Novel Predictors of COVID-19 Protective Behaviors Among US Adults: Cross-sectional Survey

BackgroundA central component of the public health strategy to control the COVID-19 pandemic involves encouraging mask wearing and social distancing to protect individuals from acquiring and transmitting the virus. ObjectiveThis study aims to understand the psychological factors that dri...

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Main Authors: Resnicow, Ken, Bacon, Elizabeth, Yang, Penny, Hawley, Sarah, Van Horn, M Lee, An, Lawrence
Format: Article
Language:English
Published: JMIR Publications 2021-04-01
Series:Journal of Medical Internet Research
Online Access:https://www.jmir.org/2021/4/e23488
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author Resnicow, Ken
Bacon, Elizabeth
Yang, Penny
Hawley, Sarah
Van Horn, M Lee
An, Lawrence
author_facet Resnicow, Ken
Bacon, Elizabeth
Yang, Penny
Hawley, Sarah
Van Horn, M Lee
An, Lawrence
author_sort Resnicow, Ken
collection DOAJ
description BackgroundA central component of the public health strategy to control the COVID-19 pandemic involves encouraging mask wearing and social distancing to protect individuals from acquiring and transmitting the virus. ObjectiveThis study aims to understand the psychological factors that drive adoption or rejection of these protective behaviors, which can inform public health interventions to control the pandemic. MethodsWe conducted an online survey of a representative sample of 1074 US adults and assessed three novel potential predictors of COVID-19 behaviors: trait reactance, COVID-19 conspiracy beliefs, and COVID-19 apocalypse beliefs. Key outcomes (dependent variables) included an index of COVID-19 protective behaviors, the number of trips taken from the home, and COVID-19 knowledge. ResultsIn bivariate analyses, all three predictors were significantly correlated in the hypothesized direction with the three COVID-19 outcomes. Specifically, each predictor was negatively (P<.01) correlated with the COVID-19 protective behaviors index and COVID-19 knowledge score, and positively correlated with trips taken from home per week (more of which was considered higher risk). COVID-19 protective behaviors and COVID-19 knowledge were significantly lower in the top median compared to the bottom median for all three predictors. In general, these findings remained significant after adjusting for all novel predictors plus age, gender, income, education, race, political party, and religiosity. Self-identified Republicans (vs other political affiliations) reported the highest values for each of the novel predictors. ConclusionsThis study can inform the development of health communication interventions to encourage the adoption of COVID-19 protective behaviors. Interestingly, we found that higher scores of all three novel predictors were associated with lower COVID-19 knowledge, suggesting that lack of an accurate understanding of the virus may be driving some of these attitudes; although, it is also possible that these attributes may interfere with one’s willingness or ability to seek and absorb accurate health information. These individuals may be particularly immune to accepting new information and yielding their beliefs. Health communication professionals may apply lessons learned from countering similar beliefs around climate change and vaccine hesitancy. Messages designed for individuals prone to reactance may be more effective if they minimize controlling language and emphasize the individual’s independence in adopting these behavioral recommendations. Messaging for those who possess conspiracy beliefs should similarly not assume that providing evidence contrary to these beliefs will alone alter behavior. Other communication techniques such as rolling with resistance, a strategy used in motivational interviewing, may be helpful. Messaging for those with apocalyptic beliefs may require using religious leaders as the message source and using scripture that would support the adoption of COVID-19 protection behaviors.
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spelling doaj.art-76f0e9bea6244910a17925afdac971402022-12-21T21:10:36ZengJMIR PublicationsJournal of Medical Internet Research1438-88712021-04-01234e2348810.2196/23488Novel Predictors of COVID-19 Protective Behaviors Among US Adults: Cross-sectional SurveyResnicow, KenBacon, ElizabethYang, PennyHawley, SarahVan Horn, M LeeAn, LawrenceBackgroundA central component of the public health strategy to control the COVID-19 pandemic involves encouraging mask wearing and social distancing to protect individuals from acquiring and transmitting the virus. ObjectiveThis study aims to understand the psychological factors that drive adoption or rejection of these protective behaviors, which can inform public health interventions to control the pandemic. MethodsWe conducted an online survey of a representative sample of 1074 US adults and assessed three novel potential predictors of COVID-19 behaviors: trait reactance, COVID-19 conspiracy beliefs, and COVID-19 apocalypse beliefs. Key outcomes (dependent variables) included an index of COVID-19 protective behaviors, the number of trips taken from the home, and COVID-19 knowledge. ResultsIn bivariate analyses, all three predictors were significantly correlated in the hypothesized direction with the three COVID-19 outcomes. Specifically, each predictor was negatively (P<.01) correlated with the COVID-19 protective behaviors index and COVID-19 knowledge score, and positively correlated with trips taken from home per week (more of which was considered higher risk). COVID-19 protective behaviors and COVID-19 knowledge were significantly lower in the top median compared to the bottom median for all three predictors. In general, these findings remained significant after adjusting for all novel predictors plus age, gender, income, education, race, political party, and religiosity. Self-identified Republicans (vs other political affiliations) reported the highest values for each of the novel predictors. ConclusionsThis study can inform the development of health communication interventions to encourage the adoption of COVID-19 protective behaviors. Interestingly, we found that higher scores of all three novel predictors were associated with lower COVID-19 knowledge, suggesting that lack of an accurate understanding of the virus may be driving some of these attitudes; although, it is also possible that these attributes may interfere with one’s willingness or ability to seek and absorb accurate health information. These individuals may be particularly immune to accepting new information and yielding their beliefs. Health communication professionals may apply lessons learned from countering similar beliefs around climate change and vaccine hesitancy. Messages designed for individuals prone to reactance may be more effective if they minimize controlling language and emphasize the individual’s independence in adopting these behavioral recommendations. Messaging for those who possess conspiracy beliefs should similarly not assume that providing evidence contrary to these beliefs will alone alter behavior. Other communication techniques such as rolling with resistance, a strategy used in motivational interviewing, may be helpful. Messaging for those with apocalyptic beliefs may require using religious leaders as the message source and using scripture that would support the adoption of COVID-19 protection behaviors.https://www.jmir.org/2021/4/e23488
spellingShingle Resnicow, Ken
Bacon, Elizabeth
Yang, Penny
Hawley, Sarah
Van Horn, M Lee
An, Lawrence
Novel Predictors of COVID-19 Protective Behaviors Among US Adults: Cross-sectional Survey
Journal of Medical Internet Research
title Novel Predictors of COVID-19 Protective Behaviors Among US Adults: Cross-sectional Survey
title_full Novel Predictors of COVID-19 Protective Behaviors Among US Adults: Cross-sectional Survey
title_fullStr Novel Predictors of COVID-19 Protective Behaviors Among US Adults: Cross-sectional Survey
title_full_unstemmed Novel Predictors of COVID-19 Protective Behaviors Among US Adults: Cross-sectional Survey
title_short Novel Predictors of COVID-19 Protective Behaviors Among US Adults: Cross-sectional Survey
title_sort novel predictors of covid 19 protective behaviors among us adults cross sectional survey
url https://www.jmir.org/2021/4/e23488
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