Community behavioral change and management of COVID-19 Pandemic: Evidence from Indonesia

2.1 Information Motivation Behavioral Skills Model (IMB-Model)

The IMB-Model of Fisher and Fisher (1992) explains that information, motivation, and behavioral skills are determinants of preventive behavior. If a person has adequate information and is well-motivated, he or she will acquire behavioral skills and apply these skills to change behavior. Behavioral skills are related to a variety of skills, such as practical knowledge, skills, and self-confidence or beliefs that lead to behavior. In the current study, information, motivation, behavioral skills, and behavioral change refer to behavioral changes in the 5Ms (wearing masks, washing hands, keeping a distance, staying away from crowds, reducing mobility) and 3Ts (tracing, testing, treatment), as well as participation in the vaccination program by the government.

2.2 Information and behavioral change

Luo et al. (2020) showed that information influences health behavior during COVID-19. Chen et al. (2018) demonstrated that information influences self-management behavior. Other scholars (Fisher et al., 2003; Fleary et al., 2020; Lee and Park, 2021; Ferarri et al., 2021) also revealed that information affects health behavior. In Indonesia, the information obtained by the public is remarkably diverse. The more accurate and reliable information, the higher the chance people change their behavior. Thus, the following hypothesis is proposed:

2.3 Motivation and behavioral change

Motivation influences behavioral change. Fleary et al. (2020) revealed that inadequate consumption of fruits and vegetables in adolescents can increase the risk of chronic diseases. Motivation explains the changes in fruit and vegetable consumption behavior. Other studies (Luo et al., 2020; Fisher et al., 2003; Lee and Park 2021; Ferarri et al., 2021) demonstrated the same results. This study argues that the higher the motivation, the higher the chance of behavioral change. Then, the following hypothesis is proposed:

2.4 Information and behavioral skills

Information affects behavioral skills. Alexander et al. (2017) revealed that information affects behavioral skills on medication adherence of patients with rare diseases. Other studies (Fisher and Fisher, 2006; Mayberry and Osborn, 2014; John et al., 2017; Luo et al., 2020; Ferarri et al., 2021) also demonstrated the same results. This study argues that the more reliable the information, the better the behavioral skills of the community. Therefore, the following hypothesis is proposed:

2.5 Motivation and behavioral skills

Motivation affects behavioral skills. Lee and Park (2021) showed that motivation influences behavioral skills on preventive behavior against respiratory infections Other scholars (Fisher and Fisher, 2006; Mayberry and Osborn, 2014; John et al., 2017; Chen et al., 2018; Luo et al., 2020; Ferarri et al., 2021) also proved the same results. This study argues that the higher the motivation, the higher the people have behavioral skills. Thus, the following hypothesis is proposed:

2.6 Behavioral skills and behavioral change

Behavior change is a core component of self-management and compliance (Chang et al. 2014). Ferarri et al. (2021) revealed that behavioral skills have a direct influence on behavioral changes in physical activities. Other studies (Fisher and Fisher, 2006; John et al., 2017; Chen et al., 2018; Luo et al., 2020; Ferarri et al., 2021) demonstrated that behavioral skills also influence health behavioral change. Luo et al. (2020) stated that behavioral skills have the greatest impact on health behavior change. The higher the behavioral skills, the higher the chance of changing behavior. Then, the following hypothesis is proposed:

2.7 Mediating role of behavioral skills on information-behavioral change relationship

Reliable information will build people's behavioral skills. This information will form the public self-awareness to make behavioral changes in the forms of consistently implementing the 5Ms health protocol, following the 3Ts practices, and participating in the vaccination program. The more reliable the information, the higher the behavioral skills, and then the greater the chance for behavioral change. Therefore, the following hypothesis is proposed:

2.8 Mediating role of behavioral skills on motivation-behavioral change relationship

People's behavioral skills are formed from personal motivation (self-awareness, fear of being infected, fear of infecting others) and social motivation (following the government, international organizations, and the community). This form of personal and social motivation will increase their behavior skills, then enhances the chance to change their behavior. The higher the motivation, the higher their behavioral skills, and the higher the behavioral change. Thus, the following is proposed:

Fig. 2 depicts the research conceptual framework of IMB-Model. The model is used to explain the relationship of four constructs employed by the current study, namely information, motivation, behavioral skills, and behavioral change.

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Fig. 2

Information Motivation Behavioral Skills Model (IMB-Model).

