Perceived Risk Of Infection Research Articles

Risk Perception and Uptake of Human Papilloma Virus Vaccine among University Students in Jos, Plateau State

Background: Human papilloma virus is the most common sexually transmitted viral infection globally. It is a well-established cause of cervical cancer and about 75% of sexually active women and men will acquire this infection at some time in life. This study assessed the risk perception of human papilloma virus infection and its vaccine uptake among university students in Jos, Plateau State Nigeria.
 Methods: This was a cross-sectional survey conducted among 300 university students who were selected using a multistage sampling technique. A semi-structured interviewer administered questionnaire was used to assess risk perception and vaccine uptake. Data was analysed using Statistical Package for Social Sciences version 23. Associations between independent and dependent variables were determined using χ2 test while binary logistic regression was used to determine factors associated with risk perception, with significant value set at < 0.05.
 Results: Respondents’ awareness of human papilloma virus infection and the vaccine was 148 (49.3%) and 62(20.7%) respectively. Ninety four (31.3%) students had good risk perception of the infection while 206 (68.7%) had poor perception. Three (1.0%) students had taken the vaccine with no statistically significant difference between health and social science students (p = 0.05). Health science students had 3 times better risk perception than social science students (OR = 3.42, 95% CI = 2.03 - 5.77; P< 0.001).
 Conclusion: Human papilloma virus infection risk perception and vaccine uptake were poor among Jos University students. There is a need to improve the vaccine uptake through awareness creation and advocacy in Nigeria.

PO-1462 Metastatic spinal compression referral patterns during pandemic lockdowns in Kent region UK

Purpose or Objective: Metastatic spinal cord compression (MSCC) is an oncological emergency with a potential for catastrophic neurological deficit. Once diagnosed, MSCC requires urgent treatment to avoid neurological disability. We looked at health-seeking behavioural changes in lockdown 1(L1) (March 23-June 24 2020) compared to the lockdown 2(L2) (Oct 25-Dec 2 2020) in England, UK. This study posited that incidence of MSCC in 2020 especially during L1, would increase due to: (i)reduced access to NHS resources due to the pandemic (ii) change in health-seeking behaviour due to perceived risk of COVID-19. (iii) changes to previously accepted practice with regards to systemic and radiotherapy treatment. Modelling studies have shown these factors led to a delay in diagnoses with increased late-stage presentations and cancer-related death. Following the national campaign that ensued due to decline in cancer diagnosis in L1, we hypothesized a reduction in MSCC presentations in L2, due to increased public health awareness and continued availability of cancer services, despite lockdown. Materials and Methods: A retrospective, multicentre analyses of MSCC cases across Kent was undertaken for year 2020. Year 2019 served as control. Study included all MSCC cases across the following NHS trusts (i) Maidstone and Tunbridge Wells (ii) Dartford and Gravesham (iii) East Kent University Hospital and (iv) Medway. Shapiro-Wilk was used to assess normality and unpaired T-test to compare referral numbers between 2019 vs 2020 and between L1 vs L2. p ≤0.05 was considered significant. Results: There were 134 MSCC cases in 2019 vs 193 in 2020. An average of 12 patients per month were treated in 2019 vs 17 in 2020, p=0.002 (fig 1). During L1, the average number of patients was 16 per month vs 11 in 2019 in the same period, p=0.08. For L2, it was 19 vs 11 respectively, p=0.10 (fig 2). More patients were offered single 8Gy fraction treatment in 2020 [77% (n=149) vs 66% (n=89)] (fig 2). (Figure Presented) Conclusion: There was an increase in the total number of MSCC in 2020 and in the average cases per month during lockdowns. This was expected given recent data showing delay in cancer diagnoses with an increase in late presentations. Though the number of MSCC was higher in L2 vs L1, there was a downward trend towards the end of L2. This may signify the positive impact of the national cancer campaign. Unfortunately, Kent region was badly hit with the new Covid 19 strain (B117) and most of the services were affected due to staff redeployment, sickness and isolation. Many patients with existing comorbidities are still anxious utilising hospital services due to perceived infection risk. Further work will be needed to reverse health-seeking behaviours to pre-pandemic levels. Focused cancer public health campaign may be required to allay patient fears and ensure safety, during use of vital health services. More single 8Gy fractions were delivered in 2020 compared to any previous years, indicating MSCC patients may now be scanned, planned and treated in one visit.

