Protection motivation to practice preventive behaviors is necessary for sustained mitigation during coronavirus disease 2019 (COVID-19); however, limited research exists on the ecological sources of influence for COVID-19 protection motivation.
Aim
To explore sources of influence (family health, media consumption, and loss of work hours) on COVID-19 protection motivation.
Method
An online quantitative survey of U.S. adults (N = 501) aged 18 years or older was administered using Qualtrics with participants recruited through Amazon Mechanical Turk. Data were collected on constructs related to the protection motivation theory and theory of planned behavior as well as sources of influence and intention to socially distance and socially isolate during COVID-19. Constructs were further defined through exploratory and confirmatory factor analyses. Structural equation modeling was used to determine relationships between constructs.
Results
A two-factor model was identified with threat appraisal as one factor and subjective norms appraisal, coping appraisal, and behavioral intention loading as another factor. Higher news media consumption and loss of work hours due to COVID-19 were both significant predictors of increased threat appraisal. Family healthy lifestyle and family health resources were significantly related to increases in the subjective norms, coping appraisal, and behavioral intention appraisal factor.
Conclusions
Family health, news media consumption, and loss of work hours are associated with COVID-19 protection motivation. COVID-19 protection motivation might be enhanced through policies and messaging that can affect ecological sources of influence.
AhmadM.IramK.JabeenG. (2020). Perception-based influence factors of intention to adopt COVID-19 epidemic prevention in China. Environmental Research, 190, Article 109995. https://doi.org/10.1016/j.envres.2020.109995
2.
AhmedF.ZviedriteN.UzicaninA. (2018). Effectiveness of workplace social distancing measures in reducing influenza transmission: A systematic review. BMC Public Health, 18(1), Article 518. https://doi.org/10.1186/s12889-018-5446-1
3.
AjzenI. (2002). Perceived behavioral control, self-efficacy, locus of control, and the theory of planned behavior. Journal of Applied Social Psychology, 32(4), 665–683. https://doi.org/10.1111/j.1559-1816.2002.tb00236.x
4.
AjzenI. (2005). Attitudes, personality, and behavior (2nd ed.). McGraw-Hill.
5.
AjzenI.FishbeinM. (2004). The influence of attitudes on behavior. In AlbarracinD.JohnsonB. T.ZannaM. P. (Eds.), The handbook of attitudes (pp. 173–222). Lawrence Erlbaum.
6.
AliH.YilmazG.FareedZ.ShahzadF.AhmadM. (2020). Impact of novel coronavirus (COVID-19) on daily routines and air environment: Evidence from Turkey. Air Quality Atmosphere & Health. Advance online publication. https://doi.org/10.1007/s11869-020-00943-2
7.
ApukeO. D.OmarB. (2020). Modelling the antecedent factors that affect online fake news sharing on COVID-19: The moderating role of fake news knowledge. Health Education Research, 35(5), 490–503. https://doi.org/10.1093/her/cyaa030
8.
BashirianS.JenabiE.KhazaeiS.BaratiM.Karimi-ShahanjariniA.ZareianS.Rezapur-ShahkolaF.MoeiniB. (2020). Factors associated with preventive behaviours of COVID-19 among hospital staff in Iran in 2020: An application of the protection motivation theory. Journal of Hospital Infection, 105(3), 430–433. https://doi.org/10.1016/j.jhin.2020.04.035
9.
BilalLatifF.BashirM. F.KomalB.TanD. (2020). Role of electronic media in mitigating the psychological impacts of novel coronavirus (COVID-19). Psychiatry Research, 289, Article 113041. https://doi.org/10.1016/j.psychres.2020.113041
10.
BothaF.PetzoldM. B.PyrkoschL.MascarellM. L.BetzlerF.RogollJ.GroßeJ.StröhleA.PlagJ. (2020). Associations between COVID-19 related media consumption and symptoms of anxiety, depression and COVID-19 related fear in the general population in Germany. European archives of psychiatry and clinical neuroscience. European Archives of Psychiatry and Clinical Neuroscience, 1–9. Advance online publication. https://doi.org/10.1007/s00406-020-01171-6
11.
BronfenbrennerU. (1979). The ecology of human development. Harvard University Press.
12.
BrownT. A. (2006). Confirmatory factor analysis for applied research. Guilford Press.
