Preventive Health Behaviors Research Articles

Communication strategies for promoting sports participation for health: an examination of goal-framing effects in South Korea

ABSTRACT The South Korean government has implemented a public campaign promoting sports participation for health since 2005. However, research on the communication strategies of this campaign is limited. This study examined message strategies to promote sports participation for health through two experiments. A convenient sample comprising individuals aged 18–55 years was recruited from a large public university in South Korea. The results of experiment 1 support the basic tenet of goal-framing effects that gain-framed messages are more effective than loss-framed messages in promoting sports participation, which is a typical preventive health behavior. In experiment 2, gain-framed messages for sports participation were further classified into two types: easy but small-gain (ESG) messages and difficult but large-gain (DLG) messages. Experiment 2 examined whether the persuasive impact of the two types of gain-framed messages varies according to individuals’ past sports experience levels (i.e. active vs. occasional sports participants). As predicted, ESG was more persuasive than DLG for occasional sports participants. However, the persuasive effects of ESG and DLG did not significantly differ among active sports participants. Theoretical and practical implications are discussed.

Differential impacts of face masks for threat evaluations of Asian versus Black faces

Wearing face masks to prevent the spread of respiratory illnesses such as COVID-19 has the potential to impact social perception. In the present research, we explore differential consequences of wearing face masks for evaluations of Asian and Black faces. Drawing on theories of prejudice and differing stereotype content for Asian and Black people in the United States, we hypothesized that being depicted wearing a face mask would mitigate evaluations of threat more for Asian faces than for Black faces. Results of a 2 (mask status: face mask vs. no mask) × 3 (face race: Asian vs. Black vs. White) within-subjects design ( n = 365) generally supported hypotheses. Additional analyses using normed ratings of face stimuli from the Chicago Face Database showed that Asian faces showed the greatest increase in threat evaluations compared to norming data. These results highlight the unique impact of the COVID-19 pandemic and related preventative health behavior on prejudice towards members of different racial groups.

Suitability of Middle Eastern and North African immigrant minimal reporting category for Arab immigrant health research in the national health interview survey

Studies of Middle Eastern immigrants using national data, with and without African immigrants, have provided important discoveries on the health of this group. However, they do not directly measure health among Arab immigrants. It is yet to be determined whether using a Middle Eastern and North African (MENA) classification can represent the health needs of Arab immigrants. The objective of this study was to assess if MENA immigrant health reflects the same patterns found in previous research focusing on Arab immigrant health. We used multiple years of data from the National Health Interview Survey in alignment with each former study methodology to compare our findings with four previous research studies. The independent variable was region of birth among non-Hispanic Whites. The dependent variables were chronic diseases, women's preventive health behaviors, men's preventive health behaviors, and cigarette smoking. Logistic regression was conducted to determine the odds of each outcome for MENA immigrants compared to US-born Whites. Then, adjusted 95% confidence intervals representing the more inclusive MENA immigrant categorization were compared to previous studies among Arab immigrants. Chronic conditions, women's and men's preventive health behaviors and cigarette smoking did not differ whether the MENA or Arab definition was used. However, statistically significant differences were observed between MENA and Arab immigrants regarding bachelor's degree or higher, not employed and years in the US. The MENA category reflects the Arab immigrant experience, even though it includes a wider set of origins, some of which are not Arab. Including a MENA identifier on future data collections will both represent Arab Americans, as well as identify this population as distinct from Whites to better represent and track health disparities.

Perceived Susceptibility and Responses to Ill-health Risks among Children of the Street in Addis Ababa, Ethiopia

Abstract This study identifies perceptions about susceptibility and responses to health risks among children of the street in Addis Ababa, Ethiopia. Using a qualitative approach, data were collected through in-depth interviews from 22 purposely selected street children. In addition to the field notes, audio was recorded, transcribed and translated into English. After coding the responses, themes and sub-themes were identified, followed by interpretations of responses. The findings showed that children of the street perceive to be highly susceptible for health risks such as HIV/AIDS, skin diseases, malaria, accidental injuries, lung cancer, and ‘Corella’. Whereas most of the health risks have been associated generally with the living situations of the children, engagement in risky behaviors such as unsafe sexual practices, addictions to drugs and other harmful substances, and sharing of sharp materials have also been reported to increase their vulnerability. The extent to which they perceive to be susceptible, the type of disease and its perceived cause were found to influence the preventive health behavior of the street children. The high risk perception among street children opened the way for individual and collective efforts of maintaining health and wellbeing which in turn facilitates interventions aimed at reintegrating street children into the society.

