Search Results (744)

Background/Objectives: Vaccine hesitancy is becoming an increasing concern, leading to preventable outbreaks of infectious diseases. During the COVID-19 pandemic, the United States served as an intriguing case study for exploring how risk perception and trust in health authorities, including scientists, are influenced by government policies and how these factors affect vaccine hesitancy. Methods: We conducted a secondary analysis using the MIT COVID-19 Survey dataset to investigate whether risk perception and trust differ between states governed by Democratic or Republican governors. Results: Our analysis (n = 6119) found that participants did not vary significantly by state political affiliation in terms of their sociodemographic factors (such as age, gender, self-rated health, education, and whether they live in a city, town, or rural area), their perceived risk for the community, or their ability to control whether they become infected. However, there was a difference in the perceived risk of infection, which was higher in states governed by Republicans. Trust also varied by gubernatorial affiliation, with higher levels of trust reported among residents of Democratic-leaning states. We also found a strong mediation effect of trust on vaccine hesitancy, but this was not the case for risk perception. Conclusion: Therefore, it appears that vaccine acceptance relies on trust in health authorities, which is influenced by governmental policies. State officials should work with local health officials to build trust and increase timely responses to public health crises. Full article

Objective: This study aims to investigate the feasibility of an online music therapy protocol for individuals previously diagnosed with COVID-19, focusing on their perceptions of their respiratory symptoms and the intervention’s impact on psychosocial measures. Methods: A within-subject experimental design was applied to examine an eight-week weekly online music therapy protocol, including singing, wind instrument playing, and music visualizations. All self-report data were collected bi-weekly throughout the 16-weeks study period, including baseline and post-tests. The measures for respiratory symptoms included the Medical Research Council’s Dyspnea Scale (MRC Dyspnea), Chronic Respiratory Questionnaire-Mastery Scores (CRQ Mastery), and Visual Analogue Scale for breathlessness. The measures for the secondary psychosocial outcomes were the Beck Depression Inventory-Short Form, the Generalized Anxiety Disorder 7-item, the Hospital Anxiety and Depression Scale, the Fatigue Severity Scale, the Epworth Sleepiness Scale, the EuroQol 5-Dimension 5-Level, and the Connor-Davidson Resilience Scale. Results: Twenty-four participants were enrolled. The participants perceived a reduction in respiratory symptoms, and shortness of breath (MRC Dyspnea). Planned comparisons showed significant decreases in MRC from baseline to post-treatment (p = 0.008). The mixed-effects model, including pre-baseline and post-treatment, was significant (p < 0.001). Significant changes in Breathing VAS were consistent with improvements in MRC Dyspnea, showing a significant baseline-to-post difference (p = 0.01). The CRQ Mastery showed significant improvements from baseline to Week 12 (p < 0.001). No significant changes were observed in other secondary measures. Conclusions: Our preliminary findings suggest that this protocol is feasible, and as a result, may help individuals previously diagnosed with COVID-19 to cope with lasting respiratory symptoms and improve their perception of shortness of breath. Live music-making, including playing accessible wind instruments and singing, may contribute to an increase sense of control over breathing. As this was a feasibility study, we conducted multiple uncorrected statistical comparisons to explore potential effects. While this approach may increase the risk of Type I error, the findings are intended to inform hypotheses for future confirmatory studies rather than to draw definitive conclusions. Full article

Background: Fear of childbirth (FOC) or tokophobia has a detrimental impact on women during and after pregnancy. Childbirth fear is multidimensional and may differ across nations and cultures. We aimed to determine the psychosocial determinants of tokophobia among Asians. Methods: We conducted a systematic literature search using the PubMed, Scopus, and Web of Science databases in September 2023. Included were original English-language articles that focused on Asian cohorts. We identified independent variables associated with maternal childbirth fear based on multivariable logistic and linear regression analysis. Results: Twenty-three studies are discussed in this review. We categorized the factors into (1) psychiatry, (2) psychology, (3) perception and experience, (4) relationships and support, (5) spirituality, and (6) COVID-19. The studies involved 10,538 women with overall FOC prevalence ranging between 56.6% to 82.1%. Maternal history of psychiatric disorder, depression, and anxiety were positive predictors of childbirth fear. Childbirth self-efficacy protects Asian mothers against tokophobia. A reduced level of fear was associated with higher maternal psychological and spiritual well-being, as well as stronger maternal resilience. Spousal and social support alongside good family function were shown to exert a protective effect against childbirth fear. Intimate partner abuse was associated with an increased risk of tokophobia in women. Studies during the pandemic indicated that maternal fear, obsession, and anxiety about COVID-19 were positively correlated to fear of childbirth. Conclusions: Childbirth fear among Asian women is greatly influenced by various psycho-social factors. More culturally driven research is needed to help develop relevant interventions that will enhance maternal psychological and spiritual well-being and reduce the fear of childbirth. Full article

