COVID-19 protective behaviors: A longitudinal study applying an extended protection motivation theory

Behavioral measures have proven indispensable to slow down the spread of COVID-19. However, adopting new health behaviors is generally challenging. This study aimed at identifying determinants of adopting protective behaviors over the course of the COVID-19 pandemic. To explain adherence to protective behaviors over time, this study applied an extended version of the protection motivation theory combined with objective contextual pandemic-specific measures.

Six measurement points covered a period of 15 months during the COVID-19 pandemic in Switzerland. The sample of N = 4,001 (M_age = 53.1, SD_age = 19.3, range_age = 18-98, 49.2% female) participated via telephone or online. Data were analyzed on inter- and intraindividual levels using generalized estimating equations with intentions and self-reported engagement in four protective behaviors (hygiene behaviors, physical distancing, adherence to recommendations in case of symptoms, and mask wearing) as outcomes.

Over time, response efficacy and self-efficacy were the most important predictors for all intentions and self-reported behaviors and on both levels of analysis. Moreover, intentions also emerged as important predictor of self-reported behavior. Social norms, measured as subjectively expected disapproval from others, were mostly negatively related to intentions and self-reported behaviors on the interindividual level, but less consistently on the intraindividual level. Perceived risks to oneself and others, as well as objective, contextual variables (incidences, mortality, stringency index) showed inconsistent effects.

This study demonstrates that threat appraisals (e.g., risk perceptions) are less important than positive beliefs about the behavior (i.e., coping appraisals) for the adherence to protective behaviors during a pandemic. (PsycInfo Database Record (c) 2023 APA, all rights reserved).