Search Results (774)

Background/Objectives: Healthcare workers (HCWs) face occupational hazards that increase their risk of Coronavirus Disease of 2019 (COVID-19). This study aims to evaluate HCWs’ perceptions of the effectiveness of Personal Protective Equipment (PPE) in preventing COVID-19 infection and to identify risk factors associated with HCW infection. Methods: A cross-sectional study design was used, with a structured, self-administered, closed-ended questionnaire to collect retrospective data for the period 2020 to 2022 at a tertiary hospital in Johannesburg, South Africa. Results: PPE was effective in reducing COVID-19 infection, according to 230 (57.07%) participants, while 173 (42.93%) disagreed. A significant association (p = 0.034) with a small effect size (Cramer’s V = 0.161) was found between the number of HCWs infected with COVID-19 and their perceptions of PPE’s effectiveness. White HCWs were more likely to perceive PPE as effective than Black HCWs (AOR = 3.82, p = 0.046). Support and clerical staff reported higher perceived effectiveness of PPE (AOR = 2.98, p = 0.040). Conclusions: HCWs encountered COVID-19 infections and various challenges that necessitate interventions and policies to safeguard them in hospital settings and ensure prompt virus management, including ensuring sufficient PPE supplies. The perceptions of PPE effectiveness among HCWs are shaped by an interplay of institutional practices, personal beliefs, and structural factors. These perceptions are closely tied to essential elements such as training, reliable PPE availability, and regular hand hygiene practices, underscoring the need to address both systemic and behavioral dimensions. Full article

The current paper examines how individual/personality factors are associated with the political legitimacy of government restrictions at the onset of the COVID-19 pandemic. A total of 1262 US-based participants completed an online survey comprising several scales (predictor factors), such as the Just World Scale, the Police Legitimacy Scale, and the Authoritarianism Scale measuring aggression, submission, and conventionalism. In addition, they completed scales measuring their Fear of COVID and Perceptions of Government (outcome factors). The results suggest that those who viewed the president or federal government as most responsible had lower legitimacy scores than those who reported their governor, state government, or local official or government to be responsible. Also, those who aligned with the Republican party had the lowest mean for fear of COVID, while the highest was in the “Other” political affiliation, followed by the Democrats, who had the second highest. It also turned out that whereas one’s relationships with those who have been hospitalized or died as a result of COVID and individual risk factors for COVID were not significant variables in predicting perceptions of the federal government’s handling of the pandemic, the most significant factors were Authoritarianism, Fear of COVID-19, (older) Age, Change in Federal Trust and Political Ideology. Fear of COVID-19 was the only significant factor predicting government legitimacy and individual decisions to engage in protection measures during the pandemic. Theoretical and practical implications are discussed. Full article

The effectiveness of infection prevention depends on not only uptake but also the timing of adoption. Vaccination studies typically treat uptake as binary, overlooking when while investigating why individuals get vaccinated. Using the novel mRNA COVID-19 vaccines as a case study, the influences of risk perceptions and social norms on vaccination timing were examined through an Innovation Diffusion framework. An online survey was conducted in November 2021 to assess vaccination behaviors, attitudes, and peer expectations of 1710 U.S. residents (51.64% females, 31.23% minorities, with a relatively balanced distribution across age and income brackets). Participants were classified by vaccination timing and intentions as early adopters, early majority, late majority, or laggards for comparative analyses. One year after vaccine rollout, 64.3% had received at least one dose; 20.1% reported no intention to vaccinate, and this resistance persisted through May 2023 when the pandemic ended. Vaccine confidence and prior behavior (e.g., influenza vaccination) demonstrated strong gradients across adoption timing. Earlier uptake was associated with higher perceived vaccine importance, infection risk, and peer uptake, whereas age and education effects diminished over time. Perceived illness severity and disease knowledge showed inconsistent influences. Later adopters anticipated higher post-vaccination infection risk and greater peer non-vaccination, reinforcing hesitancy. Social norms (but not risk perception) mediated the relationship between confidence and timing; earlier adoption further predicted booster acceptance. These findings highlight the importance of trust, correcting efficacy misperceptions, and leveraging positive peer norms to promote timely vaccination and inform strategies for other infectious diseases. Full article

