Health Disparities in Online COVID-19 Information Seeking and Protective Behaviors: A Two-Wave Longitudinal Study

ABSTRACT

The COVID-19 outbreak was declared a pandemic by the World Health Organization and claimed hundreds of thousands of lives in the U.S. However, the adoption of protective behaviors in response to COVID-19 varies among sociodemographic groups. To better understand the disparities in U.S. adults’ adoption of protective behaviors in relation to sociodemographic factors, we conducted a two-wave panel survey in the U.S. Although sociodemographic factors were not found to be significant predictors in lagged regression analysis, results from a cross-sectional analysis showed that the White, younger, and higher educated individuals were more likely to take protective behaviors. Furthermore, based on the structural equation modeling, indirect effects were observed. Specifically, online COVID-19 information seeking mediated the effects of age and education on performance of protective behaviors, and subjective norms and online COVID-19 information seeking were found to be significant serial mediators of these relationships. The study not only extends the health disparities and health information seeking literature, but also offers practical insights to health campaigns and interventions promoting protective behaviors during a pandemic and reducing health disparities.

Acknowledgement

We thank Ms. Abby Wolff for her great help with data cleaning and editing, and the three anonymous reviewers for their constructive feedback in the peer review process.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. To enhance the generalizability of results, the proportional quota sampling method that the number of participants recruited in the first wave of data collection was proportional to the number of group members in the national census in terms of age, gender, race/ethnicity, education, and income was applied in the first wave of data collection.

2. We chose a one-month lag as a tradeoff between greater attrition during a longer interval between waves and giving respondents as much time as possible to initiate OCIS and protective behaviors. Given the feasibility of OCIS and COVID-19 protective behaviors (e.g., wearing a mask, self-isolation), they are able to be implemented in a relatively short amount of time (Rains & Ruppel, 2016; Trifiletti et al., 2021).

3. We first conducted an exploratory factor analysis (EFA) of the seven items measuring COVID-related protective behaviors. The EFA results suggested that only one factor was extracted from these seven items based on the eigenvalue-greater-than-one rule and the scree plot. The detailed EFA results are available upon request.

4. SEM, which takes measurement errors into consideration by treating focal variables as latent constructs and analyzes the hypothesized lagged model with all variables simultaneously, is considered superior to regression analyses. Maximum likelihood estimation was applied with standard errors that were robust to non-normality. Model fit was examined using the following indices and criteria: values greater than .90 for comparative fit index (CFI) and Tucker-Lewis index (TLI), and values smaller than .08 for the standardized root mean square residual (SRMR) and root mean square of approximation (RMSEA; Browne & Cudeck, 1993; Hu & Bentler, 1998; McDonald & Ho, 2002).

5. To closely examine the racial disparities on COVID-19 protective behaviors, we conducted a post-hoc analysis with White as the reference group and African American, Hispanic and Asian race/ethnicity dummy coded respectively. The results indicated that Asian participants were more likely to perform protective behaviors one month later (β = .06, p < .05) than participants of another race/ethnicity, whereas African American (β = -.02, p = .35) or Hispanic (β = .01, p = .84) race/ethnicity was not significantly predicting preventative behaviors.

Additional information

Funding

Research reported in this manuscript was supported by the Waterhouse Family Institute (WFI) under award number 20210085. The content is solely the responsibility of the authors and does not necessarily represent the official views of the WFI.