Protective Health Behaviors Research Articles

Digital Health Literacy in the Training of Informal Caregivers – Community Intervention

Abstract Background Health Literacy allows optimizing healthy lifestyles and preventive and health protective behaviors (DGS, 2019). Low literacy can lead to a greater number of hospitalizations, a more frequent use of emergency services and a lower prevalence of preventive attitudes in the field of health. Internet-based interventions could have a positive impact on informal caregivers, reducing the geographical barrier, promoting self-efficacy in managing their own emotions, reducing burden. Aim Contribute to the training of informal caregivers of a primary health care unit in Lisbon, through the promotion of digital health literacy. Methods The Community Intervention project was carried out in the context of a home visit, focusing on 11 informal caregivers, through the presentation of an interactive digital manual. It was based on the methodology of health planning, through the elaboration of a diagnosis of the situation, definition of priorities, setting of objectives, selection of strategies, operational preparation and evaluation (Imperatori & Giraldes, 1993). Results It was found that not all informal caregivers have access to the internet or digital technologies, and it was necessary to deliver the printed manual. Caregivers who accessed the interactive digital manual rated its content as very important, having accessed the suggested links without difficulty. The possibility of forwarding the digital manual to other caregivers was valid for all. Conclusions Digital technologies promote communication in terms of health promotion, contributing to universal access and digital training in health, giving individuals the opportunity to increase care for their own health. The creation of digital health tools must be directed to the characteristics of the population. For individuals with low digital literacy, simple technologies must be created and for those who cannot or do not want to use digital tools, adequate alternatives must be created. Key messages • Primary care health professionals may use digital technologies to promote health literacy. • Vulnerable groups with low digital health literacy need support to increase access to digital technology that can promote health literacy.

The Conditional Effects of Authoritarianism on COVID-19 Pandemic Health Behaviors and Policy Preferences.

A large literature contends that conservatives differ from liberals in their dispositional sensitivity to threat and needs for social order and security. Thus, a puzzle emerged during the COVID-19 pandemic when American conservatives, despite their purported threat sensitivity, responded to the pandemic in ways that evinced little concern toward the risks posed by COVID-19. Threat tolerant liberals present an equally interesting case, having fervently masked, isolated, and advocated for stringent public health restrictions when facing down COVID-19. Why did so many Americans adopt health behaviors and policy preferences at odds with their dispositional orientations toward threat and needs for security during the COVID-19 pandemic? In this paper, I analyze three national surveys to evaluate how psychological dispositions affected Americans’ responses to COVID-19. I find that authoritarianism, a common measure of dispositional threat sensitivity and needs for security, conditionally affected Americans’ responses to the pandemic. Directly, authoritarianism was associated with greater concern over COVID-19 and, in turn, increased willingness to engage in protective health behaviors, support restrictive public health measures, and support economic interventions amidst the pandemic-induced downturn. Indirectly, however, authoritarianism promoted identification with and cue-taking from right-wing elites who frequently downplayed the severity of COVID-19; attention to such rhetoric reduced politically engaged authoritarians’ concern over COVID-19 and, in turn, their willingness to adopt protective health behaviors and support public health restrictions or economic interventionism. Attention to political discourse thus appears to have countervailed Americans’ dispositional orientations toward threat and security during the COVID-19 pandemic.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11109-022-09828-9.

Gender differences in health protective behaviours and its implications for COVID-19 pandemic in Taiwan: a population-based study

IntroductionSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection produces more severe symptoms and a higher mortality in men than in women. The role of biological sex in the immune response to SARS-CoV-2 is believed to explain this sex disparity. However, the contribution of gender factors that influence health protective behaviors and therefore health outcomes, remains poorly explored.MethodsWe assessed the contributions of gender in attitudes towards the COVID-19 pandemic, using a hypothetical influenza pandemic data from the 2019 Taiwan Social Change Survey. Participants were selected through a stratified, three-stage probability proportional-to-size sampling from across the nation, to fill in questionnaires that asked about their perception of the hypothetical pandemic, and intention to adopt health protective behaviors.ResultsA total of 1,990 participants (median age = 45·92 years, 49% were women) were included. Significant gender disparities (p < .001) were observed. The risk perception of pandemic (OR = 1·28, 95% CI [1·21 − 1·35], p < .001), older age (OR = 1·06, 95% CI [1·05 − 1·07], p < .001), female gender (OR = 1·18, 95% CI [1·09-1·27], p < .001), higher education (OR = 1·10, 95% CI [1·06 − 1·13], p < .001), and larger family size (OR = 1·09, 95% CI [1·06 − 1·15], p < .001) were positively associated with health protective behaviors. The risk perception of pandemic (OR = 1·25, 95% CI [1·15 − 1·36]), higher education (OR = 1·07, 95% CI [1·02 − 1·13], p < .05), being married (OR = 1·17, 95% CI [1·01–1·36, p < .05), and larger family size (OR = 1·33, 95% CI [1·25 − 1·42], p < .001), were positively associated with intention to receive a vaccine. However, female gender was negatively associated with intention to receive a vaccine (OR = 0·85, 95% CI [0·75 − 0·90], p < ·01) and to comply with contact-tracing (OR = 0·95, 95% CI [0·90 − 1·00], p < .05) compared to men. Living with children was also negatively associated with intention to receive vaccines (OR = 0·77, 95% CI [0·66 − 0·90], p < .001).ConclusionThis study unveils gender differences in risk perception, health protective behaviors, vaccine hesitancy, and compliance with contact-tracing using a hypothetical viral pandemic. Gender-specific health education raising awareness of health protective behaviors may be beneficial to prevent future pandemics.

A systematic survey of adults’ health-protective behavior use during early COVID-19 pandemic in Canada, Germany, United Kingdom, and the United States, and vaccination hesitancy and status eight months later

Adoption of health-protective behaviors, including social distancing measures, are a mainstay of mitigating pandemics, so it is important to understand the characteristics associated with those who use them or not. We aimed to delineate local and personal factors associated with self-reported use of health-protective behaviors (HPB) in response to COVID-19, among adults across 4 economically developed countries.We conducted an exploratory, cross-sectional, representative, on-line survey of adults in Canada, Germany, U.K., or the U.S. during the COVID-19 pandemic (June–July 2020) with two and eight month follow-ups. All countries were experiencing the initial waves of the COVID-19 pandemic. We obtained N = 6,990 participants, who reported 20 specific health-protective behaviors (dependent measure), along with locally mandated health measures, individual characteristics and psychological scales. Using health-protective behaviors (HPB-Quartile score) was significantly associated with 28 of 35 variables studied. In stepwise logistic regression, 21 variables predicted 23.51 % of the variance in HPB-Q scores (p <.000). The strongest predictors were locally mandated protective measures, immature defense mechanisms, COVID-fears, age, moving due to COVID-19, domestic violence, and perceived emotional support from significant others. HPB-Q predicted vaccination hesitancy/willingness (OR = 4.61, CI-95 %: 2.66–8.00) and adoption 8 months later. During the early pandemic, HPB use was most strongly associated with locally mandated measures, followed by psychiatric, demographic, and other personal factors. Considering these empirically derived characteristics may improve public health approaches to optimize HPB and vaccination adoption, mitigating SAR-CoV-2 transmission. Findings may also inform public health responses to future epidemics/pandemics.

