Engagement In Preventive Behaviors Research Articles

Factors influencing CDC- recommended preventative behaviors through the COVID-19 pandemic in college students.

Objective: To understand how student perceptions of physical health and generalized concern about infection influenced engagement in COVID-19 preventive behaviors. Participants: 418 full-time undergraduate and graduate students attending a public university in South Carolina, USA. Methods: A self-administered survey was distributed during the 2020-2021 academic year. The health belief model, structural equation modeling, and regression methods were used to evaluate associations between students' perceived physical health and the use of CDC-recommended mitigation strategies. Results: Our findings suggest that an individual's perception of their own physical health impacted engagement in preventive behaviors by influencing concerns about disease severity (p = 0.01) and susceptibility (p = 0.03). However, perceived physical health was not associated with perceived benefits (p = 0.21), barriers (p = 0.57), or self-efficacy (p = 0.62) of mitigation strategies. Conclusions: Intrapersonal factors may play a strong role in the way a student undertakes disease control and prevention.

A Mixed-Methods Analysis of Coercive Control and COVID-19 Stress Among Black Women Experiencing Intimate Partner Violence During the COVID-19 Pandemic.

During times of crises, women are at elevated risk for intimate partner violence (IPV), but extant discourse fails to consider how this landscape amplifies disparities for Black women. This study examined the prevalence and associations of COVID-19 pandemic-specific coercive control and COVID-19-related stress among Black women experiencing IPV. Fifty-five Black women reporting past-year IPV participated in a prospective cohort study in 2020 and completed surveys on pandemic-specific coercive control, COVID-19-related stress, and sociodemographic characteristics. A subset of 15 participants completed semi-structured interviews in 2021. We conducted multivariable regression analyses to examine associations between coercive control and stress. We used interpretive phenomenological analysis to contextualize women's experiences of coercive control and stress during the pandemic. In the past 3 months, 76% (42 of 55) of women had a partner blame them for exposing them to COVID-19, 74% (41 of 55) had a partner minimize their pandemic concerns, and 52% (29 of 55) had a partner prevent them from getting a COVID-19 test. A higher average of pandemic-specific coercive control was associated with greater severity of COVID-19-related traumatic stress (b [SE] = 0.033 [0.009]; P = .001) and socioeconomic consequences related to COVID-19 (b [SE] = 0.019 [0.008]; P = .03). We identified 3 superordinate themes that illustrated Black women's experiences: (1) coercive control, (2) pandemic-driven shifts in relational context, and (3) women's structural and psychosocial stressors. Experiencing coercive control during the pandemic interfered with Black women's engagement in preventive behaviors, which exacerbated distress. Intersectional public health efforts should address sociostructural and relational factors to prevent coercive control and stress among Black women experiencing IPV.

Adding COVID to cancer: does cancer status influence COVID-19 infection preventive behaviors?

A better understanding of how to promote disease mitigation and prevention behaviors among vulnerable populations, such as cancer survivors, is needed. This study aimed to determine patterns of and factors associated with COVID-19-related preventive behaviors among cancer survivors and assess whether the COVID-19 preventive behaviors of cancer survivors differ from the general population. In June 2020, an online survey of adults (N = 897) assessed predictors of COVID-19-related preventive behaviors, including socio-demographics, COVID-19 beliefs and perceptions (Health Belief Model [HBM] variables), and cancer statuses (cancer survivors currently in treatment, cancer survivors not currently in treatment, and individuals with no history of cancer). An average score of respondent engagement in eight preventive behaviors was calculated. Differences in HBM variables and preventive behaviors by cancer status were assessed using ANCOVAs. Hierarchical multiple regression analyzed associations among socio-demographics, HBM constructs, cancer statuses, and engagement in COVID-19 preventive behaviors. Participants reported engaging in 3.5 (SD = 0.6) preventive behaviors. Cancer survivors not in treatment engaged in preventive behaviors significantly less than the comparison group. In the final adjusted model, after adding COVID-19 beliefs and perceptions, cancer status was no longer significant. All HBM constructs except perceived susceptibility were significant predictors of preventive behaviors. COVID-19 beliefs and perceptions were more robust predictors preventive behaviors than cancer status. Nonetheless, public health organizations and practitioners should communicate the risk and severity of infection among cancer survivors and emphasize the need to engage in protective behaviors for COVID-19 and other infectious diseases with this vulnerable population.

