Personal Risk Perception Research Articles

Healthcare Workers' Perceptions and Medically Approved COVID-19 Infection Risk: Understanding the Mental Health Dimension of the Pandemic. A German Hospital Case Study.

IntroductionThis study analyses how healthcare workers (HCWs) perceived risks, protection and preventive measures during the COVID-19 pandemic in relation to medically approved risks and organizational measures. The aim is to explore “blind spots” of pandemic protection and make mental health needs of HCWs visible.MethodsWe have chosen an “optimal-case” scenario of a high-income country with a well-resourced hospital sector and low HCW infection rate at the organizational level to explore governance gaps in HCW protection. A German multi-method hospital study at Hannover Medical School served as empirical case; document analysis, expert information and survey data (n = 1,163) were collected as part of a clinical study into SARS-CoV-2 serology testing during the second wave of the pandemic (November 2020-February 2021). Selected survey items included perceptions of risks, protection and preventive measures. Descriptive statistical analysis and regression were undertaken for gender, profession and COVID-19 patient care.ResultsThe results reveal a low risk of 1% medically approved infections among participants, but a much higher mean personal risk estimate of 15%. The majority (68.4%) expressed “some” to “very strong” fear of acquiring infection at the workplace. Individual protective behavior and compliance with protective workplace measures were estimated as very high. Yet only about half of the respondents felt strongly protected by the employer; 12% even perceived “no” or “little” protection. Gender and contact with COVID-19 patients had no significant effect on the estimations of infection risks and protective workplace behavior, but nursing was correlated with higher levels of personal risk estimations and fear of infection.ConclusionsA strong mismatch between low medically approved risk and personal risk perceptions of HCWs brings stressors and threats into view, that may be preventable through better information, training/education and risk communication and through investment in mental health and inclusion in pandemic preparedness plans.

Perceptions of personal and public risk: Dissociable effects on behavior and well-being

When faced with a global threat peoples’ perception of risk guides their response. When danger is to the self as well as to others two risk estimates are generated—to the self and to others. Here, we set out to examine how people’s perceptions of health risk to the self and others are related to their psychological well-being and behavioral response. To that end, we surveyed a large representative sample of Americans facing the COVID-19 pandemic at two times (N1 = 1145, N2 = 683). We found that people perceived their own risk to be relatively low, while estimating the risk to others as relatively high. These risk estimates were differentially associated with psychological well-being and behavior. In particular, perceived personal but not public risk was associated with people’s happiness, while both were predictive of anxiety. In contrast, the tendency to engage in protective behaviors were predicted by peoples’ estimated risk to the population, but not to themselves. This raises the possibility that people were predominantly engaging in protective behaviors for the benefit of others. The findings can inform public policy aimed at protecting people’s psychological well-being and physical health during global threats.

THE STUDY OF INSOMNIA IN DIFFERENT GROUPS OF WORKERS DURING THE COVID-19 PANDEMIC

To understand the contribution of the work-related and extra-professional factors on the risk of insomnia during the COVID-19 pandemic. The survey was prepared on a GoogleDrive form. The questionnaire was distributed online and collected data from 769 responders. The dependent variable was the presence or absence of insomnia. Non parametric tests and correlations were used to find the main predictors linked with a greater chance of developing insomnia. The onset or the aggravation of the insomnia was reported by 41.01% of responders. The maximum rate was in healthcare workers (42.01%). Significant direct correlations were found between insomnia and work load, fear for the inefficiency of the personal protective equipment, changes in workplace, procedures and working schedule, belonging to a vulnerable health group, general psycho-social strain and lack of social recognition. A significant occupational stressor related to insomnia was represented by the contact with COVID-19 patients followed by fear of developing infection at work. The personal perception of risk was found a composite indicator and it was the only non-occupational factor related to insomnia. The best identified predictors for insomnia consisted in work overload (OR=2.13, CI=1.7-2.5, p=0.03), occupations supposing contact with COVID-19 patients (OR=2.04, CI =1.7-2.3, p=0.01), belonging to a vulnerable health group (OR=1.53, CI=1.1-2.3, p=0.001), personal perception of risk (OR=1.26, CI =1.2-1.3, p=0.001) and lack of social recognition (OR=1.21, CI =1-1.3, p=0.02). The study highlights the main risk factors that should be avoided in order or to reduce the occurrence of insomnia and its consequences.

