Cultural orientation and perceived control over COVID-19 preventive behaviors

ABSTRACT

We examine whether cultural orientation can explain the variation in the uptake of preventive actions against COVID-19 and how messagingshould be framed depending on individuals’ cultural orientations. We show that people with a high vertical cultural orientation are less likely to follow preventive measures because they perceive themselves as having less control over their decisions. However, people with a high horizontal cultural orientation are likely to feel high levels of control over their response to preventive measures and are therefore more likely to adopt them. Furthermore, we show that when preventive measures are framed as protecting the self (versus others), people with a vertical cultural orientation perceive greater control and a greater willingness to comply with that measure.

KEYWORDS:

• COVID-19
• cultural orientation
• vertical orientation
• horizontal orientation
• perceived control

Introduction

COVID-19 has had an immense impact on societies, economies, and individuals all over the world for the past few years (WHO, 2022). Given the high transmissibility of COVID-19, preventive measures were essential in controlling the virus’s spread. Health organizations have urged individuals to follow preventive measures such as washing their hands and practicing social distancing since the first wave of the pandemic in 2020 (Centers for Disease Control and Prevention, 2020; Chinese Center for Disease Control and Prevention, 2020; Gov UK, 2020). Compliance with preventive measures across the globe has been shaped by individual decision-making. Such individual decisions to take preventive actions can be affected by psychological, social, political, personality (Asselmann et al., 2020; Carvalho et al., 2020; Harper et al., 2021; Miguel et al., 2021; Myerson et al., 2021), and cultural factors (Airhihenbuwa et al., 2020; Gelfand et al., 2021; Huynh, 2020; Im, Wang, and Chen, 2021; Lu et al., 2021; Webster et al., 2021). Hence, it is important to understand the cultural and individual processes that can help persuade people to comply with preventive measures.

However, prior research on culture and COVID-19 preventive behaviors have mostly focused on the individualism and collectivism dimensions of culture (Im, Wang, and Chen, 2021; Lu et al., 2021; Webster et al., 2021) and less attention has been paid to understanding the effect of vertical and horizontal dimensions (Triandis & Gelfand, 1998). Although not in the context of COVID −19 and preventive behaviors, a few studies examined the vertical and horizontal distinctions that are nested within the individualism and collectivism distinctions, which they studied mostly with the U.S. participants (e.g., Torelli & Shavitt, 2010). In this paper, we extend this prior work on vertical and horizontal dimensions and test how these dimensions have an effect on the preventive behaviors against COVID-19, and whether the effect holds across individuals in different countries such as the U.S. and Hong Kong. In this paper, we examine whether individuals’ compliance with preventive measures is strongly related to their cultural orientations, specifically o the vertical and horizontal dimensions of culture. Furthermore, we propose that this relationship is mediated by perceived control over the prescribed preventive health measures. We argue that vertical cultural orientation is negatively related to perceived control over preventive behaviors, while horizontal cultural orientation is positively related to perceived control over preventive behaviors. More importantly, we suggest ways to communicate with people with a high vertical orientation through message framing to help them feel they have more personal control over preventive behaviors. In doing so, we document the ways in which the horizontal/vertical orientation aspect of culture can influence people’s behavior in the context of a global pandemic. We test these propositions with two experiments conducted with a U.S. sample (on the online panel Mturk) and a Hong Kong sample (lab experiment).

Cultural orientation: horizontal and vertical orientations

Societies can be categorized into different groups according to distinct dimensions such as individualism versus collectivism, and vertical versus horizontal distinctions in thinking styles and values (Shavitt and Koo 2015; Triandis & Gelfand, 1998; Triandis, 1995). A vast body of research has focused on the distinction between individualist and collectivist cultural orientations (Agrawal & Maheswaran, 2005; Markus & Kitayama, 1991; Pfundmair et al., 2015; S.-P. Han & Shavitt, 1994; Triandis and Suh, 2002). The COVID-19 pandemic has led researchers to examine how individualist and collectivist orientations have affected responses to COVID-19 and variations in mortality rates (Im, Wang, and Chen, 2021; Lu et al., 2021; Webster et al., 2021). However, less attention has been paid to horizontal and vertical cultural orientations that address existing hierarchies and conceptualizations of power (Aaker, 2006; Shavitt & Cho, 2016; Shavitt et al., 2006; Triandis & Gelfand, 1998; Triandis, 1995). Understanding the distinction between horizontal and vertical orientations is important because some cultural differences cannot be explained in terms of individualism or collectivism (Aaker, 2006; Shavitt & Cho, 2016; Shavitt et al., 2006; Triandis & Gelfand, 1998; Triandis, 1995). For example, while Scandinavian countries and the US both feature individualistic cultural orientations, individuals in Scandinavian countries tend to be averse to braggarts (Nelson & Shavitt, 2002) whereas Americans tend to strive for success and approve of boastfulness (Markus & Kitayama, 1991; Triandis & Gelfand, 1998). Such distinctions can only be explained when considering the horizontal and vertical cultural orientations.

