Perceived Effectiveness of COVID-19 Preventive Practices and Behavioral Intention: Survey of a Representative Adult Sample in the United States

Abstract

Background Using existing models of behavioral health promotion, specifically the Extended Parallel Process Model, previous research has identified factors that may impact engagement in preventive health behaviors during the COVID-19 pandemic such as perceived threat, perceived susceptibility to the threat, perceived severity, and perceived efficacy. Objective This study aims to examine the role of perceived effectiveness of COVID-19 preventive behaviors, perceived susceptibility, perceived threat, and perceived severity of COVID-19 in participants’ intentions to engage in Centers for Disease Control (CDC)–recommended individual health behaviors in the first year of the pandemic. Methods In October 2020, a representative sample of 506 US adults completed a web-based survey through the RAND American Life Panel. Results The study primarily found that participants who perceived that CDC-recommended health practices were effective had stronger intentions to engage in those practices. The second strongest correlate was participants’ perceived severity of COVID-19 across the United States. Perceived effectiveness of recommended practices accounted for the largest variance in behavioral intention. However, analysis of individual behaviors indicated a mismatch in the behaviors perceived to be the most effective (avoiding sick people and mask-wearing) and those participants indicated intention to engage in (throwing away used tissues, avoiding sick people, and coughing into their elbows) in the next 30 days. Conclusions The authors recommend tailoring public health messaging to address the perceived threat of COVID-19 and self-efficacy. Thus, health promotion efforts should emphasize the effectiveness of CDC-recommended practices while highlighting the pandemic’s severity. Additionally, rebuilding trust in public health messaging and messengers is necessary to increase perceived self-efficacy. As the COVID-19 pandemic continues, health messaging must continue to promote and build trust in CDC-recommended health practices and educate regarding the efficacy of vaccination and other preventive behaviors.