The causal relationship model of factors influencing COVID-19 preventive behaviors during the post-pandemic era and implications for health prevention strategies: a case of Bangkok City, Thailand.

BACKGROUND: Though, many countries are currently in the COVID post-pandemic era, people's health protective behaviours are still essential to protect their health and well-being. This study aims to evaluate people's understanding and perceptions of COVID-19 risk characteristics (i.e. threat occurrence, threat severity, perceived susceptibility and exposure), the health risk perception towards COVID-19, and health protective behaviours. The study also aims to estimate the associations among these factors by the analysis of structural equation modelling (SEM). METHODS: From 15 October to 9 November 2022, questionnaire surveys were administrated to 521 people living in Bangkok of Thailand by using the convenience sampling technique. The analyses were carried out in three phases including descriptive statistical analyses, a measurement model assessment using a confirmatory factor analysis (CFA), and structural equation modelling (SEM) analysis. RESULTS: The results of descriptive analyses demonstrated that the majority of respondents, 39.9%, had the age between 20 and 30 years old, and 61.4% of them were female. Approximately 52.1% of them had a bachelor's degree. Upon analysing individuals' understanding and perceptions of all risk characteristics, individuals' understanding of COVID-19 severity did not statistically affect health risk perception towards COVID-19, whereas perceived exposure had the strongest effect and in turn influenced health protective behaviours. Perceived susceptibility and understanding of the threat occurrence also significantly affected health risk perception, and indirectly affected health protective behaviours. CONCLUSIONS: This study implies that though the potential health impact of COVID-19 is perceived as less severe, people can still construct a perception of its risk particularly based on their perceived exposure and susceptibility. Thus, communicating people about exposure conditions and susceptibility can greatly contribute to people' construction of risk perception towards COVID-19 which subsequently leads to the decision to perform health protective behaviours.

Do we protect ourselves against West Nile Virus? A systematic review on knowledge, attitudes, and practices and their determinants.

BACKGROUND: West Nile virus (WNV) is a mosquito-borne flavivirus. In humans, 80% of infections are asymptomatic, while approximately 20% experience influenza-like symptoms. Fewer than 1% develop the neuroinvasive form which can lead to encephalitis, meningitis, acute flaccid paralysis, and even death. The global spread of the virus to areas where it was not previously present has become a growing concern. Since the 2000 s, there have been numerous outbreaks affecting local and travelling populations worldwide. Given the lack of a vaccine, preventative measures are primarily focused on surveillance, vector control, and the use of personal protective behaviours (PPBs). The importance of PPBs is central to public health recommendations. However, translating these messages into coherent action by the public can prove challenging, as the uptake of such measures is inevitably influenced by socio-economic factors, awareness, knowledge, and risk perception. METHODS: A PRISMA-based systematic research was conducted on EMBASE, PubMed/MEDLINE, and Web of Science databases. PROSPERO registration number CRD42023459714. Quality of studies included in the final stage was evaluated using the Critical Appraisal Checklist for Cross-Sectional Study (CEBMa). RESULTS: 2963 articles were screened, and 17 studies were included in the final round. Out of these, six were deemed of high quality, ten were of medium quality, and one was of low quality. In almost all studies considered, both awareness and knowledge of WNV transmission were above 90%, while concern about WNV ranged from 50% to 80%. Concern about the safety of repellents, either with or without DEET, ranged from 27% to 70%. The percentage of people actually using repellents ranged from 30% to 75%, with the lowest usage reported among individuals over 60 years old (29%) and pregnant women (33%), and the highest among students aged 9-11 (75%). Concern for West Nile Virus (WNV) was consistently linked to an increase in taking preventative measures, including the use of repellents, by two to four times across studies. The school-based intervention was effective in increasing the practice of removing standing water (AOR=4.6; 2.7-8.0) and wearing long clothing (AOR=2.4; 95%CI: 1.3-4.3), but did not have a significant impact on the use of repellents. CONCLUSIONS: The present systematic review provides an overview of the knowledge, attitudes, and practices (KAP) of WNV and their determinants. While concern about West Nile Virus (WNV) and its effects can be a significant motivator, it is important to promote evidence-based personal protective behaviours (PPBs) to counter unwarranted fears. For example, the use of repellents among the most vulnerable age groups. Given the geographical expansion of WNV, it is necessary to target the entire population preventively, including those who are difficult to reach and areas not yet endemic. The findings of this investigation could have significant implications for public health and support well-informed and effective communication strategies and interventions.

