COVID-19 stressors and health behaviors: A multilevel longitudinal study across 86 countries

Anxiety associated with the COVID-19 pandemic and home confinement has been associated with adverse health behaviors, such as unhealthy eating, smoking, and drinking. However, most studies have been limited by regional sampling, which precludes the examination of behavioral consequences associated with the pandemic at a global level. Further, few studies operationalized pandemic-related stressors to enable the investigation of the impact of different types of stressors on health outcomes. This study examined the association between perceived risk of COVID-19 infection and economic burden of COVID-19 with health-promoting and health-damaging behaviors using data from the PsyCorona Study: an international, longitudinal online study of psychological and behavioral correlates of COVID-19. Analyses utilized data from 7,402 participants from 86 countries across three waves of assessment between May 16 and June 13, 2020. Participants completed self-report measures of COVID-19 infection risk, COVID-19-related economic burden, physical exercise, diet quality, cigarette smoking, sleep quality, and binge drinking. Multilevel structural equation modeling analyses showed that across three time points, perceived economic burden was associated with reduced diet quality and sleep quality, as well as increased smoking. Diet quality and sleep quality were lowest among respondents who perceived high COVID-19 infection risk combined with high economic burden. Neither binge drinking nor exercise were associated with perceived COVID-19 infection risk, economic burden, or their interaction. Findings point to the value of developing interventions to address COVID-related stressors, which have an impact on health behaviors that, in turn, may influence vulnerability to COVID-19 and other health outcomes

Trust in government regarding COVID-19 and its associations with preventive health behaviour and prosocial behaviour during the pandemic: A cross-sectional and longitudinal study

Background The effective implementation of government policies and measures for controlling the coronavirus disease 2019 (COVID-19) pandemic requires compliance from the public. This study aimed to examine cross-sectional and longitudinal associations of trust in government regarding COVID-19 control with the adoption of recommended health behaviours and prosocial behaviours, and potential determinants of trust in government during the pandemic.  Methods This study analysed data from the PsyCorona Survey, an international project on COVID-19 that included 23 733 participants from 23 countries (representative in age and gender distributions by country) at baseline survey and 7785 participants who also completed follow-up surveys. Specification curve analysis was used to examine concurrent associations between trust in government and self-reported behaviours. We further used structural equation model to explore potential determinants of trust in government. Multilevel linear regressions were used to examine associations between baseline trust and longitudinal behavioural changes.  Results Higher trust in government regarding COVID-19 control was significantly associated with higher adoption of health behaviours (handwashing, avoiding crowded space, self-quarantine) and prosocial behaviours in specification curve analyses (median standardised β = 0.173 and 0.229, p < 0.001). Government perceived as well organised, disseminating clear messages and knowledge on COVID-19, and perceived fairness were positively associated with trust in government (standardised β = 0.358, 0.230, 0.056, and 0.249, p < 0.01). Higher trust at baseline survey was significantly associated with lower rate of decline in health behaviours over time (p for interaction = 0.001).  Conclusions These results highlighted the importance of trust in government in the control of COVID-19

Pandemic Boredom: Little Evidence That Lockdown-Related Boredom Affects Risky Public Health Behaviors Across 116 Countries

Some public officials have expressed concern that policies mandating collective public health behaviors (e.g., national/regional “lockdown”) may result in behavioral fatigue that ultimately renders such policies ineffective. Boredom, specifically, has been singled out as one potential risk factor for noncompliance. We examined whether there was empirical evidence to support this concern during the COVID-19 pandemic in a large cross-national sample of 63,336 community respondents from 116 countries. Although boredom was higher in countries with more COVID-19 cases and in countries that instituted more stringent lockdowns, such boredom did not predict longitudinal within-person decreases in social distancing behavior (or vice versa; n = 8,031) in early spring and summer of 2020. Overall, we found little evidence that changes in boredom predict individual public health behaviors (handwashing, staying home, self-quarantining, and avoiding crowds) over time, or that such behaviors had any reliable longitudinal effects on boredom itself. In summary, contrary to concerns, we found little evidence that boredom posed a public health risk during lockdown and quarantine

Identifying important individual- and country-level predictors of conspiracy theorizing: A machine learning analysis

Psychological research on the predictors of conspiracy theorizing—explaining important social and political events or circumstances as secret plots by malevolent groups—has flourished in recent years. However, research has typically examined only a small number of predictors in one, or a small number of, national contexts. Such approaches make it difficult to examine the relative importance of predictors, and risk overlooking some potentially relevant variables altogether. To overcome this limitation, the present study used machine learning to rank-order the importance of 115 individual- and country-level variables in predicting conspiracy theorizing. Data were collected from 56,072 respondents across 28 countries during the early weeks of the COVID-19 pandemic. Echoing previous findings, important predictors at the individual level included societal discontent, paranoia, and personal struggle. Contrary to prior research, important country-level predictors included indicators of political stability and effective government COVID response, which suggests that conspiracy theorizing may thrive in relatively well-functioning democracies

Intentions to be Vaccinated Against COVID-19: The Role of Prosociality and Conspiracy Beliefs across 20 Countries

Understanding the determinants of COVID-19 vaccine uptake is important to inform policy decisions and plan vaccination campaigns. The aims of this research were to: (1) explore the individual- and country-level determinants of intentions to be vaccinated against SARS-CoV-2, and (2) examine worldwide variation in vaccination intentions. This cross-sectional online survey was conducted during the first wave of the pandemic, involving 6697 respondents across 20 countries. Results showed that 72.9% of participants reported positive intentions to be vaccinated against COVID-19, whereas 16.8% were undecided, and 10.3% reported they would not be vaccinated. At the individual level, prosociality was a significant positive predictor of vaccination intentions, whereas generic beliefs in conspiracy theories and religiosity were negative predictors. Country-level determinants, including cultural dimensions of individualism/collectivism and power distance, were not significant predictors of vaccination intentions. Altogether, this study identifies individual-level predictors that are common across multiple countries, provides further evidence on the importance of combating conspiracy theories, involving religious institutions in vaccination campaigns, and stimulating prosocial motives to encourage vaccine uptake

