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2.
Health Psychol ; 39(12): 1026-1036, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-950643

ABSTRACT

OBJECTIVE: The present study examined patterns and psychosocial correlates of coronavirus guideline adherence in a U.S. sample (N = 500) during the initial 15-day period advocated by the White House Coronavirus Task Force. METHOD: Descriptive and correlational analyses were used to examine the frequency of past 7-day adherence to each of 10 guidelines, as well as overall adherence. Guided by a disposition-belief-motivation model of health behavior, path analyses tested associations of personality traits and demographic factors to overall adherence via perceived norms, perceived control, attitudes, and self-efficacy related to guideline adherence, as well as perceived exposure risk and perceived health consequence if exposed. RESULTS: Adherence ranged from 94.4% reporting always avoiding eating/drinking inside bars/restaurants/food courts to 13.6% reporting always avoiding touching one's face. Modeling showed total associations with overall adherence for greater conscientiousness (ß = .191, p < .001), openness (ß = .098, p < .05), perceptions of social endorsement (ß = .202, p < .001), positive attitudes (ß = .105, p < .05), self-efficacy (ß = .234, p < .001), and the presence versus absence or uncertainty of a shelter-in-place order (ß = .102, p < .01). Age, self-rated health, sex, education, income, children in the household, agreeableness, extraversion, neuroticism, perceived exposure risk, and perceived health consequence showed null-to-negligible associations with overall adherence. CONCLUSIONS: The results clarify adherence frequency, highlight characteristics associated with greater adherence, and suggest the need to strengthen the social contract between government and citizenry by clearly communicating adherence benefits, costs, and timelines. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Subject(s)
/prevention & control , Communicable Disease Control , Guideline Adherence , Health Behavior , Personality , Adult , Age Factors , Attitude , Attitude to Health , Educational Status , Ethnic Groups , Extraversion, Psychological , Family Characteristics , Female , Humans , Income , Male , Marital Status , Middle Aged , Motivation , Neuroticism , Personality Inventory , Self Efficacy , Sex Factors
3.
Ann Intern Med ; 173(12): 964-973, 2020 12 15.
Article in English | MEDLINE | ID: covidwho-1022196

ABSTRACT

BACKGROUND: Coronavirus disease 2019 (COVID-19) has rapidly instigated a global pandemic. Vaccine development is proceeding at an unprecedented pace. Once available, it will be important to maximize vaccine uptake and coverage. OBJECTIVE: To assess intent to be vaccinated against COVID-19 among a representative sample of adults in the United States and identify predictors of and reasons for vaccine hesitancy. DESIGN: Cross-sectional survey, fielded from 16 through 20 April 2020. SETTING: Representative sample of adults residing in the United States. PARTICIPANTS: Approximately 1000 adults drawn from the AmeriSpeak probability-based research panel, covering approximately 97% of the U.S. household population. MEASUREMENTS: Intent to be vaccinated against COVID-19 was measured with the question, "When a vaccine for the coronavirus becomes available, will you get vaccinated?" Response options were "yes," "no," and "not sure." Participants who responded "no" or "not sure" were asked to provide a reason. RESULTS: A total of 991 AmeriSpeak panel members responded. Overall, 57.6% of participants (n = 571) intended to be vaccinated, 31.6% (n = 313) were not sure, and 10.8% (n = 107) did not intend to be vaccinated. Factors independently associated with vaccine hesitancy (a response of "no" or "not sure") included younger age, Black race, lower educational attainment, and not having received the influenza vaccine in the prior year. Reasons for vaccine hesitancy included vaccine-specific concerns, a need for more information, antivaccine attitudes or beliefs, and a lack of trust. LIMITATIONS: Participants' intent to be vaccinated was explored before a vaccine was available and when the pandemic was affecting a narrower swath of the United States. Questions about specific information or factors that might increase vaccination acceptance were not included. The survey response rate was 16.1%. CONCLUSION: This national survey, conducted during the coronavirus pandemic, revealed that approximately 3 in 10 adults were not sure they would accept vaccination and 1 in 10 did not intend to be vaccinated against COVID-19. Targeted and multipronged efforts will be needed to increase acceptance of a COVID-19 vaccine when one becomes available. PRIMARY FUNDING SOURCE: Agency for Healthcare Research and Quality.