Explaining differences in self-focused and other-involved public health preventive behaviors between the US and China: the role of self- construal and health locus of control.

This study examined national similarities and differences in people's engagement in health preventive behaviors during a public health crisis, as well as investigated the underlying individual-level psychological mechanisms. A conceptual distinction was made between self-focused and other-involved preventive behaviors in response to public health crises. Two cross-sectional surveys were conducted in the United States (N = 888) and China (N = 844) during the early stage of the COVID-19 pandemic. Hayes' PROCESS was utilized to assess national differences in seven preventive behaviors, along with the mediating effects of self-construal and health locus of control. The results showed that American participants reported greater engagement in self-focused preventive behaviors than Chinese, whereas Chinese participants reported greater engagement in other-involved preventive behaviors than Americans. Chinese participants also engaged more in other-involved than self-focused preventive behaviors. Self-construal and health locus of control partially explained the observed differences in engagement in preventive behaviors. This study introduces a culture-sensitive approach to provide insights for crafting communication interventions that can enhance the effectiveness of health campaigns in the context of a public health crisis.

Attentive immobility: Investigating the emotional-cognitive mechanism underlying conspiracy mentality and Covid-19 preventive behaviors.

While conspiracy theories have received extensive attention in the realm of misinformation, there has been limited research exploring the impact of conspiracy mentality on individuals' preventive behaviors during acute public health crises. This study investigates how conspiracy mentality may affect compliance with preventive health measures necessary to fight the COVID-19 pandemic, and the underlying emotional and cognitive mediators. Data was collected through a survey among 1878 Chinese respondents at the conclusion of the pandemic. The results indicate that individuals with higher levels of conspiracy mentality are significantly less engaged in preventive behaviors. Furthermore, this correlation is mediated by a sequence of mediating factors, starting from anger leading to institutional distrust and fear leading to perceived risk. Conspiracists' response mode can be described as a state of "attentive immobility," in which the impact of heightened institutional distrust outweighs their perceptions of risk, ultimately reducing engagement in preventive behaviors during crises. These findings underscore the importance of debunking initiatives that aim to address and mitigate the negative consequences of conspiracy mentality by targeting the mediating psychological processes during future pandemic threats.

Preventive Behaviors, Psychological Distress, and their Associated Factors in Iranians during the SARS-CoV-2 Delta Variant Outbreak

Background: Up to now, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected and killed millions of people across the globe. In these conditions, Iran was experiencing the fifth wave of the Coronavirus disease 2019 (COVID-19) pandemic, accrued by the Delta variant, over the course of the present study. Objectives: The present study aimed to reflect on preventive behaviors, psychological distress, and their associated factors in Iranians during the SARS-CoV-2 Delta variant outbreak. Methods: Utilizing a descriptive-analytical cross-sectional research design, this study was performed on 1,015 Iranian individuals referred to the comprehensive healthcare centers in Kashan, central Iran, selected via simple random sampling. Data collection tools included the sociodemographic information questionnaire, the Preventive Behaviors against COVID-19 Questionnaire (PBCQ), and the 12-item General Health Questionnaire (GHQ-12). Results: The study results revealed that the mean±standard deviation (SD) of PBCQ was 17.20±4.18 (12-36). In addition, involvement in preventive behaviors against COVID-19 was at higher levels in male (P=0.007), younger (P≤0.001), and self-employed (P=0.016) participants with a fair family economic status (P=0.007), as compared to other cases. Those receiving no vaccines (P=0.023), together with the subjects recently contracting COVID-19, also adhered to only some preventive behaviors (P≤0.001). The GHQ-12 mean±SD was equal to 2.15±2.41 (0-12). Moreover, the study results indicated that female (P=0.021) younger (P=0.017), married (P=0.024), self-employed (P=0.003) subjects with a fair or poor family economic status (P=0.001) and recent infection with COVID-19 (P=0.010) were more susceptible to psychological distress, as compared to others. Conclusion: The present study demonstrated that engagement in preventive behaviors against COVID-19 significantly dwindled, and the incidence rate of psychological distress augmented in the course of the fifth wave of the pandemic in Iranians. These findings could provide healthcare planners and policymakers with valuable information.

