The United Nations have described the outbreak of the coronavirus disease 2019 (COVID-19) as the worst global crisis since the second world war. Behavioral protective measures, such as good hand hygiene and social distancing, may strongly affect infection and fatality rates worldwide. In two studies (total N = 962), we aimed to identify central predictors of acceptance and adoption of protective measures, including sociodemographic variables, risk perception, and trust. We found that men and younger participants show lower acceptance and adoption of protective measures, suggesting that it is crucial to develop targeted health messages for these groups. Moreover, trust in politics and trust in science emerged as important predictors for the acceptance and adoption of protective measures. These results show that maintaining and ideally strengthening trust in politics and trust in science might be central for overcoming the COVID-19 pandemic.

The United Nations have described the outbreak of the coronavirus disease 2019 (COVID-19) as the worst global crisis since the second world war. Behavioral protective measures, such as good hand hygiene and social distancing, may strongly affect infection and fatality rates worldwide. In two studies (total N = 962), we aimed to identify central predictors of acceptance and adoption of protective measures, including sociodemographic variables, risk perception, and trust. We found that men and younger participants show lower acceptance and adoption of protective measures, suggesting that it is crucial to develop targeted health messages for these groups. Moreover, trust in politics and trust in science emerged as important predictors for the acceptance and adoption of protective measures. We discuss factors that contribute to the development of trust and derive implications for effective health communication during COVID-19.

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Some people believe that their own health is rather malleable and can be changed (incremental theory), whereas other people believe that their health is relatively fixed (entity theory). Previous research suggests that individuals who hold a strong incremental theory of health have more positive health‐related attitudes and engage in more health‐promoting behaviors in everyday life. However, less is known about the interpersonal effects of an incremental theory of health. A strong incremental theory of health could have detrimental consequences, such as increasing blame and reducing social support towards others who are ill. To test this, two studies (Study 1: N = 433, Study 2: N = 397) were conducted in which implicit theories of health (incremental vs. entity) were experimentally manipulated, and participants were presented with vignettes describing individuals suffering from different illnesses. The dependent variables included blame, sympathy, outcome expectancy, and social support. Study 1 demonstrated that an incremental theory of health increased blame towards people suffering from an illness, regardless of whether a physical or mental illness was presented, and blame indirectly attenuated social support. Study 2 showed that an incremental theory increased outcome expectancy, which indirectly amplified social support. In sum, this research suggests that an incremental theory of health may decrease social support via blame, but increases in outcome expectancy may counteract this effect.

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BACKGROUND Implicit theories of health are beliefs about whether health is perceived as malleable (incremental theory) or fixed (entity theory). Research has shown that an incremental theory of health is connected to many health-promoting outcomes. However, research on its influence on actual health-promoting behaviors is scarce. OBJECTIVE The objective of our study was to investigate whether a smartphone-based ecological momentary intervention designed to promote an incremental theory of health increases the frequency of performing health-promoting behaviors in daily life. METHODS In this two-arm, single-blind, delayed intervention, 149 German participants (mean[age]=30.58, SD 9.71; 79 female) were asked daily over a period of three weeks to indicate whether they had performed 10 health-promoting behaviors throughout the day. Either after one week (early intervention; n=72) or two weeks (delayed intervention; n=77) of baseline behavior measurement, participants were presented with intervention materials designed to strengthen an incremental theory of health. Data collection for this study ran between September and October 2019. RESULTS Multilevel analyses revealed that across conditions, participants reported to engage in health-promoting behaviors more often after being confronted to the intervention materials compared to baseline (b=0.14, t[146.65]=2.06, SE 0.07, P=.04, 95% CI 0.01-0.28). When analyzed separately, this intervention effect was only present for the delayed intervention group (b=0.27, t[492.37]=3.50, SE 0.08, P<.001, 95% CI 0.12-0.42) while no significant increase in health-behaviors occurred for the early intervention group (b=0.02, t[69.23]=0.14, SE 0.11, P=.89, 95% CI -0.2 to 0.23). CONCLUSIONS This intervention shows that a smartphone-based intervention promoting an incremental theory of health can serve as a time- and cost-efficient approach to increase the frequency of performing health-promoting behaviors. We discuss why the intervention's effectiveness differs between intervention groups. In addition, implications are derived that may guide future digital health interventions that focus on implicit theories to achieve health behavior change. CLINICALTRIAL DRKS – German Clinical Trials Register DRKS00017379; https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00017379

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