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3.1 Sample and data collection

This study employs the snowball sampling method to obtain a wide sample based on a small sample and makes it easier to collect qualitative data (Cooper & Schindler, 2014: 360). Primary data were collected using an online survey. A pilot test that was conducted on 50 people in Surabaya confirmed the validity and reliability. Furthermore, 10 to 15 questionnaires were sent to respondents throughout Indonesia via the WhatsApp application. The online focus group discussions (FGD) were conducted in three regions with the representatives of various community groups as presented in Table 1. FGD was conducted using the following key questions: (1) What are the reliable sources of information on COVID-19? (2) Which forms of communication are the most effective? (3) Who are the parties conveying information? (4) What kind of media are used? (5) What are the motivations that make people change their behavior? and (6) What are the type of behavioral changes? Table 1 shows the participants of the FGD.

3.2 Definitions and measurements

Behavioral change. Behavioral change is defined as a change that a person makes to comply with health rules. Behavioral change is measured using six statements developed by Vannabouathong et al. (2020), Michie and West (2021), and Lee et al. (2021) which consist of the following main items: (1) application of the 5Ms health protocol, (2) healthy living behavior, both physically and mentally, (3) good behavior in spiritual life, (4) following 3Ts practices, (5) participating the vaccination program, (6) behavior on digital technology and non-contact-based technology. A Likert scale rating from 1 (strongly disagree) to 5 (strongly agree) is used.

Behavioral skills. Behavioral skills are defined as beliefs (self-efficacy) and skills to use. Behavioral skills are measured by 12 statements developed by previous researchers (Robinson, 2017; Tsamlag et al., 2020) which consist of the following main items: (1) implementing programs consistently, orderly, and correctly to prevent COVID-19, (2) consistently implements self-awareness programs without being influenced by sanctions/punishments, (3) implementing programs without being influenced by government assistance, and (4) implementing programs without being influenced by various community leaders. A Likert scale rating from 1 (strongly unsure) to 5 (strongly sure) is used. The higher the score, the higher the behavioral skills associated with health behavior change.

Information. Information refers to the basic knowledge about the disease, health conditions, and preventive behavior. The information can be from the central/regional government, printed and electronic media, social media, and chat applications such as the WhatsApp groups. Information is measured using 16 statements developed by previous scholars (Robinson, 2017; Tsamlag et al., 2020) consisting of the following main items: (1) information related to COVID-19, (2) information on the implementation of the 5Ms health protocol, (3) information about the 3Ts practices, and (4) information on the benefits of vaccination. A Likert scale rating from 1 (very ignorant) to 5 (very knowledgeable) is used.

Motivation. Motivation refers to attitudes toward health behaviors, beliefs of intervention outcomes to minimize the spread of COVID-19, and social support to engage in certain behaviors. Motivation is measured using 12 statements developed by previous scholars (Robinson, 2017; Tsamlag et al., 2020; Michie & West, 2021) which consists of the following main items: (1) implementing the program in an orderly and correct manner to prevent and minimize COVID-19, (2) following government advice to implement programs, (3) following international organization’ recommendations to implement programs, (4) following the majority of the population to implement programs. A Likert scale rating from 1 (strongly disagree) to 5 (strongly agree) is used. The higher the score, the higher the motivation.

4.1 Characteristics of respondents

Table 2 shows that the respondents are dominated by male respondents with more than 40 years old. Their last education is mostly master's degrees, undergraduate degrees, and senior high schools. Their occupations are mostly lecturer/teacher, students, and employees.

4.2 Descriptive statistics

The following interval class calculation is needed to categorize the respondents’ answers. $$\mathrm{I}\mathrm{n}\mathrm{t}\mathrm{e}\mathrm{r}\mathrm{v}\mathrm{a}\mathrm{l}\mathrm{c}\mathrm{l}\mathrm{a}\mathrm{s}\mathrm{s}=\frac{(\mathrm{H}\mathrm{i}\mathrm{g}\mathrm{h}\mathrm{e}\mathrm{s}\mathrm{t}\mathrm{s}\mathrm{c}\mathrm{o}\mathrm{r}\mathrm{e}-\mathrm{L}\mathrm{o}\mathrm{w}\mathrm{e}\mathrm{s}\mathrm{t}\mathrm{S}\mathrm{c}\mathrm{o}\mathrm{r}\mathrm{e})}{\mathrm{N}\mathrm{u}\mathrm{m}\mathrm{b}\mathrm{e}\mathrm{r}\mathrm{o}\mathrm{f}\mathrm{c}\mathrm{l}\mathrm{a}\mathrm{s}\mathrm{s}\mathrm{e}\mathrm{s}}$$ $$\mathrm{I}\mathrm{n}\mathrm{t}\mathrm{e}\mathrm{r}\mathrm{v}\mathrm{a}\mathrm{l}\mathrm{c}\mathrm{l}\mathrm{a}\mathrm{s}\mathrm{s}=\frac{(5-1)}{5}=0,8$$

Based on the calculation, the respondents’ answers are categorized in Table 3:

Table 4 presents the result of descriptive statistics showing the categorization of the respondents’ answers. In summary, the answers tend to “agree” and “strongly agree”.

