Longitudinal study of theory-based predictors of COVID-19 vaccination.

Efforts to mitigate the impact of COVID-19 now focus primarily on encouraging vaccination. These efforts have been hampered, however, by vaccine hesitancy. A better understanding of the factors associated with vaccination may help identify those most likely to experience hesitancy and inform the content of public health outreach efforts. The aims of this study were to evaluate whether two theory-based factors (perceived vaccine efficacy and vaccination intention) and political party affiliation were associated with vaccination in the United States (US) and to provide descriptive analysis of factors shaping vaccination decisions. A longitudinal online survey was conducted with 108 adults in the US. Participants completed surveys in July 2020 (Time 1) and October 2021 (Time 2). As hypothesized, greater vaccination intention and perceived vaccine efficacy were significant predictors of vaccine uptake. The second hypothesis was also supported as political party affiliation was associated with vaccination (i.e. Democrats were more likely to vaccinate than Republicans). Descriptive data indicated that vaccinated participants (including those reluctant to vaccinate at Time 1) had been motivated by a desire to protect themselves and others from COVID-19. Participants who had chosen not to vaccinate were influenced by a variety of factors including concerns about vaccine safety and efficacy. Understanding the predictors of vaccination is critical to identifying those unlikely to vaccinate and creating effective interventions to encourage the uptake of this essential public health strategy. Messaging should emphasize the efficacy of COVID-19 vaccines and be delivered by those seen as trustworthy in communities prone to vaccine hesitancy.

The roles of risk perception, negative emotions and perceived efficacy in the association between COVID-19 infection cues and preventive behaviors: a moderated mediation model.

Preventive behaviors during the COVID-19 pandemic are especially critical to the protection of individuals whose family members or acquaintances have been infected. However, limited research has explored the influence of infection cues on preventive behaviors. This study proposed an interaction model of environment-cognitive/affective-behavior to elucidate the mechanism by which infection cues influence preventive behaviors and the roles of risk perception, negative emotions, and perceived efficacy in that influence. To explore the relationships among these factors, we conducted a cross-sectional online survey in 34 provinces in China during the first wave of the COVID-19 pandemic. A total of 26,511 participants responded to the survey, and 20,205 valid responses (76.2%) were obtained for further analysis. The moderated mediation results show that infection cues positively predicted preventive behaviors in a manner mediated by risk perception and negative emotions. Moreover, perceived efficacy moderated the influence of infection cues not only on preventive behaviors but also on risk perception and negative emotions. The higher the perceived efficacy, the stronger these influences were. These findings validated our model, which elucidates the mechanisms underlying the promoting effect of infection cues on preventive behaviors during the initial stage of the COVID-19 pandemic. The implications of these results for the COVID-19 pandemic and beyond are discussed.

Creating persuasive health messages on social media: Effects of humor and perceived efficacy on health attitudes and intentions.

This study examined how humor (incongruity humor vs. no humor) interacts with individual differences in perceived efficacy to influence health attitudes and behavioral intentions. Results of a controlled experiment (N = 294) revealed that among individuals with lower levels of perceived efficacy, incongruity humor, relative to no humor condition, resulted in greater source liking, which in turn, enhanced their attitudes and intentions to perform preventive health behaviors. However, for individuals higher in perceived efficacy, incongruity humor (vs. no humor) had an indirect negative effect on intentions via decreased attitudes. Theoretical and practical implications of these findings are discussed.

Personality and perceived stress during COVID-19 pandemic: Testing the mediating role of perceived threat and efficacy.

Prolonged stress is associated with poor physical and mental health outcomes. Understanding the mediators between personality and stress is critical for developing effective stress management interventions during a pandemic. Our study explored whether perceptions of threat from COVID-19 and efficacy to follow government recommendations for preventing COVID-19 would mediate the relationships between personality traits (e.g., neuroticism, conscientiousness-goal-striving, extroversion-activity and sociability) and perceived stress. In an online survey of a representative sample of Canadian adults (n = 1055), we found that higher neuroticism and extroversion were associated with higher levels of stress during the pandemic and a greater increase in stress levels compared to levels before the pandemic. Perceived threat and efficacy significantly mediated the relationship between neuroticism and stress, which suggested that individuals with higher neuroticism experienced higher levels of stress due to higher levels of perceived threat and lower levels of efficacy. Perceived threat did not mediate the relationship between extroverts and stress, which suggested that the source of stress may stem from elsewhere (e.g., inability to socialize). Our findings highlighted that personality traits could be an important factor in identifying stress-prone individuals during a pandemic and that stress management interventions need to be personality specific.