Self-imposed social isolation among clients of social care organisations in the COVID-19 pandemic

Although self-imposed social isolation is an important way of reducing the risk of COVID-19 infection, previous research indicates that this behaviour varies substantially between different groups and individuals. Socially marginalized people are generally less involved in protective health behaviours, but there are few studies of their COVID-19 protective behaviours. The aims of the paper are therefore to: 1) compare self-imposed social isolation to avoid COVID-19 among socially marginalized groups, and to 2) examine factors influencing this, focusing especially on the role of social capital, risk awareness and sources of information about COVID-19. The study is based on survey data (N = 173) from people who are clients of social care organisations in Estonia, Norway, Hungary and Portugal. The sample involves clients living: a) in their homes, b) in facilities, and c) on the street or under temporary arrangements. Results indicate that the level of social isolation among the marginalized groups is comparable to that of the general population in previous studies. As hypothesized, we find that respondents living on the street or under temporary arrangements engage in less self-imposed social isolation than e.g. the respondents living in their homes. We also find lower levels of risk awareness, social capital and trust in authorities' information about COVID-19 among people living on the street or under temporary arrangements. Only linking social capital and trust in authorities' information was significantly related to respondents’ social isolation, and not worry for COVID-19 infection. Thus, it seems that respondents largely self-isolated because of “duty” and not worry for infection.

Media exposure, threat processing, and mitigation behaviors in Gulf Coast residents facing the co-occurring threats of COVID-19 and hurricanes.

The 2020 hurricane season threatened millions of Americans concurrently grappling with COVID-19. Processes guiding individual-level mitigation for these conceptually distinct threats, one novel and chronic (COVID-19), the other familiar and episodic (hurricanes), are unknown. Theories of health protective behaviors suggest that inputs from external stimuli (e.g., traditional and social media) lead to threat processing, including perceived efficacy (self- and response) and perceived threat (susceptibility and severity), guiding mitigation behavior. We surveyed a representative sample of Florida and Texas residents (N =1846) between April 14, 2020 and April 27, 2020; many had previous hurricane exposure; all were previously assessed between September 8, 2017 and September 11, 2017. Using preregistered analyses, two generalized structural equation models tested direct and indirect effects of media exposure (traditional media, social media) on self-reported (1) COVID-19 mitigation (handwashing, mask-wearing, social distancing) and (2) hurricane mitigation (preparation behaviors), as mediated through perceived efficacy (self- and response) and perceived threat (susceptibility and severity). Self-efficacy and response efficacy were associated with social distancing (p = .002), handwashing, mask-wearing, and hurricane preparation (ps<0.001). Perceived susceptibility was positively associated with social distancing (p =0.017) and hurricane preparation (p < 0.001). Perceived severity was positively associated with social distancing (p < 0.001). Traditional media exhibited indirect effects on COVID-19 mitigation through increased response efficacy (ps< 0.05), and to a lesser extent self-efficacy (p < 0.05), and on hurricane preparation through increased self-efficacy and response efficacy and perceived susceptibility (ps< 0.05). Social media did not exhibit indirect effects on COVID-19 or hurricane mitigation. Communications targeting efficacy and susceptibility may encourage mitigation behavior; research should explore how social media campaigns can more effectively target threat processing, guiding protective actions.

Luck perception is associated with less frequent preventive practices and a higher number of social contacts among adults during the SARS-CoV-2 pandemic

ObjectivesNon-pharmaceutical interventions have been crucial to reduce transmission of the SARS-CoV-2 virus in many countries including the United Kingdom. A key research priority has been to better understand psychological and social determinants of health behaviours. We aimed to quantify the impact of luck perception on contact and preventive behaviours among adults in the UK, adjusting for key confounders. Study designA cross-sectional study. MethodsData were collected between July 28 and August 31, 2020. Luck perception, which refers to a belief whether individual's SARS-CoV-2 infection status is determined by fate or chance, was measured using Chance score, drawing on Health Locus of Control Theory. Self-reporting online questionnaires were administered to obtain participants' contact patterns and frequencies of avoiding crowds, hand washing and wearing a mask. Associations between luck perception and protective behaviours and contact patterns were quantified using regression models. ResultsData from 233 survey respondents were analysed. Chance score was negatively associated with all protective behaviours; avoiding crowds (adjusted odds ratio (aOR) 0.46, 95% confidence interval (CI) 0.25–0.86, p = 0.02), washing hands (aOR 0.35, 95%CI 0.17–0.70, p = 0.003), and wearing masks (aOR 0.58, 95%CI 0.34–0.99, p = 0.046). For non-physical contacts (with or without distancing), a significant interaction was identified between Chance score and ethnicity. Chance score increased the number of non-physical contacts among white British, an opposite trend was observed for non-white participants. ConclusionsLuck perception during the pandemic may affect individuals’ health protection behaviours and contact patterns. Further mechanistic understandings of human behaviours against infectious diseases are indispensable for effective response to future pandemics.

