Protective Health Behaviors Research Articles

How to improve the effectiveness of the cooperation networks of emergency science communication for public health emergencies

Emergency science communication is an important emergency activity that can enhance public safety awareness and risk perception ability, optimize health-protective behaviors, and reduce losses from emergencies. Certainly, emergency science communication needs to be multisource information and cross-organization. Moreover, increasing cooperation in emergency science communication is the key to improving the effectiveness of science communication in public health emergencies. To clarify the cooperation relationships among emergency organizations in emergency science communication, emergency science communication cooperation networks (ESCCNs) are constructed on the basis of the social network analysis method, and the practice of emergency science communication in response to COVID-19 in China is taken as the case. Through an interpretation of the characteristics of ESCCNs in the emergency response phase and the ongoing emergency phase, the differences in the cooperation modes of public health emergencies in different phases are analyzed. Moreover, the influence of different emergency phases on the formation of the ESCCN of the whole phase is discussed. With the evolution of the emergency phase, the network tightness, equilibrium and connectivity of the ESCCN all tend to increase, whereas network agglomeration decreases. In the emergency response phase, the core-edge features of the ESCCN are obvious, and emergency science communication organizations (ESCOs) are more inclined to form emergency science communication cooperation with other ESCOs of the same type. However, in the ongoing emergency phase, the cooperation relationships between ESCOs are more balanced, and more diversified cross-group cooperation relationships are formed. The diversification of ESCO types, the closeness of ESCO relationships and the connectivity of ESCCNs are the main factors that promote the formation of the ESCCN of the whole phase. Furthermore, implications for strengthening the efficiency of science popularization cooperation in public health emergencies are proposed in connection to matching dynamic characteristics, optimizing resource allocation and strengthening institutional guarantees.

Knowledge of the risks of ultraviolet radiation, sun exposure attitudes and practices among Lebanese university students

BackgroundExposure to Ultraviolet radiation (UVR) is a major risk factor for skin cancer. Data about UVR risk knowledge and exposure behaviors in the Lebanese population are scarce. AimTo evaluate the association between UVR risks knowledge, attitudes, and behaviors among Lebanese university students in the aim of promoting primary prevention of skin cancer. MethodsWe conducted a quantitative cross-sectional study between January and March 2022. An online survey was sent to Saint Joseph University students in Lebanon consisting of 5 sections: sociodemographic data, skin and health status, UVR exposure and protection behaviors, attitudes towards exposure and risks’ knowledge. Descriptive analysis was conducted, in addition to bivariate analysis and logistic regression with sunburn and sunbathing as outcomes respectively. Statistical significance was defined as p < 0.05. ResultsA total of 385 students responded to our questionnaire with a mean age of 23.59. 62.1 % reported at least one episode of sunburn during the last summer. The most common sun protective measure was sunscreen application; however, its frequency wasn’t satisfactory considering the high knowledge level of UVR risks. The most frequent barrier into applying sunscreen was its expensive price (42.4 %). Furthermore, positive attitudes towards tanning, particularly among women, and sunbathing were high. 75.1 % of students sunbathed for at least one day. ConclusionLebanese university students are aware of the risks of UVR risks; however, sunburn and sunbathing are common and protective behaviors are often not applied. Future awareness campaigns for skin cancer and promotion of sun safety are necessary.

Risk perception and reappraisal during the COVID-19 pandemic in southeast Alaska: Self-identified determinants of risk and protective health behaviors

