Research article Topical Sections

Protective behaviors during COVID-19 confinement measures in Greece: the role of anxiety, perceived risk and risky-choice framing

  • Received: 14 October 2022 Revised: 23 March 2023 Accepted: 27 March 2023 Published: 25 April 2023
  • Confinement measures at the beginning of the COVID-19 pandemic imposed major changes on the global population. The aim of this study was to explore the level to which the public adhered to protective guidelines by adopting the most appropriate behaviors at that time (such as hand washing with soap and using sanitizer gel) and to identify the determinants of these behaviors. A purposive sample of 1013 individuals was invited and voluntarily participated in the online survey. The questionnaire collected information on demographic data, hand washing, risk perception, anxiety (through the S = Anxiety scale of STAI) and risky-choice framing. Results showed increased levels of anxiety, a moderate perception of the risk of catching coronavirus and increased adoption of protective behaviors, such as handwashing and cleaning surfaces with disinfectant/antiseptic products. Multiple ordinal logistic regression models showed that being female, more educated and cleaning home with disinfectant / antiseptic products predicted handwashing with soap. Additionally, having an increased perception of getting the coronavirus, being older and cleaning the home with disinfectant / antiseptic products predicted handwashing with antiseptics. Public health interventions should take into consideration the unified cleaning pattern and the combined effect of sociodemographic variables and risk perception on the adoption of protective behaviour in the context of a health crisis which is out of people's control.

    Citation: George Koulierakis, Anastasia Dermatis, Dimitris Zavras, Elpida Pavi. Protective behaviors during COVID-19 confinement measures in Greece: the role of anxiety, perceived risk and risky-choice framing[J]. AIMS Public Health, 2023, 10(2): 281-296. doi: 10.3934/publichealth.2023021

    Related Papers:

  • Confinement measures at the beginning of the COVID-19 pandemic imposed major changes on the global population. The aim of this study was to explore the level to which the public adhered to protective guidelines by adopting the most appropriate behaviors at that time (such as hand washing with soap and using sanitizer gel) and to identify the determinants of these behaviors. A purposive sample of 1013 individuals was invited and voluntarily participated in the online survey. The questionnaire collected information on demographic data, hand washing, risk perception, anxiety (through the S = Anxiety scale of STAI) and risky-choice framing. Results showed increased levels of anxiety, a moderate perception of the risk of catching coronavirus and increased adoption of protective behaviors, such as handwashing and cleaning surfaces with disinfectant/antiseptic products. Multiple ordinal logistic regression models showed that being female, more educated and cleaning home with disinfectant / antiseptic products predicted handwashing with soap. Additionally, having an increased perception of getting the coronavirus, being older and cleaning the home with disinfectant / antiseptic products predicted handwashing with antiseptics. Public health interventions should take into consideration the unified cleaning pattern and the combined effect of sociodemographic variables and risk perception on the adoption of protective behaviour in the context of a health crisis which is out of people's control.



    加载中

    Acknowledgments



    We would like to thank all participants in this survey. The authors also thank the Laboratory for Health Technology Assessment – LabHTA, which funded, by own funds, the electronic formulation of the questionnaire and data collection through the Special Account for Research Grants - University of West Attica, code no. 80712.

    Conflict of interest



    The authors have no conflicts of interest to declare.

