Department of Sport, Physical Education and Health, Faculty of Social Sciences, Hong Kong Baptist University, 12/F, Hong Kong Baptist University ShekMun Campus, 8 On Muk Street, ShekMun, Shatin, Hong Kong.
Centre for Health and Exercise Science Research, Hong Kong Baptist University, Hong Kong, China.
BMC Geriatr. 2022 Feb 2;22(1):91. doi: 10.1186/s12877-022-02785-2.
Older adults are at a higher risk from COVID-19. Individual preventive behaviors including frequent hand washing, mask wearing, and social distancing play important roles in reducing the transmission of COVID-19 in the community. This study aimed to identify the determinants of three preventive behaviors of older adults during the COVID-19 pandemic by using an Integrated Social Cognition Model.
Using a prospective study design, 516 Chinese older adults from Hubei province of China (mean age = 67.55 years, SD = 6.60, 57.9% females) completed two online questionnaire surveys. The demographics, social cognition constructs (motivational self-efficacy, risk perception, attitude, subjective norm, health knowledge, intention, volitional self-efficacy, planning, action control) and three preventive behaviors were measured during the first-wave online survey from 18 May 2020 to 7 June 2020. One month later, three preventive behaviors were measured again during the second-wave online survey. Data were analyzed by structural equation modelling.
Models showed attitude, motivational self-efficacy and subjective norm were consistent predictors of intention, motivational self-efficacy was a consistent predictor of volitional self-efficacy, planning and volitional self-efficacy were consistent predictors of action control, and health knowledge was a consistent predictor of behaviors across all three preventive behaviors. In addition, mediating relationships were found in the model of hand washing behavior. In particular, planning (β = .109, p = .042) and action control (β = .056, p = .047) mediated between volitional self-efficacy and hand washing respectively. Action control also mediated between planning and hand washing (β = .087, p = .044). Moreover, the inclusion of past behaviors in three models attenuated most of the structural relations.
The current study's findings basically supported the Integrated Social Cognition Model and identified key modifiable determinants of preventive behaviors. Based on this model, future interventions aiming to promote COVID-19 preventive behaviors among older adults are warranted.
老年人感染 COVID-19 的风险更高。个人预防行为，包括勤洗手、戴口罩和保持社交距离，在减少社区中 COVID-19 的传播方面发挥着重要作用。本研究旨在使用综合社会认知模型来确定 COVID-19 大流行期间老年人三种预防行为的决定因素。
采用前瞻性研究设计，来自中国湖北省的 516 名中国老年人（平均年龄=67.55 岁，标准差=6.60，57.9%为女性）完成了两次在线问卷调查。在第一次在线调查中，于 2020 年 5 月 18 日至 6 月 7 日期间测量了人口统计学、社会认知结构（动机自我效能、风险感知、态度、主观规范、健康知识、意图、意志自我效能、计划、行动控制）和三种预防行为。一个月后，在第二次在线调查中再次测量了这三种预防行为。通过结构方程模型进行数据分析。
模型表明，态度、动机自我效能和主观规范是意图的一致预测因素，动机自我效能是意志自我效能的一致预测因素，计划和意志自我效能是行动控制的一致预测因素，健康知识是所有三种预防行为的一致预测因素。此外，在洗手行为模型中发现了中介关系。具体而言，计划（β=0.109，p=0.042）和行动控制（β=0.056，p=0.047）分别在意志自我效能和洗手行为之间起中介作用。行动控制也在计划和洗手之间起中介作用（β=0.087，p=0.044）。此外，将过去行为纳入三个模型减弱了大多数结构关系。
本研究结果基本支持综合社会认知模型，并确定了预防行为的关键可调节决定因素。基于该模型，有必要针对老年人开展未来的干预措施，以促进 COVID-19 的预防行为。
