Background: In the face of the global pandemic of coronavirus disease‐2019 (COVID‐19), people’s adherence to precautionary behavioral measures (e.g. social distancing) largely influences the effectiveness of those measures in containing the spread of the coronavirus. The present study aims at testing the applicability of the health belief model (HBM) and generalised social beliefs (i.e. social axioms) to explore strategies for promoting adherence to COVID‐19 precautionary measures. Methods: We conducted a telephone survey with a two‐step stratified random sampling method and obtained a probability sample of 616 adults in Macao, China (18–87 years old; 60.9% women) in April 2020. Results: Our participants showed stronger adherence to some COVID‐19 precautionary measures (e.g. face mask wearing; 96.4%) but not others (e.g. social distancing; 42.3%). Their adherence to those measures was found to be significantly associated with four HBM factors and two social axioms, after controlling for gender, age, and years of education. Conclusions: The HBM and the generalised social beliefs of social cynicism and reward for application can be applied to understanding adherence to precautionary measures against COVID‐19. Strategies based on beliefs were proposed to facilitate the promotion of precautionary measures.

Background and aims: Internet gaming disorder (IGD) has been mainly studied among adolescents, and no research to date has examined its prevalence in general Chinese adult populations. This study estimated the prevalence of probable IGD in community-dwelling adults in Macao, China. Associations between IGD and psychological distress (i.e., depression and anxiety) as well as IGD and character strength (i.e., psychological resilience and purpose in life) were also tested. Methods: A random, representative sample of 1,000 Chinese residents (44% males; mean age = 40.0) was surveyed using a telephone poll design from October to November 2016. Results: The estimated prevalence of probable IGD was 2.0% of the overall sample and 4.3% among the recent gamers (n = 473), with no statistically significant sex and age effects observed (p > .05). The two most prevalent IGD symptoms were mood modification and continued engagement, despite negative consequences. Probable IGD respondents were more vulnerable to psychological distress (25.0% and 45.0% for moderate or above levels of depression and anxiety, respectively) than their non-IGD counterparts. They also reported a lower level of psychological resilience than non-IGD respondents. No significant buffering effect of the two character strength variables on the distress–IGD relationship was found. Discussion and conclusions: These results provide empirical evidence that IGD is a mental health threat not only to adolescents but also to adults. IGD was significantly associated with psychological distress, which should be addressed in conjunction with IGD symptoms in interventions. Inclusion of gamers of both sexes and different age groups in future prevention programs is also recommended.

Macao, China’s only city with legalized casinos, has maintained a high prevalence of gambling participation and gambling disorder (GD) over the past decade. The mental health risks associated with such high levels have been overlooked. In order to estimate the comorbid prevalence of GD with depression, anxiety, and Internet gaming disorder (IGD) and to explore the potential buffering effect of psychological resilience and purpose in life, this study obtained a representative adult Chinese sample (N = 1000, 44% male, aged 18–97 years) from a telephone survey conducted between October and November of 2016. As hypothesized, the highest psychiatric comorbid prevalence was observed in the GD subgroup (n = 19, 21.1% probable IGD, 26.3% probable depression, and 37.0% probable anxiety). All these mental health problems could increase one’s proclivity to GD, and vice versa. Psychological resilience was found to buffer the association between anxiety symptoms and probable GD (χ²(1) = 4.30, p = 0.04/GD symptoms, F_change (1,162) = 6.29, p = 0.01), whereas purpose in life did not display any hypothesized moderating effect. These results indicate the usefulness of mental health screening for GD, taking into consideration its associated risks, and of fostering psychological resilience in prevention and treatment programs.

COVID-19 vaccines have been shown to provide protection against severe disease and death. However, substantial individual differences in vaccination intentions have hindered achieving optimal vaccination rates across the population. To look for efficient strategies to promote vaccination, this study tested whether the protection motivation theory (PMT), a cognitive model based upon threat and coping appraisals, would account for the differences in vaccination intentions under three scenarios (i.e., in the context of getting vaccinated in general, and in the context of high- and low- efficacy for reducing COVID-19 transmission risk). A phone survey was conducted in early 2021 and obtained a probability community sample (n = 472; 49.2% men) in Macao, China. We found that 54.0% of respondents indicated their relatively strong intention to receive COVID-19 vaccination for high-efficacy vaccines, compared to 29.5% for low-efficacy vaccines and 31.0% for vaccines in general. After adjusting for demographics, self-efficacy (i.e., the perceived capability of receiving COVID-19 vaccines) and maladaptive response reward (i.e., the perceived benefits of not receiving COVID-19 vaccines) were consistently associated with COVID-19 vaccination intentions under all three scenarios. The perceived severity of COVID-19 infection and response cost (i.e., the perceived costs of receiving COVID-19 vaccines) were significantly associated with vaccination intention for high-efficacy vaccines, while the response efficacy of lowering the COVID-19 impact with COVID-19 vaccination was positively associated with vaccination intention for general and low-efficacy vaccines. Given that the relative strength of PMT constructs depends on perceived vaccine efficacy, we recommend taking PMT constructs and vaccine efficacy into account for encouraging vaccination.