What drives preventative health behaviors one year into a pandemic? A replication and extension.

Objective: There is continued interest in understanding what leads people to engage in CDC-recommended COVID-19 prevention behaviors. We tested whether fear and COVID-19 worry would replicate as the primary drivers of six CDC recommended prevention behaviors. Methods and Measures: We recruited 741 adult participants during the second major peak of the COVID-19 pandemic in the United States (early 2021). Using very similar methods to the original study, participants completed a 10-day daily diary. Mixed effects models identified the strongest predictors of each individual prevention behavior as well as approach and avoidance behavior clusters. Results: At the between-person level, COVID-19 worry, COVID-19 perceived susceptibility, fear, and positive emotions all had positive zero-order associations with the prevention behaviors. However, with all predictors in the same model together, primarily COVID-19 worry remained significant for both the individual behaviors and behavior clusters. At the within-person level, only fear related to assessing oneself for COVID-19 and approach behaviors on the same day, but not the next day. Mediational analyses suggested COVID-19 worry, but not COVID-19 susceptibility, mediated the links between fear and approach/avoidance behaviors. Conclusion: Findings replicated worry about yourself or a loved one getting COVID-19 as the strongest predictor of prevention behaviors.

Injunctive social norms and perceived message tailoring are associated with health information seeking.

Social norms messages may promote information seeking, especially when the norms refer to a group with which a person identifies. We hypothesized that tailored social norms messages would increase COVID-19 testing willingness and intentions. College students (n = 203, 75% female, 87% White) were randomly assigned to one of four conditions in a 2 (Descriptive norms: Relevant vs. Irrelevant to COVID-19 testing) x 2 (Tailoring: Specific vs. General group information) experimental design. Participants reported COVID-19 testing willingness and intentions, perceived injunctive norms, and identification and connectedness with the group in the message. Although neither the norm nor tailoring manipulation worked as intended, participants who perceived greater message tailoring and injunctive norms reported greater willingness and intentions, with no effect of perceived descriptive norms on either outcome. Tailored messages as well as messages promoting injunctive norms may promote information seeking across health contexts, thereby enabling more informed decisions.

Information Avoidance: Past Perspectives and Future Directions.

In the present age of unprecedented access to information, it is important to understand how and why people avoid information. Multiple definitions of "information avoidance" exist, and key aspects of these definitions deserve attention, such as distinguishing information avoidance from (lack of) information seeking, considering the intentionality and temporal nature of information avoidance, and considering the personal relevance of the information. In this review, we provide a cross-disciplinary historical account of theories and empirical research on information avoidance and seeking, drawing from research in multiple fields. We provide a framework of antecedents of information avoidance, categorized into beliefs about the information (e.g., risk perceptions), beliefs about oneself (e.g., coping resources), and social and situational factors (e.g., social norms), noting that constructs across categories overlap and are intertwined. We suggest that research is needed on both positive and negative consequences of information avoidance and on interventions to reduce information avoidance (when appropriate). Research is also needed to better understand temporal dynamics of information avoidance and how it manifests in everyday life. Finally, comprehensive theoretical models are needed that differentiate avoidance from seeking. Research on information avoidance is quickly expanding, and the topic will only grow in importance.

Field experiment of signs promoting hand hygiene during the COVID-19 pandemic.

OBJECTIVE: During the COVID-19 pandemic, the U.S. public was encouraged to practice good hand hygiene, such as hand washing or the use of hand sanitizer. Young adults reported lower levels of hand hygiene compared to adults of other ages. The aim of the current study was to test the effectiveness of different messages to promote hand sanitizer use among young adults. METHOD: Over a 6-week period, we examined whether 3 brief messages (gain-frame, static descriptive norms, dynamic descriptive norms), placed next to sanitizer dispensers in university residence halls, predicted dispenser use in comparison to dispensers with no sign. Amount of sanitizer usage was measured 3 times per week via the weight of dispenser units. We tracked and controlled for the number of positive COVID-19 cases in residence halls because we expected it might influence sanitizer usage. RESULTS: Compared to no signage, dispensers with signs had 35% greater usage, with the static descriptive norms sign associated with greatest usage (46% compared to no sign), although differences did not reach conventional levels of significance. The strongest predictor of sanitizer use was a residence hall's degree of COVID-19 risk based on the hall's case positivity. CONCLUSIONS: Dispensers with signs had higher use than those without signs, but this difference was not statistically significant. We conclude that compared to prior research, "nudges" such as evidence-based messaging may have had less of an effect on health behavior engagement due to methodological differences across studies or characteristics of the COVID-19 context. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

What Drives Preventive Health Behavior During a Global Pandemic? Emotion and Worry.