COVID-19: Perceived Infection Risk and Barriers to Uptake of Pfizer-BioNTech and Moderna Vaccines Among Community Healthcare Workers

BackgroundThe health and economic ramifications of the coronavirus pandemic have prompted the need for a timely and effective vaccine development. While the rollout of the COVID-19 vaccine in record time is being hailed as a scientific feat, skepticism about the safety, side effects, and even its long-term effects remain. Acceptance of the vaccine may therefore be a challenge among healthcare workers (HCWs), whose role is considered a proxy to determining the COVID-19 vaccine uptake response by the general population.MethodsIn December 2020, prior to the arrival and receipt of the Pfizer-BioNTech and Moderna COVID-19 vaccine, we conducted a cross-sectional survey to assess the readiness for vaccine uptake among HCWs at three community-based, university-affiliated health centers.ResultsA total of 205 (82%) respondents out of 250 completed the questionnaire. Fifty-four percent of respondents agreed to receive vaccine once available. Females (odds ratio (OR) =0.22, p=0.014), non-Hispanic Blacks (OR=0.066, p=0.010), and Hispanics (OR=0.11, p=0.037) were less likely to accept the vaccine. Respondents with moderate-risk perception were more likely to accept (OR=2.79, p=0.045) compared to those with low-risk perception while no association was found between high-risk perception and vaccine acceptance (p=0.226). After adjusting for perceived risk, sex, race/ethnicity, and age, acceptance in non-Hispanic Black population remained statistically significant (adjusted OR=0.07, p=0.014), with Hispanic (AOR=0.12, p=0.051) showing a trend.ConclusionsEnthusiastic acceptance of the COVID-19 vaccine is lacking among surveyed HCWs of certain racial/ethnic groups. Provision of resources and public health interventions targeting underserved, minority populations are necessary to halt opposition to vaccine uptake.

Psychological distress of COVID-19 pandemic and associated psychosocial factors among Mexican students: An exploratory study.

COVID‐19 related social isolation measures and school closures have likely increased students' stress levels. In our study, we assess the level of psychological distress and psychosocial factors among students in Mexico at the beginning of the pandemic. We conducted a cross‐sectional exploratory study with 848 participants, the majority undergraduate or postgraduate (79.7%). Participants completed the Impact of Event Scale‐Revised to measure emotions, and a COVID‐19 questionnaire. We conducted a logistic regression analysis to find variables associated with stress: 36% (n = 309) had elevated stress, 31.4% (n = 266) anxiety, and 18.2% (n = 154) sadness often or all the time. Those who identified as women and reported a reduction in their incomes also reported a higher stress level. Stress was positively correlated with anxiety, anger, sadness, days in isolation, and hours watching TV daily; and negatively correlated with relaxation and happiness. The variable most strongly correlated with stress was a high perception of infection risk. Our findings will inform mental health strategies for students who are at higher risk of stress due to the COVID‐19 pandemic response.

Perceptions, risk and understandings of the COVID-19 pandemic in urban South Africa.

BackgroundHow people perceive the coronavirus disease 2019 (COVID-19) pandemic and understand their risk can influence their health, behaviours and overall livelihood. The disease’s novelty and severity have elicited a range of attitudes and perspectives countrywide, which consequently influence the public’s adherence to public health prevention and treatment guidelines.AimTo investigate perceptions, experiences and knowledge on COVID-19 in a community-based cohort study.SettingAdults living in Soweto in South Africa’s Gauteng province during the first six weeks of the national lockdown regulations (i.e. Alert Level 5 lockdown from end of March to beginning of May 2020).MethodsParticipants completed a series of surveys and answered open-ended questions through telephonic interviews (n = 391). We queried their perceptions of the origins of COVID-19, understandings of the disease, personal and communal risks and its relations with the existing disease burden.ResultsFindings from our sample of 391 adults show that perceptions and knowledge of COVID-19 vary across several demographic characteristics. We report moderate levels of understanding about COVID-19, prevention methods and risk, as well as exposure to major physical, psychosocial and financial stressors. Depressive symptoms, perceived infection risk and concern about COVID-19 significantly predicted COVID-19 prevention knowledge.ConclusionPublic health communication campaigns should focus on continuing to improve knowledge and reduce misinformation associated with the virus. Policymakers should consider the mental health- and non-health-related impact of the pandemic on their citizens in order to curb the pandemic in a manner that maximises well-being.