Subject(s)
Attitude to Health , /therapy , /immunology , Adult , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Pandemics , Retrospective Studies , United States/epidemiology
8.
BMJ Open ; 10(12): e041641, 2020 12 31.
Article in English | MEDLINE | ID: covidwho-1004168

ABSTRACT

INTRODUCTION: The COVID-19 pandemic has certainly resulted in an increased level of anxiety and fear in communities in terms of disease management and infection spread. Due to fear and social stigma linked with COVID-19, many individuals in the community hide their disease and do not access healthcare facilities in a timely manner. In addition, with the widespread use of social media, rumours, myths and inaccurate information about the virus are spreading rapidly, leading to intensified irritability, fearfulness, insomnia, oppositional behaviours and somatic complaints. Considering the relevance of all these factors, we aim to explore the perceptions and attitudes of community members towards COVID-19 and its impact on their daily lives and mental well-being. METHODS AND ANALYSIS: This formative research will employ an exploratory qualitative research design using semistructured interviews and a purposive sampling approach. The data collection methods for this formative research will include indepth interviews with community members. The study will be conducted in the Karimabad Federal B Area and in the Garden (East and West) community settings in Karachi, Pakistan. The community members of these areas have been selected purposively for the interview. Study data will be analysed thematically using NVivo V.12 Plus software. ETHICS AND DISSEMINATION: Ethical approval for this study has been obtained from the Aga Khan University Ethical Review Committee (2020-4825-10599). The results of the study will be disseminated to the scientific community and to the research subjects participating in the study. The findings will help us explore the perceptions and attitudes of different community members towards the COVID-19 pandemic and its impact on their daily lives and mental well-being.


Subject(s)
Anxiety , Social Perception/psychology , Social Stigma , Stress, Psychological , Adult , Anxiety/diagnosis , Anxiety/etiology , Attitude to Health , /prevention & control , Community Medicine/methods , Fear , Female , Humans , Male , Mental Health/statistics & numerical data , Mental Health/trends , Middle Aged , Pakistan/epidemiology , Population Surveillance , Qualitative Research , Research Design , Stress, Psychological/diagnosis , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Stress, Psychological/psychology
9.
J Med Internet Res ; 22(12): e24550, 2020 12 03.
Article in English | MEDLINE | ID: covidwho-999991

ABSTRACT

BACKGROUND: Emerging evidence suggests that people with arthritis are reporting increased physical pain and psychological distress during the COVID-19 pandemic. At the same time, Twitter's daily usage has surged by 23% throughout the pandemic period, presenting a unique opportunity to assess the content and sentiment of tweets. Individuals with arthritis use Twitter to communicate with peers, and to receive up-to-date information from health professionals and services about novel therapies and management techniques. OBJECTIVE: The aim of this research was to identify proxy topics of importance for individuals with arthritis during the COVID-19 pandemic, and to explore the emotional context of tweets by people with arthritis during the early phase of the pandemic. METHODS: From March 20 to April 20, 2020, publicly available tweets posted in English and with hashtag combinations related to arthritis and COVID-19 were extracted retrospectively from Twitter. Content analysis was used to identify common themes within tweets, and sentiment analysis was used to examine positive and negative emotions in themes to understand the COVID-19 experiences of people with arthritis. RESULTS: In total, 149 tweets were analyzed. The majority of tweeters were female and were from the United States. Tweeters reported a range of arthritis conditions, including rheumatoid arthritis, systemic lupus erythematosus, and psoriatic arthritis. Seven themes were identified: health care experiences, personal stories, links to relevant blogs, discussion of arthritis-related symptoms, advice sharing, messages of positivity, and stay-at-home messaging. Sentiment analysis demonstrated marked anxiety around medication shortages, increased physical symptom burden, and strong desire for trustworthy information and emotional connection. CONCLUSIONS: Tweets by people with arthritis highlight the multitude of concurrent concerns during the COVID-19 pandemic. Understanding these concerns, which include heightened physical and psychological symptoms in the context of treatment misinformation, may assist clinicians to provide person-centered care during this time of great health uncertainty.