One of the key distinctions between the vertical and horizontal cultural orientations is the conceptualization of ‘personalized power’ (i.e., the power a person has to advance their own or their in-group’s status and prestige) and its effect on people’s decisions and behaviors (Aaker, 2006; Shavitt et al., 2011; Torelli & Shavitt, 2010). A study of US students from different cultural backgrounds found that individuals with a high vertical orientation tend to value their personalized power over others or resources (Schwartz, 1992; Torelli & Shavitt, 2010). A study of people from Denmark and the US found that vertically oriented individuals strive for success and status by competing with others (e.g., vertical individualism; Nelson & Shavitt, 2002; Shavitt et al., 2006). Other research suggests that individuals with a vertical orientation and tendency toward collectivism tend to exert power over the groups to which they belong (Shavitt & Cho, 2016). As such, people with a high vertical orientation are less likely to engage in behaviors that would prevent them from acquiring or retaining personal power (Torelli & Shavitt, 2010) or power in the context of their in-groups (Shavitt et al., 2006). However, people with a high horizontal orientation tend to view power differently than people with a high vertical orientation (Torelli & Shavitt, 2010). For example, people with a high horizontal orientation tend to discourage the pursuit of personalized power (Torelli & Shavitt, 2010). They tend to value modesty and self-reliance and may frown upon overt displays of personalized power and status, as they consider themselves to have the same status as others in society (Nelson & Shavitt, 2002). Research suggests that individuals with a high horizontal orientation tend to see power as a tool through which to enhance their self-reliance or the welfare of others, thus reflecting a preference for socialized over personalized power (Shavitt & Cho, 2016; Shavitt et al., 2011; Torelli & Shavitt, 2010). As such, people with a high horizontal orientation are more likely to behave in ways that promote equality between themselves and others rather than trying to increase their personalized power in competition with others (Shavitt & Cho, 2016).

Horizontal and vertical orientations and perceived control

Despite many researchers having called for studies of the horizontal and vertical dimensions of culture (Aaker, 2006; Shavitt & Cho, 2016; Shavitt et al., 2006; Triandis & Gelfand, 1998; Triandis, 1995), few scholars have explored how these orientations affect individuals’ decision-making and information-processing (Shavitt & Cho, 2016; Shavitt et al., 2011). Researchers have yet to explore the role of horizontal and vertical orientations in shaping individuals’ decision-making during the COVID-19 pandemic or similar crises. The lack of research in this area is surprising given that perceived control is a key predictor of an individual’s intention to engage in health behaviors (see the theory of planned behavior in Ajzen, 1991), and the level of perceived control over decisions to engage in preventive behaviors can be strongly affected by the value a person places on personalized power. Perceived control is defined as ‘one’s belief that he or she is capable of obtaining desired outcomes, avoiding undesired outcomes, and achieving goals’ (Landau et al., 2015). One meta-analysis concluded that perceived control is an important predictor of COVID-19 preventive behaviors in general, although the correlation between perceived control and behavioral intentions appears weaker for people or nations with higher individualism than collectivism (Fischer & Karl, 2022). However, the cultural dimension of horizontal and vertical orientations might be a better predictor of perceived control.