Alcohol intoxication and sexual risk intentions: Exploring cultural factors among heavy drinking women

IntroductionSexually Transmitted Infections (STI) rates are the highest of the last 20 years, with people of color and women particularly affected. Ongoing research has identified risk factors (e.g., alcohol intoxication) and protective factors (e.g., risk perception) for sexual risk behaviors, such as inconsistent condom use. Depending on behavioral norms within a group, ethnic identity (EI) – the exploration and sense of belonging to one’s ethnicity – may be a risk or protective factor. This study examined the relations between EI, alcohol intoxication, and STI risk perception on sexual risk intentions among women of color (WOC) and white women (WW). MethodsCisgender women (N = 390; 35% WOC; 65% WW) completed measures and were randomly assigned to an alcohol condition (0.10% BrAC vs control). They projected themselves into an eroticized scenario and self-reported two aspects of STI risk perception (personal, partner) and two sexual risk behaviors (condomless sex intentions, condom decision abdication intentions). ResultsPath analysis indicated that intoxicated women endorsed higher sexual risk intentions compared to women in the control group. Personal STI risk perception was negatively associated with sexual risk intentions. Indirect effects indicated that race was indirectly associated with both indicators of sexual risk, such that WOC reported higher perceived personal STI risk and subsequently endorsed lower sexual risk intentions compared to WW. Surprisingly, EI was associated with higher perceived partner risk for WW only. ConclusionsPrevention initiatives that address STI risk perception, condom assertion behaviors, and alcohol may be effective for mitigating women’s sexual risk behaviors.

Predictors of adherence to public health behaviors for fighting COVID-19 derived from longitudinal data

The present paper examines longitudinally how subjective perceptions about COVID-19, one’s community, and the government predict adherence to public health measures to reduce the spread of the virus. Using an international survey (N = 3040), we test how infection risk perception, trust in the governmental response and communications about COVID-19, conspiracy beliefs, social norms on distancing, tightness of culture, and community punishment predict various containment-related attitudes and behavior. Autoregressive analyses indicate that, at the personal level, personal hygiene behavior was predicted by personal infection risk perception. At social level, social distancing behaviors such as abstaining from face-to-face contact were predicted by perceived social norms. Support for behavioral mandates was predicted by confidence in the government and cultural tightness, whereas support for anti-lockdown protests was predicted by (lower) perceived clarity of communication about the virus. Results are discussed in light of policy implications and creating effective interventions.

Resident physicians' perceptions of COVID-19 risk.

Resident physicians provide front-line care to coronavirus disease 2019 (COVID-19) patients, but little is known about how they perceive the risk to their own health or how this is affected by the increasing role of social media in disseminating information. This study aims to determine resident physicians' perceptions of personal COVID-19 risk during the first COVID wave and compare risk perceptions between low-average and high social media users. We conducted a cross-sectional survey at the University of Toronto in May 2020 among resident physicians in internal medicine, emergency medicine, critical care, and anaesthesia. Participants were considered high social media users if above the median for daily social media use and low-average users if at or below the median. The primary outcome was perceived risk of hospitalization with COVID-19 within 6 months. A total of 98 resident physicians reported a median of 1-2 hours daily on social media, and 55.7% endorsed social media as a very or the most common source of information on COVID-19. The median overall perceived risk of hospitalization was 10% (inter-quartile range [IQR] 5-25)-7.5% for low-average social media users and 17.5% for high social media users (p = 0.10). Resident physicians have an elevated perception of COVID-19 risk, including a perceived risk of hospitalization 250 times greater than the local population risk. Although social media are an important source of information on COVID-19, risk perception did not significantly differ between high and low-average social media users.

