Strategies to reduce risk perception among grocery shoppers in the US: A survey study.

During the COVID-19 lockdown in the US, many businesses were shut down temporarily. Essential businesses, most prominently grocery stores, remained open to ensure access to food and household essentials. Grocery shopping presents increased potential for COVID-19 infection because customers and store employees are in proximity to each other. This study investigated shoppers' perceptions of COVID-19 infection risks and put them in context by comparing grocery shopping to other activities outside home, and examined whether a proactive preventive action by grocery stores influence shoppers' perceived risk of COVID-19 infection. Our data were obtained via an anonymous online survey distributed between April 2 and 10, 2020 to grocery shoppers in New York State (the most affected by the pandemic at the time of the study) and Washington State (the first affected by the pandemic). We found significant factors associated with high levels of risk perception on grocery shoppers. We identified some effective preventive actions that grocery stores implement to alleviate anxiety and risk perception. We found that people are generally more concerned about in-store grocery shopping relative to other out-of-home activities. Findings suggest that a strict policy requiring grocery store employees to use facemasks and gloves greatly reduced shoppers' perceived risk rating of infection of themselves by 37.5% and store employees by 51.2%. Preventive actions by customers and businesses are critical to reducing the unwitting transmission of COVID-19 as state governments prepare to reopen the economy and relax restrictions on activities outside home.

Exploring rural inhabitants' perceptions towards food wastage during COVID-19 lockdowns: Implications for food security in Pakistan.

The lessening of food wastage, specifically among nations where about half of its worldwide quantity is produced, has turned to be a mammoth challenge for environmental, social and economic sustainability, and represents one of the seventeen Sustainable Development Goals (SDG) within the Agenda 2030. The quantity of food being thrown away in spite of being in an edible condition has become alarming in middle and high income countries. The COVID-19 lockdown strategy, both at local and international levels, has expressively altered work, life and food consumption behaviors globally, directing to food wastage as a multi sectoral issue. Pakistan has no exception to such manifestations. The main objective of this study is to analyze the perceptions of rural people of Pakistan regarding food wastage during the COVID-19 pandemic. To evaluate whether behavior about food wastage among rural households varied or not during the pandemic, a descriptive survey was carried out using a self-administered questionnaire and 963 responses were selected for further empirical investigations. The findings of the study reveal that food waste actually decreased in spite of an increased amount of purchased food during the lockdown. Our results highlight that the effect of the pandemic has led to reduction in food wastage among rural respondents, an increased consciousness for the morals of food waste, and awareness of environmental impacts of food wastage. The conclusions of this study highlight that rural consumers of Pakistan are emerging with a new level of responsiveness about food wastage with possible positive impact on the environment in terms of decreased greenhouse gas (GHG) emission and other pollutants. The study findings imply that this pandemic time provides a suitable window to raise awareness about food wastage among rural as well as urban households while contemplating effective strategies to overcome the issue of food wastage in the country.

Analysing the impact of COVID-19 risk perceptions on route choice behaviour in train networks.

INTRODUCTION: Unlike previous pandemics, COVID-19 has sustained over a relatively longer period with cyclical infection waves and numerous variants. Public transport ridership has been hit particularly hard. To restore travellers' confidence it is critical to assess their risk determinants and trade-offs. METHODS: To this end, we survey train travellers in the Netherlands in order to: (i) quantify the impact of trip-specific, policy-based, and pandemic-related attributes on travellers' COVID-19 risk perceptions; and (ii) evaluate the trade-off between this risk perception and other travel attributes. Adopting the hierarchical information integration approach, in a two-stage stated preference experiment, respondents are asked to first rate how risky they perceive different travel situations to be, and then to choose between different travel options that include their own perceived risk rating as an attribute. Perceived risk ratings and choices between travel options are modelled using a linear regression and a mixed multinomial logit model, respectively. RESULTS: We find that on-board crowding and infection rates are the most important factors for risk perception. Amongst personal characteristics, the vulnerability of family and friends has the largest impact-nearly twice that of personal health risk. The bridging choice experiment reveals that while values of time have remained similar to pre-pandemic estimates, travellers are significantly more likely to choose routes with less COVID-19 risk (e.g., due to lower crowding). Respondents making longer trips by train value risk four times as much as their shorter trip counterparts. By combining the two models, we also report willingness to pay for mitigating factors: reduced crowding, mask mandates, and increased sanitization. CONCLUSION: Since we evaluate the impact of a large number of variables on route choice behaviour, we can use the estimated models to predict behaviour under detailed pandemic scenarios. Moreover, in addition to highlighting the importance of COVID-19 risk perceptions in public transport route choices, the results from this study provide valuable information regarding the mitigating impacts of various policies on perceived risk.