Background: Psychological impacts of the coronavirus disease 2019 (COVID-19) pandemic on individuals with chronic medical conditions remain understudied. Chronic kidney disease (CKD) is one of the chronic conditions associated with an increased risk of severe COVID-19 outcomes. The aim of this study was to define the psychological burden of individuals with CKD during the COVID-19 pandemic. Methods: In this cross-sectional study, 219 individuals with CKD were recruited from the Nephrology Outpatient Unit at the University Hospital Essen, Germany, and completed anonymous surveys incorporating validated psychological assessment tools for generalized anxiety (GAD-7) and depressive symptoms (PHQ-2), along with self-generated items addressing COVID-19-specific concerns and behavioral changes. These participants were propensity score matched with controls from the general German population. Results: Individuals with CKD exhibited lower levels of generalized anxiety and depressive symptoms compared to the general population. However, they reported significantly greater risk perceptions regarding the likelihood of experiencing symptoms, a severe disease course, and death from COVID-19. COVID-19-related fear and associated behavioral changes were more frequently reported among CKD patients. Adherent and dysfunctional safety behaviors predominated among the CKD cohort. Conclusions: This study underscores psychological challenges faced by individuals with CKD during the COVID-19 pandemic. The increased risk perceptions and fears of severe disease and mortality from COVID-19 emphasize the need for mental health interventions aimed at improving coping strategies alongside physical health management in this vulnerable population. Full article

Background and Objectives: This study explores gender variations in the associations between lifestyle choices, mental health, and social behaviors among adolescents in the Transylvania region of Romania. The analysis is based on data obtained through the Global School-Based Student Health Survey (GSHS). Materials and Methods: Data on 900 Romanian adolescents aged 11–18 years were obtained via the GSHS. This study evaluated nutritional statuses through BMI Z-scores, employing World Health Organization (WHO) cut-offs applied to self-reported height and weight; furthermore, it assessed well-being and perceived health; worries and sleep anxiety; social connections through having friends, loneliness, peer support, and emotional support; parental bonding relations; experiences of being bullied; safety and protection factors, including distance learning during the COVID-19 pandemic and testing or vaccinations for COVID-19; and social behaviors, including the use of social networks. A multiple logistic regression was used to predict sleep disturbance anxiety, depending on sex, bullying, cyberbullying, loneliness, social network use, and peer support. Results: Results showed that the majority of the adolescents reported having one or more friends (96.8%), with no significant difference between girls and boys (p = 0.071). There were no statistically significant differences in bullying and cyberbullying experiences between sexes (p = 0.063). Notably, gender disparities exist in both health perceptions and risk behaviors, with girls experiencing higher rates of negative health perceptions, sleep anxiety (p < 0.001), and loneliness (p = 0.011) and boys exhibiting more overweight/obesity (p < 0.001) and school truancy (p = 0.027). According to the results, loneliness is significantly associated with a higher likelihood of sleep-disturbing anxiety (p < 0.001). Students who have experienced cyberbullying are more likely to also experience traditional bullying. Students who feel lonely are more likely to be victims of bullying. Conclusions: This study reveals significant gender disparities in adolescent health, particularly in mental health, risk behaviors, and social support. It highlights the need for gender-specific interventions to address these challenges and promote healthy development. Furthermore, this study emphasizes the importance of social connections, family support, and parental involvement in adolescent well-being. Addressing bullying, promoting mental health awareness, and providing accessible support services are crucial for improving adolescent health in Romania. Full article

