From the first reported case of COVID-19, the pandemic wrought havoc across the world, bringing countries to a halt and exposing them to societal issues exacerbated by the pandemic’s circumstances (LaFee, 2021). Given the nature of the pandemic, it was essential for individuals to adopt recommended public health measures, such as wearing masks, increasing hand hygiene, practicing social distancing, and staying at home. However, the federal government deferred to state and local governments to put mandates in place, resulting in confusion due to varying policies in different states and, at times, different counties within the same state (Franck, 2021). Although states implemented mask mandates and stay-at-home orders, there was no comprehensive federal response to the pandemic, leading to uncertainty among citizens over who to trust and what to do.

According to Geldsetzer (2020)), “the general public in the United States and United Kingdom appears to have important misconceptions about COVID-19,” with many people turning to social media to find answers, only to encounter misinformation that could strongly influence behavior and affect the efficacy of government countermeasures (Cinelli et al., 2020). This division created two groups: those who were willing to follow COVID-19 prevention measures and those who were not (Bélanger & Leander, 2020). Kleitman et al. (2021) found that 90% of individuals were compliant, leaving 10% of the population putting themselves and others at risk.

In response to the variations in levels of adherence to COVID-19 prevention measures observed among individuals, this study seeks to address a pivotal question: What factors influenced individuals’ attitudes toward these prevention protocols and ultimately shaped their compliance behaviors? Clearly, multiple factors are associated with individuals’ attitudes toward COVID-19 prevention measures and their subsequent behaviors. This study primarily focuses on variables such as individual-level collectivism, uncertainty avoidance, political ideology, and perceptions about the media coverage of both traditional and social media outlets during the COVID-19 pandemic. Additionally, we explore resistance to persuasion as a potential moderating variable that could influence the relationship between these predictors and both COVID-19 prevention attitudes and behaviors.

Building on theoretical frameworks such as the health belief model (HBM; Becker, 1974 and social cognitive theory (SCT; Bandura, 1986), this study selects specific variables to explore individual attitudes toward COVID-19 prevention measures. It is important to acknowledge, however, that the variables included in this study do not represent an exhaustive list of all possible factors influencing individuals’ attitudes toward or adoption of COVID-19 prevention measures. Despite this, the selected variables offer a valuable opportunity for a detailed analysis of the dynamics shaping individual attitudes and behaviors in the context of COVID-19 prevention.

It is anticipated that the findings of this study will offer both theoretical and practical implications related to public health outcomes during the pandemic. Theoretically, this research will enrich our understanding of health behavior models by integrating and testing various psychological and social predictors, such as individual-level collectivism, uncertainty avoidance, political ideology, and media perceptions. Practically, the insights gained from this study will be critical for public health officials and policymakers. Understanding what motivates people to comply with preventative measures, such as wearing masks, practicing social distancing, and getting vaccinated, can help in designing more effective public health campaigns and messaging.

The HBM explains health-related behaviors by identifying four key factors that influence an individual’s decision to engage in a health behavior: perceived susceptibility, severity, benefits, and barriers. The model also considers individual characteristics, such as demographic factors, personality traits, and past experiences (Rosenstock, 1974). The HBM has been used to explain why individuals may or may not get vaccinated against influenza, with the model suggesting that those who perceive themselves to be at higher risk of developing influenza and who believe that the benefits of vaccination outweigh the potential barriers are more likely to get vaccinated (Horne et al., 2008). In the context of the COVID-19 pandemic, the HBM can provide a valuable framework for understanding how individuals’ perceptions of their risk of developing health conditions and their beliefs about the benefits and barriers of engaging in health behaviors influence their decision to engage in those behaviors.

