COVID-19 Preventive Behaviors Research Articles

Design and psychometrics of a tool for measuring social cognitive factors related to the preventive behaviors toward Covid-19 in the society.

With the emergence of new strains of Covid-19, the adoption of preventive behaviors is still considered a requirement to control this disease. Therefore, considering the importance of social cognitive factors in adopting various types of preventive behaviors, the present study was conducted to design and psychometrically measure the social cognitive factors related to Covid-19 preventive behaviors. A cross-sectional study was conducted on 526 people ages 18 and over with multi-stage stratified, cluster and random sampling in Isfahan, Iran in 2022. The questionnaire was validated and formulated in three stages: designing, creating and reducing items. After collecting information and creating a bank of items, qualitative and quantitative methods were used to calculate the tool's validity. Data analysis was done in SPSS23 software at a significance level of less than 0.05. In the present study, the average age score of the participants was 39.16 ± 11.48. The results related to the construct validity in the exploratory part show that the five factors (Outcome expectations, self-efficacy, social support, self-regulation and barrier self-efficacy) obtained have a specific value higher than one and range from 1.376 to 9.343. Correlation between factors shows that all factors have a relatively high relationship with each other (P < 0.05). According to the exploratory factor analysis, the final questionnaire contains 29 items and 5 constructs from socio-cognitive theory. The results showed that the thematically and technically designed tool has been prepared in an appropriate way for each of the structures and can accurately measure the structures of outcome expectations, self-efficacy, social support, self-regulation and barrier self-efficacy to explain the preventive behaviors of Covid-19 to evaluate.

Trust in Government and COVID-19 Preventive Behaviors

High levels of trust are positively correlated with increased collaboration, prosocial actions, and heightened adherence to preventive behaviors during the COVID-19 pandemic. Previous studies on trust during the pandemic have primarily focused on either cross-sectional data or its impact in conjunction with other related variables, such as political party affiliations or vaccine availability. In this study, we employed a national survey panel comprising data from 760 individuals interviewed at three intervals between July 2020 and January 2021. We used pooled datasets, panel datasets, and dependent variable lags to control for time-invariant unobservable variables and endogeneity. Our findings reveal that trust in government influences individuals&amp;rsquo; behavior when they are requested to follow public interventions. Notably, trust in local government is associated with increased adherence to COVID-19 preventive behaviors, similar to the effect observed with an annual income exceeding $100,000.

Factors influencing protective gear use in crisis-affected Afghanistan during COVID-19

Abstract Background Afghanistan has faced considerable challenges in healthcare delivery during the COVID-19 pandemic. These challenges were compounded by limited health literacy, shortages of skilled health workers, and fragile health infrastructure, which increased the country’s double burden of disease. The World Health Organization (WHO) recommended the use of masks as part of a comprehensive strategy to mitigate the spread of SARS-CoV-2. Nevertheless, research on mask-wearing practices in Afghanistan is limited. This study aims to investigate the factors influencing the wearing of protective gear, including masks, during the COVID-19 pandemic in Afghanistan. Methods This study analyzed 16,058 households from the 2020 Afghanistan Multi-Sector Needs Assessment (MSNA) survey data. This survey was conducted between August and September 2020 by the Racial and Ethnic Approaches to Community Health (REACH) Initiative. Sampling weighted multivariable binary logistic regression analysis was performed. Results Recent internally displaced persons (IDPs) and returnees in Afghanistan were more likely to wear protective gear to prevent COVID-19 compared to non-recent IDPs. Factors such as household sizes, household income, knowledge of humanitarian support, and the distance to healthcare facilities were significantly associated with the likelihood of wearing protective gear. Conclusions The study suggests that certain factors place crisis-affected populations in Afghanistan at high risk in COVID-19 preventive behaviors, especially in wearing protective gear. The findings in this study indicate that public health interventions should focus on improving healthcare accessibility and enhancing information dissemination while considering socioeconomic factors. Additionally, this study highlights the need for access to personal protective gear during outbreaks of infectious disease, such as the COVID-19 pandemic. Key messages • Socioeconomic factors and accessibility on health services and information can affect COVID-19 preventive behaviors in crisis-affected populations. • This study can inform public health professionals to develop adequate interventions during infectious disease outbreaks.