Subject(s)
Arthritis/psychology , Attitude to Health , Pandemics , Patients/psychology , Social Media/statistics & numerical data , Communication , Female , Humans , Male , Retrospective Studies , Social Media/supply & distribution , United States/epidemiology
10.
JMIR Public Health Surveill ; 6(3): e21607, 2020 09 14.
Article in English | MEDLINE | ID: covidwho-999979

ABSTRACT

BACKGROUND: The COVID-19 pandemic forced many health systems to proactively reduce care delivery to prepare for an expected surge in hospitalizations. There have been concerns that care deferral may have negative health effects, but it is hoped that telemedicine can provide a viable alternative. OBJECTIVE: This study aimed to understand what type of health care services were being deferred during the COVID-19 pandemic lockdown, the role played by telemedicine to fill in care gaps, and changes in attitudes toward telemedicine. METHODS: We conducted a cross-sectional analysis of survey responses from 1694 primary care patients in a mid-sized northeastern city. Our main outcomes were use of telemedicine and reports of care deferral during the shutdown. RESULTS: Deferred care was widespread-48% (n=812) of respondents deferred care-but it was largely for preventive services, particularly dental and primary care, and did not cause concerns about negative health effects. In total, 30.2% (n=242) of those who delayed care were concerned about health effects, with needs centered around orthopedics and surgery. Telemedicine was viewed more positively than prior to the pandemic; it was seen as a viable option to deliver deferred care, particularly by respondents who were over 65 years of age, female, and college educated. Mental health services stood out for having high levels of deferred care. CONCLUSIONS: Temporary health system shutdowns will give rise to deferred care. However, much of the deferrals will be for preventive services. The effect of this on patient health can be moderated by prioritizing surgical and orthopedic services and delivering other services through telemedicine. Having telemedicine as an option is particularly crucial for mental health services.


Subject(s)
Attitude to Health , Coronavirus Infections , Health Care Rationing , Health Services Accessibility , Health Services , Pandemics , Pneumonia, Viral , Telemedicine , Adolescent , Adult , Aged , Betacoronavirus , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Cross-Sectional Studies , Delivery of Health Care , Female , General Surgery , Humans , Male , Mental Health Services , Middle Aged , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Primary Health Care , Surveys and Questionnaires , Young Adult
11.
BMJ Open ; 10(12): e045309, 2020 12 29.
Article in English | MEDLINE | ID: covidwho-999265

ABSTRACT

OBJECTIVES: This study explored the impact of COVID-19 on people identified as at high risk of severe illness by UK government, and in particular, the impact of lockdown on access to healthcare, medications and use of technological platforms. DESIGN: Online survey methodology. SETTING: UK. PARTICIPANTS: 1038 UK adults were recruited who were either identified by UK government as at high risk of severe illness from COVID-19 or self-identified as at high risk with acute or other chronic health conditions not included in the UK government list. Participants were recruited through social media advertisements, health charities and patient organisations. MAIN OUTCOMES MEASURES: The awareness, attitudes and actions survey which explores the impact of COVID-19, on including access to healthcare, use of technology for health condition management, mental health, depression, well-being and lifestyle behaviours. RESULTS: Nearly half of the sample (44.5%) reported that their mental health had worsened during the COVID-19 lockdown. Management of health conditions changed including access to medications (28.5%) and delayed surgery (11.9%), with nearly half of the sample using telephone care (45.5%). Artificial Intelligence identified that participants in the negative cluster had higher neuroticism, insecurity and negative sentiment. Participants in this cluster reported more negative impacts on lifestyle behaviours, higher depression and lower well-being, alongside lower satisfaction with platforms to deliver healthcare. CONCLUSIONS: This study provides novel evidence of the impact of COVID-19 on people identified as at high risk of severe illness. These findings should be considered by policy-makers and healthcare professionals to avoid unintended consequences of continued restrictions and future pandemic responses.


