Risk Perception Research Articles

COVID-19 impact on childhood vaccination attitudes in pregnant antenatal class attendants in Rome

Abstract Background The COVID-19 pandemic caused a decrease in vaccination rates, impacting vulnerable populations such as pregnant women (PW), who concern about future children’s immunisations. The aim of this study was to assess whether the pandemic led to changes in childhood vaccination attitudes among PW attending antenatal classes at the Fondazione Policlinico Universitario A. Gemelli in Rome. Specifically, it assessed the impact of the pandemic on the perceived usefulness of information sources, their trust in healthcare workers (HCWs) and the National Health Service (NHS), their perception of the risk of infection and severity of vaccine-preventable diseases (VPDs), and their vaccination intentions. Methods A repeated cross-sectional study was conducted across three flu seasons by administering an anonymous questionnaire: one before and two during the pandemic. Intention to vaccinate children was expressed as the percentage of PW who selected each vaccination from the questionnaire. Trust in HCWs and the NHS, and perception of the risk of infection and severity of VPDs were expressed as the percentage of PW who answered “quite” or “very”. For the usefulness of information sources, mean scores were calculated. To assess differences of the three periods a chi-square test was performed (p = 0.05). Results Course attendance surged from 105 to 340. Significant shifts in vaccination intentions were noted: 7.5% and 10% decreases for measles (p = 0.02) and pertussis (p = 0.004), respectively, from 2019-20 to 2020-21. Perceived contagion risk decreased, but perceived disease severity increased. A significant reduction in the proportion of PW suspecting economic interest behind NHS workers promoting vaccination, and an increase in the perceived usefulness of non-institutional websites and of the advice from non-NHS physicians were noted. Conclusions PW’s attitudes towards vaccinations might have been modified by COVID-19 pandemic, regarding risk perception and trust in NHS HCWs. Key messages • Our findings suggests that PW’s attitudes towards childhood vaccinations might be modified by the COVID-19 pandemic, in particular risk perception and trust in NHS healthcare workers. • These findings could help Public Health to develop evidence-based interventions and communication strategies, to maintain vaccine confidence and mitigate potential adverse effects.

Risk perceptions and risk behavior among children attending a road safety education program in Greece

Abstract Background Road Traffic Injuries (RTI’s) are a significant public health concern for children, placing a considerable burden on their well-being. Greece has consistently recorded high numbers of RTI’s among adolescents. Methods A university lab (LaHeRS, HMU) offers a road safety education program for primary and secondary students in Heraklion, Greece. The program consists of two parallel sessions (practical training using a driving simulator and activity-based risk-perception training) aimed at enhancing competencies in resilience to peer influence, empowering children to engage in informed decision-making and fostering hazard perceptions skills. The current presentation reports on 800 students who attended the program between October 2023 and April 2024. A structured questionnaire was used to collect data on student’s beliefs, attitudes and practices on road safety. Results A total of 800 students attended the program from the broader Crete Region. 50.5% were girls with a mean age of 12.6 (SD = 2.3) years, 60.9% secondary education students, 58% resided in rural areas. 33.9% reported using a motorcycle and 33.8% a car without a driving license. 23.3% reported experiencing a road traffic incident while commuting. 57.1% identified road safety as a problem in their place of residence, only 26.5% felt safe on local streets and only 9.1% considered other road users as watchful. Additionally, 66.8% highly valued helmet use as a precaution in short distances. 71.6% reported always wearing seatbelt in front seats and 68.9% thought seatbelts are important at back seats. 52.1% did not identify themselves as risk takers on the street, and only 22.5% felt competent in avoiding road risks. 32.9% admitted experiencing peer pressure while commuting. Conclusions Risk taking behaviors and low use of protective measures are prevalent among school aged children and need to be addressed through targeted road safety education programs and interventions. Key messages • Promoting safe behaviors and enhancing risk perception is critical among children and young adolescents. • Road safety education should be integrated into school curricula, starting from pre-school education.

Risk-taking Factors in a Dynamic Approach

The most common definition of risk is quantified by the probability of an adverse event occurring and the value of the adverse consequence. Theoretically, the decision to take a risk can also be based essentially on these two pieces of information. In addition, according to traditional risk-taking models, the perception of risk, the psychological characteristics of the decision-makers and their relevant experience are also important. In the case of mathematical-statistical-psychological models, little emphasis is placed on the fact that risk is in fact the inability to completely control the activity in question. The causes of this incompleteness are based on the shortcomings in the relevant capabilities of the economic agent. Economic agents have different capabilities, so they rarely face the same risks, even for almost identical activities. Just as the requirements and circumstances of the activity are constantly changing, so are the capabilities of the economic agent. Consequently, the size of the capability gap of an economic agent is also constantly changing. This should be taken into account in risk-taking decisions and their revision. The paper attempts to model this dynamic risk-taking mechanism and to show how different risk-taking strategies may be pursued by economic agents in certain baseline situations.