Vaccine Hesitancy and COVID-19 Risk Behaviors Associated with Social Media Use in Japan

ABSTRACT We examined the associations between the use of different types of media and COVID-19 vaccine hesitancy, as well as risk behaviors of COVID-19 infection, in Japan in late 2021. Cross-sectional surveys were conducted using rapid online surveys of residents in Iwate Prefecture from February 5 to 7, 2021, and from October 1 to 3, 2021. Each individual’s risk of acquiring SARS-CoV-2 infection was calculated using a quantitative assessment tool (the microCOVID). Intention to get vaccinated for COVID-19 was assessed by self-report. Usage of five types of media for obtaining COVID-related information was assessed: (1) newspapers, (2) television or radio, (3) internet or news apps, (4) social network services (SNS) (excluding LINE, a popular messaging app), and (5) other. Reliance on SNS did not show significant associations with either intention to get vaccinated or engaging in risky behavior for acquiring COVID-19. Although users of the internet or news apps were marginally significantly less likely to engage in high-risk behavior, significant associations between vaccine hesitancy and the usage of the internet or news apps were found in the middle age and elderly groups (OR [95% confidence interval (CI)] in middle age: 1.55 [1.07–2.23]; in elderly; 9.24 [3.28–26.02]). The differential associations between different types of media use and COVID-19 prevention behaviors may assist in preparing for future pandemic outbreaks. One implication for public health risk communication is audience segmentation, such as emphasizing vaccine safety and effectiveness for older audiences.

Adherence to COVID-19 measures and the associated factors: evidence from a two-wave longitudinal study in Singapore

BackgroundAt the onset of the Coronavirus disease (COVID-19) pandemic when pharmaceutical interventions were not readily available, governments relied on public health mandates and social distancing measures to counter rising infection rates. In order to address the dearth of longitudinal studies, this study sought to identify factors associated with continued adherence to COVID-19 preventive behaviours in Singapore.MethodsData were from a two-wave longitudinal cohort study; baseline study was conducted from May 2020 to June 2021 and follow-up study from October 2021 to September 2022. Participants (n = 858) were Singapore residents, aged 18 and above, and able to speak English, Chinese or Malay. Weighted multivariable logistic regressions were conducted to identify factors associated with adherence to the COVID-19 measures.ResultsAdherence rates of ‘avoid dining out’, ‘crowded places’, ‘people with flu symptoms’ and ‘small group gatherings’ at baseline were 39.41%, 60.82%, 79.82%, and 44.82% respectively. All measures had a decrease in adherence rates across the two-waves. Older age groups were associated with greater adherence to ‘avoid dining out’ and ‘avoid crowded places’. Having high trust in local public health experts was associated with greater adherence to ‘avoid crowded places’ and ‘avoid people with flu symptoms’. Fear of family and friends getting infected with COVID-19 was associated with ‘avoid dining out’ and ‘avoid crowded places’.ConclusionsSoft interventions like nudges can be implemented at crowded places to remind the public of the ease of transmitting the virus to their loved ones. Increasing media presence of public health experts can be a viable alternative to improve adherence.

Predictors of older adults’ health behaviours to prevent COVID-19 transmission: a multilevel analysis

ObjectivesWhile older adults showed higher mortality during COVID-19 pandemic, protective behaviours (knowledge regarding coping with COVID-19 symptoms and preventive behaviours) were highlighted to be important to prevent the spread of...

Identifying Population Segments by Differing Levels of COVID-19 Vaccine Confidence and Evaluating Subsequent Uptake of COVID-19 Prevention Behaviors: Web-Based, Longitudinal, Probability-Based Panel Survey.