We argue that the different conceptualizations of power between individuals with vertical and horizontal cultural orientations are reflected in the perceived control that they feel when making decisions about following preventative measures against COVID-19. For people who are highly vertically oriented, the preventive behaviors associated with the current pandemic may seem like restrictions on their personalized power (Shavitt & Cho, 2016). Given COVID-19’s highly contagious nature, preventive actions are considered as a form of collective action (Fischer & Karl, 2022), and organizations and media outlets have asked people to consider how their actions or inactions can affect others, including members of out-groups. This may result in vertically oriented people feeling that their personalized power with regard to the prescribed preventative actions is limited. Furthermore, highly vertically oriented individuals may feel a lack of autonomy in choosing to comply with their respective government’s suggested preventative health measures. This loss of choice is linked to perceptions of being controlled by others (Deci & Ryan, 1987), which can lead to lower perceived control over decisions to engage in preventive behaviors for those who are highly vertically oriented.

In contrast, for people with a high horizontal orientation, who do not focus on exerting their personalized power, adopting preventative behaviors that may restrict personalized power does not conflict with their values. Indeed, they may perceive that adhering to government policy and preventive measures is consistent with the pursuit of socialized power or with self-reliance (Shavitt and Cho, 2016; Torelli & Shavitt, 2010) in terms of preventing the spread of the disease and thus helping others. Thus, people with a high horizontal orientation are likely to have a higher level of perceived control over decisions to engage in preventive measures, as adopting these measures is consistent with their desired outcomes (Deci & Ryan, 1987).

H1a:

A higher vertical cultural orientation is associated with lower perceived control over the prescribed COVID-19 preventive measures.

H1b:

A higher horizontal cultural orientation is associated with higher perceived control over the prescribed preventive measures.

Furthermore, we suggest that perceived control over the prescribed preventive measures predicts an individual’s intention to practice preventive actions. Perceived control is an important predictor of health intentions and behavior (see Godin & Kok, 1996, for a review). Perceived control can predict exercise behavior (Ajzen & Driver, 1992), weight loss intention (Schifter & Ajzen, 1985), smoking cessation (Godin et al., 1992), and vaccination behavior (Wang and Ahern, 2015). Self-efficacy, the belief that one can perform an action, is associated with perceived control and can predict intentions and compliance levels (Bandura, 1982; D. Han et al., 2016; Keller, 2006). As such, we propose that individuals’ perceived control over their COVID-19 preventive behaviors predicts their intention to follow the prescribed preventive measures.

H2:

Perceived control over COVID-19 preventive measures mediates the relationship between cultural orientation (vertical and horizontal) and behavioral intentions.

We expect that we may not observe the direct effects of cultural orientation (vertical and horizontal) on behavioral intentions, as the vertical and horizontal cultural orientations are likely to exert a greater influence on perceived control than on compliance intentions. The direct effect on the dependent variable does not necessarily need to be significant when the effect on the mediator is more powerful than the effect on the dependent variable (Hayes, 2009; Kenny & Judd, 2014; Krosch & Amodio, 2019; O’Rourke & MacKinnon, 2015; Preacher & Hayes, 2008; Shrout & Bolger, 2002; Zhao, Lynch, and Chen, 2010).

Vertical cultural orientation and protecting the self

If people with a high vertical orientation perceive that they have less control over the decision to comply with preventive measures, what forms of communication can encourage them to follow the recommended preventive measures? We suggest that message framing may present a possible solution to this problem. Several scholars have posited that framing may affect the extent to which individuals are persuaded by a message, depending on an individual’s perceptions in the context of their cultural orientation (Aaker & Lee, 2001; Spassova & Lee, 2013).

We suggest that messages that focus on the individual benefits of adopting preventative measures (e.g., protect yourself) will allow vertically oriented people to perceive themselves as being in control because adhering to the suggested measures will result in benefits for the self or for the in-group. We suggested that vertically oriented individuals may perceive typical preventive measures (e.g., social distancing) as beneficial to others, thus, these individuals may view complying with preventative measures as a violation of their perceived control. However, when the same behaviors are framed in a way to highlight that the behaviors are beneficial for the self, this will allow high (vs. low) vertical individuals to feel greater perceived control. On the other hand, people with a high horizontal orientation are likely to perceive adhering to typical preventive measures as an expression of self-reliance or exercising socialized power for their in-group (Shavitt & Cho, 2016). As horizontally oriented individuals do not perceive following such preventive behaviors as a violation of their personal control, we argue that message framing will not have an effect on perceived control for this group.

H3a:

Message framing influences the relationship between vertical cultural orientation and perceived control such that when preventive action is framed as a means to protect the self (vs. others), people with a vertical cultural orientation will express higher levels of perceived control.

