A cross-sectional study of perceptions of COVID-19 and adherence to preventive measures among Saudi college students using the health belief model
More Detail
1 Department of Mass Communication, College of Humanities & Social Sciences, King Saud University, Riyadh, SAUDI ARABIA
* Corresponding Author
Online Journal of Communication and Media Technologies, Volume 13, Issue 4, Article No: e202357.
https://doi.org/10.30935/ojcmt/13783
OPEN ACCESS 1051 Views 542 Downloads Published online: 17 Oct 2023
ABSTRACT
This study utilized the health belief model (HBM) to investigate the association between the perceptions of COVID-19, adherence to healthy behaviors, and the credibility of COVID-19 information. This cross-sectional study utilized an online survey distributed to a random sample of graduate and undergraduate college students (N = 408) at a large public university in Riyadh, Saudi Arabia, during the COVID-19 pandemic. The study utilized two validated and reliable 5-point Likert scales to assess individuals’ perceptions of COVID-19 and the credibility of health messages promoted via various communication channels. Various statistical analyses, including Kruskal-Wallis H and Pearson correlation coefficient (r) tests, suggested a positive association between the credibility of COVID-19 information and the HBM and a positive association between the HBM and adopting COVID-19 preventive measures. Individuals perceived public health authorities as more credible sources of COVID-19 information than traditional and social media platforms. The study recommends that public health authorities convey tailored, effective, consistent, and transparent health messages via proper communication channels to persuade and motivate individuals to adopt healthy behaviors during future pandemics.
CITATION
Alsulaiman, S. A. (2023). A cross-sectional study of perceptions of COVID-19 and adherence to preventive measures among Saudi college students using the health belief model.
Online Journal of Communication and Media Technologies, 13(4), e202357.
https://doi.org/10.30935/ojcmt/13783
REFERENCES
- Adam, S., Urman, A., Arlt, D., Gil-Lopez, T., Makhortykh, M., & Maier, M. (2023). Media trust and the COVID-19 pandemic: An analysis of short-term trust changes, their ideological drivers and consequences in Switzerland. Communication Research, 50(2), 205-229. https://doi.org/10.1177/00936502221127484
- Alsulaiman, S. A. (2022). Understanding Saudi millennials news consumption in a digital world. Online Journal of Communication and Media Technologies, 12(3), e202220. https://doi.org/10.30935/ojcmt/12181
- Alsulaiman, S. A., & Rentner, T. L. (2018). The health belief model and preventive measures: A study of the Ministry of Health campaign on coronavirus in Saudi Arabia. Journal of International Crisis and Risk Communication Research, 1(1), 27-56. https://doi.org/10.30658/jicrcr.1.1.3
- Alsulaiman, S. A., & Rentner, T. L. (2021). The use of the health belief model to assess US college students’ perceptions of COVID-19 and adherence to preventive measures. Journal of Public Health Research, 10(4), jphr-2021. https://doi.org/10.4081/jphr.2021.2273
- Alsulaiman, S. A., & Rentner, T. L. (2022). Information seeking behaviors and media credibility among college students during the COVID-19 pandemic. Atlantic Journal of Communication, 30(5), 549-569. https://doi.org/10.1080/15456870.2021.1981330
- Atkin C. K., & Hornik, R. C. (2002). Theory and principles of public communication campaigns. In R. C. Hornic (Ed.), Public health communication: Evidence for behavior change (pp. 3-19). Lawrence Erlbaum Associates, Inc.
- Austin, E. W., & Dong, Q. (1994). Source v. content effects on judgments of news believability. Journalism Quarterly, 71(4), 973-983. https://doi.org/10.1177/107769909407100420
- Baldwin, A. S., Tiro, J. A., & Zimet, G. D. (2023). Broad perspectives in understanding vaccine hesitancy and vaccine confidence: An introduction to the special issue. Journal of Behavioral Medicine, 46(1-2), 1-8. https://doi.org/10.1007/s10865-023-00397-8
- Callison, C. (2001). Do PR practitioners have a PR problem?: The effect of associating a source with public relations and client-negative news on audience perception of credibility. Journal of Public Relations Research, 13(3), 219-234. https://doi.org/10.1207/S1532754XJPRR1303_2
- Centers for Disease Control and Prevention (2022, August 11). Understanding risk. https://www.cdc.gov/coronavirus/2019-ncov/your-health/understanding-risk.html
- Centers for Disease Control and Prevention (2023, January 26). How to protect yourself and others. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/prevention.html
- Champion, V. L. (1984). Instrument development for health belief model constructs. Advances in Nursing Science, 6(3), 73-85. https://doi.org/10.1097/00012272-198404000-00011
- Champion, V. L., & Skinner, C. S. (2008). The health belief model. In K. B. Glanz, K. Rimer, & K. Viswanath (Eds.), Health behavior and health education: Theory, research, and practice (pp. 45-65). Jossey-Bass.