A Tale of Two Audiences: Formative Research and Campaign Development for Two Different Latino Audiences, to Improve COVID-19 Prevention Behavior.

The COVID-19 pandemic disproportionately affected the Latino population in the United States, further exacerbating the existing racial and ethnic health disparities that this group faces. While government health entities rushed to develop COVID-19 prevention educational materials in Spanish, these failed to recognize the unique motivators and barriers that move different Latino audience segments to act. We conducted five online focus groups with two different Latino audience segments, general Latino people, and Latino migrant workers, to assess their experience navigating the pandemic, their engagement in preventive behavior, and their consumption of health news. While the general Latino audience had higher levels of social capital and established preventive healthcare, they were more skeptical about getting the COVID-19 vaccine. Migrant workers needed to be vaccinated to retain their jobs, and saw the vaccine as the only way to keep their families healthy. We used the focus group results to develop two different creative concepts that aligned with each audience's unique experience. Our study highlights the importance of developing hyper-focused messages, responsive to the experience of distinct audience segments, for maximum impact.

Why we should care about moral foundations when preparing for the next pandemic: Insights from Canada, the UK and the US.

Health behaviors that do not effectively prevent disease can negatively impact psychological wellbeing and potentially drain motivations to engage in more effective behavior, potentially creating higher health risk. Despite this, studies linking "moral foundations" (i.e., concerns about harm, fairness, purity, authority, ingroup, and/or liberty) to health behaviors have generally been limited to a narrow range of behaviors, specifically effective ones. We therefore explored the degree to which moral foundations predicted a wider range of not only effective but ineffective (overreactive) preventative behaviors during the COVID-19 pandemic. In Study 1, participants from Canada, the United Kingdom, and the United States reported their engagement in these preventative behaviors and completed a COVID-specific adaptation of the Moral Foundations Questionnaire during the pandemic peak. While differences occurred across countries, authority considerations consistently predicted increased engagement in both effective preventative behaviors but also ineffective overreactions, even when controlling for political ideology. By contrast, purity and liberty considerations reduced intentions to engage in effective behaviors like vaccination but had no effect on ineffective behaviors. Study 2 revealed that the influence of moral foundations on U.S participants' behavior remained stable 5-months later, after the pandemic peak. These findings demonstrate that the impact of moral foundations on preventative behaviors is similar across a range of western democracies, and that recommendations by authorities can have unexpected consequences in terms of promoting ineffective-and potentially damaging-overreactive behaviors. The findings underscore the importance of moral concerns for the design of health interventions that selectively promote effective preventative behavior.

We're very grateful: moral emotions, role models, and trust predict vaccine uptake intent in India

AbstractThis study investigated determinants of the willingness to get vaccinated in India and examined the relationship between engagement in preventive behaviours and vaccine uptake intent. A large-scale online survey covering aspects of COVID-19 preventive behaviours, vaccination status, moral emotions, trust in others, role models, and socio-demographics was used. A total of 953 Indians participated in the survey between May and June 2021, of which 770 contained valid data on vaccination status. Past preventive health behaviours (PHBs) such as avoiding social gatherings, higher interpersonal trust, and moral emotions were robustly associated with the willingness to take a COVID-19 vaccine. Results also showed that unvaccinated individuals were less likely to follow other PHBs, like wearing a mask; past COVID-19 infection status was associated with similar lower adherence to PHBs. Given the strong associations between positive moral emotions, like gratitude, and vaccine uptake intent (especially in the unvaccinated subsample), targeted communication interventions can boost uptake intent, and subsequently vaccine uptake, in jurisdictions with low vaccination rates.