H3b:

Message framing does not affect the relationship between horizontal orientation and perceived control.

Overview of the studies

We conducted two studies to test our hypotheses.¹ In both studies, we tested hypotheses 1 and 2 with measured cultural orientations and explored whether message framing (protecting self vs. others) moderates the relationship between vertical orientation and perceived control but not the relationship between horizontal orientation and perceived control (thus testing H3a and H3b). For Study 1, we recruited US participants using Amazon Mechanical Turk (Mturk). For study 2, we recruited a convenience sample of student participants from a university in Hong Kong with the aim of replicating and increasing the validity and the generalizability of our findings in Study 1. As we sought to investigate individual differences stemming from participants’ higher (vs. lower) vertical or horizontal cultural orientations, a nation-level comparison was not necessary. Thus, the focus of our analysis was on differences in perceived control and preventive behavioral intentions between individuals with a vertical or horizontal cultural orientation. However, by testing our hypotheses and replicating the proposed effects on individuals from an individualistic society (US) and on individuals from a collectivist society (Hong Kong; Aaker & Lee, 2001; Triandis & Gelfand, 1998), we can attest to the generalizability of our findings regarding the effects of differences in cultural orientations on individuals.

Study 1

Study 1 tested the relationships between the vertical and horizontal orientations and perceived control, and whether the relationship between vertical orientation and perceived control was influenced by a health message that framed preventive measures as protecting the self (vs. others).

Participants and design

We recruited 200 US-based participants using Mturk during the week of 3 July 2020 (male = 42.5%, female = 57.7%; mean age = 41.83 years, SD = 12.87). The study consisted of one manipulated factor (message framing: others vs. self) and one measured factor (cultural orientation).

Procedure

The participants were asked to complete a survey on COVID-19, and were randomly assigned to either the ‘self’ or the ‘other’ condition. The participants in the self (other) group were shown a social distancing advertisement that featured the words ‘Protect Yourself’ (‘Protect Others’) (see Figure 1). Next, the participants were asked to rate the extent to which they agreed with the message and how likely they were to practice social distancing. The participants were also asked to report on the extent to which they thought they had control over practicing social distancing, using a 7-point scale (1 = ‘not at all,’ 7 = ‘very much’). Before answering demographic questions, the participants completed Triandis and Gelfand’s (1998) 16-item cultural orientation scale, on which four items measured vertical individualism (VI), four items measured horizontal individualism (HI), four items measured horizontal collectivism (HC), and four items measured vertical collectivism (VC).

Figure 1. Message Framing.

Results

An exploratory factor analysis (EFA) revealed that the items for HI, VI, HC, and VC loaded on four different dimensions (explaining 61.31% of the total variance; KMO: .76; Bartlett’s test of sphericity: χ² = 1060.79, p < .001). When we conducted the EFA with a fixed number of two factors, the items from HI and VI were loaded on the same factor, and the items from HC and VC were loaded on the same factor. This is consistent with well-established finding that the most profound dimension of cultural orientations is that distinguishing individualism and collectivism (Gudykunst & Ting-Toomey, 1988; Shavitt et al., 2006). However, researchers have argued that the dimension of horizontal and vertical orientations is nested within the distinction between individualism and collectivism and can provide a more nuanced understanding of cultural orientation (Singelis et al., 1995; Triandis and Gelfand, 1998; Triandis et al., 1998; Triandis, 1995). We, therefore, conducted two different analyses of the effects of cultural orientations on perceived control: (1) an analysis combining the VI and VC subscales to represent the vertical cultural orientation and combining the HI and HC subscales to represent the horizontal cultural orientation, and (2) an analysis with all four cultural orientations.

Vertical versus horizontal orientation

We created a composite vertical orientation score by averaging the four VI items and four VC items (α = .73) and a composite horizontal orientation score by averaging the four HI items and four HC items (α = .67). We averaged the extent to which the participants agreed with their assigned message and their likelihood of practicing social distancing to create a intention to practice social distancing score (α = .86).