In addition to the HBM, SCT provides a relevant theoretical framework for understanding individual behavior during the COVID-19 pandemic. SCT posits that behavior is shaped by personal, environmental, and behavioral factors and that individuals can change their behavior by acquiring new knowledge and skills, observing others’ behaviors, and receiving feedback and reinforcement (Bandura, 1977). Personal factors, such as self-efficacy beliefs, which refer to an individual’s confidence in their ability to perform a particular behavior, are important in predicting behavior change (Bandura, 1986). Environmental factors, such as social norms and expectations, as well as the physical context in which a specific behavior occurs, also play a significant role in shaping behavior. Past experiences, reinforcement, and observational learning are also important factors that influence behavior (Bandura, 1977).

SCT has been widely applied to various fields, including health, education, and social psychology, and it can provide a comprehensive framework for understanding how personal, environmental, and behavioral factors interacted to shape behavior during the COVID-19 pandemic (Bandura, 1986). For instance, SCT has been used to explain how individuals acquire and maintain health behaviors, such as exercise and healthy eating habits, which are also relevant to COVID-19 prevention measures (Bandura, 1997). By utilizing the SCT framework, this study gains a better understanding of the factors that contributed to individuals’ attitudes toward COVID-19 prevention measures and ultimately determined their compliance behavior. This approach can help identify effective strategies for behavior change used during the pandemic by targeting the personal, environmental, and behavioral factors that influenced compliance with COVID-19 prevention guidelines.

The phenomenon of resistance to persuasion has been extensively studied by psychologists and communications researchers. Resistance can be broadly defined as “reaction against change” (Knowles & Linn, 2014), and in the context of persuasion, it can be defined as reaction against change in response to a persuasive attempt. According to the persuasion knowledge model, individuals develop persuasion knowledge over their lifetime in the form of personal knowledge about the tactics used in persuasion attempts (Friestad & Wright, 1994). This persuasion knowledge leads to resistance to persuasion as individuals develop psychological techniques to avoid being persuaded (Ahluwalia, 2000).

Ahluwalia (2000) found that when one resistance mechanism fails, other mechanisms become stronger, such as the emergence of relative weighting. Highly committed individuals are more resistant to persuasion because they can compartmentalize negative information. Knowles and Linn (2014) noted that people’s individual beliefs about their own susceptibility to persuasion impact how persuaded they are by messages. Therefore, it is crucial to examine individual differences in resistance to persuasion.

Individuals have a diverse set of techniques at their disposal to respond to persuasive messages. In the context of persuasion, a critical question that emerges is how to effectively convince individuals who exhibit a lack of receptiveness. Amid the COVID-19 pandemic, a faction of the populace demonstrated resilient resistance to messages related to public health behavior. This obstruction can be attributed to multifarious factors, such as political beliefs, institutional trust, and personal experiences, thereby elucidating the rationale for investigating resistance to persuasion as a moderating variable. The following hypotheses are proposed:

H1: Resistance to persuasion about COVID-19 prevention protocols will be negatively related to attitudes toward COVID-19 prevention measures (COVID-19 prevention attitudes).

H2: Resistance to persuasion about COVID-19 prevention protocols will be negatively related to compliance behaviors with COVID-19 prevention measures (COVID-19 prevention behaviors).

Individualism/collectivism is a cultural measure introduced by Hofstede (2011) that refers to the level of integration of individuals into groups in a society. In individualist societies, individuals are expected to be independent and take care of themselves, whereas in collectivist societies, group values are highly regarded, and people are more interdependent. Western societies tend to be more individualistic, while Eastern societies are typically more collectivist. In this study, we aim to explore the relationship between individuals’ degrees of individualism or collectivism and how they affect their willingness to comply with COVID-19 prevention guidelines.

The United States is generally considered to be a highly individualistic society, although there are variations among states (Vandello & Cohen, 1999). Vandello and Cohen (1999) observed that the southern region of the United States tends to exhibit more collectivist tendencies. On the other hand, the Great Plains and Mountain West regions, which have lower population densities, tend to display more individualistic attitudes. This highlights that there are individual differences in the levels of individualism and collectivism across the United States, which could potentially have impacted individuals’ decisions to comply with COVID-19 prevention guidelines. The following hypotheses are proposed:

H3: People higher in collectivism will be more receptive to COVID-19 prevention measures.