Perceptions, risk and understandings of the COVID-19 pandemic in urban South Africa

Background: How people perceive the coronavirus disease 2019 (COVID-19) pandemic and understand their risk can influence their health, behaviours and overall livelihood. The disease’s novelty and severity have elicited a range of attitudes and perspectives countrywide, which consequently influence the public’s adherence to public health prevention and treatment guidelines.Aim: To investigate perceptions, experiences and knowledge on COVID-19 in a community-based cohort study.Setting: Adults living in Soweto in South Africa’s Gauteng province during the first six weeks of the national lockdown regulations (i.e. Alert Level 5 lockdown from end of March to beginning of May 2020).Methods: Participants completed a series of surveys and answered open-ended questions through telephonic interviews (n = 391). We queried their perceptions of the origins of COVID-19, understandings of the disease, personal and communal risks and its relations with the existing disease burden.Results: Findings from our sample of 391 adults show that perceptions and knowledge of COVID-19 vary across several demographic characteristics. We report moderate levels of understanding about COVID-19, prevention methods and risk, as well as exposure to major physical, psychosocial and financial stressors. Depressive symptoms, perceived infection risk and concern about COVID-19 significantly predicted COVID-19 prevention knowledge.Conclusion: Public health communication campaigns should focus on continuing to improve knowledge and reduce misinformation associated with the virus. Policymakers should consider the mental health- and non-health-related impact of the pandemic on their citizens in order to curb the pandemic in a manner that maximises well-being.

Hand Hygiene during the Early Neonatal Period: A Mixed-Methods Observational Study in Healthcare Facilities and Households in Rural Cambodia.

Background: Globally, infections are the third leading cause of neonatal mortality. Predominant risk factors for facility-born newborns are poor hygiene practices that span both facilities and home environments. Current improvement interventions focus on only one environment and target limited caregivers, primarily birth attendants and mothers. To inform the design of a hand hygiene behavioural change intervention in rural Cambodia, a formative mixed-methods observational study was conducted to investigate the context-specific behaviours and determinants of handwashing among healthcare workers, and maternal and non-maternal caregivers along the early newborn care continuum. Methods: Direct observations of hygiene practices of all individuals providing care to 46 newborns across eight facilities and the associated communities were completed and hand hygiene compliance was assessed. Semi-structured interactive interviews were subsequently conducted with 35 midwives and household members to explore the corresponding cognitive, emotional and environmental factors influencing the observed key hand hygiene behaviours. Results: Hand hygiene opportunities during newborn care were frequent in both settings (n = 1319) and predominantly performed by mothers, fathers and non-parental caregivers. Compliance with hand hygiene protocol across all caregivers, including midwives, was inadequate (0%). Practices were influenced by the lack of accessible physical infrastructure, time, increased workload, low infection risk perception, nurture-related motives, norms and inadequate knowledge. Conclusions: Our findings indicate that an effective intervention in this context should be multi-modal to address the different key behaviour determinants and target a wide range of caregivers.