Impact of COVID-19 forecast visualizations on pandemic risk perceptions.

People worldwide use SARS-CoV-2 (COVID-19) visualizations to make life and death decisions about pandemic risks. Understanding how these visualizations influence risk perceptions to improve pandemic communication is crucial. To examine how COVID-19 visualizations influence risk perception, we conducted two experiments online in October and December of 2020 (N = 2549) where we presented participants with 34 visualization techniques (available at the time of publication on the CDC's website) of the same COVID-19 mortality data. We found that visualizing data using a cumulative scale consistently led to participants believing that they and others were at more risk than before viewing the visualizations. In contrast, visualizing the same data with a weekly incident scale led to variable changes in risk perceptions. Further, uncertainty forecast visualizations also affected risk perceptions, with visualizations showing six or more models increasing risk estimates more than the others tested. Differences between COVID-19 visualizations of the same data produce different risk perceptions, fundamentally changing viewers' interpretation of information.

Medical students' perceptions and motivations during the COVID-19 pandemic.

BACKGROUND: There has been a rapid increase in the number of cases of COVID-19 in Latin America, Africa, Asia and many countries that have an insufficient number of physicians and other health care personnel, and the need for the inclusion of medical students on health teams is a very important issue. It has been recommended that medical students work as volunteers, undergo appropriate training, not undertake any activity beyond their level of competence, and receive continuous supervision and adequate personal protective equipment. However, the motivation of medical students must be evaluated to make volunteering a more evidence-based initiative. The aim of our study was to evaluate the motivation of medical students to be part of health teams to aid in the COVID-19 pandemic. METHODS AND FINDINGS: We developed a questionnaire specifically to evaluate medical students' perceptions about participating in the care of patients with suspected infection with coronavirus during the COVID-19 pandemic. The questionnaire had two parts: a) one part with questions on individual characteristics, year in medical school and geographic location of the medical school and b) a second part with twenty-eight statements assessed on a 5-point Likert scale (totally agree, agree, neither agree nor disagree, disagree and totally disagree). To develop the questionnaire, we performed consensus meetings with a group of faculty and medical students. The questionnaire was sent to student organizations of 257 medical schools in Brazil and answered by 10,433 students. We used multinomial logistic regression models to analyze the data. Statements associated with greater odds ratios for participation of medical students in the COVID-19 pandemic were related to a sense of purpose or duty ("It is the duty of the medical student to put himself or herself at the service of the population in the pandemic"), altruism ("I am willing to take risks by participating in practice in the context of the pandemic"), and perception of good performance and professional identity ("I will be a better health professional for having experienced the pandemic"). Males were more prone than females to believe that only interns should participate in the care of patients with COVID-19 (odds ratio 1.36 [coefficient interval 95%:1.24-1.49]) and that all students should participate (OR 1.68 [CI:1.4-1.91]). CONCLUSIONS: Medical students are more motivated by a sense of purpose or duty, altruism, perception of good performance and values of professionalism than by their interest in learning. These results have implications for the development of volunteering programs and the design of health force policies in the present pandemic and in future health emergencies.

Ain't Just Imagination! Effects of Motor Imagery Training on Strength and Power Performance of Athletes during Detraining.

