Search

BackgroundThis study investigated the public’s support for the Living with the Virus (LWV) policy, its associated factors, and related mediations at a time when more countries were considering adopting the LWV policy amid the COVID-19 pandemic.MethodsA random, population-based telephone survey was conducted among 500 Chinese adults in Hong Kong during March/April 2022.Results39.6% of the participants were supportive/strongly supportive of the LWV policy. Perceived efficacy of the control measures was negatively associated with the support and was partially mediated via the perception that the policy would greatly improve the economy/daily life of the policy. Perceived physical harms of the Omicron variant was negatively associated with the support and was fully mediated via perceived negative impacts of the policy. 26.2%/54.6% believed that the policy would improve the economy/daily life greatly; about 40% perceived negative impacts on deaths and the medical system due to the policy. COVID-19 ever infection did not significantly moderate the studied associations.ConclusionThe public was split regarding the support for the LWV policy and whether it would cause better economy/daily life, unnecessary deaths, and the collapse of the medical system. Health communication is needed in shifting toward the LWV policy.

Abstract Background The levels of resource losses due to coronavirus disease 2019 (COVID-19) and mental distress may change during the pandemic period. Based on the Conservation of Resource (COR) Theory, this study investigated such changes and the mediation between survey time (Round 2 versus Round 1) and depression via resource losses. Methods Two serial random population-based telephone surveys interviewed 209 and 458 Hong Kong Chinese adults in April 2020 and May 2021, respectively. Probable depression was defined as 9-item Patient Health Questionnaire (PHQ-9) score ≥ 10. The validated Conservation of Resources Scale for COVID-19 (CORS-COVID-19) scale was used to assess resource losses due to COVID-19. Multivariable logistic regression analysis, hierarchical logistic regression analysis, and structural equation modeling (SEM) was conducted to test the association, interaction, and mediation hypotheses, respectively. Results The prevalence of probable depression declined from 8.6% to 1.0% over time, together with reductions in losses of financial resource (Cohen’s d = 0.88), future control (Cohen’s d = 0.39), social resource (Cohen’s d = 0.60), and family resource (Cohen’s d = 0.36) due to COVID-19. All the overall scale/subscales of the CORS-COVID-19 were positively and associated with probable depression [adjusted odds ratio (aOR) ranged from 2.72 to 42.30]. In SEM, the survey time was negatively associated with the latent variable of resource loss (β = − 0.46), which in turn was positively associated with probable depression (β = 0.73). In addition, the direct effect of survey time on probable depression was statistically non-significant (β = − 0.08), indicating a full mediation effect of resource losses. Conclusions The lessening of the resource losses might have fully accounted for the significant decline in probable depression from Month 3 to 15 since the first COVID-19 outbreak in Hong Kong, China. The level of depression might have increased during the first phase of the pandemic, but might decline in the later phases if resources losses could be lessened. All stakeholders should hence work together to minimize individuals’ COVID-19-related resource losses to prevent depression in the general population, as COVID-19 might be lasting.

BackgroundThere is a global trend for countries to adopt the Living with the Virus (LWV) policy regarding COVID-19. Little is known about the public’s supportiveness and emotional responses (e.g., anticipated panic) related to this policy. Such responses may be associated with illness representations of COVID-19 (i.e., how people think and feel about COVID-19). This novel topic was investigated in this study to facilitate policy-making and health communication.MethodsA random, population-based telephone survey interviewed 500 adults aged ≥18 of the Hong Kong general adult population from March to April 2022.ResultsThe prevalence of the public’s support and anticipated panic regarding the LWV policy, which were negatively correlated with each other, was 39.6 and 24.2%, respectively. The illness representation constructs of consequences, timeline, identity, illness concern, and emotional representations were negatively associated with supportiveness and positively associated with anticipated panic regarding the LWV policy. Illness coherence was significantly associated with policy support but not with anticipated panic. The associations between personal control/treatment control and supportiveness/anticipated panic were statistically non-significant. Moderation analyses showed that the above significant associations were invariant between those with and without previous COVID-19 infection.ConclusionPolicymakers need to be sensitized about the public’s supportive/unsupportive attitude and potential worry (panic) when adopting the LWV policy. Such attitudes/emotional responses may be affected by people’s illness representations of COVID-19. In general, those who found COVID-19 involving a milder nature and less negative emotions would be more supportive and anticipated less panic under the LWV policy.

