Relationships Between Initial COVID-19 Risk Perceptions and Protective Health Behaviors: A National Survey

Perceptions of health risks inform decisions about protective behaviors, but COVID-19 was an unfamiliar risk as it began to spread across the U.S. In the initial stage of the epidemic, authors examined perceived risks for COVID-19 infection and infection fatality and whether these risk perceptions w...

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Vydané v:	American journal of preventive medicine Ročník 59; číslo 2; s. 157 - 167
Hlavní autori:	Bruine de Bruin, Wändi, Bennett, Daniel
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Netherlands Elsevier Inc 01.08.2020 Elsevier Science Ltd American Journal of Preventive Medicine. Published by Elsevier Inc
Predmet:	Adult Aged Behavior Communicable Diseases, Emerging - prevention & control Coronavirus Infections - epidemiology Coronavirus Infections - prevention & control Coronaviruses COVID-19 Cross-Sectional Studies Crowds Disease Outbreaks - prevention & control Disease Outbreaks - statistics & numerical data Epidemics Fatalities Female Hand Disinfection - methods Health Behavior Health risks Humans Infections Male Masks - statistics & numerical data Middle Aged Pandemics - prevention & control Perception Perceptions Pneumonia, Viral - epidemiology Pneumonia, Viral - prevention & control Polls & surveys Primary Prevention - methods Respondents Risk Assessment Risk behavior Risk communication Risk perception Risk-Taking Social distancing Social factors Time Factors United States United States United States > US
ISSN:	0749-3797, 1873-2607, 1873-2607
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Abstract	Perceptions of health risks inform decisions about protective behaviors, but COVID-19 was an unfamiliar risk as it began to spread across the U.S. In the initial stage of the epidemic, authors examined perceived risks for COVID-19 infection and infection fatality and whether these risk perceptions were associated with protective behaviors. They also examined whether findings differed between later versus earlier responders. Between March 10 and March 31, 2020, a cross-sectional online survey was conducted with a nationally representative U.S. sample (n=6,684). Half responded before March 13, 2020 (versus later). Participants assessed their risks of COVID-19 infection and infection fatality (0%–100%) which were transformed into quartiles (1–4). They reported their implementation of protective behaviors like handwashing and social distancing (yes/no). Analyses were conducted in April‒May 2020. Median perceived risk was 10.00% for COVID-19 infection and 5.00% for infection fatality, but respondents showed large disagreement. An increase of 1 quartile in perceived infection risk was associated with being 1.45 times (95% CI=1.33, 1.58) more likely to report handwashing, with perceived infection fatality risk showing no significant association. When predicting social distancing behaviors such as avoiding crowds, both quartile-based risk perceptions were significant (OR=1.24, 95% CI=1.17, 1.30 for infection and OR=1.19, 95% CI=1.13, 1.26 for infection fatality). Perceived COVID-19 infection risk, protective behaviors, and their relationship increased among later (versus earlier) responders. Despite disagreements about the risks, people perceiving greater risks were more likely to implement protective behaviors—especially later (versus earlier) in March 2020. These findings have implications for risk communication.
AbstractList	Introduction: Perceptions of health risks inform decisions about protective behaviors, but COVID-19 was an unfamiliar risk as it began to spread across the U.S. In the initial stage of the epidemic, authors examined perceived risks for COVID-19 infection and infection fatality and whether these risk perceptions were associated with protective behaviors. They also examined whether findings differed between later versus earlier responders. Methods: Between March 10 and March 31, 2020, a cross-sectional online survey was conducted with a nationally representative U.S. sample (n=6,684). Half responded before March 13, 2020 (versus later). Participants assessed their risks of COVID-19 infection and infection fatality (0%–100%) which were transformed into quartiles (1–4). They reported their implementation of protective behaviors like handwashing and social distancing (yes/no). Analyses were conducted in April‒May 2020. Results: Median perceived risk was 10.00% for COVID-19 infection and 5.00% for infection fatality, but respondents showed large disagreement. An increase of 1 quartile in perceived infection risk was associated with being 1.45 times (95% CI=1.33, 1.58) more likely to report handwashing, with perceived infection fatality risk showing no significant association. When predicting social distancing behaviors such as avoiding crowds, both quartile-based risk perceptions were significant (OR=1.24, 95% CI=1.17, 1.30 for infection and OR=1.19, 95% CI=1.13, 1.26 for infection fatality). Perceived COVID-19 infection risk, protective behaviors, and their relationship increased among later (versus earlier) responders. Conclusions: Despite disagreements about the risks, people perceiving greater risks were more likely to implement protective behaviors-especially later (versus earlier) in March 2020. These findings have implications for risk communication. Perceptions of health risks inform decisions about protective behaviors, but COVID-19 was an unfamiliar risk as it began to spread across the U.S. In the initial stage of the epidemic, authors examined perceived risks for COVID-19 infection and infection fatality and whether these risk perceptions were associated with protective behaviors. They also examined whether findings differed between later versus earlier responders. Between March 10 and March 31, 2020, a cross-sectional online survey was conducted with a nationally representative U.S. sample (n=6,684). Half responded before March 13, 2020 (versus later). Participants assessed their risks of COVID-19 infection and infection fatality (0%–100%) which were transformed into quartiles (1–4). They reported their implementation of protective behaviors like handwashing and social distancing (yes/no). Analyses were conducted in April‒May 2020. Median perceived risk was 10.00% for COVID-19 infection and 5.00% for infection fatality, but respondents showed large disagreement. An increase of 1 quartile in perceived infection risk was associated with being 1.45 