    [1] Grover S, Sahoo S, Mehra A, et al. (2020) Psychological impact of COVID-19 lockdown: An online survey from India. Indian J Psychiatry 62: 354-362. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_427_20
    [2] World Health Organization (WHO) WHO Director-General's statement on IHR Emergency Committee on Novel Coronavirus (2019-nCoV).
    [3] World Health Organization (WHO) WHO Coronavirus (COVID-19) Dashboard. Available from: https://covid19.who.int/.
    [4] National Public Health Organization Current state of Covid-19 outbreak in Greece and timeline of key containment events. Available from: https://eody.gov.gr/en/current-state-of-covid-19-outbreak-in-greece-and-timeline-of-key-containment-events/.
    [5] National Public Health Organization Epidemiological Report (COVID-19). Available from: https://eody.gov.gr/wp-content/uploads/2020/04/covid-gr-daily-report-20200427.pdf.
    [6] National Public Health Organization Weekly Epidemiological Report on SARS-COV-2 (19–25 September 2022). Available from: https://eody.gov.gr/wp-content/uploads/2022/09/covid-gr-weekly-report-2022-38.pdf.
    [7] Dergiades T, Milas C, Mossialos E, et al. (2022) Effectiveness of government policies in response to the first COVID-19 outbreak. PLOS Glob Public Health 2: e0000242. https://doi.org/10.1371/journal.pgph.0000242
    [8] Kousi T, Mitsi LC, Simos J (2021) The Early Stage of COVID-19 Outbreak in Greece: A Review of the National Response and the Socioeconomic Impact. Int J Env Res Public Health 18: 322. https://doi.org/10.3390/ijerph18010322
    [9] Rodríguez-Fernández P, González-Santos J, Santamaría-Peláez M, et al. (2021) Psychological Effects of Home Confinement and Social Distancing Derived from COVID-19 in the General Population-A Systematic Review. Int J Environ Res Public Health 18: 6528. https://doi.org/10.3390/ijerph18126528
    [10] Chinna K, Sundarasen S, Khoshaim HB, et al. (2021) Psychological impact of COVID-19 and lock down measures: An online cross-sectional multicounty study on Asian university students. PLoS One 16: e0253059. https://doi.org/10.1371/journal.pone.0253059
    [11] Sang X, Menhas R, Saqib ZA, et al. (2021) The Psychological Impacts of COVID-19 Home Confinement and Physical Activity: A Structural Equation Model Analysis. Front Psychol 11: 614770. https://doi.org/10.3389/fpsyg.2020.614770
    [12] Uribe-Restrepo JM, Waich-Cohen A, Ospina-Pinillos L, et al. (2022) Mental health and psychosocial impact of the COVID-19 pandemic and social distancing measures among young adults in Bogotá, Colombia. AIMS Public Health 9: 630-643. https://doi.org/10.3934/publichealth.2022044
    [13] Magdy DM, Metwally A, Magdy O (2022) Assessment of community psycho-behavioral responses during the outbreak of novel coronavirus (2019-nCoV): a cross-sectional study. AIMS Public Health 9: 26-40. https://doi.org/10.3934/publichealth.2022003
    [14] Schelhorn I, Ecker A, Lüdtke MN, et al. (2021) Psychological Burden During the COVID-19 Pandemic in Germany. Front Psycholy 12: 640518. https://doi.org/10.3389/fpsyg.2021.640518
    [15] Favieri F, Forte G, Tambelli R, et al. (2021) The Italians in the Time of Coronavirus: Psychosocial Aspects of the Unexpected COVID-19 Pandemic. Front Psychol 12: 551924. https://doi.org/10.3389/fpsyt.2021.551924
    [16] Zavras D (2021) A cross-sectional population-based study on the influence of the COVID-19 pandemic on incomes in Greece. AIMS Public Health 8: 376-387. https://doi.org/10.3934/publichealth.2021029
    [17] Leite Â, Vidal DG, Sousa HFPe, et al. (2021) Portuguese version of COVID-19 perceived risk scale and COVID-19 phobia scale: Psychometric properties. Eur J Invest Health 11: 1044-1060. https://doi.org/10.3390/ejihpe11030078
    [18] Magano J, Vidal DG, Sousa HFPe, et al. (2021) Validation and psychometric properties of the Portuguese version of the Coronavirus Anxiety Scale (CAS) and Fear of COVID-19 Scale (FCV-19S) and associations with travel, tourism and hospitality. Int J Environ Res Public Health 18: 427. https://doi.org/10.3390/ijerph18020427
    [19] Fazia T, Bubbico F, Nova A, et al. (2022) Online Short-Term Mindfulness-Based Intervention During COVID-19 Quarantine in Italy: Effects on Wellbeing, Stress, and Anxiety. Front Psychol 13. https://doi.org/10.3389/fpsyg.2022.914183
    [20] Parlapani E, Holeva V, Voitsidis P, et al. (2020) Psychological and Behavioral Responses to the COVID-19 Pandemic in Greece. Front Psychol 11: 821. https://doi.org/10.3389/fpsyt.2020.00821