Awareness, Willingness, and Perceived Efficacy of Pre-exposure Prophylaxis among Adolescent Sexual Minority Males.

Despite the approval of PrEP for adolescents by the FDA in 2018, little is known about the awareness and attitudes about PrEP use among adolescent sexual minority males, who are at the greatest risk for HIV. We analyzed baseline data from the MyPEEPS Mobile study, a multi-site randomized controlled trial evaluating the effectiveness of a mobile behavioral HIV prevention intervention. A substantial proportion (68.2%) of study participants (ages 13-18) had previously heard about PrEP, and an overwhelming majority (90.8%) reported willingness to take PrEP, to prevent HIV. On the other hand, only about one third (34.6%) of participants indicated that taking a daily HIV pill would be "very" or "completely" effective in preventing HIV when having sex without a condom. These findings suggest that high awareness and willingness to use PrEP across various adolescent subgroups present opportunities for increased PrEP advocacy among this young age group.

Perceptions of the Efficacy of Prayer and Conventional Medicine for Health Concerns.

Previous research has associated prayer practices with positive health outcomes, but few studies have examined: (a) the perceptions of prayer in relation to perceptions of the efficacy of conventional medicine, and (b) whether the perceptions of prayer efficacy differ based on illness type, context of prayer, and whether prayer is for the self or someone else. The current study surveyed 498 emerging adults at a public university. Conventional medicine was perceived as more effective for alleviating health concerns overall, but participants perceived prayer as most effective when performed in a group setting for someone else. Individuals perceived prayer as more effective than conventional medicine when they reported greater religious activity, lower health locus of control, and higher spiritual locus of control.

Role of individual perceptions in the consistent use of malaria preventive measures: mixed methods evidence from rural Rwanda.

BACKGROUND: Malaria preventive measures, including long-lasting insecticide-treated bet nets (LLINs), indoor residual spraying (IRS), and controlling mosquito breeding sites, are key measures to achieve malaria elimination. Still, compliance with these recommended measures remains a major challenge. By applying a novel and comprehensive model for determinants of malaria prevention behaviour, this study tests how individual perceptions influence the intentions to use malaria preventive measures and explores strategies that stimulate their consistent use. METHODS: The study was carried out in the sectors of Ruhuha and Busoro, Rwanda during October and November 2017, and these were conducted into two phases. Phase one involved a questionnaire survey (N = 742), whereas Phase two employed a qualitative approach that included nine focus group discussions, seven key informant interviews, and three in-depth interviews. RESULTS: The findings of the quantitative study showed that participants very often use LLINs (66.6%), accept IRS (73.9%), and drain stagnant water in case of presence (62%). The intentions to use malaria preventive measures were consistently driven by perceived severity, perceived self-efficacy, perceived response efficacy, and subjective norms, and hindered by perceived barriers. The intentions were also positively associated with the actual use of LLINs, acceptance of IRS, and drainage of stagnant water. There is no evidence that either not having enough LLINs (ownership of at least one bed net in the household, here referred to as availability) or having sufficient LLINs (having one LLIN per two people in the household, here referred to as accessibility) moderated the relationship between behavioural intentions and actual use of LLINs. The qualitative study indicated that participants believed malaria risk to be high and perceived a high mosquito density. They also believed that repetitive malaria episodes are caused by the perceived low effectiveness of anti-malaria medications. Lack of LLINs increased the perceived added value of LLINs, and together with the increased malaria burden increased the perceived response efficacy. Participants highlighted the need to continuously mobilize and engage community members especially those who do not use LLINs when having one, and those who do not accept the spraying activities. CONCLUSION: Malaria prevention interventions should target individual perceptions to enhance consistent use of malaria preventive measures. Three strategies to improve consistent use and acceptance of these measures are highlighted: (1) ensure access to LLINs and regular spraying activities, (2) community mobilization and (3) citizen engagement in malaria prevention activities.