Facebook Intervention for Young-Onset Melanoma Survivors and Families: Protocol for a Randomized Controlled Trial

Individuals diagnosed with melanoma before the age of 40 years (young-onset melanoma survivors) and their first-degree relatives (FDRs) are a growing population at risk for developing recurrent melanoma or new melanomas. Regular surveillance using clinical skin examination (CSE) and skin self-examination (SSE) and engagement in preventive behaviors including sun protection are recommended. Given the growing population of survivors and their families who are at increased risk, it is surprising that no behavioral interventions have been developed and evaluated to improve risk-reduction behaviors. We describe the rationale and methodology for a randomized controlled trial evaluating the efficacy of a Facebook intervention providing information, goal setting, and peer support to increase CSE, SSE, and sun protection for young-onset melanoma survivors and their FDRs. Overall, 577 survivors and 577 FDRs will be randomly assigned to either the Young Melanoma Family Facebook Group or the Melanoma Family Healthy Lifestyle Facebook Group condition. Participants will complete measures of CSE, SSE, and sun protection, and mediator measures of attitudes and beliefs before and after the intervention. The primary aim is to evaluate the impact of the Young Melanoma Family Facebook intervention versus the Melanoma Family Healthy Lifestyle Facebook intervention on CSE, SSE frequency and comprehensiveness, and sun protection among FDRs. The secondary aims examine the efficacy of the Young Melanoma Family Facebook intervention on survivors' SSE frequency and comprehensiveness and sun protection behaviors and mechanisms of intervention efficacy for intervention impact on FDR and survivor outcomes. The exploratory aim is to evaluate the efficacy of the 2 interventions on perceived stress, physical activity, and healthy eating. This project was funded by the National Institutes of Health (R01CA221854). The project began in May 2018, and recruitment started in January 2019. We anticipate completing enrollment by November 2023. Power calculations recommended a sample size of 577 survivors and 577 FDRs. Multilevel modeling treating family as the upper-level sampling unit and individual as the lower-level sampling unit will be the primary data analytic approach. Fixed effect predictors in these models will include condition, role, sex, all 2- and 3-way interactions, and covariates. The Young Melanoma Family Facebook intervention aims to improve primary and secondary skin cancer prevention for young-onset melanoma survivors and their family members. The intervention's delivery via a popular, freely available social media platform increases its impact because of the potential for dissemination in many contexts. If efficacious, this program could be disseminated by dermatologist practices, public health or nonprofit organizations focused on melanoma, and existing melanoma and skin cancer Facebook groups, thereby expanding its reach. This project will produce a content library of posts and a moderation guide for others. ClinicalTrials.gov NCT03677739; https://clinicaltrials.gov/ct2/show/NCT03677739. DERR1-10.2196/39640.

Fear, Risk Perception, and Engagement in Preventive Behaviors for COVID-19 during Nationwide Lockdown in Nepal.

The world has faced huge negative effects from the COVID-19 pandemic between early 2020 and late 2021. Each country has implemented a range of preventive measures to minimize the risk during the COVID-19 pandemic. This study assessed the COVID-19-related fear, risk perception, and preventative behavior during the nationwide lockdown due to COVID-19 in Nepal. In a cross-sectional study, conducted in mid-2021 during the nationwide lockdown in Nepal, a total of 1484 individuals completed measures on fear of COVID-19, COVID-19 risk perception, and preventive behavior. A multiple linear regression analysis was used to identify factors associated with COVID-19 fear. The results revealed significant differences in the fear of COVID-19 in association with the perceived risk of COVID-19 and preventive behaviors. Age, risk perception, preventive behavior, and poor health status were significantly positively related to fear of COVID-19. Perceived risk and preventive behaviors uniquely predicted fear of COVID-19 over and above the effects of socio-demographic variables. Being female and unmarried were the significant factors associated with fear of COVID-19 among study respondents. Higher risk perception, poor health status, and being female were strong factors of increased fear of COVID-19. Targeted interventions are essential to integrate community-level mental health care for COVID-19 resilience.

Abstract PR009: Breast cancer (BC) risk reduction in young women with ductal carcinoma in situ (DCIS)