We conducted a regression analysis with perceived control as the dependent variable, and message framing (‘protect yourself’ = 1, ‘protect others’ = 0), the standardized horizontal orientation and standardized vertical orientation scores, and the interactions between message framing and the horizontal orientation score and vertical orientation score, as predictors (see Table 1). The analysis yielded a simple effect of message framing (β = −.14, SE = .17, t = −2.06, p = .04). As hypothesized (H1a and H1b), we found a simple effect of vertical orientation (β = −.25, SE = .15, t = −2.07, p = .04) and a simple effect of horizontal orientation (β = .37, SE = .13, t = 3.65, p < .001), suggesting that people with a higher vertical orientation felt less perceived control over social distancing, whereas people with a higher horizontal orientation felt greater perceived control over social distancing. Also as hypothesized (H3b), the interaction between message framing and horizontal orientation was not significant (β = −.10, SE = .18, t = −.96, p = .34), suggesting that the framing did not affect the participants with a high horizontal orientation. Moreover, as expected, we found a significant interaction between message framing and vertical orientation (β = .34, SE =.19, t = 2.87, p = .005; see Figure 2).

Figure 2. Interaction between message framing and vertical orientation.

Table 1. Regression Analyses with Vertical, Horizontal Cultural Orientations and Message Framing (Study 1).

Dependent Variable: Perceived Control	ß	SE	t
Message Framing	−.138*	.168	−2.06
Horizontal	.369***	.128	3.65
Vertical	−.247*	.150	−2.07
Horizontal x Message Framing	−.098	.184	−.96
Vertical x Message Framing	.344**	.190	2.87

*p < .05, **p < .01, ***p < .001

We then conducted a simple slope analysis (Preacher et al., 2006) to interpret this interaction. When the message was framed around protecting others, the participants with a higher vertical orientation reported lower perceived control (β = −.25, SE = .15, t = −2.07, p = .039). However, when the message was framed around the self, the participants with a higher vertical orientation reported greater perceived control (β = .019, SE = .12, t = 2.01, p = .046), suggesting that the message that focused on self-benefits strengthened the positive relationship between vertical orientation and perceived control. A post-hoc power analysis using G*Power3.1 indicated an effect size of f² = .17 and statistical power of .99.

Next, we examined the mediating role of perceived control on participants’ intention to practice social distancing (H2) and the moderating effect of message framing (H3a). We used a moderated mediation model (Model 8; Hayes, 2013) to test whether the indirect effect of vertical orientation on the intention to practice social distancing through perceived control was moderated by message framing. Horizontal orientation was entered as a covariate. As expected, perceived control significantly predicted intention to practice social distancing (β = .34, SE = .08, t = 4.47, p < .001), and the moderated mediation effect was significant (β = .16, SE = .08, 95% CI from .03 to .34).

As we had not developed hypotheses on the interactions between message framing and horizontal orientation, we used Model 4 (Hayes, 2013) to examine whether perceived control mediated the effect of horizontal orientation on intention to practice social distancing, with vertical orientation as a covariate. Perceived control significantly predicted intention to practice social distancing (β = .32, SE = .07, t = 4.26, p < .001) and significantly mediated the effect of horizontal orientation on intention to practice social distancing (β = .11, SE = .05, 5% CI from .02 to .22).

All four cultural orientations

We conducted a regression analysis with perceived control as the dependent variable and message framing (‘protect yourself’ = 1, ‘protect others’ = 0), standardized cultural orientations (HI, VI, HC, VC), and the interactions between message framing and each of the cultural orientations as predictors. Consistent with hypothesis H1b, we found simple effects of HI (β = .19, SE = .12, t = 2.00, p = .047) and HC (β = .24, SE = .15, t = 2.04, p = .042). As expected in H1a, we found that VI negatively predicted perceived control (β = −.30, SE = .14, t = −2.80, p = .006). However, we did not find any relationship between VC and perceived control (β = .02, SE = .15; t = .13, p = ns). The interactions between HI and message framing (β = −.04, SE = .17, t = −.45 p = ns) and between HC and message framing (β = −.11, SE = .19, t = −.94, p = ns) were not significant, as hypothesized. The interaction between VC and message framing was significant (β = .23, SE = .20, t = 2.00, p = .048), and the interaction between VI and message framing was not significant (β = .21, SE = .18, t = 1.92, p = .055). The correlations and summary of regression analyses can be found in Tables 2 and 3 respectively.

Table 2. Correlations of Four Cultural Orientations (Study 1).