Knowledge, protective behaviours, and perception of Lyme disease in an area of emerging risk: results from a cross-sectional survey of adults in Ottawa, Ontario.

BACKGROUND: The number of Lyme disease risk areas in Canada is growing. In regions with emerging tick populations, it is important to emphasize peridomestic risk and the importance of protective behaviours in local public health communication. This study aims to identify characteristics associated with high levels of Lyme disease knowledge and adoption of protective behaviours among residents in the Ottawa, Ontario region. METHODS: A geographically stratified web survey was conducted in November 2020 (n = 2018) to determine knowledge, attitudes, and practices regarding Lyme disease among adult residents. Responses were used to calculate: (i) composite scores for knowledge and adoption of protective practices; and (ii) an exposure risk index based on reported activity in woodlands during the spring-to-fall tick exposure risk period. RESULTS: 60% of respondents had a high knowledge of Lyme disease, yet only 14% indicated they often use five or more measures to protect themselves. Factors strongly associated with a high level of Lyme disease knowledge included being 55 or older (Odds Ratio (OR) = 2.04), living on a property with a yard (OR = 3.22), having a high exposure index (OR = 1.59), and knowing someone previously infected with Lyme disease (OR = 2.05). Strong associations with the adoption of a high number of protective behaviours were observed with membership in a non-Indigenous racialized group (OR = 1.70), living on a property with a yard (OR = 2.37), previous infection with Lyme disease (OR = 2.13), prior tick bite exposure (OR = 1.62), and primarily occupational activity in wooded areas (OR = 2.31). CONCLUSIONS: This study highlights the dynamics between Lyme disease knowledge, patterns of exposure risk awareness, and vigilance of personal protection in a Canadian region with emerging Lyme disease risk. Notably, this study identified gaps between perceived local risk and protective behaviours, presenting opportunities for targeted enhanced communication efforts in areas of Lyme disease emergence.

Health protective behaviours during the COVID-19 pandemic: Risk adaptation or habituation?

Many epidemiological works show that human behaviours play a fundamental role in the spread of infectious diseases. However, we still do not know much about how people modify their Health Protective Behaviours (HPB), such as hygiene or social distancing measures, over time in response to the health threat during an epidemic. In this study, we examined the role of the epidemiological context in engagement in HPB through two possible mechanisms highlighted by research into decision-making under risk: risk adaptation and risk habituation. These two different mechanisms were assumed to explain to a large extent the temporal variations in the public's responsiveness to the health threat during the COVID-19 pandemic. To test them, we used self-reported data collected through a series of 25 cross-sectional surveys conducted in France among representative samples of the adult population, from March 2020 to September 2021 (N = 50,019). Interestingly, we found that both mechanisms accounted relatively well for the temporal variation in the adoption of social distancing during the pandemic, which is remarkable given their different assumptions about the underlying social cognitive processes involved in response to a health threat. These results suggest that strengthening the incentives to encourage people to maintain health protective behaviours and to counter risk habituation effects is crucial to disease control and prevention over time.

Factors associated with wearing a facemask in shops in England following removal of a legal requirement to do so during the COVID-19 pandemic.

