Are you afraid of COVID ‐19? Motivation and engagement in infection–prevention behaviour in a UK community cohort during the first 2 years of the COVID ‐19 pandemic

Objectives: To investigate the relationship between motivation and COVID‐19 infection–prevention behaviour during the first 2 years of the COVID‐19 pandemic. Design: Prospective longitudinal online survey in a UK community‐based cohort. Methods: During March/April 2020, n = 11,113 people, recruited via the HealthWise Wales research registry and social media advertising, completed the COVID‐19 Public Experiences (COPE) study baseline survey, with follow‐up at 3, 12, 18 and 24 months. Online questionnaires assessed COVID‐19 infection–prevention behaviour, perceived susceptibility, fear, personal control over infection transmission and reliability of information from media and government. Repeated‐measures ANOVA identified changes in motivation and behaviour over time. Multivariable regression models at each time point assessed associations between motivation and behaviour. Results: COVID‐19 infection–prevention behaviour and motivational variables (fear of COVID‐19, perceived susceptibility and perceived control) fluctuated over time as the disease and socio‐political environment changed, decreasing overall by 24 months. Regression models for association between motivational variables and COVID‐19 infection–prevention behaviour were statistically significant at three (F(10, 5981) = 76.69, p < .001, adjusted R2 .112), 12 (F(11, 3732) = 48.40, p < .001, adjusted R2 .122), 18 (F(11, 3665) = 108.34, p < .001, adjusted R2 .243) and 24 months (F(11, 3355) = 136.20, p < .001, adjusted R2 .306). Higher levels of fear, older age, lower perceived personal control over infection transmission, more trust in government and less trust in social media were associated with more infection–prevention behaviour. Conclusions: Motivation to engage in infection–prevention behaviour during a pandemic is multi‐factorial and dynamic. Beliefs about infection and trust in government and media need to be considered in developing effective communication strategies.