- Chen, J., & Wang, Y. (2021). Social media use for health purposes: Systematic review. Journal of Medical Internet Research, 23(5), e17917. https://doi.org/10.2196/17917
- Chou, W. Y. S., Hunt, Y. M., Beckjord, E. B., Moser, R. P., & Hesse, B. W. (2009). Social media use in the United States: Implications for health communication. Journal of Medical Internet Research, 11(4), e1249. https://doi.org/10.2196/jmir.1249
- Cooley, S. C., & Cooley, A. B. (2011). An examination of the situational crisis communication theory through the General Motors bankruptcy. Journal of Media and Communication Studies, 3(6), 203. https://doi.org/10.5897/JMCS.9000006
- Coombs, W. T. (2007). Crisis management and communications. Institute for Public Relations. https://instituteforpr.org/crisis-management-and-communications/
- Coombs, W. T. (2010). Parameters for crisis communication. In W. T. Coombs, & S. J. Holladay (Eds.), The handbook of crisis communication (pp. 17-53). Blackwell Publishing Ltd. https://doi.org/10.1002/9781444314885.ch1
- Costello, A. B., & Osborne, J. (2005). Best practices in exploratory factor analysis: Four recommendations for getting the most from your analysis. Practical Assessment, Research, and Evaluation, 10(1), 7.
- Curtin, P. A., & Gaither, T. K. (2007). International public relations: Negotiating culture, identity, and power. SAGE. https://doi.org/10.4135/9781452224817
- Dry, S., & Leach, M. (2010). Epidemics: Science, governance and social justice. Routledge. https://doi.org/10.4324/9781849776424
- Eastin, M. S. (2001). Credibility assessments of online health information: The effects of source expertise and knowledge of content. Journal of Computer-Mediated Communication, 6(4), JCMC643. https://doi.org/10.1111/j.1083-6101.2001.tb00126.x
- Fehr, S. K., Vidourek, R. A., King, K. A., & Nabors, L. A. (2017). Perceived barriers and benefits of condom use among college students. American Journal of Health Studies, 32(4). https://doi.org/10.47779/ajhs.2017.80
- Gallagher, K. M., & Updegraff, J. A. (2012). Health message framing effects on attitudes, intentions, and behavior: A meta-analytic review. Annals of Behavioral Medicine: A Publication of the Society of Behavioral Medicine, 43(1), 101-116. https://doi.org/10.1007/s12160-011-9308-7
- Gaziano, C. (1988). How credible is the credibility crisis? Journalism Quarterly, 65(2), 267-278. https://doi.org/10.1177/107769908806500202
- Gehrau, V., Fujarski, S., Lorenz, H., Schieb, C., & Blöbaum, B. (2021). The impact of health information exposure and source credibility on COVID-19 vaccination intention in Germany. International Journal of Environmental Research and Public Health, 18(9), 4678. https://doi.org/10.3390/ijerph18094678
- Ghazy, R. M., Abdou, M. S., Awaidy, S., Sallam, M., Elbarazi, I., Youssef, N., Fiidow, O. A., Mehdad, S., Hussein, M. F., Adam, M. F., Abdullah, F. S. A., Rebai, W. K., Raad, E. B., Hussein, M., Shehata, S. F., Ismail, I. I., Salam, A. A., & Samhouri, D. (2022). Acceptance of COVID-19 vaccine booster doses using the health belief model: A cross-sectional study in low-middle- and high-income countries of the East Mediterranean region. International Journal of Environmental Research and Public Health, 19(19), 12136. https://doi.org/10.3390/ijerph191912136
- Gilles, I., Bangerter, A., Clémence, A., Green, E. G., Krings, F., Staerklé, C., & Wagner-Egger, P. (2011). Trust in medical organizations predicts pandemic (H1N1) 2009 vaccination behavior and perceived efficacy of protection measures in the Swiss public. European Journal of Epidemiology, 26, 203-210. https://doi.org/10.1007/s10654-011-9577-2
- Guilford, K., McKinley, E., & Turner, L. (2017). Breast cancer knowledge, beliefs, and screening behaviors of college women: Application of the health belief model. American Journal of Health Education, 48(4), 256-263. https://doi.org/10.1080/19325037.2017.1316694
- Hochbaum, G. M. (1958). Public participation in medical screening programs: A socio-psychological study (No. 572). US Department of Health, Education, and Welfare, Public Health Service, Bureau of State Services, Division of Special Health Services, Tuberculosis Program.
