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The Interplay Between Strictness of Policies and Individuals' Self-Regulatory Efforts: Associations with Handwashing During the COVID-19 Pandemic

Luszczynska A 1 , Szczuka Z 1 , Abraham C 2 , Baban A 3 , Brooks S 4 , Cipolletta S 5 Show all authors , Danso E 6 , Dombrowski SU 4 , Gan Y 7 , Gaspar T 8 , de Matos MG 8 , Griva K 9 , Jongenelis MI 10 , Keller J 11 , Knoll N 11 , Ma J 7 , Miah MAA 12 , Morgan K 12 , Peraud W 13 , Quintard B 13 , Shah V 14 , Schenkel K 15 , Scholz U 15 , Schwarzer R 11 , Siwa M 1 , Taut D 3 , Tomaino SCM 5 , Vilchinsky N 16 , Wolf H 16

Affiliations 

  • 1 Wroclaw Faculty of Psychology, SWPS University of Social Sciences and Humanities, Wroclaw, Poland
  • 2 School of Psychology, Deakin University, Geelong, Australia
  • 3 Department of Psychology, Babes-Bolyai University, Cluj-Napoca, Romania
  • 4 Faculty of Kinesiology, University of New Brunswick, Fredericton, Canada
  • 5 Department of General Psychology, University of Padova, Padova, Italy
  • 6 Medical Research Council Unit-The Gambia at London School of Hygiene and Tropical Medicine, Serrekunda, Gambia
  • 7 School of Psychological and Cognitive Sciences, Peking University, Beijing, China
  • 8 Institute of Environmental Health, Medical School, University of Lisbon, Lisbon, Portugal
  • 9 Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
  • 10 Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Australia
  • 11 Department of Education and Psychology, Freie Universität Berlin, Berlin, Germany
  • 12 School of Medicine, Perdana University-Royal College of Surgeons in Ireland, Kuala Lumpur, Malaysia
  • 13 Department of Psychology, INSERM 1219, University of Bordeaux, Bordeaux, France
  • 14 Department of Infectious Diseases, Environmental Health Group, London School of Hygiene and Tropical Medicine, London, UK
  • 15 Department of Psychology, Applied Social and Health Psychology, University of Zurich , Zurich, Switzerland
  • 16 Department of Psychology, Bar-Ilan University, Ramat-Gan, Israel
Ann Behav Med, 2021 Dec 06.
PMID: 34871341 DOI: 10.1093/abm/kaab102

Abstract

BACKGROUND: Patterns of protective health behaviors, such as handwashing and sanitizing during the COVID-19 pandemic, may be predicted by macro-level variables, such as regulations specified by public health policies. Health behavior patterns may also be predicted by micro-level variables, such as self-regulatory cognitions specified by health behavior models, including the Health Action Process Approach (HAPA).

PURPOSE: This study explored whether strictness of containment and health policies was related to handwashing adherence and whether such associations were mediated by HAPA-specified self-regulatory cognitions.

METHODS: The study (NCT04367337) was conducted among 1,256 adults from Australia, Canada, China, France, Gambia, Germany, Israel, Italy, Malaysia, Poland, Portugal, Romania, Singapore, and Switzerland. Self-report data on cross-situational handwashing adherence were collected using an online survey at two time points, 4 weeks apart. Values of the index of strictness of containment and health policies, obtained from the Oxford COVID-19 Government Response Tracker database, were retrieved twice for each country (1 week prior to individual data collection).

RESULTS: Across countries and time, levels of handwashing adherence and strictness of policies were high. Path analysis indicated that stricter containment and health policies were indirectly related to lower handwashing adherence via lower self-efficacy and self-monitoring. Less strict policies were indirectly related to higher handwashing adherence via higher self-efficacy and self-monitoring.

CONCLUSIONS: When policies are less strict, exposure to the SARS-CoV-2 virus might be higher, triggering more self-regulation and, consequently, more handwashing adherence. Very strict policies may need to be accompanied by enhanced information dissemination or psychosocial interventions to ensure appropriate levels of self-regulation.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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