Protective Health Behaviors Research Articles

The role of the environment: how mask wearing varies across different activities

BackgroundPeople’s decisions to engage in protective health behaviors, such as mask wearing during the COVID-19 pandemic, are influenced by environmental and social contexts. Previous research on mask wearing used a single question about general mask usage in public, which may not reflect actual behavior in every setting. The likelihood of wearing a mask during one activity is also related to the likelihood of wearing a mask in another or avoiding an activity entirely. This analysis compared responses between a general question and activity-specific questions and identified patterns of mask-wearing behavior across activities.MethodsOnline, opt-in, cross-sectional surveys were conducted every 2 months from November 2020 to May 2021 (n = 2508), with quota sampling and weighting to achieve a representative sample of the U.S.population. Respondents were asked how frequently they wore a mask in public and during 12 specific activities including: on public transportation, while shopping, and attending social gatherings indoors and outdoors. Spearman’s rank order correlation was used to compare the frequency of mask wearing reported using a general question versus an activity specific question. Additionally, a latent class analysis was conducted to identify patterns of mask wearing behavior across activities.ResultsThere was little to no correlation (r = .16–0.33) between respondents’ general attitudes towards mask wearing and their reported frequency of mask wearing in different activities. Latent class analysis identified six distinct groups based on their mask wearing behaviors and avoidance of certain activities. The largest group (29%) avoided ten of the twelve activities and always wore a mask during activities that could not be avoided. Additional groups included those who avoided most activities but made exceptions when around friends or family (20%), part time mask wearers (18%), and never mask wearers (6%).ConclusionsThe findings suggest that activity-specific questions provide more accurate and useful information than a single general question. Specific, context based, questions allow for analyses that consider the nuances of people’s decision-making regarding engaging in protective health behaviors, such as mask wearing, thus enabling public health professionals to create targeted guidelines and messages.

Using machine learning to unveil relevant predictors of adherence to recommended health-protective behaviors during the COVID-19 pandemic in Denmark.

What were relevant predictors of individuals' proclivity to adhere to recommended health-protective behaviors during the COVID-19 pandemic in Denmark? Applying machine learning (namely, lasso regression) to a repeated cross-sectional survey spanning 10 months comprising 25 variables (Study 1; N = 15,062), we found empathy toward those most vulnerable to COVID-19, knowledge about how to protect oneself from getting infected, and perceived moral costs of nonadherence to be strong predictors of individuals' self-reported adherence to recommended health-protective behaviors. We further explored the relations between these three factors and individuals' self-reported proclivity for adherence to recommended health-protective behaviors as they unfold between and within individuals over time in a second study, a Danish panel study comprising eight measurement occasions spanning eight months (N =441). Results of this study suggest that the relations largely occurred at the trait-like interindividual level, as opposed to at the state-like intraindividual level. Together, the findings provide insights into what were relevant predictors for individuals' overall level of adherence to recommended health-protective behaviors (in Denmark) as well as how these predictors might (not) be leveraged to promote public adherence in future epidemics or pandemics.

Study on The Implementation Intention of Health Protection Behavior of College Students in Epidemic Situation of Infectious Diseases

From the perspective of social cognitive theory, this paper refines and integrates the theory of protective motivation, the theory of planned behavior and the individual and social environment factors in risk research, a comprehensive analytical framework was built to predict the implementation intention of public health behaviors. Through the investigation of the college students during the epidemic of Covid-19, we found that the willingness of the public to carry out health behaviors was influenced by two kinds of factors: external social environment and individual internal conditions. As far as the external environment is concerned, perceived normative influence of “Significant others” and informational influence from mass media can positively promote the implementation intention of health protection behavior. At the same time, media attention can also indirectly affect the public's willingness to carry out health behaviors through the mediating effects of self-efficacy and coping efficacy, respectively. As far as internal factors are concerned, self-efficacy is the most powerful direct factor to predict individuals' health behaviors. The existence of cognitive deficit and optimism bias results in the failure of the predictive power of the element of threat assessment on the willingness to carry out health behaviors, however, perceived severity can have a negative effect on health behavior intention through the mediation of the “Avoidance” concept. The study also found that the emotional response not only positively affected the intention to carry out healthy behaviors independently of the cognitive assessment process, but also played a positive moderating role between media attention and the intention to carry out healthy behaviors, however, improper risk concept may have a blocking effect on the implementation intention of health behavior.

