Observational studySocial science & medicine (1982)2023
Handwashing adherence during the COVID-19 pandemic: A longitudinal study based on protection motivation theory.
Observational study in Social science & medicine (1982), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04367337 (Health Behavior Change During COVID-19 Pandemic), which is not on this map. Cited by 6 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Health Behavior Change During COVID-19 Pandemic: the Focus on Handwashing
Who cites it
6 citing papers in PubMed.
- Pandemic fatigue and associated factors: a meta-analysis using the COM-B model.Frontiers in psychology · 2026Review
- Effectiveness of a lymphedema prevention program for patients with breast cancer: A randomized controlled trial based on the Protection Motivation Theory and Information-Motivation-Behavioral Skills Model.Asia-Pacific journal of oncology nursing · 2025Article
- Assessing the relationship between delay discounting and decisions to engage in various protective behaviors during COVID-19.Cognitive research: principles and implications · 2024Article
- When do people increase COVID-19 protective behaviors? A longitudinal analysis of the impact of infections among close contacts and in the community.Preventive medicine reports · 2023Article
- Meta-analysis on application of Protection Motivation Theory in preventive behaviors against COVID-19.International journal of disaster risk reduction : IJDRR · 2023Review
- Threat Appraisal, Resilience, and Health Behaviors in Recovered COVID-19 Patients: The Serial Mediation of Coping and Meaning-Making.International journal of environmental research and public health · 2023Article
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Authors and funding
29 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
rationaleThe 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.
objectiveApplying 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).
methodThe 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).
resultsAcross 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.
conclusionsWe 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.
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