Background/Objectives: Reports on seasonal influenza vaccine (SIV) coverage in Gulf Cooperation Council (GCC) countries showed lower than targeted coverage among high-risk populations both before and after the COVID-19 pandemic and subsequent COVID-19 vaccine release. This narrative review aims to synthesise SIV coverage following the introduction of COVID-19 vaccines among at-risk groups in the GCC region. Methods: Database searches included PubMed and Google Scholar for articles assessing SIV uptake, acceptance, hesitancy, and intention to vaccinate among adults in high-risk groups in GCC countries, with data collected after the introduction of COVID-19 vaccines. Results: SIV uptake ranged from 1.8% among pregnant women to 64.1% among dialysis patients in Saudi Arabia. Healthcare workers (HCWs) demonstrated the highest overall coverage, reaching 64.5% for annual uptake in Bahrain, with 79% of HCWs in Saudi Arabia intending to vaccinate. Prevalent barriers included low risk perception and consideration of influenza as a mild disease not necessitating SIV uptake, as well as vaccine effectiveness and safety concerns. Previous vaccination, physician advice, and policy or mandates for HCWs were identified as frequent facilitators of uptake. Conclusion: Suboptimal uptake was reported among most high-risk groups in GCC countries. Health Belief Model components and physician involvement appear to have a significant impact on vaccine uptake among the intended population. More emphasis should be directed toward effective risk communication and action cues methods to enhance uptake among high-risk groups. Future research is needed to cover understudied areas like the elderly aged ≥ 65 years, cancer and other high-risk groups, in addition to further studies for GCC countries other than Saudi Arabia in the post-COVID-19 vaccine period. Full article

Background/Objectives: Nonpharmaceutical interventions such as social distancing and face mask use were central to controlling infectious disease transmission during the early phases of the COVID-19 pandemic, particularly when vaccines and treatments were limited or unevenly available. Although public health strategies emphasized individual compliance, adherence varied widely. Empirical evidence remains limited regarding how individuals integrate influences across individual, interpersonal, and community levels when assessing their ability and readiness to socially distance. This study examined how residents evaluated, prioritized, and experienced multi-level factors shaping perceived ability and readiness to practice social distancing during the early phase of the COVID-19 epidemic. Methods: We conducted a cross-sectional online survey of adults (≥18 years) residing in St. Louis City and St. Louis County, Missouri, between April and July 2020. Participants selected and ranked individual/interpersonal and community-level factors influencing social distancing and provided open-ended explanations of their choices. Quantitative data were analyzed descriptively to assess selection frequency and ranking priority. Qualitative responses were analyzed using iterative thematic coding to examine how participants interpreted and combined these factors. Results: The analytic sample included 1692 respondents. At the individual/interpersonal level, family and friends’ distancing behavior (58.9%), desire for in-person interaction (52.4%), and personal risk of COVID-19 (48.9%) were frequently selected, while personal risk, caring for others, and ability to work from home were most often ranked as the highest priority. At the community level, others’ distancing in public spaces (66.2%), availability of COVID-19 testing (58.9%), and businesses’ ability to ensure distancing and sanitation (57.2%) were most frequently selected, with epidemic severity, testing availability, and treatment availability ranked as most influential. Qualitative findings indicated that respondents experienced these influences as interconnected, integrating personal and relational risk, local epidemic conditions, healthcare access, visible community norms, and employer policies. Conclusions: Perceived ability and readiness to practice social distancing emerge from interdependent social and structural conditions rather than isolated individual motivations. Public health responses to emerging infectious diseases may be more effective when individual-level guidance is complemented by accessible testing and treatment, supportive workplace policies, and community environments that visibly reinforce protective behaviors. Full article

Background: Health-related misinformation is a pervasive phenomenon that expanded substantially during the COVID-19 pandemic, particularly regarding concerns about vaccine safety and effectiveness. Objective: The aim of this study was to investigate the impact of online health misinformation susceptibility on health behaviors and vaccine hesitancy. Methods: A cross-sectional study with a convenience sample of 402 individuals was conducted in Greece, with data collected via an online survey during September 2025. We used the Health-Related Online Misinformation Susceptibility Scale to measure online health misinformation susceptibility. The Health Behavior Inventory–Short Form was used to measure health behaviors, while the Vaccine Hesitancy Scale (VHS) was used to measure participants’ hesitancy towards vaccination. We performed multivariable analysis to identify the independent effect of health misinformation after adjustment for several confounders. Results: Multivariable linear regression analysis showed a positive association between online health misinformation susceptibility and diet score (adjusted coefficient beta = 0.026; 95% confidence interval [CI] = 0.006 to 0.046; p = 0.010) and anger and stress score (adjusted coefficient beta = 0.033; 95% CI = 0.013 to 0.052; p = 0.001). After adjustment for confounders, we found a positive association between online health misinformation susceptibility and score on the factors “lack of confidence” (adjusted coefficient beta = 0.016; 95% CI = 0.005 to 0.028; p = 0.006) and “risk perception” (adjusted coefficient beta = 0.023; 95% CI = 0.010 to 0.036; p = 0.001). Conclusions: Our findings suggest that higher susceptibility to online health misinformation is associated with poorer health behaviors and greater vaccine hesitancy. Full article

