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Perceived Risk of COVID-19 Pandemic: The Role of Public Worry and Trust

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Electronic Journal of General Medicine
2020, 17(4), em203
e-ISSN: 2516-3507 Letter to the Editor OPEN ACCESS
Perceived Risk of COVID-19 Pandemic: The Role of Public Worry and
Mohsen Khosravi 1*
1 Department of Psychiatry and Clinical Psychology, Baharan Psychiatric Hospital, Zahedan, Sistan and Baluchistan, IRAN
*Corresponding Author:
Citation: Khosravi M. Perceived Risk of COVID-19 Pandemic: The Role of Public Worry and Trust. Electron J Gen Med. 2020;17(4):em203.
Received: 23 Mar. 2020
Accepted: 26 Mar. 2020
In late December 2019, an outbreak of the novel
coronavirus disease (COVID-19) was started in Wuhan, China,
and quickly reached the other countries of the world (1). In
comparison with the other members of coronaviruses family
such as SARS-CoV and MERS-CoV, COVID-19 appears to have a
lower fatality rate (virulence). However, the high transmission
rate of this virus, as well as the lack of vaccines and certain
pharmaceutical treatments for COVID-19 have posed serious
challenges to the control of the disease spread (1-3). To tackle
such problems, it is necessary to implement non-medical
measures such as the promotion of personal protection
practices (e.g. use of face masks and following personal
hygiene), imposing travel restrictions, and maintaining social
distance from possibly infected cases. To achieve the
successful implementation of such measures recommend by
public health authorities, the willingness of the public plays an
important and decisive role. However, it is still a health
problem to encourage the public to unconditionally follow
these recommended preventive actions. Peoples risk
perception of pandemic is one of the factors contributing to an
increase in public participation in adopting preventive
measures (4-6). According to the Protection Motivation Theory
(PMT), the intention of the general public to adopt protective
measures is significantly influenced by high levels of perceived
risk. The theory posits that public perception of the severity
and vulnerability to a certain health threat determines their
risk perception about a disease (7). Therefore, during a new
pandemic, getting information from various sources, such as
public health professionals, the government, and the media,
can increase peoples awareness about the risk, and
consequently, their adoption of preventive measures (4).
However, several factors might affect the subjects' perception
of their actual risk for disease. This discussion aims to
investigate the role of public worry and trust in the perceived
risk of the COVID-19 pandemic.
The worry over getting a disease can influence the
perceived risk of a pandemic. It is an affective emotional
response to a threat, which can predict protective behaviors
independent of the risk severity. In other words, worrying is a
predictor for the individuals behaviors when facing a threat.
Various factors, including socio-demographic characteristics,
social context, and individual values can affect worry about a
pandemic (8,9). Based on recent studies, being older, female,
more educated, and non-white are associated with a higher
chance of adopting the protective behaviors (10). Note that the
worry over a threat doesnt occur in a vacuum; rather under a
circumstance where individuals might be quickly influenced by
the emotional reactions of others. This reveals a strong
correlation between perceiving the anxieties of family and
friends, and personal concern (8). In any stage of a pandemic,
practitioners must be aware of the rumors going around and
the potential risk of emotional contagionamong populations
(8,11). Also, the social context may affect the experienced
levels of worry. For instance, the low-income class is more
concerned with issues such as the equal and fair distribution of
health services. Thus, during a pandemic, such class may
experience emotional responses to health risks, more risk
perceptions, increased negative emotions expressions such as
anger or fear, and huge challenges to the risk reduction (9).
Another factor affecting public worry includes conservation
values such as security, conformity, and tradition. Individuals
who emphasize conservation values would carefully put
preventive measures into practice. Whereas people with the
opposite values (e.g. high self-direction, stimulation, and
hedonism based on Schwartzs model) pay less attention to the
desirable behavior (8).
One more factor that contributes to shaping an accurate
risk perception of disease is trust. According to the Trust and
Confidence Model, trust plays an important part in managing a
threat by affecting the publics judgments about the risks and
the related benefits. It can indirectly impact the adoption of the
recommended measures. Trust is believed as the main core of
hearing, interpreting, and responding to public health
messages. This has resulted in a growing dependency of the
effective risk and crisis communication on the method of
receiving information and the level of trust in the government
during the pandemic period. Therefore, governments must
provide complete information about the pandemic to maintain
2 / 2 Khosravi / ELECTRON J GEN MED, 2020;17(4):em203
public trust, even when the information is very limited.
