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. 2023 Jun 19;41(27):4019-4026.
doi: 10.1016/j.vaccine.2022.10.004. Epub 2022 Oct 13.

Cognitive predictors of COVID-19 mitigation behaviors in vaccinated and unvaccinated general population members

Anna Hudson  1 , Peter A Hall  2 , Sara C Hitchman  3 , Gang Meng  4 , Geoffrey T Fong  5
Affiliations

Cognitive predictors of COVID-19 mitigation behaviors in vaccinated and unvaccinated general population members

Anna Hudson et al. Vaccine. .

Abstract

Background: Given the long-term threat posed by COVID-19, predictors of mitigation behaviors are critical to identify. Prior studies have found that cognitive factors are associated with some COVID-19 mitigation behaviors, but few studies employ representative samples and no prior studies have examined cognitive predictors of vaccination status. The purpose of the present study was to examine associations between cognitive variables (executive function, delay discounting, and future orientation) and COVID-19 mitigation behaviors (mask wearing, social distancing, hand hygiene and vaccination) in a population representative sample.

Methods: A population representative sample of 2,002 adults completed validated measures of delay discounting, future orientation, and executive function. Participants also reported frequency of mitigation behaviors, vaccination status, and demographics.

Results: Future orientation was associated with more mask wearing (β = 0.160, 95 % CI [0.090, 0.220], p < 0.001), social distancing (β = 0.150, 95 % CI [0.070, 0.240], p < 0.001), hand hygiene behaviors (β = 0.090, 95 % CI [0.000, 0.190], p = 0.054), and a higher likelihood of being fully vaccinated (OR = 0.80, 95 % CI [0.670, 0.970], p = 0.020). Lower delay discounting predicted more consistent mask wearing (β = -0.060, 95 % CI[-0.120, -0.010], p = 0.032) and being fully vaccinated (OR = 1.28, 95 % CI [1.13, 1.44], p < 0.001), while more symptoms of executive dysfunction predicted less mask wearing (β = -0.240, 95 % CI [-0.320, -0.150] p < 0.001) and hand hygiene (β = -0.220, 95 % CI [-0.320, -0.130], p < 0.001), but not vaccination status (OR = 0.96, 95 % CI [0.80, 1.16], p = 0.690) or social distancing behaviors (β = -0.080, 95 % CI [-0.180, 0.020], p = 0.097). Overall, social distancing was the least well-predicted outcome from cognitive factors, while mask wearing was most well-predicted. Vaccination status was not a significant moderator of these effects of cognitive predictors on mitigation behaviors.

Conclusions: Cognitive variables predict significant variability in mitigation behaviors. regardless of vaccination status. In particular, thinking about the future and discounting it less may encourage more consistent implementation of mitigating behaviors.

Keywords: COVID-19; Executive functions; Mitigating behaviors; SARS-CoV-2; Vaccination.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Main effects of (a) delay discounting, (b) executive function, and (c) future orientation on frequency of COVID-19 mitigation behaviors. Higher scores on the y-axis reflect increased frequency of behavior performance. Participants were split into the lower (pink), mid (green), and higher categories (white) based on z-scores (-1.0, 0, +1.0). Error bars represent standard errors. Created with BioRender.com. (For interpretation of the references to colour in this figure legend, the reader is referred to the web version of this article.)
See this image and copyright information in PMC

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