Dynamics of COVID-19 risk perception and predictors in South Korea: a two-year longitudinal study from the pandemic’s beginning (2020–2021)

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Understanding the public’s cognitive and affective perceptions of risk, along with their predictors and the role of trust in various stakeholders, is essential for effective risk management. Cognitive and affective dimensions of perceived risk play a critical role in engaging the public during health emergencies, particularly in the early stages. This study investigates the evolving dynamics of COVID-19 risk perception, identifies its predictors, and examines how these factors changed over time from the beginning of the pandemic. We conducted a longitudinal repeated cross-sectional survey in South Korea, over the initial two years of the pandemic (2020–2021) from over 9,000 participants, beginning four weeks after the first confirmed case. Data were analyzed using one-way ANOVA and multiple linear regression, with time included as an interaction term. Results showed significant fluctuations in both cognitive and affective risk perceptions throughout the study period. Specifically, perceived susceptibility to infection was associated with respondents’ locality, policy stringency, and daily case counts, while perceived severity was significantly related to age and subjective health. Affective risk perception was predicted by gender and socioeconomic status. Notably, a contradictory association emerged between trust in the central government and public health authorities and perceived risk; while trust in the central government correlated with lower perceived risk, trust in public health authorities was linked to higher perceived risk. Additionally, the influence of trust in the central government on perceived risk diminished over time. These findings underscore the dynamic nature of risk perception and highlight the importance of fostering public trust in risk management strategies. Moreover, the study highlights the importance of communication strategies that respond to changing risk perceptions during emergencies, ensuring messages align with the evolving concerns of different sociodemographic groups and supporting ‘person-centered’ approaches to promote effective behavioral responses and strengthen public health efforts.