The effect of cognition and affect on preventive behaviors during the COVID-19 pandemic: a cross-sectional study in China

Background The global outbreak of COVID-19 has become an international public health crisis. Specific antiviral treatments for COVID-19 are not yet available, and prevention is of particular importance to fight the virus. This study tends to explore and compare the roles of cognitive and affective factors in predicting preventive behavior adoption during the COVID-19 pandemic in China. Methods An online survey using a quota sampling method to collect responses from 3000 Chinese adults was conducted from March 2, 2020 to March 23, 2020. Questions included sociodemographic features, coronavirus knowledge, negative emotion, risk perception, and behavioral responses. Multiple regression analyses were conducted to examine the predictors of behavioral responses toward COVID-19. Results On average, respondents had low levels of knowledge about COVID-19 (the overall correct response rate was 7.5%). Most respondents reported moderate to strong negative emotions towards the virus (3.47 out of 5). The average reported perceived chance of infection was 23.89%. For behavioral responses, respondents reported low frequencies of going out for activities (1.98 out of 4) and high frequencies of taking preventive measures (3.22 out of 4). Behavioral responses toward COVID-19 were found to be determined by cognitive and affective variables. Knowledge was negatively related to frequency of going out for activities (beta = - 0.11, p < .001). Negative emotion (beta = 0.34, p < .001), and risk perception (beta = 0.05, p = .007) were positively associated with going out for activities. The explanatory power of affective variables (Delta R-2 = 12.1%) was greater than cognitive variables (Delta R-2 = 1.0%). For preventive behaviors, knowledge was positively associated with preventive behaviors (beta = 0.22, p < .001). Negative emotion (beta = - 0.28, p < .001) and risk perception (beta = - 0.05, p = .002) were all negatively associated with preventive measures. Affective variables still showed stronger explanatory power (Delta R-2 = 8%) than cognitive variables (Delta R-2 = 4.4%) in predicting preventive behaviors. Conclusions After the rising period of the COVID-19 outbreak in mainland China, cognitive and affective variables still played important roles in predicting behavioral responses. Compared with cognitive factors, affective factors demonstrated stronger explanatory power in predicting behavioral responses toward COVID-19. The findings may have implications for enhancing individual compliance with guidelines of adopting preventive behaviors in response to COVID-19.