OBJECTIVES: We aimed to identify psychological factors associated with the use of facemasks in shops in England following removal of legal requirements to do so, and to compare associations with and without legal restrictions. DESIGN: Repeated cross-sectional online surveys (n ≈ 2000 adults) between August 2020 and April 2022 (68,716 responses from 45,682 participants) using quota sampling. METHODS: The outcome measure was whether those who had visited a shop for essentials in the previous seven days reported always having worn a facemask versus sometimes or not at all. Psychological predictor variables included worry, perceived risk and severity of COVID-19 and the perceived effectiveness of facemasks. Socio-demographic variables and measures of clinical vulnerability were also measured. For the period following removal of legal restrictions, multivariable regression was used to assess associations between the primary outcome variable and predictors adjusting for socio-demographic and clinical vulnerability measures. The analysis was repeated including interactions between psychological predictors and presence versus absence of legal restrictions. RESULTS: Worry about COVID-19, beliefs about risks and severity of COVID-19 and effectiveness of facemasks were substantially and independently associated with the use of facemasks. Removal of legal obligations to wear facemasks was associated with a 25% decrease in wearing facemasks and stronger associations between psychological predictors and wearing facemasks. CONCLUSIONS: Legal obligations increase rates of wearing a facemask. Psychological factors associated with wearing a facemask could be targets for interventions aiming to alter rates of wearing a facemask. These interventions may be more effective when there are no legal obligations to wear a face covering in place.

An online RCT on behavioural expectations effects of COVID-19 certification policies in England.

Objective: The aim of this study was to compare the effects of different types of COVID-19 certification policy on subsequent behavioural expectations. Design: 4 × 2 between-subjects pre-registered randomised controlled trial. Method: In August 2022, participants (n = 2726) in England were presented with a scenario describing a rise in COVID-19 infections and the introduction of new protective measures. The protective measures described varied with regards to the setting (healthcare vs. recreational) and the type of policy (no certification vs. vaccination vs. vaccination or free Lateral Flow test vs. vaccination or Lateral Flow test at personal cost). Participants then answered questions on their expectations to receive another dose of the COVID-19 vaccine, to receive the seasonal influenza vaccine and to adhere to other protective behaviours following the announcement, as well as questions based on Self-Determination Theory, COVID-19 vaccine hesitancy and broader vaccine hesitancy. Results: We found no main effects of setting or type of certification on expectation to receive the next dose of the COVID-19 vaccine, to receive the seasonal influenza vaccine, or to adhere to other protective measures, when controlling for baseline expectations. Conclusions: These findings suggest that it is unlikely that the concept of certification, however it is framed, alters inclinations in the English population towards COVID-19 and seasonal flu vaccination or inclinations towards adhering to other protective behaviours within settings to which certification would apply. These findings are based on a hypothetical scenario and should be interpreted with caution.

Understanding the sexual and reproductive health rights and experiences of very young adolescents in rural Uganda from the perspectives of emerging adults.

We investigated the sexual and reproductive health rights and experiences of very young adolescents (VYAs), 10-14 years old, from the perspective of emerging adults (18-25 years old). Data collection and analysis were guided by the socio-ecological and positive youth development frameworks. Data were collected through naturalistic observation of the community, photovoice, key informant interviews (n=5), and focus group discussions with emerging adults (n=20). Key emerging themes included: limited economic resources, sex education, and gender expectations. While limited economic resources and certain gender expectations play a role in increasing VYAs' exposure to risky settings and behaviours, sex education in schools and parental support play an important role in protecting VYAs from poor sexual and reproductive health outcomes. Identifying ways to minimize exposure to risky settings and behaviours while strengthening existing protective factors found in the community need to be considered when designing future strength-based, community tailored, and culturally sensitive interventions.