Background: The COVID-19 pandemic significantly disrupted health systems, including the delivery of childhood immunizations. This study assessed COVID-19 vaccination coverage in families of children with incomplete routine immunization and explored why adults accepted COVID-19 vaccines despite skipping routine vaccination for their children in the district of Swat, Khyber Pakhtunkhwa, Pakistan. Methods: A mixed-methods study was conducted in Swat District during March 2022–April 2023. A cross-sectional survey assessed COVID-19 vaccination in household members of children under 2 years of age for whom vaccination registries showed missed routine vaccinations. In-depth interviews with 18 household members explored motivations for vaccine acceptance through thematic analysis. Results: Among 249 families of children with incomplete immunization found through vaccination records, 237 families (88% response) were interviewed. Among 382 children below 2 years of age in these families, 29.5% (n = 113) were fully vaccinated, 67.5% (n = 258) were incompletely vaccinated according to age, and 2.9% (n = 11) had not received any vaccine. Data from 237 of the defaulter children—one per household—was included in further analysis. Among household members above 12 years of age, 87% (964/1103) of males and 82% (n = 901/1093) of females were vaccinated against COVID-19. Households with at least one fully vaccinated child were significantly more likely to have vaccinated family members. Multivariable analysis showed maternal COVID-19 vaccination (AOR 2.08, 95% CI: 1.15–3.76) and urban residence (AOR 2.08, 95% CI: 1.14–3.79) were associated with full childhood vaccination. In-depth interviews revealed that key motivators for COVID-19 vaccination included the perception that it was mandatory, house-to-house vaccination, and fear of hospitalization or death. Conclusions: Vaccine requirements and ease of access to vaccination services enhanced coverage with COVID-19 vaccines among families of children with incomplete routine immunization. Ethical use of vaccine requirements and community education to enhance levels of risk perception of vaccine-preventable diseases could potentially improve childhood immunization. Full article

COVID-19 brought on health-related stressors which have not been previously explored as risks for intimate partner violence (IPV). The current study applies the ABCX model of family stress to assess whether health-related stressors were associated with more severe IPV and the mediational role of resources (i.e., negotiation skills, emotion regulation skills, social support) and perceptions (i.e., meaning in life, loneliness) in these relationships. Using MTURK, adults across the United States participated in an anonymous online survey. Participants were allocated to groups according to relationship status and IPV presence and severity. A series of multiple mediation analyses was conducted to investigate if personal resources and perception of circumstance mediated the relationship between health-related stressors and IPV severity. The findings indicate a positive association between COVID-19 health-related stressors and IPV severity. These relationships were primarily mediated by increased attempts to suppress emotional expression, feelings of loneliness, and search for meaning in one’s life. The findings support the applicability of the ABCX models to understanding IPV, suggesting that the health-related stressors should be considered as risk factors for IPV, and identify explanatory mechanisms that could also be targets for intervention. Full article

Complete or partial loss of smell (anosmia), sometimes in association with distorted olfactory perceptions (parosmia), is a common neurological symptom affecting nearly 60% of patients suffering from post-acute neurological sequelae of COronaVIrus Disease of 2019 (COVID-19) syndrome, called long COVID. Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) may gain access from the nasal cavity to the brain (neurotropism), and the olfactory route has been proposed as a peripheral site of virus entry. COVID-19 is a risk factor for developing Alzheimer’s Disease (AD), an age-dependent and progressive neurodegenerative disorder characterized in affected patients by early olfaction dysfunction that precedes signs of cognitive decline associated with neurodegeneration in vulnerable brain regions of their limbic system. Here, we summarize the recent literature data supporting the causal correlation between the persistent olfactory deterioration following SARS-CoV-2 infection and the long-delayed manifestation of AD-like memory impairment. SARS-CoV-2 infection of the olfactory neuroepithelium is likely to trigger a pattern of detrimental events that, directly and/or indirectly, affect the anatomically interconnected hippocampal and cortical areas, thus resulting in tardive clinical dementia. We also delineate future advancement on pharmacological and rehabilitative treatments to improve the olfactory dysfunction in patients recovering even from the acute/mild phase of COVID-19. Collectively, the present review aims at highlighting the physiopathological nexus between COVID-19 anosmia and post-pandemic mental health to favor the development of best-targeted and more effective therapeutic strategies in the fight against the long-term neurological complications associated with SARS-CoV-2 infection. Full article