- Hochbaum, G., Rosenstock, I., & Kegels, S. (1952). Health belief model. United States Public Health Service, 1.
- Hoffman, S. J., & Justicz, V. (2016). Automatically quantifying the scientific quality and sensationalism of news records mentioning pandemics: Validating a maximum entropy machine-learning model. Journal of Clinical Epidemiology, 75, 47-55. https://doi.org/10.1016/j.jclinepi.2015.12.010
- Hovland, C. I., & Weiss, W. (1951). The influence of source credibility on communication effectiveness. Public Opinion Quarterly, 15(4), 635-650. https://doi.org/10.1086/266350
- Janz, N. K., & Becker, M. H. (1984). The health belief model: A decade later. Health Education Quarterly, 11(1), 1-47. https://doi.org/10.1177/109019818401100101
- Johnson, T. J., & Kaye, B. K. (2009). In blog we trust? Deciphering credibility of components of the Internet among politically interested internet users. Computers in Human Behavior, 25(1), 175-182. https://doi.org/10.1016/j.chb.2008.08.004
- Khan, A., Alsofayan, Y., Alahmari, A., Alowais, J., Algwizani, A., Alserehi, H., & Jokhdar, H. (2021). COVID-19 in Saudi Arabia: The national health response. Eastern Mediterranean Health Journal, 27(11), 1114-1124. https://doi.org/10.26719/emhj.21.048
- King, K. A., Singh, M., Bernard, A., Merianos, A. L., & Vidourek, R. A. (2012). Employing the health belief model to examine stress management among college students. American Journal of Health Studies, 27, 192-203.
- Klemm, C., Das, E., & Hartmann, T. (2016). Swine flu and hype: A systematic review of media dramatization of the H1N1 influenza pandemic. Journal of Risk Research, 19(1), 1-20. https://doi.org/10.1080/13669877.2014.923029
- Laing, A. (2011). The H1N1 crisis: Roles played by government communicators, the public and the media. Journal of Professional Communication, 1(1), 123-149. https://doi.org/10.15173/jpc.v1i1.88
- Ledingham, J. A., & Bruning, S. D. (2000). Public relations as relationship management: A relational approach to the study and practice of public relations. Routledge. https://doi.org/10.4324/9781410604668
- Limbu, Y. B., Gautam, R. K., & Pham, L. (2022). The health belief model applied to COVID-19 vaccine hesitancy: A systematic review. Vaccines, 10(6), 973. https://doi.org/10.3390/vaccines10060973
- Maiman, L. A., & Becker, M. H. (1974). The health belief model: Origins and correlates in psychological theory. Health Education Monographs, 2(4), 336-353. https://doi.org/10.1177/109019817400200404
- McCroskey, J. C., & Teven, J. J. (1999). Goodwill: A reexamination of the construct and its measurement. Communications Monographs, 66(1), 90-103. https://doi.org/10.1080/03637759909376464
- McNab C. (2009). What social media offers to health professionals and citizens. Bulletin of the World Health Organization, 87(8), 566. https://doi.org/10.2471/blt.09.066712
- McRee, A. L., Gower, A. L., Kiss, D. E., & Reiter, P. L. (2023). Has the COVID-19 pandemic affected general vaccination hesitancy? Findings from a national study. Journal of Behavioral Medicine, 46(1-2), 9-14. https://doi.org/10.1007/s10865-022-00298-2
- Metzger, M. J., Flanagin, A. J., Eyal, K., Lemus, D. R., & McCann, R. M. (2003). Credibility for the 21st century: Integrating perspectives on source, message, and media credibility in the contemporary media environment. Annals of the International Communication Association, 27(1), 293-335. https://doi.org/10.1080/23808985.2003.11679029
- Meyer, P. (1988). Defining and measuring credibility of newspapers: Developing an index. Journalism Quarterly, 65(3), 567-574. https://doi.org/10.1177/107769908806500301
- Ministry of Health (2023a). COVID-19 dashboard: Saudi Arabia. https://covid19.moh.gov.sa/
- Ministry of Health (2023b, January 29). COVID-19 guidelines. https://www.moh.gov.sa/en/Ministry/MediaCenter/Publications/Pages/covid19.aspx