Existing knowledge, myths, and perceptions about hepatitis B and liver cancer within highly impacted immigrant communities

BackgroundImmigrant groups from Southeast Asia, the Pacific Islands, sub-Saharan Africa, and the Caribbean bear the heaviest burden of chronic hepatitis B and primary liver cancer in the United States. Educational campaigns to increase knowledge about these diseases and their connection are necessary to promote protective health behaviors within these communities, to ultimately reduce the burden of disease, lessen stigma, and eliminate health disparities. ObjectivesThis project sought to engage groups within highly impacted communities to identify existing gaps in hepatitis B- and liver cancer-related knowledge, in order to inform future health education programming that will aim to reduce stigma and promote liver cancer prevention and early detection behaviors within and across groups. MethodsFifteen focus groups and two key informant interviews were conducted virtually with participants from Micronesian, Chinese, Hmong, Nigerian, Ghanaian, Vietnamese, Korean, Somali, Ethiopian, Filipino, Haitian, and Francophone West African communities. Qualitative data were analyzed using thematic coding. ResultsThere are large gaps in knowledge and awareness of hepatitis B and liver cancer, and the link between these two diseases among Asian, Pacific Islander, African and Haitian immigrant communities. This limited knowledge and misinformation, exacerbated by stigma, hinder these groups’ utilization of hepatitis B and liver cancer diagnostic and preventative healthcare services. ConclusionTo reduce hepatitis B and liver cancer health disparities within heavily burdened groups, health education needs to be community-informed, culturally sensitive, and actionable. Study results can guide the development of culturally and linguistically appropriate education programs that focus on the link between hepatitis B and liver cancer and the need for vaccination and routine screening, and that are responsive to the knowledge gaps and misperceptions of diverse communities. The results also provide valuable insights for healthcare providers to improve the knowledge gaps of the diverse patient populations that they serve.

The effect of consumer-perceived COVID-19 ad value on health-protective behavior: Mediating role of engagement

Though the pandemic has passed, social media-based messaging continues to exhibit COVID-19-related cues (e.g., wearing a face mask to stay safe), continuing to foster consumers’ health-protective behavior. However, it remains unclear how social media communications (e.g., advertising) affect such behavior, exposing an important literature-based gap. Addressing this gap, we deploy Ducoffe’s advertising value model to examine how pandemic-related advertisements (e.g., those urging consumers to stay safe, including post-the pandemic) impact their health-protective behavior. We also examine how consumer engagement (CE) mediates these associations. To explore these issues, we collected data from a sample of 301 Gen Z consumers, which was analyzed using partial least squares structural equation modeling (PLS-SEM). We find that informative, credible, irritating, and obtrusive ads raise consumer engagement and health-protective behavior. Engagement was also found to strengthen these associations, revealing their strategic value. We conclude by outlining important theoretical and practical implications that arise from our analyses.

Let’s (not) talk about sexual health: How sexual communication apprehension with healthcare providers and peer communication influence intentions to protect sexual health

ObjectiveThis study examined how patients’ clinical and peer interactions may affect their communication apprehension with healthcare providers, a major communication barrier to sexual health protective behaviors (SHPB). MethodsBetween January 2022 and February 2023, we conducted an online survey with 310 participants recruited through snowball sampling. Using structural equation modeling (SEM), we explored relationships among patient-provider interactions, peer communication about sex, communication apprehension with providers, and SHPB intentions. ResultsSignificant predictors of SHPB intentions included lower communication apprehension and more peer communication. Communication apprehension was a significant mediator in paths from peer communication and three types of patient-provider communication to SHPB intentions. ConclusionsOur study indicates the need to address communication barriers to increase patients’ SHPB intentions. Active patient involvement and patient-centered communication may open up discussions about sex in the clinical setting. Peer interactions, informed by scientific guidance, may reduce patients’ apprehension, leading to better health outcomes. Practice implicationsCommunication interventions are needed to promote collaborative patient-provider environments and peer sexual communication. Active involvement and evidence-based discussions can help patients navigate difficult conversations (e.g., like sex), improving SHPB.

