UNASSIGNED: Examine college students\' behavior intention to reduce viral outbreak transmission in the context of Mpox, and what preventive messaging strategies would be most effective in future transmissible disease outbreaks based on the Reasoned Action Approach (RAA).
UNASSIGNED: Undergraduates at a mid-Atlantic U.S. University.
UNASSIGNED: An online survey (n = 266) conducted at the height of the recent Mpox outbreak in the U.S., asked about five target behaviors to reduce Mpox transmission, including RAA determinants for each behavior.
UNASSIGNED: Highest intention was safe sex practices, lowest were vaccination and sexual abstinence, and sharing dishes and fabrics were in between. RAA determinants differed by target behavior, although attitudes were significantly positively associated with intention for all five behaviors.
UNASSIGNED: College students are potentially open to preventative behaviors to reduce viral transmission during an outbreak. However, specific target behavior matters and messaging should focus on differing RAA determinants depending on target behavior.

BACKGROUND: Time preferences for preventive behavior under novel risks and uncertain contexts may differ from timing preferences related to familiar risks. Therefore, it is crucial to examine drivers of preventative health behavior timing in light of new health risks. Using the case of COVID-19, we examine factors affecting vaccination timing plans when vaccines were widely available in the European Union (EU).
METHODS: We use data from the Flash Eurobarometer 494 survey (May 21-26, 2021), which collected information on EU residents\' attitudes towards COVID-19 vaccinations. We also use the \'Our World in Data\' vaccination database for country-level COVID-19 vaccination rates. Probit regressions were conducted to determine how local vaccination rates, trust in information sources, social norms, vaccine safety beliefs, and risk understanding affected the probability of COVID-19 vaccination delay.
RESULTS: Of total participants (n = 26,106), 9,063 (34.7%) were vaccinated, 7,114 (27.3%) wanted to get vaccinated as soon as possible, 5,168 (19.8%) wanted to delay vaccination and 2,962 (11.4%) resisted vaccination. Participants were more likely to delay COVID-19 vaccination if they lived in a country with lower vaccination prevalence, trusted online social networks, family, friends, and colleagues for vaccination information, were eager to follow vaccination-related social norms, expressed vaccine safety concerns, and understood the risk of catching COVID-19 without a vaccine to be lower.
CONCLUSIONS: Results from the study contribute to understanding important factors that predict timing of vaccination plans. These findings can also contribute to the wider knowledge base about timing of preventive behavior uptake in novel risk contexts.

The new coronavirus disease 2019 (COVID-19) has become a complex issue around the world. As the disease advancing and death rates are continuously increasing, governments are trying to control the situation by implementing different response policies. In order to implement appropriate policies, we need to consider the behavior of the people. Risk perception (RP) is a critical component in many health behavior change theories studies. People\'s RP can shape their behavior. This research presents a system dynamics (SD) model of the COVID-19 outbreak considering RP. The proposed model considers effective factors on RP, including different media types, awareness, and public acceptable death rate. In addition, the simplifying assumption of permanent immunity due to infection has been eliminated, and reinfection is considered; thus, different waves of the pandemic have been simulated. Using the presented model, the trend of advancing and death rates due to the COVID-19 pandemic in Iran can be predicted. Some policies are proposed for pandemic management. Policies are categorized as the capacity of hospitals, preventive behaviors, and accepted death rate. The results show that the proposed policies are effective. In this case, reducing the accepted death rate was the most effective policy to manage the pandemics. About 20% reduction in the accepted death rate causes about 23% reduction in cumulative death and delays at epidemic peak. The mean daily error in predicting the death rate is less than 10%.

