COVID-19 has become a global pandemic. Throughout most of the pandemic, mitigating its spread has relied on human behavior, namely on adherence to protective behaviors (e.g., wearing a face mask). This research proposes that Protection Motivation Theory (PMT) can contribute to understanding differences in individual adherence to COVID-19 behavioral guidelines. PMT identifies four fundamental cognitive components that drive responses to fear appeals: perceptions of susceptibility (to the disease), severity (of the disease), self-efficacy (to protect oneself), and response efficacy (i.e., recommended behaviors' effectiveness). Two online self-report studies assessed PMT components' capacity to predict adherence to protective behaviors concurrently and across culturally different countries (Israel, Germany, India; Study 1), and again at six-week follow-up (Israeli participants; Study 2). Study 1's findings indicate excellent fit of the PMT model, with about half of the variance in adherence explained. No significant differences were found between participants from Israel (n = 917), Germany (n = 222) and India (n = 160). Study 2 (n = 711) confirmed that PMT components continue to predict adherence after six weeks. In both studies, response efficacy was the PMT component most strongly associated with adherence levels. This study demonstrates that PMT can serve as a theoretical framework to better understand differences in adherence to COVID-19 protective behaviors. The findings may further inform the design of adherence-promoting communications, suggesting that it may be beneficial to highlight response efficacy in such messages.
Keywords: COVID-19; adherence; health behavior; protection motivation theory; response efficacy.