Effectiveness of BNT162b2 Vaccine Against Symptomatic SARS-CoV-2 Infection in Children Aged 5-11 Years in Japan During Omicron Variant Predominate Periods.

Although the effectiveness of BNT162b2 messenger RNA vaccines against the Omicron variant has been reported in several countries, data are limited in children living in Asian countries. Therefore, this study aimed to estimate the effectiveness of the pediatric primary two-dose monovalent mRNA vaccine series in preventing symptomatic novel coronavirus disease 2019 (COVID-19) in Japan. We conducted a test-negative case-control study (262 test-positive cases and 259 test-negative controls) in patients aged 5-11 years who presented with COVID-19-like symptoms during the Omicron BA.2- and BA.5-predominant periods. Vaccination status, demographic data, underlying medical conditions, lifestyle, personal protective health behaviors, living environment, and PCR test results were obtained using parent-administered questionnaires and clinical records. Vaccine effectiveness (VE) against symptomatic COVID-19 was calculated using a multivariate logistic regression analysis. Of the test-positive cases and test-negative controls, 9.2% (n = 24) and 12.7% (n = 33) received two vaccine doses, respectively. Having siblings and a BA.5-dominant period were significantly associated with symptomatic COVID-19. After adjusting for age, siblings, study period, and duration after the last vaccination, the overall VE of two-dose vaccination was 50.0% (95% confidence interval [CI], 5-74%). VE was 72% (95% CI, 24-89%) within 3 months after the two-dose vaccination, while it decreased to 24% (95% CI, -80% to 68%) after 3 months. Two BNT162b messenger RNA vaccine doses provided moderate protection against symptomatic COVID-19 during the Omicron variant period. A time-dependent decrease in VE was noted after the second dose; thus, a booster dose 3 months after the second dose is warranted.

Health risk perception and exercise intention of college students: a moderated mediation model of health anxiety and lay theories of health.

Health risk perception is an important predictor of health-protective behaviors according to the health belief model. However, the underlying mechanism connecting health risk perception and exercise behaviors is not well understood. The current study investigates how health risk perception predicts college students' exercise intention in the post-pandemic era in China and analyzes the mediating effect of health anxiety and the moderating effect of lay theories of health. This cross-sectional study adopted convenience sampling and recruited 767 students from a province in central China. The Health Risk Perception Scale, Health Anxiety Scale, Lay Theories of Health Scale, and the Chinese version of the Exercise Intention Scale were used to measure the levels of health risk perception, health anxiety, implicit health theory, and exercise intention, respectively. The results of the moderated mediation model indicated that the health risk perception of college students significantly and positively affected exercise intention (β = 0.110, t = 2.852, p < 0.01). Meanwhile, the indirect effect of health anxiety on the relationship between health risk perception and exercise intention was significant. Furthermore, lay theories of health buffered the association between health anxiety and exercise intention, according to the moderated mediation analysis (β = 0.068, t = 2.067, p < 0.05). For college students holding incremental health theory, the influence of health anxiety on exercise intention was positively and statistically significant. The health risk perception of college students can lead to health anxiety, which can positively affect their exercise intention. In addition, lay theories of health can moderate the effect of health anxiety on exercise intention. The results have practical implications for developing effective, applicable, and scalable interventions to promote physical exercise by reducing the level of entity theory of health or increasing the level of incremental theory.

Mindful self-compassion program based on Watson's theory of human caring in nursing students: A randomized controlled study

Aims and backgroundThis study investigated the impact of the Mindful Self-Compassion Program, based on Watson's Theory of Human Caring Model, on the physical and mental health of nursing students. The essence of nursing is care and compassion. While there are studies on compassion in nursing care, nurses' self-compassion is an underrecognized concept in the literature. MethodsThe study employed a randomized controlled design and involved 80 seconds-grade nursing students from a university in Turkey between December 2021 and June 2022. The intervention group received an online program consisting of six weekly sessions, while the control group did not receive any intervention. The data were collected using the Promotive and Protective Health Behaviors Scale, Watson Caritas Self-Rating Score, Brief Resilience Scale, and Self-Compassion Scale before, at the end of, and 5 months after the program. ResultsIn both the post-test and follow-up test, the intervention group exhibited an increase in health-promoting and protective behaviors, self-care perception, psychological resilience, and self-compassion compared to the control group. ConclusionTherefore, it is recommended to use the program to improve the physical and mental health of individuals in nursing practice areas. Additionally, it would be beneficial to include the program in the nursing education curriculum. Our findings provide evidence supporting the use of the program for nursing students and nurses.