PURPOSE: This study aimed to investigate the effects of motor imagery (MI) training on strength and power performances of professional athletes during a period of detraining caused by the COVID-19 outbreak. METHODS: Thirty male professional basketball players (age, 26.1 ± 6.2 yr) were randomly assigned to three counterbalanced groups: two MI training groups, who completed imagery training by mentally rehearsing upper and lower limb resistance training exercises loaded with either 85% of one repetition maximum (85%1RM) or optimum power loads (OPL), or a control group. For six consecutive weeks, although all groups completed two weekly sessions of high-intensity running, only the MI groups performed three additional MI sessions a week. Maximal strength and power output were measured through 1RM and OPL assessments in the back squat and bench press exercises with a linear positioning transducer. Vertical jump and throwing capabilities were assessed with the countermovement jump and the seated medicine ball throw tests, respectively. Kinesthetic and visual imagery questionnaires, and chronometry and rating of perceived effort scores were collected to evaluate MI vividness, MI ability, and perceived effort. RESULTS: Physical performances improved significantly following both MI protocols (range, ~2% to ~9%), but were reduced in the control group, compared with preintervention (P ≤ 0.016). Moreover, interactions (time-protocol) were identified between the two MI groups (P ≤ 0.001). Whereas the 85%1RM led to greater effects on maximal strength measures than the OPL, the latter induced superior responses on measures of lower limb power. These findings were mirrored by corresponding cognitive and psychophysiological responses. CONCLUSIONS: During periods of forced detraining, MI practice seems to be a viable tool to maintain and increase physical performance capacity among professional athletes.

The social amplification and attenuation of COVID-19 risk perception shaping mask wearing behavior: A longitudinal twitter analysis.

INTRODUCTION: Twitter represents a mainstream news source for the American public, offering a valuable vehicle for learning how citizens make sense of pandemic health threats like Covid-19. Masking as a risk mitigation measure became controversial in the US. The social amplification risk framework offers insight into how a risk event interacts with psychological, social, institutional, and cultural communication processes to shape Covid-19 risk perception. METHODS: Qualitative content analysis was conducted on 7,024 mask tweets reflecting 6,286 users between January 24 and July 7, 2020, to identify how citizens expressed Covid-19 risk perception over time. Descriptive statistics were computed for (a) proportion of tweets using hyperlinks, (b) mentions, (c) hashtags, (d) questions, and (e) location. RESULTS: Six themes emerged regarding how mask tweets amplified and attenuated Covid-19 risk: (a) severity perceptions (18.0%) steadily increased across 5 months; (b) mask effectiveness debates (10.7%) persisted; (c) who is at risk (26.4%) peaked in April and May 2020; (d) mask guidelines (15.6%) peaked April 3, 2020, with federal guidelines; (e) political legitimizing of Covid-19 risk (18.3%) steadily increased; and (f) mask behavior of others (31.6%) composed the largest discussion category and increased over time. Of tweets, 45% contained a hyperlink, 40% contained mentions, 33% contained hashtags, and 16.5% were expressed as a question. CONCLUSIONS: Users ascribed many meanings to mask wearing in the social media information environment revealing that COVID-19 risk was expressed in a more expanded range than objective risk. The simultaneous amplification and attenuation of COVID-19 risk perception on social media complicates public health messaging about mask wearing.

Perception versus preference: The role of self-assessed risk measures on individual mitigation behaviors during the COVID-19 pandemic.

In the midst of a global pandemic, prevention methods stand as a crucial first step toward addressing the public health crisis and controlling the spread of the virus. However, slowing the spread of the virus hinges on the public's willingness to follow a combination of mitigation practices to avoid contracting and transmitting the disease. In this study, we investigate the factors related to individuals' risk perceptions associated with COVID-19 as well as their general self-assessed risk preferences. We also provide insights regarding the role of risk perceptions and preferences on mitigation behavior by examining the correlation between these risk measures and both the likelihood of following various mitigation practices and total number of practices followed. Although we find both risk perceptions and preferences to be significantly correlated with mitigation behaviors, risk perceptions are correlated with a larger number of practices. Additionally, we find significant heterogeneity in mitigation behaviors across numerous individual and household characteristics. These results can serve as a benchmark for the design and development of interventions to increase awareness and promote higher adoption of mitigation practices.

Pairing facts with imagined consequences improves pandemic-related risk perception.

