At the beginning of this study, there was no widespread effective treatment or vaccine. On January 14, 2021, COVID-19 vaccination began in Turkey, and 81.6% of the population was fully vaccinated against COVID-19 in a year, according to the Ministry of Health(Repuclic of Turkey Ministry of Health, 2021). Although this rate appears to be satisfactory, it is necessary to adhere to protective behaviors because the vaccines are protective for 6–9 months, and the vaccine response to every new COVID-19 variant will be unknown. As a result, protective behavior remains critical during this period when the number of COVID-19 cases and deaths are continuously improving. In the current study, the potential variables that could influence protection behaviors were investigated.
Sociodemographic Characteristics
There are psychological, social, and behavioral differences in addition to hormones, genes and immune responses between sexes that affect COVID-19 progression(Wenham et al., 2020). In this study, women engaged in more COVID-19 protection behaviors than men, just as they did at the start of the pandemic (Mellström, 2020; Yıldırım et al., 2021). Additionally, younger age groups were less likely to adopt COVID-19 protection behaviors, which was consistent with previous studies .(Faasse & Newby, 2020; Pasion et al., 2020). The clinical symptoms of COVID-19 manifest less frequently, and background diseases are less common in the younger population than in the older population (Davies et al., 2020). As a result, younger age groups may have adopted fewer protective behaviors. Thus, a younger demographic structure and lower adherence to protective behavior in the 18-30 age group may pose a critical risk for the spread of COVID-19 in Turkey.
In this study, a modest relationship was found between protective behaviors and education. Previous studies have shown that education is less effective in adopting prevention behavior, but the physical environment, and financial resources provided by education level may have contributed to protection behavior (Faasse & Newby, 2020). Even so, because the majority of our sample consisted of highly educated people, this result should be interpreted with caution.
Vaccinating against COVID-19 appears to cause immunity, but the duration of the immunity or effectiveness of the vaccines for each new COVID-19 variant is unknown. Due to an increase in vaccine refusal and a lack of widely used new treatment options, the best way to control the spread of infections is to adapt COVID-19 protection behaviors. Owing to the apparent predictive effect of gender, age, and education level on protective behaviors, specific plans should be created to strengthen COVID-19 preventive behaviors.
The Perceptions About COVID-19 and Self-efficacy
Consistent with previous studies, perceived susceptibility to COVID-19 had a positive effect on COVID-19 protection behaviors (Kim & Crimmins, 2020).
In various countries, the level of knowledge is important in adapting to protective behaviors (Clavel et al., 2021). It was also determined that the frequency of obtaining information and having correct knowledge about COVID-19 were positive predictors of protective behavior in this study. Furthermore, self-efficacy was conceptualized in this study as the perceived capability of managing protective behaviors (Rad et al., 2021; Watkins et al., 2008). According to current findings, perceived self-efficacy has a positive effect on protective behavior.
Emotional Factors Related to Pandemic
The worry associated with the pandemic could motivate people to engage in protective behaviors (Liao et al., 2014; Prete et al., 2020). The concern for the pandemic should be evaluated from multiple perspectives, because the COVID-19 pandemic is a crisis with health, social, and economic implications. In this study, people who engage in protection behavior were more worried about their own financial situations and the country's economy, but mostly their own and their immediate surroundings' health, and being unable to support loved ones when they are in need. Additionally, the latter was an important positive predictor of protection behavior. According to studies, high collectivism indexes at both the personal and national levels positively correlate with infectious disease prevalence (Fincher et al., 2008) and protective behavior (Germani et al., 2020). Furthermore, protective behavior should be understood within the context of the cultural framework (Kemmelmeier & Jami, 2021). Turkey is also a collectivist country, which appears to mean that "we" is important rather than "I" (Ayçiçegi-Dinn & Caldwell-Harris, 2011). At the individual level, the cultural framework may influence 'concerning about other people's health conditions' and 'inability to help them when they are in need.' The current findings may guide future studies on the interaction of health behavior with affective and cultural factors.
Trust in Institutions and Beliefs in Conspiracy Theories
Adherence to protective behavior was associated with a higher level of trust in healthcare professionals (hospitals, medical professional organizations) and the information they provide. Although the Ministry of Health has demonstrated effective and timely responses since the outbreak began, the variability in data-sharing policy may have influenced public risk perception and adherence to protective measures(Liao et al., 2014; Prete et al., 2020) However, this subject warrants further exploration.
Since the pandemic is a process dominated by uncertainty and panic, which may increase distrust in institutions (G et al., 2011), it is crucial that official institutions such as the Ministry of Health build trust and commitment in the later stages of the pandemic. While restricted access to reliable information increases beliefs in conspiracy theories (de Coninck et al., 2021), belief in conspiracy theory reduces trust in institutions and adherence to protective behavior (Pavela Banai et al., 2021). Consistent with this study, it was determined that belief in conspiracy theories reduces COVID-19 protection behaviors. Thus, it is the responsibility of the government and the health authorities to provide access to accurate information. Furthermore, the information should be communicated by medical professionals and scientists as a result of these findings.