Hospital-Based Healthcare Worker Perceptions of Personal Risk Related to COVID-19: One Year Follow-Up

The COVID-19 pandemic has significantly impacted health care workers (HCW). Most research focused on the adverse mental health effects during the initial surge of cases; and yet little is known about approximately how workers are faring 1 year into the pandemic. The objective of this study is to examine stress, burnout, and risk perception in an academic medical system, 1 year after the start of the pandemic. HCW across care specialties participated in online surveys in Spring 2020 and Spring 2021. The surveys included questions related to workplace stress and risk perception related to COVID-19. Correlates of stress and burnout were explored using multivariable linear regression models. Professional Quality of Life Scale (PROQOL) questions were added to the second survey. While HCW reported significantly fewer concerns about the risk of COVID-19 transmission to themselves and their families during the 2021 survey (compared with 2020), the percentage of workers who reported feeling excess stress at work or considered resigning stayed the same. One year into the pandemic, 57% of study participants met criteria for moderate or high levels of traumatic stress and 75% met criteria for moderate or high levels of burnout. As compared with participants who cared for no COVID-19 deaths, participants who cared for COVID-19 patients who died had significantly higher traumatic stress (1 to 10: Coef. = 2.7, P = .007; >10: Coef. = 6.7, P < .001) and burnout scores (1 to 10: Coef. = 2.7, P = .004; >10: Coef. = 2.6, P = .036). While Although perceptions of risk declined over the course of the year, levels of stress still remained high despite high vaccination rates. Those who witnessed more COVID-19 deaths were more likely to report increased burnout and post-traumatic stress. As our nation continues to grapple with the COVID-19 pandemic and new variants emerge it is imperative to focus on recovery strategies for high burnout groups to ensure the wellbeing of our health care workforce.

Developing a framework to describe stigma related to cervical cancer and HPV in western Kenya

BackgroundDespite a high prevalence of human papillomavirus (HPV) and cervical cancer in low and middle-income countries, stigma remains an issue. Addressing HPV and cervical cancer stigma could significantly improve health outcomes for these conditions. The objective of this study was to identify the manifestations of stigma and their potential impacts on health-seeking behavior.MethodsTwenty-six in-depth interviews were conducted with women living with HIV, HIV-negative women, community health volunteers, and health care providers in Kisumu, Kenya in 2019. The interviews were designed to draw out existing attitudes or experiences related to stigma within the community. We conducted a thematic analysis of the interviews to identify internalized, anticipated, and discriminatory attitudes.ResultsWithin internalized attitudes, a prominent observed theme was a fear of death associated with a positive HPV test. This stemmed from a lack of understanding of differences between HPV and cervical cancer and posed a significant barrier for women deciding to seek screening or to continue with treatment. Discriminatory attitudes of community members, including assumptions of promiscuity, infidelity, or HIV status, were perceived to prevent women from accessing screening and treatment opportunities. The interviews also exhibited a limited awareness of HPV in this region, which may have contributed to a lack of enacted stigma towards people living with HPV or cervical cancer.ConclusionStigma has the potential to lead to decreased screening and treatment uptake through its drivers. This includes a decreased perception of personal risk due to a lack of knowledge, which results in increased HPV-risk behaviors. Future research must focus on creating and integrating stigma-reducing interventions, primarily to encourage women to seek out primary and secondary preventative measures.

High school students’ trust and risk perception of typhoon disaster: Moderating role of government ability in disaster management

Under global warming and environmental changes, coastal cities have witnessed significant typhoon disasters that attract considerable attention from scholars. Existing studies mainly focused on typhoon disaster prevention and reduction by examining the impact of the public's trust on risk perception. However, these studies overlooked the influence of government ability, even though government plays an important role in disaster management. Therefore, this study takes Ningbo, China as an example to analyze the impact of trust on risk perception and explore the role of government ability on the referred relationship. High school students are taken as the research targets as they are vulnerable but important in typhoon disaster mitigation, which may have been overlooked in existing studies. Regression is used to examine these relationships. The findings of this study are as follows. First, students' trust in meteorological departments, expert institutions, and government agencies positively impact economic, personal, and environmental risk perception. Second, government ability negatively moderates the relationships between students' trust in meteorological departments and expert institutions and all types of risk perception. Moreover, it only has a significant negative moderating effect on the relationship between students' trust in government agencies and economic risk perception. The study reveals the moderating role of government ability between trust and risk perception and provides references for further study on the relationship between trust and risk perception.