Nous avons étudié les droits et les expériences liés à la santé sexuelle et reproductive des très jeunes adolescents (VYAs), âgés de 10 à 14 ans, du point de vue des adultes émergents (18 à 25 ans). La collecte et l'analyse des données ont été guidées par les cadres socio-écologiques et du développement positif de la jeunesse. Les données ont été collectées à travers l'observation naturaliste de la communauté, la méthode photovoix, les entretiens avec des informateurs clés (n = 5), et des discussions de groupe avec des adultes émergents (n = 20). Les principaux thèmes émergents comprenaient : les ressources économiques limitées, l'éducation sexuelle et les attentes liées au genre. Malgré le fait que les ressources économiques limitées et certaines attentes liées au genre contribuent à accroître l'exposition des VYA à des environnements et à des comportements à risque, l'éducation sexuelle dans les écoles et le soutien parental jouent un rôle important dans la protection des VYA contre de mauvais résultats liés à la santé sexuelle et reproductive. L'identification des moyens de minimiser l'exposition à des contextes et des comportements à risque tout en renforçant les facteurs de protection existants trouvés dans la communauté doit être prise en compte lors de la conception de futures interventions basées sur les atouts des jeunes adolescents, adaptées à leurs communauté et sensibles à leurs cultures.

Influence of setting-dependent contacts and protective behaviours on asymptomatic SARS-CoV-2 infection amongst members of a UK university.

We survey 62 users of a university asymptomatic SARS-CoV-2 testing service on details of their activities, protective behaviours and contacts in the 7 days prior to receiving a positive or negative SARS-CoV-2 PCR test result in the period October 2020-March 2021. The resulting data set is novel in capturing very detailed social contact history linked to asymptomatic disease status during a period of significant restriction on social activities. We use this data to explore 3 questions: (i) Did participation in university activities enhance infection risk? (ii) How do contact definitions rank in their ability to explain test outcome during periods of social restrictions? (iii) Do patterns in the protective behaviours help explain discrepancies between the explanatory performance of different contact measures? We classify activities into settings and use Bayesian logistic regression to model test outcome, computing posterior model probabilities to compare the performance of models adopting different contact definitions. Associations between protective behaviours, participant characteristics and setting are explored at the level of individual activities using multiple correspondence analysis (MCA). We find that participation in air travel or non-university work activities was associated with a positive asymptomatic SARS-CoV-2 PCR test, in contrast to participation in research and teaching settings. Intriguingly, logistic regression models with binary measures of contact in a setting performed better than more traditional contact numbers or person contact hours (PCH). The MCA indicates that patterns of protective behaviours vary between setting, in a manner which may help explain the preference for any participation as a contact measure. We conclude that linked PCR testing and social contact data can in principle be used to test the utility of contact definitions, and the investigation of contact definitions in larger linked studies is warranted to ensure contact data can capture environmental and social factors influencing transmission risk.

Factors influencing COVID-19 health protective behaviours in Zambian university students with symptoms of low mood.

BACKGROUND: Health protective behaviours are crucial in the prevention of the spread of COVID-19, particularly in university students who typically live and study in large groups. Depression and anxiety are common in students and can impact young people's motivations to follow health advice. The study aims to assess the relationship between mental health and COVID-19 health-protective behaviours in Zambian university students with symptoms of low mood. METHODS: The study was a cross-sectional, online survey of Zambian university students. Participants were also invited to take part in a semi-structured interview to explore views about COVID-19 vaccination. Invitation emails were sent explaining the study aims and directed students who self-identified as having low mood in the past two weeks to an online survey. Measures included COVID-19 preventive behaviours, COVID-19-related self-efficacy, and Hospital and Anxiety Depression scale. RESULTS: A total of 620 students (n=308 female, n=306 male) participated in the study, with a mean participant age of 22.47±3.29 years (range 18-51). Students reported a mean protective behaviour score of 74.09/105 and 74% scored above the threshold for possible anxiety disorder. Three-way ANOVA showed lower COVID-19 protective behaviours in students with possible anxiety disorder (p=.024) and those with low self-efficacy (p<0.001). Only 168 (27%) said they would accept vaccination against COVID-19, with male students being twice as likely to be willing to accept COVID-19 vaccination (p<0.001). Of 50 students interviewed. 30 (60%) expressed fears about the vaccination and 16 (32%) were concerned about a lack of information. Only 8 (16%) participants expressed doubts about effectiveness. CONCLUSION: Students who self-identify as having symptoms of depression have high levels of anxiety. The results suggest that interventions to reduce anxiety and promote self-efficacy might enhance students' COVID-19 protective behaviours. Qualitative data provided insight into the high rates of vaccine hesitancy in this population.

