Behavioral Beliefs Predict Recommended Behaviors, Especially When Trust in Public Health Sources is Low: Evidence from a Longitudinal Study of Three COVID-19 Prevention Behaviors Among U.S. Adults

Abstract

Public distrust in official sources of health information and uncertainty about novel guidelines may discourage engagement in recommended disease prevention practices. The current study tests the hypothesis that building confidence in positive behavioral outcomes may support recommendation following even in the context of low trust in recommendation sources. This set of longitudinal studies examines the main and interaction effects of trust in official sources and behavioral beliefs in their prediction of recommended COVID-19 prevention behaviors (facemask wearing, social distancing, vaccination). Repeated measurement data were collected from a nationally representative sample of U.S. adults in May/June 2020 (T1; n = 1074), July 2020 (T2; n = 889), and April/June 2021 (T3; n = 750). All five tests, using lagged linear regression, found negative interactions between trust and behavioral beliefs, as hypothesized; three were significant (T1-T2: facemask wearing B=-0.10, SE = 0.04; T1-T3: social distancing B=-0.20, SE = 0.06; T2-T3 vaccination B=-0.27, SE = 0.10) and two were consistent albeit not significant (T1-T3: social distancing B=-0.13, SE = 0.08; T1-T3: facemask wearing B=-0.11, SE = 0.06). Supporting hypotheses, trust in recommendation sources predicted behavior most among those who were less certain about behavioral outcomes and confidence in behavioral benefits predicted behavior most among those with low trust in recommendation sources. Theoretical and practical implications are discussed.