Longitudinal Patterns of Food Procurement Over the Course of the COVID-19 Pandemic: Findings From a Canadian Online Household Survey.

IntroductionConsumer food procurement during the COVID-19 pandemic has been understudied. This investigation aimed to longitudinally evaluate food procurement patterns, concern of virus exposure in grocery retailers, and food access challenges over the pandemic among a sample of households in Quebec, Canada.MethodsOnline surveys were collected at three time points of the pandemic: first wave in spring 2020 (lockdown period), summer 2020 (deconfinement period), and second wave in winter 2021 (curfew period). Respondents were the household's primary grocery shopper (n = 491). Non-parametric tests and multivariable logistic regression were conducted to compare responses over time and to evaluate characteristics of respondents who regularly used no-contact grocery methods (store pick-up or home delivery).ResultsFrequency of in-store grocery shopping was lowest during the lockdown (once per week or less), and significantly increased over time to resemble pre-pandemic frequency. Concern of virus exposure in grocery retailers and disinfection/discarding of food packaging was highest during the lockdown, but significantly decreased over time. At all time points, use of public transit, walking or cycling for grocery shopping was associated with regular use of no-contact grocery methods (curfew odds ratio (OR): 3.13 (95% confidence interval 1.60, 6.14). Age (60 years+) was associated with regular use during the lockdown [OR: 2.27 (1.13, 4.59)].ConclusionAmong our sample, frequency of in-store grocery shopping was lowest and concern of virus exposure in stores was highest during the lockdown period. No-contact grocery use was associated with transportation mode and potentially with personal risk perception (age).

Knowledge of majority scientific agreement on anthropogenic climate change predicts perceived global risk better than perceived personal risk

Studies examining climate change risk perceptions rarely differentiate between personal and general risk perceptions. Researchers could come to conflicting conclusions about what variables are important in predicting people’s perceptions of risk if they do not differentiate between perceptions of personal and general risk. In this study, we used data from a survey of residents in a Midwestern region of the United States to examine the relationship between two measures of knowledge and perceptions of the risk of climate change at personal and the global (i.e. general) levels. Knowledge of the scientific consensus on anthropogenic climate change significantly predicted perceptions of both types of risks, but was more strongly related to greater risk perceptions at the global level. Knowledge of climate change’s impact on regional flooding predicted greater climate change risk perception, and we did not find a difference in its association with risk perception at the global versus the personal level. Understanding how different types of knowledge influence peoples’ perception of climate change risks can foster a better understanding of related decision-making processes and used to support more strategic public education and communication on climate change. Supplemental data for this article is available online at https://doi.org/10.1080/13669877.2022.2028883 .

Understanding the relationship between sharing personal anecdotes, warmth, curiosity, risk perception and mitigation in communicating the threat of climate change

While most Americans believes in climate change, to elicit action, communicators should use strategies to convey risks. One strategy is to cognitively engage individuals by eliciting curiosity. Previous studies have shown that individuals with higher science curiosity are more likely to perceive the risk of climate change. This study uses scientists’ act of sharing personal anecdotes to elicit curiosity and examines the effect of scientist’s traits on risk perception. Results show that anecdotes do not affect any of the variables. However, there is a positive relationship between curiosity and risk perception, and between trust in scientists and risk perception.