Abstract Background: Young women with DCIS are at increased risk of recurrence and second BC compared to older women and may derive the greatest benefit from risk reduction strategies. Little is known about treatment decision-making, engagement in preventive behaviors, or fear of recurrence among young DCIS survivors. Thus, we sought to investigate treatment and prevention issues in this population. Methods: Using a multicenter prospective cohort that enrolled 1302 women with stage 0-IV BC at age ≤40, we identified participants with DCIS only who completed surveys in the year following diagnosis (dx). Surveys assessed treatment decisions, lifestyle factors (alcohol, smoking, physical activity [PA]), and fear of recurrence (Lasry Scale). Data was summarized with descriptive statistics and groups were compared with Fisher’s exact test. Results: Among 87 patients (median age 38, range 26-40), 75 had available treatment decision data, 19 (25%) of whom had breast-conserving surgery (BCS), 11 (15%) unilateral mastectomy (UM), and 45 (60%) bilateral mastectomy (BM). Most (77%) indicated their doctor said BCS was an option or recommended, including 34 (59%) who had BM. Of 40 patients who reported a patient-driven surgical decision, 73% had BM, 13% UM, and 15% BCS. Among 15 patients who reported the decision as doctor-driven, none had BM, 27% UM, and 73% BCS. Those who had BM were more likely to be extremely confident about the decision (80% vs. 73% UM vs. 53% BCS, p=0.022). Adjuvant tamoxifen was used by 10/27 (37%) patients with ER+ DCIS who had BCS/UM. Most who took tamoxifen reported this decision was shared with their doctor (90%); 1 reported the decision was made on her own. Of the 17 patients who did not take tamoxifen, 88% indicated their doctor said endocrine therapy was an option or recommended. Among all 87 patients, 31 (36%) were former and 3 (4%) were current smokers at baseline assessment (median 5 months post-dx); 51 (59%) never smoked. Overall, 4 quit within 1 year of dx. Most patients (83%) were current drinkers at baseline, though 79% consumed <5 alcoholic beverages/week; 8% reported lower consumption at 1 year. Regarding PA at 1 year, 73% (58/80) reported ≥150 minutes of moderate-intensity PA/week. Overall, 41% of young survivors were at least moderately concerned about their BC coming back, with concern varying numerically by surgery (65% post-BCS, 50% post-UM, 29% post-BM, p=0.053). Conclusions: BC recurrence concerns were frequent among young DCIS patients, particularly among those with remaining breast tissue. BM decisions were largely patient-driven and made with high confidence, reflecting preferences towards surgical prevention. While adherence to survivorship lifestyle guidelines was high, including not smoking, consumption of ≤7 drinks/week, and engaging in PA, tamoxifen use was low, even when offered by a provider. Young DCIS survivors appear motivated to lower future BC risk through surgery and maintenance of healthy behaviors, and less so with tamoxifen; such values should be considered during treatment and survivorship counseling. Citation Format: Megan E. Tesch, Julia S. Wong, Laura Dominici, Kathryn J. Ruddy, Rulla Tamini, Lidia Schapira, Virginia F. Borges, Ellen Warner, Steven E. Come, Karen Sepucha, Laura C. Collins, Ann H. Partridge, Shoshana M. Rosenberg. Breast cancer (BC) risk reduction in young women with ductal carcinoma in situ (DCIS) [abstract]. In: Proceedings of the AACR Special Conference on Rethinking DCIS: An Opportunity for Prevention?; 2022 Sep 8-11; Philadelphia, PA. Philadelphia (PA): AACR; Can Prev Res 2022;15(12 Suppl_1): Abstract nr PR009.

I love you too much to keep social distance: Closeness in relationships and (dis)engagement in preventive behaviors during the COVID-19 pandemic.

Although we are witnessing a new phase in the management of COVID‐19, understanding what predicts adherence to preventive behaviors still remains crucial. In this study we focus on interpersonal relationships by specifically investigating whether engagement in preventive behaviors when in the presence of others may be a function of the type of relationship (in terms of closeness) one has with others. Because close others are often perceived similar to the self compared to strangers, we put forward that close relationships may inadvertently decrease COVID‐19 risk perceptions which may ultimately decrease compliance with recommended behaviors when in their presence. To test this hypothesis, 747 Italian respondents were invited to answer one out of four versions of a questionnaire differing on the target (i.e., friends vs. parents vs. grandparents vs. strangers), including questions regarding COVID‐19 risk perceptions and intentions to engage in preventive behaviors. Mediation analysis showed that close relationships (i.e., with friends, parents, and grandparents) compared to nonclose relationships (i.e., with strangers) predicted lower intentions to engage in preventive behaviors via lower risk perceptions. Altogether, these results shed light on the role played by closeness in indirectly shaping individuals' dis(engagement) in preventive behaviors and contribute to better understand possible unconscious biases which may undermine our safety during the COVID‐19 pandemic.

