Why do people comply with health guidelines in a competing information environment?

Résumé

The COVID-19 pandemic unfolded in parallel with an infodemic where competing information from formal and informal sources shaped protective behavior. This study conducted a secondary analysis of cross-sectional survey data from 742 U.S. adults to examine how reliance on different information channels influenced risk perceptions, socio-political beliefs, and protective intentions. Structural equation modeling revealed that reliance on formal sources, such as government websites and mainstream news, was positively associated with perceived severity, reduced conspiracy endorsement, and more liberal political orientation, all of which increased mask-wearing and vaccination intentions. Reliance on informal sources, including social media and peer networks, reduced severity perceptions, heightened conspiracy beliefs, and reinforced more conservative orientations, which in turn undermined compliance. Perceived severity functioned as a central mediator, directly encouraging mask use and indirectly promoting vaccination through reduced conspiracy endorsement. Political ideology and conspiracy beliefs further shaped vaccine intentions, highlighting the ideological pathways through which information exerts influence. Mask-wearing and vaccination clustered together, indicating a generalized orientation toward protective action. The model underscored the critical role of information environments as upstream determinants of health behavior during crises. These findings emphasize that managing both formal and informal channels is essential for effective crisis communication and for strengthening public compliance in future health emergencies.