Subject(s)
Communicable Disease Control/methods , Health Services Accessibility/trends , Mental Health/trends , Risk Assessment , Social Isolation/psychology , Adult , Artificial Intelligence , Attitude to Health , /prevention & control , Chronic Disease/epidemiology , Female , Humans , Male , Risk Factors , Surveys and Questionnaires , United Kingdom/epidemiology
12.
J Occup Environ Med ; 62(12): 981-985, 2020 12.
Article in English | MEDLINE | ID: covidwho-998535

ABSTRACT

OBJECTIVE: The number of COVID-19 cases in Arizona is rapidly increasing, leading the country in the rate of new daily cases. Exposure among first responders remains unknown. METHODS: Rates of SARS-CoV-2 IgG among first responders in Arizona were determined, and attitudes/views about the impact of COVID-19 on their work life was analyzed. RESULTS: Of 3326 first responders, 50 (1.50%) tested positive for SARS-CoV-2 IgG. Most first responders thought antibody testing would help ease their anxieties (62.5%) and be beneficial to their work-life (60.6%). CONCLUSION: The rate of COVID-19 exposure among first responders in Arizona is low-1.50%. COVID-19 is a concern among many of the first responders, and antibody testing was beneficial in easing their anxieties about going to work and performing work-related duties.


Subject(s)
/transmission , Emergency Responders , Occupational Diseases , Occupational Exposure/statistics & numerical data , Adolescent , Adult , Arizona/epidemiology , Attitude to Health , /epidemiology , Female , Humans , Male , Middle Aged , Occupational Diseases/diagnosis , Occupational Diseases/epidemiology , Occupational Diseases/psychology , Occupational Exposure/adverse effects , Occupational Exposure/analysis , Young Adult
14.
Front Public Health ; 8: 583408, 2020.
Article in English | MEDLINE | ID: covidwho-993476

ABSTRACT

The current study investigates how public attitudes and perceptions about the COVID-19 pandemic evolve over time and influence self-reported health behaviors (e. g., social distancing). Specific attention was paid to respondents' exposure to different news media channels (public vs. commercial). We used data from a two-wave panel study with a 3-week interval (W1 at the start and W2 at the peak of the pandemic) and a large sample of the adult population in Flanders, Belgium (n = 870). The results of mixed ANOVAs indicate that besides a time-effect there was also a significant effect of the different types of news media exposure and respondents' support for protective health measures and behaviors. Whereas, perceived vulnerability to disease, feelings of loneliness, and solidarity were mostly determined by respondents' overall frequency of media exposure, support of governmental measures and self-reported health behaviors were mostly determined by the type of news media exposure. Respondents with a predominantly public/quality news media diet had the highest scores on these variables. A stepwise linear regression analysis with individual's change scores demonstrated that (self-)protective behavior was positively determined by respondents' age, solidarity, and the belief that the measures are necessary, but negatively determined by one's cumulative exposure to commercial/tabloid news media. This longitudinal study provides a new perspective on the role of news media in times of a public health crisis. It offers support for (A) the "double bind hypothesis" (i.e., while news media consumption encourages (self-)isolation, it fosters feelings of loneliness); and (B) the "dual effects hypothesis" (i.e., exposure to commercial/tabloid news media generates different outcomes than exposure to public/quality news media). Affective responses and socio-psychological perceptions are influenced by overall news media exposure, whereas support for the government and its handling of the crisis are mainly determined by one's selection of media channels, whereby audiences of public news media evaluate these outcomes more positively than the audiences of commercial news media channels.


Subject(s)
Attitude to Health , Health Behavior , Mass Media/statistics & numerical data , Mass Media/trends , Pandemics/statistics & numerical data , Public Opinion , Adult , Aged , Aged, 80 and over , Belgium , Female , Forecasting , Humans , Longitudinal Studies , Male , Middle Aged , Surveys and Questionnaires
15.
BMC Public Health ; 20(1): 1922, 2020 Dec 21.
Article in English | MEDLINE | ID: covidwho-992466

ABSTRACT

BACKGROUND: Individual perceptions of personal and national threats posed by COVID-19 shaped initial response to the pandemic. The aim of this study was to investigate the changes in residents' awareness about COVID-19 and to characterize those who were more aware and responsive during the early stages of the pandemic in Louisiana. METHODS: In response to the mounting threat of COVID-19, we added questions to an ongoing food preference study held at Louisiana State University from March 3rd through March 12th, 2020. We asked how likely it was that the spread of the coronavirus will cause a national public health crisis and participants' level of concern about contracting COVID-19 by attending campus events. We used regression and classification tree analysis to identify correlations between these responses and (a) national and local COVID case counts; (b) personal characteristics and (c) randomly assigned information treatments provided as part of the food preference study. RESULTS: We found participants expressed a higher likelihood of an impending national crisis as the number of national and local confirmed cases increased. However, concerns about contracting COVID-19 by attending campus events rose more slowly in response to the increasing national and local confirmed case count. By the end of this study on March 12th, 2020 although 89% of participants agreed that COVID-19 would likely cause a public health crisis, only 65% of the participants expressed concerns about contracting COVID-19 from event attendance. These participants were significantly more likely to be younger students, in the highest income group, and to have participated in the study by responding to same-day, in-person flyer distribution. CONCLUSIONS: These results provide initial insights about the perceptions of the COVID-19 public health crisis during its early stages in Louisiana. We concluded with suggestions for universities and similar institutions as in-person activities resume in the absence of widespread vaccination.