Willingness to be vaccinated, preventative behaviors, and social contact patterns during the COVID-19 pandemic among US college students

Objective: To assess the frequency of preventative COVID-19 behaviors and vaccination willingness among United States (US) college and university students during the COVID-19 pandemic. Participants: Participants (N = 653) were ≥18 years old and students at institutions for higher education in the US in March 2020. Methods: Students self-reported preventative behaviors, willingness to be vaccinated, and social contact patterns during four waves of online surveys from May-August 2020. Results: Student engagement in preventative behaviors was generally high. The majority of students intended to be vaccinated (81.5%). Overall, there were no significant differences in the proportion adopting preventative behaviors or in willingness to be vaccinated by sex or geographic location. The most common reason for willingness to get vaccinated was wanting to contribute to ending COVID-19 outbreaks (44.7%). Conclusions: Early in the pandemic, college students primarily reported willingness to vaccinate and adherence to preventative behaviors. Outreach strategies are needed to continue this momentum.

Determinants of adherence to personal preventive behaviours based on the health belief model: a cross-sectional study in South Korea during the initial stage of the COVID-19 pandemic

BackgroundAlong with the rapid transmission of COVID-19, adherence to preventive behaviours plays a crucial role with respect to the control of COVID-19. However, different individuals’ psychological characteristics and risk perception result in various forms of response to preventive behaviours. Based on the Health Belief Model, this study identifies the factors associated with preventive behaviours towards COVID-19 in South Korea during the initial stage of the COVID-19 pandemic.MethodsA cross-sectional study was conducted in April 2020 through an anonymous online survey. A total of 1207 people in the age bracket of 20–59 years participated in the survey. Single and multiple linear regression analyses were conducted to identify the determinants of preventive behaviours against COVID-19.ResultsThe following factors were associated with preventive behaviours towards COVID-19: female gender (β = .124, p < 0.001), has a master’s degree or above (β = 0.065, p = 0.010), perceived susceptibility (β = .197, p < 0.001), self-efficacy (β = .404, p < 0.001), trust in radio (β = −.080, p = .006), trust in official government website (β = .057, p = .045), trust in social networks (β = .054, p = .033), and trust in family and friends (β = .068, p = .009), with an explanatory power of 41.5% (R2 = 0.415).ConclusionsTo flatten the epidemic curve, it is important to understand the public’s risk perception and the motivation behind behavioural responses that aim to promote preventive behaviours among the public. Thus, this study calls for the provision of accessible and credible information sources and demonstrates a public health campaign that encourages the public’s engagement in preventive behaviours towards COVID-19.

Embodying Temporality in Response Efficacy: How Coping Appraisal Promotes Preventive Behavioral Engagement During the Ongoing Pandemic

ABSTRACT This study heightens the understanding of response efficacy as a determinant of engagement in preventive behavior during the ongoing COVID-19 pandemic. To achieve a more nuanced conceptualization of response efficacy, this study proposes and examines a time-based coping appraisal framework, drawing upon a part of the extended parallel process model (EPPM). The current study investigates how the temporality of coping response message features work in generating social distancing behavioral intentions and explicates the role of anticipated emotions in this motivational process. Results of the experimental study (N = 584) indicate that proximal future framed coping response message (vs. distant future message) led to greater response efficacy, which in turn led to greater anticipated guilt and pride, and by extension increased social distancing behavioral intentions. Mediation analyses also demonstrated the indirect effects of the temporality conditions (proximal future-oriented message vs. distant future-oriented message) on social distancing intentions through response efficacy, anticipated guilt, and anticipated pride. The theoretical and practical implications of this study are discussed.

Understanding the Association between Online Social Support Obtainment and Coping during a Public Crisis

This study aims to examine how the process of online support obtainment may affect cognitive and behavioral coping during a public crisis. A cross-sectional online survey (N = 555) was conducted during the early stage of the COVID-19 pandemic in the U.S. Our findings revealed that informational support, obtained primarily through passive and private online involvement, led to increased risk perceptions of COVID-19; emotional support, obtained mainly via private online involvement, appeared to elicit higher perceived efficacy to cope with the crisis. People’s engagement in preventive behaviors was found to be affected by efficacy perceptions, but not by risk perceptions. The results suggested that online social support functioned as a double-edged sword to affect people’s coping with a public crisis.