Social determinants and drivers of use of SARS-CoV-2 self-tests in a French national cohort study

Abstract Background Self-tests for SARS-CoV-2 became quickly available after the onset of the epidemic. They were especially recommended for high-risk and hard-to-reach populations. This study examines whether self-tests successfully reached vulnerable groups during first months of availability in France. Methods The EpiCov study is a national population-based cohort study conducted in France during the Covid-19 pandemic. Primary outcome variable was use of self-test at last SARS-CoV-2 test, among those who reported testing at least once between May-July 2021. Univariate and multivariate binomial weighted logistic regressions were run, stratified by age group (16-24 yrs, 25-59, 60+), to identify social determinants and drivers of use of self-tests. Results Overall, 11% of the population who tested for SARS-CoV-2 between May-July 2021 reported using a self-test as last test. Demographic factors were highly predictive of use of self-tests among 25-59 y/o, but not among younger and older age groups. Use of self-tests was highest among 16-24 y/o, people with higher education, lowest population density areas, and people with high overall frequency of testing. Use was lowest among 60+ y/o, unemployed and retired people, and first-generation immigrants. When stratifying by age, 16-24 y/o with high perceived Covid-19 risk were more likely to use self-tests (aOR 1.99, 95% CI 1.10-3.59). Among 25-59 y/o, in-person workers were more likely to use self-tests than remote workers (aOR 1.91 [1.20-3.05]). Among 60+ y/o, employed people were more likely than retired people (aOR 3.97 [2.30-6.85]). Conclusions With higher utilization in low population density areas and among frequent testers, convenience may be a primary driver of use of self-tests. Additional drivers include perceived risk among younger people and exposure at work for those ≥25 yrs. Inequities in use were observed, with lower use among people with low education, older age, and immigrants. Key messages • Use of self-tests in France during the Covid-19 pandemic was low among vulnerable population groups, including people with lower education, immigrants, and older individuals. • Drivers of use included geographical access to healthcare services, perception of risk among younger respondents, and exposure at work among adults aged ≥25 years.

Reduction of screen induced myopia by parental interventions

Abstract Background Excessive use of digital devices, including smartphones and tablets, has been shown to increase the risk of myopia in children. Gaps persist in understanding parental attitudes towards handheld screen use and effective interventions guiding eye health policies. This study examined the associations between parental behavior related to myopia and children’s handheld screen use. Methods Data obtained from 395 parents of pre-adolescents (Mean age 10.63; SD 1.09) were used, collected from an online community panel. Parents reported on various behavioral determinants related to myopia and their child’s screen time: knowledge, attitude, risk perception and self-efficacy. They reported on their child’s frequency and amount of screen use. Logistic regression analysis was used to assess associations between variables, using parental efforts to reduce screens as outcome measure. Results Of the 395 participating 9-12 year-olds, 73.4% of the children spent up to two hours a day on recreational handheld screens, 26% more than two hours. Of the parents surveyed, 28.1% perceived the risk of screen-induced myopia as significant, prompting 62.6% of them to take active measures to minimize screen time. The more knowledge parents had on child myopia the more they attempted to reduce screen time (OR = 2.57; 95% CI [1.57-4.19], p = <.001). Moreover, a more negative attitude towards screens was significantly related to attempting to reduce screen time (OR = 1.26; 95% CI[1.17-1.35],p = <.001). Key messages • These findings emphasize a need to address parental knowledge and attitude towards myopia and screen time reduction. • We recommend increasing knowledge, influencing attitude and searching for alternatives as a part of behavioral change strategies.