Investigating the effects of the outbreak of COVID-19 on perishable food supply chains: an empirical study using PLS-SEM

PurposeAt the end of 2019, the first case of the Corona Virus Disease (COVID-19) was reported in Wuhan city of China. The disease was declared a pandemic without imagining the magnitude of damage currently caused in all branches of the economy. One of the most affected sectors was food and mostly perishable food (PF), which are more susceptible to environmental conditions. Thus, the research examines the effect of the COVID-19 outbreak on Ecuador's perishable food supply chains (PFSCs) during the pandemic. It contributes to new results on the special issue (SI) PFSC response to event risk and uncertainty, such as those that generated the pandemic.Design/methodology/approachThe data used are from primary information sources, which were collected through a questionnaire. The questionnaire was applied to 298 companies belonging to the sector, and later the information was processed through partial least squares structural equation model. The convergent validity, discriminate and robustness tests provide arguments for the suitability of the model. Therefore, the findings are reliable and valid for the adequate measures to improve the PFSC due to a COVID-19 outbreak.FindingsThe results show that the perception of personal risk (PPR) produced by COVID-19 has caused the companies of the PFSC to adopt preventive policies (PO) to avoid contagion and guarantee the operation of the companies. In addition, the PPR has been responsible for the alterations in the demand and price (DP) of PF. Next, PO and DP have a significant effect on PFSC, which shows the evidence favouring the malfunction of PFSC operations due to anti-contagion PO, the mismatch of DP. On the contrary, circular economy practices contribute to the excellent performance of the PFSC. Finally, the research suggests some policy implications to consider in improving the PFSC.Originality/valueThis study is the first to be carried out in Ecuador's country on the PFSC; its contribution is unprecedented and makes it a road-map to be considered to guarantee the correct functioning of the PFSCs, and it will provide policymakers with valid elements to design efficient PFSCs that better respond to unforeseen events and uncertainties. Future research will focus on analysing the management of PF consumption in Ecuador during the pandemic.

Alcohol risk perception and the risk target. Results from a survey among the Polish adult population

Employing a nationally representative sample (n = 2,000), this research investigated how specific beliefs about alcohol along with alcohol-related experiences relate to personal and general alcohol risk perceptions in Poland. Multiple hierarchical logistic regression models were performed to assess the impact of demographic and alcohol-related variables including alcohol consumption and beliefs about the benefits and hazards of drinking. In order to understand how the risks associated with alcohol consumption are viewed, we draw on the concept of ‘risk target’. Respondents tended to perceive the level of general alcohol risk to be higher than the personal risk. We were able to confirm that drinkers tend to be clearly overoptimistic towards alcohol risks, and that those who consume more alcohol rate the personal risks to be higher. Individuals who experienced the need to cut down their drinking were more concerned by alcohol risks. The same was true for people who have known someone with an alcohol problem, in terms of general risk. We also found that risk perceptions were affected by beliefs about the harmful and protective functions of drinking which shows the importance of providing substantive knowledge on alcohol risk to individuals expected to make informed choices about their drinking. All in all, most of the explanatory variables significantly influenced general risk perception while the analyses of personal risk perception yielded only a few significant results; the latter did have, however, stronger effects than general risk perception.

The role of anxiety in mediating the relationship between information consumption and COVID-19 protective behaviours

ABSTRACT Throughout the COVID-19 pandemic, concerns have been raised about an ‘infodemic’, with information and misinformation being spread across multiple channels and mediums. Information consumption has also been associated with increased anxiety throughout the pandemic. Thus, the present study investigates the mediating role of state anxiety on the relationship between information consumption (defined as mean frequency of information consumption multiplied by number of information sources) and COVID-19 protective behaviours. We compare results across Australian and United States samples and account for personal risk perception and belief in misinformation about COVID-19. Cross-sectional data collected between 28 and 30 April 2020 were analysed using Bayesian structural equation modelling among participants from Australia (N = 201), and the United States (N = 306). State anxiety scores were above the conventional clinical cut-off. Information consumption was positively associated with state anxiety, personal risk perception, and COVID-19 protective behaviours in the Australian and the United States samples. Additionally, the relationship between information consumption and COVID-19 protective behaviours was positively mediated by state anxiety in both nations, suggesting some functional benefits of anxiety. Differences in risk perception and belief in misinformation existed between the Australian and United States sample. Findings provide support for current guidance from organisations such as the WHO, APA, and APS on limiting information consumption to reduce anxiety. To effectively communicate critical public health messaging while minimising potential burdens on mental health, there is a need to develop and test interventions that assist people in calibrating the extent and nature of their information consumption.