H3-1: People higher in collectivism will exhibit more positive attitudes toward COVID-19 prevention measures.

H3-2: People higher on the collectivism scale will follow more COVID-19 prevention measures.

To examine the moderating effects of resistance to persuasion between variables, the following research question is posed:

RQ1: How does resistance to persuasion moderate the relationship between individualism/collectivism and COVID-19 prevention attitudes and behaviors?

Uncertainty avoidance is the extent to which a culture programs its members to feel comfortable or uncomfortable in unstructured situations (Hofstede, 2011). Individuals with high uncertainty avoidance tend to avoid unpredictable situations, whereas those with low uncertainty avoidance are more comfortable taking risks. Uncertainty avoidance can trigger the need for cognitive closure, which may explain why people exhibit unusual behaviors when confronted with uncertain situations (Gründl & Aichholzer, 2020).

Uncertainty avoidance shapes people’s assumptions about communication styles and can impact how individuals perceive and react to messages. Individuals with strong uncertainty avoidance tend to filter out one sender’s message and focus on reducing uncertainty rather than actively listening to others’ messages (Merkin, 2006). Therefore, those who are high in uncertainty avoidance tend to prioritize resolving their own cognitive dissonance over actively listening to the message being conveyed to them.

The COVID-19 pandemic created unstructured situations in which people were unsure of what might happen next, leading to behaviors such as panic buying (Ntontis et al., 2022). In addition, people did not know the long-term outcomes of prevention measures or the potential consequences of contracting the illness. Misinformation and confusion surrounding masks also led to uncertainty (Bartolome, 2020). Uncertainty avoidance plays a significant role in how people respond to uncertain situations, such as the COVID-19 pandemic, and it impacts individuals’ willingness to take risks and perceptions of communication styles. The following hypotheses are proposed:

H4: People higher in uncertainty avoidance will be more receptive to COVID-19 prevention measures.

H4-1: People higher in uncertainty avoidance will exhibit more positive attitudes toward COVID-19 prevention measures.

H4-2: People higher in uncertainty avoidance will follow more COVID-19 prevention measures.

To examine the moderating effects of resistance to persuasion between variables, the following research question is posed:

RQ2: How does resistance to persuasion moderate the relationship between uncertainty avoidance and COVID-19 prevention attitudes and behaviors?

Throughout the pandemic, conservative TV personalities and leaders routinely downplayed the severity of COVID-19, even holding indoor events such as political rallies that violated recommendations by the Centers for Disease Control and Prevention and the World Health Organization to stay at home (Waldrop & Gee, 2020). Despite historical evidence suggesting that conservatives tend to be more risk-averse than liberals, they were less likely to comply with public health guidelines and mandates regarding COVID-19 (Stroebe et al., 2021). This highlights the potent influence of political ideology, even in the face of a lethal virus.

Bartels’s (2002) assertion that the presence of biased views among political partisans contributes significantly to the maintenance and strengthening of polarized opinions between the Democratic and Republican parties partially explains this phenomenon. The COVID-19 pandemic is a case in point: Democrats mostly adhered to prevention guidelines, and Democrat-led states were among the first to implement restrictions to contain the spread of the virus, whereas Republicans downplayed the pandemic, denying its severity and dismissing it as no worse than the flu (Cillizza, 2020). In this light, the following hypotheses are proposed:

H5: People who identify as more conservative (than liberal) will be less receptive to COVID-19 prevention measures.

H5-1: People who identify as more conservative (than liberal) will exhibit more negative attitudes toward COVID-19 prevention measures.

H5-2: People who identify as more conservative (than liberal) will follow fewer COVID-19 prevention measures.

To examine the moderating effects of resistance to persuasion between variables, the following research question is posed:

RQ3: How does resistance to persuasion moderate the relationship between political ideology and COVID-19 prevention attitudes and behaviors?

