Cross-temporal relations of conditional risk perception measures with protective actions against COVID-19

Two decades ago a research team clarified that cross-sectional associations of risk perceptions and protective behavior can only test an “accuracy” hypothesis: e.g., people with higher risk perceptions at Ti should also exhibit low protective behavior and/or high risky behavior at Ti. They argued that these associations are too often interpreted wrongly as testing two other hypotheses, only testable longitudinally: the “behavioral motivation” hypothesis, that high risk perception at Ti increases protective behavior at Ti+1, and the “risk reappraisal” hypothesis, that protective behavior at Ti reduces risk perception at Ti+1. Further, this team argued that risk perception measures should be conditional (e.g., personal risk perception if one's behavior does not change). Yet these theses have garnered relatively little empirical testing. An online longitudinal panel study of U.S. residents' COVID-19 views across six survey waves over 14 months in 2020–2021 tested these hypotheses for six behaviors (hand washing, mask wearing, avoiding travel to infected areas, avoiding large public gatherings, vaccination, and [for five waves] social isolation at home). Accuracy and behavioral motivation hypotheses were supported for both behaviors and intentions, excluding a few waves (particularly in February–April 2020, when the pandemic was new in the U.S.) and behaviors. The risk reappraisal hypothesis was contradicted—protective behavior at one wave increased risk perception later—perhaps reflecting continuing uncertainty about efficacy of COVID-19 protective behaviors and/or that dynamic infectious diseases may yield different patterns than chronic diseases dominating such hypothesis-testing. These findings raise intriguing questions for both perception-behavior theory and behavior change practice.