Social and cultural context shapes how communities perceive health, well-being, and risk. Risk reappraisal can occur over time as a product of new information and improved understanding. We investigate risk perception and protective behaviors in Lingít Aaní (Southeast Alaska) during the first year of the COVID-19 pandemic. Surveys were circulated at two time points: (1) April–June 2020, before COVID-19 reached epidemic levels in the region, and (2) November 2020–February 2021. Ordinary least squares (OLS) regression models were used to analyze how demographic characteristics of the respondent population were related to risk perception. OLS models were again used to predict how individuals engaged in protective behaviors while controlling for risk perceptions. Controlling for demographic characteristics, risk perception increased as age increased for perceived risk of getting sick and dying from COVID-19, males perceived lower risk in general for all tested variables, and Alaska Native respondents perceived higher risk than non-Alaska Native respondents. Controlling for risk perception, results for protective behaviors were mixed; however, the strongest association identified was that knowing someone with a positive COVID-19 diagnosis increased protective behaviors. Between the two time points, risk perceptions increased significantly for variables related to oneself, others, and community members becoming infected with COVID-19. Protective behaviors like traveling less than normal, buying more cleaning products, and engaging in more subsistence gathering significantly increased. Identifying patterns of risk perception and protective behaviors, and especially how they change over time, are critical to developing place-specific public health recommendations, action, and preparedness plans against future infectious threats.

Finding benefits during collective stress: A study of health behaviors in a longitudinal representative U.S. sample during the COVID-19 era.

Cognitive strategies like finding benefits during adversity may facilitate coping during collective stressors (like COVID-19) by reducing distress or motivating health protective behaviors. We explored relationships between benefit finding, collective- and individual-level adversity exposure, psychological distress, and health protective behaviors using longitudinal data collected during the COVID-19 era from a representative, probability-based sample of U.S. residents: Wave 1 (N = 6,514, March 18, 2020-April 18, 2020, 58.5% completion rate); Wave 2 (N = 5,661, September 26, 2020-October 16, 2020, 87.1% completion rate); Wave 3 (N = 4,881, November 8, 2021-November 24, 2021, 75.3% completion rate); and Wave 4 (N = 4,859, May 19, 2022-June 16, 2022, 75.1% completion rate). Benefit finding was common; k-means clustering (an exploratory, data-driven approach) yielded five trajectories: always high (15.85%), always low (18.52%), always middle (28.47%), increasing (17.79%), and decreasing (19.37%). Benefit-finding trajectories were generally not strong correlates of psychological distress and functional impairment over time. Rather, benefit finding robustly correlated with health protective behaviors relevant to COVID-19 and the seasonal flu. In covariate-adjusted models, benefit finding positively correlated with more social distancing (β = .24, p < .001) and mask wearing (β = .18, p < .001) at Wave 2 and greater COVID-19 (odds ratio, OR = 1.23, p = .001) and flu (OR = 1.29, p < .001) vaccination at Wave 3. Although benefit finding was not generally associated with lower psychological distress during a collective stressor, it correlated with engagement in stressor-related health protective behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Why Are Young People Willing to Pay for Health? Chained Mediation Effect of Negative Emotions and Information Seeking on Health Risk Perception and Health Consumption Behavior.

The perception of health risks can influence people's health behaviors. However, in the context of modern consumer society, few people delve into in-depth discussions on health consumption as a form of health protection behavior. Inspired by the Health Belief Model and Protection Motivation Theory, this study interprets health consumption behavior as a new form of health protection behavior. A survey was conducted on a sample of Chinese youth (N = 885) to explore the mechanisms of action between health risk perception and health consumption behavior using structural equation modeling. The study found that: (1) health risk perception has a significant positive impact on the health consumption behavior of young people; (2) negative emotions and information seeking play mediating roles respectively in the mechanism of the impact of health risk perception on health consumption behavior; and (3) in addition to their individual mediating roles, negative emotions and information seeking behavior collectively play a chained mediation role in this process. Implications of these results, both theoretical and practical, are further discussed.

