Factors Influencing Americans’ Preventive Behaviours during the COVID-19 Pandemic: Lessons for Strategic Health and Risk Communicators

Sung In Choi (PhD student), Yan Jin, and Mark Badham. (forthcoming). “Factors Influencing Americans’ Preventive Behaviours during the COVID-19 Pandemic: Lessons for Strategic Health and Risk Communicators.” Strategic Communication in a Global Crisis: National and International Responses to the COVID-19 Pandemic (Eds. R. Tench, J. Meng, and A. Moreno-Fernández), Routledge.

Abstract: This chapter examines factors influencing Americans’ preventive behaviours, including their COVID-19 vaccination intentions, in response to the U.S. Government’s strategic communication about COVID-19 guidelines. This chapter draws on the theory of planned behaviour to shed light on three factors that can help strategic health and risk communicators predict future behaviours during a pandemic: attitude toward a recommended vaccine, social norms (i.e., the likelihood that individuals will follow others’ opinions about recommended behaviour), and self-efficacy (i.e., individuals’ confidence in their own ability to follow recommended behaviour). Based on an online survey of American adults in October-November 2020, the study found, first, that a relatively high proportion of Americans were adopting government-recommended behaviours to prevent infection and spread of the virus. Second, Americans who follow the government’s recommended behaviours tend to have higher vaccination intentions. Third, younger Americans are more likely to be influenced by social norms to adopt recommended behaviours. Fourth, younger Americans have higher levels of self-efficacy than older Americans. Finally, Americans with higher education levels tend to have higher self-efficacy to follow recommended actions, thus leading to higher levels of preventive behaviours. These findings have important implications for strategic health and risk communicators, particularly when attempting to persuade the public to follow government health recommendations during a public health crisis.

An Investigation of Cognitive Processing of Fear Appeal Messages Promoting HPV Vaccination: Predictors and Outcomes of Magnitude and Valence of Cognitive Responses

Abstract: An improvement in HPV vaccination rates is one of the primary goals of public health organizations. Toward this end, fear appeal communication is commonly used in health interventions, warning individuals of threats of HPV infection and promoting vaccination. However, little is known about how threat-related emotions, such as fear and anxiety, influence the cognitive processing of vaccination information and how this processing is associated with vaccination intention. To address this void, this study tests a model drawing upon functional emotion theories and dual-process models of persuasion. Results from an experimental study showed that fear and anxiety, which arose from exposure to threat information, triggered motivation to process HPV protection-related information, which in turn, was positively associated with depth of HPV vaccination information processing. Subsequently, greater depth of processing led to a greater number of positive cognitive responses when participants were presented with information with a high (vs. low), level of response efficacy. Finally, greater positivity of cognitive responses predicted greater intention to obtain HPV vaccination. Collectively, our findings provide a theory-based explanation about how the sequential provision and processing of threat and efficacy information in fear appeals contribute to the promotion of HPV vaccination. Implications for designing fear appeal messages are discussed.

The Effects of User Comment Valence of Facebook Health Messages on Intention to Receive the Flu Vaccine: The Role of Pre-existing Attitude Toward the Flu Vaccine and Psychological Reactance.

Kim, Hanyoung (Grady PhD Student), Seo, Y.,(Grady PhD Student) Yoon, H. J., Han, J. Y., & Ko. Y.(Grady PhD Student), (Forthcoming).

Abstract: This study examined if and how Facebook user-generated comments about the flu vaccine influenced psychological reactance in conjunction with pre-existing flu vaccine attitude. Psychological reactance was further tested as a mediating factor influencing behavioural intention to receive the vaccine. An experimental study was conducted with 264 college students. The results showed that pre-existing attitude positively influenced participants’ intention to obtain the flu vaccine through an increase (a decrease) in psychological reactance when there was inconsistency (consistency) between the pre-existing attitude and valence of comments. Collectively, the results demonstrate that psychological reactance is one possible theoretical mechanism through which social media users’ health behaviours are influenced by user-generated comments.

Adherence to Timely Vaccinations in the United States

Hargreaves AL, Glen J. Nowak, Paula Frew, AR Hinman, WA Orenstein et al., “Adherence to Timely Vaccinations in the United States,” Pediatrics, 145(3, March 2020):e20190783.

Abstract: We used 2014 National Immunization Survey provider-verified vaccination data to classify vaccination patterns as “recommended” (ie, in line with ACIP dose- and age-specific
recommendations), “alternate” (ie, in line with either limiting the number of shots per visit or skipping at least 1 vaccine series), or “unknown or unclassifiable” (i.e., not in line with ACIP recommendations or clearly limiting shots per visit or vaccine series). The majority of children’s patterns were classified as “recommended” (63%), with 23% and 14% following alternate or unknown or unclassifiable patterns, respectively; 58% of children were up-to-date with all ACIP-recommended immunizations by 19 to 35 months. Not being up-to-date was associated with alternate and unknown or unclassifiable patterns.

Understanding flu vaccination attitudes and behaviors: Exploring a measure of health decision-making preferences.

Abstract: Annual influenza vaccination has been recommended for all adults in the United States since 2010, but coverage estimates indicate that less than half of American adults complied during the 2018-19 flu season. A number of studies have assessed the correlates of adult influenza vaccination attitudes and behaviors, but stagnating flu vaccination rates suggest new approaches are needed to better understand influenza vaccination beliefs, behaviors, and intentions. This work introduces a new concept to the vaccination attitude and behavior literature. This new measure of health decision-making preferences is not only correlated with vaccine confidence and hesitancy, but it is positively related to prior flu vaccination behaviors and future flu vaccination intentions, even after controlling for a host of factors known to influence vaccine attitudes and behaviors. The implications of the new measure for communication and targeted (flu) vaccination messaging are discussed.