Reducing Invasive Species Transport among Recreational Anglers: The Importance of Values and Risk Perceptions

AbstractThe behavioral patterns of recreational anglers are an increasingly common focus of fishery management agencies, particularly due to the unintentional spread of aquatic invasive species. Previous research in this area has focused on understanding stakeholder awareness, use patterns, and beliefs. Although informative, these drivers of behavior are easily shifted by new information and are thus potentially less influential for encouraging long‐term behavior change. There is a pressing need to account for the effects of human values in management of aquatic invasive species because values are a fundamental driver of behavior that changes slowly over time and represents a core basis for angler decision making. Therefore, this study assessed the relationships among values, risk perceptions, and reported aquatic invasive species prevention behavior to inform management decisions aimed at minimizing angler transport of aquatic invasive species. We generated a data set from a mixed‐mode survey of license‐holding recreational anglers from counties adjacent to the Great Lakes in three U.S. states (n = 788). Results from a structural equation model revealed that biospheric values positively predicted social and personal risk perceptions. Personal risk perceptions in turn positively predicted private and public dimensions of reported behaviors related to reducing the spread of aquatic invasive species. Efforts to reduce the spread of aquatic invasive species within the study context would be best served by emphasizing the personal impacts rather than broader social and ecological consequences from biological invasions. Agencies should also shift their attention to thinking about the role of values in explaining how people process and respond to environmental threats and degradation from aquatic invasive species.

Resident physicians’ perceptions of COVID-19 risk

BACKGROUND: Resident physicians provide front-line care to coronavirus disease 2019 (COVID-19) patients, but little is known about how they perceive the risk to their own health or how this is affected by the increasing role of social media in disseminating information. This study aims to determine resident physicians’ perceptions of personal COVID-19 risk during the first COVID wave and compare risk perceptions between low–average and high social media users. METHODS: We conducted a cross-sectional survey at the University of Toronto in May 2020 among resident physicians in internal medicine, emergency medicine, critical care, and anaesthesia. Participants were considered high social media users if above the median for daily social media use and low-average users if at or below the median. The primary outcome was perceived risk of hospitalization with COVID-19 within 6 months. RESULTS: A total of 98 resident physicians reported a median of 1–2 hours daily on social media, and 55.7% endorsed social media as a very or the most common source of information on COVID-19. The median overall perceived risk of hospitalization was 10% (inter-quartile ratio [IQR] 5–25)—7.5% for low–average social media users and 17.5% for high social media users ( p = 0.10). CONCLUSIONS: Resident physicians have an elevated perception of COVID-19 risk, including a perceived risk of hospitalization 250 times greater than the local population risk. Although social media are an important source of information on COVID-19, risk perception did not significantly differ between high and low–average social media users.

The Effectiveness of Disaster Education for Undergraduate Nursing Students' Knowledge, Willingness, and Perceived Ability: An Evaluation Study.

As future healthcare professionals, nursing students should possess the appropriate knowledge, skills, and positive attitude to respond to public health emergencies or disasters worldwide. This study evaluated the effectiveness of a disaster management training course at improving Hong Kong nursing students’ disaster knowledge, willingness, and perceived ability. A mixed-method design using a single group with pre- and post-intervention comparisons followed by qualitative focus group interviews, was conducted. A 45-h disaster management training course with theoretical and practical inputs was conducted. A total of 157 students participated in and completed the pre- and post-intervention questionnaires. Positive significant results in disaster knowledge (t(156) = −8.12, p < 0.01, d = −0.84) and perceived ability (t(156) = −7.95, p < 0.01, d = −0.72) were found, but no substantial change in willingness to respond to disasters was observed. The participants expressed various concerns regarding their willingness to respond, which can be summarized and grouped as (1) personal risk perceptions, (2) contextual factors of the disaster events, and (3) organizational support. Incorporating disaster training into the tertiary education curricula for basic nursing professionals’ training could be a long-term strategy to prepare and expand the competent workforce for future disasters. Government or healthcare organizations are recommended to provide strategies and adequate support to alleviate nursing professionals’ concerns and enhance their willingness.