The COVID-19 pandemic prompted the launch of the US Department of Health and Human Services' COVID-19 Public Education Campaign to boost vaccine confidence and uptake among adults, as vaccines are key to preventing severe illness and death. Past segmentation research relevant to COVID-19 behavior has found important differences in attitudes, sociodemographics, and subsequent COVID-19 prevention behaviors across population segments. This study extends prior work by incorporating a more comprehensive set of attitudes, behaviors, and sociodemographic variables to identify population segments by differing levels of COVID-19 vaccine confidence and evaluate differences in their subsequent uptake of COVID-19 prevention behaviors. Data were obtained from 5 waves (January 2021 to June 2022) of a web-based longitudinal, probability-based panel survey of US adults (N=4398) administered in English and in Spanish. Participants were recruited from NORC at the University of Chicago's national AmeriSpeak panel and were invited to participate across multiple waves. Latent class cluster analysis estimated segments of respondents based on over 40 COVID-19 attitudes, beliefs, behaviors, and sociodemographics as reported in wave 1. Survey-weighted cross-tabulations and bivariate regression analyses assessed differences in COVID-19 vaccine uptake, booster uptake, mask use, and social distancing in all segments across all 5 survey waves. A total of 6 segments (hardline nonintenders, prevention-compliant nonintenders, burned-out waiters, anxious waiters, skeptical confidents, and ready confidents) were identified, which differed by their COVID-19 vaccine confidence, prevention-related attitudes and behaviors, and sociodemographics. Cross-tabulations and regression results indicated significant segment membership differences in COVID-19 vaccine and booster timing, mask use, and social distancing. Results from survey-weighted cross-tabulations comparing COVID-19 vaccine and booster uptake across segments indicate statistically significant differences in these outcomes across the 6 segments (P<.001). Results were statistically significant for each segment (P<.01 for booster uptake among burned-out waiters; P<.001 for all other coefficients), indicating that, on average, respondents in segments with lower intentions to vaccinate reported later receipt of COVID-19 vaccines and boosters relative to the timing of vaccine and booster uptake among ready confidents. Results extend previous research by showing that initial beliefs and behaviors relevant to COVID-19 vaccination, mask use, and social distancing are important for understanding differences in subsequent compliance with recommended COVID-19 prevention measures. Specifically, we found that across respondent segments, the probability of vaccine and booster uptake corresponded with both COVID-19 vaccine confidence and mask use and social distancing compliance; more compliant segments were more likely to get vaccinated or boosted than less compliant segments given similar levels of vaccine confidence. These findings help identify appropriate audiences for campaigns. Results highlight the use of a comprehensive list of attitudes, behaviors, and other individual-level characteristics that can serve as a basis for future segmentation efforts relevant to COVID-19 and other infectious diseases.

Lessons Learned from Community Partnership During the COVID-19 Pandemic

Abstract: Underserved communities have been disproportionately affected by the COVID-19 pandemic. The Project Promoting Engagement and COVID-19 Testing for Health (PEACH) study was designed to understand the attitudes, beliefs, and infrastructure associated with COVID-19 risk, testing, and prevention behaviors in people living with, caring for, or at risk for type 2 diabetes. The purpose of this joint community–academic partnered manuscript is to share lessons learned for maintaining community partnerships through the challenging times of a pandemic. New and existing community partners were invited to share their perceptions about the facilitators and barriers of partnering with academia during the COVID-19 public health crisis. Key facilitators included those partners felt heard and their input valued. And the changing nature and demands in response to the pandemic on the partners’ responsibilities were among the key challenges. Successful maintenance of the partnerships required flexibility, creativity, and a willingness to adapt engagement as community partners responded to the needs of their communities.

The causal relationship model of factors influencing COVID-19 preventive behaviors during the post-pandemic era and implications for health prevention strategies: a case of Bangkok City, Thailand

BackgroundThough, many countries are currently in the COVID post-pandemic era, people’s health protective behaviours are still essential to protect their health and well-being. This study aims to evaluate people’s understanding and perceptions of COVID-19 risk characteristics (i.e. threat occurrence, threat severity, perceived susceptibility and exposure), the health risk perception towards COVID-19, and health protective behaviours. The study also aims to estimate the associations among these factors by the analysis of structural equation modelling (SEM).MethodsFrom 15 October to 9 November 2022, questionnaire surveys were administrated to 521 people living in Bangkok of Thailand by using the convenience sampling technique. The analyses were carried out in three phases including descriptive statistical analyses, a measurement model assessment using a confirmatory factor analysis (CFA), and structural equation modelling (SEM) analysis.ResultsThe results of descriptive analyses demonstrated that the majority of respondents, 39.9%, had the age between 20 and 30 years old, and 61.4% of them were female. Approximately 52.1% of them had a bachelor’s degree. Upon analysing individuals’ understanding and perceptions of all risk characteristics, individuals’ understanding of COVID-19 severity did not statistically affect health risk perception towards COVID-19, whereas perceived exposure had the strongest effect and in turn influenced health protective behaviours. Perceived susceptibility and understanding of the threat occurrence also significantly affected health risk perception, and indirectly affected health protective behaviours.ConclusionsThis study implies that though the potential health impact of COVID-19 is perceived as less severe, people can still construct a perception of its risk particularly based on their perceived exposure and susceptibility. Thus, communicating people about exposure conditions and susceptibility can greatly contribute to people’ construction of risk perception towards COVID-19 which subsequently leads to the decision to perform health protective behaviours.