Subject(s)
Attitude to Health , Disease Susceptibility/psychology , Health Behavior , Public Health , Adolescent , Adult , Female , Food Preferences/psychology , Humans , Louisiana/epidemiology , Male , Perception , Regression Analysis , Students/psychology , Surveys and Questionnaires , Universities , Young Adult
17.
BMJ Open ; 10(12): e045593, 2020 12 08.
Article in English | MEDLINE | ID: covidwho-969976

ABSTRACT

OBJECTIVE: As cases of COVID-19 infections surge, concerns have renewed about intensive care units (ICUs) being overwhelmed and the need for specific triage protocols over winter. This study aimed to help inform triage guidance by exploring the views of lay people about factors to include in triage decisions. DESIGN, SETTING AND PARTICIPANTS: Online survey between 29th of May and 22nd of June 2020 based on hypothetical triage dilemmas. Participants recruited from existing market research panels, representative of the UK general population. Scenarios were presented in which a single ventilator is available, and two patients require ICU admission and ventilation. Patients differed in one of: chance of survival, life expectancy, age, expected length of treatment, disability and degree of frailty. Respondents were given the option of choosing one patient to treat or tossing a coin to decide. RESULTS: Seven hundred and sixty-three participated. A majority of respondents prioritised patients who would have a higher chance of survival (72%-93%), longer life expectancy (78%-83%), required shorter duration of treatment (88%-94%), were younger (71%-79%) or had a lesser degree of frailty (60%-69%, all p<0.001). Where there was a small difference between two patients, a larger proportion elected to toss a coin to decide which patient to treat. A majority (58%-86%) were prepared to withdraw treatment from a patient in intensive care who had a lower chance of survival than another patient currently presenting with COVID-19. Respondents also indicated a willingness to give higher priority to healthcare workers and to patients with young children. CONCLUSION: Members of the UK general public potentially support a broadly utilitarian approach to ICU triage in the face of overwhelming need. Survey respondents endorsed the relevance of patient factors currently included in triage guidance, but also factors not currently included. They supported the permissibility of reallocating treatment in a pandemic.


Subject(s)
Attitude to Health , Health Care Rationing/organization & administration , Triage/organization & administration , Adult , Female , Health Care Rationing/ethics , Humans , Intensive Care Units/organization & administration , Male , Middle Aged , Pandemics , Surveys and Questionnaires , Triage/ethics , United Kingdom
18.
BMC Pulm Med ; 20(1): 319, 2020 Dec 09.
Article in English | MEDLINE | ID: covidwho-968723

ABSTRACT

BACKGROUND: The COVID-19 pandemic is having profound psychological impacts on populations globally, with increasing levels of stress, anxiety, and depression being reported, especially in people with pre-existing medical conditions who appear to be particularly vulnerable. There are limited data on the specific concerns people have about COVID-19 and what these are based on. METHODS: The aim of this study was to identify and explore the concerns of people with long-term respiratory conditions in the UK regarding the impact of the COVID-19 pandemic and how these concerns were affecting them. We conducted a thematic analysis of free text responses to the question "What are your main concerns about getting coronavirus?", which was included in the British Lung Foundation/Asthma UK (BLF-AUK) partnership COVID-19 survey, conducted between the 1st and 8th of April 2020. This was during the 3rd week of the UK's initial 'social distancing measures' which included advice to stay at home and only go outside for specific limited reasons. RESULTS: 7039 responses were analysed, with respondents from a wide range of age groups (under 17 to over 80), gender, and all UK nations. Respondents reported having asthma (85%), COPD (9%), bronchiectasis (4%), interstitial lung disease (2%), or 'other' lung diseases (e.g. lung cancer) (1%). Four main themes were identified: (1) vulnerability to COVID-19; (2) anticipated experience of contracting COVID-19; (3) pervasive uncertainty; and (4) inadequate national response. CONCLUSIONS: The COVID-19 pandemic is having profound psychological impacts. The concerns we identified largely reflect contextual factors, as well as their subjective experience of the current situation. Hence, key approaches to reducing these concerns require changes to the reality of their situation, and are likely to include (1) helping people optimise their health, limit risk of infection, and access necessities; (2) minimising the negative experience of disease where possible, (3) providing up-to-date, accurate and consistent information, (4) improving the government and healthcare response.


