Analysis of the Relationship Between Vertical Collectivism, Health

Behaviors, and Covid-19 Vaccine Intentions:

Based on the “Process-Person-Situation-Time” Model

Zijian Zhang, Jiwen Chen, Shuangshuang Cai, Lei Xu and Shun Peng

Psychology Department, Jianghan University, 8 Sanjiaohu Road, Wuhan, Hubei, 430060, China

Keywords: R, Path Analysis, Vertical Collectivism, Health Behavior, COVID-19 Vaccine Willingness, COVID-19

Attitudes.

Abstract: The purpose of this study was to examine the relationship among vertical collectivism, health behaviors, and

vaccine intentions; and the mediating role of COVID-19 attitudes. A total of 2244 participations was collected

in this study. R software environment was used to conduct the path analysis in this study. The results showed

that (1) there was a significant positive relationship between vertical collectivism, individuals' health

behaviors and COVID-19 vaccine intentions; (2) COVID-19 attitudes mediated the relationship between

vertical collectivism, health behaviors, and COVID-19 vaccine intentions. The results of this study have

theoretical and practical implications for the prevention and vaccination of neo-coronavirus, and this study

also provides empirical evidence to use R software environment and new methodological approaches in public

health area.

1 INTRODUCTION

COVID-19 was officially classified as a global

pandemic in March 2020 (WHO 2020 Coronavirus

disease (COVID-19) Situation Report). To reduce the

spread of the virus and reduce the likelihood of

illness, most countries recommend or require

individuals to adopt or partially adopt healthy

behaviours (e.g., social distance and wearing masks)

to curb the spread of the virus, and to reduce the strain

on national public health systems and the number of

deaths (National Health Commission of the PRC

Prevention and control of COVID19). The

governments and WHO provided guidelines for

healthy behaviours such as frequent hand washing,

avoiding facial contact, disinfecting touched objects,

maintaining social distance, and wearing masks; In

addition, vaccination is effective in reducing group

infection rates and prevent serious illness after

infection (WHO 2020 Coronavirus disease (COVID-

19) Situation Report; National Health Commission of

the PRC Prevention and control of COVID19).

Despite global calls from governments and mass

media, there are still significant differences in

Corresponding author’s e-mail

people’s health behaviours in different regions

(Anderson, 2020). Therefore, it becomes necessary to

understand the mechanisms by which individuals'

health behaviours occur and develop during a new

crown epidemic.

1.1 Vertical Collectivism, Health

Behaviors, and Covid-19 Vaccine

Intention

Although there have been many studies

demonstrating the effectiveness of health behaviors

and the covid-19 vaccine (Lewnard, 2020; Kim,

2021), not all individuals adopt them. One reason is

that these behaviors require individuals to make some

sacrifices for the health of others and the community.

For example, maintaining social distance may require

separation from family and friends; wearing a mask

may cause discomfort; and vaccinations may have

side effects. These practices could be regarded as

social dilemma in which individuals’ short-term

interests conflict with collective long-term interests

(Bogaert, 2008; Van Lange, 2013). Henceforth,

researchers have attempted to understand individuals'

Zhang, Z., Chen, J., Cai, S., Xu, L. and Peng, S.

Analysis of the Relationship Between Vertical Collectivism, Health Behaviors, and Covid-19 Vaccine Intentions: Based on the “Process-Person-Situation-Time” Model.

DOI: 10.5220/0012040300003620

In Proceedings of the 4th International Conference on Economic Management and Model Engineering (ICEMME 2022), pages 599-603

ISBN: 978-989-758-636-1

 2023 by SCITEPRESS – Science and Technology Publications, Lda. Under CC license (CC BY-NC-ND 4.0)

599

health behaviors and vaccination intentions during

COVID-19 from a collectivist-individualist

perspective (Huang, 2020).

Vertical collectivism is the recognition of

hierarchical relationships among members of a

society, emphasizing solidarity within the group,

advocating individual service, dedication, and even

sacrifice for the collective (Singelis, 1995).

Biddlestone, Green, and Douglas have found that,

vertical collectivism positively predicted the level of

individuals' intentions to maintain social distance

during COVID-19 and high vertical collectivism

individuals also have a higher vaccine hesitancy

(Biddlestone, 2020). Furthermore, the pathogen

prevalence hypothesis suggests that collectivists are

more likely to consider the interests of others than to

focus solely on their own interests (Arnocky, 2007);

and collectivism is more likely than individualism to

promote individuals to adopt health behaviors and

protective collective behaviors such as vaccination in

the face of epidemics (Murray, 2011). Therefore, the

hypothesis of this study was that significant positive

relationships among vertical collectivism,

individuals' health behaviors and COVID-19 vaccine

intention (H1).

