Associations of delay in doctor consultation with COVID-19 related fear, attention to information, and fact-checking

Abstract

Objective: Delaying doctor consultation is harmful. We examined the associations of delay in doctor consultation amidst the pandemic with sociodemographic characteristics, COVID-19 related fear, attention to information, and fact-checking. Methods: We conducted a population-based online cross-sectional survey in May 2020 on Hong Kong Chinese adults. Respondents reported whether the pandemic caused any delay in doctor consultation (yes/no), level of COVID-19 related fear, attention to information and fact-checking (all on a scale of 0 to 10). Regression analyses were used to examine the associations of delay and fear with sociodemographic characteristics, attention and fact-checking, adjusting for covariates. Results: Of 4551 respondents (46.5% male, 59.7% aged over 45 years), 10.1% reported delay in doctor consultation. The mean score was 6.4 for fear, 8.0 for attention and 7.4 for factchecking. Delay was more common in males and increased with age and fear. More respondents with a high level of fear reported delay than those with a low level of fear [adjusted odd ratios (AOR), 95% confidence interval (CI): 2.68 (2.08, 3.47)]. More respondents with a moderate level of attention reported delay than those with a low level of attention [AOR (95% CI): 1.28 (0.98, 1.67)]. Fewer respondents with a moderate or high level of fact-checking reported delay than those with a low level of fact-checking [AOR (95% CI): 0.72 (0.56, 0.92) and 0.78 (0.60, 1.02), respectively]. Females reported greater fear and fear decreased with age. Fear also increased with attention to information and decreased with fact-checking. Fear substantially mediated the association of delay with attention (96%) and fact-checking (30%). Conclusion: We have first shown that delay in doctor consultation increased with fear of COVID-19 and decreased with fact-checking amidst the pandemic. Fear also increased with attention to COVID-19 related information and decreased with fact-checking. If causal, factchecking may reduce delay in doctor consultation and fear. Understanding these associations can help policymakers develop targeted communication and support to the public to reduce delayed doctor consultations and the associated COVID-19-related or unrelated morbidity and mortality in the community.