- Nadeem, R. (2022). Lack of preparedness among top reactions Americans have to public health officials’ COVID-19 response. Pew Research Center. https://www.pewresearch.org/science/2022/10/05/lack-of-preparedness-among-top-reactions-americans-have-to-public-health-officials-covid-19-response/
- Nan, X., Iles, I. A., Yang, B., & Ma, Z. (2022). Public health messaging during the COVID-19 pandemic and beyond: Lessons from communication science. Health Communication, 37(1), 1-19. https://doi.org/10.1080/10410236.2021.1994910
- Pearman, O., Boykoff, M., Osborne-Gowey, J., Aoyagi, M., Ballantyne, A. G., Chandler, P., Daly, M., Doi, K., Fernández-Reyes, R., Jiménez-Gómez, I., Nacu-Schmidt, A., McAllister, L., McNatt, M., Mocatta, G., Petersen, L. K., Simonsen, A. H., & Ytterstad, A. (2021). COVID-19 media coverage decreasing despite deepening crisis. Lancet Planetary Health, 5(1), e6-e7. https://doi.org/10.1016/S2542-5196(20)30303-X
- Pieri, E. (2019). Media framing and the threat of global pandemics: The Ebola crisis in UK media and policy response. Sociological Research Online, 24(1), 73-92. https://doi.org/10.1177/1360780418811966
- Pornpitakpan, C. (2004). The persuasiveness of source credibility: A critical review of five decades’ evidence. Journal of Applied Social Psychology, 34(2), 243-281. https://doi.org/10.1111/j.1559-1816.2004.tb02547.x
- Rimmer, T., & Weaver, D. (1987). Different questions, different answers? Media use and media credibility. Journalism Quarterly, 64(1), 28-44. https://doi.org/10.1177/107769908706400104
- Rosenstock, I. M. (1974). The health belief model and preventive health behavior. Health Education Monographs, 2(4), 354-386. https://doi.org/10.1177/109019817400200405
- Ross, T. P., Ross, L. T., Rahman, A., & Cataldo, S. (2010). The bicycle helmet attitudes scale: Using the health belief model to predict helmet use among undergraduates. Journal of American College Health, 59(1), 29-36. https://doi.org/10.1080/07448481.2010.483702
- Salathé, M., & Khandelwal, S. (2011). Assessing vaccination sentiments with online social media: Implications for infectious disease dynamics and control. PLoS Computational Biology, 7(10), e1002199. https://doi.org/10.1371/journal.pcbi.1002199
- Scheiber, A., Prinster, T. B., Stecko, H., Wang, T., Scott, S., Shah, S. H., & Wyne, K. (2023). COVID-19 vaccination rates and vaccine hesitancy among Spanish-speaking free clinic patients. Journal of Community Health, 48(1), 127-135. https://doi.org/10.1007/s10900-022-01150-z
- Seeger, M, W., Reynolds B., & Sellnow T. L. (2010). Crisis and emergency risk communication in health contexts: Applying the CDC model to pandemic influenza. In R.L. Heath, & D. H. O’Hair (Eds.), Handbook of risk and crisis communication (pp. 493-506). Routledge. https://doi.org/10.4324/9781003070726-27
- Sellnow, T. L., Veil, S. R., Streifel, R. A., & Johnson CL. (2010). Credibility seeking through an inter-organizational alliance: Instigating the Fen-Phen confrontation crisis. In W. T. Coombs, & S. J. Holladay (Eds.), The handbook of crisis communication (pp. 657-674). Blackwell Publishing Ltd. https://doi.org/10.1002/9781444314885.ch32
- Silva, J., Bratberg, J., & Lemay, V. (2021). COVID-19 and influenza vaccine hesitancy among college students. Journal of the American Pharmacists Association, 61(6), 709-714.e1. https://doi.org/10.1016/j.japh.2021.05.009
- Simons, H. W., Berkowitz, N. N., & Moyer, R. J. (1970). Similarity, credibility, and attitude change: A review and a theory. Psychological Bulletin, 73(1), 1-16. https://doi.org/10.1037/h0028429
- Slater, M. D., & Rouner, D. (1996). How message evaluation and source attributes may influence credibility assessment and belief change. Journalism & Mass Communication Quarterly, 73(4), 974-991. https://doi.org/10.1177/107769909607300415