Governments must never downplay the reality of risk and
vulnerabilities to reduce public fears and worries. Besides,
contradictory information maintains by the government can be
associated with reduced public trust. Recent studies found that
in a pandemic, governments must consider that healthcare
workers and municipal health services are among the most
trusted information sources during the process of providing
information. The media has the lowest trust position in such an
event (4,12).
Since major coronavirus outbreaks often occur in waves,
surviving the first wave may be accompanied by a misleading
sense of immunity. Moreover, worrying about the infection
may change rapidly during the course of a disease. For
instance, due to peoples concern about a specific behavior
(e.g. vaccination), they may be encouraged to examine that
behavior. However, this behavioral action would reduce the
levels of worry in later stages. Such a case, therefore, can lead
to apparently conflicting worrybehavior correlations(8).
The results show that public initial emotional concerns and
trust can play an essential role in improving the perceived risk
of a pandemic and increasing public participation in adopting
preventive measures. Therefore, practitioners can utilize and
develop these models of responding to a pandemic when
facing newly emergent threats.
1. Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al.
Pathological findings of COVID-19 associated with acute
respiratory distress syndrome. Lancet Respir Med. 2020. PMID:
2. Lai CC, Shih TP, Ko WC, Tang HJ, Hsueh PR. Severe acute
respiratory syndrome coronavirus 2 (SARS-CoV-2) and
corona virus disease-2019 (COVID-19): the epidemic and
the challenges. Int J Antimicrob Agents. 2020;55(3):105924. PMID:
3. Abdulamir AS, Hafidh RR. The Possible Immunological
Pathways for the Variable Immunopathogenesis of COVID
19 Infections among Healthy Adults, Elderly and Children.
Electron J Gen Med. 2020;17(4):em202.
4. van der Weerd W, Timmermans DR, Beaujean DJ, Oudhoff
J, van Steenbergen JE. Monitoring the level of government
trust, risk perception and intention of the general public to
adopt protective measures during the influenza A (H1N1)
pandemic in the Netherlands. BMC public health.
PMID: 32081636 PMCID: PMC3152536
5. Cowling BJ, Ng DM, Ip DK, Liao Q, Lam WW, Wu JT, et al.
Community psychological and behavioral responses
through the first wave of the 2009 influenza A (H1N1)
pandemic in Hong Kong. J Infect Dis. 2010;202(6):867-76. PMID: 20677945
6. Ibuka Y, Chapman GB, Meyers LA, Li M, Galvani AP. The
dynamics of risk perceptions and precautionary behavior in
response to 2009 (H1N1) pandemic influenza. BMC Infect
Dis. 2010;10:296.
296 PMID: 20946662 PMCID: PMC2964717
7. Rogers RW. A protection motivation theory of fear appeals
and attitude change1. J Psychol. 1975;91(1):93-114. PMID:
8. Goodwin R, Gaines SO, Myers L, Neto F. Initial psychological
responses to swine flu. Int J Behav Med. 2011;18(2):88-92. PMID:
20195809 PMCID: PMC7090401
9. Vaughan E, Tinker T. Effective health risk communication
about pandemic influenza for vulnerable populations. Am
J Public Health. 2009;99(S2):S324-32.
10.2105/AJPH.2009.162537 PMID: 19797744 PMCID:
10. Bish A, Michie S. Demographic and attitudinal
determinants of protective behaviours during a pandemic:
a review. Br J Health Psychol. 2010;15(4):797-824. PMID:
11. Goodwin R, Haque S, Neto F, Myers LB. Initial psychological
responses to Influenza A, H1N1 (Swine flu). BMC Infect
Dis. 2009;9(1):166.
166 PMID: 19807908 PMCID: PMC2765446
12. Siegrist M, Zingg A. The role of public trust during
pandemics. Eur Psychol. 2014;19(1):23-32.
... Exposure to the mass media for risk information may either amplify or attenuate the perception of susceptibility and severity towards health crises (Erubami, Bebenimbo & Ugwuoke, 2021), and media deployment of certain communication frames and valence tends to influence how the public understands the salience of risk perception (Paek & Hove, 2017). Essentially, a repeated media coverage of a risky situation increases the extent of perceived severity among the public (Yiwei, 2018;Khosravi, 2020). For instance, a study of women in Nepal's rural communities' showed that mothers exposed to mass media campaigns tended to, on average, have a greater risk perception towards antenatal care services and were more likely to attend antenatal visits, take adequate rest, sleep during pregnancy and receive Tetanus Toxoid Immunisation than their non-exposed counterparts (Charya et al., 2015). ...