Understanding everyday strategies used to manage indulgent food consumption: A mixed-methods design.

To maintain a healthy body weight or support weight loss efforts, dietary self-management must allow for the limitation of tempting high energy-dense foods. We were interested in people's implementation of day-to-day strategies in order to successfully manage their indulgent food and beverage consumption. Participants from the Swansea area, UK (N = 25; Mage = 37; 68% male) were divided into four focus groups. The average BMI was within the healthy range (23 kg/m2). Each group discussed the approaches that they used to manage their consumption of indulgent foods and drinks. Group discussions were then transcribed, thematically analysed and independently reviewed by a second researcher. In a follow-up phase, participants were asked to rate how often they used the identified strategies and to rate the perceived effectiveness of any that applied to them. The thematic analysis revealed four major themes: Exercise, Cognitive Strategies, Availability and Meal Formation. Variability in the frequency with which strategies were used and perceived as effective was evident. Notably, participants tended to use multiple strategies and even lean participants who did not identify themselves as 'dieters' none-the-less employed a variety of strategies to successfully manage their exposure to and consumption of tempting foods. The findings suggest that dietary advice could be improved by taking into account the strategies for managing indulgent food consumption that are frequently used by individuals, as well as those that are perceived as effective.

Threat appeals in health communication: messages that elicit fear and enhance perceived efficacy positively impact on young male drivers.

BACKGROUND: Health communications often present graphic, threat-based representations of the potential consequences of health-risk behaviours. These 'threat appeals' feature prominently in public health campaigns, but their use is controversial, with studies investigating their efficacy reporting inconsistent, and often negative, findings. This research examined the impact of a threat-based road safety advertisement on the driving behaviour of young male drivers. METHODS: To address limitations of previous research, we first identified a road safety advertisement that objectively and subjectively elicited fear using physiological and subjective measures. Study 1 (n = 62) examined the effect of this advertisement, combined with a manipulation designed to increase perceived efficacy, on speed choice. Study 2 (n = 81) investigated whether a state emotion, anger, impacts on the effectiveness of the advertisement in changing four distinct driving behaviours. Both studies examined short-term effects only. RESULTS: Study 1 findings indicated that a high threat message, when combined with high perceived efficacy, can lead to a decrease in speed choice. Study 2 results suggested that increased levels of state anger may counteract the potential value of combining fear-arousing threats and efficacy-building messages. CONCLUSIONS: Findings suggest that threat-based road safety communications that target affective (fear) and cognitive (perceived efficacy) mechanisms can positively affect driving behaviours. State emotions, such as anger, may negatively impact on the effectiveness of the message. Taken together, these findings provide additional support for the use of efficacy-building messages in threat-based communications, but highlight the need for further research into the complex array of affective influences on driving.

Participation of chronic patients in medical consultations: patients' perceived efficacy, barriers and interest in support.

AIMS: Chronic patients are increasingly expected to participate actively in medical consultations. This study examined (i) patients' perceived efficacy and barriers to participation in consultations, (ii) patients' interest in communication support and (iii) correlates of perceived efficacy and barriers, with an emphasis on differences across providers' disciplines. METHODS: A representative panel of chronic patients (n = 1314) filled out the short Perceived Efficacy in Patient-Provider Interaction scale and were questioned about barriers to participation and interest in communication support. Potential correlates included socio-demographic (age, sex, education, living situation), clinical (discipline care provider, type of illness, comorbidity, illness duration, functional disabilities, health consultations in last year) and personal characteristics (information preference, health literacy, level of general patient activation). RESULTS: Most patients felt efficacious in consultations, although 46% reported barriers to participation and 39% had an interest in support. Barriers most frequently recognized were 'not wanting to be bothersome', 'perception there is too little time' and 'remembering subjects only afterwards'. Patients most frequently endorsed relatively simple support. Patients perceived the least barriers and were least likely to endorse support when seeing a nurse. In multivariate models, consistent risk factors for low efficacy and perceived barriers were low health literacy and a low general patient activation. CONCLUSIONS: Many chronically ill patients feel confident in medical interactions. Still, a significant number might benefit from support. Often this concerned more generally vulnerable patients, that is, the low literate and generally less activated. Relatively simple supportive interventions are likely to be endorsed and might overcome frequent barriers.