Variable	HI	VI	HC	VC
HI	-
VI	.23**	-
HC	.05	.04	-
VC	.18*	.22**	.48**	-

Note: *p < .05, **p < .01.

Table 3. Regression Analyses with Four Cultural Orientations and Message Framing (Study 1).

Dependent Variable: Perceived Control	ß	SE	t
Message Framing	−.124	.166	−1.88
HI	.192*	.122	2.00
VI	−.303**	.138	−2.80
HC	.239*	.149	2.04
VC	.015	.146	.13
HI x Message Framing	−.044	.174	−.45
VI x Message Framing	.214	.180	1.93
HC x Message Framing	−.110	.195	−.94
VC x Message Framing	.232*	.198	.199

*p < .05, **p < .01

Study 2

Study 2 tested the findings from Study 1 using a sample of participants from Hong Kong. As social distancing was mandated by law in Hong Kong, we instead examined the participants’ willingness to participate in a hypothetical clinical trial of a COVID-19 vaccine.

Participants and design

Three hundred and eighty-nine undergraduate students (male = 39.7%, female = 60.3%; mean age = 19.48 years, SD = 1.43) from Hong Kong participated in an online class session for course credits from February 21 to 5 March 2021. The study featured one manipulated factor (message framing: others vs. self) and one measured factor (cultural orientation).

Procedure

The participants were asked to complete a survey about a clinical trial for a COVID-19 vaccine. They were told that a pharmaceutical company was developing a new vaccine and was recruiting a large number of participants for their final clinical trial. The participants who were assigned to the ‘protect yourself’ condition were shown an advertisement and a short passage highlighting the personal benefits of participating in the clinical trial. The participants in the ‘protect others’ condition were shown an advertisement and a short passage highlighting the benefits to others in relation to participating in the clinical trial (see Figure 3).

Figure 3. Message Framing.

Next, the participants were asked to rate how likely they were to sign up for the clinical trial and the extent to which they agreed with the respective messages. To measure their sense of personal control over their behavior, we asked the participants to indicate the extent to which they acted autonomously in deciding whether to participate in the clinical trial, using a 9-point scale (1 = ‘not at all,’ 9 = ‘very much’). Finally, the participants completed a cultural orientation scale (Triandis and Gelfand, 1998) and answered some demographic questions. The participants were told that the clinical trial was hypothetical and that their answers would be used only to understand people’s intentions.

Results

As in Study 1, the EFA results showed that the items for HI, VI, HC, and VC loaded on four different dimensions (explaining 55.70% of the total variance; KMO: .82; Bartlett’s test of sphericity: χ² = 1547.10, p < .001). Items from HI and VI loaded on the same factor, and the items from HC and VC loaded on the same factor when we fixed the number of factors to two, suggesting that individualism and collectivism comprise a profound distinction in cultural orientation. To extend the understanding of how cultural orientation influences perceived control, we analyzed the results in two ways: (1) using only horizontal and vertical orientations, and (2) using the four different cultural orientations.

Horizontal and vertical orientations

We first created a vertical orientation score by averaging the four VI items and the four VC items (α = .71) and a horizontal orientation score by averaging the four HI items and the four HC items (α = .71). The extent to which the participants agreed with the message and the likelihood of participating in the clinical trial were averaged to create an intention to try the vaccination score (α = .75).

A regression analysis was used to assess the impact of cultural orientations and message framing on perceived control (see Table 4). We entered perceived control as the dependent variable, and message framing (protect self = 1, protect others = 0), standardized horizontal orientation score, standardized vertical orientation score, the interactions between message framing and the horizontal orientation score, and vertical orientation score as independent variables. Consistent with our findings in Study 1, we found a negative effect of vertical orientation (β = −.17, SE = .20, t = −2.07, p = .039) and a positive effect of horizontal orientation (β = .27, SE = .22, t = 2.95, p = .003). As predicted, we found no significant interaction between message framing and horizontal orientation (β = −.13, SE = .30, t = −1.39, p = .17). Consistent with our predictions, there was a significant interaction between message framing and vertical orientation (β = .25, SE =.29, t = 2.90, p = .004; see Figure 4). A simple slope analysis (Preacher et al., 2006) revealed that when the message was framed to highlight protecting others, higher vertical orientation significantly predicted lower perceived control (β = −.42, SE = .20, t = −2.07, p = .039). However, when the message emphasized the benefits to the self, the more vertically oriented participants reported significantly greater perceived control (β = .43, SE = .21, t = 2.03, p = .04). A post-hoc power analysis using G*Power3.1 indicated an effect size of f² = .06 and statistical power of .97.