How Does Self-Control Promote Health Behaviors? A Multi-Behavior Test of Five Potential Pathways.

Self-control is generally defined as the capacity to override impulses and is a robust predictor of health behaviors. This paper integrates trait, reasoned action, and habit approaches to develop and test a mechanistic account of how self-control influences health actions. We tested five potential pathways from self-control to behavior, termed the valuation, prioritization, habituation, translation, and inhibition routes. At baseline, participants (N = 663 adults) completed survey measures of reasoned action approach variables and habits in relation to eight health behaviors and the Brief Self-Control Scale. Three months later, participants reported their behavior. Multi-level modeling was used to test pathways across behaviors. Supporting the valuation route, affective attitude, cognitive attitude, descriptive norms, and perceived behavioral control mediated the self-control-intention relation, and intentions and perceived behavioral control mediated the relationship between self-control and health behaviors. Self-control also predicted the priority accorded to different considerations during intention formation. Higher self-control was associated with stronger prediction by cognitive attitudes and perceived behavioral control and weaker prediction by habits and injunctive norms. Self-control predicted habit formation, and habits mediated the self-control-behavior relation. Finally, self-control was associated with the improved translation of intentions into health behaviors and with greater inhibition of affective and habitual influences. Findings for the different pathways were not moderated by whether approach (health-protective behaviors) or avoidance responses (health-risk behaviors) were at issue. The present research offers new insights into why self-control promotes health behavior performance, and how deficits in self-control might be offset in future behavior-change interventions.

"It just never ends": Childhood cancer survivors' perceived psychosocial impacts of recurrence and second cancer.

Childhood cancer survivors are at risk of developing primary recurrences and new second cancers. Experiencing a recurrence and/or second cancer can be highly distressing for survivors and families. We aimed to understand the psychological impacts of experiencing a recurrence or second cancer and how this potentially influences survivors' engagement with survivorship care. We invited childhood cancer survivors or their parents if survivors were ≤16years of age from 11 tertiary pediatric oncology hospitals across Australia and New Zealand to complete interviews. We conducted a thematic analysis facilitated by NVivo12. We interviewed 21 participants of whom 16 had experienced a recurrence, 3 had a second cancer, and 2 had both a recurrence and second cancer. Participants reported that a recurrence/second cancer was a stressful sudden disruption to life, accompanied by strong feelings of uncertainty. Participants tended to be less aware of their second cancer risk than recurrence risk. Some participants reported feelings of anxiousness and despair, describing varying responses such as gratitude or avoidance. Participants shared that the fear of cancer recurrence either motivated them to adopt protective health behaviors or to avoid information and disengage from survivorship care. Some survivors and their parents have a poor understanding and expressed reluctance to receive information about their risk of second cancer and other treatment-related late effects. Improving the delivery of information about late effects to families may improve their engagement with survivorship care and surveillance, although care must be taken to balance information provision and survivors' anxieties about their future health.

Multimorbidity resilience and health behaviors among older adults: A longitudinal study using the Canadian Longitudinal Study on Aging.