    [21] Kornilaki Α (2022) The psychological consequences of COVID-19 pandemic on University students in Greece. The role of daily activities during the quarantine. Psychology 26: 144-164.
    [22] Nikopoulou VA, Holeva V, Parlapani E, et al. (2022) Mental health screening for COVID-19: A proposed cutoff score for the Greek version of the Fear of COVID-19 Scale (FCV-19S). Int J of Ment Health Addict 20: 907-920. https://doi.org/10.1007/s11469-020-00414-w
    [23] Gozzi N, Tizzani M, Starnini M, et al. (2020) Collective Response to Media Coverage of the COVID-19 Pandemic on Reddit and Wikipedia: Mixed-Methods Analysis. J Med Internet Res 22: e21597. https://doi.org/10.2196/21597
    [24] Sobkow A, Zaleskiewicz T, Petrova D, et al. (2020) Worry, Risk Perception, and Controllability Predict Intentions Toward COVID-19 Preventive Behaviors. Front Psychol 11: 582720-582720. https://doi.org/10.3389/fpsyg.2020.582720
    [25] Szczuka Z, Abraham C, Baban A, et al. (2021) The trajectory of COVID-19 pandemic and handwashing adherence: findings from 14 countries. BMC Public Health 21: 1791-1791. https://doi.org/10.1186/s12889-021-11822-5
    [26] Chen X, Ran L, Liu Q, et al. (2020) Hand Hygiene, Mask-Wearing Behaviors and Its Associated Factors during the COVID-19 Epidemic: A Cross-Sectional Study among Primary School Students in Wuhan, China. Int J Environ Res Public Health 17: 2893. https://doi.org/10.3390/ijerph17082893
    [27] Nivette A, Ribeaud D, Murray A, et al. (2021) Non-compliance with COVID-19-related public health measures among young adults in Switzerland: Insights from a longitudinal cohort study. Soc Sci Med 268: 11337. https://doi.org/10.1016/j.socscimed.2020.113370
    [28] Mouchtouri VA, Agathagelidou E, Kofonikolas K, et al. (2020) Nationwide Survey in Greece about Knowledge, Risk Perceptions, and Preventive Behaviors for COVID-19 during the General Lockdown in April 2020. Int J Environ Res Public Health 17: 8854. https://doi.org/10.3390/ijerph17238854
    [29] Souliotis K, Giannouchos TV, Peppou LE, et al. (2021) Public Health Behaviors during the COVID-19 Pandemic in Greece and Associated Factors: A Nationwide Cross-sectional Survey. Inquiry 58: 469580211022913. https://doi.org/10.1177/00469580211022913
    [30] Encyclopedia of behavioral medicine. Cham: Springer International Publishing. https://doi.org/10.1007/978-3-030-39903-0
    [31] Lammers J, Crusius J, Gast A (2020) Correcting misperceptions of exponential coronavirus growth increases support for social distancing. P Natl Acad Sci 117: 16264-16266. https://doi.org/10.1073/pnas.2006048117
    [32] Shiina A, Niitsu T, Kobori O, et al. (2020) Relationship between perception and anxiety about COVID-19 infection and risk behaviors for spreading infection: A national survey in Japan. Brain Behav Immun Health 6: 10010. https://doi.org/10.1016/j.bbih.2020.100101
    [33] Taylor S (2022) The Psychology of Pandemics. Annu Rev Clin Psychol 18: 581-609. https://doi.org/10.1146/annurev-clinpsy-072720-020131
    [34] Saviola F, Pappaianni E, Monti A, et al. (2020) Trait and state anxiety are mapped differently in the human brain. Sci Rep 10: 11112. https://doi.org/10.1038/s41598-020-68008-z
    [35] Asmundson GJG, Abramowitz JS, Richter AA, et al. (2010) Health Anxiety: Current Perspectives and Future Directions. Curr Psychiat Rep 12: 306-312. https://doi.org/10.1007/s11920-010-0123-9
    [36] Asmundson GJG, Taylor S, Nicholas Carleton R, et al. (2012) Should health anxiety be carved at the joint? A look at the health anxiety construct using factor mixture modeling in a non-clinical sample. J Anxiety Disord 26: 246-251. https://doi.org/10.1016/j.janxdis.2011.11.009
    [37] Gilles I, Bangerter A, Clémence A, et al. (2011) Trust in medical organizations predicts pandemic (H1N1) 2009 vaccination behavior and perceived efficacy of protection measures in the Swiss public. Eur J Epidemiol 26: 203-210. https://doi.org/10.1007/s10654-011-9577-2
    [38] Tversky A, Kahneman D (1981) The Framing of Decisions and the Psychology of Choice. Science 211: 453-458. https://doi.org/10.1126/science.7455683
    [39] McNeil BJ, Pauker SG, Sox HC, et al. (1982) On the Elicitation of Preferences for Alternative Therapies. N Engl J Med 306: 1259-1262. https://doi.org/10.1056/NEJM198205273062103
    [40] Mandel DR (2014) Do framing effects reveal irrational choice?. J Exp Psychol Gen 143: 1185-1198. https://doi.org/10.1037/a0034207
    [41] Chick CF, Reyna VF, Corbin JC (2016) Framing effects are robust to linguistic disambiguation: A critical test of contemporary theory. J Exp Psychol Learn 42: 238-256. https://doi.org/10.1037/xlm0000158