Patterns and predictors of COVID-19 vaccination among young adults at 44 US sites: Secondary analysis of a randomized, controlled, open-label trial, March – December 2021

Background: The introduction of vaccines during the COVID-19 pandemic provided an opportunity to slow transmission of SARS-CoV-2, but initial uptake of COVID-19 vaccination was slow. We analyzed data from a randomized clinical trial of the mRNA-1273 vaccine (NCT04811664) to describe the patterns of uptake of COVID-19 vaccines among young adults.Methods: The CoVPN 3006 trial randomized adults ages 18–29 from 44 sites in the United States to receive 1) immediate mRNA-1273 vaccination from the study site, or 2) standard of care, including the option to seek vaccination at any time in the future. Randomization occurred between March and November 2021, and an observational arm of adults who declined vaccination was enrolled beginning June 2021. Among participants in the standard of care (SoC) or Vaccine Declined arms, we estimated demographic, behavioral, and health history correlates of vaccination, and the four-month cumulative incidence of COVID-19 vaccination using inverse probability weighted Kaplan-Meier estimators.Results: Among 728 SoC and 470 Vaccine Declined participants, 79% and 16% received COVID-19 vaccination, respectively. SoC and Vaccine Declined participants were more likely to seek and receive vaccination if they reported COVID-19 preventive behaviors, including wearing masks, physically distancing, and avoiding large gatherings. We identified strong predictors of vaccination in the Vaccine Declined arm, including attending class in person (adjusted risk ratio [aRR]: 0.47, 95% confidence interval [CI] 0.21, 1.03), having a COVID-19 relevant medical condition (aRR: 1.95, 95% CI: 0.89, 4.26), and avoiding large gatherings (aRR: 2.24, 95% CI: 1.18, 4.25), though low vaccination rates in this arm led to imprecise estimates.Conclusions: Individuals who initially decline vaccination can be convinced to vaccinate, particularly if they are already practicing other forms of COVID-19 prevention. Continued outreach and education from the scientific community can combat low vaccine confidence.

Addressing COVID-19 and Health Literacy Disparities Among Correctional Facility Residents Through Dialogue-Based Education.

Carceral communities face heightened COVID-19-related risks while simultaneously experiencing medical mistrust and limited access to health information and services. Health education programs that incorporate dialogue-based, participatory learning models have been shown to motivate health behavior and increase health knowledge in carceral settings. To increase health literacy and change COVID-19-related health behavior among jail residents in the United States, a local health department developed a dialogue-based education program centered around COVID-19 prevention, misinformation, and navigating health care systems. Dialogue-based health information sessions took place in person in a county jail. Pre- and postsurveys gauged the sessions' influence on self-reported health literacy and behavior intention. Overall, 595 residents collectively attended 43 facilitated discussions. Key findings indicate that dialogue-based education can temper medical mistrust, influencing COVID-19 preventive behaviors and increasing health literacy in a carceral setting.

Predictors of fear of COVID-19 in a low-income country: health literacy is important.

Excessive fear of a threatening condition or situation can result in individuals engaging in unhealthy behaviors, especially during the COVID-19 pandemic. Identifying the influential factors of fear can be effective in designing and implementing health-center interventions to control and reduce the COVID-19 pandemic. This study was a cross-sectional design implemented in Iran in 2022. Participants were adults 18-65 years of age recruited randomly from primary Health Care Services Centers (HCSCs) by medical records (n = 380, 64.7% female, mean (SD) age 32.14 ± 10.98 years) in urban and rural areas of the county. The data collection included a demographic form, Fear of COVID-19 questionnaire, Perceived Barriers of COVID-19 preventive behaviors, Self-efficacy, and Health Literacy for Iranian Adults (HELIA) questionnaire. It was determined that the fear of COVID-19 showed statistically significant differences according to gender (p-value = 0.013), education level (p-value = 0.001), and job status (p-value = 0.001). According to the hierarchical linear regression, educational level (p-value = 0.001; β = 0.665), job (β = 0.126; p-value = 0.018), self-efficacy (p-value = 0.015; β = 0.103), and Health Literacy (HL) (p-value = 0.001; β = 0.446) were significant predictors of fear of COVID-19. Also, among variables, educational level (p-value = 0.001; β = 0.665) and HL (p-value = 0.001; β = 0.446) were the most important predictors for fear of COVID-19. This research shows that HL has a potential and determinative role in controlling fear of COVID-19. The findings can help healthy policymakers and healthcare providers design HL-based programs in similar epidemics and pandemic situations.

