What influences the adoption of SARS-CoV-2 mitigation behaviors–both personal, such as mask wearing and frequent handwashing, and social, such as avoiding large gatherings and physical contact–across countries? Understanding why some individuals are more willing to change their behavior to mitigate the spread of a pandemic will not only help us to address the current SARS-CoV-2 pandemic but also to respond to future ones. Researchers have pointed to a variety of factors that may influence individual adoption of personal and social mitigation behaviors, including social inequality, risk perception, personality traits, and government policies. While not denying the importance of these factors, we argue that the role of trust and confidence has received insufficient attention to date. Our study explores whether there is a difference in the way trust and confidence in particular leaders and organizations affect individual compliance and whether this effect is consistent across different types of mitigation behaviors. Specifically, we utilize an original cross-national survey conducted during the first wave of the SARS-CoV-2 pandemic (May-June 2020) to investigate how trust in scientists, medical professionals, politicians, and religious leaders and confidence in global, national, and local health organizations affects individual compliance in 16 countries/territories across five world regions. Our analyses, which control for the aforementioned factors as well as several others, suggest that trust in politicians and confidence in national health ministries have the most consistent influence on whether individuals adopt both personal and social mitigation behaviors. Across our sample, we find that greater trust in politicians is associated with lower levels of individual compliance with public health directives, whereas greater confidence in the national health ministry is associated with higher levels of individual compliance. Our findings suggest the need to understand trust and confidence as among the most important individual level characteristics driving compliance when developing and delivering messaging about the adoption of mitigation behaviors. The content of the message, it seems, will be most effective when citizens across countries trust its source. Trusted sources, such as politicians and the national health ministry, should thus consider working closely together when determining and communicating recommended health behaviors to avoid contradicting one another.
Using Health Concept Surveying to Elicit Usable Evidence: Case Studies of a Novel Evaluation Methodology
Background Developers, designers, and researchers use rapid prototyping methods to project the adoption and acceptability of their health intervention technology (HIT) before the technology becomes mature enough to be deployed. Although these methods are useful for gathering feedback that advances the development of HITs, they rarely provide usable evidence that can contribute to our broader understanding of HITs. Objective In this research, we aim to develop and demonstrate a variation of vignette testing that supports developers and designers in evaluating early-stage HIT designs while generating usable evidence for the broader research community. Methods We proposed a method called health concept surveying for untangling the causal relationships that people develop around conceptual HITs. In health concept surveying, investigators gather reactions to design concepts through a scenario-based survey instrument. As the investigator manipulates characteristics related to their HIT, the survey instrument also measures proximal cognitive factors according to a health behavior change model to project how HIT design decisions may affect the adoption and acceptability of an HIT. Responses to the survey instrument were analyzed using path analysis to untangle the causal effects of these factors on the outcome variables. Results We demonstrated health concept surveying in 3 case studies of sensor-based health-screening apps. Our first study (N=54) showed that a wait time incentive could influence more people to go see a dermatologist after a positive test for skin cancer. Our second study (N=54), evaluating a similar application design, showed that although visual explanations of algorithmic decisions could increase participant trust in negative test results, the trust would not have been enough to affect people’s decision-making. Our third study (N=263) showed that people might prioritize test specificity or sensitivity depending on the nature of the medical condition. Conclusions Beyond the findings from our 3 case studies, our research uses the framing of the Health Belief Model to elicit and understand the intrinsic and extrinsic factors that may affect the adoption and acceptability of an HIT without having to build a working prototype. We have made our survey instrument publicly available so that others can leverage it for their own investigations.
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- Award ID(s):
- 1813675
- NSF-PAR ID:
- 10357271
- Date Published:
- Journal Name:
- JMIR Human Factors
- Volume:
- 9
- Issue:
- 1
- ISSN:
- 2292-9495
- Page Range / eLocation ID:
- e30474
- Format(s):
- Medium: X
- Sponsoring Org:
- National Science Foundation
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- Free Publicly Accessible Full Text
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Accepted Manuscript1.0
- Journal Article:
- https://doi.org/10.2196/30474