CoppockA. (2019). Generalizing from survey experiments conducted on Mechanical Turk: A replication approach. Political Science Research and Methods, 7(3), 613–628. https://doi.org/10.1017/psrm.2018.10
15.
CrandallA.Weiss-LaxerN. S.BroadbentE.HolmesE. K.MagnussonB. M.OkanoL.BergeJ. M.BarnesM. D.HansonC. L.JonesN.NovillaL. B. (2020). The family health scale: Reliability and validity of a short- and long-form. Frontiers in Public Health, 8, Article 587125. https://doi.org/10.3389/fpubh.2020.587125
16.
De CastilhoA. R. F.MialheF. L.BarbosaT. D.Puppin-RontaniR. M. (2013). Influence of family environment on children’s oral health: A systematic review. Jornal de Pediatria, 89(2), 116–123. https://doi.org/10.1016/j.jped.2013.03.014
17.
DenhamS. A. (2003a). Family health: A framework for nursing. F. A. Davis.
18.
DenhamS. A. (2003b). Relationship between family rituals, family routines, and health. Journal Family Nursing, 9(3), 305–330. https://doi.org/10.1177/1074840703255447
19.
DepouxA.MartinS.KarafillakisE.PreetR.Wilder-SmithA.LarsonH. (2020). The pandemic of social media panic travels faster than the COVID-19 outbreak. Journal of Travel Medicine, 27(3). Advance online publication. https://doi.org/10.1093/jtm/taaa031
FarooqA.LaatoS.IslamA. (2020). Impact of online information on self-isolation intention during the COVID-19 pandemic: Cross-sectional study. Journal of Medical Internet Research, 22(5), e19128. https://doi.org/10.2196/19128
22.
FieseB. H. (2007). Routines and rituals: Opportunities for participation in family health. OTJR: Occupation Participation and Health, 27(Suppl. 1), 41s–49s. https://doi.org/10.1177/15394492070270s106
23.
FloydD. L.Prentice-DunnS.RogersR. W. (2000). A meta-analysis of research on protection motivation theory. Journal of Applied Social Psychology, 30(2), 407–429. https://doi.org/10.1111/j.1559-1816.2000.tb02323.x
24.
FongV. C.GardinerE.IarocciG. (2020). Can a combination of mental health services and ADL therapies improve quality of life in families of children with autism spectrum disorder?Quality of Life Research, 29(8), 2161–2170. https://doi.org/10.1007/s11136-020-02440-6
25.
FongV. C.IarocciG. (2020). Child and family outcomes following pandemics: A systematic review and recommendations on COVID-19 policies. Journal of pediatric psychology, 45(10), 1124–1143. https://doi.org/10.1093/jpepsy/jsaa092
26.
GostinL. O.WileyL. F. (2020). Governmental public health powers during the COVID-19 pandemic: Stay-at-home orders, business closures, and travel restrictions. Journal of the American Medical Association, 323(21), 2137–2138. https://doi.org/10.1001/jama.2020.5460
27.
HuffC.TingleyD. (2015). “Who are these people?” Evaluating the demographic characteristics and political preferences of MTurk survey respondents. Research and Politics, 2(3), 1–15. https://doi.org/10.1177/2053168015604648
28.
JanickeD. M.SteeleR. G.GayesL. A.LimC. S.CliffordL. M.SchneiderE. M.CarmodyJ. K.WestenS. (2014). Systematic review and meta-analysis of comprehensive behavioral family lifestyle interventions addressing pediatric obesity. Journal of Pediatric Psychology, 39(8), 809–825. https://doi.org/10.1093/jpepsy/jsu023
KerrW. C.KaplanM. S.HuguetN.CaetanoR.GiesbrechtN.McFarlandB. H. (2017). Economic recession, alcohol, and suicide rates: comparative effects of poverty, foreclosure, and job loss. American Journal of Preventive Medicine, 52(4), 469–475. https://doi.org/10.1016/j.amepre.2016.09.021
31.
Khazaee-PoolM.NaghibiS. A.PashaeiT.JahangiryL.DaneshniaM.PonnetK. (2020). Development and initial validation of a scale for assessing affecting factors on preventive behaviors of COVID-19 (AFPB-CO): Using the protection motivation theory. Research Square. https://doi.org/10.21203/rs.3.rs-23051/v1
32.
LangeL.KatzE.AusderauK. (2018). Family mealtime frequency and the effects on family member health and well-being: A systematic review. American Journal of Occupational Therapy, 72, Article 02729490. https://doi.org/10.5014/ajot.2018.72S1-PO3018
33.