The effects of the Dark Triad personality traits on health protective behaviours: dyadic approach on self-reports and partner-reports.

OBJECTIVE: The growing evidence show that romantic partners' personality traits mutually influence each other's health. The research on relationship between personality and health behaviours should include both partner's perspectives - relations between individuals' traits and their own outcomes (actor effects), and relations between individuals' traits and their partners' outcomes (partner effects). The objective of this study was to examine the actor and partner effects of the Dark Triad (DT) personality traits (psychopathy, Machiavellianism and narcissism) on the health protective behaviours (HPB) in romantic couples. DESIGN: A convenience sample of 188 heterosexual romantic couples participated in a cross-sectional round-robin study. Three predictor measures were Self-Report Psychopathy Scale-III, Narcissistic Personality Inventory and MACH-IV inventory, whereas HPB inventory was used as criterion variable. RESULTS: Data were analysed using the Actor-Partner Interdependence Model (APIM). The results suggest that men's psychopathy, and to a lesser extent men's Machiavellianism exert deleterious effects on their own and their partner's HPB. The majority of these effects replicated across both self-reports and partner-reports. Women's DT traits exerted weaker actor and partner effects on the HPB than men's DT traits. CONCLUSIONS: Findings show that men's psychopathy and Machiavellianism have detrimental effects on their own as well as their partner's HPB.

Protective Behavioural Mechanisms Against Cannabis Use Among Adolescents in Cannabis-Growing Settings of South Africa: Insights Into Adolescent Cannabis Use Prevention.

We aimed to explore the behavioural protective mechanisms against cannabis use among adolescents living in South African illicit cannabis-growing communities, based on the Self Determination Theory (SDT). Exploratory qualitative design techniques were followed in conducting the study. The snowball sampling technique was used to recruit thirty (30) non-cannabis smoking adolescents from 2 purposively selected communities and grouped into 4 focus groups and interviewed. A semi-structured focus group interview guide was used to moderate the discussions. Data were analysed inductively, using the ATLAS. ti software. Nine behavioural coping mechanisms, grouped under intrinsic and extrinsic protective behavioural mechanisms, protected participants from using cannabis. Intrinsically, participants' determination not to engage in bad behaviours, focus on their academic work during their free periods, their non-financial dependence on cannabis-using peers, self-preservation to ensure good marriages, and religious beliefs on substance abuse motivated them to not use cannabis. On the other hand, the concept of Ukuphoxa (preservation of family dignity), fear of arrest, fear of being tagged a social deviant, and the fear of contracting illnesses such as lung cancer served as protective behavioural mechanisms against cannabis use. Health promotion and education programmes for adolescents on non-cannabis use in communities where illicit cannabis abounds must identify and draw on contextual intrinsic and extrinsic motivations that ensure non-cannabis use.

The mechanism of governments' and individuals' influence on protective behaviours during the second wave of COVID-19: a multiple mediation model.

Background: The SARS-CoV-2 virus continues to spread and resurge globally with signs of a second wave, despite actions by governments to curb the COVID-19 pandemic. However, evidence-based strategies to combat COVID-19 recurrence are poorly documented. Objective: To reveal how governments and individuals should act to effectively cope with future waves, this study proposed a preventive model of COVID-19 resurgence. Method: A questionnaire survey was conducted among 1,137 residents of Beijing, where the epidemic reoccurred. Structural equation model was used to explore the mechanism among government intervention, perceived efficacy, positive emotions, posttraumatic growth (PTG) and protective behaviours. Results: Data analysis revealed that during COVID-19 resurgence, government intervention could directly and indirectly influence protective behaviours through individual factors (i.e. perceived efficacy, positive emotions), and PTG could mediate the indirect pathway to protective behaviours. Conclusions: These findings implied that government intervention needs to be integrated with individual factors to effectively control repeated COVID-19 outbreaks.