Relationship between COVID-19 perceived risk and perfectionism – a preliminary study

IntroductionResearch following the Covid-19 pandemics has shown that psychological reactions to the pandemic and its constraints can vary significantly depending on personality. One of the traits that has not been studied yet, but can play a harmful role in the COVID-19 psychological impact is perfectionism. This trait, characterized by setting excessively high standards of performance and striving for flawlessness, has increased in recent years and is considered a transdiagnostic process involved in several (mental) health problems (Curran & Hill 2019).ObjectivesTo analyze the role of Perfectionism in the levels of fear of COVID19 and of perception of infection risk by COVID-19.Methods234 adults (75.6% women; mean age=29.53±12.51) completed an on-line survey with the Portuguese validated versions of Covid-19 Perceived Risk Scale (C19PRS; Pereira et al. 2020), Fear of COVID-19 Scale (FC19S; Cabaços et al. 2020) and Big Three Perfectionism Scale (BTPS; Garrido et al. 2020). SPSS was used to perform correlation and regression analysis.ResultsPerceived Risk and Fear of COVID-19 were significantly correlated with perfectionism (.243, .228, respectively) (both, p<.01). Perfectionism explains 5.5% (Adjusted R2) of the FC19S variance (Beta=.243, p<.001) and 4.8% of the C19PRS variance (Beta=.228, p=.01).ConclusionsThis study provides preliminary, but completely innovative evidence that perfectionism contribute to the psychological impact of Covid-19 pandemics. In the near future we will test the hypothesis that the nature of unpredictability and the limitations imposed by the global crisis may be exacerbating the already high levels of psychological distress that affect negative perfectionists.

Perceptions of risk and adherence to care in MS patients during the COVID-19 pandemic: A cross-sectional study

BackgroundThe COVID-19 pandemic has raised concerns for increased risk of infection in patients with multiple sclerosis (MS) and disrupted their routine MS care. The aim of this study is to characterize the extent of MS patients’ perceptions of risk and adherence to care during the pandemic. MethodsA survey was emailed to patients from a large MS center in New York City during the local peak of the pandemic to assess perceptions of infection risk and adherence to MS care including appointments, laboratory studies, MRIs, and taking disease-modifying therapies (DMT). Results529 patients from the MS center responded to the survey during two weeks in April 2020. Patients collectively showed concern about becoming infected with COVID-19 (88%) and perceived a higher infection risk due of having MS (70%) and taking DMTs (68%). Patients frequently postponed appointments (41%), laboratory studies (46%), and MRIs (41%). Noncompliance with DMTs was less common (13%). Decisions to alter usual recommendations for care were made by the patient more often than by the provider regarding adherence to appointments (68%), laboratory studies (70%), MRI (67%), and DMT (65%). Degree of concern for infection was associated with adherence to appointments (p=0.020) and laboratory studies (p=0.016) but not with adherence to MRI and DMTs. Thirty-five patients reported being tested for COVID-19, of whom fourteen reported a positive test. ConclusionPatients with MS were highly concerned about becoming infected during the local peak of the COVID-19 pandemic. Behaviors that deviated from originally recommended MS care were common and often self-initiated, but patients were overall compliant with continuing DMTs.

Individual, social, and environmental factors for infection risk among home healthcare patients: A multi-method study.

There has been limited research into the individual, social, and environmental factors for infection risk among patients in the home healthcare (HHC) setting, where the infection is a leading cause of hospitalisation. The aims of this study were to (1) explore nurse perceptions of individual, social, and environmental factors for infection risk among HHC patients; and (2) identify the frequency of environmental barriers to infection prevention and control in HHC. Data were collected in 2017-2018 and included qualitative interviews with HHC nurses (n=50) and structured observations of nurse visits to patients' homes (n=400). Thematic analyses of interviews with nurses suggested they perceived infection risk among patients as being influenced by knowledge of and attitudes towards infection prevention and engagement in hygiene practices, receipt of support from informal caregivers and nurse interventions aimed at cultivating infection control knowledge and practices, and the home environment. Statistical analyses of observation checklists revealed nurses encountered an average of 1.7 environmental barriers upon each home visit. Frequent environmental barriers observed during visits to HHC patients included clutter (39.5%), poor lighting (38.8%), dirtiness (28.5%), and pets (17.2%). Additional research is needed to clarify inter-relationships among these factors and identify strategies for addressing each as part of a comprehensive infection control program in HHC.