Subject(s)
Disease Transmission, Infectious/prevention & control , Psychological Distress , Respiratory Tract Diseases , Social Perception , Uncertainty , Vulnerable Populations , Attitude to Health , /prevention & control , Communicable Disease Control/methods , Comorbidity , Female , Humans , Male , Mental Health , Middle Aged , Qualitative Research , Respiratory Tract Diseases/classification , Respiratory Tract Diseases/epidemiology , Respiratory Tract Diseases/psychology , United Kingdom/epidemiology , Vulnerable Populations/psychology , Vulnerable Populations/statistics & numerical data
19.
Pediatr Ann ; 49(12): e523-e531, 2020 Dec 01.
Article in English | MEDLINE | ID: covidwho-963766

ABSTRACT

Although vaccine acceptance and uptake are overall high among children in the United States, vaccine delays or refusals are a growing concern. Vaccine hesitancy is a challenge for the pediatric provider, given the diverse factors associated with hesitancy and the limited evidence on effective strategies for addressing vaccine hesitancy in the provider office. In this article, we review available evidence and approaches for vaccine communication, including the importance of using a whole-team approach, building trust, starting the conversation early, using a presumptive approach for vaccine recommendations, motivational interviewing with parents who have concerns for vaccines, and additional techniques for responding to parent questions. We also review organizational strategies to help create a culture of immunization in the practice, including evidence-based approaches for increasing vaccine uptake and efficiency. Although these communication approaches and organizational strategies are intended to reassure parents who are vaccine hesitant that all routine, universally recommended vaccines are safe and effective, they likely will take on increased significance as the development, implementation, and evaluation of coronavirus disease 2019 vaccines continue to unfold. [Pediatr Ann. 2020;49(12):e523-e531.].


Subject(s)
Immunization Programs , Parents , Pediatrics , Vaccination , Attitude to Health , Child , Communication , Humans , Parents/education , Patient Education as Topic , Physician-Patient Relations , Professional-Family Relations , Reminder Systems , Standing Orders , Vaccination Refusal
20.
Front Public Health ; 8: 562300, 2020.
Article in English | MEDLINE | ID: covidwho-961666

ABSTRACT

Little is known about the evaluative and cognitive foundations for adopting preventive measures to reduce the spread of COVID-19. Recognizing the existence of a gap in the knowledge describing the intention and behavior of participating in health measures, this study investigated the drivers that contribute to the intention to take health protective measures among 305 rural youth from the Dashtestan Region, Bushehr Province, and southern Iran, reached through an online survey. Protection motivation theory (PMT) served as the theoretical framework for the study. It was able to forecast variation in intentions and behaviors with accuracies of 39 and 64%, respectively. Furthermore, the variables of response efficiency, perceived severity, and self-efficacy had a positive and significant effect on protective intentions. Additionally, perceived severity, self-efficacy, and intention produced a positive and significant impression on behaviors, with most of the behavioral variance being accounted for by intention, as was hypothesized. In conclusion, it is suggested that health development including training measures that take account of both the concrete issues of health resources and technologies and of more abstract ones, such as mindset readiness, are important for engagement in positive health care behaviors. Accordingly, training-based interventions for rural youth should be contemplated, with the object of changing their intentions.


Subject(s)
Attitude to Health , Intention , Motivation , Adolescent , Adult , Cross-Sectional Studies , Female , Humans , Iran , Male , Pandemics , Psychological Theory , Rural Population , Surveys and Questionnaires , Young Adult
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