Antecedentes: El virus SARS-CoV-2 continúa propagándose y resurgiendo a nivel mundial con signos de una segunda ola, a pesar de las acciones de los gobiernos para frenar la pandemia de COVID-19. Sin embargo, las estrategias basadas en evidencia para combatir la recurrencia de COVID-19 están pobremente documentadas.Objetivo: Para revelar cómo deben actuar los gobiernos y las personas para hacer frente de manera efectiva a futuras olas, este estudio propuso un modelo preventivo del resurgimiento de COVID-19.Método: Se realizó una encuesta entre 1.137 residentes de Beijing, donde la epidemia volvió a ocurrir. Se utilizó un modelo de ecuación estructural para explorar el mecanismo entre la intervención del gobierno, la eficacia percibida, las emociones positivas, el crecimiento postraumático (CPT) y las conductas protectoras.Resultados: El análisis de datos reveló que durante el resurgimiento de COVID-19, la intervención del gobierno podría influir directa e indirectamente en los comportamientos de protección a través de factores individuales (es decir, eficacia percibida, emociones positivas), y CPT podría mediar en el camino indirecto hacia los comportamientos de protección.Conclusiones: Estos hallazgos implicaron que la intervención del gobierno debe integrarse con factores individuales para controlar de manera efectiva los brotes repetidos de COVID-19.

Changes in preventive behaviour after COVID-19 vaccination in Thailand: a cross-sectional study.

BACKGROUND: Protective behaviours (e.g., mask-wearing, handwashing, avoiding social gatherings) and mass vaccination are effective ways to control the coronavirus disease 2019 (COVID-19) pandemic. Previous studies found that people who get vaccinated may change their protective behaviours. The Thai government has endorsed several mix-and-match vaccine regimens to eliminate the insufficiency of each vaccine brand. This study aimed to determine levels of protective behavioural changes after COVID-19 vaccination and its relationship with various vaccine regimens in Thailand. METHODS: A descriptive cross-sectional study was conducted between September 13, 2021, and January 14, 2022. Data were collected using an online questionnaire distributed via social media platforms and posters in public places in Thailand. The questionnaire comprised six items for demographic characteristics, seven items for COVID-19 vaccine regimens, and four items for protective behaviours. The vaccinated Thai population aged ≥ 18 years were surveyed. Statistical analyses included a Chi-squared test, Wilcoxon signed rank test, and multivariate logistic regressions. RESULTS: Of the 469 participants, more than half were females (67.4%), single (57.4%), and lived in an urban area (67.2%). Significant differences were observed with regard to median scores in handwashing (5.0 vs. 5.0, p-value < 0.001), physical distancing (4.0 vs. 5.0, p-value = 0.019), and avoiding social activity (4.0 vs. 5.0, p-value = 0.010) in pre- and post-vaccination situations. Approximately 70-90% of the participants did not report changes in protective behaviours after vaccination. Overall, 17.4%, 13.9%, and 12.7% of participants showed improvements in avoiding social activity, physical distancing, and handwashing respectively. Multivariate analysis revealed that improvements in protective behaviours were significantly associated with the age group (between 18 and 24 years), non-healthcare worker status, and those who lived in urban areas. No significant evidence of vaccine regimens was found relative to improved protective behaviours. CONCLUSION: This evidence revealed that Thai people maintain their protective behaviours after vaccination but rather improved them. Moreover, demographic data were significantly associated with improved protective behaviours, but various vaccine regimens were not. These findings might be useful for implementing policies to maintain personal protective behaviours after vaccination against COVID-19.

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

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

The converging influence of social, economic and psychological factors on public responsiveness to the COVID-19 pandemic in South Africa.

