Self-Interested Framed and Prosocially Framed Messaging Can Equally Promote COVID-19 Prevention Intention: A Replication and Extension of Jordan et al.'s Study (2020) in the Japanese Context

Falsification of home rapid antigen lateral flow tests during the COVID-19 pandemic

During the COVID-19 pandemic, lateral flow tests (LFTs) were used to regulate access to work, education, social activities, and travel. However, falsification of home LFT results was a concern. Falsification of test results during an ongoing pandemic is a sensitive issue. Consequently, respondents may not answer truthfully to questions about LFT falsification behaviours (FBs) when asked directly. Indirect questioning techniques such as the Extended Crosswise model (ECWM) can provide more reliable prevalence estimates of sensitive behaviors than direct questioning. Here we report the prevalence of LFT FBs in a representative sample in England (n = 1577) using direct questioning (DQ) and the ECWM. We examine the role of demographic and psychological variables as predictors of LFT FBs. We show that the prevalence estimates of the FBs in the DQ condition were significantly lower than the ECWM estimates, e.g., reporting a negative result without conducting a test: 5.7% DQ vs 18.4% ECWM. Moral norms, subjective norms, anticipated regret, perception of risk to self, and trust in government predicted some of the FBs. Indirect questioning techniques can help provide more realistic and higher quality data about compliance with behavioural regulations to government and public health agencies.

Holiday Tweets: A Qualitative Analysis of How Major Health Organizations Addressed Culture During the COVID-19 Pandemic

This study examines COVID-19-related messages disseminated by major health and government organizations on Twitter during the overlapping holidays of Easter and Ramadan in 2022. Recognizing the importance of tailored health communication, the research focuses on the textual and visual content of tweets to understand how messages attend to diverse cultural, religious, and ethnic groups. Qualitative analysis of 382 Tweets revealed 3 Major Themes related to COVID-19 and Easter and 4 Major Themes associated with Ramadan. Easter-related tweets emphasized celebrating safely and the importance of vaccinations using science-based messaging, slang, and playful imagery. Ramadan-related tweets prioritized safety during religious practices, incorporating traditional symbols and religious references; countering vaccine-related myths; and social responsibility. The findings highlight culturally relevant health communication and tailoring messages to specific cultural contexts. The study contributes insights for public health organizations aiming to improve communication strategies during pandemics, fostering engagement, and addressing the unique needs of diverse populations.

"I can't do it": A qualitative study exploring case and contact experiences with COVID-19 contact tracing

BACKGROUND

Low engagement in contact tracing for COVID-19 dramatically reduces its impact, but little is known about how experiences, environments and characteristics of cases and contacts influence engagement.

METHODS

We recruited a convenience sample of COVID-19 cases and contacts from the New Haven Health Department's contact tracing program for interviews about their contact tracing experiences. We analyzed transcripts thematically, organized themes using the Capability, Opportunity, Motivation, Behavior (COM-B) model, and identified candidate interventions using the linked Behavior Change Wheel Framework.

RESULTS

We interviewed 21 cases and 12 contacts. Many felt physically or psychologically incapable of contact tracing participation due to symptoms or uncertainty about protocols. Environmental factors and social contacts also influenced engagement. Finally, physical symptoms, emotions and low trust in and expectations of public health authorities influenced motivation to participate.

CONCLUSION

To improve contact tracing uptake, programs should respond to clients' physical and emotional needs; increase clarity of public communications; address structural and social factors that shape behaviors and opportunities; and establish and maintain trust. We identify multiple potential interventions that may help achieve these goals.

Framing Effects on US Adults’ Reactions to COVID-19 Public Health Messages: Moderating Role of Source Trust

Increasing politicization of health guidance and fluctuating trust in public health institutions have challenged effective coronavirus disease 2019 (COVID-19) public health communication in the United States. Applying the extended parallel process model, this research reports findings from two online survey experiments conducted at different points in the pandemic regarding two advocated risk reduction behaviors. Analyses test US adults’ emotional and argument strength reactions to experimental tweets attributed to the Centers for Disease Control (CDC) and Prevention which vary with regards to advocated behavior (social distancing; vaccination), emotional appeal, wellbeing orientation (individual vs. collective), and content frame (health vs. economic outcomes). Trust in the CDC is treated as a potential moderator. Results of path analyses indicated that emotional appeal and content frame had little impact on emotional or cognitive responses to the social distancing tweets, though unvaccinated adults with low trust in the CDC experienced greater hope and fear responses to tweets emphasizing collective benefits of vaccination. Hope reactions in both studies predicted greater perceived response efficacy for the advocated behavior, particularly among those with low CDC trust, while message annoyance undermined efficacy among low trust participants. Particularly among adults with low trust in the CDC, fear reactions led to reduced efficacy. Perceived efficacy of vaccination predicted greater intention to receive a COVID-19 vaccine, controlling for prior intention. Messages which inspire hope with regards to risk reduction behaviors and include sound arguments may be more motivating than fear-appeal messages, particularly among individuals with low levels of trust in public health institutions.

Persuading republicans and democrats to comply with mask wearing: An intervention tournament

Many people practiced COVID-19-related safety measures in the first year of the pandemic, but Republicans were less likely to engage in behaviors such as wearing masks or face coverings than Democrats, suggesting radical disparities in health practices split along political fault lines. We developed an "intervention tournament" which aimed to identify the framings that would promote mask wearing among a representative sample of Republicans and Democrats in the U.S. from Oct 14, 2020, to Jan 14, 2021 (N = 4931). Seven different conditions reflecting different moral values and factors specific to COVID-19-including protection from harm (self), protection from harm (community), patriotic duty, purity, reviving the economy, threat, and scientific evidence-were implemented to identify which framings would "win" in terms of promoting mask wearing compared to a baseline condition. We found that Republicans had significantly more negative attitudes toward masks, lower intentions to wear them, and were less likely to sign or share pledges on social media than Democrats, which was partially mediated by Republicans, compared to Democrats, perceiving that the threat of COVID-19 was lower. None of our framing conditions significantly affected Republicans' or Democrats' attitudes, intentions, or behaviors compared to the baseline condition, illustrating the difficulty in overcoming the strength of political polarization during COVID-19.