times (95% CI=1.33, 1.58) more likely to report handwashing, with perceived infection fatality risk showing no significant association. When predicting social distancing behaviors such as avoiding crowds, both quartile-based risk perceptions were significant (OR=1.24, 95% CI=1.17, 1.30 for infection and OR=1.19, 95% CI=1.13, 1.26 for infection fatality). Perceived COVID-19 infection risk, protective behaviors, and their relationship increased among later (versus earlier) responders. Despite disagreements about the risks, people perceiving greater risks were more likely to implement protective behaviors—especially later (versus earlier) in March 2020. These findings have implications for risk communication. Perceptions of health risks inform decisions about protective behaviors, but COVID-19 was an unfamiliar risk as it began to spread across the U.S. In the initial stage of the epidemic, authors examined perceived risks for COVID-19 infection and infection fatality and whether these risk perceptions were associated with protective behaviors. They also examined whether findings differed between later versus earlier responders.INTRODUCTIONPerceptions of health risks inform decisions about protective behaviors, but COVID-19 was an unfamiliar risk as it began to spread across the U.S. In the initial stage of the epidemic, authors examined perceived risks for COVID-19 infection and infection fatality and whether these risk perceptions were associated with protective behaviors. They also examined whether findings differed between later versus earlier responders.Between March 10 and March 31, 2020, a cross-sectional online survey was conducted with a nationally representative U.S. sample (n=6,684). Half responded before March 13, 2020 (versus later). Participants assessed their risks of COVID-19 infection and infection fatality (0%-100%) which were transformed into quartiles (1-4). They reported their implementation of protective behaviors like handwashing and social distancing (yes/no). Analyses were conducted in April‒May 2020.METHODSBetween March 10 and March 31, 2020, a cross-sectional online survey was conducted with a nationally representative U.S. sample (n=6,684). Half responded before March 13, 2020 (versus later). Participants assessed their risks of COVID-19 infection and infection fatality (0%-100%) which were transformed into quartiles (1-4). They reported their implementation of protective behaviors like handwashing and social distancing (yes/no). Analyses were conducted in April‒May 2020.Median perceived risk was 10.00% for COVID-19 infection and 5.00% for infection fatality, but respondents showed large disagreement. An increase of 1 quartile in perceived infection risk was associated with being 1.45 times (95% CI=1.33, 1.58) more likely to report handwashing, with perceived infection fatality risk showing no significant association. When predicting social distancing behaviors such as avoiding crowds, both quartile-based risk perceptions were significant (OR=1.24, 95% CI=1.17, 1.30 for infection and OR=1.19, 95% CI=1.13, 1.26 for infection fatality). Perceived COVID-19 infection risk, protective behaviors, and their relationship increased among later (versus earlier) responders.RESULTSMedian perceived risk was 10.00% for COVID-19 infection and 5.00% for infection fatality, but respondents showed large disagreement. An increase of 1 quartile in perceived infection risk was associated with being 1.45 times (95% CI=1.33, 1.58) more likely to report handwashing, with perceived infection fatality risk showing no significant association. When predicting social distancing behaviors such as avoiding crowds, both quartile-based risk perceptions were significant (OR=1.24, 95% CI=1.17, 1.30 for infection and OR=1.19, 95% CI=1.13, 1.26 for infection fatality). Perceived COVID-19 infection risk, protective behaviors, and their relationship increased among later (versus earlier) responders.Despite disagreements about the risks, people perceiving greater risks were more likely to implement protective behaviors-especially later (versus earlier) in March 2020. These findings have implications for risk communication.CONCLUSIONSDespite disagreements about the risks, people perceiving greater risks were more likely to implement protective behaviors-especially later (versus earlier) in March 2020. These findings have implications for risk communication.
Author	Bruine de Bruin, Wändi Bennett, Daniel
Author_xml	– sequence: 1 givenname: Wändi surname: Bruine de Bruin fullname: Bruine de Bruin, Wändi email: wandibdb@usc.edu organization: Sol Price School of Public Policy, Dornsife Department of Psychology, and Schaeffer Center for Health Policy and Economics, University of Southern California, Los Angeles, California – sequence: 2 givenname: Daniel surname: Bennett fullname: Bennett, Daniel organization: Center for Economic and Social Research, University of Southern California, Los Angeles, California
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License	Copyright © 2020 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved. Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.
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Snippet	Perceptions of health risks inform decisions about protective behaviors, but COVID-19 was an unfamiliar risk as it began to spread across the U.S. In the... Introduction: Perceptions of health risks inform decisions about protective behaviors, but COVID-19 was an unfamiliar risk as it began to spread across the...
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SubjectTerms	Adult Aged Behavior Communicable Diseases, Emerging - prevention & control Coronavirus Infections - epidemiology Coronavirus Infections - prevention & control Coronaviruses COVID-19 Cross-Sectional Studies Crowds Disease Outbreaks - prevention & control Disease Outbreaks - statistics & numerical data Epidemics Fatalities Female Hand Disinfection - methods Health Behavior Health risks Humans Infections Male Masks - statistics & numerical data Middle Aged Pandemics - prevention & control Perception Perceptions Pneumonia, Viral - epidemiology Pneumonia, Viral - prevention & control Polls & surveys Primary Prevention - methods Respondents Risk Assessment Risk behavior Risk communication Risk perception Risk-Taking Social distancing Social factors Time Factors United States
Title	Relationships Between Initial COVID-19 Risk Perceptions and Protective Health Behaviors: A National Survey
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