The COVID-19 pandemic reached staggering new peaks during a global resurgence more than a year after the crisis began. Although public health guidelines initially helped to slow the spread of disease, widespread pandemic fatigue and prolonged harm to financial stability and mental well-being contributed to this resurgence. In the late stage of the pandemic, it became clear that new interventions were needed to support long-term behavior change. Here, we examined subjective perceived risk about COVID-19 and the relationship between perceived risk and engagement in risky behaviors. In study 1 (n = 303), we found that subjective perceived risk was likely inaccurate but predicted compliance with public health guidelines. In study 2 (n = 735), we developed a multifaceted intervention designed to realign perceived risk with actual risk. Participants completed an episodic simulation task; we expected that imagining a COVID-related scenario would increase the salience of risk information and enhance behavior change. Immediately following the episodic simulation, participants completed a risk estimation task with individualized feedback about local viral prevalence. We found that information prediction error, a measure of surprise, drove beneficial change in perceived risk and willingness to engage in risky activities. Imagining a COVID-related scenario beforehand enhanced the effect of prediction error on learning. Importantly, our intervention produced lasting effects that persisted after a 1- to 3-wk delay. Overall, we describe a fast and feasible online intervention that effectively changed beliefs and intentions about risky behaviors.

How the experience of medical assistance in dying changed during the COVID-19 pandemic in Canada: a qualitative study of providers.

BACKGROUND: In March 2020, all levels of government introduced various strategies to reduce the impact of the COVID-19 pandemic. The purpose of this study was to document how the experience of providing medical assistance in dying (MAiD) changed during the COVID-19 pandemic. METHODS: We conducted a qualitative study using semistructured interviews with key informants in Canada who provided or coordinated MAiD before and during the COVID-19 pandemic. We interviewed participants from April to June 2020 by telephone or email. We collected and analyzed data in an iterative manner and reached theme saturation. Our team reached consensus on the major themes and subthemes. RESULTS: We interviewed 1 MAiD coordinator and 15 providers, including 14 physicians and 1 nurse practitioner. We identified 4 main themes. The most important theme was the perception that the pandemic increased the suffering of patients receiving MAiD by isolating them from loved ones and reducing available services. Providers were distressed by the difficulty of establishing rapport and closeness at the end of life, given the requirements for physical distancing and personal protective equipment. They were concerned about the spread of SARS-CoV-2, and found it difficult to enforce rules about distancing and the number of people present. Logistics and access to MAiD became more difficult because of the new restrictions, but there were many adaptations to solve these problems. INTERPRETATION: Providers and coordinators had many challenges in providing MAiD during the COVID-19 pandemic, including their perception that the suffering of their patients increased. Some changes in how MAiD is provided that have occurred during the pandemic, including more telemedicine assessments and virtual witnessing, are likely to remain after the pandemic and may improve service.

'Do I, don't I?' A qualitative study addressing parental perceptions about seeking healthcare during the COVID-19 pandemic.

BACKGROUND: Paediatric emergency departments have seen reduced attendance during the COVID-19 pandemic. Late paediatric presentations may lead to severe illness and even death. Maintaining provision of healthcare through a pandemic is essential. This qualitative study aims to identify changing care-seeking behaviours in child health during the pandemic and ascertain parental views around barriers to care. METHODS: Semistructured interviews were conducted with caregivers of children accessing acute paediatric services in a hospital in North-West London. Thematic content analysis was used to derive themes from the data, using a deductive approach. RESULTS: From interviews with 15 caregivers an understanding was gained of care-seeking behaviours during the pandemic. Themes identified were; influencers of decision to seek care, experience of primary care, other perceived barriers, experiences of secondary care, advice to others following lived experience. Where delays in decision to seek care occurred this was influenced predominantly by fear, driven by community perception and experience and media portrayal. Delays in reaching care were focused on access to primary care and availability of services. Caregivers were happy with the quality of care received in secondary care and would advise friends to seek care without hesitation, not to allow fear to delay them. CONCLUSION: A pandemic involving a novel virus is always a challenging prospect in terms of organisation of healthcare provision. This study has highlighted parental perspectives around access to care and care-seeking behaviours which can inform us how to better improve service functioning during such a pandemic and beyond into the recovery period.

Tumor patients' fears and worries and perceived changes of specific attitudes, perceptions and behaviors due to the COVID-19 pandemic are still relevant.

