Why Are Young People Willing to Pay for Health? Chained Mediation Effect of Negative Emotions and Information Seeking on Health Risk Perception and Health Consumption Behavior.

The perception of health risks can influence people's health behaviors. However, in the context of modern consumer society, few people delve into in-depth discussions on health consumption as a form of health protection behavior. Inspired by the Health Belief Model and Protection Motivation Theory, this study interprets health consumption behavior as a new form of health protection behavior. A survey was conducted on a sample of Chinese youth (N = 885) to explore the mechanisms of action between health risk perception and health consumption behavior using structural equation modeling. The study found that: (1) health risk perception has a significant positive impact on the health consumption behavior of young people; (2) negative emotions and information seeking play mediating roles respectively in the mechanism of the impact of health risk perception on health consumption behavior; and (3) in addition to their individual mediating roles, negative emotions and information seeking behavior collectively play a chained mediation role in this process. Implications of these results, both theoretical and practical, are further discussed.

Social Vulnerability and Compliance With World Health Organization Advice on Protective Behaviors Against COVID-19 in African and Asia Pacific Countries: Factor Analysis to Develop a Social Vulnerability Index.

BACKGROUND: COVID-19 protective behaviors are key interventions advised by the World Health Organization (WHO) to prevent COVID-19 transmission. However, achieving compliance with this advice is often challenging, particularly among socially vulnerable groups. OBJECTIVE: We developed a social vulnerability index (SVI) to predict individuals' propensity to adhere to the WHO advice on protective behaviors against COVID-19 and identify changes in social vulnerability as Omicron evolved in African countries between January 2022 and August 2022 and Asia Pacific countries between August 2021 and June 2022. METHODS: In African countries, baseline data were collected from 14 countries (n=15,375) during the first Omicron wave, and follow-up data were collected from 7 countries (n=7179) after the wave. In Asia Pacific countries, baseline data were collected from 14 countries (n=12,866) before the first Omicron wave, and follow-up data were collected from 9 countries (n=8737) after the wave. Countries' socioeconomic and health profiles were retrieved from relevant databases. To construct the SVI for each of the 4 data sets, variables associated with COVID-19 protective behaviors were included in a factor analysis using polychoric correlation with varimax rotation. Influential factors were adjusted for cardinality, summed, and min-max normalized from 0 to 1 (most to least vulnerable). Scores for compliance with the WHO advice were calculated using individuals' self-reported protective behaviors against COVID-19. Multiple linear regression analyses were used to assess the associations between the SVI and scores for compliance to WHO advice to validate the index. RESULTS: In Africa, factors contributing to social vulnerability included literacy and media use, trust in health care workers and government, and country income and infrastructure. In Asia Pacific, social vulnerability was determined by literacy, country income and infrastructure, and population density. The index was associated with compliance with the WHO advice in both time points in African countries but only during the follow-up period in Asia Pacific countries. At baseline, the index values in African countries ranged from 0.00 to 0.31 in 13 countries, with 1 country having an index value of 1.00. The index values in Asia Pacific countries ranged from 0.00 to 0.23 in 12 countries, with 2 countries having index values of 0.79 and 1.00. During the follow-up phase, the index values decreased in 6 of 7 African countries and the 2 most vulnerable Asia Pacific countries. The index values of the least vulnerable countries remained unchanged in both regions. CONCLUSIONS: In both regions, significant inequalities in social vulnerability to compliance with WHO advice were observed at baseline, and the gaps became larger after the first Omicron wave. Understanding the dimensions that influence social vulnerability to protective behaviors against COVID-19 may underpin targeted interventions to enhance compliance with WHO recommendations and mitigate the impact of future pandemics among vulnerable groups.

The perception of air pollution and its health risk: a scoping review of measures and methods.

