Since the first case of COVID-19, the disease caused by the novel coronavirus SARS-CoV-2 that was first reported in December 2019 in Wuhan, Hubei Province, China, the virus has achieved a global spread. While China has reported a significant reduction of new cases, the outbreak continues to escalate in other parts of the world. The virus is especially difficult to control as many infected individuals experience only mild to moderate respiratory symptoms and recover with no medical treatment [1]. Despite efforts to develop an effective treatment for COVID-19 and a vaccine against the virus, currently there is nothing yet available that has been shown to be effective. Public officials in the United States have suggested that a vaccine against Sars-CoV-2 will likely be available in 12 to 18 months [2]; [3].
While the public awaits a vaccine, public health measures need to be taken to stop the spread of SARS-CoV-2. To both prevent and slow transmission of the virus, the WHO has recommended protective behaviors such as regularly washing hands with soap and water or alcohol-based hand sanitizers, keeping a distance of at least one meter from others, avoiding crowded places, covering the mouth and nose when coughing, staying at home or self-isolating at home, and practicing physical activities [4] [5]. Governments have disseminated information and encouraged people to stay at home through television, newspapers, internet-based media, and social media. However, hoaxes, rumors, and false information are also spreading through social media, which has influenced the public’s perception of COVID-19.
Although the majority of people strongly support social distancing practices, the number of people who refuse to socially distance remains high. For example, a Politico/Morning Consult Poll involving 1,991 people conducted from April 21-26, 2020 in the United States revealed that 73% of respondents socially distanced, with 15% refusing to engage in the practice [6]. In India, Bangladesh, Pakistan, and Indonesia people continue to go to shopping malls, houses of worship, tourism destinations, as well as continue to use public transport [7]; [8], which are activities that make social distancing difficult. As governments decide not to impose lockdown policies, effective control over the spread of the virus and minimizing the effects of the pandemic will be dependent on public behavior. Exploring factors that determine whether people adopt social distancing measures is, therefore, critical to reducing the spread of the virus. As Indonesia is one the most densely populated and diverse countries in terms of culture, race, language, and religion, the population is especially vulnerable to COVID-19.
One theory used to explore factors that determine whether people practice social distancing behavior is the Theory of Planned Behavior (TPB) [9]. The TPB is popular as it can be used to explain a wide-range of behaviors and can be applied to different populations and contexts [10]; [11]; [12]; [13]; [14]; [15]; [16]. According to the TPB, behavior is predicted by intention, and intention is influenced by attitudes towards the behavior, subjective norms, and perceived behavior control (PBC). The more strongly an individual holds an attitude, subjective norm, or PBC towards a behavior, the more likely the person intends to perform the behavior. Based on this theory, attitude is the degree to which a person is in favor (or not) of a particular behavior. A person who accepts as true that performing a certain behavior will lead to a mostly positive outcome will hold a favorable attitude towards performing the behavior [9]. Social norms are a function of beliefs that most referents will approve and support a particular behavior, which will exert pressure on an individual to perform the behavior. Referents can be family members, religious leaders, friends, and teachers. Another component of the TPB is PBC. PCB refers to a person's perception of whether there is an aid or obstacle to performing a given behavior [17].
Due to the widespread news during the COVID-19 outbreak, it is advantageous to include other variables related to the performance of health behaviors: risk perception and media use [18]. Previous studies that have applied the TPB have demonstrated an increasing predictive ability of the model by adding more TPB variables [19]; [20]; [21]; [22]. Risk perception, in particular, has been widely used to investigate protective behavior. A number of studies have concluded that disaster preparedness and health-risk behavior is influenced by risk perception [23]; [24]. For example, the Health Behavior Model (HBM) theory posits that people will perform health behaviors in response to perceived susceptibility, severity, benefits, barriers, and cues to action [25]. Moreover, the integration of risk perception and the TPB has been found to be effective in studies of dental flossing [26], predicting safe food handling in adolescents [27], and the intention to take precautions to avoid consuming foods with additives [28]. However, few studies have been conducted that include risk perception in determining the components of the TPB.
The causal relationship between information and risk perception has also been studied. For instance, the effect of audience motivation and influence of news media on risk perception [29]; [30]; [31]. Most researchers agree that information and an individual’s level of knowledge can positively influence protective behavior [32]. For example, the results of a study on malaria prevention in Rwanda showed that providing timely malaria-related information improved the ability of people to control and eliminate the disease [33]. Likewise, the results of review on inaccurate communication regarding mortality caused by air pollution showed that shifting the focus away from blame to more accurate and clear information help people change their behaviors [34]. Another study that applied the extended TPB found evidence to support the important role of information in determining behavioral changes. However, the role of media use in influencing attitudes, social norms, and PBC are limited, especially in the context of a pandemic.
Other studies related to health behavior have investigated the role of demographic variables in determining health behavior. In particular, gender, age, and income are often used to explain variation in behavior. One study, conducted by Mniszewski and his colleagues [35], concerned the use of face masks during an epidemic in Southern California. They found that using masks was correlated with an individual's age and gender, whereby females and older adults were more likely to wear a mask than males or youths. Other studies that have investigated the relationship between demographic variables and protective behavior support findings such as income differences concerning the prevention of SARS [36] and the association between age and preventative cardiovascular disease behaviors [37].
The purpose of this study was to explore people’s intention to practice social distancing during the COVID-19 pandemic based on the extended TPB. We proposed the following hypotheses:
- Hypothesis 1 (H1): Attitude positively influences the intention to socially distance
- Hypothesis 2 (H2): Subjective norms influence the intention to socially distance
- Hypothesis 3 (H3): PBC positively influences the intention to socially distance
- Hypothesis 4 (H4): Risk perception positively influences attitudes towards social distancing
- Hypothesis 5 (H5): Risk perception positively influences subjective norms
- Hypothesis 6 (H6): Risk perception positively influences PBC
- Hypothesis 7 (H7): Media use positively influences risk perception
- Hypothesis 8 (H8): Media use positively influences attitudes towards social distancing
- Hypothesis 9 (H9): Media use positively influences subjective norms
- Hypothesis 10 (H10): Media use positively influences PBC
We also explored demographic variables such gender, age and residential areas relative to the intension to socially distance. Previous studies have supported the idea that there are different behaviors between males and females, elder and young people, as well as whether one lives in a rural or urban area.