Lifestyle choice is an important determinant of personal health [1]. Individual behavior, especially the choice of preventive measures, plays a key role in the spread of respiratory disease [2]. The effective preventive behaviors include health education, vaccination, antiviral treatment and avoiding exposure to virus [3].
Preventive behavior is essential for the control of epidemic situation and prevention of infection, and it is very effective [4]. The study found that through a series of preventive actions, such as the adoption of new methods of health education in communities and schools, the infectious diseases in Southeast Asia has been effectively prevented [5]. Health belief education can increase residents' susceptibility to infectious diseases [6]. The study found that individual and community level factors were significantly associated with Ebola prevention behavior [7]. Fear of assessing COVID-19 was significantly associated with the preventive behavior of COVID-19 [8]. Cancer information seeking (CISE) is significantly associated with cancer prevention behavior [9]. Compared with urban residents, rural residents are less likely to have preventive behaviors, they hold negative attitude towards the effectiveness of preventive behaviors, and their information evaluation skills are lower [10]. In the absence of vaccines or drugs, non-drug interventions are the most important coping strategies based on community interventions, such as distance between people, wearing masks, isolation and good personal hygiene (hand washing) - all of which have been proven to reduce the spread of this seemingly unstoppable global impact of natural disasters [11]. The performance of preventive behavior increased with the increase of educational level and age [12]. Skin cancer related preventive behaviors can reduce the risk of skin cancer [13].
Psychological adaptation refers to that when the external environment changes, the subject makes psychological activities and behavior through the self-regulation system, and is a positive internal growth process in which individuals redefine the way they want to be realized or start a new hope [14]. It has been found that strengthening psychological capital contributes to better psychological adaptation [15]. It is found that the health-related quality of life in high acceptance group and high dependence group is significantly higher than that in control group [16]. There is a negative correlation between psychological adaptation and emotional distress [17]. A 10-year follow-up study found that there was a significant negative correlation between physical adaptation and depression [18].
Some researchers explored the relationship between tooth health and psychological adaptation. The results showed that the participants with higher degree of psychological adaptation were more likely to seek preventive care, and both behavioral and psychological cultural adaptation could predict oral health outcomes [19]. Individuals with higher resilience are more likely to have adaptive preventive behavior [20]. The study found that fear of not being able to cope with or unable to adapt to the environment, namely cognitive vulnerability perceptions, was significantly negatively correlated with preventive behavior [21]. In view of this, we propose hypothesis 1: psychological adaptation can positively predict preventive behavior.
Respondents who know more about Ebola are more likely to take preventive actions against Ebola virus, while those who think they are at high risk of Ebola infection are much less likely to engage in Ebola prevention [7]. Because the actual risk of infection is usually uncertain, individual behavior is affected by perceived risk. Low risk cognition may reduce the use of preventive measures (behavior), and there is a bidirectional correlation between risk perception and behavior; with the increase of risk awareness, preventive behavior also increases [2]. Disease cognition is related to individual seeking help and prevention behavior [22]. There is a significant correlation between climate risk perception and farmers' adaptation behavior [23].
According to the protection motivation theory (PMT), there are two main perception processes: the first is "risk assessment", that is, a person assesses the possibility and potential damage of a threat to the things he cherishes without changing his behavior. This cognitive process produces a specific perception of risk; the second process is "adaptation assessment", in which a person assesses his or her ability to avoid being threatened and the cost of such action. The result of this cognitive process is a specific perceptual adaptability [24]. If we only pay attention to the risk and do not make psychological adaptation changes, there may be some avoidable maladjustment reactions such as rejecting risk [25]. Therefore, we speculate that since psychological adaptation is an adaptive assessment of risk, high psychological adaptation means low risk cognition. In view of this, we propose hypothesis 2: risk cognition has a mediating effect between psychological adaptation and preventive behavior.
Stress coping can be defined as the individual's psychological resources when dealing with stress or adverse situations; stress coping includes not only actions, including behaviors (cognition and emotion), and personal assessment of the situation [26]. Some research found that stress coping can affect the individual's response to stress, and then affect the results of mental health [27]. Positive stress coping reduces cancer-related negative behavioral reactions [28]. Stress coping is significantly correlated with risk cognition [29]. Stress vulnerability and good stress coping are the corresponding concepts. Some researchers have studied the relationship between stress vulnerability and risk cognition and other psychological factors in earthquake disasters, and found that people's stress vulnerability is significantly positively related to their cognition of earthquake risk [30]. Therefore, we speculate that compared with high stress coping individuals, low stress coping individuals have higher risk perception, so their psychological adaptation has a stronger negative predictive effect on their risk cognition. In view of this, we propose hypothesis 3: stress coping moderates the relationship between psychological adaptation and b risk cognition.
In conclusion, this study mainly discusses the impact of psychological adaptation on prevention behavior of college students during the peak period of epidemic, and then explores the mediating role of risk cognition and the moderating role of stress coping on the mediating process. The hypothetical model is shown in Fig. 1.