Diet and physical activity behaviors: how are they related to illness perceptions, coping, and health-related quality of life in young people with hereditary cancer syndromes?

Individuals with inherited cancer syndromes, such as Li-Fraumeni syndrome (LFS), may be motivated to adopt health-protective behaviors, such as eating more fruits and vegetables and increasing physical activity. Examining these health behaviors among young people with high lifetime genetic cancer risk may provide important insights to guide future behavioral interventions that aim to improve health-related quality of life (HRQOL). We used a self-regulatory framework to investigate relationships among diet and physical activity behaviors and psychosocial constructs (e.g., illness perceptions, coping, HRQOL) in adolescents and young adults (AYAs; aged 15–39 years) with LFS. This longitudinal mixed-methods study included 57 AYAs aged 16–39 years at enrollment), 32 (56%) of whom had a history of one or more cancers. Participants completed one or two telephone interviews and/or an online survey. We thematically analyzed interview data and conducted regression analyses to evaluate relationships among variables. AYAs described adopting healthy diet and physical activity behaviors to assert some control over health and to protect HRQOL. More frequent use of active coping strategies was associated with greater reported daily fruit and vegetable intake. Greater reported physical activity was associated with better quality of psychological health. Healthy diet and physical activity behaviors may function as LFS coping strategies that confer mental health benefits. Clinicians might emphasize these potential benefits and support AYAs in adopting health behaviors that protect multiple domains of health. Future research could use these findings to develop behavioral interventions tailored to AYAs with high genetic cancer risk.

Osteoporotic quality of life, self-efficacy, and fracture protection behaviors in postmenopausal women

SummaryIt is important for postmenopausal women to acquire bone health protective behaviors to protect them from fractures. For this reason, it is necessary to evaluate bone health during menopause and to inform women.PurposeThis study was conducted to examine osteoporotic fracture protection behaviors, quality of life, and self-efficacy in postmenopausal women.MethodsIn the study, the data were evaluated with the socio-demographic data form, Osteoporotic Fracture Protection Scale, Osteoporosis Self-Efficacy-Efficacy Scale, European Osteoporosis Foundation Quality of Life Questionnaire-41, which includes introductory information on socio-demographic characteristics.ResultsIt was determined that the postmenopausal women included in our study were between the ages of 45–92; more than half of them had chronic diseases; their average BMI was 29; and their DEXA score was − 3.00 ± 0.41. Among the people included in our study, those with a history of fractures had lower self-efficacy scores. It was determined that the fracture prevention scale scores of the participants were above the average, and the average of the osteoporosis-related quality of life score was high. In addition, it was determined that there was a strong positive correlation between self-efficacy and fracture prevention scale.ConclusionIt is important to determine behaviors to prevent osteoporotic fractures in postmenopausal women, to raise the necessary awareness and to inform patients about the precautions to be taken. It is thought that it will increase patients’ quality of life by increasing their disease-related self-efficacy. Therefore, there is a need for research on providing education to op patients and examining the results.

Communicating radon risks: the impact of different risk formulations on risk perception and protection intention

Communication campaigns addressing radon-related health risks have struggled to promote health-protective behaviour effectively. Typically framed as a ‘naturally occurring gas’, this study explores whether this framing might attenuate radon risk perception. It compares the impact of framing radon as an ‘indoor air pollutant’ versus a ‘natural gas’ on risk perceptions and on intentions to protect against radon. It also explores the role of perceptions of the burdensomeness of mitigation, self-efficacy and stigma as potential moderators of the framing effect for health protection intentions. Using Computer-Assisted Web Interviewing (CAWI), 2,012 stratified respondents, representative of the Slovenian adult population, completed a survey. Respondents were randomly assigned to one of two radon frames: ‘indoor air pollutant’ or ‘natural gas’. Results reveal low compliance to test and mitigate radon, regardless of residing in high- or low-risk areas. Risk perception was significantly higher when framed as ‘Indoor air pollution.’ However, the ‘natural gas’ frame resulted in slightly stronger intentions to test and mitigate radon. The impact of framing on intentions was significantly moderated by (a) perceptions of the burdensomeness and (b) the stigma. In conclusion, how radon risk is framed in communication strategies needs careful attention, as it influences risk perception and individuals’ intentions to take action.