    [42] Rachev NR, Han H, Lacko D, et al. (2021) Replicating the Disease framing problem during the 2020 COVID-19 pandemic: A study of stress, worry, trust, and choice under risk. PLoS One 16: e0257151. https://doi.org/10.1371/journal.pone.0257151
    [43] Spielberger CD (1970) Manual for the state-trait anxiety inventory (Self-evaluation questionnare).Consulting Psychogyists Press.
    [44] Fountoulakis KN, Papadopoulou M, Kleanthous S, et al. (2006) Reliability and psychometric properties of the Greek translation of the State-Trait Anxiety Inventory form Y: preliminary data. Ann Gen Psychiatry 5: 1-10. https://doi.org/10.1186/1744-859X-5-2
    [45] Brant R (1990) Assessing Proportionality in the Proportional Odds Model for Ordinal Logistic Regression. Biometrics 46: 1171-1178. https://doi.org/10.2307/2532457
    [46] Lipsitz SR, Fitzmaurice GM, Molenberghs G (1996) Goodness-of-Fit Tests for Ordinal Response Regression Models. J R Stat Soc C-Appl 45: 175-190. https://doi.org/10.2307/2986153
    [47] Long JS, Freese J Regression models for categorical dependent variables using stata, Stata Press (2014).
    [48] Fagerland MW, Hosmer DW (2017) How to Test for Goodness of Fit in Ordinal Logistic Regression Models. Stata J 17: 668-686. https://doi.org/10.1177/1536867X1701700308
    [49] Xu F, Huang L (2022) The Influence of Trait Emotion and Spatial Distance on Risky Choice Under the Framework of Gain and Loss. Front Psychol 13. https://doi.org/10.3389/fpsyg.2022.592584
    [50] Cicerale A, Blanzieri E, Sacco K (2022) How does decision-making change during challenging times?. PLoS One 17: e0270117. https://doi.org/10.1371/journal.pone.0270117
    [51] Li P, Zhu H (2022) Sense of Control and Safety Compliance in the Prevention of COVID-19: A Framework Based on Conservation of Resources Theory. Front Psychol 13. https://doi.org/10.3389/fpsyg.2022.790459
    [52] Dev R, Raparelli V, Bacon SL, et al. (2022) Impact of biological sex and gender-related factors on public engagement in protective health behaviours during the COVID-19 pandemic: cross-sectional analyses from a global survey. BMJ Open 12: e059673. https://doi.org/10.1136/bmjopen-2021-059673
    [53] Tan J, Yoshida Y, Ma KS-K, et al. (2021) Gender Differences in Health Protective Behaviors During the COVID-19 Pandemic in Taiwan: An Empirical Study. medRxiv . https://doi.org/10.1101/2021.04.14.21255448
    [54] Bruine de Bruin W (2021) Age Differences in COVID-19 Risk Perceptions and Mental Health: Evidence From a National U.S. Survey Conducted in March 2020. J Gerontol B Psychol Sci Soc Sci 76: e24-e29. https://doi.org/10.1093/geronb/gbaa074
    [55] Ssentongo P, Ssentongo AE, Heilbrunn ES, et al. (2020) Association of cardiovascular disease and 10 other pre-existing comorbidities with COVID-19 mortality: A systematic review and meta-analysis. PLoS One 15: e0238215. https://doi.org/10.1371/journal.pone.0238215
    [56] Brankston G, Merkley E, Fisman DN, et al. (2021) Socio-demographic disparities in knowledge, practices, and ability to comply with COVID-19 public health measures in Canada. Can J Public Health 112: 363-375. https://doi.org/10.17269/s41997-021-00501-y
    [57] Capraro V, Barcelo H (2020) The effect of messaging and gender on intentions to wear a face covering to slow down COVID-19 transmission. J Behav Econ Policy 4: 45-55. https://doi.org/10.31234/osf.io/tg7vz
    [58] Pawlowski B, Atwal R, Dunbar RIM (2008) Sex Differences in Everyday Risk-Taking Behavior in Humans. Evol Psychol 6: 147470490800600100. https://doi.org/10.1177/147470490800600104
    [59] Wise T, Zbozinek TD, Michelini G, et al. (2020) Changes in risk perception and self-reported protective behaviour during the first week of the COVID-19 pandemic in the United States. R Soc Open Sci 7: 200742-200742. https://doi.org/10.1098/rsos.200742
    [60] Brown LG, Hoover ER, Barrett CE, et al. (2020) Handwashing and disinfection precautions taken by U.S. adults to prevent coronavirus disease 2019, Spring 2020. BMC Res Notes 13: 550. https://doi.org/10.1186/s13104-020-05398-3
  • Reader Comments
  • © 2023 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0)
通讯作者: 陈斌, bchen63@163.com
  • 1. 

    沈阳化工大学材料科学与工程学院 沈阳 110142

  1. 本站搜索
  2. 百度学术搜索
  3. 万方数据库搜索
  4. CNKI搜索

Metrics

Article views(1058) PDF downloads(83) Cited by(0)

Article outline

Figures and Tables

Tables(4)

/

DownLoad:  Full-Size Img  PowerPoint
Return
Return

Catalog