| Literature DB >> 35622891 |
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Abstract
Finding communication strategies that effectively motivate social distancing continues to be a global public health priority during the COVID-19 pandemic. This cross-country, preregistered experiment (n = 25,718 from 89 countries) tested hypotheses concerning generalizable positive and negative outcomes of social distancing messages that promoted personal agency and reflective choices (i.e., an autonomy-supportive message) or were restrictive and shaming (i.e., a controlling message) compared with no message at all. Results partially supported experimental hypotheses in that the controlling message increased controlled motivation (a poorly internalized form of motivation relying on shame, guilt, and fear of social consequences) relative to no message. On the other hand, the autonomy-supportive message lowered feelings of defiance compared with the controlling message, but the controlling message did not differ from receiving no message at all. Unexpectedly, messages did not influence autonomous motivation (a highly internalized form of motivation relying on one’s core values) or behavioral intentions. Results supported hypothesized associations between people’s existing autonomous and controlled motivations and self-reported behavioral intentions to engage in social distancing. Controlled motivation was associated with more defiance and less long-term behavioral intention to engage in social distancing, whereas autonomous motivation was associated with less defiance and more short- and long-term intentions to social distance. Overall, this work highlights the potential harm of using shaming and pressuring language in public health communication, with implications for the current and future global health challenges.Entities:
Keywords: COVID-19; behavior change; health communication; motivation; self-determination theory
Mesh:
Year: 2022 PMID: 35622891 PMCID: PMC9295806 DOI: 10.1073/pnas.2111091119
Source DB: PubMed Journal: Proc Natl Acad Sci U S A ISSN: 0027-8424 Impact factor: 12.779
Reliabilities, means, SDs, and correlations with CIs
| Variable | ICC | M (SD) | Condition M (SD) | 1 | 2 | 3 | 4 | 5 | 6 | |||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C | NM | AS | ||||||||||
| 1) Baseline adherence | 0.88/0.91 | 0.15 | 5.24 | 5.22 | 5.26 | 5.23 | ||||||
| (1.60) | (1.62) | (1.60) | (1.59) | |||||||||
| 2) Perceived control | 0.67/0.67 | 0.04 | 3.79 | 4.15 | 3.76 | 3.46 | –0.13** | |||||
| (1.72) | (1.78) | (1.67) | (1.63) | [–0.14, –0.12] | ||||||||
| 3) Autonomous motivation | 0.96/0.97 | 0.14 | 6.02 | 6.01 | 5.96 | 6.09 | 0.38** | –0.35** | ||||
| (1.18) | (1.21) | (1.22) | (1.10) | [0.37, 0.39] | [–0.36, –0.34] | |||||||
| 4) Controlled motivation | 0.71/0.77 | 0.10 | 4.53 | 4.68 | 4.34 | 4.58 | 0.10** | 0.11** | 0.28** | |||
| (1.42) | (1.42) | (1.45) | (1.38) | [0.09, 0.11] | [0.10, 0.12] | [0.27, 0.29] | ||||||
| 5) Defiance | 0.91/0.93 | 0.05 | 2.71 | 2.79 | 2.79 | 2.54 | –0.22** | 0.52** | –0.47** | 0.04** | ||
| (1.60) | (1.68) | (1.58) | (1.53) | [–0.24, –0.21] | [0.51, 0.53] | [–0.48, –0.47] | [0.03, 0.05] | |||||
| 6) Intention to social distance next 1 wk | 0.91/0.93 | 0.13 | 5.57 | 5.54 | 5.60 | 5.56 | 0.57** | –0.16** | 0.46** | 0.14** | –0.28** | |
| (1.53) | (1.54) | (1.53) | (1.52) | [0.57, 0.58] | [–0.17, –0.15] | [0.450.47] | [0.13, 0.16] | [–0.29, –0.26] | ||||
| 7) Intention to social distance next 6 mo | 0.90/0.92 | 0.09 | 17.51 | 17.61 | 17.56 | 17.37 | 0.39** | –0.28** | 0.47** | 0.05** | –0.41** | 0.43** |
| (6.74) | (6.77) | (6.68) | (6.79) | [0.380.40] | [–0.30, –0.27] | [0.460.48] | [0.03, 0.06] | [–0.42, –0.40] | [0.42, 0.44] | |||
N = 25,718. M and SD are used to represent mean and SD, respectively. ICC is the intraclass correlation coefficient. Values in square brackets indicate the 95% CI for each correlation. The 95% CI is a plausible range of population correlations that could have caused the sample correlation. AS, autonomy supportive; C, controlling; NM, no message. **P < 0.001.
