Do health beliefs about COVID-19 predict morbidity? A longitudinal study

In a highly powered (N ≈ 5000), six-months longitudinal study (December 2020-May 2021), we tested the assumption that beliefs concerning COVID-19 and the precautions against it predicted morbidity. Six months after having filled out a survey measuring beliefs about the disease and the precautions against it, participants reported if they were or had been ill with COVID-19. A lower likelihood of being or having been ill with COVID-19 was predicted by personal optimism concerning infection, perceived personal control over infection, perceived effectiveness of precautions, and self-reported personal or better-than-average adherence to the precautions. A higher likelihood of being or having been ill with COVID-19 was predicted by perceived personal control over a good outcome of an infection, egocentric impact perception concerning the impact of the disease, perceived difficulty of adherence to the precautions, and both personal and egocentric impact perception concerning the impact of the precautions. Comparative optimism did not predict morbidity, nor did personal optimism concerning severe disease or a good outcome, perceived personal control over severe disease, and moralization of the precautions. We discuss implications for public health communication.     

Implicit and explicit COVID-19-vaccine harmfulness/helpfulness associations predict vaccine beliefs,intentions, and behaviors

We investigated the role of implicit and explicit associations between harm and COVID-19 vaccines using a large sample (N = 4668) of online volunteers. The participants completed a brief implicit association test and explicit measures to evaluate the extent to which they associated COVID-19 vaccines with concepts of harmfulness or helpfulness. We examined the relationship between these harmfulness/helpfulness COVID-19 vaccine associations and vaccination status, intentions, beliefs, and behavior. We found that stronger implicit and explicit associations that COVID-19 vaccines are helpful relate to vaccination status and beliefs about the COVID-19 vaccine. That is, stronger pro-helpful COVID-19 vaccine associations, both implicitly and explicitly, related to greater intentions to be vaccinated, more positive beliefs about the vaccine, and greater vaccine uptake.     

Safety behaviors were associated with greater anxious symptoms during the first year of the COVID-19 pandemic

Research shows that people who use safety behaviors are at greater risk factor for anxiety than people who do not use safety behaviors. However, the perception of some safety behaviors changed during the COVID-19 pandemic; behaviors that were once considered unnecessary or excessive were now commonplace (e.g., monitoring bodily symptoms, avoiding crowds). The purpose of this study was to determine the degree to which the pandemic changed the status of health-related safety behaviors as a risk factor for symptoms of anxiety. To this end, we tested the effect of safety behavior use on anxious symptoms during the first year of the pandemic using a longitudinal design with 8 time points and participants (n = 233) from over 20 countries. Despite possible changes in their perception, those engaging in high levels of safety behaviors reported the greatest levels of anxious symptoms throughout the pandemic year. However, the outcomes for safety behavior users were not all negative. Safety behavior use at baseline was the only predictor of participants' willingness to receive the COVID-19 vaccine (measured one year later).     

Behavioral extremity moderates the association between certainty in attitudes about COVID and willingness to engage in mitigation-related behaviors

People generally intend to act more on beliefs and attitudes about which they have greater certainty. However, we introduce a boundary condition to the positive association between certainty and behavioral intentions—behavioral extremity. Uncertainty about a threatening issue like COVID-19 can be disconcerting, and we propose that uncertain people cope in part through increased openness to extreme actions like accepting risky medical treatments and aggression toward those defying mitigation policies. Testing this, we compiled and analyzed all the data on certainty about COVID-19 mitigation policies and willingness to engage in mitigation-related behaviors that our lab collected during the pandemic (6 samples, 20 behaviors, Ns up to 1496). External ratings of the behaviors' extremity moderated certainty-willingness associations: whereas greater certainty was associated with increased willingness to engage in moderate behaviors (the typical result), lower certainty was associated with increased willingness to engage in extreme behaviors, especially among those worried about becoming ill.     

Social cohesion predicts COVID-19 vaccination intentions and uptake

COVID-19 vaccination is widely regarded as an individual decision, resting upon individual characteristics and demographic factors. In this research, we provide evidence that psychological group membership, and more precisely, social cohesion—a multidimensional concept that encompasses one's sense of connectedness to, and interrelations within, a group—can help us understand COVID-19 vaccination intentions (Study 1) and uptake (Study 2). Study 1 is a repeated-measures study with a representative sample of 3026 Australians. We found evidence that social cohesion can be conceptualised as a multidimensional structure; moreover, social cohesion at Wave 1 (early in the COVID-19) predicted greater vaccination intention and lower perceived risk of vaccination at Wave 2 (4 months later). In Study 2 (a cross-sectional study, N = 499), the multidimensional structure of social cohesion was associated with greater uptake of vaccine doses (in addition to willingness to receive further doses and perceived risk of the vaccine). These relations were found after controlling for a series of demographic (i.e., sex, age, income), health-related factors (i.e., subjective health; perceived risk; having been diagnosed with COVID-19), and individual differences (political orientation, social dominance orientation, individualism). These results demonstrate the need to go beyond individual factors when it comes to behaviours that protect groups, and particularly when examining COVID-19 vaccination—one of the most important ways of slowing the spread of the virus.     