Longitudinal relationships between COVID-19 preventative behaviors and perceived vulnerability to disease

Engagement in infection-preventing behaviors (e.g., mask wearing) has become crucial in the context of the COVID-19 pandemic, and health-related anxiety may be an important determinant of individual compliance with recommended guidelines. However, little is known about transactional associations between health anxiety and preventative behaviors, particularly with respect to COVID-19. The present study aimed to longitudinally examine the links between preventative behaviors and both emotion-driven (Germ Aversion) and belief-based (Perceived Infectability) aspects of health anxiety during the COVID-19 pandemic. We hypothesized that greater health anxiety at Time 1 (early in the pandemic) would predict future compliance with preventative behaviors six months later. Two hundred and ninety-six adults (M/SDage= 30.9/10.9 years, 42.2% female) completed two online assessments during the COVID-19 pandemic (Time 1 =June 2020; Time 2 =December 2020). Longitudinal cross-lagged analyses revealed that initial Germ Aversion predicted greater engagement in preventative behaviors at follow-up (β = 0.16; p = <.001), over and above initial engagement in such behaviors. Similarly, initial engagement in preventative behaviors predicted increases in Germ Aversion at follow-up (β = .23; p = <.001), over and above initial Germ Aversion. The present findings indicate that affect-driven aspects of health anxiety have a complex transactional relationship with engagement in behaviors aimed at curbing the spread of the COVID-19 pandemic. Clinical and public health implications are discussed.

Abstract P094: Awareness Of Cardiovascular Disease Is Low Among Young Women And Varies By Region

Background: Prior research has shown that awareness of cardiovascular disease (CVD) and its risk factors is low among young women. The present study used preliminary data to compare the awareness of CVD in young women seen in primary care clinics in the Northeastern and Southeastern United States. Methods: We recruited 370 females ages 15-24 years from two primary care clinics located in Boston, MA (n=331) and Atlanta, GA (n=39). Recruitment in Atlanta, GA is ongoing. Participants completed a modified version of the AHA Women’s Health Survey. We examined the relationship between location and 1) knowledge about CVD and 2) engagement in preventive behaviors, while controlling for race/ethnicity, age group, and primary caregiver education. Results: Sixty-two percent (n=23) of young women in Atlanta reported feeling informed about CVD, while 53% (n=163) of young women in Boston reported feeling informed about CVD. Only 13% (n=34) of participants in Boston and 6% (n=2) of participants in Atlanta correctly identified CVD as the leading cause of death for women. Participants in Atlanta were less likely to report engagement in CVD preventive behaviors such as exercising (OR: 0.32, 95% CI: 0.12, 0.91), maintaining a healthy cholesterol (OR: 0.13, 95% CI: 0.04, 0.50) or blood pressure level (OR: 0.24, 95% CI: 0.08, 0.74), and reducing sugar in their diet (OR: 0.33, 95% CI: 0.12, 0.91). Moreover, young women in Atlanta were more than twice as likely to report having never discussed CVD-related health topics such as family history of CVD, blood pressure, and cholesterol with their health care provider (OR: 2.46, 95% CI: 0.86, 7.02). Conclusion: CVD awareness is low among young women and varies by region. Despite living in a region where CVD is highly prevalent, young women in Atlanta were less likely to engage in preventive behaviors and less likely to discuss CVD-related topics with their health care provider. In this region where cardiovascular health disparities are common, opportunities remain to promote heart healthy behavior among young women to reduce CVD risk.

COVID-19 information overload: Intolerance of uncertainty moderates the relationship between frequency of internet searching and fear of COVID-19

The COVID-19 pandemic has led to unprecedented levels of uncertainty for people around the world. Research suggests that internet searching resulting in contradictory information can lead to increased levels of distress, particularly for people who have a high intolerance of uncertainty (IU). In the present correlational study, U.S. undergraduate students (N = 317) indicated their IU, the frequency with which they search for COVID-19 related information online, their overall health anxiety, their fear of COVID-19 (FCV-19), and engagement in prevention behaviors. Consistent with previous research, individual differences in IU moderated the relationship between internet searches and FCV-19 such that for people high in IU, more internet searching was associated with greater fear. In turn, we also found that greater FCV-19 predicted more social-distancing behaviors. These findings are important in both future mental health and public health initiatives.