IQ Health Department, Radboud University Medical Center, Nijmegen, The Netherlands.
Department of Social, Health and Organizational Psychology, Utrecht University, Utrecht, The Netherlands.
Br J Health Psychol. 2025 Feb;30(1):e12755. doi: 10.1111/bjhp.12755. Epub 2024 Oct 2.
Physical distancing and handwashing can be important infection prevention measures during an infectious disease outbreak such as the COVID-19 pandemic. To stimulate these behaviours, knowledge of psychosocial determinants as well as contextual factors is vital. We present longitudinal, within-person analyses of the impact of contextual and psychosocial factors on handwashing and distancing behaviour.
We used individual-level data (186,490 participants completing 971,899 surveys) from the Corona Behavioural Unit COVID-19 Cohort, a dynamic cohort study conducted during 26 months of the COVID-19 pandemic in the Netherlands.
Fixed-effects models were employed to estimate within-person associations between psychosocial factors and behaviour, combined with main and moderating effects of contextual factors.
Pandemic severity was associated with more handwashing and distancing behaviour, while the duration of the pandemic had little effect. Within-person changes in response efficacy were most relevant for changes in both handwashing and distancing behaviour, while self-efficacy, descriptive norms and perceived severity of infecting others affected behaviour indirectly. These effects were stable over time. Associations were larger in cross-sectional models, indicating that such models tend to overestimate effects.
Our study highlights the importance of longitudinal data and within-person models to detect possible causal associations. The results suggest that during an outbreak, government and public health professionals should clearly communicate the severity of the pandemic (e.g., hospitalization rates) and the effectiveness of recommended prevention measures in reducing that risk; and seek to improve people's capabilities and opportunities to adhere to guidelines, for example, by modifying the environment.
在传染病爆发期间，如 COVID-19 大流行期间，身体距离和洗手是重要的感染预防措施。为了刺激这些行为，了解社会心理决定因素和背景因素至关重要。我们提出了关于背景和社会心理因素对手卫生和距离行为影响的纵向个体内分析。
我们使用了 Corona Behavioural Unit COVID-19 队列的个体水平数据（971899 次调查中有 186490 名参与者），这是一项在荷兰 COVID-19 大流行期间进行的 26 个月的动态队列研究。
采用固定效应模型估计社会心理因素与行为之间的个体内关联，结合背景因素的主要和调节作用。
大流行严重程度与更多的洗手和距离行为相关，而大流行的持续时间影响较小。反应效能的个体内变化与洗手和距离行为的变化都最为相关，而自我效能、描述性规范和感知感染他人的严重程度则通过间接影响行为。这些效应是稳定的。在横断面模型中，关联更大，表明这些模型往往高估了效应。
我们的研究强调了纵向数据和个体内模型的重要性，以检测可能的因果关联。结果表明，在疫情爆发期间，政府和公共卫生专业人员应明确传达疫情的严重程度（例如住院率）以及建议的预防措施在降低风险方面的有效性；并寻求改善人们遵守指导方针的能力和机会，例如通过改变环境。