Figure 4. Interaction between message framing and vertical orientation.

Table 4. Regression Analyses with Vertical, Horizontal Cultural Orientations and Message Framing (Study 2).

Dependent Variable: Perceived Control	ß	SE	t
Message Framing	.012	.233	.24
Horizontal	.269**	.215	2.95
Vertical	−.172*	.195	−2.07
Horizontal x Message Framing	−.132	.287	−1.39
Vertical x Message Framing	.251**	.283	2.90

Note: *p < .05, **p < .01.

Furthermore, we estimated a moderated mediation model (Model 8; Hayes, 2013) of the intention to try the vaccination, with vertical orientation as an independent variable, message framing as a moderator, perceived control as a mediator, and horizontal orientation as a covariate. As expected, perceived control significantly predicted the intention to try the vaccination (β = .19, SE = .04, t = 4.88, p < .001), and there was a significant moderated mediation effect (β = .11, SE = .05, 95% CI from .03 to .22).

As we had not developed hypotheses on the interactions between message framing and horizontal orientation, we used Model 4 (Hayes, 2013) to examine whether perceived control mediated the effect of horizontal orientation on willingness to sign-up, with vertical orientation as a covariate. Perceived control significantly predicted willingness to sign-up (β = .18, SE = .04, t = 4.71, p < .001) and significantly mediated the effect of horizontal orientation on persuasion (β = .08, SE = .03, 95% CI from .03 to .15).

All four cultural orientations

We ran an additional regression analysis on perceived control with message framing, the four cultural orientations, and the interactions between message framing and cultural orientations as predictors (see Table 5). We found that HI significantly predicted perceived control (β = .19, SE = .19, t = 2.28, p = .028) but HC did not predict perceived control (β = .16, SE = .20, t = 1.85, p = .066). Moreover, unlike the findings of Study 1 and the findings obtained using the composite horizontal and vertical scales, we did not find significant effects of VI (β = −.10, SE = .18, t = −1. 24, p = .22) or VC (β = −.12, SE = .19, t = −1. 40, p = .16). As in Study 1, the interactions between HI and message framing (β = −.09, SE = .26, t = −1. 10, p = ns) and HC and message framing (β = −.06, SE = .27, t = −.76, p = ns) were not significant. Moreover, a significant interaction between VI and message framing (β = .17, SE = .28, t = 1.49, p = .029) was found, but the interaction between VC and message framing was not significant (β = .13, SE = .28, t = 1.50, p = .135). The weaker relationship between VI or VC and perceived control, compared to the findings of Study 1, might be related to the nature of the stimuli used in Study 2. Unlike Study 1, in which the stimuli were related to social distancing, Study 2 used a hypothetical vaccination clinical trial. Whereas the successful implementation of social distancing relies on cooperation, participation in a clinical trial of vaccination is largely dependent on one’s own will. Thus, the relationships between VI or VC and perceived control over vaccination might have been weakened.

Table 5. Regression Analyses with Four Cultural Orientations and Message Framing (Study 2).

Dependent Variable: Perceived Control	ß	SE	t
Message Framing	.014	.235	.289
HI	.188*	193	2.28
VI	−.095	.181	−1.24
HC	.156	.198	1.85
VC	−.115	.193	−1.40
HI x Message Framing	−.094	.263	−1.10
VI x Message Framing	.174*	.262	2.20
HC x Message Framing	−.064	.273	−.756
VC x Message Framing	.125	.281	1.93

Note: *p < .05, **p < .01.

Discussion

Our findings reveal several important points. First, perceived control is a key predictor of individuals’ intention to adopt actions to prevent the spread of COVID-19. Second, people with a higher horizontal orientation feel greater perceived control over preventive behaviors, whereas people with a higher vertical orientation feel lower perceived control over these behaviors. However, the lower perceived control of people with a high vertical orientation can be moderated by framing preventive actions as having a protective function for the self (vs. others).

