170925 20260430151735.0 doi 10.1186/s12982-026-01815-3 sideral 148990 ART-2026-148990 eng Sánchez-Recio, Raquel Universidad de Zaragoza (orcid)0000-0002-0078-0663 An alternative approach to acute respiratory illness through a sex-based analysis, psychosocial attitudes, mood, and self-perceived health 2026 Aim To examine the role of psychosocial attitudes in the relationship between mood and self-rated health by sex during COVID-19 pandemic. Methodology A cross-sectional design was used with data from residents of Zaragoza (Spain) aged 16 years and older, collected during the initial lockdown (Phase I) and 20 months later (Phase II). Mediation analyses were conducted using three regression models to assess the role of psychosocial attitudes. Results Psychosocial attitudes explained 30–55% of the variance in the relationship between mood and self-rated health in both sexes. Significant direct effects of mood on self-rated health were found in men and women (Phase I: βmen: 0.293, p < .001; βwomen: 0.226, p < .001; Phase II: βmen: 0.266, p < .001; β_women = 0.292, p < .001), as well as significant effects of psychosocial attitudes (Phase I: βmen: 0.054, p < .001; βwomen: 0.052, p < .001; Phase II: βmen=0.042, p < .001; βwomen: 0.049, p < .001). Indirect effects of mood through psychosocial attitudes were also significant (Phase I: βmen: 0.224; βwomen: 0.273; Phase II: βmen: 0.163, p < .001; βwomen: 0.193, p < .001). Women consistently reported worse moods and lower self-rated health than men across both phases. Conclusion Promoting healthy behaviours is essential, particularly for women and other vulnerable groups, to reduce health disparities and support public health. Keywords Psychosocial attitudes, Respiratory illness, Pandemic, Self-perceived health, Mood, Sex differences Access copy available to the general public Unrestricted info:eu-repo/grantAgreement/ES/AEI/PID2020-115904RB-I00 info:eu-repo/semantics/openAccess by-nd https://creativecommons.org/licenses/by-nd/4.0/deed.es info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Parrilla-Huertas, Juan A. Sebastián-Ariño, Antonio Zuil, Marcos Llorente, José María Asensio-Martínez, Ángela Universidad de Zaragoza (orcid)0000-0001-5208-7556 Zúñiga-Antón, María Universidad de Zaragoza (orcid)0000-0002-9541-5609 1006 255 Universidad de Zaragoza Dpto. Fisiatría y Enfermería Área Enfermería 4009 740 Universidad de Zaragoza Dpto. Psicología y Sociología Área Psicología Social 3006 435 Universidad de Zaragoza Dpto. Geograf. Ordenac.Territ. Área Geografía Humana 23, 1 (2026), 422 [19 pp.] Discover public health 1743369 http://zaguan.unizar.es/record/170925/files/texto_completo.pdf Versión publicada 2001760 http://zaguan.unizar.es/record/170925/files/texto_completo.jpg?subformat=icon icon Versión publicada oai:zaguan.unizar.es:170925 articulos driver 2026-04-30-13:57:12 ARTICLE