Monitoring the Public Health and Safety Impact of the Groningen Gas-Extraction Crisis

Abstract Background Gas extraction in the Dutch province of Groningen began in 1963 and was initially seen as an economic boon for the nation. Yet, it turned into a significant burden for the region, leading to earthquakes, damage to houses and property, complicated compensation processes, recovery, and reinforcement programs, as well as a lack of recognition. In 2016, the research group Gronings Perspectief (GP) was established with the objective of independently monitoring the public health and safety impact of the gas-extraction crisis from the residents’ perspective. Methods Monitoring activities take place in dialogue with sounding boards comprising residents, professionals, scientists, and local and national governments. GP employs a longitudinal mixed-methods approach, combining qualitative and quantitative research methods. Representative panel surveys are conducted yearly among residents in the provinces of Groningen (twice) and Drenthe (once). Additionally, 20 in-depth interviews are carried out each year, alongside a survey among households in the reinforcement program. GP analyses the periodic health monitors conducted by municipal health authorities. All reports are publicly accessible. Results Since 2016, monitoring consistently points to a profound and enduring effect of housing damage on health and well-being, subjective safety, risk perceptions, trust in governments and agencies among residents. The impact of the procedural burden imposed by governments and institutions, is as significant as the effects of earthquakes and housing damage. Conclusions GP’s findings were included in a parliamentary inquiry, which concluded in 2023 that the interests of residents were persistently neglected in favour of economic gain. New risk reduction and reconciliation programs are introduced. Despite the recent decision to end the gas extraction, continuation of GP is needed to monitor further developments. Key messages • GP’s stakeholder-driven monitoring approach made the impact of the gas-extraction crisis visible. • Enduring public health and safety risks, beyond the gas extraction, require continuing monitoring.

Preventing unintentional injuries due to home and leisure time accidents in children: the parents’ beliefs matters (CHILD Vigilance project - CHIVI)

Abstract Background The CHILD Vigilance project is a European study supported by the Injury Prevention section of the European Public Health Association and aims at contributing to the epidemiological knowledge of injuries and accidents in Greece, Portugal and Lithuania, through increasing knowledge on parents’ and caregivers’ safety perceptions. Methods A descriptive, observational, cross-sectional study was developed in these countries between February and April 2023, under the CHILD Vigilance project. Information was collected online via a questionnaire exploring parents’ and/or caregivers’ knowledge, attitudes and risk perception towards prevention of unintentional injuries in children and adolescents. Results A total of 916 valid responses were obtained, involving 1229 children (51.4% male; mean age 7.8 years). Falls were perceived as the most common type of unintentional injuries in pre-schoolers and school-age children (47,8% in Greece; 63,5% in Portugal; 74,8% in Lithuania). Country differences were observed in terms of the most commonly perceived types of injury in adolescents, which were road traffic crashes in Greece and Portugal (41.2% and 39.5% respectively) vs poisonings in Lithuania (38.1%). Some differences were also observed between these countries as to the most common causes of death. In Greece and Lithuania diseases were reported as the main cause of death in pre-schoolers (62.5%; 35.1%) and in children attending primary education (55.1%; 29.7%), while injuries were identified as a cause only in the oldest group of children. In Portugal on the other hand, injuries were identified as the most frequent cause of death in all groups, pre-schoolers (40.5%), children attending primary education (47.1%) and in the oldest (55.1%). Conclusions The study emphasizes the need to address misperceptions, improve safety attitudes and invest more efforts in managing harmonised injury outcomes across global initiatives.

7.I. Skills building seminar: Beyond the jargon: an interactive workshop for effective risk communication

Abstract Risk communication plays a central role in epidemiology to provide information for disease surveillance and outbreak control. It is one of the of the eight core functions that WHO Member States must comply with as part of the International Health Regulations (2005) ensuring national and global preparedness for health threats. It refers to the timely and accurate exchange of information between public health experts or authorities and individuals who are confronted with a threat to their survival, health, economic or social well-being. At its core, risk communication is about empowering people exposed to a risk to make well-informed decisions in order to mitigate potential risks and adopt preventive actions and measures. Risk communication considers political, social, and economic factors; it analyses risk and risk perception; and it places a great emphasis on dialogue with impacted and targeted populations to help them make the best decisions they can. Therefore, it requires an understanding of stakeholders’ perceptions, concerns, and beliefs, as well as their knowledge and practices. In the context of the COVID-19 pandemic, the need for effective and efficient risk communication has become even more evident than before. Risk communication should be able to recognise and deal with rumours and disinformation, and reach the most vulnerable groups, who have a higher risk of contracting the virus and suffering from COVID-related consequences. Lately, increasing attention has been given to this topic. The WHO set-up, in April 2023, a technical Advisory Group for Risk Communication, Community Engagement and Infodemic management (TAG-RCCE-IM) to provide independent review and technical advice in the context of emergency preparedness and response in Europe. The Joint Action PreventNCD aims to also build a framework for country-specific communication strategies for non-communicable diseases (NCD) patients in health crises in one of the Work Packages, by collecting and analysing health communication strategies in different European countries targeting NCDs. In this interactive skills-building seminar, we will share with the participants the knowledge, skills, and process of effective risk communication by using case studies from experts in the field. The session will start with a presentation on the core elements of risk communication followed by examples from the field. This workshop will foster an inclusive interactive environment where participants will hear from panellists sharing their experiences from different settings such as international organisations and national public health institutes. Participants will be split into groups and will be provided with a piece of scientific output, such as a research study or epidemiological report and encouraged to translate this technical message into a clear, concise message that can effectively communicate the key points to the general public. Key messages • Risk communication is essential to fight disinformation while empowering the public to make informed decisions related to their health and well-being. • Epidemiologists and researchers should be encouraged to employ efficient and targeted communication strategies when disseminating their findings. Speakers/Panelists Stefan Schaub Bundeszentrale für gesundheitliche Aufklärung (BZgA, Cologne, Germany Federica Rossetti Sciensano, Brussels, Belgium Stefan Adrian Voinea WHO/Europe, Copenhagen, Denmark