LateefF. (2020). Face to face with coronavirus disease 19: Maintaining motivation, psychological safety, and wellness. Journal of Emergencies, Trauma, and Shock, 13(2), 116–123. https://doi.org/10.4103/JETS.JETS_27_20
34.
LaveeY.MccubbinH. I.PattersonJ. M. (1985). The double ABCX model of family stress and adaptation: An empirical-test by analysis of structural equations with latent-variables. Journal of Marriage and the Family, 47(4), 811–825. https://doi.org/10.2307/352326
LeeS. T.BasnyatI. (2013). From press release to news: Mapping the framing of the 2009 H1N1 A influenza pandemic. Health Communication, 28(2), 119–132. https://doi.org/10.1080/10410236.2012.658550
37.
LiW.YangY.LiuZ. H.ZhaoY. J.ZhangQ. G.ZhangL.CheungT.XiangY. T. (2020). Progression of mental health services during the COVID-19 outbreak in China. International Journal of Biological Sciences, 16(10), 1732–1738. https://doi.org/10.7150/ijbs.45120
38.
LiX.FangX.LinD.MaoR.WangJ.CottrellL.HarrisC.StantonB. (2004). HIV/STD risk behaviors and perceptions among rural-to-urban migrants in China. AIDS Education and Prevention, 16(6), 538–556. https://doi.org/10.1521/aeap.16.6.538.53787
39.
LiuL. Q.XieJ. Z.LiK.JiS. H. (2020). Exploring how media influence preventive behavior and excessive preventive intention during the COVID-19 pandemic in China. International Journal of Environmental Research and Public Health, 17(21). Advance online publication. https://doi.org/10.3390/ijerph17217990
40.
LoganD. G. (2020). Coronavirus economic stimulus payments: Who gets it, how, and impact on other benefits. Psychiatry Information in Brief, 17(8), 1148. https://doi.org/10.7191/pib.1148
41.
LuoY.YaoL.HuL.ZhouL.YuanF.ZhongX. (2020). Urban-rural disparities on personal health behaviors and the influencing factors during the COVID-19 outbreak in China: Based on an extended IMB model. Disaster Medicine and Public Health Preparedness, 1–11. https://doi.org/10.1017/dmp.2020.457
MarmotM. G.BellR. (2009). Action on health disparities in the United States: Commission on social determinants of health. Journal of the American Medical Association, 301(11), 1169–1171. https://doi.org/10.1001/jama.2009.363
44.
McCauleyM.MinskyS.ViswanathK. (2013). The H1N1 pandemic: Media frames, stigmatization and coping. BMC Public Health, 13, Article 1116. https://doi.org/10.1186/1471-2458-13-1116
45.
MilneS.OrbellS.SheeranP. (2002). Combining motivational and volitional interventions to promote exercise participation: Protection motivation theory and implementation intentions. British Journal of Health Psychology, 7(Pt. 2), 163–184. https://doi.org/10.1348/135910702169420
46.
MilneS.SheeranP.OrbellS. (2000). Prediction and intervention in health-related behavior: A meta-analytic review of protection motivation theory. Journal of Applied Social Psychology, 30(1), 106–143. https://doi.org/10.1111/j.1559-1816.2000.tb02308.x
47.
MohlerG.BertozziA. L.CarterJ.ShortM. B.SledgeD.TitaG. E.UchidaC. D.BrantinghamP. J. (2020). Impact of social distancing during COVID-19 pandemic on crime in Los Angeles and Indianapolis. Journal of Criminal Justice, 68, Article 101692. https://doi.org/10.1016/j.jcrimjus.2020.101692
48.
MoorI.SpallekJ.RichterM. (2017). Explaining socioeconomic inequalities in self-rated health: A systematic review of the relative contribution of material, psychosocial and behavioural factors. Journal of Epidemiology and Community Health, 71(6), 565–575. https://doi.org/10.1136/jech-2016-207589
49.
MullinixK. J.LeeperT. J.DruckmanJ. N.FreeseJ. (2015). The generalizability of survey experiments. Journal of Experimental Political Science, 2(2), 109–138. https://doi.org/10.1017/XPS.2015.19
50.
MurryV. M.BerkelC.Gaylord-HardenN. K.Copeland-LinderN.NationM. (2011). Neighborhood poverty and adolescent development. Journal of Research on Adolescence, 21(1), 114–128. https://doi.org/10.1111/j.1532-7795.2010.00718.x
51.