BACKGROUND & PURPOSE: Primary prevention of COVID-19 has focused on encouraging compliance with specific behaviors that restrict contagion. This investigation sought to characterize engagement in these behaviors in U.S. adults early during the pandemic and to build explanatory models of the psychological processes that drive them. METHODS: US adults were recruited through Qualtrics Research Panels (N = 324; 55% female; Mage = 50.91, SD = 15.98) and completed 10 days of online reports of emotion, COVID-19 perceived susceptibility and worry, and recommended behaviors (social distancing, hand washing, etc.). Factor analysis revealed behaviors loaded on two factors suggesting distinct motivational orientations: approach and avoidance. RESULTS: Changes in approach and avoidance behaviors over the 10 days indicated large individual differences consistent with three types of participants. Discrete emotions, including fear, guilt/shame, and happiness were associated with more recommended behaviors. Fear and COVID-19 worry indirectly influenced each other to facilitate more behavioral engagement. While emotions and worry strongly predicted individual differences in behavior across the 10 days, they did not predict as well why behaviors occurred on one day versus another. CONCLUSIONS: These findings suggest how daily affective processes motivate behavior, improving the understanding of compliance and efforts to target behaviors as primary prevention of disease.

Adherence of Internet-Based Cancer Risk Assessment Tools to Best Practices in Risk Communication: Content Analysis.

BACKGROUND: Internet-based risk assessment tools offer a potential avenue for people to learn about their cancer risk and adopt risk-reducing behaviors. However, little is known about whether internet-based risk assessment tools adhere to scientific evidence for what constitutes good risk communication strategies. Furthermore, their quality may vary from a user experience perspective. OBJECTIVE: This study aims to understand the extent to which current best practices in risk communication have been applied to internet-based cancer risk assessment tools. METHODS: We conducted a search on August 6, 2019, to identify websites that provided personalized assessments of cancer risk or the likelihood of developing cancer. Each website (N=39) was coded according to standardized criteria and focused on 3 categories: general website characteristics, accessibility and credibility, and risk communication formats and strategies. RESULTS: Some best practices in risk communication were more frequently adhered to by websites. First, we found that undefined medical terminology was widespread, impeding comprehension for those with limited health literacy. For example, 90% (35/39) of websites included technical language that the general public may find difficult to understand, yet only 23% (9/39) indicated that medical professionals were their intended audience. Second, websites lacked sufficient information for users to determine the credibility of the risk assessment, making it difficult to judge the scientific validity of their risk. For instance, only 59% (23/39) of websites referenced the scientific model used to calculate the user's cancer risk. Third, practices known to foster unbiased risk comprehension, such as adding qualitative labels to quantitative numbers, were used by only 15% (6/39) of websites. CONCLUSIONS: Limitations in risk communication strategies used by internet-based cancer risk assessment tools were common. By observing best practices, these tools could limit confusion and cultivate understanding to help people make informed decisions and motivate people to engage in risk-reducing behaviors.

Math matters: A novel, brief educational intervention decreases whole number bias when reasoning about COVID-19.

At the onset of the coronavirus disease (COVID-19) global pandemic, our interdisciplinary team hypothesized that a mathematical misconception-whole number bias (WNB)-contributed to beliefs that COVID-19 was less fatal than the flu. We created a brief online educational intervention for adults, leveraging evidence-based cognitive science research, to promote accurate understanding of rational numbers related to COVID-19. Participants from a Qualtrics panel (N = 1,297; 75% White) were randomly assigned to an intervention or control condition, solved health-related math problems, and subsequently completed 10 days of daily diaries in which health cognitions and affect were assessed. Participants who engaged with the intervention, relative to those in the control condition, were more accurate and less likely to explicitly mention WNB errors in their strategy reports as they solved COVID-19-related math problems. Math anxiety was positively associated with risk perceptions, worry, and negative affect immediately after the intervention and across the daily diaries. These results extend the benefits of worked examples in a practically relevant domain. Ameliorating WNB errors could not only help people think more accurately about COVID-19 statistics expressed as rational numbers, but also about novel future health crises, or any other context that involves information expressed as rational numbers. (PsycInfo Database Record (c) 2022 APA, all rights reserved).