COVID-19 Risk Perception and its Related Factors and Outcomes in Vulnerable Groups: A Systematic Review

Abstract

Background:The COVID-19 disease has worse outcomes in individuals with underlying diseases and elderly individuals. Therefore, identifying COVID-19 risk perception and its related factors and outcomes in vulnerable groups is essential for the health system. Objectives: This study aimed to determine COVID-19 risk perception, its related factors, and outcomes in vulnerable groups (individuals with underlying diseases, smokers, opioid addicts, the elderly, and pregnant women). Methods: This systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search was carried out using the keywords "Risk perception" and "COVID-19" in PubMed, Scopus, Science Direct, SID, Proquest, and Magiran databases in the period from 2019 to July 3, 2021. The quality of selected studies was checked by two authors independently according to Newcastle-Ottawa Scale adapted for cross-sectional. Results: In the initial search, 640 articles were found, of which 56 remained in the screening phase. Then, the full text of 56 articles was studied. Eventually, based on the inclusion and exclusion criteria of the articles, 8 articles were reviewed. This systematic review showed that suffering from an underlying disease, more anxiety, younger age, and female gender are associated with higher COVID-19 risk perception. The outcomes of COVID-19 risk perception were higher COVID-19 risk perception, delayed treatment sessions, increased anxiety and fear, increased ineffective safety behaviors, and greater compliance with health protocols. Conclusion:Creating sensitivity and proper COVID-19 risk perception is necessary to follow health protocols, but high COVID-19 risk perception can endanger vulnerable groups' mental and physical health. Besides, reducing the sensitivity of vulnerable groups toward COVID-19 can expose them to the disease.

Risk perception and avoidance of preventive behavior on the COVID‐19 among cancer patients

“…The results of a qualitative study by Alqahtani et al 30 in Saudi Arabia also showed that risk perception is the basis of the tendency to deny risks or react with exaggeration in terms of precautionary reactions related to COVID‐19. This is a vicious cycle because the higher risk perception of contracting COVID‐19 can lead to an increase in anxiety and fear of chronic patients and subsequently cause postponement of treatment sessions and increase in avoidance behaviors 16 …”

“…This is a vicious cycle because the higher risk perception of contracting COVID-19 can lead to an increase in anxiety and fear of chronic patients and subsequently cause postponement of treatment sessions and increase in avoidance behaviors. 16 T A B L E 3 Regression analysis of EPPM constructs for COVID-19. In the present study, defensive avoidance was dependent variables influenced by perceived severity and fear.…”

“…This is a vicious cycle because the higher risk perception of contracting COVID‐19 can lead to an increase in anxiety and fear of chronic patients and subsequently cause postponement of treatment sessions and increase in avoidance behaviors. 16 …”

“…In the present study, it was somewhat differently from the previous studies and preventive behaviors were not investigated, but rather the effect of risk perception and efficacy appraisal on defensive avoidance in relation to protective behaviors of COVID‐19 was investigated. Risk perception is one of the determinants of disease prevention and treatment, and studies have shown that in the case of COVID‐19, risk perception has a significant relationship with compliance with preventive behaviors 2,16,17 . One of the most widely used models in the field of risk perception is the extended parallel process model (EPPM), 18,19 which is commonly used in health communication campaigns when a message is trying to persuade an audience to adopt a healthy behavior 20 .…”

“…Risk perception is one of the determinants of disease prevention and treatment, and studies have shown that in the case of COVID‐19, risk perception has a significant relationship with compliance with preventive behaviors. 2 , 16 , 17 One of the most widely used models in the field of risk perception is the extended parallel process model (EPPM), 18 , 19 which is commonly used in health communication campaigns when a message is trying to persuade an audience to adopt a healthy behavior. 20 EPPM has seven constructs including perceived susceptibility, perceived severity, self‐efficacy, response efficacy, fear, defensive avoidance, and protection motivation.…”