BACKGROUND: The recent COVID-19 pandemic has contributed to the emergence of several technologies for infectious disease management. Although much focus has been placed on contact-tracing apps, another promising new tactic is proximity tracing, which focuses on health-related behavior and can be used for primary prevention. Underpinned by theories on behavioral design, a proximity-detection system can be devised that provides a user with immediate nudges to maintain physical distance from others. However, the practical feasibility of proximity detection during an infectious disease outbreak has not been sufficiently investigated.
OBJECTIVE: We aimed to evaluate the feasibility of using a wearable device to nudge for distance and to gather important insights about how functionality and interaction are experienced by users. The results of this study can guide future research and design efforts in this emerging technology.
METHODS: In this retrospective case study, a wearable proximity-detection technology was used in a workplace for 6 weeks during the production of a music competition. The purpose of the technology was to nudge users to maintain their physical distance using auditory feedback. We used a mixed methods sequential approach, including interviews (n=8) and a survey (n=30), to compile the experiences of using wearable technology in a real-life setting.
RESULTS: We generated themes from qualitative analysis based on data from interviews and open-text survey responses. The quantitative data were subsequently integrated into these themes: feasibility (implementation and acceptance-establishing a shared problem; distance tags in context-strategy, environment, and activities; understanding and learning; and accomplishing the purpose) and design aspects (a purposefully annoying device; timing, tone, and proximity; and additional functions).
CONCLUSIONS: This empirical study reports on the feasibility of using wearable technology based on proximity detection to nudge individuals to maintain physical distance in the workplace. The technology supports attention to distance, but the usability of this approach is dependent on the context and situation. In certain situations, the audio signal is frustrating, but most users agree that it needs to be annoying to ensure sufficient behavioral adaption. We proposed a dual nudge that involves vibration followed by sound. There are indications that the technology also facilitates learning how to maintain a greater distance from others, and that this behavior can persist beyond the context of technology use. This study demonstrates that the key value of this technology is that it places the user in control and enables immediate action when the distance to others is not maintained. This study provides insights into the emerging field of personal and wearable technologies used for primary prevention during infectious disease outbreaks. Future research is needed to evaluate the preventive effect on transmission and investigate behavioral changes in detail and in relation to different forms of feedback.

We use a cultural psychology approach to examine the relevance of the Health Belief Model (HBM) for predicting a variety of behaviors that had been recommended by health officials during the initial stages of the COVID-19 lockdown for containing the spread of the virus and not overburdening the health system in Europe. Our study is grounded in the assumption that health behavior is activated based on locally relevant perceptions of threats, susceptibility and benefits in engaging in protective behavior, which requires careful attention to how these perceptions might be structured and activated. We assess the validity of the HBM in two European countries that have been relatively understudied, using simultaneous measurements during acute periods of infection in Romania and Italy. An online questionnaire provided a total of (N = 1863) valid answers from both countries. First, to understand individual difference patterns within and across populations, we fit a General Linear Model in which endorsement was predicted by behavior, country, their interaction, and a random effect for participants. Second, we assess the effect of demographics and health beliefs on prevention behaviors by fitting a multi-group path model across countries, in which each behavior was predicted by the observed health belief variables and demographics. Health beliefs showed stronger relationships with the recommended behaviors than demographics. Confirming previously reported relationships, self-efficacy, perceived severity, and perceived benefits were consistently related to the greater adoption of individual behaviors, whereas greater perceived barriers were related to lower adoption of health behaviors. However, we also point to important location specific effects that suggest that local norms shape protective behavior in highly contextualized ways.

OBJECTIVE: The aim of this study is to identify the effects of a case management program on knowledge about oral cancer, preventive behavior for oral cancer, and level of uncertainty for patients with oral precancerous lesions.
METHODS: A randomized controlled trial was conducted with two groups, using a pre- and posttest design. The experimental group received a case management program and telephone follow-up sessions; the control group received routine care. Patients were assessed at three time points: first visit to the otolaryngology clinic for biopsy examination (T0), and then at 2 weeks (T1) and 4 weeks (T2) after the biopsy examination.
RESULTS: Patients in both groups had significantly higher levels of knowledge about oral cancer, preventive behavior for oral cancer, and lower level of uncertainty at T2 compared to T0. At T2, participants in the experimental group had significantly greater knowledge about oral cancer, more preventive behavior for oral cancer, and less uncertainty compared to those in the control group.
CONCLUSIONS: The case management program with telephone counseling effectively improved knowledge about oral cancer, preventive behavior for oral cancer, and uncertainty levels in patients with oral precancerous lesions in the four weeks after receiving a biopsy examination. The case management program can be applied with positive results to patients receiving different types of cancer screening, including colorectal, breast, and cervical screening.