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Background Based on theory, COVID-19 transmission-reducing behaviors (TRBs) should become habitual because of their frequent performance. Habits have been hypothesized to develop through reflective processes and, to act in conjunction with them. Purpose We investigated the existence, development, and consequences of TRB habits, for physical distancing, handwashing, and wearing face coverings. Methods A representative sample of the Scottish population (N = 1,003) was interviewed by a commercial polling company in August–October 2020 and half were re-interviewed later. Measures included adherence, habit, personal routine tendency, reflective processes, and action control for three TRBs. Data were analyzed using general linear modeling, regression, and mediation analyses. Results Handwashing was most habitual; only face covering became more habitual over time. Routine tendencies predicted TRB habits, and adherence to handwashing and physical distancing. Those reporting greater habits reported better adherence, for physical distancing and handwashing, and this remained true after controlling for previous adherence. Reflective and habit processes independently predicted adherence for physical distancing and handwashing; only reflective processes were independently predictive for face covering. The relationship between planning and forgetting and adherence was partly direct, and partly mediated by habit. Conclusions The results confirm hypotheses from habit theory including the role of repetition and of personal routine tendency in developing habits. They are consistent with dual processing theory in finding that both reflective and habit processes predict adherence to TRBs. Action planning partly mediated the relation between reflective processes and adherence. The COVID-19 pandemic has enabled the testing and confirmation of several theoretical hypotheses about habit processes in the enactment of TRBs. [ABSTRACT FROM AUTHOR]

There is a need for a measure to monitor adherence to transmission-reducing behaviours (TRBs) during pandemics. An adherence measure can monitor current TRBs, assess change over time and, potentially, predict later behaviours. The TRB adherence measure (scale consisting of seven items) includes questions based on government behavioural directives in Scotland that were common internationally, i.e., physical distancing, face covering and hand hygiene. Data were collected weekly for 6 weeks at the beginning of the pandemic, including a later follow-up repeated measure of some participants, in 20-minute structured telephone surveys with a nationally representative random sample of adults in Scotland. A total of 2969 people completed the adherence items and were highly adherent. Confirmatory factor analysis supported a unidimensional scale (CFI =.95; TLI =.93; RMSEA =.08; SRMR =.08), although internal consistency was low (Cronbach's alpha =.49). The adherence score significantly predicted adherence to a validity test item (ΔR2 =.114, F(1,2964) = 379.76, p <.001). It also predicted adherence to TRBs later over and above personal habitual styles (Creature of Habit Scale: COHS). The adherence score has been developed for routine monitoring of adherence to TRBs during the COVID-19 pandemic. It can be used to predict future similar behaviours and adherence to other behaviours, although it may be necessary to explore adherence to the specific behaviours occasionally. Adherent behaviour for one TRB is likely to be associated with adherence to government directives to other TRBs. Importantly, these TRBs are likely to be crucial in reducing COVID-19 case numbers, as well as protecting against other infectious diseases including influenza and the common cold. [ABSTRACT FROM AUTHOR]

Objectives: Self‐efficacy is important for adherence to transmission‐reducing behaviours (e.g., physical distancing) as also shown in the CHARIS project. We aimed to show that a theory‐based short message can increase physical distancing self‐efficacy and intentions to keep physical distance. Design: Structured telephone surveys with a randomly selected nationally representative sample of adults in Scotland (N = 497). Methods: Participants were randomly assigned to one of two experimental conditions: message condition (short message to increase self‐efficacy via vicarious experiences, verbal persuasion and emotional arousal) or control condition (no message). Followed by measures for self‐efficacy and intention for physical distancing on 4‐point scales. Adherence to physical distancing was assessed on a 5‐point frequency scale (never – always). Results: Using mediation analyses with bootstrapping procedures, we first confirmed that self‐efficacy was associated indirectly with adherence, via higher intentions in a partial mediation (unstandardized indirect effect.21, 95% CI.18–.25). The message increased self‐efficacy; participants receiving the message reported higher self‐efficacy (M = 4.23, SD =.80) compared to participants in the control condition (M = 4.08, SD =.77; standardized regression coefficient =.19, p <.05) and self‐efficacy affected intention (.48, p <.001). There was a small significant indirect effect of the message on intention via self‐efficacy (unstandardized indirect effect.07, CI.01–.14). Conclusions: Increasing self‐efficacy for physical distancing with a short message can successfully increase intention to physical distance via increased self‐efficacy. As both self‐efficacy and intentions are important predictors of adherence to transmission‐reducing behaviours short messages have potential to limit the spread of COVID‐19. [ABSTRACT FROM AUTHOR]

Objectives: To examine the ability of four models of behaviour, namely, Protection Motivation Theory (PMT), the Common Sense Self-Regulation Model (CS-SRM), and Social Cognitive Theory and the Reasoned Action Approach (SCT and RAA) to understand adherence to transmission-reducing behaviours (TRBs) advised by national governments for suppression of SARS-CoV2.Design: A series of six cross-sectional telephone surveys of a random representative sample of adults living in Scotland.Methods: Self-reported adherence to three TRBs (physical distancing, wearing a face covering and handwashing), PMT, CS-SRM, and SCT/RAA constructs, and sociodemographic variables were measured each week for 6 weeks (n = ~500 p/w; third June-15th July) via a 15 min telephone survey.Results: Adherence was high ('Always' or 'Most times') throughout for physical distancing and handwashing, and, when mandated, for wearing a face covering. Older people were more adherent to all TRBs. Constructs from all three models predicted all three TRBs. Intention and self-efficacy (SCT/RAA) were the only beliefs to predict to all three TRBs each week and for all groups equally; intention was the strongest predictor. The predictive utility of PMT and CS-SRM varied by TRB and by group. Of note was the observation that several illness beliefs were associated with adherence only for those who believed they had not had COVID-19.Conclusions: The CHARIS project has identified beliefs about specific behaviours, the illness and the risks associated with lower adherence rates that might be addressed in national interventions. It confirms previous findings that some groups show lower levels of adherence and might be specially targeted. [ABSTRACT FROM AUTHOR]

Background: Investigations about mental health report prevalence rates with fewer studies investigating psychological and social factors influencing mental health during the Covid-19 pandemic. Study aims: (1) identify sociodemographic groups of the adult population at risk of anxiety and depression and (2) determine if the following social and psychological risk factors for poor mental health moderated these direct sociodemographic effects: loneliness, social support, threat perception, illness representations. Methods: Cross-sectional nationally representative telephone survey in Scotland in June 2020. If available, validated instruments were used, for example, Patient Health Questionnaire (PHQ-4) to measure anxiety and depression. Simple linear regressions followed by examination of moderation effect. Results: A total of 1006 participants; median age 53 years, 61.4% female, from all levels of area deprivation (i.e., 3.8% in the most deprived decile and 15.6% in the most affluent decile). Analyses show associations of anxiety and depression with sociodemographic (age, gender, deprivation), social (social support, loneliness) and psychological factors (perceived threat and illness representations). Mental health was poorer in younger adults, women and people living in the most deprived areas. Age effects were exacerbated by loneliness and illness representations, gender effects by loneliness and illness representations and deprivation effects by loneliness, social support, illness representations and perceived threat. In each case, the moderating variables amplified the detrimental effects of the sociodemographic factors. Conclusions: These findings confirm the results of pre-Covid-19 pandemic studies about associations between sociodemographics and mental health. Loneliness, lack of social support and thoughts about Covid-19 exacerbated these effects and offer pointers for pre-emptive action. [ABSTRACT FROM AUTHOR]