*Only two items were included for this variable: “try to pressure people” and “aren’t very sensitive to people’s needs.” The original three-item measure yielded α = 0.55 and ω = 0.62. We preregistered that if α or ω < 0.70, the composite would only include items with corrected item–total correlations above 0.30. More details are in .
†Excluding erroneous data.
Fig. 1.Flowchart delineating the final samples used in analyses.
Fig. 2.Data distributions for all study variables (the y axis indicates the proportion of sample, and the x axis indicates response scales).
Random intercept–only models testing confirmatory effects of experimental conditions (Hypothesis 1) and autonomous and controlled motivation (Hypothesis 2) on outcomes
| Outcome and term |
| SE |
| df |
| 95% CI around | Variance of random effects | ||
|---|---|---|---|---|---|---|---|---|---|
| Lower | Upper | ||||||||
| Autonomous motivation Hypothesis 1 | |||||||||
| Controlling (intercept) | 6.01 | 0.06 | 107.99 | 76.01 | 0.048 | 0.036 | 0.060 | <0.001 | 0.191 |
| Vs. no message | −0.04 | 0.02 | −2.10 | 25,649.85 | –0.012 | –0.024 | -0.001 | 0.036 | |
| Vs. autonomy supportive | 0.10 | 0.02 | 5.83 | 25,649.03 | 0.034 | 0.021 | 0.046 | <0.001 | |
| Controlled motivation Hypothesis 1 | |||||||||
| Controlling (intercept) | 4.57 | 0.06 | 78.37 | 77.52 | 0.099 | 0.088 | 0.112 | <0.001 | 0.20 |
| Vs. no message | −0.34 | 0.02 | −16.24 | 25,646.41 | –0.096 | –0.108 | –0.084 | <0.001 | |
| Vs. autonomy supportive | −0.09 | 0.02 | −4.47 | 25,644.91 | –0.026 | –0.039 | –0.014 | <0.001 | |
| Defiance Hypothesis 1 | |||||||||
| Controlling (intercept) | 2.77 | 0.05 | 55.54 | 69.88 | 0.073 | 0.061 | 0.085 | <0.001 | 0.13 |
| Vs. no message | −0.01 | 0.02 | −0.44 | 25,412.46 | –0.003 | –0.015 | 0.000 | 0.657 | |
| Vs. autonomy supportive | −0.25 | 0.02 | −10.50 | 25,409.08 | –0.064 | –0.076 | –0.052 | <0.001 | |
| Defiance Hypothesis 2 | |||||||||
| Intercept | 6.20 | 0.07 | 93.79 | 297.72 | 0.524 | 0.516 | 0.532 | <0.001 | 0.11 |
| Autonomous motivation | −0.75 | 0.01 | −94.64 | 25,338.34 | –0.522 | –0.530 | –0.514 | <0.001 | |
| Controlled motivation | 0.23 | 0.01 | 36.10 | 25,413.67 | 0.223 | 0.211 | 0.234 | <0.001 | |
| Intention to avoid 1 wk Hypothesis 1 | |||||||||
| Controlling (intercept) | 5.42 | 0.07 | 77.26 | 74.77 | 0.017 | 0.007 | 0.030 | <0.001 | 0.30 |
| Vs. no message | 0.06 | 0.02 | 2.91 | 25,235.70 | 0.017 | 0.005 | 0.029 | 0.004 | |
| Vs. autonomy supportive | 0.03 | 0.02 | 1.52 | 25,234.29 | 0.009 | 0.001 | 0.021 | 0.128 | |
| Intention to avoid 1 wk Hypothesis 2 | |||||||||
| Intercept | 2.00 | 0.07 | 28.24 | 212.79 | 0.446 | 0.437 | 0.456 | <0.001 | 0.17 |
