The current study aims to provide a more nuanced understanding of threat and efficacy appraisal and account for the influence of disparity in the accessibility to risk prevention resources in predicting attitudes and behaviors. We propose a Risk-Efficacy Framework by integrating theories, including the extended parallel process model, health belief model, social cognitive theory, and construal level theory of psychological distance to achieve such a goal. An online survey targeting the U.S. population was conducted to empirically test the model (N = 729). The survey measured people’s threat and efficacy appraisals related to COVID-19 and its vaccines and their attitudes and behavioral intention. The results of the survey supported the model’s propositions. Specifically, perceived susceptibility moderated perceived severity’s effects on attitudes and behaviors, such that perceived severity’s influence attenuated as perceived susceptibility increased. Perceived accessibility to risk prevention resources moderated the influence of self and response efficacy. The former’s effects on attitudes and behaviors increased, and the latter’s effects decreased when perceived accessibility was high. The proposed framework provides a new perspective to examine the psychological determinants of prevention adoption and contributes to designing and implementing campaigns distributing prevention to underserved populations. The framework offers insights for risk managers such as public health authorities by articulating the dynamic nature of risks. When communicating early-stage lesser-known risks to the public, campaigns should highlight their severity and the response efficacy of risk solutions. Differently, more resources should be devoted to cultivating self-efficacy for widespread risks with more mitigation resources.

当前的研究旨在提供对威胁和功效评估的更细致的理解，并解释风险预防资源可及性差异对预测态度和行为的影响。我们通过整合理论，包括扩展并行过程模型、健康信念模型、社会认知理论和心理距离解释水平理论，提出了风险-功效框架来实现这一目标。一项针对美国人口的在线调查对模型进行了实证检验（N  = 729）。该调查衡量了人们对 COVID-19 及其疫苗的威胁和功效评估以及他们的态度和行为意图。调查结果支持了该模型的主张。具体来说，感知的易感性调节了感知的严重性对态度​​和行为的影响，使得感知的严重性的影响随着感知的易感性的增加而减弱。对风险预防资源的感知可及性调节了自我和应对效能的影响。当感知可达性较高时，前者对态度和行为的影响增加，而后者的影响减少。拟议的框架提供了一个新的视角来研究采取预防措施的心理决定因素，并有助于设计和实施向服务不足的人群分发预防措施的运动。该框架通过阐明风险的动态性质，为公共卫生当局等风险管理者提供了见解。在向公众传达早期鲜为人知的风险时，活动应强调其严重性和风险解决方案的响应功效。不同的是，应该投入更多的资源来培养针对广泛风险的自我效能，并提供更多的缓解资源。