Motivating people to stay at home: using the Health Belief Model to improve the effectiveness of public health messaging during the COVID-19 pandemic

Abstract

INTRODUCTION Since the beginning of the COVID-19 pandemic in Canada, governments at the municipal, provincial, and federal level have imposed public health measures, restrictions, and advice intended to limit the spread of COVID-19. Despite the good intentions of these directives, which include such things as stay-at-home orders, limits on social gathering sizes, and advice to avoid all nonessential travel, they have been met with considerable noncompliance, running the gamut from gatherings exceeding provincial size limits, to anti-stay-at-home marches [1], to the establishment of underground casinos and nightclubs [2, 3]. In response to these acts, the government has doubled-down on its public health messaging, urging its residents to “Help limit the spread of COVID-19,” and “Restez à la maison!” Yet, blatant disregarding of public health directives to gather and travel continues, even as the overwhelming majority of Canadians remain partially or fully unvaccinated [4]. This begs the question: Where are public health messaging and mass media campaigns failing in their attempts to convince residents to stay at home? If we conceptualize staying at home as a health behavior that can limit one’s susceptibility to contracting COVID-19, then we can harness psychological theories of health behavior to understand why people may choose to gather and travel during the COVID-19 pandemic, despite public health messaging urging otherwise. The Health Belief Model, which aims to explain why and under what conditions people take action to prevent disease [5], may be especially useful in elucidating why noncompliance to public health messaging exists. The Model can also be harnessed to develop theorydriven public health messaging that is more effective at persuading residents to stay at home not only during this pandemic, but during future epidemics or pandemics as well. THE HEALTH BELIEF MODEL The Health Belief Model was developed in the mid-20th century by social psychologists at the U.S. Public Health Service [6] in an attempt to identify several variables that explain health behavior in individuals who believe themselves to be free of illness [5]. In the case of the current pandemic, this theory applies to individuals who have not contracted COVID-19, or who are ignorant of their preor asymptomatic COVID-19 status. The Model was developed from a large body of both theoretical and empirical research [5, 7], and its utility in explaining and predicting the undertaking of preventive health behavior has been validated in a large body of research studies and meta-analyses [8–10]. The Health Belief Model identifies five variables that predict health-promoting behavior [5]. The first is perceived susceptibility, the degree to which an individual feels vulnerable or susceptible to a particular health condition. According to the model, individuals who believe they are at high risk of applyparastyle fig//caption/p[1] parastyle FigCapt applyparastyle fig parastyle Figure applyparastyle article/front/article-meta/contrib-group/affiliation/aff parastyle Affiliation