Longitudinal data resource from the Wellbeing of Older People cohort of people aged >50 years in Uganda and South Africa from 2009 to 2019.

The population of people aged ≥60 years continues to increase globally, and has been projected by the United Nations Population Division to increase to 21% of the total population by 2050. In addition, the number of older people living with HIV has continued to increase owing to the introduction of antiretroviral therapy as a treatment for HIV-infected people. Most of the older people living with HIV are in sub-Saharan Africa, an area that faces the biggest burden of HIV globally. Despite the high burden, there are limited reliable data on how HIV directly and indirectly affects the health and wellbeing of older people within this region. To showcase the availability of data on how HIV directly and indirectly affects the health and wellbeing of older people in Uganda and South Africa (SA). The World Health Organization Study on global AGEing and adult health (SAGE), in collaboration with Medical Research Council/Uganda Virus Research Institute and London School of Hygiene and Tropical Medicine (MRC/UVRI and LSHTM) Uganda Research Unit and the Africa Health Research Institute (AHRI) in SA, started the SAGE Wellbeing of Older People Study (WOPS) in Uganda and SA in 2009. Since initiation, respondents have been surveyed every 2 years, with four waves of surveys conducted in Uganda and three waves in South Africa. The available datasets consist of two cohorts of people, aged >50 years, who were surveyed every 2 years between 2009 and 2018. The prevalence of HIV positivity over this period increased from 39% to 54% in Uganda and 48% to 62% in SA. The datasets provide comparisons of variables at a household level and at an individual level. At the individual level, the following measures can be compared longitudinally for a 10-year period for the following variables: sociodemographic characteristics; work history and benefits; health states and descriptions; anthropometrics performance tests and biomarkers; risk factors and preventive health behaviours; chronic conditions and health services coverage; healthcare utilisation; social cohesion; subjective wellbeing and quality of life; and impact of caregiving. This article describes the WOPS in Uganda and SA, the population coverage of this study, and the survey frequency of WOPS, survey measures, data resources available, the data resource access and the strengths and weaknesses of the study. The article invites interested researchers to further analyse the data and answer research questions of interest to enhance the impact of these data.

Determinants of COVID-19 preventive health behaviors in Iranian adults based on extended parallel process model

Performing preventive behaviors by individuals has been recognized as one of the important strategies for the prevention and control of Coronavirus Disease 2019 (COVID-19). This study aimed to assess the determinants of adopting preventive behaviors of COVID-19 in a sample of Iranian adults based on Extended Parallel Process Model (EPPM) variables. In this cross-sectional study, 300 adults from Tehran, Iran were selected using cluster sampling method from five areas of the city: north, south, west, east, and center. The participants completed a study instrument developed to assess demographic information and EPPM variables. Finally, the data were analyzed using SPSS software. The mean age of the participants was 40.11 (± 15.158) years. The results showed that 88.3% (n = 265) of the participants were in the process of danger control. Perceived self-efficacy, attitude, response efficiency, behavioral intention, and the number of hours of activity outside home were determinants of performing COVID-19 preventive behaviors among the participants. These predictors might be used to develop theory-based educational efforts based on EPPM variables due to encouraging people to adopt COVID-19 preventive behaviors. Our results suggest that because many participants were engaged in danger control, health professionals should focus on increasing perceived efficacy.

Political and nonpolitical belief change elicits behavioral change.

Beliefs have long been theorized to predict behaviors and thus have been the target of many interventions aimed at changing false beliefs in the population. But does changing beliefs translate into predictable changes in behaviors? Here, we investigated the impact of belief change on behavioral change across two experiments (N = 576). Participants rated the accuracy of a set of health-related statements and chose corresponding campaigns to which they could donate funds in an incentivized-choice task. They were then provided with relevant evidence in favor of the correct statements and against the incorrect statements. Finally, they rated the accuracy of the initial set of statements again and were given a chance to change their donation choices. We found that evidence changed beliefs and this, in turn, led to behavioral change. In a preregistered follow-up experiment, we replicated these findings with politically charged topics and found a partisan asymmetry in the effect, such that belief change triggered behavioral change only for Democrats on Democratic topics, but not for Democrats on Republican topics or for Republicans on either topic. We discuss the implications of this work in the context of interventions aimed at stimulating climate action or preventative health behaviors. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Number lines can be more effective at facilitating adults' performance on health-related ratio problems than risk ladders and icon arrays.