1.2 The Mediating Role of COVID-19

Attitudes

For individuals, public health policies/

recommendations may bring some economic and

psychological costs. The effectiveness of these

measures depends on public attitudes toward

COVID-19 (Galasso, 2020), which influences an

individual's response to emotions (Ahmed, 2020).

Numerous studies have shown that attitudes have a

direct impact on individuals' behavior, such as

COVID-19-related studies have shown that COVID-

19 attitudes are significantly and positively

associated with the frequency of behaviors, such as

keeping social distance, washing hands, and

sanitizing (Shook, 2020).

Vertical collectivism can evoke individuals'

concerns about collective threats and thus increase

their worries about such threats (Xiao, 2021).

Furthermore, the Process-Person-Context-Time

Model suggests that there is a “distal and proximal"

distinction between the factors that influence

individual development (Bronfenbrenner, 2005). The

"distal factors" influence individual behavior through

the mediation of the "proximal factor". In the present

study, vertical collectivism as an individual value can

be considered as a distal factor, while COVID-19

attitude as an influenced emotional state can be

considered as a proximal factor. Therefore, this study

hypothesized that COVID-19 attitudes mediate

between vertical collectivism, health behaviors, and

COVID-19 vaccine intentions (H2).

2 RESEARCH METHOD

2.1 Participants

This study adopted the method of online survey

research, and a total of 2511 subjects participated in

this study. Finally, 2244 valid questionnaires were

obtained, with the efficiency of questionnaire was

89.37%. Among them, 810 (36.10%) were male and

1434 (63.90%) were female. The average age of the

subjects was 22.06 years (SD = 7.22).

2.2 Measurements

2.2.1 Health Behavior

The Coronavirus Safety Behaviors Scale was used to

assess the individuals' health behaviors during the

new crown outbreak, which consists of 9 items with

a 11-point scale as score (0 "none" ~ 10 "very much")

(Knowles, 2021). Higher scores indicated a higher

frequency of hygienic behaviors among individuals.

The Cronbach's α coefficient for this scale in the

present study was 0.89.

2.2.2 COVID-19 Vaccination Intention

The Vaccine Behavioural Intentions scale developed

by Head et al. was used, which consists of 2 items.

The question was scored on an 11-point scale (0 "very

unlikely" ~ 10 "very likely") (Head, 2020). The

higher the score, the more likely the individual was

to be vaccinated. In this study, Cronbach's α

coefficient for this scale was 0.71.

2.2.3 COVID-19 Attitude

The COVID-19 attitude scale including 7 items was

modified from the Swine Flu inventory to assess

individuals' concerns about the spread of the COVID-

19 virus (Wheaton, 2012). The questionnaire was

scored on an 11-point scale (0 "very unlikely" ~ 10

"very likely"). Higher scores indicated that the

individual was more worried about the spread of the

COVID-19 virus. The Cronbach's α coefficient for

this scale in this study was 0.82.

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2.2.4 Vertical Collectivism

The vertical collectivism subscale of the

individualism-collectivism questionnaire revised by

Wang et al. was used, which consists of 3 items on a

5-point scale (1 "totally disagree" ~ "totally agree")

(Yongli, 2003). The higher the score, the higher the

individual's level of vertical collectivism. The

Cronbach's α coefficient for this subscale in this study

was 0.77.

2.3 Data Analysis Method

In this study, R was used to analyze the data, rstatix

package was used to conduct descriptive statistics,

psych package was adopted to reliability test, and

lavaan package was used for testing path analysis.

3 RESULTS

3.1 Descriptive Statistical Results

Correlation analysis showed (see Table 1) that age

was significantly and positively correlated with

vertical collectivism, COVID-19 attitudes, and health

behaviors; gender was significantly and positively

correlated with vertical collectivism, COVID-19

attitudes, and negatively correlated with health

behaviors; vertical collectivism was significantly and

positively correlated with COVID-19 attitudes,

health behaviors, and COVID-19 vaccine intentions.

There was a significant positive correlation between

COVID-19 attitude and health behavior, and

COVID-19 vaccine willingness; there was a

significant positive correlation between health

behavior and COVID-19 vaccine willingness.

3.2 Mediating Model Test

In this study, gender and age were included as control

variables in the mediation model, vertical

collectivism as the independent variable, COVID-19

attitude as the mediating variable, health behaviors

and vaccination intentions as the dependent variables.