ObjectiveThere has been a growing interest in examining why some individuals adapt and bounce back from multimorbidity (resilience) better than others. This paper investigates the positive role of protective health behaviors on multimorbidity resilience (MR) among older adults focusing on older persons with two or more concurrent chronic conditions, and separately for three multimorbidity chronic illness clusters.MethodsUsing Baseline and Follow-up One data from the Comprehensive Cohort of the Canadian Longitudinal Study on Aging, we studied 10,628 participants aged 65 years and older who reported two or more of 27 chronic conditions, and three multimorbidity clusters: Cardiovascular/metabolic, Musculoskeletal, and Mental health. Associations between health behaviors and MR were evaluated using Linear Mixed Models, adjusting for socio-demographic, social/environmental, and illness context social determinants of health.ResultsAmong older adults with two or more illnesses, smoking, satisfaction with sleep, appetite, and skipping meals were associated with MR in the expected direction. Also, obesity (compared to normal weight) and skipping meals showed longitudinal interaction effects with survey wave. Most of the results were replicated for the physical multimorbidity clusters (Cardiovascular/metabolic and Musculoskeletal) compared to the full 2+ multimorbidity analyses; however, for the Mental health cluster, only satisfaction with sleep was supported as a lifestyle predictor of MR.DiscussionSeveral modifiable health behaviors identified in the broader health and aging literature are important in affecting levels of multimorbidity resilience in older age. These factors are important strength-based areas to target. Additionally, several social determinants of health are also supported and parallel research on multimorbidity risk. The effects of lifestyle factors for resilience among older adults is dependent on the type of multimorbidity measured. We conclude that the results have significant public health, program intervention, and clinical implications for healthy aging among persons coping with multimorbidity.

The prospective relations of substance use frequency to social distancing behaviors and intentions during the COVID-19 pandemic: the role of social distancing self-efficacy.

To identify factors that increase risk for nonadherence to recommended health protective behaviors during pandemics, this study examined the prospective relations of substance use frequency to both adherence to social distancing recommendations and social distancing intentions during the COVID-19 pandemic, as well as the role of social distancing self-efficacy in these relations. A U.S. community sample of 377 adults completed a prospective online study, including an initial assessment between March 27 and April 5, 2020, and a follow-up assessment one-month later. Results revealed a significant direct relation of baseline substance use frequency to lower adherence to social distancing recommendations one-month later. Results also revealed significant indirect relations of greater substance use frequency to lower levels of both social distancing behaviors and intentions one-month later through lower social distancing self-efficacy. Results highlight the relevance of substance use and social distancing self-efficacy to lower adherence to social distancing during the COVID-19 pandemic.

Circulating Illness and Changes in Thermometer Use Behavior: Series of Cross-sectional Analyses.

BackgroundTemperature-taking behaviors vary with levels of circulating infectious illness; however, little is known about how these behaviors differ by demographic characteristics. Populations with higher perceived risks of illness are more likely to adopt protective health behaviors.ObjectiveWe investigated differences in temperature-taking frequency and the proportion of readings that were feverish among demographic groups (age, gender, urban/rural status) over influenza offseason; influenza season; and waves 1, 2, and 3 of the COVID-19 pandemic.MethodsUsing data from smart thermometers collected from May 1, 2019, to February 28, 2021, across the United States, we calculated the frequency of temperature-taking and the proportion of temperature readings that were feverish. Mixed-effects negative binomial and mixed-effects logistic regression analyses were performed to identify demographic characteristics associated with temperature-taking frequency and the proportion of feverish readings, respectively. Separate models were fit over five study periods: influenza offseason (n=122,480), influenza season (n=174,191), wave 1 of COVID-19 (n=350,385), wave 2 (n=366,489), and wave 3 (n=391,578).ResultsBoth temperature-taking frequency and the proportion of feverish readings differed by study period (ANOVA P<.001) and were the highest during influenza season. During all periods, children aged 2-5 years and 6-11 years had significantly higher frequencies of temperature-taking than users aged 19-30 years, and children had the highest proportion of feverish readings of all age groups, after adjusting for covariates. During wave 1 of COVID-19, users over the age of 60 years had 1.79 times (95% CI 1.76-1.83) the rate of temperature-taking as users aged 19-30 years and 74% lower odds (95% CI 72%-75%) of a reading being feverish. Across all periods, men had significantly lower temperature-taking frequency and significantly higher odds of having a feverish reading compared to women. Users living in urban areas had significantly higher frequencies of temperature-taking than rural users during all periods, except wave 2 of COVID-19, and urban users had higher odds of a reading being feverish in all study periods except wave 1 of COVID-19.ConclusionsTemperature-taking behavior and the proportion of readings that were feverish are associated with both population disease levels and individual demographic characteristics. Differences in the health behavior of temperature-taking may reflect changes in both perceived and actual illness risk. Specifically, older adults may have experienced an increase in perceived risk during the first three waves of COVID-19, leading to increased rates of temperature monitoring, even when their odds of fever were lower than those of younger adults. Men’s perceived risk of circulating infectious illnesses such as influenza and COVID-19 may be lower than that of women, since men took their temperature less frequently and each temperature had a higher odds of being feverish across all study periods. Infectious disease surveillance should recognize and incorporate how behavior impacts illness monitoring and testing.