The US Public's Perception of the Threat of COVID-19 During the Rapid Spread of the COVID-19 Outbreak: Cross-Sectional Survey Study.

BackgroundThe rapid spread of the COVID-19 pandemic in the United States has made people uncertain about their perceptions of the threat of COVID-19 and COVID-19 response measures. To mount an effective response to this epidemic, it is necessary to understand the public's perceptions, behaviors, and attitudes.ObjectiveWe aimed to test the hypothesis that people’s perceptions of the threat of COVID-19 influence their attitudes and behaviors.MethodsThis study used an open dataset of web-based questionnaires about COVID-19. The questionnaires were provided by Nexoid United Kingdom. We selected the results of a questionnaire on COVID-19–related behaviors, attitudes, and perceptions among the US public. The questionnaire was conducted from March 29 to April 20, 2020. A total of 24,547 people who lived in the United States took part in the survey.ResultsIn this study, the average self-assessed probability of contracting COVID-19 was 33.2%, and 49.9% (12,244/24,547) of the respondents thought that their chances of contracting COVID-19 were less than 30%. The self-assessed probability of contracting COVID-19 among women was 1.35 times that of males. A 5% increase in perceived infection risk was significantly associated with being 1.02 times (OR 1.02, 95% CI 1.02-1.02; P<.001) more likely to report having close contact with >10 people, and being 1.01 times (OR 1.01, 95% CI 1.01-1.01; P<.001) more likely to report that cohabitants disagreed with taking steps to reduce the risk of contracting COVID-19. However, there was no significant association between participants who lived with more than 5 cohabitants or less than 5 cohabitants (P=.85). Generally, participants who lived in states with 1001-10,000 COVID-19 cases, were aged 20-40 years, were obese, smoked, drank alcohol, never used drugs, and had no underlying medical conditions were more likely to be in close contact with >10 people. Most participants (21,017/24,547, 85.6%) agreed with washing their hands and maintaining social distancing, but only 20.2% (4958/24,547) of participants often wore masks. Additionally, male participants and participants aged <20 years typically disagreed with washing their hands, maintaining social distancing, and wearing masks.ConclusionsThis survey is the first attempt to describe the determinants of the US public’s perception of the threat of COVID-19 on a large scale. The self-assessed probability of contracting COVID-19 differed significantly based on the respondents’ genders, states of residence, ages, body mass indices, smoking habits, alcohol consumption habits, drug use habits, underlying medical conditions, environments, and behaviors. These findings can be used as references by public health policy makers and health care workers who want to identify populations that need to be educated on COVID-19 prevention and health.

Face Masks During the COVID-19 Pandemic: A Simple Protection Tool With Many Meanings.

Wearing face masks is recommended as part of personal protective equipment and as a public health measure to prevent the spread of coronavirus disease 2019 (COVID-19) pandemic. Their use, however, is deeply connected to social and cultural practices and has acquired a variety of personal and social meanings. This article aims to identify the diversity of sociocultural, ethical, and political meanings attributed to face masks, how they might impact public health policies, and how they should be considered in health communication. In May 2020, we involved 29 experts of an interdisciplinary research network on health and society to provide their testimonies on the use of face masks in 20 European and 2 Asian countries (China and South Korea). They reflected on regulations in the corresponding jurisdictions as well as the personal and social aspects of face mask wearing. We analyzed those testimonies thematically, employing the method of qualitative descriptive analysis. The analysis framed the four dimensions of the societal and personal practices of wearing (or not wearing) face masks: individual perceptions of infection risk, personal interpretations of responsibility and solidarity, cultural traditions and religious imprinting, and the need of expressing self-identity. Our study points to the importance for an in-depth understanding of the cultural and sociopolitical considerations around the personal and social meaning of mask wearing in different contexts as a necessary prerequisite for the assessment of the effectiveness of face masks as a public health measure. Improving the personal and collective understanding of citizens' behaviors and attitudes appears essential for designing more effective health communications about COVID-19 pandemic or other global crises in the future. To wear a face mask or not to wear a face mask? Nowadays, this question has been analogous to the famous line from Shakespeare's Hamlet: “To be or not to be, that is the question.” This is a bit allegorical, but certainly not far from the current circumstances where a deadly virus is spreading amongst us... Vanja Kopilaš, Croatia.

