Cross-national network analysis of the biopsychosocial model: lessons from COVID-19 for pandemic preparedness

OBJECTIVE: Research has shown that health outcomes are shaped by complex, interrelated factors, highlighting the value of the biopsychosocial model and network analysis; however, most studies have examined these variables in isolation, overlooking their dynamic interplay. Drawing on insights from COVID-19, this study examined the complex interconnections among socio-demographics, psychological resources, immune functioning, and vaccination attitudes across four countries. METHODS AND MEASURES: = 475) for this study. Participants completed psychological measures and provided demographics information, with the resulting data analysed using network analysis. RESULTS: Our network models revealed that religiosity and subjective social status emerged as dual-impact predictors of health outcomes, exerting both positive and negative influences across different cultural contexts. Across all countries, the network models consistently showed the dual protective role of positive psychological resources, demonstrating their capacity to promote vaccination acceptance and strengthen immune functioning, thereby supporting preventive strategies against viral infections. CONCLUSION: The findings suggested the importance of emotional well-being during pandemics, epidemics, and emerging health threats like Pathogen X. Our findings align with the World Health Organization's call for preparedness against high-risk Pathogen X with potential global impact.