Conspiracy beliefs predicting health behaviors: an integration of the theory of planned behavior and health belief model

Abstract

Conspiracy beliefs and misinformation can impact health behaviors and initiatives. The current study used structural equation modeling to test integrated models comprised of the Theory of Planned Behavior (TPB) and Health Belief Model (HBM) within the context of the COVID-19 pandemic to determine how conspiracy beliefs may predict relevant behaviors. Based on a sample of 529 US and Canadian adults, two types of behaviors were assessed (i.e., vaccination status and subsequent booster willingness) using models based on two common COVID-19 conspiracy belief types (hoax and government). Overall, conspiracy beliefs predicted most factors of the TPB and HBM. Perceived susceptibility was a consistent mediator regardless of conspiracy type or outcome variable. Findings have implications for public health interventions and compliance with public health initiatives such as vaccination uptake.

Appendices

Appendix A

HBM Components	Source	Item
Perceived Susceptibility
	Shmueli (2021)	I believe that if I do not get vaccinated, the likelihood of…
		1.) …me getting infected with this disease will increase
		2.) …my friends and relatives getting infected with this disease increase
	Shahnazi et al. (2020)	3.) I consider myself to be at risk of this disease
		4.) I am more likely to get this disease
		5.) I don’t care about this disease and do my daily activities like before
	Guidry et al. (2021)	6.) It is likely that I will get this disease
Perceived Severity
	Shmueli (2021)	Even if I get infected with this disease…
		1.) …I do not think it will cause me significant suffering or complications
		2.) …the likelihood of recovering is very high
	Shahnazi et al. (2020)	3.) This disease has a high mortality rate
		4.) This disease is not very dangerous
		5.) The transmission power of this disease is high
	Guidry et al. (2021)	6.) It would be serious for me to get this disease in the next few months
Perceived Barriers
	Shmueli (2021)	1.) Getting vaccinated is expensive requires time and effort
	Shahnazi et al. (2020)	2.) It is difficult to follow the instructions to prevent this disease
		3.) I don’t have the patience to follow preventative instructions
		4.) It is difficult to wash hands regularly with soap and water
		5.) The mask is scarce in the market, and thus I do not wear a mask
		6.) Disinfectant gels and solutions are scarce and expensive in the market
		7.) Alcohol pads are scarce in the market
		8.) It is difficult not to touch hands mouth, nose, and eyes
		9.) Staying at home to prevent this disease is difficult
	Guidry et al. (2021)	10.) To what extent do you agree that the current recommended preventative actions are inconvenient to follow
Perceived Benefits
	Shmueli (2021)	1.) I believe that this disease vaccine will have high efficacy in preventing significant suffering and complications of the disease
		2.) I believe that if I get vaccinated against this disease the risk of getting infected with the disease or infecting others will decrease
	Shahnazi et al. (2020)	This disease can be easily prevented by…
		3.) …washing hands regularly with soap and water
		4.) …personal protective equipment such as masks and disposable gloves
	Guidry et al. (2021)	5.) To what extent do you agree that current recommended preventative actions can prevent contracting and spreading this disease
Self-Efficacy
	Shmueli (2021)	1.) If I take all of the necessary precautions (disinfection of hands, etc.) I do not need to be vaccinated against this disease
	Shahnazi et al. (2020)	2.) I have the ability to follow every preventative instruction against this disease
	Guidry et al. (2020)	3.) How confident are you that you yourself can prevent yourself getting this disease

Appendix B

TPB Components	Item
Subjective Norms
1.) People who are important to me
	2.) People who are my family
	3.) People who are my friends
	4.) I feel/felt under social pressure to get a COVID-19 vaccination
	5.) People who are important to me influence(d) my decision to get a COVID-19 vaccination
Perceived Behavioral Control
	1.) Getting the COVID-19 Vaccination would be easy for me
	2.) It would be a good idea to get the COVID-19 Vaccination
	3.) Whether or not I get the COVID-19 vaccine is completely up to me
	4.) If I really wanted to, I know I could get the COVID-19 vaccine
	5.) It would be difficult for me to get the COVID-19 vaccine
	6.) I am confident I can find a place to receive the COVID-19 vaccine

1. Note. All items in Appendix B are from Husain et al. (2021).

Appendix C

COVID Conspiracies	Item
Government
Olesky et al. (2021)	1.) I think that the development of the pandemic may be beneficial to certain groups whose interests we are unaware of
	2.) I think there are groups interested in exaggerating the panic over COVID-19 to achieve their own goals
	3.) I think that the coronavirus was created in the laboratory as a biological weapon
	4.) I believe that the authorities are hiding the true scale of victims of the pandemic from society
Imhoff & Lamberty (2020)	5.) COVID-19 was intentionally brought into the world to reduce the population
	6.) Dark forces want to use the virus to rule the world
	7.) I think it is nonsense that the virus was created in a laboratory
Hoax
Olesky et al. (2021)	8.) I wouldn’t be surprised if after some time, it turned out that COVID-19 doesn’t exist
Imhoff & Lamberty (2020)	9.) COVID-19 is intentionally presented as dangerous in order to mislead the public
	10.) Experts intentionally mislead us for their own benefit, even though the virus is not worse than a flu
	11.) We should believe experts when they say that the virus is dangerous