Cyberchondria, Fear of Infection, Prevention Intent, and Trust in Public Health: A Multinational Population-Based Survey of 16 Countries

Abstract

<title>Abstract</title> Objectives Amid the spread of monkeypox (Mpox) clades across African regions, there is a pressing need to enhance national preparedness and implement effective response strategies to save lives and contain the outbreak. Therefore, this study aims to assess the prevalence of cyberchondria, fear of infection, preventive intentions, and trust in public health authorities. Study design: A multi-national quantitative, comparative, cross-sectional design was adopted. Methods Participants completed three instruments including the Fear of COVID-19 Scale, the Mpox Preventive Behaviours Index, and a Trust in Public Health Authorities, Science, and Medicine Scale. Data were collected across 16 countries spanning three continents: Ethiopia, Somalia, Nigeria, Ireland, Thailand, Egypt, United Arab Emirates, Yemen, Bahrain, Iraq, Saudi Arabia, Jordan, Palestine, Turkey, Pakistan, and South Sudan. Data was collected from September 2024 to May 2025. Results The moderated mediation analysis revealed significant mediation effects through fear of mpox. Cyberchondria severity showed a strong positive relationship with fear (Path a: β = 0.293, p &lt; .001), which in turn significantly predicted PB (Path b: β = 0.239, p &lt; .001). The direct effect of CS on PB remained significant (Path c': β = 0.073, p = .002). The interaction between fear and trust was non-significant (β = 0.009, p = .085), as was the index of moderated mediation (β = 0.003, 95% CI [-0.001, 0.007]). Conclusion Cyberchondria severity and engagement in preventive behaviours were highest among participants from low-income countries. Trust in public health authorities increased with income level, peaking in high-income countries. These findings underscore the need for cross-national collaboration to build trust and manage digital health challenges during epidemics.