- Truong, J., Bakshi, S., Wasim, A., Ahmad, M., & Majid, U. (2022). What factors promote vaccine hesitancy or acceptance during pandemics? A systematic review and thematic analysis. Health Promotion International, 37(1), daab105. https://doi.org/10.1093/heapro/daab105
- Tseng, S., & Fogg, B. J. (1999). Credibility and computing technology. Communications of the ACM, 42(5), 39-44. https://doi.org/10.1145/301353.301402
- Tsui, J., Martinez, B., Shin, M. B., Allee-Munoz, A., Rodriguez, I., Navarro, J., Thomas-Barrios, K. R., Kast, W. M., & Baezconde-Garbanati, L. (2023). Understanding medical mistrust and HPV vaccine hesitancy among multiethnic parents in Los Angeles. Journal of Behavioral Medicine, 46(1-2), 100-115. https://doi.org/10.1007/s10865-022-00283-9
- Valenti A., Mirabile M., Cannone E., Boccuni F., Dionisi P., Fortuna G., Gagliardi D., Vizzaccaro R., & Iavicoli S. (2023). The impact of COVID-19 pandemics on the development of health risk communication: challenges and opportunities. International Journal of Environmental Research and Public Health, 20(1), 645. https://doi.org/10.3390/ijerph20010645
- Wakefield, M. A., Loken, B., & Hornik, R. C. (2010). Use of mass media campaigns to change health behavior. The Lancet, 376(9748), 1261-1271. https://doi.org/10.1016/S0140-6736(10)60809-4
- Wang, H., Huang, Y.-M., Su, X.-Y., Xiao, W.-J., Si, M.-Y., Wang, W.-J., Gu, X.-F., Ma, L., Li, L., Zhang, S.-K., Yang, C. X., Yu, Y.-Q., & Qiao, Y.-L. (2022). Acceptance of the COVID-19 vaccine based on the health belief model: A multicenter national survey among medical care workers in China. Human Vaccines & Immunotherapeutic, 18(5), 2076523. https://doi.org/10.1080/21645515.2022.2076523
- West, M. D. (1994). Validating a scale for the measurement of credibility: A covariance structure modeling approach. Journalism Quarterly, 71(1), 159-168. https://doi.org/10.1177/107769909407100115
- Wong, L. P., & Sam, I. C. (2010). Public sources of information and information needs for pandemic influenza A (H1N1). Journal of Community Health, 35, 676-682. https://doi.org/10.1007/s10900-010-9271-4
- Wong, L. P., Alias, H., Wong, P. F., Lee, H. Y., & AbuBakar, S. (2020). The use of the health belief model to assess predictors of intent to receive the COVID-19 vaccine and willingness to pay. Human vaccines & Immunotherapeutic, 16(9), 2204-2214. https://doi.org/10.1080/21645515.2020.1790279
- World Health Organization (2020a, October 13). Impact of COVID-19 on people’s livelihoods, their health, and our food systems: Joint statement by ILO, FAO, IFAD and WHO. https://www.who.int/news/item/13-10-2020-impact-of-covid-19-on-people's-livelihoods-their-health-and-our-food-systems
- World Health Organization (2020b, May 03). Translation_methodology. https://www.who.int/tools/whoqol/whoqol-100/docs/default-source/publishing-policies/whoqol-100-guidelines/translation-methodology
- World Health Organization (2023a). WHO coronavirus (COVID-19) dashboard. https://covid19.who.int/?adgroupsurvey={adgroupsurvey}&gclid=EAIaIQobChMI8YeW4ujc-gIV2JTVCh2yww2BEAAYASABEgLZjDBwE
- World Health Organization (2023b). Communicating for health: WHO strategic framework for effective communications. https://www.who.int/about/communications
- World Health Organization (2023c). Coronavirus disease (COVID-19). https://www.who.int/health-topics/coronavirus#tab=tab_1
- World Health Organization (2023d). Coronavirus disease (COVID-19) pandemic. https://www.who.int/emergencies/diseases/novel-coronavirus-2019
- Yang, Z. J. (2015). Predicting young adults’ intentions to get the H1N1 vaccine: An integrated model. Journal of Health Communication, 20(1), 69-79. https://doi.org/10.1080/10810730.2014.904023
- Zhong, Y., Liu, W., Lee, T. Y., Zhao, H., & Ji, J. (2021). Risk perception, knowledge, information sources and emotional states among COVID-19 patients in Wuhan, China. Nursing Outlook, 69(1), 13-21. https://doi.org/10.1016/j.outlook.2020.08.005