TY - JOUR
T1 - Handwashing adherence during the COVID-19 pandemic
T2 - A longitudinal study based on protection motivation theory
AU - Szczuka, Zofia
AU - Siwa, Maria
AU - Abraham, Charles
AU - Baban, Adriana
AU - Brooks, Sydney
AU - Cipolletta, Sabrina
AU - Danso, Ebrima
AU - Dombrowski, Stephan U.
AU - Gan, Yiqun
AU - Gaspar, Tania
AU - Gaspar de Matos, Margarida
AU - Griva, Konstadina
AU - Jongenelis, Michelle
AU - Keller, Jan
AU - Knoll, Nina
AU - Ma, Jinjin
AU - Abdul Awal Miah, Mohammad
AU - Morgan, Karen
AU - Peraud, William
AU - Quintard, Bruno
AU - Shah, Vishna
AU - Schenkel, Konstantin
AU - Scholz, Urte
AU - Schwarzer, Ralf
AU - Taut, Diana
AU - Tomaino, Silvia C.M.
AU - Vilchinsky, Noa
AU - Wolf, Hodaya
AU - Luszczynska, Aleksandra
N1 - Publisher Copyright:
© 2022 Elsevier Ltd
PY - 2023/1
Y1 - 2023/1
N2 - Rationale: The associations between the number of COVID-19 cases/deaths and subsequent uptake of protective behaviors may reflect cognitive and behavioral responses to threat-relevant information. Objective: Applying protection motivation theory (PMT), this study explored whether the number of total COVID-19 cases/deaths and general anxiety were associated with cross-situational handwashing adherence and whether these associations were mediated by PMT-specific self-regulatory cognitions (threat appraisal: perceived vulnerability, perceived illness severity; coping appraisal: self-efficacy, response efficacy, response costs). Method: The study (#NCT04367337) was conducted in March–September 2020 among 1256 adults residing in 14 countries. Self-reports on baseline general anxiety levels, handwashing adherence across 12 situations, and PMT-related constructs were collected using an online survey at two points in time, four weeks apart. Values of COVID-19 cases and deaths were retrieved twice for each country (one week prior to the individual data collection). Results: Across countries and time, levels of adherence to handwashing guidelines were high. Path analysis indicated that smaller numbers of COVID-19 cases/deaths (Time 0; T0) were related to stronger self-efficacy (T1), which in turn was associated with higher handwashing adherence (T3). Lower general anxiety (T1) was related to better adherence (T3), with this effect mediated by higher response efficacy (T1, T3) and lower response cost (T3). However, higher general anxiety (T1) was related to better adherence via higher illness severity (T1, T3). General anxiety was unrelated to COVID-19 indicators. Conclusions: We found a complex pattern of associations between the numbers of COVID-19 cases/deaths, general anxiety, PMT variables, and handwashing adherence at the early stages of the pandemic. Higher general anxiety may enable threat appraisal (perceived illness severity), but it may hinder coping appraisal (response efficacy and response costs). The indicators of the trajectory of the pandemic (i.e., the smaller number of COVID-19 cases) may be indirectly associated with higher handwashing adherence via stronger self-efficacy.
AB - Rationale: The associations between the number of COVID-19 cases/deaths and subsequent uptake of protective behaviors may reflect cognitive and behavioral responses to threat-relevant information. Objective: Applying protection motivation theory (PMT), this study explored whether the number of total COVID-19 cases/deaths and general anxiety were associated with cross-situational handwashing adherence and whether these associations were mediated by PMT-specific self-regulatory cognitions (threat appraisal: perceived vulnerability, perceived illness severity; coping appraisal: self-efficacy, response efficacy, response costs). Method: The study (#NCT04367337) was conducted in March–September 2020 among 1256 adults residing in 14 countries. Self-reports on baseline general anxiety levels, handwashing adherence across 12 situations, and PMT-related constructs were collected using an online survey at two points in time, four weeks apart. Values of COVID-19 cases and deaths were retrieved twice for each country (one week prior to the individual data collection). Results: Across countries and time, levels of adherence to handwashing guidelines were high. Path analysis indicated that smaller numbers of COVID-19 cases/deaths (Time 0; T0) were related to stronger self-efficacy (T1), which in turn was associated with higher handwashing adherence (T3). Lower general anxiety (T1) was related to better adherence (T3), with this effect mediated by higher response efficacy (T1, T3) and lower response cost (T3). However, higher general anxiety (T1) was related to better adherence via higher illness severity (T1, T3). General anxiety was unrelated to COVID-19 indicators. Conclusions: We found a complex pattern of associations between the numbers of COVID-19 cases/deaths, general anxiety, PMT variables, and handwashing adherence at the early stages of the pandemic. Higher general anxiety may enable threat appraisal (perceived illness severity), but it may hinder coping appraisal (response efficacy and response costs). The indicators of the trajectory of the pandemic (i.e., the smaller number of COVID-19 cases) may be indirectly associated with higher handwashing adherence via stronger self-efficacy.
KW - Anxiety
KW - COVID-19
KW - Handwashing
KW - Protection motivation theory
UR - http://www.scopus.com/inward/record.url?scp=85142535909&partnerID=8YFLogxK
U2 - 10.1016/j.socscimed.2022.115569
DO - 10.1016/j.socscimed.2022.115569
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C2 - 36436259
AN - SCOPUS:85142535909
SN - 0277-9536
VL - 317
JO - Social Science and Medicine
JF - Social Science and Medicine
M1 - 115569
ER -