The novel coronavirus disease 2019 (COVID-19) pandemic constitutes a public health crisis on a scale unseen since the 1918 influenza pandemic. As of mid-March, 2022, there were over 458 million confirmed cases of COVID-19 worldwide, including over 6 million deaths . In the United States alone, over 79 million cases and 965,000 pandemic-related deaths have been documented .
The toll of the pandemic has not just been physical, but also psychological, as people have dealt with the pandemic and its many consequences, including economic repercussions [3,4,5], negative effects of social distancing and quarantine on mental health [6,7,8], fear that oneself or one’s loved ones might contract the virus [9,10,11], and, of course, grief from losing loved ones to the pandemic [12,13,14]. Fortunately, even before the recent development of safe and effective vaccines, research clearly showed that the spread of the virus could be mitigated by engaging in evidence-based public health behaviors (henceforth, PHBs), particularly washing hands, wearing masks, and social distancing . These behaviors are among several recommendations from the CDC  and WHO  to suppress the spread of the virus. However, academic research [18, 19], as well as polls by Harris and Gallup [20, 21], have shown high but not universal levels of compliance with these guidelines throughout the pandemic. In particular, some studies indicate that younger adults are less likely to engage in PHBs than older adults [22, 23]. Therefore, understanding who is and is not likely to engage in PHBs among young adults is crucial to mitigating the effects of the virus. Given the stressful nature of the pandemic and the importance of engaging in PHBs, this study examined the relations between stress appraisal of the pandemic, problem-focused coping, and compliance with public health recommendations among young adults.
Stress appraisal and problem-focused coping
The most common theoretical framework for understanding an individual’s experience of stress and their choice of how to respond is Lazarus and Folkman’s Transactional Theory of Stress and Coping (TTSC) [24,25,26]. TTSC is a cognitive-relational theory of how an individual interacts with their environment when faced with a stressor. The interaction is dynamic and bidirectional, given that a person’s response to the stressor changes as the nature of the stressor, and thus the person’s appraisal of it, changes. The theory posits that stress elicits a coping response through stress appraisal (henceforth, SA), with the latter involving two cognitive processes, primary and secondary appraisal. When faced with a potential stressor, individuals engage in primary appraisal whereby they evaluate the potential stressor in terms of its characteristics, such as centrality, uncontrollability, and threat. A stressor (e.g., a stimulus or event) is considered central if it is perceived to have direct, negative consequences to the self, uncontrollable if it is perceived as being outside of one’s own control, and threatening if it is perceived as anxiety-inducing and having a negative outcome. These three aspects of stress appraisal are in keeping with TTSC’s original themes of harm/loss, threat, or challenge . Collectively, these different components of SA help to shape the personal meaning of stress and regulate the impact of stress on psychosocial functioning. Folkman further articulated that different dimensions of primary appraisal need not necessarily co-occur, and people can show complex patterns in how they appraise stress (e.g., viewing the stressor as being central and threatening, but not uncontrollable) .
According to TTSC, if people determine a stimulus or event to be something that they need to respond to, then the primary appraisal is followed by a secondary appraisal in which they evaluate whether their actions can ameliorate the impact of the stressor by considering their coping strategies (e.g., problem-focused coping, emotion-focused coping) and coping resources (e.g., physical, social, psychological, and material assets). Coping strategies are responses aimed at mitigating stress and are typically categorized into two types: problem-focused and emotion-focused coping. Problem-focused coping (henceforth, PFC) consists of active efforts to instrumentally manage the problem that is causing stress. Emotion-focused coping is a reactive effort to remove the negative emotional state itself without addressing its cause, for instance by venting, dismissing, or diverting one’s attention. In the context of the pandemic as a stressor, PHBs such as washing hands, wearing masks, and social distancing are direct, active strategies that individuals can use to prevent the spread of the virus and protect themselves and others from infection. In other words, they are strategies that are aimed at mitigating the stressor itself, rather than attenuating negative emotional states. Therefore, PFC, but not emotion-focused coping, is expected to be particularly relevant to people’s compliance with public health recommendations.
Individuals may differ from one another not only quantitatively (i.e., mean differences) in terms of their appraisal of stressors and use of coping strategies but also qualitatively (i.e., patterns of stress appraisal and use of coping strategies). Conceivably, individuals who exhibit similar patterns can be classified into unique subgroups. Such an approach involves examining subgroup heterogeneity (i.e., the potential existence of unique subgroups with distinct response patterns) using a person-centered approach . Although prior research has examined individual differences in SA and coping strategies, we are not aware of any research that has specifically addressed the question of whether there are “typologies” of people who exhibit unique patterns of both SA and coping strategies. Several researchers [25, 28] have alluded to this type of subgroup heterogeneity; however, it has not been rigorously examined using any form of cluster-based analytic technique.
Another important area of concern is how SA and coping strategies relate to compliance with recommended PHBs. There is some empirical evidence suggesting that those who consider the coronavirus more severe and more controllable are more likely to engage in PHBs [29,30,31]. Additionally, some research has found a link between active coping approaches and positive attitudes and skills regarding COVID-19 prevention and protection . However, to our knowledge, no research has examined primary appraisals and coping strategies simultaneously to identify typologies and then related them to PHBs. The spate of recent studies that examined compliance with public health recommendations has generally not done so within a stress-coping framework [18, 33, 34]. Moreover, to our knowledge, only one study on this subject used a person-centered approach to study PHBs during the pandemic , but the classification strategy was applied to PHBs, not stress-coping.
The present study
In the present study, we used latent class analysis (LCA) to examine subgroup heterogeneity (that is, typologies or “classes”) based on SA and PFC. By examining how individuals both appraise and respond to a stressor (i.e., the pandemic), the present research directly captures the transactional nature of coping. Folkman and Lazarus considered their theory “transactional” because people use information from their appraisal of a stressor to modify their coping responses as they “transact” with the stressor. Conversely, individuals can modify their appraisal of the stressor based on the coping response they use.
The use of a person-centered approach like LCA differs from traditional variable-centered approaches because it does not examine relationships among variables that are often assumed to apply to all people. Rather, LCA focuses on an individual’s set of responses as a whole and classifies them into subtypes based on their item endorsement patterns (e.g., likelihood of engaging in a specific PFC behavioral response) . High consistency in item endorsement patterns is used to characterize the unique composition of classes. Once membership in the mutually exclusive classes has been determined, models can be covariate-adjusted to learn more about the distinctive characteristics associated with class membership. In the current study, we examined age, gender, race, employment status during the pandemic, living situation, education, and sample recruitment strategy. Latent class membership can also be used to predict an observed distal outcome, which, in the current study, is compliance with public health recommendations during the early phase of the pandemic. Moreover, given increasing empirical evidence that women are more likely than men to engage in PHBs during epidemics and pandemics [29, 36,37,38,39] as well as in health behaviors more generally , we examined possible gender differences in the relations between typologies of stress appraisal and problem-focused coping and PHBs.