Actions Speak Louder Than Words: Health Behaviours and the Literacy of Future Healthcare Professionals.

Our everyday behaviours in life can positively and negatively impact our health, thus cumulatively shaping our lifestyles as more or less healthy. These behaviours are often determined by our knowledge, literacy, motivations and socioeconomic backgrounds. The authors aimed to assess health behaviours and explore variables that may affect persons studying to become future healthcare professionals in Poland. This study was conducted with a group of 275 undergraduate students attending the Poznan University of Medical Sciences representing six different majors of study. We used self-reported, cross-sectional survey conducted through the use of a questionnaire that consisted of one standardised scale (Juczyński’s Health Behaviour Inventory) as well as a self-developed health literacy measure. The students showed average to high levels of health-promoting behaviours (mean HBI = 82.04 ± 11.26). Medium to strong associations were found between these behaviours and high scores on the health literacy scale (p = 0.001, r = 0.45 between total scores of the two scales). Dietetics students and female respondents scored significantly better on both scales, which suggests that their self-reported behaviours and health literacy were higher than those of other participants. Exhibiting health-protective behaviours and high health literacy is likely to result in the better individual health of our respondents, but, more importantly, will also influence their future professions. As members of the healthcare workforce they will be responsible for the health of the population and it is crucial for them not only to provide care, education, and guidance, but also to act as role-models for their patients and society.

Passengers' self-protective intentions while using ride-hailing services during the COVID-19 pandemic

In the transport context, there has been limited research examining passengers' health-protective behaviour while travelling during a health-related crisis such as COVID-19. This study develops a conceptual model aiming to explore determinants associated with passengers' self-protective intentions using the context of ride-hailing services in Vietnam. Ride-hailing services are popular in countries where public transport is underdeveloped. The conceptual model is based on perceived risk and self-efficacy as the main predictor of self-protective intentions when using ride-hailing services. In addition, the proposed conceptual model explores the direct and indirect impact of subjective knowledge and the perceived effectiveness of preventive measures on self-protective intentions. The proposed conceptual model was tested on a large sample of ride-hailing users in Vietnam (n = 527). The structural equation modelling (SEM) analysis results indicate that self-efficacy has the highest total impact on self-protective behaviour, followed by subject knowledge and perceived effectiveness of preventive measures. Self-efficacy also plays a fully mediating role in the linkage between the perceived effectiveness of preventive measures implemented by ride-hailing organisations and the intention to engage in self-protective behaviour. The results of this study expand the current understanding of ride-hailing passengers' health-protective behaviour and contribute to the transport and public health literature.

Predictors of Health-Protective and Helping Behaviors during the Covid-19 Pandemic: The Role of Social Support and Resilience.

