COVID-19 fear mediates the relationship between perceived risk and preventive behaviors: the moderating role of perceived effectiveness

Objective To investigate COVID-19 perceived risk and fear as predictors of preventive behaviors among young adult undergraduates, guided by the Extended Parallel Process Model (EPPM). Design Participants (N = 174;M-age = 21.94, SD = 3.24; 62% Hispanic, 79% women) were recruited from a large public university in Southern California and completed measures at two timepoints over a three-month period. Main outcome measures Participants self-reported COVID-19 risk, fear, preventive behaviors, and perceived effectiveness. Results Asymptotic moderated mediation indicated that COVID-19 fear fully mediated the association between perceived risk and preventive behaviors. Greater COVID-19 perceived risk was associated with more fear and, in turn, the engagement in more COVID-19 preventive behaviors. Furthermore, in partial support of the EPPM, participants' perceived effectiveness of preventive behaviors moderated the relationship between fear and preventive behaviors where a significant conditional effect was found among only participants endorsing low levels of perceived effectiveness of preventive behaviors. Conclusion This study offers important implications for future health communication strategies by providing a network of associations that either attenuate or promote the engagement in risk-reducing preventive behaviors among young adult undergraduates. Findings highlight the importance of augmenting undergraduate knowledge on health promotion and illness prevention strategies.