Risk perception survey for healthcare-associated infections in a large teaching hospital in Rome

Abstract Background Healthcare-associated infections (HAIs) are the main complications of hospitalization. The goal of the study was to enhance awareness, improve risk perception, and facilitate measures to reduce the outcomes of HAIs. A bottom-up approach, in which the healthcare workers involved play a key role, can be adopted to decrease the spread of HAIs. Therefore, a survey was conducted in a large teaching hospital in Rome from 2019 to 2023, excluding 2020 due to COVID-19. Methods A longitudinal study was conducted in all integrated care departments with beds. The data was collected using a standardized, anonymous, self-administered questionnaire for healthcare workers. The questionnaire consisted of 61 items assessing socio-professional features, knowledge of HAIs, attitudes and barriers to hygiene compliance, self-analysis of professional behavior and advice for new interventions. The study lasted 21 days between November and December, which is considered a period of normal care activity. A multivariable logistic regression model was built. Statistical analyses were performed with STATA 18.0. Results There were 384 health workers respondents: female (67.7%) and nurses (56.5%). The most represented areas were internal medicine (37.9%) and surgery (27.3%). The correct frequency of perception of HAIs increased from 33.3% in 2019 to 36.3% in 2023. From 2022 to 2023, the multivariable model showed that physicians (OR 0.48, CI 95% 0.24-0.93, p-value 0.03) and elder staff (OR 1.02, CI 95%, 1.0-1.1, p-value 0.04) seemed to be more aware of the prevalence of HAIs in their ward. Conclusions Targeted training days were organized after the study to discuss the data collected. Staff awareness of the prevalence of HAIs in their ward is improving, even if it is complicated to quantify it by attending HAIs training events. The survey has been included as a corporate goal for 2024 as a useful tool to improve awareness of HAIs and to evaluate the effectiveness of ongoing training. Key messages • A bottom-up approach, in which healthcare workers assume a pivotal role, can be employed to reduce the spread of HAIs as it serves as a valuable tool to evaluate the efficacy of targeted training. • The results indicate that the education of healthcare workers is a crucial factor in enhancing awareness of HAIs. Therefore, there is a need to improve the education of younger and non-medical staff.

Risk communication with asylum-seekers: Insights from the COVID-19 Pandemic experience in Munich

Abstract Background The COVID-19 pandemic has created a ‘double crisis’ for asylum-seekers, whose lives were already in crisis. Many reports indicated the syndemic consequences on asylum seekers’ health, underscoring the need for their inclusion in risk communication (RC) and community engagement (CE) and infodemic management (IM) actions. This study aims to describe RCCE experience with asylum seekers in Munich during the COVID-19 pandemic from an expert perspective and thus gain a thorough understanding of the requirements for inclusive RCCE. Methods Our qualitative study involved people who conducted COVID-19-related RCCE for asylum-seekers. Volunteers/workers of civil society organizations and health professionals were interviewed using purposeful sampling. After reviewing international guidelines, an interview form was created. The content analysis resulted in themes and categories. Results Four of the interviewees were health managers, while 8 were working in civil society organizations. The first category of the results describes the context in which RCCE occurs; syndemic factors (uncertainty; social exclusion and stigma; precarious housing; limited access to healthcare and unmet mental health needs) and pandemic management. The second category includes determinants of RCCE from both the asylum-seeker (trust; risk perception; health literacy; language; culture and gender) and RCCE member (competences; overburden; continuity) standpoint. The third category focuses on various RCCE-IM measures, including their effectiveness and consequences. Conclusions Syndemic factors hampered the effective implementation of RCCE for asylum seekers in Munich. RCCE determinants show that pre-crisis actions are necessary for an effective response and individual interactions should accompany community-level activities, particularly for female and marginalised migrants. This study’s scope will be expanded by incorporating the IM component.

