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Perceived Risk of COVID-19 Pandemic: The Role of Public Worry and Trust

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Mohsen Khosravi at Zahedan University of Medical Sciences
Mohsen Khosravi
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Electronic Journal of General Medicine
2020, 17(4), em203
e-ISSN: 2516-3507
https://www.ejgm.co.uk/ Letter to the Editor OPEN ACCESS
Perceived Risk of COVID-19 Pandemic: The Role of Public Worry and
Trust
Mohsen Khosravi 1*
1 Department of Psychiatry and Clinical Psychology, Baharan Psychiatric Hospital, Zahedan, Sistan and Baluchistan, IRAN
*Corresponding Author: m.khosravi@zaums.ac.ir
Citation: Khosravi M. Perceived Risk of COVID-19 Pandemic: The Role of Public Worry and Trust. Electron J Gen Med. 2020;17(4):em203.
https://doi.org/10.29333/ejgm/7856
ARTICLE INFO
Received: 23 Mar. 2020
Accepted: 26 Mar. 2020
In late December 2019, an outbreak of the novel
coronavirus disease (COVID-19) was started in Wuhan, China,
and quickly reached the other countries of the world (1). In
comparison with the other members of coronaviruses family
such as SARS-CoV and MERS-CoV, COVID-19 appears to have a
lower fatality rate (virulence). However, the high transmission
rate of this virus, as well as the lack of vaccines and certain
pharmaceutical treatments for COVID-19 have posed serious
challenges to the control of the disease spread (1-3). To tackle
such problems, it is necessary to implement non-medical
measures such as the promotion of personal protection
practices (e.g. use of face masks and following personal
hygiene), imposing travel restrictions, and maintaining social
distance from possibly infected cases. To achieve the
successful implementation of such measures recommend by
public health authorities, the willingness of the public plays an
important and decisive role. However, it is still a health
problem to encourage the public to unconditionally follow
these recommended preventive actions. People’s risk
perception of pandemic is one of the factors contributing to an
increase in public participation in adopting preventive
measures (4-6). According to the Protection Motivation Theory
(PMT), the intention of the general public to adopt protective
measures is significantly influenced by high levels of perceived
risk. The theory posits that public perception of the severity
and vulnerability to a certain health threat determines their
risk perception about a disease (7). Therefore, during a new
pandemic, getting information from various sources, such as
public health professionals, the government, and the media,
can increase people’s awareness about the risk, and
consequently, their adoption of preventive measures (4).
However, several factors might affect the subjects' perception
of their actual risk for disease. This discussion aims to
investigate the role of public worry and trust in the perceived
risk of the COVID-19 pandemic.
The worry over getting a disease can influence the
perceived risk of a pandemic. It is an affective emotional
response to a threat, which can predict protective behaviors
independent of the risk severity. In other words, worrying is a
predictor for the individual’s behaviors when facing a threat.
Various factors, including socio-demographic characteristics,
social context, and individual values can affect worry about a
pandemic (8,9). Based on recent studies, being older, female,
more educated, and non-white are associated with a higher
chance of adopting the protective behaviors (10). Note that the
worry over a threat doesn’t occur in a vacuum; rather under a
circumstance where individuals might be quickly influenced by
the emotional reactions of others. This reveals a strong
correlation between perceiving the anxieties of family and
friends, and personal concern (8). In any stage of a pandemic,
practitioners must be aware of the rumors going around and
the potential risk of “emotional contagion” among populations
(8,11). Also, the social context may affect the experienced
levels of worry. For instance, the low-income class is more
concerned with issues such as the equal and fair distribution of
health services. Thus, during a pandemic, such class may
experience emotional responses to health risks, more risk
perceptions, increased negative emotions expressions such as
anger or fear, and huge challenges to the risk reduction (9).
Another factor affecting public worry includes conservation
values such as security, conformity, and tradition. Individuals
who emphasize conservation values would carefully put
preventive measures into practice. Whereas people with the
opposite values (e.g. high self-direction, stimulation, and
hedonism based on Schwartz’s model) pay less attention to the
desirable behavior (8).
One more factor that contributes to shaping an accurate
risk perception of disease is trust. According to the Trust and
Confidence Model, trust plays an important part in managing a
threat by affecting the public’s judgments about the risks and
the related benefits. It can indirectly impact the adoption of the
recommended measures. Trust is believed as the main core of
hearing, interpreting, and responding to public health
messages. This has resulted in a growing dependency of the
effective risk and crisis communication on the method of
receiving information and the level of trust in the government
during the pandemic period. Therefore, governments must
provide complete information about the pandemic to maintain
2 / 2 Khosravi / ELECTRON J GEN MED, 2020;17(4):em203
public trust, even when the information is very limited.
Governments must never downplay the reality of risk and
vulnerabilities to reduce public fears and worries. Besides,
contradictory information maintains by the government can be
associated with reduced public trust. Recent studies found that
in a pandemic, governments must consider that healthcare
workers and municipal health services are among the most
trusted information sources during the process of providing
information. The media has the lowest trust position in such an
event (4,12).
Since major coronavirus outbreaks often occur in waves,
surviving the first wave may be accompanied by a misleading
sense of immunity. Moreover, worrying about the infection
may change rapidly during the course of a disease. For
instance, due to people’s concern about a specific behavior
(e.g. vaccination), they may be encouraged to examine that
behavior. However, this behavioral action would reduce the
levels of worry in later stages. Such a case, therefore, “can lead
to apparently conflicting worry–behavior correlations” (8).
