{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T18:00:28Z","timestamp":1782842428817,"version":"3.54.5"},"reference-count":36,"publisher":"JMIR Publications Inc.","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JMIRx Med"],"abstract":"Abstract<\/jats:title>\n \n Background<\/jats:title>\n In situations of acute stress, individuals may engage in prosocial behaviors or risk-taking self-oriented behaviors. The COVID-19 pandemic created large stress-promoting conditions that impacted individuals\u2019 decisions to adhere to COVID-19 preventative behaviors.<\/jats:p>\n <\/jats:sec>\n \n Objectives<\/jats:title>\n The study aimed to examine the relationship between anxiety during the pandemic and adherence behaviors to prevent the spread of COVID-19, and the moderating influence of prosocial behaviors. We hypothesized that individuals with high anxiety during COVID-19 would adhere more to preventive COVID-19 behaviors than ones with low anxiety and that this relationship would be stronger in those individuals with higher prosocial behaviors.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n A web-based survey was administered through the SONA web-based participant tool of the psychology department of a university in the Northeastern United States. A final sample of 54 undergraduate students completed web-based questionnaires during the second wave of the COVID-19 pandemic, from January to May 2021, which included demographic measures and surveys on prosocial behaviors, anxiety, and COVID-19 preventive behaviors. Moderation analyses were conducted using PROCESS in SPSS.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Participants reported high levels of trait and state anxiety symptoms, most of them meeting or exceeding the cutoff criteria to be clinically meaningful (state anxiety: 47\/54, 87%; trait anxiety: 38\/44, 86%), and over 50% highly adhered to the COVID-19 preventive behaviors of wearing a face mask, using hand sanitizer, handwashing, coughing\/sneezing into their elbow or a tissue, self-quarantining, maintaining social distance, avoiding social gatherings, and avoiding nonessential travel. No significant associations were observed between prosocial behavior, anxiety types, and adherence to COVID-19 preventive behaviors. However, when moderation analyses were conducted between anxiety types and adherence to COVID-19 preventive behaviors, results demonstrated a statistically significant interaction of public prosocial behavior with state anxiety (\u03b2=\u2212.17,\n t<\/jats:italic>\n 53<\/jats:sub>\n =\u22122.60;\n P<\/jats:italic>\n =.01), predicting engagement in COVID-19 preventative behaviors. At high levels of anxiety, low levels of prosocial public behaviors were associated with higher engagement in COVID-19 preventative behaviors. In contrast, high levels of public prosocial behavior were associated with low engagement in COVID-19 preventative behaviors at higher levels of anxiety.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n These results provide information that can aid in the creation of interventions that could increase adherence to COVID-19 preventative behaviors (Reviewed by the Plan P #PeerRef Community).<\/jats:p>\n <\/jats:sec>","DOI":"10.2196\/52970","type":"journal-article","created":{"date-parts":[[2024,5,27]],"date-time":"2024-05-27T12:34:25Z","timestamp":1716813265000},"page":"e52970-e52970","source":"Crossref","is-referenced-by-count":3,"title":["The Role of Anxiety and Prosocial Behaviors on Adherence Behaviors to Prevent COVID-19 in University Students in the United States: Cross-Sectional 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