Visual displays, such as icon arrays and risk ladders, are often used to communicate numerical health information. Number lines improve reasoning with rational numbers but are seldom used in health contexts. College students solved ratio problems related to COVID-19 (e.g., number of deaths and number of cases) in one of four randomly assigned conditions: icon arrays, risk ladders, number lines, or no accompanying visual display. As predicted, number lines facilitated performance on these problems-the number line condition outperformed the other visual display conditions, which did not perform any better than the no visual display condition. In addition, higher performance on the health-related ratio problems was associated with higher COVID-19 worry for oneself and others, higher perceptions of COVID-19 severity, and higher endorsement of intentions to engage in preventive health behaviors, even when controlling for baseline math skills. These findings have important implications for effectively presenting health statistics. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Influences of Anxiety and Resilience on Preventive Health Behavior in Nursing Students against COVID-19

Influences of Anxiety and Resilience on Preventive Health Behavior in Nursing Students against COVID-19

Illness-Related Attitudes toward COVID-19 and Precautionary Practices among Kuwaiti Males during the Total Lockdown and Curfew in Kuwait

COVID-19 is a worldwide pandemic that affects individuals’ physical and mental health. The aim of this descriptive cross sectional study was to investigate relationships between precautionary practices (washing hands, taking vitamins, and eating a healthy diet) and attitudes about illness related to COVID-19 (worry about illness, concern about pain, hypochondriacal beliefs, thanatophobia, and treatment experience). This study used non-probability sample method to recruit the participants. The study sample was restricted to males who were 18 and older and who lived in Kuwait during the COVID-19 pandemic. A total of 430 males volunteered to participate in this study. The participants completed an online questionnaire that included three sections with questions about demographics, types of precautionary behavior related to COVID-19, and attitudes toward COVID-19. The findings revealed that there is a significant relationship between following preventative health behaviors related to COVID-19 and men’s illness-related attitudes toward COVID-19. Individuals’ attitudes, beliefs, and behaviors about health significantly affect their mental health condition. Therefore, there is a need to increase individuals’ attitudes, and beliefs that precautionary behavior is important for avoiding COVID-19, which could reflect on their physiological and mental health condition.
 
 Key words: Illness, Attitudes, COVID-19, Precautionary Practice, Males, SARS-CoV-2, Coronavirus.

An omni-channel, outcomes-focused approach to scale digital health interventions in resource-limited populations: a case study.

Populations in resource-limited communities have low health awareness, low financial literacy levels, and inadequate access to primary healthcare, leading to low adoption of preventive health behaviours, low healthcare-seeking behaviours, and poor health outcomes. Healthcare providers have limited reach and insights, limiting their ability to design relevant products for resource limited settings. Our primary preventive health intervention, called the Saathealth family health interventions, is a scaled digital offering that aims to improve knowledge levels on various health topics, nudge positive behaviour changes, and drive improved health outcomes. This case study presents our learnings and best practices in scaling these digital health interventions in resource-limited settings and maximising their impact. We scaled the Saathealth interventions to cumulatively reach >10 million users across India using a multi-pronged approach: (1) ensuring localization and cultural relevance of the health content delivered through user research; (2) disseminating content using omni-channel approaches, which involved using diverse content types and multiple digital platforms; (3) using iterative product features such as gamification and artificial intelligence-based (AI-based) predictive models; (4) using real-time analytics to adapt the user's digital experience by using interactive content to drive them towards products and services and (5) experiments with sustainability models to yield some early successes. The Saathealth family health mobile app had >25,000 downloads and the intervention reached >873,000 users in India every month through the mobile app, Facebook, and Instagram combined, from the time period of February 2022 to January 2023. We repeatedly observed videos and quizzes to be the most popular content types across all digital channels being used. Our AI-based predictive models helped improve user retention and content consumption, contributing to the sustainability of the mobile apps. In addition to reaching a high number of users across India, our scaling strategies contributed to deepened engagement and improved health-seeking behaviour. We hope these strategies help guide the sustainable and impactful scaling of mobile health interventions in other resource-limited settings.