Modelling the Non-linear Associations between Age and Health: Implications for Care

Abstract Background Ageing is a complex biological process that weakens the body's defences against various health problems and diseases. This decline is not uniform or linear; rather, it varies significantly among individuals. Understanding the non-linear progression of ageing is crucial for identifying critical periods where intervention might be most beneficial. This study aimed to explore nonlinearities in the association between age and health outcomes. Methods Using generalised additive models, we analysed data from the 2020 wave of the United States Health and Retirement Study. This modelling approach allows for the detailed examination of nonlinearities in health outcomes across different ages. Our sample consisted of adults aged over 50 (n = 1338; mean = 68; range = 50 – 95). We assessed seven health outcomes (heart conditions, diabetes, cholesterol, blood pressure, fatigue, back pain, and headaches) and seven protective behaviours (prostate exams, mammograms, cholesterol screenings, pap smears, flu vaccinations, dental check-ups, and smoking patterns) reflecting various aspects of health status and behaviour. Results The analysis indicated a significant and pronounced non-linear relationship between age and certain health outcomes, namely headaches, blood pressure, diabetes, and heart conditions. Additionally, ageing was non-linearly associated with specific health behaviours, including the uptake of prostate exams, mammograms, flu vaccinations, and smoking prevalence. Notably, distinct patterns emerged concerning health behaviours in relation to age-specific screening policies. Conclusion The findings of this study reveal that the probability of developing health problems or engaging in health protective behaviours do not increase/decrease linearly in direct proportion to age. Rather, the probability curve exhibits fluctuations, presenting periods of heightened odds interspersed with phases of relative stability. Such non-linearity may be partially attributed to policy decisions but could also reflect a complex interplay of factors such as weakened immune systems, access to healthcare, personal health beliefs, and the evolving perception of risk as one grows older.

Perceived risk, health protective behavior, and trust: a case study of the flint water crisis

ABSTRACT The Flint Water Crisis exemplifies one of the most significant environmental disasters in the recent U.S. history. While hazard exposure and effects pertaining to the crisis have been addressed, and technical experts have pronounced Flint’s water safe for consumption, media reports and stories from community members suggest that significant distrust remains among residents regarding their water supply. We use data from an online survey administered in Flint and surrounding counties in Southeast Michigan to examine the extent and variation in risk perception, health protective behavior, and trust in these communities with respect to their water supply. Conceptually, we engage the Social Amplification of Risk Framework. Accordingly, Flint residents indeed have higher risk perceptions and report higher negative health impacts compared to residents in surrounding counties. They also report engaging in more health protective behavior. On the contrary, Flint residents express lower levels of trust in entities that are tasked with managing risks. Risk perception, negative health experience, and trust appear as statistically significant correlates of Flint residents’ confidence in their water supply. The salience and variation of attitudes across the region suggests that the water crisis has had ripple effects as predicted by the Social Amplification of Risk Framework.

Notes from the Field: Support for Wastewater Monitoring and Influence on Protective Behavioral Intentions Among Adults - United States, July 2024.

In 2020, during the COVID-19 pandemic, CDC established the National Wastewater Surveillance System and later expanded it to include mpox and influenza A data dashboards.† Wastewater utility partners have cited community health benefits as a motivating factor for participating in wastewater surveillance; a lack of public support for wastewater surveillance activities might lead utility partners to cease participation (1,2). However, little is known about public support for wastewater monitoring and its influence on protective health behaviors. As innovative surveillance strategies such as wastewater surveillance evolve, ethical considerations, including understanding public perceptions regarding support for these activities and potential risks to communities, are essential (3).

A rapid assessment of depressive and anxious symptoms among university students during the COVID-19 public health emergency: A repeated cross-sectional analysis

Objectives To identify potential associations between student characteristics and mental health symptoms during the early parts of the pandemic. Participants 3,883 students at a large public university on the West Coast of the United States. Methods We conducted a repeated cross-sectional survey to assess health-protective behaviors, mental health, social support, and stigma resistance. The survey was administered in April 2020 and again in November/December 2020. Odds of mental health symptoms were estimated using multinomial logistic regression. Results 39% of respondents reported anxious symptoms, 9% reported depressive symptoms, and 27% reported both anxious and depressive symptoms. AAPI had lower odds of reporting both anxious/depressive symptoms compared to whites (OR = 0.59; 95% CI:0.43–0.81). Conclusion Students reported elevated levels of psychological stress during the pandemic, yet our results may underestimate the actual odds due to stress brought on by COVID-19.

