Predicting hand washing, mask wearing and social distancing behaviors among older adults during the covid-19 pandemic: an integrated social cognition model

Abstract

Background Older adults are at a higher risk from COVID-19. Individual preventive behaviors including frequent hand washing, mask wearing, and social distancing play important roles in reducing the transmission of COVID-19 in the community. This study aimed to identify the determinants of three preventive behaviors of older adults during the COVID-19 pandemic by using an Integrated Social Cognition Model. Methods Using a prospective study design, 516 Chinese older adults from Hubei province of China (mean age = 67.55 years, SD = 6.60, 57.9% females) completed two online questionnaire surveys. The demographics, social cognition constructs (motivational self-efficacy, risk perception, attitude, subjective norm, health knowledge, intention, volitional self-efficacy, planning, action control) and three preventive behaviors were measured during the first-wave online survey from 18 May 2020 to 7 June 2020. One month later, three preventive behaviors were measured again during the second-wave online survey. Data were analyzed by structural equation modelling. Results Models showed attitude, motivational self-efficacy and subjective norm were consistent predictors of intention, motivational self-efficacy was a consistent predictor of volitional self-efficacy, planning and volitional self-efficacy were consistent predictors of action control, and health knowledge was a consistent predictor of behaviors across all three preventive behaviors. In addition, mediating relationships were found in the model of hand washing behavior. In particular, planning (β = .109, p = .042) and action control (β = .056, p = .047) mediated between volitional self-efficacy and hand washing respectively. Action control also mediated between planning and hand washing (β = .087, p = .044). Moreover, the inclusion of past behaviors in three models attenuated most of the structural relations. Conclusions The current study’s findings basically supported the Integrated Social Cognition Model and identified key modifiable determinants of preventive behaviors. Based on this model, future interventions aiming to promote COVID-19 preventive behaviors among older adults are warranted.

Association of Social-Cognitive Factors with Individual Preventive Behaviors of COVID-19 among a Mixed-Sample of Older Adults from China and Germany

“…In addition, considering the parsimonious mode and operational feasibility of online survey among older adults, some variables were measured using one or two items. Although the validity and reliability of these items were approved in previous studies [ 8 , 12 , 18 ], the measure biases cannot be ignored and applying comprehensive questionnaires to measure relevant outcomes is warranted.…”

“…Self-monitoring was assessed using one item measuring participants’ perceptions of their self-regulation over the preventive behaviors. The participants were asked “I have consistently monitored myself about how and in what situations to wash my hands/wear a face mask/keep a safe physical distance”, with responses rated on a 6-point Likert scale, from 1 = strongly disagree to 6 = strongly agree [ 12 , 18 , 48 ].…”

“…Afterwards, the binary dummy variable of country was added in the Model 4 and the interaction of country and social-cognitive predictors were added in the Model 5. To further elaborate the magnitude of the association between preventive behaviors and their associated factors in regression analyses, effect size ( f 2 ) was estimated with the conversion formula: f 2 = R 2 /(1- R 2 ), with 0.02, 0.15, and 0.35 indicating a small, medium, and large effect, respectively [ 12 ].…”

“…In general, social-cognitive factors of behavior change comprise motivational factors associated with behavior initiation and volitional factors associated with behavior maintenance [ 12 ]. Recently, there has been an increasing group of evidence investigating preventive behaviors and their social-cognitive factors in older adults during the COVID-19 pandemic [ 13 , 14 , 15 ].…”

A systematic review and meta-analysis on the preventive behaviors in response to the COVID-19 pandemic among children and adolescents

“…A series of potential factors may determine and modify compliance with virus transmission preventive behaviors. Previous psychosocial theories, such as health belief model (HBM), the theory of planned behavior (TPB), health action process approach (HAPA), and ecological model, have proposed that individuals preventive behaviors could be affected by diverse demographic and psychosocial factors that should be targeted in the relevant behavioral promotion intervention and policy making [ 12 ]. For example, HBM suggested that individuals’ preventive behaviors are determined by their health beliefs (e.g., risk awareness, perceived susceptibility, and severity) [ 13 , 14 ].…”