Factors perceived by village health volunteers to implement the strategies of the COVID-19 Control Centre in Thailand.

The proactive strategy of village health volunteers could help decrease the spread of coronavirus disease 2019 (COVID-19) in Thailand. This research aimed to study the factors that influence the operation of the COVID-19 Control Centre in the village health volunteer communities in Thailand. Thai village health volunteers are trained in infection control education, so they could help control the spread of COVID-19 in the country. This questionnaire study examined factors related to the work of volunteers who could influence the outcomes of initiatives of the COVID-19 Control Centre in Thailand. A questionnaire was used that gathered demographic data about the volunteers in section 1, assessed the factors influencing the operation of the control centre in section 2, and evaluated the operation of the control centre in section 3. A predictive correlational design was conducted with 10 400 village health volunteers nationwide. Cronbach's alpha was used to assess the reliability of the instrument, with a score range of .773 to .917. The data were analysed using multiple regression analysis. Factors associated with the volunteers that could influence their implementation of the initiatives of the Thai COVID-19 Control Centre were disease severity awareness (β = .196), preventive health behaviours (β = .159), organisational support awareness (β = .167), motivation (β = .120), and work duration (β = .036). These five factors yielded 26% variance (adj. R2 = .260, p < .001). The village health volunteers have an important role in implementing the initiatives of the Thai COVID-19 Control Centre. The key findings suggest that disease severity awareness, preventive health behaviour, and organisational support awareness are critical factors influencing the operation of the COVID-19 Control Centre by village health volunteers in Thailand. Understanding and addressing these factors could contribute to early and effective interventions in managing the spread of COVID-19 and potentially future other epidermics. SO WHAT?: These outcomes may positively contribute to effective early interventions as well as appropriate responses to the spread of COVID-19 and to be better prepared to tackle future infectious threats. Further support for the village health volunteers is warranted to determine their efficacy.

Sexual orientation and gender identity inequities in cervical cancer screening by race and ethnicity.

In the United States, inequities in preventive health behaviors such as cervical cancer screening have been documented. Sexual orientation, gender identity, and race/ethnicity all individually contribute to such disparities. However, little work has investigated their joint impact on screening behavior. Using sampling weighted data from the 2016 and 2018 Behavioral Risk Factor Surveillance System, we assessed differences in two metrics via chi-square statistics: 1) lifetime uptake, and 2) up-to-date cervical cancer screening by sexual orientation and gender identity, within and across racial/ethnic classifications. Within all races, individuals who identify as members of sexual and gender minority (SGM) communities reported higher rates of never being screened (except for Black transgender men) than straight or cisgender individuals (p < 0.0001). [*START*Across all races, the Asian/Pacific Islander transgender population (32.4%; weighted n (w.n.) = 1,313) had the lowest proportion of lifetime screening, followed by the Asian/Pacific Islander gay/lesbian (53.0%, w.n. = 21,771), Hispanic transgender (58.7%; w.n. = 24,780), Asian/Pacific Islander bisexual (61.8%, w.n. = 54,524), and Hispanic gay/lesbian (69.6%, w.n. = 125,781) populations. *END*]Straight or cisgender Non-Hispanic White (w.n. = 40,664,476) individuals had the highest proportion of lifetime screening (97.7% and 97.5%, respectively). However, among individuals who had been screened at least once in their lifetime, identifying as SGM was not associated with a decreased proportion of up-to-date screening within or between races. Due to small sample sizes, especially among Asian/Pacific Islander and Hispanic populations, confidence intervals were wide. Heterogeneity in screening participation by SGM status within and across racial/ethnic groups were observed. These screening disparities reveal the need to disaggregate data to account for intersecting identities and for studies with larger sample sizes to increase estimate reliability.