BACKGROUND: Although there is increasing awareness of the health risks of air pollution as a global issue, few studies have focused on the methods for assessing individuals' perceptions of these risks. This scoping review aimed to identify previous research evaluating individuals' perceptions of air pollution and its health effects, and to explore the measurement of perceptions, as a key resource for health behaviour. METHODS: The review followed the methodological framework proposed by Arksey and O'Malley. PubMed and Web of Science were searched. After initial and full-text screening, we further selected studies with standardised scales that had previously been tested for reliability and validity in assessing awareness and perceptions. RESULTS: After full-text screening, 95 studies were identified. 'Perception/awareness of air quality' was often measured, as well as 'Perception of health risk.' Only nine studies (9.5%) used validated scaled questionnaires. There was considerable variation in the scales used to measure the multiple dimensions of risk perception for air pollution. CONCLUSION: Few studies used structured scales to quantify individuals' perceptions, limiting comparisons among studies. Standardised methods for measuring health risk perception are needed.

Main findings: Among 95 studies assessing health risk perception of air pollution, only nine studies used standardised scales.Added knowledge: There was considerable variation in the scales measuring the multiple dimensions of risk perception for air pollution, which makes comparison among the studies difficult.Global health impact for policy and action: This review highlights the need for the development of globally standardised scale to measure the health risk perception of air pollution.

Health risk perception and exercise intention of college students: a moderated mediation model of health anxiety and lay theories of health.

Background: Health risk perception is an important predictor of health-protective behaviors according to the health belief model. However, the underlying mechanism connecting health risk perception and exercise behaviors is not well understood. The current study investigates how health risk perception predicts college students' exercise intention in the post-pandemic era in China and analyzes the mediating effect of health anxiety and the moderating effect of lay theories of health. Materials and methods: This cross-sectional study adopted convenience sampling and recruited 767 students from a province in central China. The Health Risk Perception Scale, Health Anxiety Scale, Lay Theories of Health Scale, and the Chinese version of the Exercise Intention Scale were used to measure the levels of health risk perception, health anxiety, implicit health theory, and exercise intention, respectively. Results: The results of the moderated mediation model indicated that the health risk perception of college students significantly and positively affected exercise intention (ß = 0.110, t = 2.852, p < 0.01). Meanwhile, the indirect effect of health anxiety on the relationship between health risk perception and exercise intention was significant. Furthermore, lay theories of health buffered the association between health anxiety and exercise intention, according to the moderated mediation analysis (ß = 0.068, t = 2.067, p < 0.05). For college students holding incremental health theory, the influence of health anxiety on exercise intention was positively and statistically significant. Conclusion: The health risk perception of college students can lead to health anxiety, which can positively affect their exercise intention. In addition, lay theories of health can moderate the effect of health anxiety on exercise intention. The results have practical implications for developing effective, applicable, and scalable interventions to promote physical exercise by reducing the level of entity theory of health or increasing the level of incremental theory.

Risk perception about communicable and vector borne diseases among international travellers to Pakistan: A cross sectional study.

With the rise in air travel, the risk of diseases travelling from one geographical area to another has also increased. Relatively little is known about how travellers know and perceive the health risks associated with travel and how they adopt preventive measures before and while travelling abroad. The objective of this study is to determine the risk perception about communicable and vector-borne diseases among international travellers arriving from different countries and to find any association between the level of risk perception and independent variables. A cross-sectional study was conducted with 426 participants enrolled through convenient sampling technique. An already validated questionnaire was used to collect information. Chi square test was applied to ascertain any significant association between dependent and independent variables. Out of 426 respondents, only 226 (53%) had a high risk perception, whereas 220 (47%) had a low risk perception. A significant association was noted between the level of risk perception and gender (x2=20.9, p=0.000), level of education (x2=42.9, p=0.000), nationality (x2=7.5, p= 0.006) and region of arrival of the passengers (x2=26.2, p= 0.000). The results of the study revealed that 220 (47%) of the travellers had a low risk perception that may lead to an increase in the burden on healthcare system in Pakistan as well as exporting any new disease from Pakistan to other parts of the world where it does not already exist.

The mediating role of pro-environmental attitude and intention on the translation from climate change health risk perception to pro-environmental behavior.