NelsonB. W.PettittA.FlanneryJ. E.AllenN. B. (2020). Rapid assessment of psychological and epidemiological correlates of COVID-19 concern, financial strain, and health-related behavior change in a large online sample. PsyArXiv. https://doi.org/10.31234/osf.io/jftze
52.
OzdinS.Bayrak OzdinS. (2020). Levels and predictors of anxiety, depression and health anxiety during COVID-19 pandemic in Turkish society: The importance of gender. International Journal of Social Psychiatry, 66(5), 504–511. https://doi.org/10.1177/0020764020927051
53.
PlotnikoffR. C.TrinhL. (2010). Protection motivation theory: Is this a worthwhile theory for physical activity promotion?Exercise and Sport Science Review, 38(2), 91–98. https://doi.org/10.1097/JES.0b013e3181d49612
54.
PrasetyoY. T.CastilloA. M.SalongaL. J.SiaJ. A.SenetaJ. A. (2020). Factors affecting perceived effectiveness of COVID-19 prevention measures among Filipinos during enhanced community quarantine in Luzon, Philippines: Integrating protection motivation theory and extended theory of planned behavior. International Journal of Infectious Disease, 99, 312–323. https://doi.org/10.1016/j.ijid.2020.07.074
55.
QuonE. C.McGrathJ. J. (2014). Subjective socioeconomic status and adolescent health: A meta-analysis. Health Psychology, 33(5), 433–447. https://doi.org/10.1037/a0033716
SpoorthyM. S.PratapaS. K.MahantS. (2020). Mental health problems faced by healthcare workers due to the COVID-19 pandemic-A review. Asian Journal of Psychiatry, 51, Article 102119. https://doi.org/10.1016/j.ajp.2020.102119
58.
Sung-ChanP.SungY. W.ZhaoX.BrownsonR. C. (2013). Family-based models for childhood-obesity intervention: A systematic review of randomized controlled trials. Obesity Review, 14(4), 265–278. https://doi.org/10.1111/obr.12000
59.
TsoW. W.WongR. S.TungK. T.RaoN.FuK. W.YamJ. C.ChuaG. T.ChenE. Y. H.LeeT. M. C.ChanS. K. W.WongW. H. S.XiongX.ChuiC. S.LiX.WongK.LeungC.TsangS. K. M.ChanG. C. F.TamP. H. K.… ParrickL. p. (2020). Vulnerability and resilience in children during the COVID-19 pandemic. European Child & Adolescent Psychiatry. Advance online publication. https://doi.org/10.1007?s00787-020-01680-8
60.
Weiss-LaxerN. S.CrandallA.OkanoL.RileyA. W. (2020). Building a foundation for family health measurement in national surveys: A modified Delphi expert process. Maternal and Child Health Journal, 24(3), 259–266. https://doi.org/10.1007/s10995-019-02870-w
61.
WiederholdB. K. (2020). Using social media to our advantage: Alleviating anxiety during a pandemic. Cyberpsychology Behavior and Social Networking, 23(4), 197–198. https://doi.org/10.1089/cyber.2020.29180.bkw
62.
WilliamsL.RasmussenS.KleczkowskiA.MaharajS.CairnsN. (2015). Protection motivation theory and social distancing behaviour in response to a simulated infectious disease epidemic. Psychology, Health and Medicine, 20(7), 832–837. https://doi.org/10.1080/13548506.2015.1028946
YanQ.TangS.GabrieleS.WuJ. (2016). Media coverage and hospital notifications: Correlation analysis and optimal media impact duration to manage a pandemic. Journal of Theoretical Biology, 390, 1–13. https://doi.org/10.1016/j.jtbi.2015.11.002
67.
YasirA.HuX.AhmadM.RaufA.ShiJ.Ali NasirS. (2020). Modeling impact of word of mouth and e-government on online social presence during covid-19 outbreak: A multi-mediation approach. International Journal of Environmental Research and Public Health, 17(8), Article 2954. https://doi.org/10.3390/ijerph17082954
68.
ZaamiS.MarinelliE.VariM. R. (2020). New trends of substance abuse during covid-19 pandemic: An international perspective. Frontiers in Psychiatry, 11. Advance online publication. https://doi.org/10.3389/fpsyt.2020.00700