Standard epidemiological models often treat human behavior as static, failing to capture the dynamic feedback loops that shape epidemic waves. To address this, we developed a compartmental model of COVID-19 that couples the disease dynamics with two co-evolving behavioral games governed by imitation dynamics: an altruistic self-isolation game for infected individuals and a self-interested vaccination game for susceptible individuals. Our simulations reveal a fundamental behavioral paradox: strong adherence to self-isolation, while effective at reducing peak infections, diminishes the perceived risk of disease, thereby undermining the incentive to vaccinate. This dynamic highlights a critical trade-off between managing acute crises through non-pharmaceutical interventions and achieving long-term population immunity. We conclude that vaccination has a powerful stabilizing effect that can prevent the recurrent waves often driven by behavioral responses to non-pharmaceutical interventions. Public health policy must therefore navigate the tension between encouraging short-term mitigation behaviors and communicating the long-term benefits of vaccination to ensure lasting population resilience. Full article

Background/Objectives: Healthcare workers (HCW) in primary care settings play a significant role in recommending vaccines to patients. We aimed to describe COVID-19 vaccination knowledge, attitudes, perception, and practices (KAPP) of HCWs in Tunisia and identify associated factors. Methods: We conducted a national cross-sectional survey (29 January to 3 February 2024) among HCWs in primary public healthcare centers using purposive sampling. Factors associated with good knowledge, positive attitude, and good practice, measured through Likert scales using face-to-face questionnaires, were identified using binary logistic regression. Results: We included 906 HCWs (mean age = 41.87 ± 8.89 years). In total, 37.75% (342/906) of HCWs had good knowledge and perception, 4.30% (39/906) had a positive attitude, and 24.9% (226/906) had good practices related to COVID-19 vaccination. Working in urban compared to rural areas was associated with good knowledge (aOR = 1.57, 95%CI = 1.12–2.21) and positive attitude (aOR = 4.94, 95%CI = 1.19–20.44) to COVID-19 vaccination. Physicians had better KAPP scores than other medical professionals. HCWs working in departments with high-risk patients were more likely to have good knowledge (aOR = 1.28, 95%CI = 1.00–1.72). Positive attitude was also associated with being male (aOR = 2.97, 95%CI = 1.75–5.07) and having at least one non-communicable disease (aOR = 1.92, 95%CI = 1.14–3.23). Being male (aOR = 1.97, 95%CI = 1.35–2.88) and having more years of professional experience (aOR = 1.81, 95%CI = 1.29–2.52) were associated with good practice. Conclusions: Just over a third of HCWs in primary healthcare clinics had good knowledge of COVID-19 vaccination, while positive attitudes and good practices were low. Targeted interventions, particularly for HCWs with less professional experience working in rural settings, are needed to increase good practices and improve COVID-19 vaccination coverage in Tunisia. Full article

Background: Vaccinations are essential to protect travelers from infectious diseases, especially in high-risk destinations. However, awareness and adherence to vaccination recommendations vary, influenced by communication, personal beliefs, and behavior. Methods: A focus group was conducted in February 2025 at a local health authority in central Italy, specifically within its travel clinic, to explore travelers’ awareness, attitudes, and behaviors regarding vaccination. The discussion was analyzed using the “3Cs” Vaccine Hesitancy model. Participants were purposively selected to ensure diversity and representativeness. Discussions included past travel experiences, knowledge of required vaccines, motivations for immunization, and barriers to access. Results: Four key thematic areas emerged: socio-cultural/environmental factors, psychological/emotional influences, knowledge/information access, and general health perceptions. Communication gaps often weakened belief in vaccine efficacy and necessity. Cultural background, past experiences, and risk perception heavily influenced decisions. Discussion: Although vaccination is widely viewed as a protective measure, vaccine hesitancy persists due to misinformation and limited institutional trust. The COVID-19 pandemic intensified both awareness and skepticism. The 3Cs model clarified hesitancy levels and barriers, emphasizing the need for effective communication and trust-building. Conclusions: Enhancing access to accurate information, strengthening healthcare professionals’ communicative role, and reducing economic obstacles are crucial. Tailored awareness campaigns and integrated health policies are essential to increasing vaccine uptake, safeguarding traveler health, and limiting global disease spread. Patient or Public Contribution: Members of the public contributed to this study by participating in a focus group, where they shared their personal experiences, perceptions, and opinions regarding travel-related vaccinations. Their insights provided valuable qualitative data that helped inform the study’s findings. However, they were not involved in the study design, the analysis of the data, or the preparation of the manuscript. The role of participants was limited to the data collection phase of the study. Full article