... This is consistent with previous studies which found that receiving public health information from mass media outlets can influence the extent of perceived risk towards public health crises (Charya et al., 2015;Wu & Li, 2017;Erubami, 2022). Usually, the media deploy certain frames and valences in the design of health messages (Paek & Hove, 2017;Erubami, Oziwele, Ohaja, Ezugwu & Anorue, 2021), and by repeatedly covering emerging public health crises, media messages tend to significantly influence public's construction of risk (Khosravi, 2020;Ben-Enukora et al., 2020). ...
... It is likely that this low perceived risk among people in Lassa fever infected communities may have encouraged their engagement in behaviours that predispose them to the disease and ultimately increase their level of vulnerability to the ailment. Previous studies have shown that women tend to perceive significantly greater risk than men when exposed to the same risky situations (Choi et al., 2017;Yiwei, 2018;Khosravi, 2020;Broche-Pérez et al., 2020); therefore, their higher tendency to avoid risk practices given that perceived risks tend to be negatively associated with risk behaviours (Charya et al., 2015;Renner et al., 2015;Al-Metwali et al., 2021;Oyeoku et al., 2021). Other studies have also shown significant geographical variations in individuals' risk perception and engagement in risk behaviours. ...
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Nigeria bears the highest burden of Lassa fever in Africa, accounting for about 60% of the 5,000 annual mortalities attributable to the haemorrhagic disease. In the absence of preventive vaccines, the mass media have been deployed as independent and complementary interventions against the spread of the infection. This study examines the influence of mass media exposure on Lassa fever risk perception and risk behaviours among residents of eight rural communities in South-south Nigeria. Anchored on the Health Belief Model and Social Influence Theory, the study used survey questionnaires to collect data from 384 respondents selected through multistage sampling. Findings show that media exposure is positively related to Lassa fever risk perception (β = .519, 95% CI: .432, .607), but negatively associated with risk behaviours towards the zoonotic disease (β =-.797, 95% CI:-.922,-.671). Nevertheless, media influence on respondents' risk perception and risk behaviours tends to vary significantly along sex, geographical region and employment status. Given the endemic nature of Lassa fever in Nigeria, the study recommends the sustenance of public sensitisation efforts aimed at preventing the spread of the disease, especially in rural areas. It also advocates the need for relevant health authorities to enforce healthier public environmental practices and initiate mastomys eradication programmes to reduce the presence of rats in residential areas.
... Since the first days of the epidemic, the lack of effective medical treatment and vaccination has revealed the importance of behavioral measures all over the world (Khosravi, 2020). Some of these measures are: hand hygiene, wearing a facemask, social distancing, not leaving home unless it is essential (Kwok et al., 2020). ...
... These behavioral measures are considered critical for Public Health Emergency Preparedness (PHEP) especially during the epidemic . The role of the public is considered vital in the effective implementation of PHEP (Khosravi, 2020). Past outbreaks have shown that correct and decisive public participation in preventive measures has reduced the spread of the epidemic and facilitated the efforts to contain it (Dryhurst et al., 2020). ...
... Within the scope of the theoretical framework mentioned above, we focused on the relationship between the belief and perception-based protection motivators and the precautionary behaviors of individuals, which are known to be particularly effective in containing COVID-19 pandemic (Bashirian et al., 2020;Costa, 2020;Hotle et al., 2020;Khosravi, 2020). Coherent with their level of necessity and dispensability in life, we examined precautionary behaviors in two titles as routine (e.g. ...
In this research, we investigated the protection motivators and precautionary behaviors against coronavirus disease 2019 (COVID-19) and the associations between them. To do this, we developed two original scales, collected data (2783 responses) using an online survey, after removing the responses (319), which were filled in incompletely or incorrectly in the questionnaire, we obtained 2464 participants covering the aged 18+ population in Turkey. Based on random sampling, our sample complies with these ratios and generally reflects the aged 18+ population of Turkey. We confirmed the psychometrical validity and reliability of our two scales using the collected data. Herewith, we found that perceived susceptibility of COVID-19 infection is very high, perceived severity of COVID-19 is medium, COVID-19 related information seeking is high, beliefs on precautions’ efficacy is high and also the practice of precautionary behaviors is high. Our research depicts that all protection motivators significantly are related with the practice of precautionary behaviors (routine and leisure). However, with the only exception of perceived severity of COVID-19 is not related with precautionary behaviors (routine). Besides, we saw that females’ average in all variables is significantly higher than males and some variables are sensitive to age, education level, marital status and the number of children. We believe that the findings provide essential inputs for authorities in establishing public health policies against the present pandemic and likely ones in the future.