| Autonomous motivation | 0.58 | 0.01 | 75.29 | 25,252.95 | 0.433 | 0.423 | 0.442 | <0.001 | |
| Controlled motivation | −0.01 | 0.01 | −0.92 | 25,265.99 | –0.006 | –0.018 | 0.000 | 0.355 | |
| Intention to avoid 6 mo Hypothesis 1 | |||||||||
| Controlling (intercept) | 17.20 | 0.27 | 64.42 | 72.23 | 0.012 | 0.003 | 0.025 | <0.001 | 4.02 |
| Vs. no message | −0.01 | 0.10 | −0.10 | 24,606.22 | –0.001 | –0.014 | 0.000 | 0.917 | |
| Vs. autonomy supportive | −0.17 | 0.10 | −1.72 | 24,604.00 | –0.010 | –0.023 | –0.001 | 0.086 | |
| Intention to avoid 6 mo Hypothesis 2 | |||||||||
| Intercept | 2.50 | 0.29 | 8.75 | 292.37 | 0.466 | 0.457 | 0.475 | <0.001 | 2.05 |
| Autonomous motivation | 2.76 | 0.03 | 79.95 | 24,528.81 | 0.465 | 0.456 | 0.474 | <0.001 | |
| Controlled motivation | −0.45 | 0.03 | −15.97 | 24,607.37 | –0.102 | –0.114 | –0.090 | <0.001 | |
B is the unstandardized coefficient; r is the partial standardized effect size for each coefficient. N = 25,718. Controlling: n = 8,368; no message: n = 8,790; autonomy supportive: n = 8,560. The controlling message was the reference group. We report three decimal places for p and r and its 95% CI since our interval null is r = –0.025 to 0.025 and two decimals for all other values. df, degree of freedom.
*Excluding erroneous data.
Maximal models testing the confirmatory effect of experimental conditions (Hypothesis 1) and autonomous and controlled motivation (Hypothesis 2) on outcomes only using countries with a sample size of 210 or above
| Outcome and term |
| SE |
| df |
| 95% CI around | Variance of random effects | ||
|---|---|---|---|---|---|---|---|---|---|
| Lower | Upper | ||||||||
| Autonomous motivation Hypothesis 1 | |||||||||
| Controlling (intercept) | 5.99 | 0.08 | 73.82 | 34.81 | 0.046 | 0.034 | 0.059 | <0.001 | 0.22 |
| Vs. no message | −0.03 | 0.03 | −1.25 | 23.72 | –0.012 | –0.024 | –0.001 | 0.223 | 0.01 |
| Vs. autonomy supportive | 0.10 | 0.03 | 3.48 | 26.33 | 0.033 | 0.020 | 0.045 | 0.002 | 0.01 |
| Controlled motivation Hypothesis 1 | |||||||||
| Controlling (intercept) | 4.66 | 0.08 | 59.42 | 34.51 | 0.097 | 0.085 | 0.110 | <0.001 | 0.20 |
| Vs. no message | −0.33 | 0.03 | −11.98 | 19.91 | –0.094 | –0.107 | –0.082 | <0.001 | 0.01 |
| Vs. autonomy supportive | −0.10 | 0.02 | −3.91 | 24.50 | –0.027 | –0.040 | –0.014 | 0.001 | 0.00 |
| Defiance Hypothesis 1 | |||||||||
| Controlling (intercept) | 2.79 | 0.06 | 46.36 | 32.80 | 0.064 | 0.051 | 0.077 | <0.001 | 0.11 |
| Vs. no message | −0.04 | 0.06 | −0.70 | 33.18 | –0.011 | –0.024 | –0.001 | 0.487 | 0.10 |
| Vs. autonomy supportive | −0.24 | 0.06 | −3.68 | 33.49 | –0.060 | –0.073 | –0.047 | 0.001 | 0.11 |
| Defiance Hypothesis 2 | |||||||||