Climate change is a serious environmental issue appearing in China. As a public service institution operating around the clock, the negative impact of hospitals on the environment is evident, promoting their workers' pro-environmental behavior (PEB) through increasing climate change health risk perception (CHRP) is an effective method to protect the environment and achieve sustainable development. This study investigates how CHRP shapes pro-environmental attitude (PEA), pro-environmental intention (PEI), and pro-environmental behavior (PEB) among hospital workers. Using structural equation modeling (SEM) to determine the chain of causation from CHRP to PEB among hospital workers. The result shows that CHRP positively affects PEA and PEI, and PEI positively affects their PEB. In addition, although CHRP has no significant direct effect on PEB, it can play a crucial indirect effect through the mediating role of PEI. Moreover, the result of multiple regression shows that there are significant differences regarding PEA, PEI, and PEB.

What Motivates Betel Quid Chewers to Quit? An Analysis of Several Cessation-Relevant Variables.

Introduction: Betel quid (BQ) is globally the fourth most consumed psychoactive substance. It is consumed by an estimated 600 million people worldwide, accounting for nearly 8% of the world's population. There have been very few studies assessing chewers' motivation to quit. Objectives: In the current study, we sought to understand the relationship between several cessation-relevant variables and chewers' motivation to quit. Hypotheses: Based on analogous research on cigarette smoking, we hypothesized that the following cessation-relevant variables would be associated with motivation to quit: health risk perceptions, number of chews per day, cost, degree of BQ dependence, withdrawal symptoms, number of quit attempts, reasons for use, personal health improvement, and type of BQ chewed. Methods: A total of 351 adult BQ chewers from Guam participated in the survey and served as the sample for the analyses. Results: Majority of chewers want to quit and intend to quit. Chewers relatively high in motivation to quit evinced greater health risk perceptions of BQ chewing, greater perceived health benefits to quitting, and a greater number of past quit attempts, compared to those relatively low in motivation to quit. Conclusions: Understanding which factors are associated with chewers' motivation to quit can be helpful for designing BQ cessation programs. The results suggest that BQ cessation programs could be improved by an increased emphasis on information about the negative health effects of BQ chewing and relapse-prevention.

The Effectiveness of Adolescent-Focused Therapy and Family-Based Therapy for Anorexia Nervosa.

Anorexia Nervosa is the most deadly mental illness due to the high mortality and relapse rates after reaching remission. The systematic review investigated the effectiveness of two empirically validated interventions (Family-Based Therapy [FBT] and Adolescent-Focused Therapy [AFT]) for an adolescent or young adult living with Anorexia Nervosa to reach partial or full remission and expected weight ratios. Twelve studies published between 1994 and 2015 were evaluated and indicated that FBT resulted in significant weight gain and higher partial and full remission rates than AFT, demonstrating its superiority in treating AN in adolescents and young adult samples, in one instance, at least up to 4 years. Despite FBT and AFT delivery, a significant proportion of participants did not achieve their target weight or full remission, indicating that both treatments may not be effective in all circumstances.

"Our bodies are not strong anymore": a focus group study on health risk perceptions of ambient air pollution near a petrochemical industry.

Background: Ambient air pollution has persisted in lessendowed communities, resulting in exposure to unhealthy pollutants. Epidemiological studies on air pollution have been mainly quantitative, with a dearth of information on community health risk perception, a key component of risk management. Objectives: The aim of this focus group study was to highlight the health risk perception of ambient air pollution among people residing near a petrochemical industry and to determine their perceptions of the existing control measures and ideas for more effective control. Methods: Participants were purposefully selected based on age, sex, long-term residence near a petroleum refinery, and occupation. Three 90-minute face-to-face focus groups and one individual interview were conducted. The moderator guided discussions using a pre-formed topic guide. Discussions were audio-recorded, transcribed manually, and coded using NVivo software. The data analysis was conducted using reflexive thematic analysis. Results: Six themes were generated: negative perception of the environment; the refinery is to blame; air pollution is seen or smelled; air pollution is associated with health and non-health risks; poor response to air pollution- everyone is to blame and the government is primarily responsible for healthy air quality. The participants were not aware of the extent of air pollution's health risks. Suggestions for air pollution control included regulating gas flaring, environmental health education, and incentives for community members. Conclusion: Participants perceived that their ambient air was unhealthy. However, concerns about the health risks were shaped by contextual factors. The key barriers to effective mitigation were poor environmental health literacy and political factors.