Covid-19 skepticism and public health norms during refugee assistance: does skepticism always lead to poor safety protocol adherence?

BackgroundSkepticism about COVID-19’s existence or severity has spread as fast as the disease itself, and in some populations has been shown to undermine protective public health behaviors that can mitigate infection. For populations that are especially vulnerable to COVID spread and severity, such as refugees, COVID skepticism is particularly problematic.MethodsWe examine data collected from observations of humanitarian services provided to refugees in Lebanon, Türkiye, and Jordan to determine if skepticism is related to adherence to specific health-protective protocols (masking, social distancing, and hand sanitizing), and whether the effects of COVID skepticism are mediated by particular populations of refugees or the country in which those refugees receive assistance.ResultsWe found that community skepticism (the frequency of COVID skepticism expressed by others within a service location) is associated with lower adherence to certain protocols and not others. We also found that with certain protocols, the country in which refugees receive services mediates the relationship between community skepticism and protocol adherence, but for other protocols the relationship between skepticism and adherence is independent of either country in which refugees reside or the refugee population being served.ConclusionsThe existence of skepticism about COVID-19 does not always lead to an unwillingness to take protective measures to avoid infection. The mechanisms underlying the relationship between skepticism and adherence to health-protective protocols vary based on the type of protocol in question. In order to increase protocol adherence, the specific variables predicting adherence to different protocols need to be assessed in order to increase adherence and improve public health during humanitarian services.

The impact of the COVID-19 pandemic on perceptions of social relationships, negative affect, and paranoid ideation.

The COVID-19 pandemic contributed to worsening mental health across the globe. The pandemic may have been especially impactful on those experiencing heightened psychosis spectrum symptomatology given greater pre-pandemic social isolation and increased vulnerability to stress. Yet, few studies exploring the impact of the COVID-19 pandemic on perceptions of social relationships and mental health have sampled individuals high in psychosis spectrum symptomatology, including those with psychosis spectrum disorders. Utilizing a mixed transdiagnostic community sample enriched for psychotic spectrum disorders, this longitudinal study investigated whether perceptions of social relationships and psychiatric symptoms changed during the COVID-19 pandemic, whether pandemic-related impacts were associated with social perceptions and symptomatology, and whether paranoid ideation was related to perceptions of the government response to the COVID-19 pandemic. Pandemic impacts were not uniform, with participants reporting a range of adverse impacts including poorer health-related behaviors, difficulties fulfilling basic needs, and medical related challenges. Results indicated that compared to pre-pandemic assessments, perceived rejection and hostility increased during the COVID-19 pandemic. Participants who experienced more pandemic-related impacts reported less social support, more social distress, greater negative affect, and greater paranoid ideation. Paranoid ideation was related to more negative perceptions of the government's response to the pandemic. These findings demonstrate the importance of assessing individual differences in pandemic-related impacts and the clinical consequences of such impacts. Results also suggest that those high in paranoid ideation may be reluctant to engage in government recommended protective health behaviors to limit the spread of COVID-19.

APOE Genotype Disclosure Influences Decisions About Future Planning but not Adoption of Healthy Lifestyle Changes in Cognitively Unimpaired Individuals.