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.

The “Cycle” of HIV: Limits of Personal Responsibility in HIV Vulnerability Among Transgender Adolescents and Young Women in Lima, Peru

Globally, transgender women (TW) face a high burden of the HIV epidemic. In Peru, HIV prevalence among TW rises at age 25, indicating a need to understand HIV vulnerability as adolescents reach adulthood. The life course of TW is often marked by abuse, discrimination and poverty fueled by transphobic stigma. Approaches to the HIV epidemic among TW and adolescents emphasize problem behaviors such as unprotected sex and substance. However, there has been a call for HIV research and interventions to understand and leverage community strengths. This qualitative study utilized a transgender-oriented, strength-based, intersectional and feminist approach to understand the strengths and protective health behaviors among 17 transgender adolescents and young women (TAYW) age 16–24 in Lima, Peru. Most participants re-located to Lima from the Amazon due to familial rejection, and engaged in obligatory sex work. TAYW demonstrated self-knowledge, motivation for education, efforts to secure employment, strong community networks, legal advocacy, avoiding problem substance use, HIV knowledge and condom use. However, strengths were impeded by multi-level barriers such as familial physical abuse, educational discrimination, and sexual assault which led to increased HIV vulnerability. We created a conceptual model of the “cycle” of HIV to describe the limits of personal responsibility within a vulnerable community denied access to family, education, employment and human rights. We recommend researchers, clinicians and public health workers follow the lead of TAYW at the frontlines of the HIV epidemic, and support beloved communities and enabling environments which may permit protective behaviors to mitigate HIV vulnerability.

Implicit attitudes toward obesity-related cues and their relation to body mass index, psychosocial functioning, and health behavior.

Differences in automatic cognitive processes exist among individuals with overweight and obesity, thus there is a need to expand our conceptualization of overweight and obesity to emphasize the predictive utility of these automatic processes, rather than focusing solely on behavioral outputs. Implicit association tests (IATs) may afford a noninvasive method of examining automatic preferences that might contribute to overweight and obesity; namely, preferences for unhealthy foods and sedentary behavior versus healthy foods and physical activity. The purpose of the current study was to examine whether implicit attitudes toward foods and physical activity differed based on body mass index (BMI) status. The relationships between implicit attitudes and key psychosocial factors and health behaviors were also examined. Participants (N = 127) included undergraduate students with an average age of 19.05 years old (SD = 1.52). Average BMI of the sample was 24.20 (SD = 4.93); 33.8% met criteria for overweight or obesity. Participants completed an IAT and questionnaires. There were no differences in implicit preferences based on BMI or BMI status. Overall, the sample demonstrated implicit preferences for healthy foods and active words, and preferences were not linked to the corresponding behavioral outputs, though preferences were linked to various indices of emotion and emotion regulation. Future research should explore an extended model to examine how implicit preferences might impact intentions to engage in protective versus risky obesity-related health behaviors, and the various psychosocial factors that might impact the translation of those preferences and intentions in actual behavioral outputs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Analysis of residents’ health and willingness to pay for environmental protection in China

Health and environmental issues have become pressing global problems that affect human society's sustainable development. Residents are not only practitioners but also direct beneficiaries of ecological protection and play a crucial role in maintaining ecological and environmental health. Health, as the basis of residents' behavioral choices, influences residents' behavior toward ecological and environmental protection. This study aims to investigate how health factors profoundly affect residents' willingness to pay (WTP) for environmental protection and reveal the intrinsic connection between health and environmental protection behavior. The 2017 China Household Finance Survey (CHFS) data and the ordered probit model were used to determine that improving residents' health greatly increases their willingness to protect the environment and passes a number of tough tests. In addition, the promotion effect of health on residents' WTP for ecological protection is markedly heterogeneous, especially in younger residents who do not have children. Therefore, we suggest to policymakers and national governments a range of countermeasures and suggestions to enhance health education, safeguard public health, and promote ecological protection education.

