellers visiting friends and relatives - Implications for control of COVID-19.

BACKGROUND: The COVID-19 pandemic has highlighted the role of international travel in spreading infections. Travellers visiting friends and relatives (VFR) are at higher risk of acquiring infections than other travellers, therefore improving the travel health behaviour of these travellers is important. Ethnic Chinese are one of the largest migrant groups in many countries, yet there have been no published studies regarding this population as VFR travellers. We present findings of a study of Australian Chinese VFR travellers relevant to the pandemic response. METHODS: In 2013, five focus groups were conducted with Australian Chinese VFR travellers, exploring topics such as vaccines, face masks, outbreaks and travel health seeking behaviour. Participants were aged 18 years or older and had travelled to China for VFR purposes in the preceding 18 months. Sessions were recorded and transcribed, and thematic analysis was undertaken. RESULTS: Participants viewed VFR travel as low risk, and underestimated the risks associated with travelling during an outbreak. However, they were generally willing to receive pre-travel vaccination specifically for an outbreak, but not otherwise. Attitudes towards face masks and other infection control measures were mixed. Multiple factors influenced their travel health behaviour, including low risk awareness, misconceptions, and cultural barriers to seeking health care. CONCLUSION: Our research found that Chinese VFR travellers undertake suboptimal precautions related to VFR travel, associated with an underestimation of risks. While they share many characteristics with other VFR travellers, unique cultural health beliefs should be taken into account when developing risk communication and educational interventions as part of a pandemic response.

Exploring How Media Influence Preventive Behavior and Excessive Preventive Intention during the COVID-19 Pandemic in China.

In the context of global fighting against the unexpected COVID-19 pandemic, how to promote the public implementation of preventive behavior is the top priority of pandemic prevention and control. This study aimed at probing how the media would affect the public's preventive behavior and excessive preventive intention accordingly. Data were collected from 653 respondents in the Chinese mainland through online questionnaires and further analyzed by using partial least squares structural equation modeling (PLS-SEM). Taking risk perception, negative emotions, and subjective norms as mediators, this study explored the impact of mass media exposure and social networking services involvement on preventive behavior and excessive preventive intention. Based on differences in the severity of the pandemic, the samples were divided into the Wuhan group and other regions group for multi-group comparison. The results showed that mass media exposure had a significant positive impact on subjective norms; moreover, mass media exposure could significantly enhance preventive behavior through subjective norms, and social networking services involvement had a significant positive impact on negative emotions; meanwhile, social networking services involvement promoted excessive preventive intention through negative emotions.

Media trust and infection mitigating behaviours during the COVID-19 pandemic in the USA.

INTRODUCTION: The COVID-19 pandemic is an unprecedented public health crisis. It is becoming increasingly clear that people's behavioural responses in the USA during this fast-changing pandemic are associated with their preferred media sources. The polarisation of US media has been reflected in politically motivated messaging around the coronavirus by some media outlets, such as Fox News. This resulted in different messaging around the risks of infection and behavioural changes necessary to mitigate that risk. This study determined if COVID-related behaviours differed according to trust in left-leaning or right-leaning media and how differences changed over the first several months of the pandemic. METHODS: Using the nationally representative Understanding America Study COVID-19 panel, we examine preventive and risky behaviours related to infection from COVID-19 over the period from 10 March to 9 June for people with trust in different media sources: one left-leaning, CNN and another right-leaning, Fox News. People's media preferences are categorised into three groups: (1) those who trust CNN more than Fox News; (2) those who have equal or no preferences and (3) those who trust Fox News more than CNN. RESULTS: Results showed that compared with those who trust CNN more than Fox news, people who trust Fox News more than CNN engaged in fewer preventive behaviours and more risky behaviours related to COVID-19. Out of five preventive and five risky behaviours examined, people who trust Fox News more than CNN practised an average of 3.41 preventive behaviours and 1.25 risky behaviours, while those who trust CNN more than Fox News engaged in an average of 3.85 preventive and 0.94 risky behaviours, from late March to June. The difference between these two groups widened in the month of May (p≤0.01), even after controlling for access to professional information and overall diversity of information sources. CONCLUSIONS: Our findings indicate that behavioural responses were divided along media bias lines. In such a highly partisan environment, false information can be easily disseminated, and health messaging, which is one of the few effective ways to slowdown the spread of the virus in the absence of a vaccine, is being damaged by politically biased and economically focused narratives. During a public health crisis, media should reduce their partisan stance on health information, and the health messaging from neutral and professional sources based on scientific findings should be better promoted.