Using machine learning to identify important predictors of COVID-19 infection prevention behaviors during the early phase of the pandemic

Before vaccines for coronavirus disease 2019 (COVID-19) became available, a set of infection-prevention behaviors constituted the primary means to mitigate the virus spread. Our study aimed to identify important predictors of this set of behaviors. Whereas social and health psychological theories suggest a limited set of predictors, machine-learning analyses can identify correlates from a larger pool of candidate predictors. We used random forests to rank 115 candidate correlates of infection-prevention behavior in 56,072 participants across 28 countries, administered in March to May 2020. The machine-learning model predicted 52% of the variance in infection-prevention behavior in a separate test sample—exceeding the performance of psychological models of health behavior. Results indicated the two most important predictors related to individual-level injunctive norms. Illustrating how data-driven methods can complement theory, some of the most important predictors were not derived from theories of health behavior—and some theoretically derived predictors were relatively unimportant

‘We are all in the same boat’: How societal discontent affects intention to help during the COVID-19 pandemic

The coronavirus disease 2019 (COVID-19) pandemic has cau-sed a global health crisis. Consequently, many countries have adopted restrictive measures that caused a substantial change in society. Within this framework, it is reasonable to suppose that a sentiment of societal discontent, defined as generalized concern about the precarious state of society, has arisen. Literature shows that collectively experienced sit-uations can motivate people to help each other. Since societal discontent is conceptualized as a collective phenomenon, we argue that it could influence intention to help others, particu-larly those who suffer from coronavirus. Thus, in the present study, we aimed (a) to explore the relationship between soci-etal discontent and intention to help at the individual level and (b) to investigate a possible moderating effect of societal discontent at the country level on this relationship. To fulfil our purposes, we used data collected in 42 countries (N = 61,734) from the PsyCorona Survey, a cross-national longitudinal study. Results of multilevel analysis showed that, when societal discontent is experienced by the entire com-munity, individuals dissatisfied with society are more prone to help others. Testing the model with longitudinal data (N = 3,817) confirmed our results. Implications for those find-ings are discussed in relation to crisis management. Please refer to the Supplementary Material section to find this arti-cle's Community and Social Impact Statement

Impact of national pandemic lockdowns on perceived threat of immigrants: a natural quasi-experiment across 23 countries

Xenophobia and anti-immigrant attacks rose during the COVID-19 pandemic, yet this may not be solely due to the disease threat. According to theories of frustration and scapegoating, situational obstructions and deprivation can motivate prejudice against outgroups. Using a global natural quasi-experimental design, this study tests whether the restrictiveness of national lock-downs can explain higher individual-level perceptions of immigrant threat. Data of 45,894 participants from 23 countries were analyzed. Both lockdown duration and lockdown severity were positively associated with individuals’ perceived threat of immi-grants. The lockdown effects were independent of objective and subjective measures of disease threat, and there was no evi-dence that disease threat drives people’s prejudice toward immigrants. Subgroup analysis suggested the lockdown effects were reliable in Europe and the Americas, but not in Asia. These findings suggest a need to mitigate frustration and scapegoating when implementing lockdowns, and to distinguish the influence of societal restrictions from disease threat

Politicization of COVID-19 health-protective behaviors in the United States: Longitudinal and cross-national evidence

During the initial phase of the COVID-19 pandemic, U.S. conservative politicians and the media downplayed the risk of both contracting COVID-19 and the effectiveness of recom-mended health behaviors. Health behavior theories suggest perceived vulnerability to a health threat and perceived effectiveness of recommended health-protective behaviors determine motivation to follow recommendations. Accordingly, we predicted that—as a result of politicization of the pandemic—politically conservative Americans would be less likely to enact recommended health-protective behaviors. In two longitudinal studies of U.S. residents, political conservatism was inversely associated with perceived health risk and adoption of health-protective behaviors over time. The effects of political orientation on health-protective behaviors were mediated by perceived risk of infection, perceived severity of infection, and perceived effectiveness of the health-protective behaviors. In a global cross-national analysis, effects were stronger in the U.S. (N = 10,923) than in an interna-tional sample (total N = 51,986), highlighting the increased and overt politicization of health behaviors in the U.S

Concern with COVID-19 pandemic threat and attitudes towards immigrants: The mediating effect of the desire for tightness

Tightening social norms is thought to be adaptive for dealing with collective threat yet it may have negative consequences for increasing prejudice. The present research investigated the role of desire for cultural tightness, triggered by the COVID-19 pandemic, in increasing negative attitudes towards immigrants. We used participant-level data from 41 countries (N = 55,015) collected as part of the PsyCorona project, a cross-national longitudinal study on responses to COVID-19. Our predictions were tested through multilevel and SEM models, treating participants as nested within countries. Results showed that people's concern with COVID-19 threat was related to greater desire for tightness which, in turn, was linked to more negative attitudes towards immigrants. These findings were followed up with a longitudinal model (N = 2,349) which also showed that people's heightened concern with COVID-19 in an earlier stage of the pandemic was associated with an increase in their desire for tightness and negative attitudes towards immigrants later in time. Our findings offer insight into the trade-offs that tightening social norms under collective threat has for human groups