COVID-19 lockdown announcements triggered global waves of panic buying, leading to widespread panic buying of essential goods and supply chain disruptions. Although the acute phase of the pandemic has passed, panic buying continues to emerge during natural disasters, extreme weather events, and other crisis-related disruptions, highlighting the ongoing need for evidence-based strategies to address its psychological drivers. Social cognition constructs, including willingness, intentions, attitudes, subjective norms, and risk perceptions, have been identified as modifiable psychological predictors of panic buying. However, few studies have experimentally tested theory-driven interventions aimed at modifying these mechanisms. This study evaluated the effectiveness of a brief, online intervention based on integrated social cognition models in reducing panic-buying-related cognitions during a hypothetical lockdown scenario. A pre-registered randomized controlled trial was conducted with Australian grocery shoppers (N = 140), who were randomly allocated to an intervention or control condition. Participants completed self-report measures assessing their willingness, intentions, attitudes, subjective norms, and risk perceptions at both pre- and post-intervention times. The hypotheses were partially supported. Compared with the control condition, the intervention group reported greater reductions across targeted psychological constructs. For hygiene products, significant decreases were observed across all five constructs, and for non-perishable foods, willingness, intention, and attitudes significantly decreased. For cleaning products, reductions were evident for attitudes, subjective norms, and intentions. These findings suggest that theory-informed, scalable interventions can effectively modify the social cognition processes underlying panic buying. This study extends existing research and demonstrates the potential for brief, theory-based communication strategies to reduce panic-buying-related cognitions. Future research should evaluate these interventions in real-world settings and explore mechanisms to target automatic cognitive processes. Full article

This study examines how consumers’ perceptions of threat severity and anxiety during public health crises influence their motivation to protect themselves and, subsequently, their intentions to purchase protection insurance products. Drawing on Protection Motivation Theory (PMT), we develop an integrated framework that links cognitive risk assessments and emotional responses to financial protection decisions. Using survey data collected from 437 respondents in Taiwan during the COVID-19 pandemic, the research model is tested through partial least squares structural equation modeling (PLS-SEM). The empirical results indicate that both perceived severity and anxiety significantly enhance protection motivation, with perceived severity exerting a stronger effect. These two antecedents also directly strengthen consumers’ intentions to purchase protection insurance. Furthermore, protection motivation partially mediates the effects of perceived severity and anxiety on purchase intention. These findings extend the application of PMT to the financial and insurance domains by demonstrating how cognitive and affective factors jointly shape demand for protection insurance in high-risk environments. The practical implications of these results for insurers include risk communication strategies, product positioning, and the development of crisis-responsive insurance solutions. Full article

This study examines the relationship between greenwashing and firm risk among listed Australian firms from 2014 to 2023. We construct a firm-level greenwashing score as the residual based on regressions of composite ESG on Scope 1–2 CO₂ emissions; positive residuals indicate overstated sustainability relative to emissions. Using realized volatility as a measure of firm risk and applying the Generalized Method of Moments (GMM) regression framework, we uncover three key findings. First, contemporaneous greenwashing significantly lowers volatility, which is consistent with legitimacy and signalling theory, as overstated ESG credentials create a temporary perception of stability. Second, the risk-reducing effect is strongest with a one-period lag, likely reflecting delayed ESG and emissions reporting cycles and investor reaction times. Third, by the two-period lag, the effect reduces in magnitude, suggesting that markets eventually recognize the misalignment between ESG claims and environmental performance. Robustness checks with the E-pillar confirm these dynamics. Additional tests excluding the COVID-19 period (2020 and 2021) reveal that the risk-mitigating effects of greenwashing are even stronger during normal market conditions, implying that pandemic-related volatility may have muted the signalling power of ESG narratives. While firm fundamentals (e.g., book-to-market) explain part of risk variation, greenwashing-driven effects are economically meaningful yet short-lived. The findings underscore that greenwashing offers only temporary risk mitigation; as transparency improves and regulatory enforcement strengthens, firms relying on inflated ESG narratives face diminishing benefits and potential long-term risk penalties. Full article