The results show that public initial emotional concerns and
trust can play an essential role in improving the perceived risk
of a pandemic and increasing public participation in adopting
preventive measures. Therefore, practitioners can utilize and
develop these models of responding to a pandemic when
facing newly emergent threats.
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... Pesquisas realizadas na Espanha e no Irã também constataram percepção reduzida do risco de contágio da doença na população geral (Khosravi, 2020;Olmo, Martínez, Ramos, Maroto, & Diaz, 2020). Contudo, verificou-se que pessoas mais velhas e com maior nível de escolaridade apresentaram maior chance de adotar comportamentos protetores, e consequentemente possuir maior percepção de vulnerabilidade (Khosravi, 2020;Olmo et al., 2020). ...
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The present review examined the importance of trust when preparing for and during a pandemic. The reviewed literature suggests that trust in health agencies positively influenced people’s willingness to adopt recommended behavior. Most of these studies are atheoretical, and due to the lack of a common framework for trust and its antecedents, finding commonalities among the studies may seem difficult. The trust, confidence, and cooperation model was used to uncover the commonalities among the various studies on trust. This framework suggests that a distinction between values and past performance may be helpful to better understand the impact of trust on risk perception and behavior. Based on the reviewed literature, the following five recommendations relevant for crisis communication during pandemics were identified: A diverse set of experts should be used as communicators, medical personnel need to model the recommended behavior, a transparent information strategy should be used, the focus should be not only on trust but also on confidence, and establishing trust in health authorities before a pandemic occurs is important. Furthermore, research gaps were identified that should be addressed to better understand the role of trust when dealing with pandemics. (PsycINFO Database Record (c) 2014 APA, all rights reserved)
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The emergence of influenza A ("swine flu") in early 2009 led to widespread public concern. However, little research has examined the factors that underlie initial worry about infection and subsequent behavioral responses to such worry. This study seeks to model some key predictors of worry and behavioral responses in the early stages of the swine flu pandemic (WHO pandemic stage 5). A cross-sectional internet questionnaire study (N = 186). Twenty-five percent of respondents rated themselves as worried about being a victim of swine flu, 40% that they were worried of a family member contracting the virus. Twenty percent had bought, or intended to buy, preparatory materials (e.g., face masks), 20% intended to delay or cancel air travel. In a structural equation model, conservation values and family or friends perception of risks predicted worry about infection, while worry correlated with the purchase of preparatory materials, a lesser willingness to travel by public transport, and difficulty in focusing on everyday activities. While previous research on pandemic risk perception has focused on cognitive risk judgments, our data suggests that initial "emotional" concerns about infection are also significant predictors of behavioral responses to pandemic threat. Such worry is likely to be influenced by a variety of individual factors, such as personal values, as well as normative pressures. Practitioners can use and expand on such models of pandemic response when tailoring health campaigns to meet newly emergent threats.
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A Protection Motivation Theory of Fear Appeals and Attitude Change1
Article
  • Sep 1975
Proposes a protection motivation theory that postulates the 3 crucial components of a fear appeal to be (a) the magnitude of noxiousness of a depicted event, (b) the probability of that event's occurrence, and (c) the efficacy of a protective response. Each of these communication variables initiates corresponding cognitive appraisal processes that mediate attitude change. The proposed conceptualization is a special case of a more comprehensive theoretical schema: expectancy-value theories. Several suggestions are offered for reinterpreting existing data, designing new types of empirical research, and making future studies more comparable. The principal advantages of protection motivation theory over the rival formulations of I. L. Janis and of H. Leventhal are discussed. (81 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
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Demographic and attitudinal determinants of protective behaviours during a pandemic: A review
Article
  • Nov 2010
Purpose: A new strain of H1N1 influenza, also known as swine flu was confirmed in the UK in May 2009 and has spread to over 100 countries around the world causing the World Health Organization to declare a global flu pandemic. The primary objectives of this review are to identify the key demographic and attitudinal determinants of three types of protective behaviour during a pandemic: preventive, avoidant, and management of illness behaviours, in order to describe conceptual frameworks in which to better understand these behaviours and to inform future communications and interventions in the current outbreak of swine flu and subsequent influenza pandemics. Methods: Web of Science and PubMed databases were searched for references to papers on severe acute respiratory syndrome, avian influenza/flu, H5N1, swine influenza/flu, H1N1, and pandemics. Forward searching of the identified references was also carried out. In addition, references were gleaned from an expert panel of the Behaviour and Communications sub-group of the UK Scientific Pandemic Influenza Advisory Group. Papers were included if they reported associations between demographic factors, attitudes, and a behavioural measure (reported, intended, or actual behaviour). Results: Twenty-six papers were identified that met the study inclusion criteria. The studies were of variable quality and most lacked an explicit theoretical framework. Most were cross-sectional in design and therefore not predictive over time. The research shows that there are demographic differences in behaviour: being older, female and more educated, or non-White, is associated with a higher chance of adopting the behaviours. There is evidence that greater levels of perceived susceptibility to and perceived severity of the diseases and greater belief in the effectiveness of recommended behaviours to protect against the disease are important predictors of behaviour. There is also evidence that greater levels of state anxiety and greater trust in authorities are associated with behaviour. Conclusions: The findings from this review can be broadly explained by theories of health behaviour. However, theoretically driven prospective studies are required to further clarify the relationship between demographic factors, attitudes, and behaviour. The findings suggest that intervention studies and communication strategies should focus on particular demographic groups and on raising levels of perceived threat of the pandemic disease and belief in the effectiveness of measures designed to protect against it.
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