COVID-19 mitigation behaviors and vaccination status prediction via delay discounting and future orientation

In a recent study posted to the medRxiv* preprint server, researchers investigated the cognitive factors that influence coronavirus disease 2019 (COVID-19) vaccination and protective behaviors in a population-based representative sample of Canadians aged 18 to 55 years.

Study: Cognitive predictors of vaccine hesitancy and COVID-19 mitigation behaviors in a population representative sample. Image Credit: New Africa/ShutterstockStudy: Cognitive predictors of vaccine hesitancy and COVID-19 mitigation behaviors in a population representative sample. Image Credit: New Africa/Shutterstock

With the COVID-19 pandemic still raging two years after it started in late 2019, identifying predictors of vaccine reluctance and mitigating behaviors is crucial. Prior research has revealed that cognitive characteristics are linked to several COVID-19 mitigation activities, but few studies use representative samples. Also, no prior research has looked at cognitive predictors of vaccine reluctance.

About the study

The present study included 18-55 years old Canadian adults, who were respondents in Wave 1 of the Canadian COVID-19 Experiences Survey, a national cohort survey of 2002. The cohort was designed to contain an equal number of those who had been vaccinated and those who had been hesitant to get vaccinated. Over 50% of the recruited individuals reported receiving two vaccine shots (i.e., were fully vaccinated according to the requirements at the time of data collection), while 43.3% reported no immunizations. A further 5.5% of the participants reported having one vaccine shot but had no plans to receive a second.

An online survey was conducted between September 28 and October 21, 2021. Participants were invited to take the survey through email, with a link sent to all qualified participants. To achieve an equal sample of vaccinated and vaccination-reluctant people, a quota objective of equal numbers of vaccinated and vaccine-hesitant individuals was used. Participants were sought from 10 Canadian provinces for each quota target.

Key findings

The findings demonstrated that those with higher executive function, reduced delay discounting, and greater future orientation were more likely to be vaccinated and engage in crucial COVID-19 mitigation activities (i.e., social distancing, mask-wearing, and hand hygiene). This was true across a wide range of demographic characteristics, including age and gender, and was supported by several sensitivity studies. Delay discounting and future orientation were the two cognitive characteristics that consistently predicted COVID-19 vaccination and mitigation actions.

This shows that the value processing that guards non-immediate outcomes from discounting and a cognitive appreciation of links between present acts and future effects are both critical in COVID-19 mitigation. Although there are neurobiological underpinnings, delay discounting and future orientation are potentially adjustable cognitive processes, and public health messaging emphasizing the importance of non-immediate outcomes may be especially crucial. On the other hand, executive dysfunction was linked to a more limited set of COVID-19 mitigation activities. Higher executive dysfunction was associated with less consistent mask-wearing and hand hygiene, which are both repetitive, discrete actions and acts of commission.

Social distancing was the least expected of the three mitigating strategies studied based on the neurocognitive variables evaluated. Given its linkages to the social fabric of everyday life, the social distance may be better predicted by social-cognitive variables (e.g., beliefs about and attitudes toward other individuals and groups) rather than the physical surroundings and de-contextualized behavior. This possibility may deserve additional investigation, given that social distancing is basically a relational activity with interpersonal repercussions.

The findings are in line with those of a number of other studies that have discovered links between executive functions and mitigation behaviors. However, this research adds to previous studies by using delay discounting and demonstrating that the relationships are the same for both vaccinated and vaccine-hesitant people.

In the population survey format, there were limitations such as the use of self-reported vaccination status and executive function, as well as shorter versions of temporal perspective measures. Also, the age range of the sample is 18-55 years, eliminating senior individuals and adolescents.

In conclusion, the data imply that cognitive characteristics such as future-oriented thinking, evaluative processing, and behavioral control are linked to the likelihood of being fully vaccinated against COVID-19 and predict more consistent mitigation behavior implementation. Health communication initiatives that reinforce and stress good future results, as well as links between current activities and subsequent consequences, may help the general public respond more positively. However, it's feasible that communications stressing more immediate benefits will have a greater impact on a less attentive population.

Among the three cognitive variables, delay discounting and future orientation were the most consistently predictive of COVID-19 vaccination and mitigation behaviors.”

*Important notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:
Saurabh Chaturvedi

Written by

Saurabh Chaturvedi

Saurabh Chaturvedi is a freelance writer from Jaipur, India. He is a gold medalist in Masters in Pharmaceutical Chemistry and has extensive experience in medical writing. He is passionate about reading and enjoys watching sci-fi movies.

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