... If the total score is less than or equal to 15, it indicates that there is no depression. Depression may be judged when the score is [16][17][18][19]. If the total score is greater than or equal to 20, it indicates that there is depression. ...
... Some studies have reached similar conclusions. They found that women tend to take defensive actions when coronavirus disease occurs in 2019 (18,19), so they are more willing to follow prevention and control recommendations, such as wearing masks and avoiding going to public places (20). This survey shows that the severity of urban pandemic affects pandemic evaluation, but did not affect pandemic panic and pandemic defense, and had no significant difference in depression. ...
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ObjectIn this study, we aimed to explore the influences of stress responses and psychological resilience on depression of vocational middle school students during the initial COVID-19 outbreak in China.Methods An online questionnaire survey on the students of a medical school in Jiangxi Province, China, and obtained 3,532 valid questionnaires. A self-compiled general situation questionnaire, Stress Response of COVID-19 Questionnaire, the Resilience Scale for Chinese Adolescents and Center for Epidemiological Studies Depression Scale (CES-D) were used. Hierarchical regression analysis was used to explore the regulatory role of psychological resilience between stress response and depression.Results(1) There were significant differences in gender between vocational middle school students' evaluation (t = 3.07, P = 0.002) and defense (t = 3.28, P = 0.001) of the pandemic. Males had higher cognitive evaluation of the pandemic than females, and females had more defense against the pandemic than males. (2) There is a significant difference between vocational middle school students from different grades in depression level (F = 3.62, P = 0.03), pneumonia defense (F = 13.65, P < 0.001) and pneumonia panic (F = 3.10, P = 0.045). (3) Depression level (F = 7.17, P < 0.001), pneumonia evaluation (F = 2.78, P = 0.04) and pneumonia panic (F = 3.32, P = 0.02) of the students concerning the spatial distance of the pandemic. (4) The severity of urban pandemic affects the evaluation of pneumonia among vocational middle school students. (5) Depression was negatively correlated with psychological resilience and pneumonia evaluation, and positively correlated with pneumonia panic. Psychological resilience was positively correlated with pneumonia evaluation and pneumonia defense, and negatively correlated with pneumonia panic. (6) Psychological resilience could reduce the level of depression caused by pneumonia evaluation and pneumonia panic.Conclusion There were significant differences in depression level and stress responses in grades, gender and spatial distance of pandemic. Resilience has a significant negative moderator effect on the relationship between pandemic panic and depression. Resilience has a significant positive moderator effect on the relationship between pandemic evaluation and depression.
... From the Protection-Motivation Theory (PMT) perspective, adopting a protective behavior against health threats such as the COVID-19 crisis is dependent on personal motivation for self-protection [23]. Consequently, individuals are more likely to safeguard themselves following the perceptions of severity, vulnerability, and self-efficacy linked to upcoming threat events [23][24][25][26]. According to the PMT, fear is appraised to predict and encourage protective behaviors and explain the cognitive processes involved in threat and coping appraisals. ...
... According to the PMT, fear is appraised to predict and encourage protective behaviors and explain the cognitive processes involved in threat and coping appraisals. COVID-19 pandemic risk or threat and coping appraisals can lead to adaptive and maladaptive responses from teachers, which are considered a threat to their health [23][24][25][26][27][28][29]. Thus, individual teachers evaluate the costs and benefits of preventive actions (e.g., cognitive-behavioral coping) according to perceived risk during pandemics such as COVID-19 [15,20,[27][28][29]. ...
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Previous research has established the link between COVID-19 risk perception and the coping behaviors of teachers in different countries. However, these studies have revealed inconsistent result patterns. Moreover, little is known about the role of COVID-19 knowledge in the link between risk perception and the coping strategies of teachers. This study, therefore, examines the relationship between COVID-19 risk perception and the coping behaviors of teachers, as well as the moderating effect of COVID-19 knowledge in this link. Through the convenience sampling technique, a cross-sectional sample of 376 teachers was recruited to respond to a questionnaire. Correlation and multiple regression analyses were used in analyzing the data. It was revealed that COVID-19 risk perception was positively correlated with active coping strategy and negatively associated with emotional support. Further, results showed that with the a high level of COVID-19 risk perception, teachers with a high level of knowledge are less likely to adopt emotional support coping. In contrast, teachers with low knowledge levels will exhibit a higher probability of adopting emotional support coping. The study projects the need for enhancing the knowledge of teachers while conscientizing them on the risky nature of COVID-19 through health education and promotion.
