Curb the spread: Leveraging intensive longitudinal data to unravel within- and between-person processes in adherence to nonpharmaceutical interventions during COVID-19.

Abstract

Objectives: Adhering to behavioral recommendations and nonpharmaceutical interventions (NPIs) is a key to control COVID-19 infection rates. However, rates have decreased globally, and potentially modifiable determinants of ongoing adherence and their interaction with social and physical momentary environments are still poorly understood. Here, we comprehensively examine within-person variations and between-person differences in known behavioral determinants (capability and motivation), as well as the moderating role of situational variable environmental factors (opportunity) in predicting adherence to hygiene and social distancing behaviors. Method: Ecological momentary assessment study over 6 months with monthly assessment bouts (4 days each and five daily assessments) in 623 German adults. Repeated daily assessments of capability, opportunity, motivation, and behavior (COM-B) model factors. Bayesian multilevel logistic regression models were estimated to examine main effects of COM-B factors and moderating effects of momentary environmental factors. Results: Momentary adherence to NPIs was predicted by within-person changes in COM-B factors (motivation: intentions, goal conflict, and control beliefs; opportunities: regulations and norms). Between-person differences in capabilities (habit strength) and motivation (intentions and control beliefs) predicted adherence across situations. Situation-specific environmental factors moderated the motivation-behavior association (regulation measures increased; goal conflict and nonadherent others decreased the association). Conclusions: Individual momentary (within-person) and stable (between-person) motivation indicators predicted adherence. However, situational environmental factors such as regulations or norms have strong main effects and moderate the motivation-behavior translation. These findings have policy implications, supporting recent claims to not rely on the narrative of "personal responsibility," but instead combine health education measures to increase individual motivation with consistent regulation. Public Significance StatementThis study found that social cues, rules, and regulations play a crucial role in ensuring widespread adherence to nonpharmaceutical interventions during COVID-19, and even support those currently low in motivation to protect themselves and others. As already short lapses in adherence to protective behaviors can increase the risk of infection, leading to negative consequences for both individuals and the healthcare system, effective interventions should combine health education with consistent regulation.Christopher M. Jones https://orcid.org/0000-0002-3182-8244 We thank Craig Enders and Brian Keller for their assistance in configuring the multiple imputation procedures as well as all authors of the following software packages we used to wrangle, analyze, or visualize data and find-

Entwicklungen in der Digitalisierung von Public Health seit 2020

“…Im Rahmen des LWC DiPH wurden dazu Scoping-Reviews durchgeführt [ 36 , 37 ], die zeigen, dass neben den Inhalten auch bestimmte Eigenschaften wie etwa Gesundheitskompetenz oder das Bedürfnis nach kognitiver Beanspruchung erklären können, ob Menschen Fehlinformationen glauben und weiterverbreiten. In einer Interventionsstudie konnte zudem gezeigt werden, dass zusätzlich zu den bekannten Maßnahmen zur Hervorhebung von Fehlinformationen soziale Mechanismen wie normative Informationen dazu beitragen können, die Verbreitung von Fehlinformationen zu reduzieren [ 38 ].…”