The Underlying Structure of Preventive Behaviors and Related Factors During the COVID-19 Pandemic: A Comprehensive Network Analysis.

Publisher: Oxford University Press Country of Publication: England NLM ID: 8510246 Publication Model: Print Cited Medium: Internet ISSN: 1532-4796 (Electronic) Linking ISSN: 08836612 NLM ISO Abbreviation: Ann Behav Med Subsets: MEDLINE

Publication: 2018- : Oxford : Oxford University Press
Original Publication: [Knoxville, TN] : The Society, [c1985-

COVID-19*/prevention & control; Adult ; Humans ; COVID-19 Vaccines ; Pandemics/prevention & control ; Health Behavior ; Altruism

Background: Various strategies against COVID-19 have been adopted in different countries, with vaccination and mask-wearing being widely used as self-preventive interventions. However, the underlying structure of these behaviors and related factors remain unclear.
Purpose: In this study, we aimed to explore the network structure of preventive behaviors during the COVID-19 pandemic and their underlying factors, incorporating age and sex in the network.
Methods: We used a multi-center sample of 20,863 adults who were vaccinated against COVID-19 in China between April 1, 2021, and June 1, 2021. Networks were estimated using unregularized partial correlation models. We also estimated the accuracy and stability of the network.
Results: The preventive behaviors related to network factors revealed that self-initiated vaccination was more connected with cognition factors, and mask-wearing was more connected with personal profiles. The two clusters were linked through information-seeking and political beliefs. Moreover, self-initiated vaccination was negatively connected with vaccine hesitancy and concerns about COVID-19 vaccines and positively connected with trust in the vaccines, pandemic-related altruism, political beliefs, and being married. Mask-wearing was negatively connected with being a professional/white collar worker and higher education level and positively connected with regular physical examination, self-rated health, migration, being married, and better family relationships. Incorporation of age and sex into the network revealed relevant associations between age and mask-wearing and age and self-initiated vaccination. The network was highly accurately estimated. The subset bootstrap showed that the order of node strength centrality, betweenness, and closeness were all stable. The correlation stability coefficient (CS-coefficient) also showed the stability of this estimate, with 0.75 for node strength, 0.75 for betweenness, and 0.67 for closeness.
Conclusions: The internal structures of vaccination and mask-wearing behaviors were quite different, the latter of which were mainly affected by socioeconomic status and health-related behaviors and the former by knowledge about vaccines and political beliefs. Information-seeking and family relationships were the bridge factors connecting these two self-preventive behavior clusters, suggesting the direction of future efforts.
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23692113400 Science and Technology Commission of Shanghai Municipality; 72274122 National Natural Science Foundation of China

Keywords: COVID-19; Information-seeking; Mask-wearing; Network analysis; Preventive behaviors; Self-initiated vaccination; Socioeconomic status

0 (COVID-19 Vaccines)

Date Created: 20240129 Date Completed: 20240214 Latest Revision: 20240220

20240221

10.1093/abm/kaad073

38284623