... COVID-19 is an important source of traumatic stress because it causes problems such as life-threatening, economic depression, uncertainty, the possibility of contagion to their families, fear of death, and desperation. Although anxiety is a normal human reaction to a threatening and uncertain situation beyond the control of individuals, it can hinder the recovery of individuals and strain their psychological health, especially when anxiety persists for a long time (Khosravi, 2020). This stress experienced during the COVID-19 process can lead to the emergence of ruminative symptoms in individuals. ...
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The aim of this study is to adapt the COVID-19 Rumination Scale to Turkish and to examine whether the level of COVID-19 rumination differs according to demographic variables and burnout levels. There were 835 participants in the study. The findings revealed that the adapted scale is a valid and reliable tool. In addition, it has been found that COVID-19 rumination is significantly higher in women, those who have lost income and lost acquaintances/relatives (human), those who have active COVID-19 patients from their acquaintances/relatives, and those with high burnout levels. The results of this research are important in terms of revealing the target group for intervention or preventive studies to reduce rumination related to COVID-19. In addition, considering that rumination related to COVID-19 is higher in people with high levels of burnout, it is thought that interventions to reduce rumination may also help reduce burnout.
... Generally, emotional influence on people's overall response to public health-related challenges could take either positive or negative dimensions. For instance, the fear of risky situations may either serve as a trigger for recommended preventive health behaviour during infectious diseases outbreak (Harper et al., 2021;Khosravi, 2020) or undermine people's cognitive abilities to rationally conceive health risks and engage in preventive behaviour (Broche-Pé rez et al., 2020;Erubami et al., 2021). For instance, there is a common fear that the COVID-19 vaccines development timeline was abridged and the products did not undergo thorough testing before approval, thereby breeding a considerable degree of distrust and low confidence in the safety and efficacy of the vaccines (Fadhel, 2021;Zizzo, 2020). ...
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There have been sustained global efforts to promote the uptake of COVID-19 vaccines, yet studies suggest the upsurge of vaccine resistance around the world. Considering the wide adoption of social media as crucial sources of health information, the nature of popular online debates on vaccination initiatives can significantly sway people's vaccine-related decisions. This study develops a structural equation model for the predictors of COVID-19 vaccine uptake among Nigerian social media users. Using an online survey of 436 respondents, the study fundamentally extends the constructs of the Health Belief Model by examining the unique roles of social media exposure, fear, and anticipated regret in the prediction of individuals' vaccination decisions. We found that perceived susceptibility to and perceived severity of vaccination risk, perceived barriers to vaccination, exposure to vaccine-critical posts on social media, fear of vaccination risk, and anticipated regret for vaccine uptake significantly predicted COVID-19 vaccine uptake. However, the perceived benefits of COVID-19 vaccine uptake and anticipated regret for inaction related to vaccination did not predict COVID-19 vaccine-related decisions. The findings accentuate why stakeholders in the public health sector should pay adequate attention to social media-related trends on public health promotion schemes, and counter any detected falsehood with credible information.
... Still, risk perception and behavioral responses are different among different regions. [3][4][5][6][7][8][9][10][11][12][13][14][15][16] Different types of vaccines have been distributed to different continents including Africa, but the utilization rate has remained low as compared to different targets set by the World Health Organization and regional health institutes. [17][18][19][20] Countries in Africa including Ethiopia have the lowest vaccinated population in the world. ...
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Background: Ethiopia was using the ChAdOx1 COV-19 vaccine, and health professionals were targets of the first phase of the vaccination strategy. Evidence on the adverse events following immunization (AEFI) was barely available. The study aimed to assess the magnitude and associated factors of adverse events following ChAdOx1 COV-19 immunization among health professionals of the University of Gondar Specialized and Comprehensive Hospital, 2021. Methods: An institution-based cross-sectional study was conducted among health professionals of the University of Gondar Comprehensive and specialized referral hospital. All health professionals who took the ChAdOx1 COV-19 vaccine in the 1st phase were surveyed. A total of 314 health professionals who took the ChAdOx1 COV-19 vaccine were included. The EpiData version and Stata 16 were used for data entry and analysis, respectively. A binary logistic regression was used to identify statistically significant factors associated with AEFI. Chi-square and multicollinearity assumptions were tested. A p-value <0.2 and 0.05 were used as cut-off values of significance in the bi- and multivariable logistic regression models, respectively. An adjusted odds ratio (AOR) with 95% CI was reported for statistically significant variables. Results: Among 314 study participants, 263 of them had at least one mild to severe AEFI of ChAdOx1 COV-19 with a prevalence of AEFI of 83.76% (95% CI: 79.23, 87.46). The commonest AEFI observed were injection site tenderness (n=198/263), fatigue (114/263), headache (n=107/263), and muscle pain (n=85/263). Females (AOR=2.75, 95% CI: 1.15, 6.58), and participants who felt the vaccine was unsafe (AOR=2.84, 95% CI: 1.03, 7.85) were having nearly three times more odds of AEFI immunization as compared to males and those who felt the vaccine was safe, respectively. Conclusion: Adverse event following immunization has been a public health problem in Northwest Ethiopia. Being female and having a feeling that the vaccine is unsafe were statistically significantly associated with AEFI.