Ethnoveterinary treatment of livestock in Ghana: Cultural importance and consensus on plants used.

The traditional free-range system of livestock rearing contributes to the socioeconomic well-being of most rural households in Ghana. The traditional management system exposes livestock to a high disease incidence, but healthcare support for animal production is limited. Ethnoveterinary practice is an integral part of livestock treatment, particularly in rural communities where veterinary services are poor. However, documentation of the plants used for ethnoveterinary treatment of livestock is scant in the country. Given the dearth of information on ethnoveterinary treatment, this study aimed to document the cultural significance and level of agreement of plant species used for treating livestock ailments in the Adaklu district. Ethnoveterinary data were collected from 120 respondents using semi-structured questionnaires. Quantitative ethnobotanical indices were used to ascertain the most culturally significant plant species for livestock healing. It was found that 38 plant species were used to treat various livestock ailments. Ethnobotanical indices revealed that Mangifera indica, Elaeis guineensis, Khaya senegalensis, Spondias mombin, and Physalis peruviana were the most culturally significant plant species for treating livestock ailments. Mangifera indica was found to be the most versatile species for treating livestock ailments and had the highest cultural importance (CI). This study reveals the high cultural importance of plants in the Adaklu district to improve livestock healthcare. The perceived efficacy influences the selection and utilization of a resource for folk medicine. The study recommends isolating and characterizing the active compounds in the most culturally significant plants and testing the properties on the medical conditions attributed to these plants.

Collective action against corruption in Western and non-Western countries: cross-cultural implications of the Axiological-Identitary Collective Action Model.

People sometimes protest government corruption, yet our current understanding of why they do so is culturally constrained. Can we separate pancultural factors influencing people's willingness to protest government corruption from factors culturally specific to each socioecological context? Surprisingly little cross-cultural data exist on this important question. To fill this gap, we performed a cross-cultural test of the Axiological-Identitary Collective Action Model (AICAM) regarding the intention to protest against corruption. As a collective action framework, AICAM integrates three classical antecedents of collective action (injustice, efficacy, identity) with axiological variables (ideology and morality). A total sample of 2,316 participants from six countries (Nigeria, Russia, India, Spain, United States, Germany) in a multilevel analysis of AICAM predictions showed that the positive relationship of the intention to protest corruption with moral obligation, system-based anger, and national identification can be considered pancultural. In contrast, the relationships between system justification and perceived efficacy are culturally specific. System justification negatively predicted the intention to participate only in countries with high levels of wealth, while perceived efficacy positively predicted it only in countries perceived as less corrupt. These findings highlight the importance of accounting features of socioecology and separating pancultural from culture-specific effects in understanding collective action.

Prosociality and Personality: Perceived Efficacy of Behaviors Mediates Relationships between Personality and Self-Reported Climate Change Mitigation Behavior.

The included studies examined the relationship between climate change mitigation behavior (CCB) and personality. In Study 1, 1089 US collegians completed a measure of the Big Five and indicated how often they engaged in five CCBs. Engaging in each CCB was regressed on the Big Five. These analyses found openness was positively related to all five CCBs, neuroticism was positively related to four of five CCBs, and extraversion was positively related to three CCBs. In Study 2, 1688 US collegians completed the same measures as in Study 1 with two additional CCBs. They also indicated how efficacious they thought each CCB was. Each CCB was regressed on the Big Five. These results largely replicated those of Study 1 and also found that conscientiousness was positively related to five of seven CCBs. Mediational analyses found that all relationships between personality factors and CCB were mediated by the perceived efficacy of the CCB. The present results suggest that efforts to increase climate change mitigation behavior need to take into account the perceived efficacy of such behaviors.

The Relationship between Job Demands and Turnover Intention among Chinese Prison Officers during the COVID-19 Pandemic: A Moderated Mediation Model.