Prosocial orientation and COVID-19 vaccine willingness in the U.S.

Despite evidence of the safety and effectiveness of COVID-19 vaccines and their wide availability, many in the U.S. are not vaccinated. Research demonstrates that prosocial orientations predict COVID-19 health behaviors (e.g., social distancing) and vaccination intentions, however, little work has examined COVID-19 vaccination willingness in the U.S. since vaccines were approved. Findings from two U.S. samples show that, in contrast to other COVID-19 health behaviors, vaccine willingness in unvaccinated people is unrelated to prosocial orientation. Study 2 demonstrates that the lack of association between vaccine willingness and prosocial orientation in unvaccinated participants was specific to those with stronger beliefs that COVID-19 vaccines are ineffective. Thus, in prosocial people, perceptions of vaccines' ineffectiveness may undermine COVID-19 vaccine willingness.     

Coping with COVID: Use,factor structure,and health behavior implications of specific emotion regulation strategies during the coronavirus pandemic

This series of studies examined U.S. individuals' use of specific emotion regulation/coping strategies during the early months of the COVID-19 pandemic, investigated the factor structure among strategies during this universally experienced stressor, and the extent to which these factors predicted engagement in COVID-related health-promoting behaviors. In Study 1, participants (N = 520) rated their use of 17 strategies for coping with pandemic-related stress during the past 24 h. Differences emerged in strategy use across demographic groups (age, race, income). Results of exploratory factor analysis suggest a factor structure grouping strategies in terms of goals beyond emotion regulation per se, rather than phases of the emotion process or a binary adaptive versus maladaptive distinction. In Study 2 (N = 264), participants reported daily on their coping strategy use and weekly on their engagement in COVID-specific health behaviors for 22 days. Results of confirmatory factor analysis replicate the factor structure found in Study 1. Some significant associations of coping strategy use with health-promoting behaviors were observed, but these were sporadic and largely involved baseline measures rather than predicting change over time. Theoretical and practical implications are discussed.     

Loneliness and the sexual behavior of sexual minority men in the context of the COVID-19 pandemic

In March 2020, in response to the COVID-19 pandemic, Canadian provincial governments instituted a variety of public health measures that included social distancing and isolation, which may have had unintended consequeses. According to the Loneliness and Sexual Risk Model, gay, bisexual, and other men who have sex with men (GBM) often cope with loneliness through risky sexual behaviors. Previous studies have demonstrated that COVID-19 measures such as social distancing and isolation led to increases in loneliness; thus, these measures may also have led to elevated sexual risk-taking among some GBM. Participants were recruited from an ongoing cohort study on GBM health and well-being, and were included in the current analysis if they had completed relevant study questions (n = 1134). GBM who reported lower levels of social support pre-COVID-19, were younger, and lived alone each reported greater loneliness during the first year of COVID-19. Although feelings of loneliness did not predict sexual risk-taking within the first year of COVID-19, loneliness did predict greater sexual risk-taking 6 months later. Additionally, younger GBM and those living alone were more likely to engage in sexual risk-taking at both COVID-19 data collection points. These findings offer some support of the Loneliness and Sexual Risk Model; however, it is possible that the unique circumstances of the COVID-19 pandemic resulted in a temporary suspension of this association, as many GBM took steps to protect themselves and partners in the context of COVID-19.     

The elderly and high technology medicine: A case for individualized,autonomous allocation

The issues involved in decision making about the aggressiveness of future medical care for older persons are explored. They are related to population trends, the heterogeneity of older persons and a variety of factors involved in individual preferences. Case studies are presented to illustrate these points, as well as a review of pertinent literature. The argument is offered that, considering these many factors, a system of flexible, individualized care by informed patient preference, is more rational than the rationing of technological services by age.     

Ethics in health care and medical technologies

In this paper a case is used to demonstrate how ethical analysis enables health care professionals, patients and family members to make treatment decisions which ensure that medical technologies are used in the overall best interests of the patient. The claim is made and defended that ethical analysis can secure four beneficial outcomes when medical technologies are employed: (1) not allowing any medical technologies to be employed until the appropriate decision makers are identified and consulted; (2) insisting that medical technologies be employed not merely to promote the medical interests of the patient but rather on the basis of their ability to contribute to the overall well-being of the patient; (3) challenging caregivers to reflect on the dynamic interplay between their conscious and unconscious values and consequent determinations of what is in the patient's best interests; and (4) providing a justification for selected interventions which makes possible rational dialogue between caregivers espousing different viewpoints about treatment options.