Disease Prevention Behavior During the COVID-19 Pandemic and the Role of Self-Esteem: An Extended Parallel Process Model
Authors Lin HC, Chen CC
Received 10 November 2020
Accepted for publication 31 December 2020
Published 10 February 2021 Volume 2021:14 Pages 123—135
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 3
Editor who approved publication: Professor Mei-chun Cheung
Hsien-Cheng Lin,1 Chia-Chen Chen2
1Business College, Taizhou University, Taizhou, Zhejiang Province, People’s Republic of China; 2Department of Anesthesiology, China Medical University Hsinchu Hospital, Zhubei, Taiwan, Republic of China
Correspondence: Hsien-Cheng Lin
Business College, Taizhou University, No. 1139, Shifu Avenue, Taizhou, Zhejiang Province, People’s Republic of China
Department of Anesthesiology, China Medical University Hsinchu Hospital, No. 199, Sec.1, Xinglong Road, Zhubei, Hsinchu Country, 302, Taiwan, Republic of China
Objective: The COVID-19 outbreak has become a serious public health problem worldwide. The purpose of this study was to use an extended parallel process model (EPPM) to understand factors in COVID-19 prevention behaviors.
Methods: This cross-sectional and analytical study was conducted on 1012 participants in Taiwan. A structured questionnaire and an online survey were used to collect data.
Results: The EPPM revealed that the severity of the COVID-19 threat perceived by respondents directly affected the arousal of fear in the respondents (β=0.268, t=9.007, p< 0.001), but perceived efficacy did not (β=− 0.019, t=− 0.619, p> 0.05); additionally, fear arousal was significantly associated with COVID-19 prevention behaviors (β=0.119, t=4.603, p< 0.001). Regarding personal characteristics, self-esteem moderated the relationship between perceived threat and fear arousal. However, the moderating effect of self-esteem was stronger in people with low self-esteem compared to those with high self-esteem (β=0.606, − 0.472; t=26.303, − 17.694; p< 0.001, p< 0.001; respectively). The results of this study also indicated that two demographic characteristics (age and gender) affect COVID-19 prevention behaviors.
Conclusion: When developing healthcare policies and community interventions for improving COVID-19 prevention behaviors during an outbreak, healthcare administrators should carefully consider the main constructs of the EPPM, particularly personal characteristics (ie, self-esteem) and demographic characteristics (ie, age and gender).
Keywords: COVID-19, extended parallel process model, perceived threat, perceived efficacy, prevention behavior
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