| Intercept | 5.98 | 0.18 | 32.68 | 31.95 | 0.518 | 0.510 | 0.527 | <0.001 | 1.00 |
| Autonomous motivation | −0.74 | 0.03 | −24.54 | 34.19 | –0.515 | –0.524 | –0.506 | <0.001 | 0.03 |
| Controlled motivation | 0.26 | 0.02 | 11.45 | 31.53 | 0.244 | 0.232 | 0.255 | <0.001 | 0.01 |
| Intention to avoid 1 wk Hypothesis 1 | |||||||||
| Controlling (intercept) | 5.37 | 0.09 | 60.85 | 34.63 | 0.016 | 0.005 | 0.030 | <0.001 | 0.26 |
| Vs. no message | 0.06 | 0.03 | 1.82 | 20.53 | 0.015 | 0.002 | 0.028 | 0.083 | 0.01 |
| Vs. autonomy supportive | 0.05 | 0.02 | 1.96 | 779.67 | 0.012 | 0.001 | 0.025 | 0.050 | 0.00 |
| Intention to avoid 1 wk Hypothesis 2 | |||||||||
| Intercept | 2.20 | 0.21 | 10.70 | 34.64 | 0.425 | 0.415 | 0.435 | <0.001 | 1.32 |
| Autonomous motivation | 0.54 | 0.03 | 16.35 | 34.93 | 0.413 | 0.402 | 0.423 | <0.001 | 0.03 |
| Controlled motivation | −0.01 | 0.01 | −1.36 | 13.98 | –0.010 | –0.023 | –0.001 | 0.196 | 0.00 |
| Intention to avoid 6 mo Hypothesis 1 | |||||||||
| Controlling (intercept) | 17.27 | 0.33 | 52.70 | 35.59 | 0.008 | 0.002 | 0.023 | <0.001 | 3.44 |
| Vs. no message | 0.07 | 0.12 | 0.57 | 22.48 | 0.004 | 0.000 | 0.017 | 0.573 | 0.08 |
| Vs. autonomy supportive | −0.06 | 0.14 | −0.43 | 17.49 | –0.004 | –0.017 | -0.000 | 0.671 | 0.20 |
| Intention to avoid 6 mo Hypothesis 2 | |||||||||
| Intercept | 3.32 | 0.82 | 4.07 | 30.70 | 0.453 | 0.443 | 0.463 | <0.001 | 19.68 |
| Autonomous motivation | 2.68 | 0.13 | 20.79 | 30.27 | 0.452 | 0.442 | 0.462 | <0.001 | 0.49 |
| Controlled motivation | −0.48 | 0.07 | −6.59 | 23.72 | –0.108 | –0.121 | –0.095 | <0.001 | 0.14 |
B is the unstandardized coefficient; r is the partial standardized effect size for each coefficient. N = 23,554. Controlling: n = 7,688; no message: n = 8,059; autonomy supportive: n = 7,807. The controlling message was the reference group. We report three decimal places for p and r and its 95% CI since our interval null is r = –0.025 to 0.025 and two decimals for all other values. df, degree of freedom.
*Excluding erroneous data.
Fig. 3.Illustrating confirmatory effects testing Hypothesis 1. Effect sizes are drawn from intercept-only models in Table 2 (n = 25,718). Values to the left of zero indicate that no message (or the autonomy-supportive message) yielded lower scores on outcomes than the controlling message. Values to the right of zero indicate that no message (or the autonomy-supportive message) yielded higher scores on those outcomes than the controlling message. The square represents the observed effect size, and the whiskers represents the 95% CIs; if the effect and its 95% CI fall outside the dotted lines (the interval null of r = −0.025 to 0.025), the effect is considered practically meaningful.
