The Pandemic within a Pandemic: Testing a Sequential Mediation Model to Better Understand Racial/Ethnic Disparities in COVID-19 Preventive Behavior.

Recent Centers for Disease Control and Prevention (CDC) data reveal that COVID-19 hospitalization and mortality rates are higher for certain racial/ethnic groups. Labeled as the "pandemic within a pandemic", African Americans and Hispanics are bearing more of the brunt of the disease compared to Caucasians. Testing a new sequential mediation model on a sample of 483 US African American, Caucasian, and Hispanic adults, the present study investigates the role of fear of COVID-19, information receptivity, perceived knowledge, and self-efficacy to explain disparities in preventive behaviors. Study contributions include the specification of a new predictive model that improves upon the long-used Health Belief Model (HBM). The Sequential Mediation Model appears to have greater explanatory capacity than the HBM. Study results also provide important insights into racial/ethnic differences in health-seeking behavior related to the coronavirus. Findings show that African Americans reported higher levels of preventive behaviors and self-efficacy than Caucasians. It is possible that SES, rather than race per se, is more important in explaining differences in COVID-19 preventive behaviors. Certain "cues to action" (precipitating factors) also help explain this somewhat surprising result. Additionally, significant differences were found across the three racial/ethnic groups for all the new model's variables except perceived knowledge. The new model was supported across all three racial/ethnic groups with notable differences across each group. Given the severity of implications surrounding the COVID-19 pandemic (physical, mental, and economic), it is critical that an improved understanding of what drives individual health-seeking behavior be achieved. Study limitations and future research suggestions are discussed.