Improving community health message reception through digital journalistic practices: Mixed-method evidence on health preventive behaviors and health podcast framing for emerging health issues

Health issues stemming from the public’s lack of access to scientific and health information prompted mounting concerns about public health responses. A growing amount of digital journalism scholarship has indicated the relevance of podcasts in health communication through reaching and engaging audiences in more significant preventive behaviors. Integrating digital journalistic practices in health podcasts as a practical and low-cost communication strategy can augment public adherence to addressing widespread health issues. However, the role of health podcasts in media framing in promoting preventive health behaviors is largely unknown. This study used a mixed-method approach (e.g., content analysis and quasi-experiments) to uncover the effectiveness of health podcasts’ framing practices (scientific vs. health frames). The content analysis results demonstrated that the health podcasts mainly used carrier and normal frames, while problem definitions and treatment were leading scientific frames. In a series of quasi-experiments comprising 640 respondents from the UAE and Pakistan, this research manipulated eight frames employed in health podcasts (i.e., two leading sub-frames for each scientific and health frame) to examine the causal mechanism that affects preventive health behaviors (hereafter PB). The findings established that the message-consistent effects of media frames manifesting scientific evidence and health orientation made audiences adopt PB. Theoretically, this research addresses the call for a more comprehensive “community digital journalistic practices model,” further delivering novel evidence on the health podcast framing approaches to offer more eloquent community health campaigns to raise public health issues.

The Relationship between Socio-Demographic Factors, Preventive Health Behaviors and Acceptance of COVID-19 Vaccine among Israeli Pregnant Women during the Coronavirus Pandemic.

The outbreak of the Coronavirus disease led the World Health Organization to publish recommendations regarding preventive health behaviors (PHB). Pregnant women are at a higher risk of severe COVID-19 infection and adherence to these recommendations is critical. There are little data regarding PHB among pregnant women. The current study aims to evaluate the contribution of socio-demographic factors and COVID-19 vaccinations in predicting PHB among pregnant women. 202 pregnant Israeli women (mean age = 30.8 years) participated in an online survey in 2021. 88% of the women were vaccinated and few had been infected. Of the women, 75.2% reported wearing face masks in closed spaces, while 12.4% reported wearing masks outdoors; 63.9% of the women did not travel abroad for fear of infection by the virus and 51% avoided crowded events. A simultaneous regression analysis to predict PHB indicated that pregnancy week and Coronavirus vaccination significantly and positively predicted PHB, but religious status was a negative predictor. Age, number of children, and level of education were not associated with PHB. These findings can be helpful as a preliminary evidence base for policy-making at present and for future epidemics regarding guidelines on PHB adjusted for pregnant women.

Perceived Self-Efficacy, Preventive Health Behaviors and Quality of Life Among Nursing Students in Nakhon Si Thammarat Province, Thailand During the COVID-19 Pandemic.

COVID-19 is a threat to health worldwide. For nursing students, it affects the physical, mental, social, and family economy. This research aimed to study the relationship between perceived self-efficacy, preventive health behaviors in COVID-19, and quality of life among nursing students during the COVID-19 pandemic. This study was descriptive research. The samples included 273 nursing students by simple random sampling. The data was collected using a questionnaire about perceived self-efficacy, preventive health behaviors, and quality of life. The data were analyzed by descriptive statistics, chi-square, and binary logistic regression statistics. The mean score of perceived self-efficacy and preventive health behaviors against COVID-19 were high (M = 71.47, S.D. = 8.46; M = 69.10, S.D.= 8.72; respectively). The mean score of quality of life was also high (M = 97.69, S.D.=13.62). In addition, it was found that perceived self-efficacy and preventive health behaviors were significantly related to quality of life among nursing students (p < 0.001). Confirmation with binary logistic regression found that perceived self-efficacy and preventive health behaviors were significantly related to the quality of life (OR = 2.87; 95% CI: 1.415.-5.85; OR = 3.39; 95% CI: 1.43-8.03; respectively) (p < 0.01). To clarify, the group with high perceived self-efficacy tended to have 2.87 times good quality of life than the group with low-moderate perceived self-efficacy. The group with high preventive health behaviors tended to have a 3.39 times good quality of life than the group with low-moderate preventive health behaviors. Well-perceived self-efficacy and preventive health behaviors against COVID-19 among nursing students were related to good quality of life. Therefore, their perceived self-efficacy should be promoted to build their confidence in the adjustment of preventive behaviors to be safe from COVID-19. This will lead to good quality of life among nursing students.