Association of national COVID-19 cases with objectively and subjectively measured mental health proxies in the Austrian Football league – an epidemiological study

We aimed to explore the association of national COVID-19 data with the objective and subjective mental health proxies (i.e. location variance, self-reported sleep quality, level of recovery, perceived risk of infection) in team and staff members of five professional Austrian Football clubs. Data were conveniently collected during the implementation of a novel monitoring concept. The concept was designed to enable safe continuation of professional Football during the COVID-19 pandemic. These data were matched with Austrian COVID-19 data and smartphone collected location data. Multivariable linear regression models explored the association of COVID-19, defined as daily novel or active Austrian cases of COVID-19, with the mental health proxies. An increasing number of novel Austrian COVID-19 cases was significantly associated with deteriorating sleep quality (B 0.48, 95% CI 0.05; 1.00). An increasing number of active Austrian COVID-19 cases was significantly associated with an increase in perceived infection risk (B 0.04, 95% CI 0.00; 0.07) and location variance (B 0.28, 95% CI 0.06; 0.49). An increasing Austrian COVID-19 incidence is adversely associated with mental health in professional Footballers and staff members. During the ongoing pandemic, targeted mental care should be included in the daily routines of this population.

Perceptions of the COVID-19 Vaccines and Rationale Surrounding the Decision to Vaccinate Among Pregnant Women of color in the United States: Lessons Learned From Four Focus Groups

Background Prior to the COVID-19 pandemic, the United States was facing a maternal health crisis grounded in health disparities. People of color have been disproportionately burdened by COVID-19. Simultaneously, maternity patients are at higher risk of severe complications and death due to COVID-19 infection. In spite of this, COVID-19 vaccination rates among pregnant women are low, and they are lowest among non-Hispanic Black women. To understand barriers and inform public health actions, this paper describes knowledge about COVID-19 infection in pregnancy, perceived infection risk, and reasons for vaccinating or not vaccinating against COVID-19 among pregnant women of color. Methods Four virtual focus group discussions were held with 32 participants in the United States. Two groups included women who had received at least one COVID-19 vaccine dose and two included those who stated they had not been vaccinated, but were considering it. Results Findings showed that both unvaccinated and vaccinated participants were knowledgeable about the risks of COVID-19 infection in pregnancy and were taking prevention precautions. Perceived benefits of vaccination included having a healthy pregnancy and baby, reduced stress about COVID-19 infection, and resuming social activities. All vaccinated participants reported having conversations with providers about vaccination, but the same provider engagement was not found among the unvaccinated. Concerns about the vaccines centered on bias in health care and vaccine safety. Conclusion Since vaccination benefits included having a healthy pregnancy and delivery, information about how the vaccines improve maternal and infant outcomes should be incorporated into health messaging. Addressing the historical and current racist practices in healthcare is critical to improve care and to improve trust in the health care system. Because health care provider engagement appears to be important for patient vaccination decisions, efforts should be made to support providers to talk to pregnant patients in culturally-sensitive ways about COVID-19 vaccines in pregnancy.

Explaining the rise and fall of psychological distress during the COVID-19 crisis in the United States: Longitudinal evidence from the Understanding America Study.

It has been shown that psychological distress rose rapidly as the COVID-19 pandemic emerged and then recovered to pre-crisis levels as social lockdown restrictions were eased in the United States. The aim of the current study was to investigate psychosocial and behavioural factors that may explain the rise and fall of distress during the initial months of the COVID-19 crisis. This study examined six waves of longitudinal nationally representative data from the Understanding America Study (UAS) collected between March and June 2020 (N=7,138, observations=34,125). Mediation analysis was used to identify whether changes in distress (PHQ-4) during the COVID-19 pandemic were explained by the following factors: perceived infection risk and risk of death, perceived financial risks, lifestyle changes resulting from the virus, perceived discrimination related to the virus, and changes in substance use and employment status. All mediating factors played a role in explaining changes in distress and together accounted for 70% of the increase in distress between 10-18 March and 1-14 April and 46.4% of the decline in distress between 1-14 April and early June 2020. Changes in perceived health risks were most important in explaining changes in distress followed by changes in lifestyle and the perceived financial risks associated with COVID-19. This study provides longitudinal population-based evidence detailing the mediating factors explaining changes in distress during the COVID-19 crisis. Perceived health risks associated with the virus may play a key role in explaining rising and falling levels of psychological distress during the COVID-19 pandemic.