Cardiac risk confrontation in primary care as a teachable moment towards improved health outcomes

Abstract Background Urgent life events, such as acute coronary events, can evoke a teachable moment (TM) for lifestyle change. This study aims to investigate whether less urgent events, such as being confronted with an increased risk of cardiovascular disease, can evoke a TM, what psychosocial factors are associated with it, and whether experiencing such a TM predicts improved health outcomes. Methods The study included 114 patients who were informed about their elevated cardiovascular risk during a primary care visit. Participants completed a survey assessing whether they experienced a TM and several psychosocial factors linked to experiencing it: perceived risk, affective impact, changed self-concept. Participants monitored their weight and blood pressure for six months using an at-home self-monitoring device. Univariate and multivariate regression analyses were conducted to examine the associations between the psychosocial factors and the lifestyle change intentions with changes in blood pressure and weight. Results Of the participants, 55.3% experienced increased lifestyle change intentions. Lower risk perception ((B = -0.27; CI = -0.39-(-0.15)) and higher change in self-concept (B = 0.34; CI = 0.23-0.44) were associated with higher intention to change lifestyle. Higher risk perception (B = 0.23; CI = 0.06-0.42) and higher change in self-concept (B = 0.54; CI = 0.37-0.72) predicted a lower weight reduction at six months. A higher change in self-concept predicted a higher blood pressure reduction (B = -3.32; CI = -6.55-(0.09)). Lastly, a higher lifestyle change intention predicted bigger reductions blood pressure (B = -5.04; CI = -9.08-(-0.29)). Conclusions Results suggest that less urgent cardiac events, such as a confrontation with an increased cardiac risk, can be experienced as a TM that urges lifestyle change intentions and affects health outcomes. Risk confrontations in primary care therefore offer a unique opportunity to provide lifestyle counseling at the right moment. Key messages • A confrontation with an increased cardiac risk in primary care can be experienced as a teachable moment. • Experiencing a teachable moment after a cardiac risk confrontation in primary care affects health outcomes.

Unequal cannabis use among European adolescents: the mediating role of perceived access and risk

Abstract Introduction Cannabis use among adolescents is a public health concern, because of its association with the use of other illicit drugs, mental health disorders, and social problems. Most studies show that adolescents from low socioeconomic status (SE) background are more likely to use cannabis, but the causes of SE inequalities remain to be understood. We test whether access and risk perceptions of cannabis use among disadvantaged adolescents explain the SE gradient. Objectives The aim of this study was to measure the mediating effect of access perception and risk perception on the association between SE status and cannabis use among European adolescents in 2019. Methods A cross-sectional, observational, analytical study was conducted, among 16-year-old students, based on data from the European School Survey Project on Alcohol and Drugs (ESPAD) in 2019. The outcome was cannabis use (experimental, regular, and problematic) and the exposure was SE status (parental education and subjective social status). Mediating variables were perceived accessibility and perceived risk of cannabis use. We used logistic regressions, where the odds ratio (OR) reduction measures the part of the association explained by the mediators. Results Regular and problematic cannabis use was significantly more prevalent among adolescents with a lower SE background (low parental education and low subjective social status, p < 0,001). This relationship remained significant after adjustment for perceived access and risk, and the modification of ORs was of a small magnitude (a non-significant reduction of the association). Conclusions Perceived accessibility and risk showed a weak mediating effect of the association between SE background and cannabis use. Consequently, these factors cannot be considered as major explanations for the higher use among worse-off adolescents. Reinforcing information or imposing stronger barriers in access may not help reduces SE inequalities in cannabis consumption. Key messages • Perceived accessibility and risk hardly explain the association between socioeconomic background and cannabis use among European adolescents. • Reinforcing information or imposing stronger barriers in access may not help reduces socioeconomic inequalities in cannabis use.