This study aimed to identify the factors influencing tourists’ travel intention following the COVID-19 vaccination program. It also examined the mediating role of fear in the context of the threat severity, vulnerability, and protection motivation pathways. Based on a quantitative method, a cross-sectional survey was employed and data were collected from 320 prospective domestic tourists through an online survey in Malaysia during the COVID-19 vaccination period. The researchers primarily adopted the protection motivation theory (PMT) model for developing a conceptual framework to empirically test the structural equation modeling (SEM) analysis technique using AMOS software. The study confirmed that protection motivation is positively related to tourists’ travel intention, trust is negatively related to this intention, and perceived risk is not related to this intention. The study concludes that threat severity, threat vulnerability, fear, response efficacy, response cost, and self-efficacy affect the protection motivation of tourists. The main contribution of this study is to develop a model and confirm it through an empirical study. The findings indicate that companies should consider some of the factors identified so they can influence protection motivation and travel intention. This study extended the PMT model by integrating cognitive constructs and newly developed measurement scales.
Objectives: The Arab ethnic minority makes up 21% of Israel's population and accounted for 40.5% of confirmed cases during the second wave of COVID-19. This study aims to assess the characteristics of compliance with the guidelines of the Ministry of Health and related factors that can explain the outbreak of COVID-19 among the Arab population during the second wave. Methods: A cross-sectional online survey was conducted among 810 respondents from the Arab community during October 2020. The survey was distributed via social media such as Facebook and WhatsApp. The health belief model items, the theory of reasoned action items, trust in formal institutions, and pandemic fatigue were assessed, and a path analysis was performed. Results: Positive correlations were demonstrated between both personal and social networks compliance (nuclear family, extended family, friends, etc.) and perceived severity of COVID-19, trust in formal institutions, attitudes toward compliance, and subjective norms (r = .12 to r = .64, p < .001, N = 810). Pandemic fatigue was negatively correlated with personal and social networks compliance, perceived severity of COVID-19, trust in institutions, attitudes toward compliance, and subjective norms (r = - .21 to r = - .48, p < .001). Positive correlations were evident between compliance with quarantine and perceived severity of COVID-19 and attitudes (r = .31 and r = .28, p < .001, respectively). Personal compliance was significantly lower among men (M = 3.93, SD = 0.94) and younger respondents (M = 4.14, SD = 0.71), while social networks compliance was lower among Muslims (M = 3.78, SD = 0.75). The negative relationship between pandemic fatigue and personal compliance was mediated by lower perceived severity of COVID-19, attitudes toward compliance, and subjective norms (p < .001). The negative relationship between pandemic fatigue and social network compliance was mediated by lower trust in institutions and subjective norms (p < .001). Lower perceived severity of COVID-19 mediated the relationship between higher pandemic fatigue and lower quarantine compliance (p = .003). Conclusions: The results highlight the important of perception of the disease severity, social and subjective norms, and the central role of trust in determining adherence to guidelines. Thus, increasing trust on authorities and planning tailored-maid interventions can raise compliance with the preventive guidelines and prevent the spread of the virus. Such interventions will address the characteristics of minority populations and take into account the implications of the guidelines and the possibility that may lead to fatigue, which in turn will lead to non-compliance with those guidelines.
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Novel Coronavirus, COVID-19 discovered in December, 2019 in Wuhan, China started a world-wide epidemic. It is not clear till now what is the pathogenesis of this virus infection in human or the exact strategies of host immune response in combating this novel threat to human beings. However, morbidity and mortality of COVID-19 infections vary widely from asymptomatic, mild to deadly critical. Strangely, children were found to be protected from severe or deadly critical infections, while elderly and immunocompromised adults are most affected badly by this virus. It is necessary to disclose the possible viral and host interactions that lead to such variable morbid effects among patients of COVID-19 infections.