BACKGROUND: This study assessed the influence of social, economic, and psychological factors on South African's responsiveness to the COVID-19 pandemic. Although the South African government responded quickly to manage the pandemic, the strict lockdown placed a significant burden on the population. Understanding the converging influence of social, economic, and psychological factors on the population's responsiveness is important for improving people's cooperation in controlling COVID-19 and for supporting individuals and communities during the ongoing and future pandemics. METHODS: Using data collected from a national telephonic survey (December 2020 to March 2021), we assessed whether selected social, economic and psychological factors were related to: 1) adoption of COVID-19 behavioural measures (hand hygiene, wearing of face masks, and physical distancing), and 2) adherence to government restrictions on movement. RESULTS: South Africans were highly responsive to the pandemic with respondents generally reporting that they very often engaged in the protective behaviours and often to very often adhered to government restriction on movement. However, those from the white population group; with a higher education; living in uncrowded households; who perceived less vulnerability to contracting COVID-19; supported the measures; trusted the scientists; thought the measures by government were implemented fairly and fairly enforced by the police; felt more anxious, sad, hopeless, isolated, angry or had trouble sleeping; inclined to engage in coping behaviour, were more likely to adopt COVID-19 protective behaviours. Furthermore, females, those with a lower education, those less likely to have experienced poverty since the beginning of lockdown; who perceived greater vulnerability to COVID-19, trusted government, and were more supportive of the behavioural measures were more likely to adhere to the restrictions of movement. CONCLUSIONS: Strengthening the South African population's responsiveness to the pandemic requires supporting those living in poor socioeconomic circumstances, promoting trust in the scientific evidence, and ensuring that the measures by government are perceived to be fairly implemented and fairly enforced by the police. Due to the impact on livelihoods, restrictions of movement should only be considered if necessary, and this will require trust and confidence in government and strategies to support those experiencing financial hardship.

Impact of ventilation and avoidance measures on SARS-CoV-2 risk of infection in public indoor environments.

BACKGROUND: The literature includes many studies which individually assess the efficacy of protective measures against the spread of the SARS-CoV-2 virus. This study considers the high infection risk in public buildings and models the quality of the indoor environment, related safety measures, and their efficacy in preventing the spread of the SARS-CoV-2 virus. METHODS: Simulations are created that consider protective factors such as hand hygiene, face covering and engagement with Covid-19 vaccination programs in reducing the risk of infection in a university foyer. Furthermore, a computational fluid dynamics model is developed to simulate and analyse the university foyer under three ventilation regimes. The probability of transmission was measured across different scenarios. FINDINGS: Estimates suggest that the Delta variant requires the air change rate to be increased >1000 times compared to the original strain, which is practically not feasible. Consequently, appropriate hygiene practices, such as wearing masks, are essential to reducing secondary infections. A comparison of different protective factors in simulations found the overall burden of infections resulting from indoor contact depends on (i) face mask adherence, (ii) quality of the ventilation system, and (iii) other hygiene practices. INTERPRETATION: Relying on ventilation, whether natural, mechanical, or mixed, is not sufficient alone to mitigate the risk of aerosol infections. This is due to the internal configuration of the indoor space in terms of (i) size and number of windows, their location and opening frequency, as well as the position of the air extraction and supply inlets, which often induce hotspots with stagnating air, (ii) the excessive required air change rate. Hence, strict reliance on proper hygiene practices, namely adherence to face coverings and hand sanitising, are essential. Consequently, face mask adherence should be emphasized and promoted by policymakers for public health applications. Similar research may need to be conducted using a similar approach on the Omicron (B.1.1.529) variant.

Source of Information on Intentions to Adopt Protective Behaviours During COVID-19 in China.

