Understanding public support for COVID-19 pandemic mitigation measures over time: Does it wear out? (preprint)

COVID-19 mitigation measures intend to protect public health, but their adverse psychological, social, and economic effects weaken popular support. Less favorable trade-offs may especially weaken support for more restrictive measures. Support for mitigation measures may also differ between population subgroups who experience different benefits and costs, and decrease over time, a phenomenon termed ‘pandemic fatigue’. We examined self-reported support for COVID-19 mitigation measures in The Netherlands over 12 consecutives waves of data collection between April 2020 – May 2021 in an open population cohort study. Participants were recruited through community panels of the 25 regional public health services, and through links to the online surveys advertised on social media. The 54,010 unique participants in the cohort study on average participated in 4 waves of data collection. Most participants were female (65%), middle-aged (57% 40-69 years), highly educated (57%), not living alone (84%), residing in an urban area (60%), and born in the Netherlands (95%). COVID-19 mitigation measures implemented in the Netherlands remained generally well-supported over time (all scores >3 on 5-point scale ranging 1 (low) – 5 (high)). During the whole period studied, support was highest for personal hygiene measures, quarantine and wearing face masks, high but somewhat lower for not shaking hands, testing and self-isolation, and restricting social contacts, and lowest for limiting visitors at home, and not traveling abroad. Women and higher educated people were more supportive of some mitigation measures than men and lower educated people. Older people were more supportive of more restrictive measures than younger people, and support for more socially restrictive measures decreased most over time in higher educated people or in younger people. This study found no support for pandemic fatigue in terms of a gradual decline in support for all mitigation measures over time. Rather, findings suggest that support for mitigation measures reflects a balancing of benefits and cost, which may change over time, and differ between measures and population subgroups.

Habit Formation of Preventive Behaviours during the COVID-19 Pandemic: A Longitudinal Study of Physical Distancing and Hand Washing (preprint)

Introduction: Since the outbreak of the COVID-19 pandemic, physical distancing and hand washing have been used as effective means to reduce virus transmission in the Netherlands. However, they pose a societal challenge as they require people to change their customary behaviours in various contexts. The science of habit formation is potentially useful for informing policy-making in public health, but the current literature largely overlooked the role of habit in predicting and explaining these preventive behaviours. Our research aimed to describe habit formation processes of physical distancing and hand washing and to estimate the influences of habit strength and intention on behavioural adherence. Methods: A longitudinal survey was conducted between July and November 2020 on a representative Dutch sample (n = 800). Respondents reported weekly their intention, habit strength, and actual adherence regarding six context-specific behaviours. Temporal developments of the measured variables were visualized, quantified, and mapped to five distinct phases of the pandemic. Regression models were used to test the effects of intention, habit strength, and their interaction on future adherence. Results: Dutch respondents generally had strong intention to adhere to all preventive measures and their actual adherence rates were between 70% and 90%. They also self-reported to experience their behaviours as more automatic over time, and this increasing trend in habit strength was more evident for physical distancing than hand washing behaviours. For all six behaviours, both intention and habit strength predicted future adherence (all ps < 2e-16). In addition, the predictive power of intention decreased over time and was weaker for respondents with strong habits for physical distancing when visiting supermarket (B = -0.63, p < .0001) and having guests at home (B = -0.54, p < .0001) in the later phases of the study, but not for hand washing. Conclusions: People’s adaptation to physical distancing and hand washing involves both intentional and habitual processes. For public health management, our findings highlight the importance of using contextual cues to promote habit formation, especially for maintaining physical distancing practice. For habit theories, our study provides a unique data set that covers multiple health behaviours in a critical real-world setting.