Impact of COVID-19 on hospital hand hygiene performance: a multicentre observational study using group electronic monitoring.

Background:Reliable reports on hand hygiene performance throughout the COVID-19 pandemic are lacking as most hospitals continue to rely on direct observation to measure this quality indicator. Using group electronic hand hygiene monitoring, we sought to assess the impact of COVID-19 on adherence to hand hygiene.Methods:Across 12 Ontario hospitals (5 university and 7 community teaching hospitals), a group electronic hand hygiene monitoring system was installed before the pandemic to provide continuous measurement of hand hygiene adherence across 978 ward and 367 critical care beds. We performed an interrupted time-series study of institutional hand hygiene adherence in association with a COVID-19 inpatient census and the Ontario daily count of COVID-19 cases during a baseline period (Nov. 1, 2019, to Feb. 29, 2020), the pre-peak period of the first wave of the pandemic (Mar. 1 to Apr. 24, 2020), and the post-peak period of the first wave (Apr. 25 to July 5, 2020). We used a Poisson regression model to assess the association between the hospital COVID-19 census and institutional hand hygiene adherence while adjusting for the correlation within inpatient units.Results:At baseline, the rate of hand hygiene adherence was 46.0% (6 325 401 of 13 750 968 opportunities) and this improved beginning in March 2020 to a daily peak of 79.3% (66 640 of 84 026 opportunities) on Mar. 30, 2020. Each patient admitted with COVID-19 was associated with improved hand hygiene adherence (incidence rate ratio [IRR] 1.0621, 95% confidence interval [CI] 1.0619–1.0623). Increasing Ontario daily case count was similarly associated with improved hand hygiene (IRR 1.0026, 95% CI 1.0021–1.0032). After peak COVID-19 community and inpatient numbers, hand hygiene adherence declined and returned to baseline.Interpretation:The first wave of the COVID-19 pandemic was associated with significant improvement in hand hygiene adherence, measured using a group electronic monitoring system. Future research should seek to determine whether strategies that focus on health care worker perception of personal risk can achieve sustainable improvements in hand hygiene performance.

Towards sustainable cities: the role of residential satisfaction in facing COVID-19 in Makkah City in Saudi Arabia

PurposeThe purpose of this paper is to investigate the role of residential satisfaction in facing the outbreaks of the COVID-19. It reveals the relationship between personal risk perception (PRP), preventive behavior (PB), residential satisfaction (RS) and level of compliance with government recommendations to stay at home (CGRS) of Makkah residents in Saudi Arabia in its effort toward containing the COVID-19 pandemic in the country.Design/methodology/approachA cross-sectional online survey design was used with a sample of 250 respondents from Makkah City selected using a simple random sampling strategy. The instrument for data collection was a developed and validated instruments tag “Risk Perception and Preventive Behavior against COVID-19 Questionnaire (RP-COVID-Q).” The data obtained through the questionnaire were screened and analyzed using descriptive and inferential statistical analyses. Similarly, a Partial-Least Square Structural Equation Modeling procedure was adopted to test the hypotheses with a bootstrap mediation effect test.FindingsThe results revealed that Makkah residents’ level of PRP, PB and CGRS was not found to vary with gender; however, the RS of the residents differs with respect to their gender. Moreover, the level of PRP was significantly related to PB, RS and level of CGRS. RS increased the likelihood of the Makkah residents to comply with government recommendations against COVID-19 while adherence to PB, which would contribute to the reduction in the spread of the pandemic in Makkah city. Further, the RS is recognized as a significant mediating factor between PRP and CGRS during the COVID-19.Research limitations/implicationsThe findings of this study help in understanding the role of residential satisfaction during pandemics and, hence, stressing the important of residential qualities that need improvements for better sustainable cities in the future.Originality/valueWhile all countries are strategizing to mitigate the impact of COVID-19, it is equally important to access residential satisfaction in the cities with high visitor inflow. Limited research has been done in Saudi Arabia.