OBJECTIVE: During the COVID-19 pandemic, tumor patients not only perceived fears and worries but were experiencing also positive changes as the perception of nature and silence, moments of wondering awe, and more intense relationships. We intended to analyze whether these perceptions may differ between patients from waves 1 and 2 of the pandemic. METHODS: Cross-sectional study at two time periods (May to June, sample 1) and September to November 2020 (sample 2) with standardized questionnaires (i.e. WHO-5, MLQ, PCQ-12). RESULTS: Patients from sample 1 (n = 292) and sample 2 (n = 221) did not differ with respect to gender, age, partner or tumor status. Most are still "irritated by statements about danger and course of the infection" (58%) and are "worrying to be infected and to have complicated course of disease" (55%). Neither their well-being nor meaning in life nor fears and worries were significantly different. In sample 2 patients, Worrying reflections and loneliness scored significantly lower, while their Perception of nature and silence was lower in trend only; more intense relationships are still relevant. Moments of wondering awe and religious trust were perceived less often during wave 2. Particularly religious patients scored stronger for Perception of nature and silence and Worrying reflections and loneliness. CONCLUSION: Oncologists/psychologist have to know that patients' situation has not changed within the time of pandemic and that they still require information, close support and encouragement to rely on their resources to cope. Perceived changes are reflecting coping strategies that could be trained to increase patients' resilience during further pandemic waves.

Perception of health risk and compliance with preventive measures related to COVID-19 in the Czech population: preliminary results of a rapid questionnaire survey.

OBJECTIVES: In the Czech Republic, an outbreak of the coronavirus disease (COVID­19) has been decelerated by quickly adopting strict and strongly limiting government measures. In this study, the authors present the preliminary results (April 1-5, 2020) of a public risk perception study of COVID­19. MATERIAL AND METHODS: The online questionnaire survey was announced in the national TV and radio stations with the nationwide coverage. Respondents were recruited through the website of the University of Ostrava during the first 5 days of the survey (N = 7966). The data covered risk perception with a focus on physical and psychological aspects, the current socio-economic situation and adaptation to the lockdown. The authors used Mann-Whitney and Kruskal-Wallis tests, as well as ordered logistic regression, with a significance level of 5% using STATA version 15. RESULTS: From the total sample of the respondents aged 40 years on average (a range of 15-87 years), the present study shows that women (p < 0.001) and elderly people (p < 0.001) perceived the health risk related to COVID­19 as significantly worse than others. Older people (>60 years) perceived their mental health as significantly better than younger participants (p < 0.001). Most of the respondents assessed the adopted measures as adequate (71%) and believed in their effectiveness (69.7%). CONCLUSIONS: This study contributes to understanding the risk perception as a public response to the COVID­19 pandemic. Int J Occup Med Environ Health. 2021;34(2):165-76.

To treat or not to treat: perceptions of the initial American Society for Reproductive Medicine COVID-19 recommendations among women's health providers.

PURPOSE: The objective of this study was to evaluate the perception of the initial ASRM COVID-19 recommendations for infertility treatment held by women's health providers within varying subspecialties, as well as their attitudes toward pregnancy and fertility during this time. METHODS: An electronic survey was sent to all women's healthcare providers, including physicians, mid-level providers and nurses, in all subspecialties of obstetrics and gynaecology (Ob/Gyn) at a large tertiary care university-affiliated hospital. RESULTS: Of the 278 eligible providers, the survey response rate was 45% (n = 127). Participants represented 8 Ob/Gyn subspecialties and all professional levels. Participants age 18-30 years were significantly more likely to feel that women should have access to infertility treatment despite the burden level of COVID-19 in respective community/states (p = 0.0058). Participants within the subspecialties of general Ob/Gyn, maternal foetal medicine and gynecologic oncology were significantly more likely to disagree that all women should refrain from planned conception during the COVID-19 pandemic, in comparison to those in urogynecology and reproductive endocrinology and infertility (p = 0.0003). CONCLUSIONS: Considering the immediate and unknown long-term impact of the COVID-19 pandemic on fertility care delivery, a better understanding of perceptions regarding infertility management during this time is important. Our study shows overall support for the initial ASRM recommendations, representing a wide spectrum of women's health providers.

Heat stress and PPE during COVID-19: impact on healthcare workers' performance, safety and well-being in NHS settings.

