Trust vs. knowledge during COVID-19: the dominance of trust in promoting preventive behaviours and its role in technology acceptance in Germany and India

Abstract Background Adherence to COVID-19 measures depended on a range of factors, including trust in authorities, knowledge of the virus, and public perception. This study compares Germany and India to examine the association of these factors on compliance and contributes to the debate between knowledge and trust. It also explores public acceptance of virus-deactivating technologies, which could reduce reliance on individual preventive behaviours and surveillance tools, offering new insights for pandemic response and public health strategies. Methods Data was collected through an online primary survey using stratified random sampling in India and Germany. The questionnaire consisted of five sections: socio-demographics, knowledge, trust, preventive behaviours, and technology acceptance. The data was analysed using descriptive statistics and statistical analyses of linear regression and ordinal logistic regression. Results Almost all preventive behaviours were more frequent in India than in Germany, while German respondents had higher overall knowledge scores. The regression analysis showed no significant relationship between knowledge and trust in India. In contrast, Germany showed a weak positive association, indicating knowledge is modestly associated with trust, though other factors are also significant. The logistic regression analysis highlighted that trust was associated with all preventive behaviours during the COVID-19 pandemic in India and Germany, consistently emerging as a significant factor. While socio-demographic factors like age, education, and income also predicted some behaviours, knowledge had only a limited association. Similar results were found for the acceptance of virus-deactivating air-purification technologies in both Germany and India. Specifically, UV-light-based air purification systems, seen as a potential replacement for measures like masks and school closures, showed high acceptance: 76% in Germany and 57% in India, suggesting a likelihood of real-world implementation. Conclusions This study adds to existing discussions on the role of knowledge, finding that trust showed a stronger association with adherence to COVID-19 measures. Comparing Germany and India, findings show that despite vast differences in healthcare systems and priorities, trust played a similarly crucial role in both contexts for preventive behaviours and acceptance of virus-deactivating technologies. Transparent communication, co-design and co-creation approaches, as well as reflexive socio-technical collaboration may support trust-building and improve public health strategies during crises.