Journal of Experimental Psychology: Applied, Vol. 27, Issue 4; Dana Rose Garfin, PhD; Baruch Fischhoff, PhD; Alison Holman, PhD; Roxane Cohen Silver, PhD; Original publication date: Jan. 25, 2022;


Understanding psychosocial correlates of engaging in health-protective behaviors during an infectious disease outbreak can inform targeted intervention strategies. We surveyed a national probability-based sample of 6,514 Americans, with three separate, consecutive representative cohorts between March 18, 2020 and April 18, 2020, as the U.S. COVID-19 epidemic began. Americans adopted many health-protective behaviors (e.g., hand hygiene, social distancing) early, performing them, on average, “most of the time,” with frequency increasing over time. In covariate-adjusted models, self-reported female gender (β = .16, p < .001), older age (β = .13, p < .001), more COVID-related secondary stressors (β = .17, p < .001), and greater perceptions of the risks of catching (β = .07, p = .001) and dying (β = .09, p < .001) from Coronavirus were associated with greater frequency of social-distancing behaviors. Wearing face masks and/or gloves was positively associated with female gender (β = .07, p < .001), older age (β = .14, p < .001), Black (β = .14, p < .001) and Hispanic (β = .07, p = .002) ethnicity, personal-COVID-19 exposure (β = .06, p < .001), reporting secondary stressors (β = .11, p < .001), and higher perceived risk of dying from Coronavirus (β = .13, p < .001). Participants in Cohorts 2 and 3 (compared to Cohort 1) wore face masks and gloves and engaged in social distancing more frequently. Overall, early in the U.S. COVID-19 outbreak, despite the novelty and uncertainty, Americans were responsive to guidelines, adopting them early and following them frequently.

Public significance statement

During the early phase of the COVID-19 pandemic in the U.S., data from three nationally representative probability samples indicated that Americans appeared to understand the risk, adopted recommended health-protective behaviors early, and followed them frequently, with higher rates among female, older, Black and Hispanic respondents, and those reporting greater risk perceptions, exposures, and secondary stressors.