Promoting public engagement through social media has always been a core issue in risk communication studies. Based on the Social Amplification of Risk Framework (SARF), this study conducts an online survey in China (N = 908) and constructs a moderated mediation model. Using bootstrapped moderated mediation analysis, this study examines the relationships among social media exposure to pandemic information, risk perception, source credibility, and public engagement on social media at the early stages of the pandemic. The results demonstrate a positive relationship between social media exposure and public engagement, which can be mediated by risk perception. The relationship between social media exposure and public engagement via risk perception is moderated by source credibility. The higher perceived credibility of official and interpersonal sources undermines risk perception, but also hinders public engagement in the crisis. The moderating effect of professional source credibility is not significant. This study has expanded the SARF and has contributed to promoting risk communication strategies from the perspective of risk information processing. Full article

Introduction: The COVID-19 pandemic highlighted the need for digital tools that support public health decision-making and behavior change. Dashboards became a primary method for communicating infectious disease data. However, their influence on preventive health behaviors (PHBs) is not well understood—especially among young adults. This group is less likely to adhere to PHBs, but highly familiar with online tools. Methods: Two experimental studies were conducted with young adult participants (200 in Study 1, 228 in Study 2) who viewed the same COVID-19 data in dashboards with or without actionable components. Participants were randomly assigned to different dashboard conditions to measure, on seven-point Likert scales, their PHB intentions and perceptions of behavioral control, attitudes, norms, and risk. The actionable dashboard interventions, designed using the theory of planned behavior, included dynamic behavioral guidance and risk level visualizations. Results: Actionable dashboards versus basic dashboards significantly increased PHB intentions (B = 0.84, p < 0.001, Study 1). Dynamic behavioral guidance was the key dashboard component influencing PHB intentions (B = 0.61, p = 0.005, Study 2). Parallel mediation analysis testing norms, attitudes, behavioral control, and perceived risk against one another found that only norms explained the link between the dashboard intervention and PHB intentions (B_boot = 0.18 and 0.19). Conclusions: Findings suggest that actionable dashboards can effectively promote PHB by influencing psychosocial beliefs. These dashboards provide context and guidance, making risky situations more manageable and directing individuals to appropriate preventive actions. Public health professionals should consider incorporating behavioral guidance into community health dashboards to improve their effectiveness. Full article

Psychological theory often reminds us that the best predictor of an individual’s future behavior is their prior behavior. Then, the pandemic happened in 2020, and at least for travel behavior and tourism consumption, everything seemed to change, stressing the importance of re-evaluating predictors. In the present study, we aimed to compare the history of travel behavior and tourism consumption with the predicted travel behavior of students coming from Generation Z, along with intrapersonal characteristics influencing risk perception, like psychological resilience and perceived invulnerability. The findings revealed that the pandemic changed the attitude towards travel for tourism-related purposes in both positive and negative directions, restructuring the attitude towards travel for the majority and also revealing many new prospective travelers. Psychological resilience was a significant variable that differentiated the respondents who changed their attitude towards tourism from those who remained consistent in their non-travel behavior and students who planned to travel more during the pandemic. Although subsamples also differed in the mean value of perceived invulnerability, the variable did not prove statistically significant. Almost 50% of the students predicting that they will travel abroad for non-tourism-related purposes in the future year were students who had not traveled abroad before the pandemic. Full article

Background/Objectives: Vaccine hesitancy has increased during the coronavirus pandemic, a period marked by the spread of disinformation and conspiracy theories about COVID-19 vaccines. This qualitative study aimed to explore the beliefs and attitudes of Spaniards towards COVID-19 vaccines and analyze the role of information sources in this process. Methods: Semi-structured interviews were conducted with 35 residents of Spain who exhibited varying levels of vaccine hesitancy. Through thematic content analysis, the narratives supporting vaccination-related decisions, as well as the influence and trust in information sources, were examined. Results: Reasons for getting vaccinated included perceptions of it being “almost an obligation” and “fear of illness and death”. Conversely, reasons for not getting vaccinated included “uncertainty about vaccines”, the belief that “the risk is not real”, and the perception that “vaccination is a personal decision”. Regarding vaccine-related information sources, interviewees expressed distrust of the media, particularly television, as they considered news about vaccine effectiveness and characteristics to be contradictory and constantly changing, which created uncertainty about its reliability. Most interviewees were unsure if social media influenced their decision not to get vaccinated. However, those who acknowledged its impact mentioned trusting sources such as people with a university education. Additionally, close contacts—particularly healthcare professionals—had a significant influence on the decision not to get vaccinated. Conclusions: This study shows that the decision not to vaccinate is shaped by personal beliefs and sources of information—particularly social media and close acquaintances, including healthcare professionals. Full article