4.3 Measurement model analysis

The PLS-SEM was employed because of its capability to simultaneously analyze many latent variables with various indicators (Hair, Ringle, and Sarstedt, 2013). Table 5 and Table 6 present the convergent validity and discriminant validity. In the first iteration, the factor loading value of BC 3 (good behavior in spiritual life) is<0.5, and it was deleted from the measurement model. In summary, the measurement model is valid and reliable.

4.4 Structural model analysis

Structural model analysis has two stages, namely: (1) direct effect test, and (2) indirect effect test. Table 7 shows the results the direct effect test (Panel A) and indirect test (Panel B).

Fig. 3 presents the results of the full model test. It shows that all paths are significant.

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Fig. 3

Results of Full Model.

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Before including the behavioral skills as the mediating variable, the results (Panel A) show that H₁ is supported and H₂ is supported. After including behavioral skills as the mediating variable, the results (Panel B) reveal that H₃, H₄, and H₅ are also supported. The β coefficient of the information-behavioral change relationship decreases from 0.22 to 0.074 and is significant. The β coefficient of the motivation-behavioral change relationship decreases from 0.399 to 0.151 and is significant. According to Baron and Kenny (1986), the results indicate the existence of partial mediation. Hence, H₆ and H₇ are supported.

5.1 Information and behavioral change

This study provides empirical evidence for the hypothesis stating that information has a positive effect on behavior change. The results support some previous scholars (Chen et al., 2018; Luo et al., 2020; Fisher et al., 2003; Fleary et al., 2020; Lee & Park, 2021). As presented in Table 8, additional information obtained from the questionnaires and focus group discussions also supports the first hypothesis. First, the public receives information on COVID-19 from the Central/Regional Government as their most trusted source of information.

Second, the type of media which is the most widely accessed by the public is social media as presented in Table 9. Television and online media are also the next choices.

5.2 Motivation and behavioral change

The results prove that motivation has a positive effect on behavior change. These results support previous scholars (Fleary et al., 2020; Luo et al., 2020; Fisher et al., 2003; Lee & Park 2021; Ferarri et al., 2021). Table 10 shows that motivation to implement health protocols is based on the motivation of fear of infecting other people (parents, children, etc.). The motivation encourages people to change their behavior to consistently implement the health protocols.

5.3 Information and behavioral skills

The results prove that information has a positive effect on behavioral skills. The results support the studies of previous researchers (Fisher & Fisher, 2006; Mayberry & Osborn, 2014; John et al., 2017; Alexander et al., 2017; Nelson et al., 2018; Luo et al., 2020). Respondents believe that the information they get will form their behavioral skills. The campaign for the 5Ms health protocol, 3 T practices, and vaccination program is one of the efforts to provide reliable information for people to have behavioral skills to fight the virus.

5.4 Motivation and behavioral skills

This study proves that motivation has a positive effect on behavioral skills. The results support studies conducted by the previous researchers (Lee & Park, 2021; Fisher & Fisher, 2006; Mayberry & Osborn, 2014; John et al., 2017; Chen et al., 2018; Luo et al., 2020; Ferrari et al., 2021). Respondents strongly believe that motivation such as fear of infecting others, self-awareness, and fear of being infected by the virus will build the community's behavioral skills to fight against the virus.

5.5 Behavioral skills and behavioral change

The results prove that behavioral skills have a positive effect on behavior change. The results support the previous researchers (Fisher & Fisher, 2006; John et al., 2017; Chen et al., 2018; Luo et al., 2020; Ferarri et al., 2021). The behavioral skills are reflected in the people’s capabilities to implement the 5Ms health protocol, the 3Ts practices, and other government programs without being influenced by punishment, government assistance, leaders, family, community, and colleagues.

5.6 Mediating role of behavioral skills on information-behavioral change relationship

This study proves that behavioral skills mediate the effect of information on behavior change. The community gets information from both digital and conventional types of media. Based on this information, the community increases their self-awareness and behavioral skills that are ready to be used for action. These behavioral skills serve as the basis for behavioral change to support COVID-19 pandemic management programs such as implementing the 5Ms health protocol in daily life, participating in the 3Ts program, participating in the vaccination program, and living in a healthy lifestyle.

5.7 Mediating role of behavioral skills on motivation-behavioral change relationship

The results prove that behavioral skills mediate the influence of motivation on behavioral change. Personal motivation (self-awareness, fear of infecting others, and fear of being infected by the COVID-19 virus) and social motivation (following the government, international organizations, and the community) have shaped the people's behavioral skills that are used to change their behavior, especially in implementing the 5Ms health protocol their daily life, following the 3Ts practices, vaccination program, and living in a healthier lifestyle.