Factors Associated With COVID-19 Behavioral Intentions: Findings From an Online Survey.

PURPOSE: The COVID-19 pandemic provides a novel context through which to evaluate salient factors for promoting behavioral change. We examined how attitudes, perceived community behaviors, and prior related behaviors predict intentions to (1) receive COVID-19 vaccination and (2) practice social distancing. DESIGN: Cross-sectional online survey administered through Amazon's Mechanical Turk in September 2020. SUBJECTS: A convenience sample of US adults (N = 1804). MEASURES: COVID-19 vaccination and social distancing intentions were measured on a 7-point Likert scale. Predictor variables included general vaccination and social distancing attitudes, perceived community mask-wearing, prior influenza vaccination, prior social distancing, and socio-demographics. ANALYSIS: Descriptive statistics and linear regressions. RESULTS: Thirty percent of respondents reported a strong willingness to receive COVID-19 vaccination, while 67% strongly intended to engage in social distancing. In regression analyses, vaccination intention was predicted by positive vaccine attitudes (b = .84; 95%CI: .78, .90; P < .001), prior influenza vaccination (b = -.47; 95%CI: -.63, -.32; P < .001), and perceived community mask-wearing (b = -.28; 95%CI: -.56, -.01; P=.049). Intention to practice social distancing was predicted by positive attitudes (b = .65; 95%CI: .61, .69; P < .001), prior social distancing (b = -.49; 95%CI: -.59, -.39; P < .001), and perceived community mask-wearing (b = -.28; 95%CI: -.46, -.09; P = .003). CONCLUSION: Findings have implications for health promotion efforts. Messages that are targeted and tailored on pre-existing attitudes may be more effective. Additionally, leveraging prior behaviors and perceived community behavior may improve communication strategies.

Effects of Narrative Messages on Key COVID-19 Protective Responses: Findings From a Randomized Online Experiment.

PURPOSE: We investigated the effectiveness of narrative vs non-narrative messages in changing COVID-19-related perceptions and intentions. DESIGN/SETTING: The study employed a between-subjects two-group (narratives vs non-narratives) experimental design and was administered online. SUBJECTS/INTERVENTION: 1804 U.S. adults recruited via Amazon MTurk in September 2020 were randomly assigned to one of two experimental conditions and read either three narrative or three non-narrative messages about social distancing, vaccination, and unproven treatments. MEASURES: Perceptions and intentions were assessed before and after message exposure (7-point scales). ANALYSIS: Using multivariable regression, we assessed main effects of the experimental condition (controlling for baseline measures) and interactions between the condition and pre-exposure perceptions/intentions in predicting post-exposure outcomes. RESULTS: Compared to non-narratives, narratives led to (1) less positive perceptions about the benefits of unproven treatments (Mnarrative = 3.60, Mnon-narrative = 3.77, P = .007); and (2) less willingness to receive an unproven drug (Mnarrative = 3.46, Mnon-narrative = 3.77, P < .001); this effect was stronger among individuals with higher baseline willingness to receive unproven drugs (baseline willingness = 2.09: b = -.06, P = .461; baseline willingness = 3.90: b = -.30, P < .001; baseline willingness = 5.71: b = -.55, P < .001). Narratives also led to more positive perceptions of vaccine safety/effectiveness, but only among individuals with lower baseline vaccine perceptions (baseline perceptions = 4.51: b = .10, P = .008; baseline perceptions = 5.89: b = .04, P = .167; baseline perceptions = 7: b = -.01, P = .688). CONCLUSION: Narratives are a promising communication strategy, particularly for topics where views are not entrenched and among individuals who are more resistant to recommendations.

Theory utilization in current communication of cancer genetic testing research: Identified gaps and opportunities.

BACKGROUND: Effective communication of cancer-related genetic and genomic testing (CGT) with patients and the public is paramount to transforming and managing cancer prevention, detection, and care. Behavioral and social science theories could improve communication effectiveness and, in turn, health outcomes. METHODS: In this study, we characterized the use of theory in recent research on communication about CGT from 2010 to 2017. RESULTS: Of 513 empirical papers focusing on communication about CGT, only 119 (23%) utilized any theory in the study design. Behavior change and health psychology/cognitive representation theories (24.2% and 21.9%, respectively) were the most commonly used with minimal use of communication theories (3%). Theories were primarily used to guide hypotheses or research question development (73.9%), and for selecting measures or codes (68.9%). Approximately half of the papers (48.3%) related their study findings to the referenced theory. Fewer papers (14.3%) discussed implications of the findings for the theory. CONCLUSIONS: While theories are being utilized to inform study design, few discuss their results in the context of theoretical implications and thus decrease potential generalizability. Greater use of theory could help scholars to identify and develop theories suited to this clinical context and inform our understanding of related communication processes more broadly.