Article révisé par les pairs
Résumé : To manage the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, governments imposed public health measures requiring considerable effort and behavioral change from citizens. Grounded in self-determination theory, we investigate the relationship between citizens’ motivation for adhering to health-protective behavior and epidemiological changes in SARS-CoV-2. Specifically, we investigated the concurrent (Hypothesis 1) and prospective (Hypothesis 2) association between daily motivation quality and daily actual growth rates in infections and hospitalizations in Belgium, thereby also testing the explanatory role of behavioral adherence to account for this prospective association (Hypothesis 3). Data were collected during the first 12 months of the SARS-CoV-2 pandemic using online surveys (N = 183,766; 7.2% missing days; 0% vaccinated; Mage = 50.41; 68.2% female) and the Google Mobility dataset. Multilevel models revealed that hospitalization rates (but not infection rates) are concurrently related to a better quality of motivation, with citizens identifying more with the value of measures and feeling less externally pressured to comply with them on a day with more hospitalizations. Across time, better quality of motivation predicted, respectively, lower infection and lower hospitalization rates 6 and 7 weeks later, with improved behavioral adherence, as assessed by self-reports and registered mobility, accounting for the benefits of motivation (i.e., mediation). We conclude that for a preventive policy to durably impact the epidemiological course, citizens need to fully identify with the importance of introduced health-protective measures such they volitionally adhere to them.

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