Studies have shown apolipoprotein E (APOE) genotype disclosure to be safe and well-tolerated in cognitively unimpaired (CU) older adults. This study aimed to examine the effect of the disclosure process on decisions about future directives and health behaviors in community-dwelling CU older adults from the Butler Alzheimer's Prevention Registry (BAPR). CU APOE E4 non-carriers (n = 106) and carriers (n = 80) aged 58-78 completed in-person psychological readiness screening to undergo APOE disclosure. Follow-up assessments were completed online 3days, 6weeks, and 6months post-disclosure. The primary outcomes were future directives, dietary habits, and physical activity scores. Disclosure was associated with decision making on future directives in E4 carriers (t = 3.59, P = .01) at 6months compared to baseline, but not non-carriers. Family history of memory impairment, SCD endorsement, and education consistently predicted scores on future directives. A significant interaction between E4+ and SCD endorsement on future directive scores was noted (OR = 163.06, 9.5-2,799.8). E4 + carrier status was associated with physical activity (W = 60,148, P = .005) but not dietary habits scores. Our findings indicate that disclosure led to a change in future directives but not protective health behaviors, specifically in E4 carriers. Future work will explore whether pairing disclosure with education about the role of lifestyle factors in AD risk and providing guidelines on making risk-lowering lifestyle modifications as an intervention approach leads to positive change.

Nurses' knowledge and protective health behaviors about prevention of COVID-19 pandemic complications at Baghdad Teaching Hospitals.

Coronavirus disease (COVID-19) is a global pandemic caused by the severe acute respiratory syndrome coronavirus, SARS-CoV-2. Infection with SARS-CoV-2 primarily occurs through binding to angiotensin-converting enzyme-2 (ACE2), which is abundantly expressed in various anatomical sites, including the nasopharynx, lungs, cardiovascular system, and gastrointestinal and genitourinary tracts. This study aimed to nurses' knowledge and protective health behaviors about prevention of covid-19 pandemic complications. A descriptive design study was conducted from October 1, 2022, to March 15, 2023. A non-probability purposive sample of 50 nurses from different educational levels, genders, and departments at Baghdad teaching hospitals was selected. Data collected were analyzed using SPSS version 25.0. The study comprised an equal distribution of male and female participants, with the majority (44%) aged between 22 and 30 years. A significant proportion (52%) of nurses held institute degrees. Forty-six percent were single, and the majority (74%) had 1-5 years of experience. The mean scores were 0.70 for nurses' knowledge and 3.22 for nurses' protective health behaviors. The findings indicate that nurses possess satisfactory knowledge and exhibit high levels of protective health behaviors regarding complications associated with the COVID-19 pandemic. It is recommended to conduct future research focusing on nurses' knowledge and practices related to patient care in the context of a pandemic.

Contrasting Objective and Perceived Risk: Predicting COVID-19 Health Behaviors in a Nationally Representative U.S. Sample.

Individuals confronting health threats may display an optimistic bias such that judgments of their risk for illness or death are unrealistically positive given their objective circumstances. We explored optimistic bias for health risks using k-means clustering in the context of COVID-19. We identified risk profiles using subjective and objective indicators of severity and susceptibility risk for COVID-19. Between 3/18/2020-4/18/2020, a national probability sample of 6,514 U.S. residents reported both their subjective risk perceptions (e.g., perceived likelihood of illness or death) and objective risk indices (e.g., age, weight, pre-existing conditions) of COVID-19-related susceptibility and severity, alongside other pandemic-related experiences. Six months later, a subsample (N = 5,661) completed a follow-up survey with questions about their frequency of engagement in recommended health protective behaviors (social distancing, mask wearing, risk behaviors, vaccination intentions). The k-means clustering procedure identified five risk profiles in the Wave 1 sample; two of these demonstrated aspects of optimistic bias, representing almost 44% of the sample. In OLS regression models predicting health protective behavior adoption at Wave 2, clusters representing individuals with high perceived severity risk were most likely to report engagement in social distancing, but many individuals who were objectively at high risk for illness and death did not report engaging in self-protective behaviors. Objective risk of disease severity only inconsistently predicted health protective behavior. Risk profiles may help identify groups that need more targeted interventions to increase their support for public health policy and health enhancing recommendations more broadly.

