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).     

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.     

CHANGING PROTECTIVE AND RISKY BEHAVIORS TO PREVENT CHILD-TO-PARENT TRANSMISSION OF CYTOMEGALOVIRUS

Child-to-parent transmission of cytomegalovirus may be reduced by increasing protective behaviors (handwashing and glove use) and decreasing risky behaviors (intimate contact between child and parent). This study showed that an educational intervention resulted in increases in reported and objective measures of protective behaviors and decreases in reported risky behaviors. Further study must determine if changes in protective and risky behavior are maintained and prevent cytomegalovirus transmission.     

Lesbian,gay, and bisexual youth in community settings: Personal challenges and mental health problems

Studied 194 lesbian, gay, and bisexual youth aged 21 and younger who attended programs in 14 community centers to determine the personal challenges they face due to their sexual orientation and their responses to these stresses. First awareness of sexual orientation typically occurred at age 10, but disclosure to another person did not occur until about age 16. There was much variability in sexual behavior, and many youths reported both same-sex and opposite-sex sexual experiences. Although most had told at least one family member about their sexual orientation, there remained much concern about family reactions. Suicide attempts were acknowledged by 42% of the sample. Attempters significantly differed from nonattempters on several milestones of sexual orientation development, social aspects of sexual orientation, parents' knowledge of sexual orientation, and mental health problems. The following organizations participated in this project and are thanked for their assistance: Affirmations (Detroit), the Atlanta Gay Center, Baltimore Gay and Lesbian Community Center, Boston Alliance of Gay and Lesbian Youth, Gay Alternative Youth (Pittsburgh), the Gay and Lesbian Youth Association of Dallas, Gay Youth Alliance — San Diego, the Gay and Lesbian Community Services Center of Los Angeles, Horizons Community Services (Chicago), the Indianapolis Youth Group, the Lesbian and Gay Community Services Center of Cleveland, Lavender Youth Recreation and Information Center (San Francisco), Outright (Denver), and Sexual Minority Youth Assistance League (Washington, DC). The following individuals associated with these groups are gratefully thanked for their help: Danny Barutta, Adriene Corbin, Tom Eversole, Chris Gonzalez, Bill Gripp, Rory Lopez, Phil Rector, Jamie Schield, Cheryl Schwartz, Jan Stephenson, Sterling Stowell, Amy Vitro, and Aubrey Wertheim. Gene Thomas is thanked for helping with data collection, as are Michael LaFlam, Patrick McNamara, and Mark Shiner, who processed the surveys. We also thank Rainer Silbereisen for his comments. This project was supported by funds from the Center for the Study of Child and Adolescent Development of the College of Health and Human Development at Pennsylvania State University.     

Health behavior, knowledge and attitudes among Swedish university students

A range of health behaviors was related to beliefs concerning health practices and health knowledge. A questionnaire dealing with health-related practices, health beliefs and knowledge of health risk factors was answered by 166 male and 179 female students aged 18–30 years at Stockholm University. Female students reported engaging in better health behavior than males. Beliefs about the importance of health behaviors were closely related to their frequency of occurrence. There was only a weak relationship between health behaviors and knowledge of specific health matters. It is concluded that health attitudes rather than health knowledge determine health behavior.