From trials to communities: implementation and scale-up of health behaviour interventions

BackgroundTo maximise their potential benefits to communities, effective health behaviour interventions need to be implemented, ideally ‘at scale’, and are often adapted as part of this. To inform future implementation and scale-up efforts, this study broadly sought to understand (i) how often health behaviour interventions are implemented in communities, (ii) the adaptations that occur; (iii) how frequency it occurred ‘at scale’; and (iv) factors associated with ‘scale-up’.MethodsA cross-sectional survey was conducted of corresponding authors of trials (randomised or non-randomised) assessing the effects of preventive health behaviour interventions. Included studies of relevant Cochrane reviews served as a sampling frame. Participants were asked to report on the implementation and scale-up (defined as investment in large scale delivery by a (non)government organisation) of their intervention in the community following trial completion, adaptations made, and any research dissemination strategies employed. Information was extracted from published reports of the trial including assessments of effectiveness and risk of bias.ResultsAuthors of 104 trials completed the survey. Almost half of the interventions were implemented following trial completion (taking on average 19 months), and 54% of those were adapted prior to doing so. The most common adaptations were adding intervention components, and adapting the intervention to fit within the local service setting. Scale-up occurred in 33% of all interventions. There were no significant associations between research trial characteristics such as intervention effectiveness, risk of bias, setting, involvement of end-user, and incidence of scale-up. However the number of research dissemination strategies was positively associated to the odds of an intervention being scaled-up (OR = 1.50; 95% CI: 1.19, 1.88; p < 0.001).ConclusionsAdaptation of implemented trials is often undertaken. Most health behaviour interventions are not implemented or scaled-up following trial completion. The use of a greater number of dissemination strategies may increase the likelihood of scaled up.

Preventive health behaviors among the middle-aged and elderly in China: Does social capital matter?

This study explores the status quo of preventive care use and social capital among middle-aged and elderly people (≥45 years old) in China, and employs a multi-level model to analyze whether social capital at different levels is associated with preventive care use. The data are derived from the 2018 China Health and Retirement Longitudinal Study (CHARLS), which includes 11,503 respondents and 450 communities. Preventive care use covers the utilization of routine physical examination services. Individual social capital is measured by the level of social network and social activities participation. Social network includes contacting with children or other people, for example, by phone, text message. Social activities participation is measured by the involvement in social activities, for example, playing mahjong, going to community club. Community social capital is evaluated by the richness of community facilities. Results reveals that the utilization of preventive care is 48.94% among middle-aged and elderly in China. The most used preventive service is routine blood test. The intra-class correlation (ICC) coefficient indicates that preventive health behaviors of the respondents are clustered at communities where they live. Multi-level regression shows that influence of social network is not significant to preventive care use (p ＞ 0.05). Community facilities and individual social activities participation are significantly associated with preventive care use (p < 0.05). The association between social capital and preventive care use could be considered as an important factor when making policies to promote preventive care use.

Can social marketing undo the COVID-19 infodemic? Predicting consumer preventive health behavior in the marginalized communities in Zimbabwe

Can social marketing undo the COVID-19 infodemic? Predicting consumer preventive health behavior in the marginalized communities in Zimbabwe

Differential effectiveness of COVID‐19 health behaviors: The role of mental health conditions in mask‐wearing, social distancing, and hygiene practice

AbstractBackgroundMental health conditions are known to increase susceptibility to infectious diseases, including coronavirus disease 2019 (COVID‐19). Health behaviors play a crucial role in mitigating this susceptibility. We aim to examine the differential effectiveness of COVID‐19 preventive health behaviors among individuals, considering the presence or absence of specific mental health disorders.MethodsMultivariable logistic regression with interaction terms was performed to examine whether associations between adherence to health behaviors and COVID‐19 infection were conditional on depression, anxiety, or eating disorders in a national sample of adults (N = 61,891) from 140 US universities, 2020–2021.ResultsAdjusting for age, race/ethnicity, and gender/sex, the effectiveness of mask‐wearing was significant and comparable among individuals with and without depression, anxiety, or eating disorders. Social distancing provided significantly less protection among individuals with depression, anxiety, or eating disorders. Hygiene practice provided significantly less protection among individuals with anxiety.ConclusionMask‐wearing is robustly effective in the prevention of COVID‐19 among individuals. However, social distancing and hygiene practice provide less significant protection among individuals with certain mental health conditions, suggesting the importance of prioritizing these individuals for additional preventive measures (e.g., vaccines targeting variants) and mitigation strategies (e.g., financial assistance, targeted mental health care, health education).