Grandiose narcissism, unfounded beliefs, and behavioral reactions during the COVID-19 pandemic

A theoretical perspective on grandiose narcissism suggests four forms of it (sanctity, admiration, heroism, rivalry) and states that these forms conduce to different ways of thinking and acting. Guided by this perspective, we examined in a multinational and multicultural study (61 countries; N = 15,039) how narcissism forms are linked to cognitions and behaviors prompted by the COVID-19 pandemic. As expected, differences in cognitions and behaviors across narcissism forms emerged. For example, higher narcissistic rivalry predicted lower likelihood of enactment of COVID-19 prevention behaviors, but higher narcissistic sanctity predicted higher likelihood of enactment of COVID-19 prevention behaviors. Further, whereas the heroism, admiration, and rivalry narcissism forms acted in a typically antisocial manner, with high narcissism predicting greater endorsement of unfounded health beliefs, the sanctity form acted in a prosocial manner, with higher narcissism being linked to lower endorsement of unfounded COVID-19 health beliefs. Thus, the findings (a) support the idea of four narcissism forms acting differently, and (b) show that these differences reflect a double-edged sword, sometimes linking to an anti-social orientation, and sometimes linking to a pro-social orientation.

Relationship Between Health Literacy Level and the Adoption of Preventive Behaviors Against Coronavirus Disease

Background: Health literacy skills play a pivotal role in adopting preventive behaviors. The COVID-19 pandemic has brought renewed emphasis on health-oriented behaviors, and health literacy is considered one of the most influential indicators affecting health-centric behaviors. Objectives: This study was conducted to determine the relationship between the level of health literacy and the adoption of preventive behaviors against COVID-19 among students at Jundishapur University of Medical Sciences in Ahvaz. Methods: In this study, the research population comprised 223 newly enrolled students from seven main faculties at Jundishapur University of Medical Sciences in Ahvaz in the year 2022. Participants were randomly selected, and data collection instruments included a COVID-19 prevention questionnaire and a health literacy questionnaire for adults. The questionnaire links and study participation consent forms were sent to the participants. Inclusion criteria consisted of willingness and consent to participate in the study, and enrollment in the first year of study (either the first or second semester) in various academic levels at Ahvaz University of Medical Sciences. The exit criteria were defined as failure to respond to more than 5% of the questions. After data collection, descriptive statistics, correlation coefficient tests, and regression analysis were employed using SPSS software for data analysis. Results: The findings revealed that women, married individuals, employed participants, and those with underlying health conditions obtained higher scores in preventive behaviors against COVID-19 and health literacy. Regression coefficients indicated that a one-unit increase in health literacy scores could lead to a 0.439-unit increase in preventive behaviors against COVID-19. According to correlation analysis, a positive, direct, and significant correlation existed among all dimensions of health literacy and preventive behaviors against COVID-19 (P &lt; 0.05), with the behavioral dimension being the only significant predictor of preventive behaviors. Specifically, a one-unit increase in the behavioral dimension score could result in a 0.373-unit increase in preventive behaviors against COVID-19 (P &lt; 0.001). Conclusions: The results showed that health literacy is directly related to COVID-19 preventive behaviors. Therefore, to promote preventive behaviors against infectious diseases, special attention should be paid to health literacy and its influential dimensions. Recognizing the importance of advancing health literacy across various dimensions can significantly contribute to the control and prevention of communicable diseases.

The role of social media on COVID-19 preventive behaviors worldwide, systematic review.