Perceptions of the health risk from hot days and the cooling effect of urban green spaces: a case study in Xi'an, China.

Background: Hot days are one of the typical threats to human health and sustainable cities. The exploration of residents' perceptions of thermal environment and its mitigation measures will support the health risk prevention. Methods: A survey with a combination of closed-ended and open-ended questions was conducted in July 2021 among 13 urban parks in Xi'an City, China. With the help of ANOVA and ordinal logistic regression, this study investigated the influencing factors both on residents' health risk perception of hot days and their perception of the effect of urban ecological landscape on reducing the thermal risk. The relationship between health risk perception and residents' needs of urban ecological construction was also explored. Results: According to 325 valid questionnaires, the male-female ratio of respondents was found to be 1:0.87, young people aged 18-29 (26.46%), the retirees (27.08%) and the ones with undergraduate education (33.23%) were, relatively, the largest groups. The results show that 92.31% of the respondents believed that their daily lives were under the influence of hot days. Housing types, occupation, cooling equipment at work, and outdoor working hours all had a significant impact on their high temperature perceptions. The proportion of respondents who were under a huge health risk and sought medical treatment due to hot days was 30.16% and 44.92%, respectively. Women were 18.52 and 2.33 times more likely to suffer health threats and experience discomforts than men. Furthermore, 73.23% of the respondents believed that the urban ecological landscapes in Xi'an had an enhanced cooling effect in recent years. Compared with the morphological characteristics, residents' recognition of the restriction of landscape's area on its cooling effect was higher, and the residence duration showed a significant influence. Conclusion: The cooling effect of green spaces and water effectively resisted urban thermal threats, and residents' needs of the urban ecological landscapes was associated with their health risk perceptions of hot days. In the future, it is necessary to promote the early warning of hot days, meanwhile, the optimization of landscape patterns of green infrastructures should be implemented in urban planning for the purposes of residents' health risk prevention.

The influence of the COVID-19 pandemic on work connectivity behavior.

Introduction: Based on event system theory, this study analyzed the influence of the event strength of major public health outside the organization on work connectivity behavior. Methods: The study collected data from 532 employees on their psychological status and working style during the COVID-19 pandemic through an online questionnaire survey. Results: The results show that driven by financial risk perception, female employees are more willing to pay work connectivity behavior than male employees and unmarried employees are more willing to pay work connectivity behavior than married employees. The risk perception of employees aged 28-33 has the greatest impact on workplace behavior. The impact of financial risk perception on behavior of employees without children is much higher than that of employees with children. The influence of financial risk perception and social risk perception on their behavior of employees with master's degree is much higher than that of health risk perception, but the workplace behavior of employees with doctor's degree is mainly affected by health risk perception. Discussion: The novelty of the Corona Virus Disease event has a negative influence on work connectivity duration. The criticality, disruption of the Corona Virus Disease event has a positive influence on work connectivity duration. The criticality of the Corona Virus Disease event has a positive influence on work connectivity frequency. Employees' social risk perception, financial risk perception and health risk perception has a positive influence on the work connectivity duration and work connectivity frequency.

Erratum: Designing mindfulness information for interaction in social media: The role of information framing, health risk perception and lay theories of health.

[This corrects the article DOI: 10.3389/fpsyg.2022.1041016.].

Unintended health benefits of adopting preventive behaviors during a virus outbreak.

This study investigates whether changes in risk perception play a critical role in improving of preventive behaviors and health outcomes by examining the 2009 H1N1 influenza (or swine flu) pandemic in Korea. We employ a difference-in-differences estimation strategy by comparing the differential effects of the H1N1 outbreak on the confirmed cases of diseases which can be prevented by preventive behaviors (e.g., intestinal infections) and the cases of diseases which cannot (e.g., injuries). Using unique administrative data from South Korea's National Health Insurance Service (NHIS), we find that the exogenous increase in health risk reduced the incidence of intestinal infections compared to the injuries during the H1N1 influenza outbreak. The reduction was the most substantial among children under five years of age, with a 25.4% decline in cases of intestinal infections relative to injuries. Our findings are robust across various alternative specifications. We provide suggestive evidence that active adoption of preventive behaviors is one of the channels underlying the unexpected decrease in diarrhea cases. The effects, however, faded away shortly after the end of the pandemic and did not last in the long run.