The Influence of Personality Traits on Stock Investment Retention: Insights from Thai Investors

Understanding the psychological factors that influence investment decisions is crucial for predicting stock investment retention. This study investigates the mediating role of the Big Five personality traits in stock investment retention, utilizing a modified version of the theory of planned behavior. By examining the influence of investors’ perceived risk and attitudes toward stock investment, data collected via an online survey with The Association of Thai Securities Companies (ASCO) were analyzed using Structural Equation Modeling (SEM). The findings reveal that extraversion, openness, and conscientiousness significantly impact attitudes toward stock investing, which in turn affects investment retention. However, personality traits do not directly influence risk perception. This research provides unique empirical evidence of the independence between the Big Five personality traits and risk perception among Thai stock investors, underscoring the importance of personality in shaping investment behavior through its effect on attitudes.

Gap between estimated cardiovascular risk and individual risk perception: a survey from a cardiovascular prevention center.

Abstract Background Cardiovascular risk scores represent a great achievement of preventive cardiology, since they allow to stratify individual risk. The recently updated European Society of Cardiology Scores offer an accurate cardiovascular risk estimation. However, a gap between perceived and calculated risk may strongly interfere in healthy lifestyle changes as well as in cardioprotective drugs adherence. Purpose: The aim of the present study was to evaluate and quantify the above-mentioned gap. Methods A cohort of subjects referred to our Cardiovascular Prevention Center were included in the present study. Cardiologists assessed each tradional and emerging risk factor in terms of presence or absence, severity, distance from target, and the cardiovascular risk was calculated using appropriate ESC scores. Each subject filled out a questionnaire in which they were asked to declare their perceived cardiovascular risk and to report, among all the traditional and emerging cardiovascular risk factors, which ones they believed to have greater impact on their individual risk. Results 366 consecutive subject were included, 70% in primary prevention and 30% with atherosclerotic cardiovascular disease, mean age was 65 years, male gender was prevalent (57%), arterial hypertension (AHT) was found in 78,7% (43,4% uncontrolled), dyslipidaemia in 91,5% (87,5% not at target), diabetes in 18,6%, smokers were 12,9% and 24,4% had obesity. Among emerging risk factors, sedentary lifestyle was found in 63%, while 18% reported regular aerobic physical activity, mediterranean diet adherence was found in 26% and moderate-to-severe perceived anxiety in 23%, depression in 17% and stress in 66%. 6,6% had low risk cardiovascular risk, 16,1% intermediate, 38,0% high and 39,3% very high. A concordance between estimated and perceived risk was found in 18,9% while a discordance in 81,1%; 93,3% underestimate their risk, while 6,7% only overestimate it (figure 1A). A significant higher rate of discordance was found with the progressive increase of the risk (p<0.0001). Different perceived cardiovascular risk among each estimated classes of risk was shown in figure 1B and figure 2; of note only 11% of high risk and 8% of very high risk were concordant in their risk perception. In particular, elderly (p<0.001), male (p<0.001), subjects with AHT (p=0.001) and dyslipidaemia (p=0.02) showed higher rate of underestimation while younger (p<0.001), female (p<0.001) as well as anxiety (p=0.047) and depressed (p=0.010) had higher rate of overestimation. Conclusions A high rate of subject underestimate its cardiovascular risk; the higher the risk, the higher the gap between perceived and estimated risk. This risk gap represents a "risk within the risk". for these reasons it is necessary to increase all efforts towards a more effective health education in the field of cardiovascular prevention in order to reinforce patients awareness and physician-patient alliance.Figure 1Figure 2

Evaluation of Covid-19 risk perception and psychological status of transplant patients

Abstract Background Liver transplant patients are in the more at-risk group in terms of COVID-19 infection and mortality due to both immunosuppressive treatment and underlying chronic diseases. The aim of this study was to evaluate the COVID-19 risk perception, compliance with preventive measures, and psychosocial status of liver transplant patients. Methods This descriptive cross-sectional survey study included 311 patients who underwent liver transplantation between 2002 -2021 and presented to the outpatient clinic for routine controls. Data were collected via a questionnaire administered through face-to-face interviews. The questionnaire form used to collect the data of the study included a demographic and clinical characteristics form, the Short Depression-Happiness Scale, the COVID-19 Prevention Guidelines Compliance Scale, and the COVID-19 Risk Perception Scale. The Mann-Whitney U, the Kruskal-Wallis test and Spearman’s Rho correlation analysis were used in statistical analyses. Results The median age of the transplant patients who participated in the study was 56 (18-76) years. Of the transplant patients, 84.9% stated that they had COVID-19 vaccination. There was a statistically significant, very weak relationship between the scores of the Brief Depression-Happiness Scale and the COVID-19 Compliance with Preventive Measures Scale (r = 0.132; p = 0.02), and a weak, significant relationship in the same direction between the scores of the COVID-19 Compliance with Preventive Measures Scale and the COVID-19 Risk Perception Scale (r = 0.344; p = 0.001). Conclusions The vaccination rates of the patients were high. As the depression status of the patients decreases, their compliance with preventive measures increases, and as their compliance with preventive measures increases, their risk perception increases. Key messages • Since transplant patients are a vulnerable group, their vaccination status is important in terms of mortality risk. • Psychological factors such as depression-happiness scores influence adherence to COVID-19 preventive measures among transplant patients.