The early attainment of high COVID-19 vaccination rates can minimize avoidable hospitalizations/deaths. The fifth wave COVID-19 outbreak in Hong Kong caused >9000 deaths, and most of them were unvaccinated older people. This study hence investigated determinants of taking the first dose vaccination at a later phase (Phase 3: during the fifth wave outbreak, i.e., February–July 2022) versus two earlier phases (Phase 1: first six months since vaccine rollout, i.e., February–July 2021; Phase 2: six months prior to the outbreak, i.e., August 2021–January 2022) via a random telephone survey among 386 ever-vaccinated Hong Kong older people aged ≥60 (June/July 2022). A total of 27.7%, 51.1%, and 21.3% took the first dose at Phase 1, Phase 2, and Phase 3, respectively. Unfavorable perceptions related to COVID-19/vaccination, exposure to conflicting/counter-information about the suitability of older people’s vaccination from various sources, unsupportive family influences prior to the outbreak, and depressive symptoms were significantly associated with taking the first dose at Phase 3 instead of Phase 1 and Phase 2. To speed up COVID-19 vaccination and avoid unnecessary deaths, the government and health professionals should rectify misinformation, provide clear/consistent information for older people and their family members, and focus on those having depressive symptoms at an earlier stage of the pandemic.

BackgroundThe study investigated the level of behavioral intention to consult doctors for flu symptoms (BICDFS) during the Coronavirus Disease 2019 (COVID-19) pandemic and examined its associations with illness representations of COVID-19 and fear of COVID-19 during clinic visits in a general Chinese adult population.MethodsA random telephone survey was conducted among 300 residents in Hong Kong, China in April 2020 when the second wave of COVID-19 was just ended in the region. The participants were asked about their intention to consult doctors if they had mild or severe flu symptoms in the next week (from 1 = definitely no to 5 = definitely yes). Illness representations of COVID-19 were measured by the Chinese version of the Brief Illness Perception Questionnaire (BIPQ). The fear of COVID-19 during clinic visits were assessed by two single items. Linear regression adjusted for background variables and hierarchical strategies were employed.ResultsOf the participants, 52.3 and 92.0% showed an intention to consult doctors for mild and severe flu symptoms, respectively. Adjusted for background factors, COVID-19-related cognitive representations (consequences: standardized b = 0.15, p = 0.010; understanding: standardized b = 0.21, p = 0.001) and emotional representations (concern: standardized b = 0.17, p = 0.001; negative emotions: standardized b = 0.19, p = 0.001) were positively associated with BICDFS. In the hierarchical model, independent significant factors of BICDFS included understanding (standardized b = 0.16, p = 0.013) and negative emotions (standardized b = 0.17, p = 0.008). The fear-related variables showed non-significant associations with the BICDFS.ConclusionsPromotion of care-seeking behaviors for flu symptoms during the COVID-19 pandemic should consider improving people's understanding of COVID-19 and providing advice on related coping strategies for emotional responses to COVID-19.

Background Restriction of gathering size in all public areas is a newly and commonly exercised governmental social distancing policy during the COVID-19 pandemic. Its effectiveness depends on the general public’s compliance. This study applied the Protection Motivation Theory (PMT) to investigate determinants (i.e., perceived severity, perceived susceptibility, perceived response efficacy, and perceived self-efficacy) of compliance with the social distancing policy of banning gathering of >4 people in all public areas (BG4PA) in the Hong Kong general adult population. Methods 300 participants were interviewed through a population-based telephone survey during April 21–28, 2020. Results The compliance rate of BG4PA was high (78%). Adjusted for the background factors, multiple linear regression analysis found that perceived response efficacy and perceived self-efficacy were significantly and positively associated with compliance with BG4PA (pConclusions PMT can be applied to understand compliance with BG4PA. Perceived response efficacy and perceived self-efficacy were more influential than perceived severity and perceived susceptibility. Health promotion may focus on improving coping appraisal.

Promotion of COVID-19 vaccination requires understanding its determinants, an important one of which is outcome expectancy. However, reliable and valid measurement tools are absent. This study thus developed and validated an Outcome Expectancy Scale for COVID-19 Vaccination (OES-COVID-19). An inductive approach was used for scale development; content validity of the items was then assessed by an independent evaluation expert panel. Iteratively, 17 scale items were created and validated in a population-based telephone survey conducted among 500 adults of the general population in Hong Kong, China, from August to September 2021. Using half of the sample (n = 249), exploratory factor analyses identified four factors of the OES-COVID-19, including (a) positive contribution to society, (b) functional benefits, (c) protective effect, and (d) negative impacts. Confirmatory factor analysis of these factors conducted on the second subsample (n = 251) was satisfactory. The OES-COVID-19 showed good psychometric properties in terms of internal consistency, absence of floor/ceiling effects, and concurrent validity. The newly created and validated OES-COVID-19 is deemed suitable for application. It may advance future studies related to COVID-19 vaccination behavior and intention, and potentially allows for comparisons across studies. Further validation with modifications across countries, populations, and phase of the pandemic are warranted.