Mental Health Conditions of Italian Healthcare Professionals during the COVID-19 Disease Outbreak.

BackgroundThe COVID‐19 pandemic in Italy represents a unique threat in terms of psychological distress. This cross‐sectional study aims to investigate the psychological health of Italian healthcare professionals during the COVID‐19 outbreak. We assessed participants’ current psychological distress and coping strategies in the midst of the COVID outbreak (March–April 2020), and also asked them to retrospectively report how they remember feeling before the COVID‐19 outbreak (December 2019). We examined associations between psychological distress and coping strategies with mental health and infection perceptions.MethodsSelf‐administered questionnaires were distributed online to healthcare professionals (N = 580) residing in different Italian regions from 26 March to 9 April 2020. The questionnaire measured changes in psychological states, coping strategies, and demographic variables testing variations in mental health and infection risk perception among Italian healthcare workers.ResultsOverall, approximately 33.5 per cent of healthcare professionals in our sample meet the threshold for psychiatric morbidity. Participants perceive their current psychological health to be worse during the COVID‐19 emergency outbreak as compared to before the outbreak, and this was especially true among women.ConclusionsBoth immediate and long‐term monitoring psychological assistance services for healthcare workers should be implemented by national institutions to re‐establish the psychological well‐being and enhance the self‐confidence and resilience of hospital personnel.

The Combined Effect of Perceived COVID-19 Infection Risk at Work and Identification with Work Community with Psychosocial Wellbeing among Finnish Social Sector and Health Care Workers.

It has been well documented that both risk perception and group identification are related to psychosocial well-being. However, their combined effect has rarely been analyzed. We examined the combined effect of perceived risk associated with COVID-19 infection at work and work community identification on psychosocial well-being (i.e., frequency of stress symptoms) among health care and social sector workers in Finland (N = 1279). Data were collected via an online questionnaire in June 2020 and analyses of covariance were conducted. Perceived COVID-19 infection risk at work was classified into high, medium and low risk. In total, 41% of participants reported a high risk. After all background variables were included, participants who reported high perceived infection risk and low work community identification reported stress symptoms more often than those who reported high perceived risk and high identification (p = 0.010). Similarly, the former differed significantly from all other comparison groups (medium and low risk, p < 0.001), being the most stressed. We found that perceived infection risk and work community identification were not related to each other. Our conclusion is that high work community identification can buffer employee stress when faced with a high perceived health risk. In the context of the COVID-19 pandemic, work organizations with a high infection risk should advance the possibility of employees’ identification with their work community.

Views on Workplace Policies and its Impact on Health-Related Quality of Life During Coronavirus Disease (COVID-19) Pandemic: Cross-Sectional Survey of Employees.