Evaluating a peer-to-peer health education program in Australian public housing communities during the COVID-19 pandemic

BackgroundThe cohealth Health Concierge program operated in Melbourne, Australia from July 2020 to 30 June 2022. It provided peer-to-peer support to culturally and linguistically diverse residents of high-rise public housing. During this time, the COVID-19 public health response changed frequently and included movement restriction, testing and vaccination. We conducted a mixed-methods evaluation to determine the Health Concierge program’s impact on residents’ engagement with health services and public health activities.MethodsThe evaluation, informed by a Project Reference Group, used the RE-AIM framework. We analysed data from 20,901 routinely collected forms describing interactions between Concierges and residents from August 2021 to May 2022. Additional evaluation-specific data were collected between March and May 2022 in four housing estates; we surveyed 301 residents and conducted 32 interviews with residents, Concierges and program stakeholders.ResultsConcierges promoted COVID-safe behaviours; linked residents with support, testing and vaccination services; and disseminated up-to-date information. Of the 20,901 recorded interactions, 8,872 (42%) included Concierges providing support around COVID-19 vaccination. Most surveyed residents (191/301, 63%) reported speaking with a Concierge in the previous six months. The self-reported two-dose COVID-19 vaccine uptake was 94% (283/301). Some residents described having meaningful, appreciated conversations with Concierges, and some described superficial interactions. While residents initially welcomed the program, many felt it failed to evolve. Poorly defined management and hiring criteria led to variable program implementation. A need for bicultural workers to continue linking residents with services was discussed.ConclusionsConcierges’ impact on residents may have contributed to high community uptake of COVID-19 testing and vaccination, and had benefits beyond the COVID-19 remit. We recommend the program be revised and continued to inform further preparedness planning and support service access generally. Program models such as this have potential to inform and reassure high-risk communities during a pandemic. In addition, such programs can help overcome vaccine hesitancy and promote protective health behaviours, regardless of whether a pandemic is currently occurring. Ensuring these programs remain responsive to the changing needs of end-users needs over time is imperative.

A dual‐angle exploration towards understanding lapses in COVID‐19 social responsibility

AbstractBreaking infection chains requires not just behaviours that allow individuals to stay healthy and uninfected (i.e. health protective behaviours) but also for those who are possibly infected to protect others from their harboured infection risk (i.e. socially responsible behaviours). However, socially responsible behaviours entail costs without clear, immediate benefits to the individual, such that public health‐risking lapses occur from time to time. In this important yet understudied area, the current exploratory study sought to identify possible psychological factors that may affect people's likelihood of engaging in socially responsible behaviours. Assuming that self‐perceived infection should provide an impetus to engage in socially responsible behaviours, we contend that lapses could occur in two scenarios: discounting of possible infection or prioritizing self‐interest over collective good. Through a vignette portraying COVID‐19 relevant symptoms presented to culturally diverse participants (Singapore and United States; N = 645), we found dispositional denialism (an ego defence mechanism) to exert a negative indirect effect on likelihood of engaging in socially responsible behaviours through its negative association with perceived infection status. Further, social value orientation and cultural orientation appeared to significantly moderate the positive association between perceived infection status and the likelihood of engaging in socially responsible behaviours, such that the positive association held only when individuals espouse both a prosocial value orientation and a collectivistic cultural orientation. Further analyses also point toward a possible attenuation of this positive association when individuals espouse a vertical cultural orientation. Future directions and implications for public health management are discussed.

The role of conspiracy mentality, reactance, and anxiety in the effectiveness of gain- vs. loss-framed messages promoting COVID-19 protective measures: Is vaccination different?

We explore how conspiracy beliefs change the effectiveness of gain- vs. loss-framed messages in promoting health-protective behavior. We focused on various recommended COVID-19 protective measures, not only vaccinations but also other preventive (like wearing masks) and detection behaviors (like testing). Our results indicate that conspiracy beliefs moderate the effectiveness of gain vs. loss framing. When participants endorse conspiracy worldviews above the average level, the gain frame may be more effective than the loss frame. In other words, in the loss frame condition, conspiracy beliefs negatively and significantly predicted attitudes toward the behavior recommended. However, in the case of the gain frame, the relationship between conspiracist views and attitudes toward promoted behavior was weaker or even nonsignificant. We also found, although only in the case of one behavior, that when participants' eagerness to look for conspiracies almost does not exist, the loss frame may be a better option than the gain frame. Finally, neither of these effects was mediated by emotional reactance or anxiety.