Perceived risk and protective behaviors related to COVID-19 among the Nigerian general population: An application of the extended parallel process model.

Since the outbreak of the coronavirus disease 2019 (COVID-19), there have been heightened levels of fear worldwide. The steadily increasing number of COVID-19 cases in Nigeria as reported by the Nigerian center for Disease Control has led to different behavioral responses influenced by perceived threat and efficacy. This study aimed to understand the levels of perceived threat and efficacy to COVID-19 in Nigeria across various demographic groups using the Extended Parallel Process Model. This was a cross-sectional study conducted across all states in Nigeria, between May and June 2020. The majority of respondents were recruited via social media, with a smaller fraction interviewed face to face due to Government restrictions on movement in some states. Based on findings, respondents had high exposure to COVID-19 messages on social media (85%), followed by television (67%), radio (54%), and the Nigeria center for Disease Control short message services (52%). High exposure to COVID-19 messages across all media platforms was significantly associated with perceived severity, response efficacy, and self-efficacy (< 0.01). Also, with an increase in age, there was a corresponding increase in the perceived susceptibility to COVID-19. As the level of education increased, respondents' perceived severity, susceptibility, self-efficacy, and response efficacy to COVID-19 increased. A chi-square test between demographic variables and intermediate outcome variables (danger or fear control process) showed a significant association with age, gender, highest educational level, and employment type. From the findings, the majority of respondents were less likely to practice the recommended protective behaviors as COVID-19 was not perceived as a threat. The proportion of the Nigerian population willing to take up recommended preventive behaviors were just 15%. Developing messages with an appropriate balance between threat and efficacy to target different audiences would likely encourage the adoption and practice of recommended COVID-19 preventive behaviors.