Background: This study explored the degree of views towards supportive workplace policies among employees during coronavirus disease 2019 (COVID-19) pandemic and its association with health-related quality of life (HRQoL) in Hong Kong. Methods: A cross-sectional study was conducted in 1049 employees using online self-administered questionnaire. Views on workplace policies were measured in term of agreement on its comprehensiveness, timeliness and transparency whereas HRQoL was measured using EQ-5D-5L Hong Kong version. Univariate estimates on the impact of HRQoL from views of measures in workplace was done. Qualitative comments on the suggestions to strengthen workplace measures were collected and presented descriptively. Results: Of 1048 respondents, 16% reported that no workplace measures nor guidelines were existed in their company related to the COVID-19 pandemics. Those who reported having workplace policy were not satisfied with the arrangement in term of comprehensiveness (36%), timeliness (38%), and transparency (63%). Regarding to the policy measure, only 68% respondents reported that their workplace supplied face masks to them. The health index was 0897, which was lower than the norm of 0.924. 64% of respondents reported having a health problem in at least 1 of 5 dimension of EQ-5D-5L with the highest proportion of having problem in anxiety/depression (55%). In addition, the workplace policy and measure had a direct effect of 0.131 on health outcome. Perception of infection risk had a direct effect of 0.218 on health outcome and partly mediated the relationship between workplace policy and measure and health outcome (0.066). Conclusion: The study highlighted the workplace policy and measure is an important mean to minimize infection risk at workplace so as to reduce tremendous stress and health outcome caused by a COVID-19 pandemic. Workplace measures related to COVID-19 pandemic should be further strengthen to mitigate the risk of infection and protect employee’s health.

Perceived risk, behavior changes and Health-related outcomes during COVID-19 pandemic: Findings among adults with and without diabetes in China

AimsTo examine perceived infection risk of COVID-19 and the health and related behavior changes among people with diabetes, compared with people without diabetes, and to examine factors associated with self-reported health during the national quarantine period in China. MethodsThe 2020 China COVID-19 Survey is an anonymous 74-item survey administered via social media across China. A national sample of 10,545 adults in all 31 provinces in mainland China provided data on sociodemographic characteristics, awareness, attitudes towards COVID-19, lifestyle factors, and health outcomes during the quarantine. Regression models tested associations among study variables adjusting for covariates. ResultsAmong the 9,016 total participants (42.6% men and 57.4% women), 585 reported having diagnosed diabetes and 8,431 had no diabetes. Participants with diabetes perceived themselves to be at higher risk and were more worried about being infected with COVID-19 when compared to non-diabetic individuals (p < 0.001). During the COVID-19 pandemic, participants with diabetes were more likely to experience food and drug shortages and to increase their physical activity, compared to their counterparts. Among diabetic respondents, a high proportion of current smokers (74.1%) and drinkers (68.5%) reported increased amounts of smoking and drinking. People with diabetes were 11% less likely to report excellent or very good health. Having 150 min/week physical activity was positively associated with excellent or very good health (prevalence ratio, PR = 1.14, 95%CI 1.11–1.16). ConclusionsA high proportion of people with diabetes perceived risk of COVID-19 infection and increased their smoking and drinking during the pandemic.

Relationships Between Initial COVID-19 Risk Perceptions and Protective Health Behaviors: A National Survey

IntroductionPerceptions of health risks inform decisions about protective behaviors, but COVID-19 was an unfamiliar risk as it began to spread across the U.S. In the initial stage of the epidemic, authors examined perceived risks for COVID-19 infection and infection fatality and whether these risk perceptions were associated with protective behaviors. They also examined whether findings differed between later versus earlier responders.MethodsBetween March 10 and March 31, 2020, a cross-sectional online survey was conducted with a nationally representative U.S. sample (n=6,684). Half responded before March 13, 2020 (versus later). Participants assessed their risks of COVID-19 infection and infection fatality (0%–100%) which were transformed into quartiles (1–4). They reported their implementation of protective behaviors like handwashing and social distancing (yes/no). Analyses were conducted in April‒May 2020.ResultsMedian perceived risk was 10.00% for COVID-19 infection and 5.00% for infection fatality, but respondents showed large disagreement. An increase of 1 quartile in perceived infection risk was associated with being 1.45 times (95% CI=1.33, 1.58) more likely to report handwashing, with perceived infection fatality risk showing no significant association. When predicting social distancing behaviors such as avoiding crowds, both quartile-based risk perceptions were significant (OR=1.24, 95% CI=1.17, 1.30 for infection and OR=1.19, 95% CI=1.13, 1.26 for infection fatality). Perceived COVID-19 infection risk, protective behaviors, and their relationship increased among later (versus earlier) responders.ConclusionsDespite disagreements about the risks, people perceiving greater risks were more likely to implement protective behaviors—especially later (versus earlier) in March 2020. These findings have implications for risk communication.