The media’s agenda-setting power can significantly influence public opinion, attitudes, and behaviors (Buturoiu & Voloc, 2021). During the COVID-19 pandemic, people relied heavily on the media for information due to their need for orientation and tendency to create mental maps of their world based on information received from others (Buturoiu & Voloc, 2021). Although crucial to communicating the gravity of the virus, mainstream media platforms, such as television, radio, and newspapers, generated news content during the initial phases of the pandemic to heighten public response and threat perception, consequently resulting in people’s excessive exposure to such information, which might have had adverse effects on their mental well-being (Olagoke et al., 2020). Another study linked the excessive consumption of COVID-19 news to a 25% increase in anxiety and depression worldwide (Brunier & Drysdale, 2022), implying that a constant deluge of COVID-19 news throughout the day could have been detrimental. Therefore, these previous findings emphasize that people needed to exercise prudence and mindfulness in their consumption of COVID-19 news from mainstream media outlets.

Despite the negative impacts that the conventional media’s coverage of COVID-19 posed, Betsch et al. (2020) discovered that individuals who received a greater amount of information about the pandemic through media sources were more inclined to adopt preventive measures to mitigate the transmission of the virus. Similarly, Gollust et al. (2021) linked the media coverage of COVID-19 to changes in public opinion regarding the pandemic. The study indicated that when media coverage emphasized the gravity of the pandemic, the public demonstrated a greater inclination to endorse policies aimed at curbing the spread of the virus, such as social distancing measures. The following hypotheses are proposed:

H6: People who perceive traditional media more positively will be more receptive to COVID-19 prevention measures.

H6-1: People who perceive traditional media more positively will exhibit more positive attitudes toward COVID-19 prevention measures.

H6-2: People who perceive traditional media more positively will follow more COVID-19 prevention measures.

To examine the moderating effects of resistance to persuasion between variables, the following research question is posed:

RQ4: How does resistance to persuasion moderate the relationship between traditional media perceptions and COVID-19 prevention attitudes and behaviors?

Social media has become a key source of information worldwide. However, the unregulated nature of social media has led to the rapid dissemination of both accurate information and misinformation, which had direct effects on health behavior during the COVID-19 pandemic. Cinelli et al. (2020) found that social media platforms amplify rumors and questionable information, leading users to shape their beliefs and behaviors accordingly. Allington et al. (2021) identified social media platforms, such as Facebook and Twitter, as major vectors of the dissemination of conspiracy beliefs and misinformation. Conspiracy theories surrounding the COVID-19 pandemic were widely circulated, and the more people saw them, the more likely they were to believe them to be true (Allington et al., 2021). The spread of misinformation and conspiracy theories on social media has been correlated with stronger beliefs in conspiracy theories and fewer protective behaviors during the pandemic (Cuello-Garcia et al., 2020).

To investigate the impact of social media perceptions on resistance to persuasion and COVID-19 attitudes and behaviors, the following research questions are posed:

RQ5: Is there an association between social media perceptions and receptiveness to COVID-19 prevention measures?

RQ5-1: Is there an association between social media perceptions and COVID-19 prevention attitudes?

RQ5-2: Is there an association between social media perceptions and COVID-19 prevention behaviors?

RQ5-3: How does resistance to persuasion moderate the relationship between social media perceptions and COVID-19 prevention attitudes and behaviors?

Figure 1 presents the conceptual model that this study aims to explore, illustrating the key variables under examination.

This study was designed to enrich the existing body of knowledge by offering a comprehensive analysis of the factors that may influence resistance to COVID-19 prevention measures. Specifically, it examined a range of predictors, such as individual-level collectivism, uncertainty avoidance, political ideology, and perceptions of traditional and social media, and their associations with attitudes and behaviors toward COVID-19 prevention. Additionally, the study explored the moderating role of resistance to persuasion in the relationships between these independent variables and COVID-19 prevention attitudes and behaviors. This multifaceted approach aimed to provide deeper insights into the complex interplay of psychological, social, and media-related factors affecting public health compliance.