“Are you OK doctor?” An expanded health belief model exploration of doctors’ experiences and perspectives of on-shift health behaviour

ABSTRACT Purpose Understanding doctors’ health beliefs is essential for developing effective and competent healthcare practices that benefit doctors and their patients. This study aimed to qualitatively explore doctors’ perceptions of on-shift health-protective behaviours and their perceived effects on competence. Methods The research applied theoretically driven Expanded Health Belief Model (EHBM) enquiry methods to explore beliefs and experiences through an occupational context survey, 14 individual depth interviews, and two focus groups. Semantic and deductive themes associated with EHBM domains were examined, and an inductive thematic analysis of the interviews was conducted. Results Doctors’ beliefs were strongly imbued by their perceived identity within the systemic context; they expressed impaired self-efficacy in reacting to their health needs on shift, and several disclosed harm to themselves and patients. Dominant themes included the psychosocial effects of the systemic culture and the influence of the situational occupational context in impacting health-protective behavioural action. The context and implications of experiences during the COVID-19 pandemic are discussed. Conclusions This study presents key belief-oriented factors influencing doctors’ health-protective behaviour at work and its implications for competent practice. Further doctor-led guidance on focus points for evidence-based theoretically driven health improvement solutions is provided regarding operational practice, formulating policies, developing interventions and further research.

Examining Chinese people’s protective health behavior in the context of COVID-19 metaphors

Examining Chinese people’s protective health behavior in the context of COVID-19 metaphors

The role of target‐specific shared reality in interpersonal interactions and protective health behaviours

The role of target‐specific shared reality in interpersonal interactions and protective health behaviours

An analysis of protective health behavior and polypharmacy among older patients: a nationwide cohort study

BackgroundThis study analyzed the relationship between protective health behaviors and polypharmacy in individuals aged 65 years and older.MethodsWe used data from a nationwide survey (KNHANES) from 2012 to 2016 in conjunction with the health insurance claims databases. A total of 3297 adults aged 65 or older were included in the study. Polypharmacy was defined as more than 30 prescription days in 6 months with five or more different drugs. Health-related behaviors (BMI, smoking, drinking, regular walking, and living alone) were extracted for 6 months before measuring polypharmacy. We used multivariable logistic regression on polypharmacy for each protective health behavior, as well as a composite score of protective health behavior. Subgroup analysis was also conducted by age and sex.ResultsAmong protective health behaviors, BMI < 25 (OR, 0.76; 95% CI, 0.66–0.88) and never smoking (OR, 0.78; 95% CI, 0.62–0.98) were associated with a lower risk of polypharmacy. Polypharmacy was significantly associated with BMI < 25 in both sex subgroups (male: OR, 0.71; 95% CI, 0.56–0.88; female: OR, 0.81; 95% CI, 0.67–0.99) and 65–79 subgroup (OR, 0.74; 95% CI, 0.63–0.86). The association between never smoking and polypharmacy was only significant in the 65–79 subgroup (OR, 0.71; 95% CI, 0.55–0.91). Participants with five protective health behaviors had a lower risk of polypharmacy than participants with zero or one health behavior, which was only statistically significant in the subgroup analysis of participants aged 65–79 years (OR, 0.52; 95% CI, 0.29–0.94).ConclusionsThis study finds that health behaviors such as obesity and smoking are associated with a higher risk of polypharmacy. Furthermore, we confirm that a high score of protective health behaviors is associated with a lower risk of polypharmacy. Our findings indicate the need for geriatric-centered management of protective health behaviors to prevent polypharmacy.