The COVID-19 pandemic has brought enormous challenges to both employees and organizations all over the world. Previous studies have found high turnover rates among prison officers since the outbreak of COVID-19. This cross-sectional study aimed to investigate the mediating role of job burnout between job demands and turnover intention, as well as the moderating role of the perceived efficacy in overcoming COVID-19 in Chinese prison officers. In total, 1316 prison officers were recruited to complete an online questionnaire between May 2022 and June 2022 (during the COVID-19 pandemic). The bootstrapping approach was used to assess the moderated mediation model in this study. The results showed that prison officers' job demands were positively associated with their turnover intention. Job burnout mediated the relationship between job demands and turnover intention. Perceived efficacy in overcoming COVID-19 moderated the effect of job burnout on turnover intention. Based on these results, suggestions were provided to reduce the high turnover rate of prison officers in public health events like the COVID-19 pandemic.

Why should I vaccinate? The role of mindfulness and health-protective behaviours during the COVID-19 pandemic.

Objective: Health maintenance of the general public through vaccination is a significant component of controlling the COVID-19 pandemic. This study aims to examine the perception of Nigerians toward the COVID-19 vaccine. Methods: Informed by the Extended Parallel Process Model (EPPM), 793 Nigerian participants completed a cross-sectional self-administered online survey to assess: (1) their perception of COVID-19 based on fear-mongering information on social media (2) the potential relationship between threat perception, efficacy, and fear associated with the COVID-19 vaccine, vaccine hesitancy, and attitudes toward the decision to uptake the vaccine using structural equation modeling (SEM) analysis, and (3) we further employed the use of the hierarchical regression analysis to test the moderating effect of mindful critical thinking between vaccine hesitancy and attitudes toward vaccines. Results: Most participants (65.7%) intend to uptake the COVID-19 vaccine. However, many people did not fear the disease (19.2%). Threat perception and efficacy were associated with a decision to uptake the COVID-19 vaccine via the mediation of attitudes toward vaccines. Previous vaccine hesitancy has no relationship with uptake decisions. The hierarchical regression analysis showed that participants exhibiting high critical thinking mindfulness were more interested in taking the vaccine. Conclusions: The findings of this study demonstrate that EPPM constructs are effective predictors of the public's decision to uptake the COVID-19 vaccine. This research highlights the theoretical and practical implications.

A longitudinal study among young adults into the predictive effect of perceived efficacy of behavioural strategies and the moderating role of drinking motives on use of protective behavioural strategies.

INTRODUCTION: Although protective behavioural strategies (PBS) have shown to be effective in minimising alcohol-related negative consequences, research on the explanatory factors of their use is very scarce. Perceived efficacy has been demonstrated to be one of the most relevant explanatory factors in the use of health-related protective behaviours. The present study prospectively examines the relationship between the perceived efficacy of PBS in reducing alcohol-related negative consequences and the use of PBS in a community-based sample of young adults. In addition, the moderating role of drinking motives in this relationship is also examined. METHODS: Prospective design with a baseline assessment and a 2-month follow up. Using a targeted sampling procedure, 339 young adults were recruited from the community [mean age: 21.1 (SD = 2.21); female = 50.7%] and completed questionnaires to measure perceived efficacy of PBS and drinking motives at baseline and PBS use at follow up. RESULTS: Perceived efficacy of PBS at baseline was positively associated with PBS use at follow up, and these relationships were weaker as social, enhancement and coping motives scores increased. DISCUSSION AND CONCLUSIONS: Our findings support the need to include the perceived efficacy of PBS to reduce alcohol-related negative consequences in future interventions aimed at promoting PBS use. Moreover, these interventions should be personalised according to the initial levels of participants' drinking motives, incorporating elements that allow for neutralising their negative effects on PBS use (e.g. training in coping skills for those with strong coping motives).

Does Trust Help to Improve Residents' Perceptions of the Efficacy of Disaster Preparedness? Evidence from Wenchuan and Lushan Earthquakes in Sichuan Province, China.

