Efficacy of Risk Messaging Styles on Health Behavior Intention during the COVID-19 Pandemic - Cross-Sectional Comparative Study

Abstract

Abstract Background The novel Coronavirus disease (COVID-19) pandemic started in late 2019. Various risk messaging styles were employed to promote public adherence to health guidelines. This study examines the effect of different risk messaging styles on public health intentions. Methods A cross-sectional interventional study used a representative sample (N=665) of adult Hebrew speakers in Israel. Participants were recruited through an online survey company and randomly assigned into five intervention groups representing different risk messaging styles and a control group. The study measured and compared health behavioral intention before and after watching the messages and measures of the Health Belief Model (HBM), trust in authorities, and personality traits. Results A slight but significant improvement in behavioral intention was observed after watching the broadcasts (+0.06 points on a scale of 1-5), mainly attributed to two of the intervention groups (+0.10 and +0.13 points). The change in behavioral intention was positively correlated with cues to action and self-efficacy. A positive correlation was found between the level of trust in authorities and change in behavioral intention (rs=0.132, P <0.001). After watching all broadcasts, the feelings tended to be either neutral or slightly positive (range: 3.45 to 4.80 on a six-point scale), and not a single broadcast evoked negative feelings exclusively. However, there was no correlation between evoked feelings and change in behavioral intention at the sample level. In a simple linear regression for predicting change in behavioral intention, which included the two most perceived negative and positive broadcasts, there was a trend toward an association between positive feelings and behavioral intention (p=0.055). Conclusions The findings may support the argument that risk messaging that evokes positive feelings, compared with negative (e.g., frightening) feelings, have a higher potential to achieve behavioral intention. It is recommended to promote future public health behavior during pandemics using messages that evoke positive feelings, strengthening their sense of self-efficacy in implementing the recommended actions and presenting the information about the optimal behavior in a clear, consistent, and reliable manner. In addition, disaster managers ought to aspire for more public trust in authorities to foster more meaningful change in attitudes toward health regulations.