Travel shaming? Re-thinking travel decision making amid a global pandemic.

The COVID-19 pandemic has placed the notion of "travel shaming" under the spotlight-tourists are concerned about being criticized for traveling during the pandemic. Yet the broader idea of travel-induced shaming, conceptualized as ethics-based evaluations in this paper, has not drawn much attention as consequence-based assessments in travel-related risk research. This paper presents two studies revealing a) how ethics- and consequence-based risk evaluations influence individuals' travel attitudes/intentions and b) how message framing about responsible travel affects travel shame and individuals' intentions to travel responsibly. Using structural equation modeling, Study 1 suggests that consequence- and ethics-based evaluations play key roles in predicting travelers' attitudes/intentions to travel. Moreover, social trust and self-efficacy significantly affect both types of risk evaluations. Study 2 adopts an experimental design and shows that, compared with loss-framed and controlled message conditions, gain-framed messaging can reduce travel shame and encourage tourists to travel responsibly. Theoretical and practical implications were discussed.

COVID-19 pandemic and tourism: The impact of health risk perception and intolerance of uncertainty on travel intentions.

Understanding tourist behavior during and after major tourism crises is essential to help destinations recover. The COVID-19 pandemic - a period of uncertainty and risk - makes it relevant to assess factors that influence travel intentions. There has been little research on tourist behavior during health crises and, in particular, on perceived health risk and uncertainty effects on travel intentions. This study was carried out at the beginning of the pandemic in Brazil and aims to investigate the role of health risk perception and intolerance of uncertainty on travel intentions for 2020 and 2021. We applied an online survey to 1150 Brazilian participants from April to May 2020. Our findings indicate that perceived COVID-19 severity, perceived probability of infection, and expected duration of the pandemic are significant predictors of travel intentions for both years. This paper contributes to a deeper understanding of crisis-resistant tourists' characteristics and provides insights for destinations' recovery.

The impact of public health education on people's demand for commercial health insurance: Empirical evidence from China.

Public health education is gaining significance globally, and it is important for managing health risks. This study empirically analyzed the effect of public health education on people's demand for commercial health insurance. And we used the fixed effects and the mediating effect models, and instrumental variables regression in our research based on panel data of 31 provinces (including municipalities and autonomous regions) in China from year 2009 to 2019. The findings show that public health education significantly increases people's demand for commercial health insurance, and this effect remains significant when considering endogeneity and robustness. We further analyzed and found that the increased demand for commercial health insurance is caused by health literacy, health risk perceptions and health risk attitudes. Through heterogeneity analysis, we found that there were significant differences in the effects of public health education in regions with different demographic and socioeconomic characteristics. We found that the effect of health education on promoting people's demand for commercial health insurance is more obvious in regions with high levels of urbanization, proportion of men, education, economic development, medical resources, and social medical insurance coverage. Governments are supposed to take further measures to enhance the effectiveness of public health education, develop high-quality commercial health insurance, and continuously improve health risk coverage.

Travel intention during the COVID-19 epidemic: The influence of institutional and interpersonal trust.

The global pandemic, COVID-19, has dealt a heavy blow to the tourism industry. Therefore, exploring the mechanisms influencing travel intention in the post-epidemic era can help provide management insights for the recovery of the travel market. Relying on the logic of social cognition theory, we conducted an empirical analysis from the perspective of trust and found that institutional trust and interpersonal trust can positively predict travel intention in the context of the epidemic, while travelers' health risk perception and safety self-efficacy mediate the relationship between trust and travel intention. Moreover, we verified the moderating role of tourists' psychological resilience. Further, the study confirms that China's active prevention policy not only reduces the physical health harm caused by the epidemic, but also effectively increases individuals' institutional trust in a proactive government. Through China's active anti-epidemic policy, individuals were able to counteract the negative impact of the COVID 19 epidemic on their travel intention. Further, theoretical and practical implications are discussed.

From Health Campaign to Interpersonal Communication: Does Traditional Diet Culture Hinder the Communication of the Chinese Gongkuai Campaign?