The likelihood of COVID-19 spreading from one individual to another is impacted by personal factors, preventive actions taken, and the quantity and length of exposure. Social media instantly shares health information with the public so medical professionals can interact with them. The review used Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. We retrieve articles by using keywords on Pub Med, Cochrane Library, and grey literatures. The Joanna Briggs Institute (JBI) Meta-Analysis of Statistics Assessment and Review Instrument was used to check the quality of articles. The main qualitative synthesis was including comments related to the characteristics of the studied populations, the study period, and the main results obtained from the social media platforms. This study includes 32 studies conducted in 20 countries globally. Most of the studies discussed that during the pandemics different types of social medias were utilized to provide knowledge to change the attitude of the people and helps to practices COVID-19 preventive behaviors. By enabling people to seek and share knowledge, socialize, and find pleasure, social media use encourages people to adopt preventive behaviors. This review demonstrated a substantial relationship between higher levels of precautionary behaviors and factors such as educational status, knowledge, fear, and reading medical pages on social media. According to the studies, watching videos is a reliable means to get accurate information, and watching animated films posted on social media can help people learn more about COVID-19 preventive strategies. In these urgent times, social media could even help with quick information availability; misinformation or inadequate understanding can cause misunderstandings within the community. This analysis revealed that following medical pages on social media, having knowledge, feeling afraid, and having an educational background were all strongly correlated with greater levels of aware preventive behavior. Therefore, it is advised for policy makers to develop social behavioral change health communication strategies, guidelines on COVID-19 prevention behaviors. Health care providers should prepare health learning materials, and provide accurate, updated and timely information using all forms of social media to correct mis- information, misperceptions, depression, and anxiety for better control of the pandemics. Future research shall focus on evaluating effectiveness of each social media platform interventions during such emergency crisis.

What drives preventative health behaviors one year into a pandemic? A replication and extension

Objective: There is continued interest in understanding what leads people to engage in CDC-recommended COVID-19 prevention behaviors. We tested whether fear and COVID-19 worry would replicate as the primary drivers of six CDC recommended prevention behaviors. Methods and Measures: We recruited 741 adult participants during the second major peak of the COVID-19 pandemic in the United States (early 2021). Using very similar methods to the original study, participants completed a 10-day daily diary. Mixed effects models identified the strongest predictors of each individual prevention behavior as well as approach and avoidance behavior clusters. Results: At the between-person level, COVID-19 worry, COVID-19 perceived susceptibility, fear, and positive emotions all had positive zero-order associations with the prevention behaviors. However, with all predictors in the same model together, primarily COVID-19 worry remained significant for both the individual behaviors and behavior clusters. At the within-person level, only fear related to assessing oneself for COVID-19 and approach behaviors on the same day, but not the next day. Mediational analyses suggested COVID-19 worry, but not COVID-19 susceptibility, mediated the links between fear and approach/avoidance behaviors. Conclusion: Findings replicated worry about yourself or a loved one getting COVID-19 as the strongest predictor of prevention behaviors.

Factors Influencing the Intention of COVID-19 Infection Preventive Behaviors Among Hemodialysis Patients in Korea: A Cross-sectional Study

Objectives: This study aimed to identify the factors influencing the intention of COVID-19 infection preventive behaviors among patients undergoing hemodialysis by applying the theory of planned behavior. Methods: The study included 209 patients with chronic renal failure undergoing hemodialysis at five hospitals in Gangwon-do, Korea. Data were collected from December 28, 2021 to January 15, 2022. The analysis involved percentage, mean and standard deviation, independent t-test, ANOVA, Pearson’s correlation coefficient, and hierarchical multiple regression using SPSS 22.0. Results: Significant correlations were observed between attitude toward COVID-19 preventive behavior, subjective norms regarding COVID-19 preventive behavior, perceived behavior control of COVID-19 preventive behavior, restricted dietary control, COVID-19 knowledge, self-efficacy in COVID-19 preventive behavior, and intention of COVID-19 infection preventive behavior. Hierarchical multiple regression analysis revealed that subjective norms regarding COVID-19 preventive behavior (β = 0.49, p &lt; 0.001) and perceived behavior control of COVID-19 preventive behavior (β = 0.26, p &lt; 0.001) significantly influenced the intention of COVID-19 infection preventive behavior among hemodialysis patients. The model accounted for 54.8% of the variance (F = 43.02, p &lt; 0.001). Conclusions: Identifying relevant factors associated with COVID-19 preventive behaviors among vulnerable hemodialysis patients is crucial for providing adequate care by healthcare professionals. Proactive measures are necessary to prevent and manage the infection in this patient population.

The Role of Anxiety and Prosocial Behaviors on Adherence Behaviors to Prevent COVID-19 in University Students in the United States: Cross-Sectional Study.