Development and validation of the climate change health protection behaviors scale for adolescents: a methodological study

ABSTRACT This study aimed to develop and validate the Climate Change Health Protection Behaviors Scale for adolescents. A total of 1036 adolescents were recruited from middle and high schools. The development of the assessment scale was carried out in three steps: item generation, content validity evaluation, and psychometric evaluation. Psychometric testing was conducted to determine the relationship between the resulting factors and the Healthy Lifestyle Belief Scale and Climate Change Awareness Scale. A 28-item scale was developed, consisting of four factors that account for 65.0% of the variance. The Cronbach’s alpha value was 0.874. Additionally, a positive correlation was observed between the Climate Change Health Protection Behaviors Scale and both the Climate Change Awareness Scale and the Healthy Lifestyle Belief Scale for adolescents. These results suggest that the Climate Change Health Protection Behaviors Scale is a reliable and valid tool for evaluating health protection behaviors related to climate change in adolescents.

Navigating vaccination choices: The intersecting dynamics of institutional trust, belonging and message perception among Congolese migrants in London, UK (a reflexive thematic analysis).

The COVID-19 pandemic disproportionately impacted intersectionally marginalised migrants, revealing systemic disparities in health outcomes and vaccine uptake. Understanding the underlying social and structural factors influencing health behaviours is necessary to develop tailored interventions for migrants, but these factors have been seldom explored. This qualitative study aimed to explore contextual factors shaping COVID-19 vaccination decision-making among Congolese migrants in the UK.A community-based participatory research study was designed and led by a community-academic partnership in London, UK (2021-2022). Peer-led, semi-structured interviews were conducted in Lingala with 32 adult Congolese migrants and explored beliefs, perceptions and lived experiences of migration, healthcare, vaccination and the COVID-19 pandemic. Reflexive thematic analysis generated two themes and a model conceptualising the vaccination decision-making process. Participants and community partners were financially compensated; ethics was granted by the University of London ethics committee (REC: 2021.0128).Participants highlighted the incompatibility of lockdown restrictions with their communal culture, which intensified feelings of exclusion and alienation. Concerns about COVID-19 vaccination were attributed to safety and effectiveness, partly informed by experiences and legacies of racial discrimination and exploitation. Inequality in the pandemic response and COVID-19 outcomes heightened participants' sense that their views and needs were being overlooked, and government sources and information were perceived as coercive. Our model depicts the interplay between institutional trust, belonging, and message perception, which shaped participants' vaccination decisions and led to (non-)engagement with COVID-19 vaccination. This research enhances understanding of how social and contextual factors may influence migrants' engagement with health interventions. It underscores the importance of partnering with migrant communities to understand their needs in context and co-design tailored interventions and inclusive messaging strategies that promote trust and belonging. Implementing systemic changes to address structural inequalities will be crucial to create an environment that supports engagement with health-protective behaviours and enhances health outcomes among migrant communities.

Investigating the causal effects of COVID-19 vaccination on the adoption of protective behaviors in Japan: Insights from a fuzzy regression discontinuity design.

During the COVID-19 pandemic, concerns emerged that vaccinated individuals might engage less in infection-preventive behaviors, potentially contributing to virus transmission. This study evaluates the causal effects of COVID-19 vaccination on such behaviors within Japan, highlighting the significance of understanding behavioral dynamics in public health strategies. Utilizing Japan's age-based vaccination priority for those born before April 1, 1957, this research employs a regression discontinuity design (RDD) to assess the vaccination's impact. Data from the fourth round of a longitudinal online survey, conducted from July 20 to 27, 2021, served as the basis for analyzing 14 infection-protective behaviors, including mask usage, handwashing, and avoiding crowds. A total of 12067 participants completed the survey. The analyzed sample size varied by outcome variable, ranging from 1499 to 5233. The analysis revealed no significant differences in the 14 behaviors examined among fully vaccinated, partially vaccinated, and unvaccinated individuals. This consistency across groups suggests that vaccination status did not significantly alter engagement in protective behaviors during the observation period. Empirical findings highlight the complexity of behavioral responses following vaccination, indicating that such responses may be influenced by various factors, rather than by vaccination status alone. Additionally, this result underscores the importance of crafting public health policies that account for the intricate interplay between vaccination and behavior. This study contributes to the broader discourse on managing responses to the pandemic and tailoring interventions to sustain or enhance protective health behaviors amid vaccination rollouts.