The findings of this study demonstrate a positive association between individual-level collectivism and proactive attitudes and behaviors toward COVID-19 prevention. Individuals with pronounced collectivist values tended to be more receptive to following COVID-19 prevention protocols. This receptiveness underscores the potential efficacy of public health messages that focus on community well-being, collective benefits, and social responsibility. Such messages resonate deeply with those who prioritize communal goals over personal interests, value group cohesion, and engage in strong, interdependent relationships within their communities. These insights suggest that health communication strategies can be particularly effective if they are tailored to align with collectivist values during health crises, such as the COVID-19 pandemic. Practically, we can suggest how health communication strategies can be adapted to better resonate with collectivist values in navigating a crisis event, such as the COVID-19 pandemic, possibly by highlighting how individual actions contribute to the health and safety of the whole community.

This study found a significant association between individual levels of uncertainty avoidance and attitudes and behaviors toward COVID-19 prevention. The emergence of COVID-19 created a highly unstructured scenario characterized by conflicting information from reputed sources, especially during the early stages of the pandemic (Pazzanese, 2020). In this context, it is understandable that individuals with high levels of uncertainty avoidance would demonstrate more favorable attitudes and behaviors toward COVID-19 prevention measures. Uncertainty avoidance reflects a person’s need for assurance and limited tolerance of ambiguity and vagueness. It encompasses a desire to manage uncertainty through mental resolution, order, and a preference for structured, routine activities over novelty and unfamiliar situations. Individuals high in uncertainty avoidance tend to favor straightforward, decisive actions rather than engaging in extensive deliberation (Gründl & Aichholzer, 2020).

This finding has several practical implications. Given that uncertainty avoidance involves a preference for clear rules, instructions, and assurances, public health messages that are straightforward and unambiguous are likely to be especially effective for individuals with high uncertainty avoidance. Such messages should explicitly outline the steps required to prevent infection and clearly communicate the benefits of adhering to these measures. Moreover, effective risk communication that addresses uncertainties and elucidates the rationale behind preventive measures is essential. This strategy is crucial for managing the fear and anxiety that often accompany uncertainty, which can pose significant barriers to the acceptance and adoption of necessary preventive actions. By directly addressing these psychological barriers, public health initiatives can enhance compliance and mitigate the impact of crises.

While this study focused on individual-level collectivism and uncertainty avoidance, it is important to note that numerous studies have explored these variables at the cross-cultural level. Consequently, there is a strong case for future research to further examine the relationships between these factors and COVID-19 prevention attitudes and behaviors across different countries. The dynamics between these variables could vary substantially across diverse cultural contexts, underscoring the need for a more nuanced understanding. Such research would broaden the discussion on the global implications of cultural values in responding to pandemics, highlighting how cultural differences can influence public health strategies and outcomes. This exploration is essential for developing culturally sensitive interventions that are effective in managing global health crises.

From a theoretical perspective, the implications of this study enrich behavioral change models by advocating the integration of cultural and social values as fundamental components. This approach facilitates the creation of more sophisticated models that account for both individual psychological factors and cultural predispositions. As a result, traditional health behavior frameworks, such as the HBM or the theory of planned behavior, could be enhanced by incorporating cultural dimensions. This adaptation would allow for a more holistic understanding of public health behavior, enabling interventions that are effectively tailored to diverse cultural contexts. Such an approach would not only improve the accuracy of behavioral predictions but also increase the efficacy of public health campaigns across different populations.

Another key finding of this study is the significant association between political ideology and attitudes and behaviors toward COVID-19 prevention. The results indicate that individuals with conservative leanings tended to have a more negative attitude toward COVID-19 prevention protocols and were less likely to adhere to behavioral guidelines than their liberal counterparts. This negative correlation is particularly noteworthy in light of the politicization of the pandemic, marked by influential conservative figures consistently downplaying the virus’s severity and disregarding public health recommendations (Shabad, 2021). These findings are consistent with research by Stroebe et al. (2021), who observed that conservatives in the United States were less likely to comply with COVID-19 public health mandates and recommendations than liberals. This trend underscores the influence of political ideology on public health compliance and highlights the challenges in overcoming political divides in health communication and policymaking.