In situations of acute stress, individuals may engage in prosocial behaviors or risk-taking self-oriented behaviors. The COVID-19 pandemic created large stress-promoting conditions that impacted individuals' decisions to adhere to COVID-19 preventative behaviors. The study aimed to examine the relationship between anxiety during the pandemic and adherence behaviors to prevent the spread of COVID-19, and the moderating influence of prosocial behaviors. We hypothesized that individuals with high anxiety during COVID-19 would adhere more to preventive COVID-19 behaviors than ones with low anxiety and that this relationship would be stronger in those individuals with higher prosocial behaviors. A web-based survey was administered through the SONA web-based participant tool of the psychology department of a university in the Northeastern United States. A final sample of 54 undergraduate students completed web-based questionnaires during the second wave of the COVID-19 pandemic, from January to May 2021, which included demographic measures and surveys on prosocial behaviors, anxiety, and COVID-19 preventive behaviors. Moderation analyses were conducted using PROCESS in SPSS. Participants reported high levels of trait and state anxiety symptoms, most of them meeting or exceeding the cutoff criteria to be clinically meaningful (state anxiety: 47/54, 87%; trait anxiety: 38/44, 86%), and over 50% highly adhered to the COVID-19 preventive behaviors of wearing a face mask, using hand sanitizer, handwashing, coughing/sneezing into their elbow or a tissue, self-quarantining, maintaining social distance, avoiding social gatherings, and avoiding nonessential travel. No significant associations were observed between prosocial behavior, anxiety types, and adherence to COVID-19 preventive behaviors. However, when moderation analyses were conducted between anxiety types and adherence to COVID-19 preventive behaviors, results demonstrated a statistically significant interaction of public prosocial behavior with state anxiety (β=-.17, t53=-2.60; P=.01), predicting engagement in COVID-19 preventative behaviors. At high levels of anxiety, low levels of prosocial public behaviors were associated with higher engagement in COVID-19 preventative behaviors. In contrast, high levels of public prosocial behavior were associated with low engagement in COVID-19 preventative behaviors at higher levels of anxiety. These results provide information that can aid in the creation of interventions that could increase adherence to COVID-19 preventative behaviors (Reviewed by the Plan P #PeerRef Community).

The relationship between health literacy and the adoption of COVID-19 preventive behaviors: A cross-sectional study in Iran.

Health literacy (HL) is one of the effective factors in controlling the COVID-19 epidemic. Considering the high prevalence of COVID-19 disease, the present study aimed to determine the relationship between HL and the adoption of COVID-19 preventive behaviors. This was a descriptive-cross sectional study conducted on 214 students selected by simple random sampling method in Esfarayen Faculty of Medical Sciences, Iran, in 2022. The data included demographic and background characteristics, health literacy for Iranian Adults (HELIA), and a valid and reliable questionnaire to measure COVID-19 preventive behaviors. The data were analyzed using SPSS 23, descriptive statistics, and ordinal logistic regression tests. The mean and standard deviation of the scores of adoption of COVID-19 preventive behaviors and HL among students were 18.18) 4.02(out of 25 and 72.14) and 12.75 (out of 100, respectively. The results of the logistic regression test showed that the HL (P = 0.003), gender (P<0.001), mother's education (P = 0.039), educational level (P = 0.031), smoking (P = 0.032), and physical activity (P = 0.007) were effective factors in adopting preventive behaviors. Adopting preventive behaviors against COVID-19 was lower among students with lower levels of health literacy, male students, students with less physical activity, students with illiterate mothers, undergraduate students, and finally smokers. Therefore, it is necessary to pay more attention to these students in designing educational programs. It is suggested to carry out more extensive studies to clarify the effect of HL on the adoption of COVID-19 preventive behaviors.

Political Affiliation Moderates the Effect of Injunctive Norms on Freedom Threat and Behavioral Intentions: Limiting Indoor Gatherings to Flatten the COVID-19 Curve

ABSTRACT Although many states in the U.S. restricted indoor social gatherings to prevent the spread of COVID-19 in the Fall of 2020, college students’ large social gatherings still caused many cluster infections. The present study aimed to explore whether perceived injunctive norms negatively influence behavioral intentions through perceived freedom threat and anger and to probe the ways that different political party affiliations interact with the normative effects. Undergraduate students were recruited to participate in an online survey (n = 170). Counter to predictions, perceived injunctive norms positively influenced Republican participants’ behavioral intentions through perceived freedom threat and anger. They reported lower perceived freedom threat as perceived injunctive norms increased, whereas Democrat participants reported higher perceived freedom threat as perceived injunctive norms increased. The findings suggested that injunctive social norms campaigns would be more effective for Republican students to promote COVID-19 preventive behaviors as contrasted with Democrat students.