ANALYSIS OF CONSUMER BEHAVIOR IN SHOPPING CHANNEL PREFERENCES IN A DUAL CHANNEL SUPPLY CHAIN STRUCTURE

Physical stores and online stores are one way that companies can continue to survive amidst competition by increasing profits from these two channels. Clothing is one of the textile commodities that is widely traded through physical stores and also online stores. This research identifies the factors that have the most significant influence on consumer preferences in choosing physical stores or online stores. Determining the factors involved adopts the results of previously conducted research. Based on existing research, there are several factors, namely Financial Risk (FR), Performance Risk (PerR), Psychological Risk (PsyR), Perceived Risk (PR), Environment Quality (EQ), Service Quality (SQ), Internet Experience (IE ), and Switching Intention (SI). From these variables, 8 hypotheses were formed. All hypotheses from the model were processed using Structural Equation Modeling with SmartPLS 3 software, it was found that H1, H2, H3, H4, H5, and H7 were accepted. H6 and H8 are rejected.

A cross-sectional study on the perceived risk of COVID-19 and its association with the usage patterns of e-cigarettes among adolescents and young adults during the COVID-19 pandemic in Nigeria

The study aimed to assess the perception of a higher risk of COVID-19 infection among young people who used e-cigarettes, and its association with a change in the use of e-cigarettes during the pandemic in Nigeria. A secondary analysis of the Nigerian component of a multi-country online survey data, which was obtained from adolescents and young adults on e-cigarette use from November 1st to December 30th, 2021, was conducted. Multi-nominal regression analyses were done to determine the associations between the dependent (use of e-cigarettes) and independent (perception that e-cigarette users are more likely to be infected with COVID-19) variables after adjusting for confounders (health status, COVID-19 status, HIV status, anxiety level, age and sex). Of the 568 respondents (52.8% male), 122 (21.5%) perceived that e-cigarette users were more likely to be infected with COVID-19. In addition, 188 (33.1%) respondents increased e-cigarette smoking during the pandemic. A greater percentage of participants who perceived that e-cigarette use is associated with a greater risk of COVID-19 infection, and a significantly higher percentage of participants with high levels of anxiety reported decreased e-cigarette use (28.6% versus 13.3%, p = 0.029). The perception that e-cigarette use increased the risk for COVID-19 was associated with higher odds of an increase in e-cigarette use (AOR: 1.328) and lower odds of a decrease in e-cigarette use (AOR: 0.580) during the COVID-19 pandemic, though these associations were not statistically significant. The persistence of e-cigarette use among the youth in Nigeria despite awareness of COVID-19 risks highlights the need for stronger public health interventions. Simply providing information on risks is insufficient; targeted strategies addressing addiction, social factors, and accessibility are crucial for meaningful behavioural change.

Cyber resilience in organisations and supply chains: from perceptions to actions

PurposeThis empirical study investigates the direct and indirect effects on managers’ perceptions of cyber risks, the implementation of cyber resilience strategies and the perceived effectiveness of these strategies for supply chains. Cyber risks pose significant threats to organisations and supply chains. Yet they remain insufficiently addressed and managed.Design/methodology/approachPrimary data were collected from a sample of Italian organisations using a survey. The structural equation modelling methodology was employed to empirically investigate cyber resilience strategies in supply chains.FindingsResults indicate that effective cyber resilience is linked to awareness of the negative impacts of cyber risks, particularly supply chain disruptions. This awareness leads to the adoption of various cyber resilience strategies. According to managers' perceptions, several strategies are identified in the study as the most effective in enhancing the cyber resilience supply chains. The findings offer insights for managers regarding the relationship between cyber risk perceptions, supply chain cyber resilience strategies and their effectiveness. These relationships are studied using the theory of perceived risk and the dynamic capabilities theory.Originality/valueThis study advances knowledge for academics and practitioners in the fields of supply chain resilience and supply chain risk management. It contributes to the development of a risk-based thinking model in organisations and supply chains by drawing upon a dual theoretical perspective.