Random intercept-only models testing Hypothesis 1: the effects of condition on outcome variables for the sample of participants who completed surveys within 30 days since their country’s rise in restrictions
|
| SE |
| df |
| 95% CI around | Variance of random effects | |||
|---|---|---|---|---|---|---|---|---|---|
| Lower | Upper | ||||||||
| Autonomous motivation | |||||||||
| Controlling (intercept) | 6.35 | 0.07 | 92.55 | 3.07 | 0.120 | 0.082 | 0.167 | <0.001 | 0.00 |
| Vs. no message | 0.07 | 0.04 | 1.68 | 1,976.40 | 0.038 | 0.003 | 0.081 | 0.094 | |
| Vs. autonomy supportive | 0.24 | 0.05 | 5.24 | 1,980.63 | 0.117 | 0.073 | 0.160 | <0.001 | |
| Covariate: Total cases per million | −2.78E-06 | 4.26E-05 | −0.07 | 2.39 | -0.003 | -0.051 | -0.001 | 0.953 | |
| Controlled motivation | |||||||||
| Controlling (intercept) | 4.97 | 0.24 | 20.91 | 5.43 | 0.123 | 0.085 | 0.170 | <0.001 | 0.07 |
| Vs. no message | −0.36 | 0.07 | −4.89 | 1,976.52 | –0.107 | –0.151 | –0.064 | <0.001 | |
| Vs. autonomy supportive | −0.23 | 0.08 | −2.92 | 1,977.58 | –0.064 | –0.108 | –0.021 | 0.004 | |
| Covariate: Total cases per million | 1.01E-04 | 1.49E-04 | 0.68 | 6.97 | 0.064 | 0.020 | 0.108 | 0.519 | |
| Defiance | |||||||||
| Controlling (intercept) | 2.66 | 0.09 | 29.17 | 2.23 | 0.227 | 0.188 | 0.270 | 0.001 | 0.00 |
| Vs. no message | −0.42 | 0.07 | −5.83 | 1,955.26 | –0.130 | –0.173 | –0.087 | <0.001 | |
| Vs. autonomy supportive | −0.74 | 0.07 | −9.84 | 1,960.96 | –0.217 | –0.258 | –0.175 | <0.001 | |
| Covariate: Total cases per million | 1.10E-04 | 5.49E-05 | 2.01 | 1.51 | 0.074 | 0.030 | 0.118 | 0.222 | |
| Intention to avoid next 1 wk | |||||||||
| Controlling (intercept) | 6.44 | 0.06 | 104.98 | 0.94 | 0.070 | 0.037 | 0.120 | 0.008 | 0.00 |
| Vs. no message | 0.04 | 0.06 | 0.75 | 1,929.64 | 0.017 | 0.001 | 0.062 | 0.451 | |
| Vs. autonomy supportive | 0.10 | 0.06 | 1.66 | 1,943.00 | 0.038 | 0.003 | 0.082 | 0.097 | |
| Covariate: Total cases per million | 7.05E-05 | 3.49E-05 | 2.02 | 0.52 | 0.059 | 0.015 | 0.103 | 0.433 | |
| Intention to avoid next 6 mo | |||||||||
| Controlling (intercept) | 15.71 | 2.07 | 7.59 | 5.91 | 0.445 | 0.411 | 0.479 | <0.001 | 14.32 |
| Vs. no message | −0.38 | 0.22 | −1.75 | 1,893.51 | –0.029 | –0.074 | –0.002 | 0.080 | |
| Vs. autonomy supportive | −0.25 | 0.23 | −1.10 | 1,892.62 | –0.018 | –0.063 | –0.001 | 0.273 | |
| Covariate: Total cases per million | 3.08E-03 | 8.80E-04 | 3.50 | 45.63 | 0.445 | 0.410 | 0.479 | 0.001 | |
B is the unstandardized coefficient; r is the partial standardized effect size for each coefficient. N = 1,981. Controlling: n = 600; no message: n = 760; autonomy supportive: n = 621. The controlling message was the reference group. We report three decimal places for p and r and its 95% CI since our interval null is r = –0.025 to 0.025 and two decimals for all other values. df, degree of freedom.