Disaster preparation can reduce the impact of an earthquake on residents. Residents are more likely to undertake disaster preparedness if they perceive it to be effective. However, few studies have analyzed the influence of trust on this perception. This study surveyed 327 households in areas stricken by the Wenchuan and Lushan earthquakes to explore these issues. Trust was divided into government trust, emotional trust, and social trust, while the efficacy of disaster preparedness was divided into self-efficacy and response efficacy. A partial least squares structural equation model was used to explore the influence of trust on perceptions of the efficacy of disaster preparedness. The results show that: (1) government trust can directly increase perceived efficacy and indirectly increase self-efficacy via emotional trust; (2) emotional trust can directly increase self-efficacy; (3) social trust can directly reduce self-efficacy while indirectly increasing it by increasing emotional trust. This study deepens our understanding of the relationship between trust and perceptions of the efficacy of disaster preparedness. This study can provide inspiration to improve risk communication and construct systems of community-based disaster-prevention.

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.

What Prompted the Adoption of Self-Protective Behaviors in Response to COVID-19? Evidence From Women Living in the Rural Areas of Western China.

Background: Self-protective behaviors, such as handwashing and mask-wearing, are effective to reduce the spread of coronavirus disease (COVID-19), but few studies have focused on women living in rural areas who bear the brunt of the impacts of the pandemic due to their economic and social vulnerabilities. This study explores what prompted the adoption of self-protective behaviors in response to COVID-19 among women living in rural areas of western China. Methods: The study sample consisted of 1,524 women from 116 townships across 10 counties in rural western China. We collected data in May and August 2020 on women's socioeconomic characteristics, exposure to COVID-19-related information, psychological response to COVID-19, and adoption of self-protective behaviors. Structural equation modeling (SEM) analyses were conducted to analyze the relations among the variables. Results: During the lockdown, 1,221 (80.12%) of the 1,524 women in the study sample reported wearing a mask every time when they went outside and 1,021 (66.99%) reported handwashing with soap every time after they came home. Perceived efficacy had the strongest association with self-protective behaviors (ß = 0.38; p < 0.001). Receiving public health guidance (ß = 0.18; p < 0.001) was indirectly associated with more self-protective behaviors via greater perceived efficacy. Higher socioeconomic status was also directly associated with increased adoption of self-protective behaviors (ß = 0.24; p < 0.001). Other variables, such as receiving surveillance and risk information, communication channels, perceived risks, and fear, were indirectly associated with the adoption of self-protective behaviors with smaller effect sizes (all ß were lower than 0.10). Conclusions: Not all women were able to adopt self-protective behaviors, such as mask-wearing and handwashing, during the COVID-19 pandemic in western China. To further encourage behavioral changes in response to public health crises, the government should develop clear and actionable guidelines and adopt targeted health communication strategies to reach the most disadvantaged groups of society. These findings may inform tailored responses to COVID-19 in other low- and middle-income countries.

Intolerance of COVID-19-Related Uncertainty and Negative Emotions among Chinese Adolescents: A Moderated Mediation Model of Risk Perception, Social Exclusion and Perceived Efficacy.

The uncertainty caused by the COVID-19 pandemic has exacerbated negative emotions, especially among adolescents, who feel unable to tolerate the uncertainty of the epidemic. However, the mechanism by which the intolerance of COVID-19-related uncertainty (COVID-19 IU) affects negative emotions in adolescents remains unclear. This study explored the underlying mechanism from COVID-19 IU to negative emotions using a moderated mediation model in adolescents. In total, 3037 teenagers completed a cross-sectional survey including measures of COVID-19 IU, risk perception, social exclusion, perceived efficacy, and negative emotions. The results showed that COVID-19 IU positively predicted negative emotions and that risk perception and social exclusion mediated this relationship. In addition, both the direct effect of COVID-19 IU on negative emotions and the mediating effect of risk perception on this relationship were moderated by perceived efficacy; in particular, COVID-19 IU had a greater impact on negative emotions among adolescents with lower levels of perceived efficacy. These findings suggest that COVID-19 IU is closely associated with negative emotions among adolescents and that effective measures should be taken to enable adolescents to improve their perceived efficacy and develop a reasonable perception of risk, help them eliminate the stigma of the disease, and strengthen their connections with society.