The adoption of preventive behaviors during the COVID-19 pandemic in China and Israel

Xue Jing Liu, Gustavo S. Mesch

    Research output: Contribution to journalArticlepeer-review


    The COVID-19 pandemic represents a massive global health crisis. The rapid transmission rate of the virus, as well as the lack of effective medications and vaccines, has posed serious challenges to controlling the spread of the disease. Dealing with this public health crisis has required major changes in people’s behavior, including the adoption of social distancing measures such as avoiding meeting with family members and friends, crowded places, and public transportation. The purpose of this study is to investigate the factors associated with the adoption of these behaviors in China and Israel. We relied on the 3Cs model that has been used to predict the adoption of a specific preventive behavior (vaccinations) with the goal of testing its applicability to other preventive behaviors such as in response to the COVID-19 pandemic. The model indicates that confidence in social institutions, complacency (fear of and assessments about the risk of becoming ill) and constraints (levels of self-efficacy and confidence in being able to engage in the behaviors) are predictors of adopting preventive behaviors. Data were collected in China and Israel through an online survey of the population (n = 1406). We used latent variables and structural equation modeling to test the hypotheses derived from the 3Cs model. The findings indicate that there are some differences in the types of preventive behaviors adopted in the two countries. In Israel, higher levels of confidence predicted the adoption of avoidant behaviors and more constraints predicted engaging in fewer avoidant behaviors. In China, more constraints also contributed to the adoption of fewer avoidant behaviors, but people’s level of confidence fully mediated this result. The multi-group analysis indicated that the conceptualized model fits the Chinese and Israeli data reasonably well. The findings suggest that the 3Cs model can be generalized from getting vaccinated to adopting avoidant behaviors and that the model can be used across cultures and countries.

    Original languageEnglish
    Article number7170
    Pages (from-to)1-18
    Number of pages18
    JournalInternational Journal of Environmental Research and Public Health
    Issue number19
    StatePublished - 1 Oct 2020

    Bibliographical note

    Publisher Copyright:
    © 2020 by the authors. Licensee MDPI, Basel, Switzerland.


    • 3C’s model
    • COVID19
    • Preventive behaviors
    • Social distance

    ASJC Scopus subject areas

    • Public Health, Environmental and Occupational Health
    • Health, Toxicology and Mutagenesis


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