Outcome expectancies involving self-directed and others-directed domains are potential determinants of completed or scheduled first-dose COVID-19 vaccination (CSFCV). This study investigated factors of CSFCV, including (a) self-directed motives [personal positive outcome expectancies (POE) and personal negative outcome expectancy (NOE)], and (b) others-directed motives (societal POE and the personality trait of prosociality). It also investigated the mediations of personal POE between societal POE and CSFCV, and moderations of prosociality between personal POE/personal NOE/societal POE and CSFCV. A cross-sectional population-based telephone survey interviewed 500 people aged 18–75 in Hong Kong in May 2021. The prevalence of CSFCV was 21.0%. Significant factors of CSFCV included personal POE (i.e., physical/practical/emotional/interpersonal benefit), personal NOE, and societal POE. The association between societal POE and CSFCV was fully mediated by the overall scale and some domains of personal POE. Furthermore, the association between physical benefit and CSFCV was stronger at lower levels of prosociality; prosociality showed a stronger effect on CSFCV at lower levels of physical benefit. The results suggest that self-directed motives might be more important than others-directed motives in affecting CSFCV. The findings require confirmations from longitudinal studies and cross-country comparisons.

Internet addiction (IA) is prevalent among adolescents and imposes a serious public health threat. Familial risk and protective factors may co-exist and interact with each other to determine IA. We conducted a cross-sectional survey among 9,618 Secondary 1 to 4 students in Hong Kong, China. About 16% of the surveyed students were classified as Internet addicted; nearly one third of them perceived that at least one of their family members had IA (FMIA). We found that FMIA was a risk factor (multivariate odds ratio [OR] = 2.04), and perceived family support was a protective factor (multivariate OR = 0.97) of IA. We also found a significant risk-enhancement moderation effect between these risk and protective factors, that is, the risk effect of FMIA increased with perceived family support. The finding highlights that family-based interventions, which modify familial risk and protective factors, should be effective for adolescent IA, but caution is required about potential risk-enhancement moderations between such factors.

Deficits in cost/benefit decision making is a critical risk factor for gambling disorder. Reward‐paired cues may play an important role, as these stimuli can enhance risk preference in rats. Despite extensive research implicating the dorsal striatum in the compulsive aspects of addiction, the role of nigrostriatal dopaminergic activity in cue‐induced risk preference remains unclear, particularly in females. Accordingly, we examined the effects of manipulating the dopaminergic nigrostriatal pathway on cue‐induced risky choice in female rats. TH:Cre rats were trained on the cued version of the rat Gambling Task. This task was designed such that maximal reward is attained by avoiding the high‐risk, high‐reward options and instead favouring the options associated with lower per‐trial gains, as they feature less frequent and shorter time‐out penalties. Adding reward‐paired audiovisual cues to the task leads to greater risky choice on average. To assess the role of the nigrostriatal pathway, a viral vector carrying either Cre‐dependent inhibitory or excitatory DREADD was infused into the substantia nigra. Rats then received clozapine‐N‐oxide either during task acquisition or after a stable performance baseline was reached. Inhibition of this pathway accelerated the development of risk preference in early sessions and increased risky choice during performance, but long‐term inhibition actually improved decision making. Activation of this pathway had minimal effects. These results provide evidence for the involvement of the dopaminergic nigrostriatal pathway in cue‐induced risk preference in females, therefore shedding light on its role in cost/benefit decision‐making deficits and expanding our knowledge of the female dopaminergic system. [ABSTRACT FROM AUTHOR]

Background: Perceptions related to COVID-19 vaccination are evolving over time, leading to potential changes in vaccination intention among unvaccinated people, which helps in the predictions of vaccination rates. This study investigated the changes in COVID-19 vaccination intention at the population level during a post-rollout period and two potential mechanisms underlying the change via the mediation/suppression effects that involve the perceived benefits/severe side effects of vaccination. Methods: Two serial random population-based telephone surveys interviewed 358 and 145 Chinese adults (aged 18–70) who were unvaccinated and who were unscheduled for COVID-19 vaccination, respectively, in May and August 2021 in Hong Kong, China. Results: The prevalence of vaccination intention increased from 14.5% to 22.8%, while the levels of perceived benefits (protection and travel-related advantages due to vaccination) and the perceived risk of severe side effects resulting from COVID-19 vaccination both significantly declined over time. Structural equation modeling found a simultaneous partial suppression effect via perceived benefits and a partial mediation effect via perceived severe side effects between the time when the surveys were conducted and COVID-19 vaccination intention, with adjustment for background factors. Conclusion: Perceptions related to COVID-19 vaccination are likely to change over time and partially account for changes in vaccination intention, sometimes in opposite directions. Ongoing health promotion may take such changes into account. Serial surveillance is warranted to monitor these changes.