The COVID -19 pandemic dramatically affected people's lives. In this study, we explored the role of social and personal factors underlying individuals' adaptive responses during the critical onset period of the outbreak. In particular, we tested two models on the mediating role of health-protective behaviors in the relationship between social support, resilience, and helping behavior. A sample of 1085 participants from Portugal and Brazil took part in an online survey during the first wave of the pandemic. First, through an Exploratory Factor Analysis of the health-protective behaviors to prevent contagion by the coronavirus, we identified two distinct dimensions, one aggregating active protective behaviors and the other as avoidant behaviors. Secondly, we found that resilience and active protective behavior sequentially mediated the relationship between social support and willingness to help. In addition, a multigroup analysis showed that this mediational process was similar in both countries. Given the wide range of social and individual factors that may predict prosocial behaviors, we highlight the role of social support on the intention to help through resilience and active protective behaviors.

Make the invisible visible: Valuation of the hidden cost of particulate-filtering facemask use against air pollution in China

The use of articulate-filtering facemasks (hereinafter referred to as facemasks) as a defensive measure to reduce air pollution exposure has not been adopted by the Chinese public. Our descriptive investigation reveals hidden barriers other than facemask expenditure that determine the choice to use facemasks. Whether discomfort or inconvenience are the major sources of inaction is largely unknown. By conducting a choice experiment, we observed how people made trade-offs between the costs and health benefits of facemask use in monetary terms, defined as willingness to pay (WTP). The results first demonstrated that discomfort and inconvenience majorly account for the inaction of facemask use, as they are, on average, valuated 6.94 and 24.00 times the facemask expenditures for year 2017 and 2022, respectively. Second, we estimated the threshold of lung cancer mortality above which the cost of facemask use weighs less than the health benefits, which implies a trigger point of health protection behavior. Third, we predicted, in the contexts of air pollution in 2017 and 2021 at the city level, that people refused to wear facemasks if they perceived lung cancer mortality as the one presented in current scientific assessments. We suggested the need to study the subjective reality of public defensive measures if the objectives of air quality and, more generally, environmental management are to be achieved.

Development of occupational health culture scale: A study based on miners and construction workers.

Culture is an essential influence on effectiveness of workplace health promotion, which can promote occupational health protection behavior. The aim of this research was to develop and validate an occupational health culture scale available to Chinese workers. Occupational health culture scale (OHCS) was developed based on elements of health culture and safety culture in workplace. Nine techniques steps of scale development were used, including a 15-member expert group, 10 workers for cognitive interview, and 1,119 questionnaires (from 710 miners and 409 construction workers) for formal investigation. Welch's variance analysis, independent samples t-test, Kruskal–Wallis test, Spearman correlation analysis was employed, respectively, to verified nine hypotheses about impact relationship on OHCS score. After the analysis reliability and validity, the final scale consisted of 21 items in five domains: leadership support, co-workers support, values, policy and norms, employee involvement, physical environment. Moreover, respirable dust concentration from individual sampler had the largest negative correlation coefficient on OHCS score, −0.469 (p < 0.01). The development of an occupational health culture among Chinese workers is necessary for the sustainability of human resources and the implementation of corporate responsibility.

Saliva testing among teachers during the COVID-19 pandemic: Effects on health concerns, well-being, and precautionary behavior