Personal protective equipment (PPE) can potentiate heat stress, which may have a negative impact on the wearer's performance, safety and well-being. In view of this, a survey was distributed to healthcare workers (HCWs) required to wear PPE during the coronavirus disease 2019 pandemic in the UK to evaluate perceived levels of heat stress and its consequences. Respondents reported experiencing several heat-related illness symptoms, and heat stress impaired both cognitive and physical performance. The majority of respondents stated that wearing PPE made their job more difficult. These, and additional, responses suggest that modification to current working practices is required urgently to improve the resilience of HCWs to wearing PPE during pandemics.

Early perceptions and behavioural responses during the COVID-19 pandemic: a cross-sectional survey of UK adults.

OBJECTIVE: To examine risk perceptions and behavioural responses of the UK adult population during the early phase of the COVID-19 epidemic in the UK. DESIGN: A cross-sectional survey. SETTING: Conducted with a nationally representative sample of UK adults within 48 hours of the UK Government advising the public to stop non-essential contact with others and all unnecessary travel. PARTICIPANTS: 2108 adults living in the UK aged 18 years and over. Response rate was 84.3% (2108/2500). Data collected between 17 March and 18 March 2020. MAIN OUTCOME MEASURES: Descriptive statistics for all survey questions, including number of respondents and weighted percentages. Robust Poisson regression used to identify sociodemographic variation in: (1) adoption of social distancing measures, (2) ability to work from home, and (3) ability and (4) willingness to self-isolate. RESULTS: Overall, 1992 (94.2%) respondents reported at least one preventive measure: 85.8% washed their hands with soap more frequently; 56.5% avoided crowded areas and 54.5% avoided social events. Adoption of social distancing measures was higher in those aged over 70 years compared with younger adults aged 18-34 years (adjusted relative risk/aRR: 1.2; 95% CI: 1.1 to 1.5). Those with lowest household income were three times less likely to be able to work from home (aRR: 0.33; 95% CI: 0.24 to 0.45) and less likely to be able to self-isolate (aRR: 0.92; 95% CI: 0.88 to 0.96). Ability to self-isolate was also lower in black and minority ethnic groups (aRR: 0.89; 95% CI: 0.79 to 1.0). Willingness to self-isolate was high across all respondents. CONCLUSIONS: Ability to adopt and comply with certain non-pharmaceutical interventions (NPIs) is lower in the most economically disadvantaged in society. Governments must implement appropriate social and economic policies to mitigate this. By incorporating these differences in NPIs among socioeconomic subpopulations into mathematical models of COVID-19 transmission dynamics, our modelling of epidemic outcomes and response to COVID-19 can be improved.

Acute metabolic responses after continuous or interval exercise in post-menopausal women with overweight or obesity.

This pilot study compared the effects of acute high-intensity intermittent exercise (HIIE) and moderate-intensity continuous exercise (MICE) on post-exercise VO2 , fat utilization, and 24-hours energy balance to understand the mechanism of higher fat mass reduction observed after high-intensity interval training in post-menopausal women with overweight/obesity. 12 fasted women (59.5 ± 5.8 years; BMI: 28.9 ± 3.9 kg·m-2 ) completed three isoenergetic cycling exercise sessions in a counterbalanced, randomized order: (a) MICE [35 minutes at 60%-65% of peak heart rate, HRmax ], (b) HIIE 1 [60 × (8-s cycling-12-s recovery) at 80%-90% of HRmax ], and (c) HIIE 2 [10 × 1min at 80%-90% of HRmax  - 1-min recovery]. Then, VO2 and fat utilization measured at rest and during the 2 hours post-exercise, enjoyment, perceived exertion, and appetite recorded during the session and energy intake (EI) and energy expenditure (EE) assessed over the next 24 hours were compared for the three modalities. Overall, fat utilization increased after exercise. No modality effect or time-modality interaction was observed concerning VO2 and fat oxidation rate during the 2 hours post-exercise. The two exercise modalities did not induce specific EI and EE adaptations, but perceived appetite scores at 1 hour post-exercise were lower after HIIE 1 and HIIE 2 than MICE. Perceived exertion was higher during HIIE 1 and HIIE 2 than MICE, but enjoyment did not differ among modalities. The acute HIIE responses did not allow explaining the greater fat mass loss observed after regular high-intensity interval training in post-menopausal women with overweight/obesity. More studies are needed to understand the mechanisms involved in such adaptations.