Background: Vaccination resistance is the key hurdle against herd immunity as it limits the final vaccination coverage. This study investigated the prevalence and factors of COVID-19 vaccination resistance (i.e., those indicating definitely not taking up COVID-19 vaccination), including individualism, perceived personal benefits (PPB) and perceived societal benefits (PSB) of COVID-19 vaccination, and related mechanisms of the association. Methods: A random telephone survey interviewed 395 unvaccinated adults aged 18–75 not having scheduled for COVID-19 vaccination in May 2021 in Hong Kong, China (response rate = 56.8%). Results: The prevalence of vaccination resistance was 56.5%. Adjusted for background factors, individualism, PPB, and PSB were significantly associated with vaccination resistance. Path analysis showed that individualism exhibited a direct effect on vaccination resistance and a 3-step indirect effect (individualism → PSB → PPB→ vaccination resistance) that explained 46.8% of the total effect. The two 2-step indirect paths via PPB only and via PSB only were non-significant. Conclusion: High prevalence of vaccination resistance was observed. Individualism increased vaccination resistance via its direct and indirect effects. Health promotion may emphasize collective good to reduce the impact of individualism and promote PPB/PSB, which may reduce vaccination resistance directly and alleviate the impact of individualism on vaccination resistance indirectly.

Background: Globally, COVID-19 vaccination programs have been rolled out. To inform health promotion, this study investigated the prevalence and associated factors of performance or being scheduled to perform at least one dose of COVID-19 vaccination (PSCV) in a Chinese adult general population. Methods: An anonymous, random telephone survey interviewed 500 adults aged 18–75 in Hong Kong, China from 14–27 May 2021. Results: The prevalence of PSCV was 21.0%, which was significantly lower among females and those aged ≤30. Positively associated factors of PSCV included perceived protection effect of vaccination, self-perceived physical fitness for vaccination, compulsory COVID-19 testing experience, perceived need to travel, general trust toward the government, and trust toward the governmental vaccination program, while negatively associated factors included perceived low efficacy of vaccination, concerns about side effects, and chronic disease status. Furthermore, the association between sex and PSCV was fully mediated by stronger concern about side effects and lower levels of self-perceived physical fitness for COVID-19 vaccination among females than males. Conclusion: Moderately low prevalence of COVID-19 vaccination was observed in Hong Kong, where there was no shortage of vaccine supply. To achieve herd immunity, health promotion is greatly warranted and may incorporate messages based on the findings of this study.

Background: Acceptance of cannabis use is growing. However, prolonged use is associated with diminished psychosocial outcomes, potentially mediated by drug-induced cognitive impairments. A9-Tetrahydrocannabinol (THC) is the main psychoactive ingredient in cannabis, yet other phytocannabinoids in the plant, such as cannabidiol (CBD), have unique properties. Given that CBD can modulate the undesirable effects of THC, therapeutic agents, such as nabiximols, contain higher CBD:THC ratios than illicit marijuana. We tested the hypothesis that THC impairs a relevant cognitive function for long-term success, namely willingness to exert cognitive effort for greater rewards, and that CBD could attenuate such decision-making impairments. Methods: Male Long-Evans rats (n = 29) performing the rat cognitive effort task (rCET) received acute THC and CBD, independently and concurrently, in addition to other cannabinoids. Rats chose between 2 options differing in reward magnitude, but also in the cognitive effort (attentional load) required to obtain them. Results: We found that THC decreased choice of hard trials without impairing the animals' ability to accurately complete them. Strikingly, this impairment was correlated with CB1 receptor density in the medial prefrontal cortex--an area previously implicated in effortful decision-making. In contrast, CBD did not affect choice. Coadministration of 1:1 CBD:THC matching that in nabiximols modestly attenuated the deleterious effects of THC in 'slacker' rats. Limitations: Only male rats were investigated, and the THC/CBD coadministration experiment was carried out in a subset of individuals. Conclusion: These findings confirm that THC, but not CBD, selectively impairs decision-making involving cognitive effort costs. However, coadministration of CBD only partially ameliorates such THC-induced dysfunction., Introduction Cannabis is the world's most widely used illicit drug, with North American estimates suggesting that 11% of adults experiment with the drug annually. (1) While the psychoactive effects of [...]