Background: The COVID-19 pandemic highlighted the crucial role of community preventive behaviors in controlling the virus’ spread. Studies show that people’s risk perceptions and awareness significantly contribute to the containment and prevention of infections by motivating adoption of desired actions and behaviors. This study aimed at assessing the role of risk communication and factors that influenced responses during the COVID-19 pandemic in rural communities in Western Kenya. Methods: A descriptive cross-sectional study was conducted using a quantitative research approach, collecting data from 806 individuals across Kisumu, Vihiga, and Kakamega counties. Descriptive statistics were used to detail the demographic characteristics of the study population, while logistic regression analysis estimated the associations between risk communication and demographic characteristics on COVID-19 vaccine acceptance, compliance with mitigation behaviors, perceived severity, and perceived susceptibility. Results: The results showed that 55% of participants were male and 45% were female, with an average moderate compliance with safety measures (mean = 5.15). A significant portion of participants wore face masks (85.3%), practiced hand hygiene (78.9%), and avoided close contact behaviors (66.6%). Most respondents received information through mass media (86.1%) and health workers (72.9%). Compliance with COVID-19 mitigation measures was highest among those who trusted information from official institutions, health professionals, and mass media, compared to social media, with increased odds of 2.7 times and 2.5 times, respectively. Higher risk perception was significantly associated with older age groups (above 50 years), being male, and working in the private sector. Effective risk communication significantly influenced risk perception, compliance with COVID-19 measures, and vaccination acceptance. Conclusions: The findings suggest that effective risk communication strategies are critical during public health emergencies and hence implications for future public health crises. The results underscore the importance of targeted communication and tailored interventions to improve compliance and vaccine acceptance among different demographic groups, ensuring a more robust public health response during outbreaks and pandemics. Full article

Despite the widespread use of crisis communication on social media during the COVID-19 pandemic, the mechanisms with which social media influence crisis-related behavioral coping have been insufficiently explored. By integrating the Social-Mediated Crisis Communication (SMCC) model with the Protective Action Decision Model (PADM), this study investigates how individuals’ protective actions are influenced by crisis-related information disseminated through social media, particularly focusing on the mediating effects of risk perception and emotional responses. This study examines two special periods: the initial outbreak (January–April 2020) and the subsequent period (May–December 2020). The results indicate that the dissemination of crisis-related information on social media platforms has significant positive associations with individuals’ risk perception, information sharing, and protective actions throughout the public health crisis. Notably, information gathering showed a positive relationship with protective actions during the initial outbreak. The study identified a chain mediation effect of emotional response and risk perception in the relationship between information dissemination and information sharing during and after the initial outbreak. Additionally, risk perception emerged as a partial mediator between information dissemination and information gathering during the subsequent period. This study enhances our understanding of the psychological mechanisms through which social media crisis communication influences collective coping responses in China, providing valuable insights for practitioners aiming to optimize crisis information dissemination strategies that promote sustainable protective behaviors on social media platforms. Full article

Background/Objectives: The COVID-19 pandemic impacted healthcare access globally, with chronic conditions like congenital heart defects (CHD) posing unique challenges. While general trends have been studied, little is known about the impact on CHD patients in Europe. This study assessed the living conditions, healthcare utilization, and psychosocial well-being of CHD patients and their families in Germany, considering CHD severity, gender differences, and changes over time. Methods: Data were derived from two cross-sectional online surveys conducted by the National Register for Congenital Heart Defects (NRCHD) in April 2020 and April 2021. Surveys targeted CHD patients and relatives, assessing healthcare access, risk perception, COVID-19-related knowledge, and psychosocial effects. Statistical analyses compared responses by gender, CHD severity, and survey period. Results: A total of 6737 responses were analyzed. Healthcare utilization declined early in the pandemic due to infection fears but partially recovered in 2021. Perceived health risks increased from 27.9% in 2020 to 38.7% in 2021 (p < 0.001), along with higher psychosocial distress. COVID-19-related knowledge was greater in 2020, but trust in government information declined, while reliance on healthcare providers increased. Gender and CHD severity influenced healthcare engagement and perceptions. Conclusions: This study highlights the challenges CHD patients faced, underscoring the need for holistic, patient-centered care. Future interventions should focus on tailored communication and support strategies, particularly for vulnerable populations, to mitigate the impact of future health crises. Full article

