Center for Health Communications Research, Rogel Cancer Center, University of Michigan, Ann Arbor, MI, United States.
Department of Health Behavior & Health Education, School of Public Health, University of Michigan, Ann Arbor, MI, United States.
J Med Internet Res. 2021 Apr 20;23(4):e23488. doi: 10.2196/23488.
A 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.
This 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.
We 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.
In 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.
This 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.
控制 COVID-19 大流行的公共卫生策略的一个核心组成部分是鼓励佩戴口罩和保持社交距离，以保护个人免受病毒感染和传播。
本研究旨在了解促使个人采纳或拒绝这些保护性行为的心理因素，以便为控制大流行的公共卫生干预措施提供信息。
我们对 1074 名美国成年人进行了一项在线调查，评估了三个新的 COVID-19 行为的潜在预测因素：特质反应性、COVID-19 阴谋论信念和 COVID-19 末世论信念。主要结果（因变量）包括 COVID-19 保护性行为指数、离家出行次数和 COVID-19 知识。
在双变量分析中，所有三个预测因素均与三个 COVID-19 结果呈假设方向的显著相关性。具体而言，每个预测因素都与 COVID-19 保护性行为指数和 COVID-19 知识得分呈负相关（P<.01），而与每周离家出行次数呈正相关（次数越多，风险越高）。在所有三个预测因素中，COVID-19 保护性行为和 COVID-19 知识的得分均明显低于最高中位数和最低中位数。一般来说，在调整所有新的预测因素以及年龄、性别、收入、教育、种族、政党和宗教信仰后，这些发现仍然具有统计学意义。自认为是共和党的人（与其他政治派别相比）在所有三个新的预测因素上的得分均最高。
本研究可以为鼓励采纳 COVID-19 保护性行为的健康传播干预措施提供信息。有趣的是，我们发现所有三个新预测因素的得分越高，COVID-19 知识得分越低，这表明缺乏对病毒的准确理解可能是导致这些态度的原因之一；尽管如此，这些特征也可能会干扰个人寻求和吸收准确健康信息的意愿或能力。这些人可能特别抗拒接受新信息并改变自己的信念。健康传播专业人员可以借鉴应对气候变化和疫苗犹豫类似信念的经验教训。为容易产生抵触情绪的个体设计的信息，如果能尽量减少控制语言并强调个体在采纳这些行为建议方面的独立性，可能会更有效。针对具有阴谋论信念的人，提供与这些信念相反的证据本身可能不足以改变行为。其他沟通技巧，如滚雪球，即一种在动机性访谈中使用的策略，可能会有所帮助。针对具有末世论信念的人的信息可能需要利用宗教领袖作为信息来源，并使用支持采取 COVID-19 保护性行为的经文。
