Metacognitions About Health and COVID-19 Preventive Behaviors: Experiential Avoidance and Coronavirus Anxiety as Mediators

People can easily be infected by the coronavirus disease 2019 (COVID-19) virus unless they adhere to the globally suggested preventive behaviors. Metacognition about health is a crucial factor that may affect health behaviors. Our study investigated the relationship between metacognition and COVID-19 preventive behaviors mediated by experiential avoidance and COVID-19 anxiety. 

After distributing online participation advertisements, 702 participants, 430 female (61%) and 272 male (39%) were recruited from the general population in Iran. They answered four questionnaires, including the preventive COVID-19 behaviors scale (PCBS; Toussaint et al., 2020), acceptance and action questionnaire II (AAQ-2; Bond et al., 2011), coronavirus anxiety scale (CAS; Lee, 2020d), and metacognition questionnaire-health anxiety (MCQ-HA; Bailey & Wells, 2015). SPSS software, version 22, LISREL software, version 8.85, and MPlus software, version 7.4 were used to analyze the data and investigate the research hypotheses. Model fit for the modified hypothetical model was tested using structural equation modeling (SEM). 

The results showed that COVID-19 anxiety and experiential avoidance could significantly predict preventive behaviors (P<0.01). However, metacognition could indirectly predict these behaviors by changing COVID-19 anxiety (P<0.01) and experiential avoidance (P<0.01). 

Identifying and modifying dysfunctional metacognitive beliefs that lead to experiential avoidance and COVID-19 anxiety can help us modify COVID-19 preventive behaviors and, as a result, reduce the spread of COVID-19 and behavioral problems.