@Article{info:doi/10.2196/23218,
author="Roberts, James A
and David, Meredith E",
title="Improving Predictions of COVID-19 Preventive Behavior: Development of a Sequential Mediation Model",
journal="J Med Internet Res",
year="2021",
month="Mar",
day="17",
volume="23",
number="3",
pages="e23218",
keywords="pandemic; COVID-19; preventive behavior; self-efficacy; prevention; behavior; modeling; student; communication",
abstract="Background: Since the beginning of the COVID-19 pandemic, social distancing, self-quarantining, wearing masks, and washing hands have become part of the new norm for many, but not all. It appears that such preventive measures are critical to ``flattening the curve'' of the spread of COVID-19. The public's adoption of such behaviors is an essential component in the battle against what has been referred to as the ``invisible enemy.'' Objective: The primary objective of this study was to develop a model for predicting COVID-19 preventive behaviors among US college students. The Health Belief Model has a long history of use and empirical support in predicting preventive health behaviors, but it is not without its purported shortcomings. This study identifies a more optimal and defensible combination of variables to explain preventive behaviors among college students. This segment of the US population is critical in helping slow the spread of COVID-19 because of the relative reluctance of college students to perform the needed behaviors given they do not feel susceptible to or fearful of COVID-19. Methods: For this study, 415 US college students were surveyed via Qualtrics and asked to answer questions regarding their fear of COVID-19, information receptivity (seeking relevant information), perceived knowledge of the disease, self-efficacy, and performance of preventive behaviors. The PROCESS macro (Model 6) was used to test our conceptual model, including predictions involving sequential mediation. Results: Sequential mediation results show that fear of COVID-19 leads individuals to seek out information regarding the disease, which increases their perceived knowledge and fosters self-efficacy; this is key to driving preventive behaviors. Conclusions: Self-imposed preventive measures can drastically impact the rate of infection among populations. Based on this study's newly created sequential mediation model, communication strategies for encouraging COVID-19 preventive behaviors are offered. It is clear that college students, and very possibly adults of all ages, must have a healthy fear of COVID-19 to set in motion a process where concerned individuals seek out COVID-19--related information, increasing their store of knowledge concerning the disease, their self-efficacy, and ultimately their likelihood of performing the needed preventive behaviors. ",
issn="1438-8871",
doi="10.2196/23218",
url="https://www.jmir.org/2021/3/e23218",
url="https://doi.org/10.2196/23218",
url="http://www.ncbi.nlm.nih.gov/pubmed/33651707"
}