Collectivism, individualism and COVID-19 prevention: a cross sectional study of personality, culture and behavior among Canadians

Background

Collectivism has been identified as a protective factor against COVID-19 - perhaps due to increased conformity with social norms regarding prevention behaviors. Other studies have also found that individualism can inspire uptake of preventative behaviors as a means of personal protection. It is possible that these cultural orientations may promote different patterns of prevention (e.g. mask wearing vs. social distancing). Furthermore, existing studies examining the role of individualism and collectivism during the COVID-19 pandemic have frequently failed to account for other psychological processes, including differences in personality, which could help provide a better understanding of the psychological process underlying prevention behavior.

Methods

Participants were recruited using social media advertisements. The Cultural Orientations Scale measured individualism-collectivism and hierarchism-egalitarianism. The Ten Item Personality Inventory measured the five factor model of personality. Multivariable models, dominance analyses and structural equation mediation tests were used to identify the most important predictors of COVID-19 prevention behavior (i.e. mask-wearing, hand-washing, reducing social interactions, physical distancing, staying at home and social bubbling), controlling for demographic and situational factors.

Results

Among 774 participants, most (i.e. 60-80%) reported uptake of COVID-19 prevention behaviors. Higher vertical (hierarchical) collectivism was associated with staying at home and higher horizontal (egalitarian) individualism was associated with mask-wearing and reducing social interactions. Neither Vertical Collectivism nor Horizontal Collectivism were significantly associated with any of the prevention behaviors when controlling for personality traits and confounding variables. Agreeableness was identified as a key mediator of the correlation between these cultural orientations on general uptake of COVID-19 prevention behaviors.

Conclusions

Cultural orientations (e.g. collectivism-individualism, hierarchism-egalitarianism) and personality traits (e.g. Agreeableness) are salient correlates of COVID-19 prevention behaviors and therefore should be accounted for in the development, design and delivery of health promotion messages aiming to increase uptake of these behaviors.

A dual-process approach to prosocial behavior under COVID-19 uncertainty

Uncertainty has been shown to reduce the willingness to cooperate in various social dilemmas and negatively affect prosocial behavior. However, some studies showed that uncertainty does not always decrease prosocial behavior, depending on the type of uncertainty. More specifically, recent research has shown that prosocial behavior tends to increase under impact uncertainty-uncertainty about the consequences for others if they become infected. In addition, researchers have argued that intuition favors prosocial behavior while deliberation leads to selfish behavior. Our study explored how intuitive (time pressure) or deliberate mental processing, under outcome, or impact uncertainty affect prosocial behavior in the context of the COVID-19 pandemic. Our sample consists of 496 participants, and we used a 4 (COVID-19 scenario: Control vs. Impact Uncertainty vs. Worst-Case vs. Indirect Transmission) by 2 (decision time: time delay vs. time pressure) between-subjects design. Results suggest that participants are more inclined to stay at home (prosocial intention) when forced to make their decisions intuitively rather than deliberately. Additionally, we found that uncertainty does not always decrease prosocial behavior. It seems that uncertainty does not affect the prosocial intention in a scenario with a real infectious disease. These findings suggest that the distinction between outcome and impact uncertainty may be due to the realism of experimental stimuli interventions.

Don't get it or don't spread it: comparing self-interested versus prosocial motivations for COVID-19 prevention behaviors

COVID-19 prevention behaviors may be seen as self-interested or prosocial. Using American samples from MTurk and Prolific (total n = 6850), we investigated which framing is more effective-and motivation is stronger-for fostering prevention behavior intentions. We evaluated messaging that emphasized personal, public, or personal and public benefits of prevention. In initial studies (conducted March 14-16, 2020), the Public treatment was more effective than the Personal treatment, and no less effective than the Personal + Public treatment. In additional studies (conducted April 17-30, 2020), all three treatments were similarly effective. Across all these studies, the perceived public threat of coronavirus was also more strongly associated with prevention intentions than the perceived personal threat. Furthermore, people who behaved prosocially in incentivized economic games years before the pandemic had greater prevention intentions. Finally, in a field experiment (conducted December 21-23, 2020), we used our three messaging strategies to motivate contact-tracing app signups (n = 152,556 newsletter subscribers). The design of this experiment prevents strong causal inference; however, the results provide suggestive evidence that the Personal + Public treatment may have been more effective than the Personal or Public treatment. Together, our results highlight the importance of prosocial motives for COVID-19 prevention.

Obligation or Desire: Variation in Motivation for Compliance With COVID-19 Public Health Guidance

Why do people comply with coronavirus disease 2019 (COVID-19) public health guidance? This study considers cultural-psychological foundations of variation in beliefs about motivations for such compliance. Specifically, we focused on beliefs about two sources of prosocial motivation: desire to protect others and obligation to society. Across two studies, we observed that the relative emphasis on the desire to protect others (vs. the obligation to the community) as an explanation for compliance was greater in the United States settings associated with cultural ecologies of abstracted independence than in Chinese settings associated with cultural ecologies of embedded interdependence. We observed these patterns for explanations of psychological experience of both others (Study 1) and self (Study 2), and for compliance with mandates for both social distancing and face masks (Study 2). Discussion of results considers both practical implications for motivating compliance with public health guidance and theoretical implications for denaturalizing prevailing accounts of prosocial motivation.