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Fear of COVID-19 and Trust in the Healthcare System Mediates the Association between Individual's Risk Perception and Preventive COVID-19 Behaviours among Iranians.

ABSTRACT: Problems caused by the novel coronavirus disease-2019 (COVID-19) and its mutations have brought challenges in pandemic control for all countries worldwide. The present study examines the mediating roles of fear of COVID-19 and trust in the healthcare system in the association between individual's risk perception and performing preventive COVID-19 behaviours among Iranians. A cross-sectional study design was used to collect data from 3652 residents of Qazvin province in Iran from 3 February to 15 April 2021 using a multistage stratified cluster sampling method. Participants responded to an online questionnaire concerning their fear of COVID-19, risk perception, trust in the healthcare system, and preventive COVID-19 behaviours. Small to medium positive interrelationships were observed between the variables of the study. Fear of COVID-19, trust in the healthcare system or both (fear of COVID-19 and trust in the healthcare system) mediated the association between an individual's risk perception and performing preventive COVID-19 behaviours. The study demonstrated there are at least four ways through which an individual's risk perception can influence preventive COVID-19 behaviours. Therefore, clinicians, health communicators, and researchers may capitalize on these findings to enhance preventive COVID-19 behaviours to help mitigate the spread of COVID-19 infection.

SUBMITTER: Alijanzadeh M

PROVIDER: S-EPMC8621944 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:BackgroundEducational disparities in health and health behaviours have always been relevant in public health research and are particularly challenging in the context of the COVID-19 pandemic. First studies suggest that factors important for the containment of the COVID-19 pandemic, such as prevention behaviour, risk perception, perceived effectiveness of containment measures, and trust in authorities handling the pandemic, vary by educational status. This study builds on recent debate by examining trends in absolute and relative educational disparities in these factors in the first year of the COVID-19 pandemic in Germany.MethodsData stem from four waves of the GESIS Panel surveyed between March and October 2020 in Germany (15,902 observations from 4,690 individuals). Trends in absolute and relative disparities were examined for preventive behaviour, risk perception, perceived effectiveness of COVID-19 containment measures, and trust in individuals and institutions handling the COVID-19 pandemic by educational status using sex, age, residence, nationality, children under 16 living in household, family status, household size, the Big Five Inventory, and income class as control factors. Descriptive statistics as well as unadjusted and adjusted linear regression models and random effects models were performed.ResultsWe observed an initially rising and then falling trend in preventive behaviour with consistent and significant absolute and relative disparities with a lower preventive behaviour among low educated individuals. Indication of a U-shaped trend with consistent significantly lower values among lower educated individuals was found for risk perception, whereas perceived effectiveness and trust decreased significantly over time but did not significantly vary by educational status.ConclusionsResults indicate persistent educational disparities in preventive behaviour and risk perception and a general decline in perceived effectiveness and trust in the first year of the COVID-19 pandemic in Germany. To address this overall downward trend and existing disparities, comprehensive and strategic management is needed to communicate the risks of the pandemic and the benefits of COVID-19 containment measures. Both must be adapted to the different needs of educational groups in particular in order to overcome gaps in preventive behaviour and risk perception by educational status.

Project description:BackgroundAlthough numerous studies have been published on the predictors of COVID-19 vaccine hesitancy, some possible predictors remain underexplored. In this study, we explored the associations of unwillingness and indecisiveness regarding COVID-19 vaccination with generalized trust, mental health conditions such as depression and generalized anxiety, and fear of COVID-19.MethodsData of wave 1 (from October 27 till November 6, 2020) and wave 3 (from April 23 till May 6, 2021) of a longitudinal online study conducted in Japan were used for the analyses. Unvaccinated participants were asked at wave 3 about their willingness to be vaccinated, with possible responses of willing, unwilling, or undecided. These three responses were used as the outcome variable, and multinomial logistic regression analyses were conducted with willingness to be vaccinated as the reference group. Explanatory variables included generalized trust, depression, generalized anxiety, and fear of COVID-19 both at wave 1 and 3, and sociodemographic and health-related variables.ResultsOf the 11,846 valid respondents, 209 (1.8%) answered that they had already been vaccinated against COVID-19, 7089 (59.8%) responded that they were willing to be vaccinated, 3498 (29.5%) responded that they were undecided, and 1053 (8.9%) responded that they were unwilling to be vaccinated. After adjusting for covariates, we found that: (1) participants with lower levels of generalized trust at wave 1 and 3 were more likely to be undecided or unwilling at wave 3; (2) respondents with moderately severe or severe depression at wave 1 and 3 were more likely to be undecided at wave 3; (3) participants with moderate or severe levels of generalized anxiety at wave 3 but not at wave 1 were more likely to be unwilling at wave 3; and (4) respondents with high levels of fear of COVID-19 at wave 1 and 3 were less likely to be undecided and unwilling at wave 3.ConclusionsGeneralized trust, mental health conditions such as depression and generalized anxiety, and low level of fear of COVID-19 are associated with unwillingness or indecision regarding being vaccinated against COVID-19.

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Fear of COVID-19 and Trust in the Healthcare System Mediates the Association between Individual's Risk Perception and Preventive COVID-19 Behaviours among Iranians.

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