Psychological disease avoidance linked to preventative behavior, study finds

Creeped out by cooties? Grossed out by germs? Squeamish about sickness?

If so, then you might also find yourself engaging in more preventative health behaviors, like frequent handwashing and disinfecting your living environment, during the ongoing coronavirus pandemic.

More than other factors, strong feelings of germ aversion and pathogen disgust are significantly associated with concern about COVID-19 and preventative behavior, according to findings from UConn School of Nursing researchers published in the journal PLOS ONE.

The findings are part of a year-long examination of how behavior and social attitudes change, and what factors influence those changes, when people in the United States are faced with the threat of widespread disease. Supported by a National Science Foundation grant, the study is tracking the well-being, feelings, and behavioral practices of about 1,000 individuals across the country, and more than 18 surveys of the participants have already been conducted since kicking off in March.

“When we feel disgust toward something, our behavioral response is to avoid it and get away from it, but people vary in their experience of disgust,” says Natalie J. Shook, a social psychologist, associate professor, and principal investigator for the study. “In thinking about these psychological processes, what we’re interested in is whether people who are already more sensitive to potential disease threats are then more inclined to follow prescribed preventative health behaviors.”

Shook and her team asked study participants about their overall concerns about COVID-19 and about how often they engaged in preventative health behaviors like physical distancing, frequent hand washing, avoiding touching their face, wearing a facemask, and cleaning and disinfecting.

Participants also answered a series of demographic and social questions, including their age, political and religious values, and socioeconomic status, as well as questions designed to gauge risk factors for the disease – whether they had an underlying health condition that might predispose them to severe illness, whether a family member might be at greater perceived risk, or whether they recently had or believed that they had been ill with COVID-19.

“What we found in our data set was that the most consistent predictors of concern about COVID and then engagement in preventative health behaviors are actually those psychological disease avoidance factors,” says Shook.

More than factors like age, perceived risk, or political stance, individuals who indicated strong feelings of germ aversion and pathogen disgust also reported greater concern for COVID-19 and increased participation in preventative behaviors. The researchers also found that the people most likely to be impacted by the virus are not necessarily those most likely to be engaging in preventative behaviors.

“Older participants reported more concern about COVID, which makes sense – they’re at higher risk,” Shook says. “But when we looked at preventative health behaviors, we weren’t necessarily seeing that older adults were engaging more in preventative health behaviors. So, where there was the concern, that wasn’t necessarily translating into the behaviors that could protect them.”

Individuals with higher incomes were associated with more engagement in physical distancing and cleaning behaviors, but they would also have greater access to resources – like cleaning supplies – and the potential to work from home because of their socioeconomic status, Shook says. Recent illness and general perceived health were also linked with many preventative health behaviors, though the individual reasons could vary, from motivations to prevent others from becoming ill to greater awareness due to recent illness.

Shook and her team say their findings identify a variety of characteristics that may place individuals at risk for contracting and spreading disease during a pandemic.

“We took a really broad approach to looking at the different factors that are related to different preventative health behaviors,” says Shook. “The fact we are seeing psychological disease avoidance variables as coming out more consistently – which conceptually was not surprising, that’s what they should be doing, but that we’re seeing those above and beyond traditional personality traits and demographics – I think might speak to something we could potentially tap into.”

Shook and her team hope to release additional findings related to initial survey data – including findings on mental health, job security and financial concerns, and vaccination related to COVID-19 – to be released in the coming weeks and months as their year-long examination continues.

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This study is supported by NSF Award No. 2027027. UConn’s Institute for Collaboration on Health, Intervention, and Policy (InCHIP) is the managing institute for the grant. Please visit nsf.gov for more information, and visit chip.uconn.edu to learn more about InCHIP and its Rapid Response Proposals to Address COVID-19.