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Top1. Introduction
In the ongoing COVID-19 pandemic, information from multiple sources can result in information overload and cause anxiety and distress (Sakurai & Chughtai, 2020) and thus create negative psychological and behavioral responses (Soroya et al., 2021). Some individuals, particularly older adults, feel distressed by information overload; therefore, they tend to ignore health information and pandemic knowledge, which has been shown to undermine compliance with prevention behaviors in many health domains (Pian et al., 2021).
As they enter old age, elderly people present health characteristics that are different from those of the general population, such as nutritional deficiencies, frailty, susceptibility to infectious diseases, coexistence of chronic diseases and significant mental health problems. As immune function declines, elderly individuals become more susceptible to infectious COVID-19 (McAuliffe et al., 2020; The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team, 2020).
Uncovering the cognitive and perceptual patterns of elderly people in the process of risk communication during COVID-19 is important for guiding prevention programs for older adults as well as the development of psychological health communication theories (Heydari et al., 2021). Until specific treatments for COVID-19 are available, prevention is critical to protect high-risk elderly populations; however, few works have been done to explore these factors, such as knowledge, risk perception, and negative emotions, which promote prevention behaviors in this population (Yu et al., 2021).
Existing studies have examined older adults' knowledge, beliefs, risk perceptions, attitudes, and coping behaviors regarding COVID-19, where adequate knowledge and positive beliefs have been shown to be strongly associated with coping behaviors (Saadatjoo et al., 2021). These findings have important implications for improving the effectiveness of COVID-19 treatment programs targeting older populations (Chen et al., 2020).
Although studies have already focused on factors affecting the older population during the COVID-19 pandemic on their preventive behaviors, few researchers have explored this issue from an internal mechanism perspective (Chen et al., 2020; Duan et al., 2021). The question of whether these factors are related and what effect they have on older adults' preventive behaviors remains unresolved (Duan et al., 2021). Having enough knowledge about COVID-19 can affect the perception and prevention measures adopted by older adults, while low levels of cognition and negative practices could increase the risk of infectious diseases. Therefore, understanding the knowledge, risk perception and coping behaviors (KRBs) of older adults and knowing the potential factors can help to improve COVID-19 prevention and treatment (Saadatjoo et al., 2021).
Some classical models, such as Social Amplification of Risk Framework (SARF) and the Knowledge Attitude Practice model (KAP), have been applied to explore the relationship among knowledge, attitudes and preventive behaviors concerned with SARS, H1N1, H7N9 and COVID-19. Those studies demonstrate associations between patterns and social-demographic predictors, but the relationship between knowledge, risk perception, and coping behavior remains unclear (Rimal & Real, 2003; Chan et al., 2020). Although many works have focused on the role of negative emotions and attitudes and examined when they can promote behavior changes, the literature assessing this relationship in older adults during COVID-19 is limited.