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

Abstract

BACKGROUND A central component of the public health strategy to control the 2019 Sars-CoV-2 (COVID-19) virus involves encouraging mask wearing and social distancing to protect individuals from acquiring and transmitting the virus. OBJECTIVE Understanding the psychologic factors that drive adoption or rejection of these protective behaviors can inform public health interventions to control the pandemic. METHODS We conducted an online survey of a representative sample of 1,074 U.S. 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, number of trips taken from the home, and COVID-19 knowledge. RESULTS In bi-variate 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 age, gender, income, education, race, and religiosity. Self-identified Republicans (vs. other political affiliations) reported the highest values for each of the novel predictors. CONCLUSIONS This study can inform the development of health communication interventions to encourage 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 should minimize controlling language and emphasize the individual’s autonomy 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 as well as using scripture that would support the adoption of COVID-19 protection.

Where the truth really lies: Listening to voices from African American communities in the Southern States about COVID-19 vaccine information and communication

“…Thus, health communication interventions can help eliminate misinformation and increase confidence in vaccination in the AA community [20]. Many efforts have been undertaken by health departments, agencies, and the CDC to develop, pilot-test, and implement various health communication interventions to promote vaccine uptake [21][22][23][24].…”