From contextual risk to preventive health behavior in a pandemic: a serial mediation analysis

While research shows that contextual characteristics affect health outcomes, their effect on preventive behaviors is understudied. Therefore, this study examines the relationship between regional infection risk and adherence to COVID-19 preventive behavior, examining frequency of information received about the local situation (from news and social contacts) and perceived susceptibility as mediators. We combined official data on county-level seven-day COVID-19 incidence rates, as an indicator of contextual risk, with a representative survey in Germany (N = 9,023). In line with previous theorizing, we operationalized perceived susceptibility conditional on taking no preventive measures. Serial mediation using structural equation modeling shows that individuals in regions with higher incidence rates engaged in more preventive behavior. The relationship between incidence rates and adherence is serially mediated by information frequency and perceived susceptibility. This study elucidates the complex pathways by which the proximal environment influences health-related information, cognitions, and behavior, further demonstrating the importance of perceived susceptibility in this process.