This study shows that an important factor in individuals’ uptake of preventive actions is their perceived control over their participation in these preventative measures. Furthermore, our research suggests that to encourage people with a vertical orientation to comply with preventive measures, it is essential to highlight the ways in which preventative behaviors will provide personal benefits to those individuals. However, horizontally oriented individuals do not perceive a loss of control when complying with preventive measures.

On a theoretical level, our results show that a cultural orientation framework, especially one that considers the distinction between vertical orientation and horizontal orientation, can provide useful insights into potential persuasive strategies in the context of encouraging individuals to adopt preventative health measures in unpredictable situations like a global pandemic.

As the findings suggested that perceived control was a key factor in predicting health behaviors (see Godin & Kok, 1996, for a review), it is surprising that the cultural dimensions that distinguish individuals’ perceptions of established hierarchies and forms of power (i.e., vertical and horizontal orientations) have not received adequate attention. We posit that perceived control may be more dependent on the verticality or horizontality of cultural orientation than on individualism and collectivism. During the pandemic, perhaps due to the increased visibility of others’ behavior (e.g., wearing masks), vertically oriented individuals may view preventive behaviors as restricting their personal and in-groups’ gains, whereas horizontally oriented individuals may view compliance behaviors as consistent with their values.

At the same time, it is still possible that individualism and collectivism may play a role in individuals’ intention to follow preventive measures. Prior studies on the relationship between the cultural orientations of individualism and collectivism and perceived control have found that people with an individualistic cultural orientation expressed higher perceived control than people with a collectivistic orientation (Sastry & Ross, 1998). However, we suggest that, in terms of predicting the ways in which individuals would react to preventive behaviors in terms of perceived control, the vertical and horizontal cultural orientations are more reliable and relevant predictors. Indeed, we found a weak relationship between perceived control and individualism or collectivism.

Furthermore, it is meaningful that our findings capture the nuanced understanding of different cultural orientations. Compared to the prior work in the culture literature that has focused on the distinction between individualism and collectivism (Agrawal & Maheswaran, 2005; Markus & Kitayama, 1991; Pfundmair et al., 2015; S.-P. Han & Shavitt, 1994; Triandis and Suh, 2002), less attention has been paid to the dimension of horizontal and vertical orientations (Aaker, 2006; Shavitt & Cho, 2016; Shavitt et al., 2006; Triandis and Gelfand, 1998; Triandis, 1995). This may possibly be because vertical and horizontal dimensions are nested within the distinction between individualism and collectivism (Singelis et al., 1995; Triandis and Gelfand, 1998; Triandis et al., 1998; Triandis, 1995), it is difficult to find a context in which examining vertical and horizontal dimensions is more meaningful than the examining the discerning distinction of individualism and collectivism. However, we show that regarding the cultural orientation effects on the perceived control and health behavioral intentions during the pandemic, vertical and horizontal dimensions may capture a more articulate understanding of people’s intentions. In addition to enriching our understanding of cultural orientation and health persuasion, this study offers recommendations for health messaging during a pandemic. Many health organizations emphasize that following simple precautions such as social distancing or vaccination can protect others. However, our findings demonstrate that such advice, especially in vertical societies such as the US, the UK, and Hong Kong, may backfire.

Although our analyses reflect individuals’ decisions with regard to compliance with COVID-19 preventative measures, future research could test whether our findings hold when considering country-level differences in cultural orientation. Another avenue for future research could be an assessment of the stability of the identified effect over time. Recent research showed that pandemics might affect people’s values and priorities (Daniel et al., 2022). Given the COVID-19 pandemic’s long duration, the ways in which vertically oriented or horizontally oriented individuals view personal power may have changed in response. Future studies could investigate whether individuals’ conceptualizations of personal power have been affected by the prolonged pandemic.

Disclosure statement

We declare that there are no relevant financial or non-financial competing interests to report.

Data availability statement

The measures used in the studies, as well as the data, can be found in the online repository available at: https://osf.io/edn6f/?view_only=4f85c3988aeb402084909dd5822a31dd.

Notes

1. There are other measures we included for exploratory purposes but they are not described here due to limited space. The other measures used in the studies, as well as the data, can be found in the online repository available at: https://osf.io/edn6f/?view_only=4f85c3988aeb402084909dd5822a31dd.