Understanding public's adoption of preventive behavior during COVID-19 pandemic using health belief model: role of psychological capital and health appraisals

Abstract

Recognizing the importance of prevention during a highly transmissible disease like COVID-19, this study analyzed the effect of health psychological capital and health appraisals (benefits, barriers, contextual threat, seriousness and susceptibility) on voluntary adoption of preventive behavior. The theoretical framework was based on health belief model. The study also proposed the mediating role of health appraisals between health psychological capital and preventive behavior. Participants from Pakistan (N = 321) and Malaysia (N = 343) completed an online survey. Samples from both countries were compared for measurement model invariance and variance in path coefficient. Partial least squares approach to SEM using SMART-PLS3 software was adopted to analyze the measurement model, structural model, importance-performance analysis, and mediation testing. Our finding showed that the model explained a higher variance in preventive behavior for Pakistani samples compared to Malaysian samples. Countries were found to moderate some of the proposed relationships. Benefits and threats are the two most important predictors of preventive behaviors in both countries. Psychological capital is more predictive of coping and threat appraisals and is, directly and indirectly, related to preventive behavior via benefits, barriers, and threats in Pakistani sample, and only indirectly related to preventive behavior via benefits and threats in the Malaysian sample. Perceived threat also mediates the relationship of susceptibility and seriousness with preventive behavior. Public health messages should focus on enhancing health psychological capital, highlight the potential benefit and emphasize the perils of not adopting the precautionary approach.