Background/Objectives: Postpartum depression (PPD) affects maternal well-being and infant development, with the COVID-19 pandemic exacerbating mental health challenges for new mothers. This study examined the prevalence and predictors of PPD among Korean mothers in the early postpartum period. Methods: A nationwide cross-sectional study was conducted in South Korea from 10 September 2021. A two-stage stratified cluster sampling method recruited 3127 mothers who gave birth between January and December 2020. Data collection included the Edinburgh Postnatal Depression Scale (EPDS) and assessments of sociodemographic, pregnancy-related, infant health, and paternal involvement factors. Results: The prevalence of PPD (EPDS score ≥ 13) was 26.5%. Risk factors included a history of depression during pregnancy (OR = 8.65, p < 0.001), multiparity (OR = 1.03, p = 0.012), and frequent infant medical treatments (OR = 1.04, p < 0.001). Protective factors included better maternal health (OR = 0.36, p < 0.001), longer postpartum care (OR = 0.99, p < 0.001), enhanced postpartum education (OR = 0.97, p < 0.001), positive infant health perception (OR = 0.44, p < 0.001), and greater paternal involvement (OR = 0.97, p < 0.001). Conclusions: PPD is influenced by multiple factors, including maternal health, infant well-being, and paternal support. Routine screening and tailored interventions are essential to improve maternal mental health. Policies promoting holistic postpartum care and paternal involvement should be prioritized, especially during global crises like COVID-19. Full article

Background: Bergamo was the most severely affected Italian province at the onset of the 2020 COVID-19 pandemic. The liver transplant (LT) patient population should be among the more sensitized to the concept of health prevention. Long-term data on both perception and outcomes of SARS-CoV-2 vaccination in LT recipients since the COVID-19 vaccine became available in Italy are still lacking. Methods: From May to October 2023, a survey on actively followed LT recipients at our institution was carried on by the local patient’ advocacy (Associazione Amici del Trapianto di Fegato) to define the rate of vaccinated subjects, SARS-CoV-2 infections and self-reported COVID-19-related outcomes. Results: Out of the consecutive 753 adult LT recipients invited to the survey, 356 responded (47.3%) [71% male, 63 years old (20–85), LT performed a mean of 9 years (1–26) before vaccination] and were included in the analysis. All patients received the first vaccine dose between December 2020 and January 2022 (81.7% Cominarty^®, 17.7% Spikevax^®, 0.3% Vaxzevria^® and 0.3% Jcovden^®). In the following years, adherence to the vaccination policy decreased progressively over time: the second, third, fourth, and fifth vaccine doses were administered to 99%, 94%, 72%, and 22% of the LT population by October, 2023. In total, 43 (12%) and 93 (26%) patients reported a COVID-19 episode before and after [13 (7–21) months] the first vaccination, respectively; none of the LT recipients reported a second COVID-19 infection after the following vaccination cycles. Forty-six (13%) reported short-term post-vaccination mild adverse events but none developed either acute or chronic rejection episodes or hospitalization for COVID-19-related symptoms. A total of 64% of LT recipients resulted positive for anti-nucleocapsid serological test in 2023. Conclusions: COVID-19 vaccines are safe and effective in LT recipients, underlining once again the importance of vaccination in this special population at higher risk of complications from communicable infectious diseases. Full article

The COVID-19 pandemic has significantly disrupted the global food supply chain, concurrently eroding consumer trust in imported food products. We conducted multi-round tracking surveys of Chinese consumers nationwide in December 2020 and January, March, April, May, July, and October 2021 to examine the stigmas induced by COVID-19 on imported cold-chain food. Results revealed that COVID-19 has induced a long-lasting stigma of imported cold-chain food among Chinese consumers. The mean willingness to pay for beef steak from the U.S., Australia, and Brazil decreased by about 4 yuan, 3 yuan, and 3 yuan, respectively, compared to that for the corresponding product before the pandemic. The results also showed that respondents’ risk perception of imported cold-chain food decreased slightly in the short term and then stayed at a high level. Elderly consumers and those with children were more likely to perceive a high risk of imported cold-chain food associated with COVID-19. Our results indicated that the stigmas of imported cold-chain food caused by COVID-19 persistently impacted consumer food behavior. Identifying ways to recover consumer trust in imported food is essential to boost consumer demand with the recovery of the global food supply chain. Full article