Interpersonal communication is beneficial in promoting individuals' tendency to accept health-campaign-targeted behavior. Based on the protective action decision model, this study investigated the key factors underlying individual's interpersonal communication on the Gongkuai campaign, which was carried out during Coronavirus disease 2019 (COVID-19). The main goal of the Gongkuai campaign was to change traditional communal eating habits and reduce public health risks. An online questionnaire survey involving 618 respondents was conducted in China after the 2020 Gongkuai campaign propagated, and the data were analyzed by using the structural equation modeling technique. The results indicated that health campaign exposure is a critical determinant of perceived campaign-related knowledge and health risk perception, which are significant predictors of interpersonal communication. Meanwhile, campaign-related knowledge can elicit risk perception. Furthermore, campaign exposure influenced interpersonal communication in ways that traditional diet culture did not predict. Risk perception was also unaffected by traditional diet culture. It is worth noting that individuals' agreement with traditional diet culture does not hinder health campaign-generated interpersonal communication in the context of public health crisis. Based on the findings, theoretical and policy implications for motivating interpersonal communication were discussed, and research limitations were pointed out.

Research on older people's health information search behavior based on risk perception in social networks-A case study in China during COVID-19.

Objective: COVID-19 has caused great loss of human life and livelihoods. The dissemination of health information in online social networks increased during the pandemic's quarantine. Older people are the most vulnerable group in sudden public health emergencies, and they have the disadvantage of infection rates and online search for health information. This study explores the relationship between the health risk perception and health information search behavior of older people in social networks, to help them make better use of the positive role of social networks in public health emergencies. Method: Based on the Risk Information Search and Processing model, and in the specific context of COVID-19, this study redefines health risk perception as a second-order construct of four first-order factors (perceived probability, perceived severity, perceived controllability, and perceived familiarity), and constructs a research model of the health risk perception and health information search behavior of older people. An online survey of people over 55 years old was conducted through convenience sampling in China from February 2020 to March 2020. Results: A total of 646 older adults completed the survey. The structural equation model showed that health risk perception is a second-order factor (H1), that health risk perception has significant positive effects on health information search behavior (H2: ß = 0.470, T = 11.577, P < 0.001), and that health risk perception has significant positive effects on affective response (H3: ß = 0.536, T = 17.356, P < 0.001). In addition, affective response has a significant positive mediating effect on information sufficiency (H4: ß = 0.435, T = 12.231, P < 0.001), and information sufficiency has a significant positive mediating effect on health information search behavior (H5: ß = 0.136, T = 3.081, P = 0.002). Conclusion: The study results indicate that the health risk perception of older people during the COVID-19 outbreak not only directly affected their health information search behavior, but also had an indirect impact on their health information search behavior by affecting affective response and information sufficiency.

Recycled water acceptance: Data from two Spanish regions with opposite levels of scarcity.

The dataset presented in this paper were collected for testing a perceptive-axiological model of recycled water acceptance for low and high contact uses. Participants were selected by proportional random sampling by sex and age the two Spanish communities with the most extreme values of water stress (Galicia, the rainiest region and Murcia, the driest). Data were collected by a company specialized in market research using an online survey housed on Qualtrics. Participants who matched the specified profile were contacted by email. The company compensated them financially. The final sample size consisted of 726 valid responses. The survey collected data on a variety of variables related to three conceptual dimensions: the diagnosis of the environmental situation, the axiological influence and the public perceptions regarding recycled water. The survey also collected demographic data from respondents. The survey was designed and reviewed by four experts in social psychology and two experts in methodology. The dataset featured in this article provides the raw survey data plus sociodemographic distribution, survey items, and other statistical data. This is the first and most comprehensive set of comparative data known to the authors on public acceptance of water reuse for high and low contact uses comparing regions with and without water scarcity. The authors have published an open access paper based on this data set, which are linked to this paper. Water industry professionals, policymakers, researchers and other stakeholders aiming to implement wastewater reuse systems in society may be interested in using the data as a point of comparison for their own study on public acceptance of water reuse or examining the data for relationships not yet explored in the literature.