Introduction: COVID-19 spread across China and other countries in a matter of weeks. Yet, it is uncertain how people have responded to protective behaviours in this pandemic. This study aims to evaluate how trust in different types of information sources influences the intention to adopt protective behaviours. Methods: In total, 122 Chinese completed a survey on Qualtrics in March 2021. Data on demographic information, protective behaviours, trust in formal information, trust in informal information, perceived risk, worry and social desirability were collected. Structural equation modelling (SEM) was used to identify associations between these variables. Results: Trust in formal information was significantly associated with perceived risk (ß = -.18) and significantly and positively associated with worry (ß = .28). Trust in informal information was significantly and positively associated with perceived risk (ß = .57). Subsequently, perceived risk was significantly associated with social distancing (ß = -.17), and worry was significantly and positively associated with mask wearing (ß = .25) and significantly associated with hand washing (ß = -.27). Trust in formal information was significantly and positively associated with hand washing (ß = .26) while trust in informal information was significantly and positively associated with social distancing and hand washing (ß = .26). Perceived risk was significantly and positively associated with worry (ß = .32). Conclusion: People who trust in informal information from social media and interpersonal communication would be more likely to adopt mask wearing and hand washing protective behaviours. People who trust in formal information from government-agency source would have a lower perceived risk of COVID-19 and are less likely to adopt social distancing, but people who trust in formal information have a greater worry about contracting COVID-19 and are more likely to wear masks.

Self-reported skin cancer-related behaviours in rural Victoria: results from repeat cross-sectional studies in 2001-2003 and 2016-2018.

OBJECTIVE: To assess whether self-reported use of sun-protective measures and skin examination have changed between 2001 and 2018 in a rural setting. METHODS: Repeat cross-sectional survey of randomly selected households in four rural Victorian towns. People aged 16 years and older were eligible to participate. Logistic regression was used to identify demographic factors associated with sun-protective measures and skin examination. RESULTS: Overall, 5,328 participated in 2001-2003 and 2,680 in 2016-2018. Among participants who go out in the sun, the mean number of reported sun-protective measures (2.6±1.3 vs. 2.6±1.6, p=0.867) and the proportion of participants reporting usually/always using sun protection (65.1% vs. 63.9%, p=0.307) were unchanged between the two surveys. However, an increased proportion of participants reported avoiding the sun when outdoors in the more recent survey (from 18.8% to 34.3%, p<0.001). Avoiding the sun was associated with being older, female, of European origin and having post-secondary school education. Skin examination rates increased between the two surveys (32.7% to 40.8%, p<0.001). Skin examinations were associated with older age groups, European origin and post-secondary school education and being male. CONCLUSIONS: Given the small changes in sun protection over time, updated skin cancer campaigns are needed to encourage increased sun-protective behaviours and skin examinations among rural residents. IMPLICATIONS FOR PUBLIC HEALTH: Results suggest that updated health promotion campaigns targeted to rural areas are warranted.

Child Sexual Abuse Prevention: Parental Discussion, Protective Practices and Attitudes.

Understanding parental practices and attitudes regarding child sexual abuse (CSA) prevention could be used to improve CSA prevention, but little information is available. In this study, we summarise survey data collected from 248 Australian and UK parents (87% female) with at least one child aged 6-11 years (M = 8.6, SD = 1.8). This is the first study to quantify parental use of protective practices, other than prevention education, which may guard against CSA. Parental media mediation, which may safeguard against online dangers, was another unique focus of this study. Participants reported their discussion of sensitive topics with their children including CSA; behaviors that may reduce the incidence of CSA (e.g., monitoring, supervision, delegation of care and checking-in with the child); mediation of their child's media use; and attitudes towards CSA prevention education. Parents reported discussing sexual abuse less than other sensitive topics such as abduction dangers, drugs, and death but more than issues surrounding puberty, sex and pornography. Parents reported using high levels of protective behaviours, however some areas of concern were revealed. Of concern was the low-moderate level of parental media mediation, with substantial numbers of children potentially exposed to online risks such as using devices unsupervised in bedrooms or chatting to individuals unknown to their parents and not having their devices checked for concerning content. Almost all parents were supportive of CSA prevention education and felt they should provide this education. However, two-thirds of parents thought CSA education may be associated with harms for the child and two-thirds of parents believed children could prevent their own abuse. Reported results will aid in our understanding of which areas of parenting could be strengthened to create safer environments for children. This research has particularly highlighted the need for parents to be more protective around their children's access to online devices.