The results of path analysis showed that vertical

collectivism (β = 0.29, se = 0.02, 95% CI = [0.25,

0.33]), age (β = 0.10, 95% CI = [0.06, 0.14]) and

gender (β = 0.04, 95% CI = [0.005, 0.084]) were

significant positive predictors of COVID-19

attitudes. The positive effect of COVID-19 attitudes

(β = 0.17, se = 0.02, 95% CI = [0.13, 0.21]) and

vertical collectivism (β = 0.30, se = 0.02, 95% CI =

[0.26, 0.34]) were significant positive predictors of

health behaviors, whereas age (β = -0.06, se = 0.02,

95%CI = [-0.10, -0.02]) and gender (β = -0.10, se =

0.02, 95%CI = [-0.13, -0.06]) had a significant

negative predictive effect on health

behaviors.COVID-19 attitudes (β = 0.12, se = 0.02,

95% CI = [0.08, 0.16]) and vertical collectivism (β =

0.16, se = 0.02, 95% CI = [0.12, 0.20]) had a

significant positive predictive effect on COVID-119

vaccination intention, while age (β = -0.05, se = 0.02,

95% CI = [-0.09, -0.01]) had a significant positive

predictive effect on COVID-119 vaccination. There

was a significant negative predictive effect of

intention and a non-significant effect of gender (β = -

0.04, se = 0.02, 95% CI = [-0.08, 0.01]) on COVID-

19 vaccination intention. See Figure 1 for details.

Table 1: Results of descriptive statistics for each variable.

1 2 3 4 5 6

1 Age —

2 Gender −0.03 —

3 Vertical collectivism 0.28

***

0.10

—

4 Health behaviors 0.06

−0.05

0.33

***

—

5 COVID-19 vaccine

intention

0.02 −0.01 0.18

***

0.34

***

—

6 COVID-19 attitudes 0.18

***

0.07

0.32

***

0.25

***

0.16

***

—

M 22.06 0.36 5.20 8.37 7.81 6.63

SD 7.22 0.48 1.03 1.52 2.03 1.46

Note: n = 2244. * p < .05, ** p < .01, *** p < .001, Gender as a dummy variable, 0 = male, 1 = female.

Mediating effects were further examined using a

bias-corrected percentile nonparametric bootstrap

procedure. The indirect effect of vertical collectivism

via COVID-19 attitudes on health behaviors was

0.049 (se = 0.007, p < 0.001, 95% CI = [0.036,

0.062]) and the indirect effect of vertical collectivism

Analysis of the Relationship Between Vertical Collectivism, Health Behaviors, and Covid-19 Vaccine Intentions: Based on the

“Process-Person-Situation-Time” Model

601

via COVID-19 attitudes on COVID-119 vaccination

intentions was 0.035 (se = 0.007, p < 0.001, 95% CI

= [0.021, 0.048]).

Figure 1: A mediation model for Covid-19 attitude.

4 DISCUSSION

This study found a significant positive predictive

effect of vertical collectivism on individuals' health

behaviors and COVID-19 vaccine intention; and the

results are consistent with previous studies

(Biddlestone, 2020). This result better explained the

current status quo, where individuals in collectivist

cultural areas have relatively higher levels of health

behaviors (e.g., mask-wearing rates) and vaccination

rates. The attachment theory suggests that individuals

activate instinctive attachment system when facing

with threats such as death, illness, or failure. Thus

individuals develop a deep-seated and largely

unconscious desire to avoid isolation from others, to

seek closeness and support from close groups; and to

respond positively to people or in-group members

who support their cultural values (Pyszczynsk, 1997).

This is especially true for collectivists, where

adherence to social norms is an important response to

a collective crisis (Murray, 2011). In addition, high

collectivists are subject to more moral and

interpersonal pressures (MENG, 2021). The more

individuals need the collective (high-vertical

collectivists), the more likely they are to "protect the

collective" or "conform to collective norms" when

the collective is under greater threat (the group places

more emphasis on "group guarding" behaviors) to

avoid being judged as unethical, thus leading them to

act in a way that protects the collective (e.g., healthier

behaviors and higher willingness to take the COVID-

19 vaccine).

In addition, this study found that COVID-19

attitudes mediated the relationship between vertical

collectivism, health behaviors, and COVID-19

vaccine intentions. Significant differences in current

prevention behaviors remain between people in

different regions (Anderson, 2020). Variables such as

cultural value will help shed light on the above issues.

Cultural psychology focuses on two dimensions:

individualism, which emphasizes individual needs

over group needs; and collectivism, which

emphasizes group needs above individual needs

(Hofstede, 2010). The pathogen prevalence

hypothesis argues that collectivism is more likely to

promote protection against epidemics than

individualism (Murray, 2011). As collectivism places

more emphasis on in-group vigilance (Liu, 2019),

this may contribute to people's intention to prevent

COVID-19 by increasing the level of concern and

worry about COVID-19. On the other hand, as

pointed out by the theory of Planned Behavior,

COVID-19 attitudes toward subjective norms like

collectivism (Subject Norm) significantly increase

individuals' adoption of health behaviors and increase

the willingness to adopt healthy behaviors, such as

vaccine. This result validates the pathogen epidemic

hypothesis that culture is a very important influence

on the behavior of the population during a pathogen

pandemic, and that the government can increase the

behavior of the population to protect themselves and

the collective by promoting collectivism.

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