Furthermore, the association found in this study between an individual’s political ideology and their attitudes and behaviors toward COVID-19 can also be linked to the media coverage of the pandemic in the United States, which often reflected the political leanings of its various audiences. Conservative-leaning media outlets have been known to propagate hoaxes and conspiracy theories, contributing to a divide in the information their viewers are willing to trust and potentially leading to diminished faith in medical professionals (Motta et al., 2020). In contrast, liberal-leaning media outlets tended to provide more extensive coverage and warnings about the pandemic (Mach et al., 2021). This polarized media landscape likely influenced individuals to align their judgments on COVID-19 prevention protocols with their political viewpoints, exacerbating divisions and impacting public health responses.

The results of this study seem to diverge from previous findings. Employing the HBM, which posits that an individual’s values and expectations significantly influence their decision-making processes regarding health-related behaviors and participation in health programs, Boslaugh (2019) observed that conservatives typically exhibit greater health consciousness than liberals. However, the current study reveals that conservatives were less likely to comply with COVID-19 prevention measures. This contradiction underscores the need for further research to unravel the complex interplay of factors that shaped attitudes and behaviors toward COVID-19 prevention and other health-related behaviors. Such studies are crucial for developing more effective health communication and intervention strategies that accommodate diverse political and cultural perspectives. This discrepancy also suggests that specific situational or contextual factors related to the COVID-19 pandemic may have uniquely influenced public health behavior across different political ideologies.

The analysis of the moderating role of resistance to persuasion revealed a significant interaction with political ideology in predicting attitudes and behaviors toward COVID-19 prevention. This suggests that an individual’s receptivity to public health messages during the pandemic is likely contingent on their position within the political spectrum, ranging from conservative to liberal. The findings indicate that the combination of political ideology and resistance to persuasion significantly influenced both attitudes and behaviors, particularly in relation to COVID-19 prevention measures. This finding enriches existing theories of persuasion and communication by highlighting how resistance to persuasion interacts with political ideology to shape public health behaviors. It supports the notion that persuasive communication is not merely a function of message content and delivery but also of individual psychological and sociopolitical characteristics.

The findings of this study indicate that individuals with a positive perception of traditional media were more likely to be receptive to COVID-19 prevention measures. Specifically, as individuals’ perceptions of traditional media become more favorable, their attitudes toward prevention measures improve, leading to increased compliance. Individuals who relied on traditional media and viewed it favorably were thus more likely to adopt COVID-19 prevention measures. This suggests the potential for public health authorities to form strategic partnerships with traditional media outlets to disseminate accurate and timely information about disease prevention. By leveraging trusted media sources, health officials can enhance public engagement and compliance with health guidelines. For future mass crises, these findings highlight the importance of including traditional media in the planning and execution of crisis communication strategies. The effective use of traditional media can aid in quickly spreading vital prevention information and managing public behavior during emergencies.

While this study provides valuable insights into the associations between individual psychological traits, media perceptions, and political ideology with attitudes and behaviors toward COVID-19 prevention, there are several limitations to consider when interpreting the results. First, the selection of variables was based solely on previous research without a robust theoretical framework, thus limiting our ability to discuss causality between variables. Second, the study was contextualized within a specific political and cultural setting (i.e., the United States), which may restrict the generalizability of the findings to other contexts in which different norms and pandemic responses may prevail. Additionally, potential confounding variables, such as socioeconomic status, education level, and access to health care, which were not controlled for, could have influenced the observed relationships. These limitations highlight the need for caution in extending these results too broadly and underscore the importance of further research to address these gaps.

Despite these limitations, this study illuminates the complex interplay between individual psychological traits, media perceptions, and political ideology on attitudes and behaviors toward COVID-19 prevention measures. The findings of this study advocate the development of tailored communication strategies that consider the nuanced influences of personality traits and ideological orientations. Future research should continue to explore these dynamics to enhance the efficacy of public health interventions across diverse populations.