A global research agenda for understanding the role of alcohol consumption in older women’s lives

Abstract Background The alcohol industry has targeted women for profit and resisted global efforts to address the impact of alcohol on women’s health. Scholars have called for research that moves beyond individual determinants of alcohol consumption in women, to investigate the range of social, environmental, and commercial factors that may contribute to women’s alcohol attitudes, risk/benefit perceptions, and consumption behaviours. While qualitative research has explored younger and midlife women’s perspectives on alcohol consumption, there is a notable lack of research focusing on older women. Methods This study investigated the factors that influence how older Australian women drinkers conceptualised the role of alcohol in their lives, using data collected from an online qualitative survey with n = 144 women aged 60-88 years. Qualitative responses were analysed using a ‘Big Q’ reflexive approach to thematic analysis. Results Participants perceived alcohol consumption as a socially accepted and normalised activity within Australian culture. For some women, alcohol served as a coping mechanism for life changes, such as retirement, and for managing stressful situations. Alcohol also formed part of daily routines and rituals, such as having wine with dinner. Participants had personal expectancies regarding ‘responsible drinking’, often aligning with alcohol industry messaging and resulting in a reduced perception of alcohol-related risks. Conclusions This research provides global lessons for future public health research examining the factors that may shape older women’s alcohol consumption beliefs and behaviours. The authors consider the unique needs and potential vulnerabilities of older women drinkers, and how these may be potentially exploited by the alcohol industry. Further public health research and policy attention should focus on the impact of alcohol industry messaging on older women’s knowledge, attitudes, and behaviours about alcohol risks and harms. Key messages • This research highlights the role of alcohol in older women’s lives, urging further public health research and policy attention to prevent alcohol-related harms in older women. • Older women’s perceptions of responsible alcohol consumption mirror the ambiguous messaging employed by the alcohol industry, highlighting the necessity for targeted interventions.

Cardiovascular diseases risk assessment: the Italian Health Examination Survey 2023 - CUORE Project

Abstract Background The reduction of NCDs premature mortality is pursued by the WHO; risk conditions targets are recommended as well as population-level monitoring of cardiovascular disease (CVD) risk. The Italian Ministry of Health (MoH) has strengthened prevention/health promotion and supported periodic CVD risk assessment through national health examination surveys (HESs), funded by the MoH-CCM and conducted within the CUORE Project. Methods In 2023 a new HES started including the 10-year fatal and non-fatal CVD risk assessment based on knowledge of sex, age, smoking habit, measured systolic blood pressure and fasting total and HDL serum cholesterol, and presence of diabetes (on measured fasting serum glycemia and/or treatment) and anti-hypertensive therapy. Up to now, data from random samples of residents in 7 Regions (of 20 regions) distributed in North, Centre and South of Italy, aged 35-69 years, without previous CVD, are available (585 men, 617 women). Determinations were assayed by a central lab. CUORE Project functions developed on and for the Italian adults were used. Results Mean values of the CVD risk assessment resulted 6.9% (95% CI: 6.3-7.4) in men and 2.3% (2.1-2.5) in women. For men aged 35-44 years risk was 1.6% (1.5-1.8), for 45-54 years 3.8% (3.5-4.2), for 55-64 years 10.0% (9.0-10.9), for 65-69 years 17.6% (16.4-18.9); for women was 0.5% (0.4-0.6), 1.0% (0.9-1.1), 3.3% (2.9-3.7) and 6.0% (5.5-6.6) respectively. Prevalence of CVD risk less than 5% was 57% (49-64) in men and 88% (84-93) in women, of 10-15% risk were 22% (15-28) of men and 9% (5-14) of women, of 15-20% risk were 5% (1.6-8.0) of men and 0% of women, of over 20% risk were 2% (0-3.6) of men and 0% of women. Conclusions Compared to 2008, these data showed stable mean levels of CVD risk both in men and women at any age-classes and stable prevalence of CVD risk classes. CVD risk perception represents a challenge in primary prevention especially for young age groups and women. Key messages • In the Italian general population, CVD risk assessment remained stable compared to 15 years ago. • CVD risk perception represents a challenge in primary prevention.