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During the course of an influenza pandemic, governments know relatively little about the possibly changing influence of government trust, risk perception, and receipt of information on the public's intention to adopt protective measures or on the acceptance of vaccination. This study aims to identify and describe possible changes in and factors associated with public's intentions during the 2009 influenza A (H1N1) pandemic in the Netherlands. Sixteen cross-sectional telephone surveys were conducted (N = 8060) between April - November 2009. From these repeated measurements three consecutive periods were categorized based on crucial events during the influenza A (H1N1) pandemic. Time trends in government trust, risk perception, intention to adopt protective measures, and the acceptance of vaccination were analysed. Factors associated with an intention to adopt protective measures or vaccination were identified. Trust in the government was high, but decreased over time. During the course of the pandemic, perceived vulnerability and an intention to adopt protective measures increased. Trust and vulnerability were associated with an intention to adopt protective measures in general only during period one. Higher levels of intention to receive vaccination were associated with increased government trust, fear/worry, and perceived vulnerability. In periods two and three receipt of information was positively associated with an intention to adopt protective measures. Most respondents wanted to receive information about infection prevention from municipal health services, health care providers, and the media. The Dutch response to the H1N1 virus was relatively muted. Higher levels of trust in the government, fear/worry, and perceived vulnerability were all positively related to an intention to accept vaccination. Only fear/worry was positively linked to an intention to adopt protective measures during the entire pandemic. Risk and crisis communication by the government should focus on building and maintaining trust by providing information about preventing infection in close collaboration with municipal health services, health care providers, and the media.
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The trajectory of an infectious disease outbreak is affected by the behavior of individuals, and the behavior is often related to individuals' risk perception. We assessed temporal changes and geographical differences in risk perceptions and precautionary behaviors in response to H1N1 influenza. 1,290 US adults completed an online survey on risk perceptions, interests in pharmaceutical interventions (preventive intervention and curative intervention), and engagement in precautionary activities (information seeking activities and taking quarantine measures) in response to H1N1 influenza between April 28 and May 27 2009. Associations of risk perceptions and precautionary behaviors with respondents' sex, age, and household size were analyzed. Linear and quadratic time trends were assessed by regression analyses. Geographic differences in risk perception and precautionary behaviors were evaluated. Predictors of willingness to take pharmaceutical intervention were analyzed. Respondents from larger households reported stronger interest in taking medications and engaged in more precautionary activities, as would be normatively predicted. Perceived risk increased over time, whereas interest in pharmaceutical preventive interventions and the engagement in some precautionary activities decreased over time. Respondents who live in states with higher H1N1 incidence per population perceived a higher likelihood of influenza infection, but did not express greater interests in pharmaceutical interventions, nor did they engage in a higher degree of precautionary activities. Perceived likelihood of influenza infection, willingness to take medications and engagement in information seeking activities were higher for women than men. Perceived risk of infection and precautionary behavior can be dynamic in time, and differ by demographic characteristics and geographical locations. These patterns will likely influence the effectiveness of disease control measures.
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The emergence of influenza A ("swine flu") in early 2009 led to widespread public concern. However, little research has examined the factors that underlie initial worry about infection and subsequent behavioral responses to such worry. This study seeks to model some key predictors of worry and behavioral responses in the early stages of the swine flu pandemic (WHO pandemic stage 5). A cross-sectional internet questionnaire study (N = 186). Twenty-five percent of respondents rated themselves as worried about being a victim of swine flu, 40% that they were worried of a family member contracting the virus. Twenty percent had bought, or intended to buy, preparatory materials (e.g., face masks), 20% intended to delay or cancel air travel. In a structural equation model, conservation values and family or friends perception of risks predicted worry about infection, while worry correlated with the purchase of preparatory materials, a lesser willingness to travel by public transport, and difficulty in focusing on everyday activities. While previous research on pandemic risk perception has focused on cognitive risk judgments, our data suggests that initial "emotional" concerns about infection are also significant predictors of behavioral responses to pandemic threat. Such worry is likely to be influenced by a variety of individual factors, such as personal values, as well as normative pressures. Practitioners can use and expand on such models of pandemic response when tailoring health campaigns to meet newly emergent threats.
Emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, previously provisionally named 2019 novel coronavirus or 2019-nCoV) disease (COVID-19) in China at the end of 2019, has caused a large global outbreak and a major public health issue. As of February 11, 2020, data from the WHO has shown that more than 43,000 confirmed cases have been identified in 28 countries/regions, with more than 99% of the cases being detected in China. On January 30, 2020, WHO has declared COVID-19 as the sixth public health emergency of international concern. The SARS-CoV-2 is closely related to two bat-derived severe acute respiratory syndrome-like coronaviruses, bat-SL-CoVZC45 and bat-SL-CoVZXC21. It is spread by human-to-human transmission via droplets or direct contact, and infection has been estimated to have mean incubation period of 6.4 days and a basic reproduction number of 2.24-3.58. Among the patients with pneumonia caused by the SARS-CoV-2 (novel coronavirus pneumonia or Wuhan pneumonia), fever was the most common symptom, followed by cough. Bilateral lung involvement with ground glass opacity was the most common finding from computerized tomography images of the chest. Although the one case of SARS-CoV-2 pneumonia in the United States responding well to remdesivir, which is now undergoing a clinical trial in China. Currently, controlling infection to prevent the spread of the SARS-CoV-2 is the primary intervention being used. However, public health authorities should keep monitoring the situation closely, as the more we can learn about this novel virus and its associated outbreak, the better we can respond.
The present review examined the importance of trust when preparing for and during a pandemic. The reviewed literature suggests that trust in health agencies positively influenced people’s willingness to adopt recommended behavior. Most of these studies are atheoretical, and due to the lack of a common framework for trust and its antecedents, finding commonalities among the studies may seem difficult. The trust, confidence, and cooperation model was used to uncover the commonalities among the various studies on trust. This framework suggests that a distinction between values and past performance may be helpful to better understand the impact of trust on risk perception and behavior. Based on the reviewed literature, the following five recommendations relevant for crisis communication during pandemics were identified: A diverse set of experts should be used as communicators, medical personnel need to model the recommended behavior, a transparent information strategy should be used, the focus should be not only on trust but also on confidence, and establishing trust in health authorities before a pandemic occurs is important. Furthermore, research gaps were identified that should be addressed to better understand the role of trust when dealing with pandemics. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
Proposes a protection motivation theory that postulates the 3 crucial components of a fear appeal to be (a) the magnitude of noxiousness of a depicted event, (b) the probability of that event's occurrence, and (c) the efficacy of a protective response. Each of these communication variables initiates corresponding cognitive appraisal processes that mediate attitude change. The proposed conceptualization is a special case of a more comprehensive theoretical schema: expectancy-value theories. Several suggestions are offered for reinterpreting existing data, designing new types of empirical research, and making future studies more comparable. The principal advantages of protection motivation theory over the rival formulations of I. L. Janis and of H. Leventhal are discussed. (81 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Purpose: A new strain of H1N1 influenza, also known as swine flu was confirmed in the UK in May 2009 and has spread to over 100 countries around the world causing the World Health Organization to declare a global flu pandemic. The primary objectives of this review are to identify the key demographic and attitudinal determinants of three types of protective behaviour during a pandemic: preventive, avoidant, and management of illness behaviours, in order to describe conceptual frameworks in which to better understand these behaviours and to inform future communications and interventions in the current outbreak of swine flu and subsequent influenza pandemics. Methods: Web of Science and PubMed databases were searched for references to papers on severe acute respiratory syndrome, avian influenza/flu, H5N1, swine influenza/flu, H1N1, and pandemics. Forward searching of the identified references was also carried out. In addition, references were gleaned from an expert panel of the Behaviour and Communications sub-group of the UK Scientific Pandemic Influenza Advisory Group. Papers were included if they reported associations between demographic factors, attitudes, and a behavioural measure (reported, intended, or actual behaviour). Results: Twenty-six papers were identified that met the study inclusion criteria. The studies were of variable quality and most lacked an explicit theoretical framework. Most were cross-sectional in design and therefore not predictive over time. The research shows that there are demographic differences in behaviour: being older, female and more educated, or non-White, is associated with a higher chance of adopting the behaviours. There is evidence that greater levels of perceived susceptibility to and perceived severity of the diseases and greater belief in the effectiveness of recommended behaviours to protect against the disease are important predictors of behaviour. There is also evidence that greater levels of state anxiety and greater trust in authorities are associated with behaviour. Conclusions: The findings from this review can be broadly explained by theories of health behaviour. However, theoretically driven prospective studies are required to further clarify the relationship between demographic factors, attitudes, and behaviour. The findings suggest that intervention studies and communication strategies should focus on particular demographic groups and on raising levels of perceived threat of the pandemic disease and belief in the effectiveness of measures designed to protect against it.