RationaleAt the start of 2021, several SARS-CoV-2 cluster outbreaks in schools threatened in-person education and created a fairly chaotic and frightening environment for school personnel. To keep the schools open while preventing COVID-19 outbreaks, intensive diagnostic testing in teachers and school personnel was strongly recommended but missing at the time. ObjectivesA project was launched in Belgian schools to weekly analyze the morning saliva of school personnel using PCR-testing to detect and prevent COVID-19 positive cases. In this quasi-experimental study, we aimed to examine whether the implementation of this saliva testing project impacted school personnel's pandemic-related health concerns, well-being, and adherence to the health-protective measures, contrasting experimental with control schools. MethodsThe data were collected during the third wave (Alpha-wave, February–March 2021) of the pandemic. The sample consisted of 435 participants from 34 different schools across Flanders (Belgium) (78.8% female; M age = 43.87 years, range = 21–67) of which 82% participated in the weekly saliva tests (i.e., experimental group) and 18% took part in the control group. ResultsResults from a series of linear mixed regression models showed that saliva testing buffered against an increase in health concerns among tested school personnel but did not affect participants' general well-being. Slight declines in adherence to the health-protective behaviors were observed, yet this was only the case for participants who felt less supported by their school principal. High degrees of principals' support also fostered the sharpest decreases in school staff's pandemic-related health concerns. ConclusionsWhen keeping the schools open in unstable pandemic times, weekly saliva testing is a promising strategy to prevent cluster outbreaks while simultaneously safeguarding health concerns among school personnel. School principals appear to play a critical role in the implementation of saliva testing to secure positive effects.

Risk perception, but also political orientation, modulate behavioral response to COVID-19: A randomized survey experiment.

Prior work has shown that accurately perceiving the risk for COVID-19 is associated with higher adherence to protective health behaviors, like face mask use, and more acceptance of governmental restrictive measures such as partial or complete banning of indoor activities and social gatherings. In this study we explored these associations at the beginning of the second wave of COVID-19 in Argentina through a national representative probabilistic survey that evaluated personal and contextual risk perception, self-reported compliance with protective health behaviors, attitude to governmental restrictive measures, and political orientation and psychological distress as potential modulators. Also, going beyond measures of association, here we sought to test whether messages highlighting potential risks increased acceptance of restrictive measures. Three types of messages were randomized to the participants. Two messages conveyed risk-related content (either through emotional arousal or cognitive appraisal) and the third a prosocial, altruistic content. Between March 29th and 30th, 2021, 2,894 participants were recruited (57.57% female). 74.64% of those surveyed evaluated the current health situation as “quite serious” or “very serious” and 62.03% estimated that the situation will be “worse” or “much worse” in the following 3 months. The perception of personal risk and the level of adherence to protective behaviors gradually increased with age. Through a regression model, age, perceived personal risk, and contextual risk appraisal were the variables most significantly associated with protective behaviors. In the case of the acceptance of restrictive measures, political orientation was the most associated variable. We then found messages aimed at increasing risk perception (both emotionally or cognitively focused) had a significantly greater effect on increasing the acceptance of restrictive measures than the prosocial message, mainly for government supporters but also for non-supporters. However, the level of response was also modulated by the political orientation of the participants. We propose a mechanism of “ideological anchoring” to explain that participants were responsive to risk modulation, but within the limits established by their pre-existent political views. We conclude that messages highlighting risk can help reinforce the acceptance of restrictive measures even in the presence of polarized views, but must be calibrated by age and political orientation.

The Impact of Positivity and Parochial Altruism on Protective Behaviours during the First COVID-19 Lockdown in Italy.

Implementation of COVID-19 protective behaviours, such as social distancing or frequent hand washing during the lockdown, was critical to prevent the spread of the COVID-19 pandemic. In this cross-sectional study, we examined the effect of positivity and parochial altruism on implementing COVID-19 health-protective behaviours during the Italian lockdown. A sample of 460 participants completed an online questionnaire that included demographic measures, Positivity Scale and COVID-19 measures of health-protective behaviours. To measure parochial altruism, we used a hypothetical dictator game played with others who could vary in their social distance from the participants. Results showed that participants in the hypothetical game gave more money to parents and siblings than to best friends, cousins, neighbours, and strangers. Furthermore, both positivity and parochial altruism (more altruism toward close vs. distant people) were positively associated with implementing hygiene behaviours but not with social distancing. Finally, mediation analysis showed that increases in parochial altruism mediated the effect of positivity on hygiene behaviour. These findings extend knowledge about the factors beyond the implementation of COVID-19 health-protective behaviours during a lockdown situation.