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1 Having a Prevention Regulatory Focus Longitudinally Predicts 1 Having a Prevention Regulatory Focus Longitudinally Predicts Distress and Health- Protective Behaviors During the COVID-9 Pandemic David L. Rodrigues1, Diniz Lopes1, and Rhonda Balzarini2 1Iscte–Instituto Universitário de Lisboa, CIS_iscte, Lisboa, Portugal 2Department of Psychology, Texas State University, San Marcos, TX, United States Corresponding author: David L. Rodrigues Iscte–Instituto Universitário de Lisboa, CIS_iscte Av. das Forças Armadas, 1649-026 Lisboa, Portugal. Email: [email protected] Word count: 209 (abstract) + 3228 (main document, excluding references) Date: December, 2020 2 Abstract Background: Past research has shown that regulatory focus shapes people’s health and well- being, with those who are focused on prevention (vs. promotion) being more motivated by safety and being less inclined to take risks. Purpose: In the current study, we tested if having a prevention (vs. promotion) focus before the COVID-19 pandemic outbreak predicted perceptions and health outcomes and threat over the course of the pandemic. Methods: Participants (N = 161, 51.6% women; Mage = 34.04, SD = 7.77) took part in a longitudinal study. Measures were assessed before the pandemic was declared (in November 2019, T1) and after a global pandemic was declared (on June 2020, T2). Results: Results suggest that people who were more focused on prevention prior to the onset of the pandemic (at T1) perceived greater risk of contracting COVID-19, were more worried about being infected, and engaged in more preventative behaviors during the pandemic (at T2). Additionally, they also reported less anxiety and felt healthier (at T2). Conclusions: People focused on prevention (i.e., motivated by security) are more aware of health threats and more likely to engage in health-protective behaviors. Acting in accordance to their motives seems to help these people to experience better health and reduces anxiety about health even during a pandemic. Keywords: Regulatory focus, Health protection; Anxiety; Worry, Preventive behaviors; Well- being 3 Having a Prevention Regulatory Focus Longitudinally Predicts Distress and Health- Protective Behaviors During the COVID-9 Pandemic The COVID-19 global pandemic caused a myriad of individual and social disruptions worldwide [1]. For example, since the onset of COVID-19, people have been experiencing more loneliness [e.g., 2], poorer psychological health and well-being [e.g., 3,4], poorer relationship quality and more relationship conflicts [e.g., 5, 6], and less sexual desire and sexual activity [e.g., 7–9]. Some researchers have examined how stressors related to COVID- 19 influence relationships and well-being. For example, people who experienced more social isolation, stress, and financial strains during the pandemic also reported less relationship adjustment [5]. Researchers have also been examining how individual differences shape people’s behaviors, experiences, and well-being during the pandemic. For example, people who perceived greater danger for their health during this pandemic reported less life satisfaction later on [10], perceived to be more vulnerable to infection [11], and were more likely to adhere to social distancing regulations [12]. One individual difference that might be particularly important in influencing people’s responses to a pandemic is regulatory focus. According to Regulatory Focus Theory [13], people with a prevention focus strive to maintain security and avoid risks, whereas people with a promotion focus strive to seek pleasure and take risks. Hence, being motivated by security and being able to regulate feelings and actions in accordance with survival motives should be crucial in health-threatening contexts [14,15]. Indeed, considering motivations toward security as a proxy for prevention focus, research also showed that people who were more motivated to protect their health reported engaging in behaviors that could help protect against contracting COVID-19 (e.g., washing hands) more frequently [16]. Research directly examining how regulatory focus has been shaping behaviors during the COVID-19 pandemic, however, is extremely limited. One exception is a study showing that people with 4 a prevention (vs. promotion) focus are more careful in searching for information related to the COVID-19 virus [17]. To fill this gap, we conducted a longitudinal study with people from the UK and the USA to examine if those with a prevention (vs. promotion) focus prior to the COVID-19 pandemic perceived more risk during the pandemic and were more motivated to engage in health-protective behaviors. The Role of Regulatory Focus on Health The Regulatory Focus Theory [13] postulates that people with a focus on prevention are motivated by security and protection and strive to avoid risks even at the cost of new opportunities. In contrast, people focused on promotion are motivated by pleasure and nurturance and strive to obtain gains, even at the cost of risks. Research has consistently shown that prevention (vs. promotion) focused people are more careful with their health [15], engaging in protective behaviors such as adherence to medical prescriptions [18], screening for cancer [19], smoking cessation [20], and using condoms with casual partners [21]. This occurs because prevention (vs. promotion) focused people are more aware of health threats and believe they have more control over their behavior [22,23]. Results from a study examining the role of regulatory focus during this pandemic [17] showed that people focused on prevention perceived to be informed about the pandemic and retrieved their COVID-19 information from more reliable sources (e.g., scientific reports). Interestingly, people focused on promotion also perceived to be informed about the pandemic, but they retrieved their COVID-19 information from less reliable sources (e.g., social media). Further, prevention (vs. promotion) focused people were less fearful of being infected with COVID-19 [17], which suggests that having a prevention focus could drive people to be more careful about the information and procedures that can help them protect their health, leading them to act accordingly, and reduce their fear of infection. Supporting this reasoning, people who felt that they were well-informed about COVID-19 also perceived 5 to have the necessary skills to avoid infection (e.g., acquiring masks and using them correctly), were less nervous and anxious about contracting the virus, and engaged in more behaviors to protect themselves [16]. Current Study Having a prevention focus (i.e., being motivated by security) heightens health concerns and fosters health-protective behaviors [15,18–22], but at the same seems to decrease fear of infection as a response to COVID-19 [16,17]. We argue that acting according to security motivations might help people focused on prevention alleviate some anxiety about COVID- 19. The current study was launched before the onset of COVID-19 (November 27, 2019). By the second measurement point on June 2020 (T2), a global pandemic had been announced, and subsequent social distancing measures were implemented in response [1,24]. We took this valuable opportunity to examine for the first time if motivations for security (i.e., prevention focus) or pleasure (i.e., promotion focus) had a significant impact on how people responded to the pandemic. First, we aimed to ensure the temporal order of our regulatory focus assessment, such that scores were expected to correlate before (T1) and after (T2) the pandemic (H1). Second, we aimed to examine if regulatory focus (T1) predicted health outcomes during the COVID-19 pandemic (T2). Specifically, we expected prevention (vs. promotion) focused people to perceive more risk (H2) and to be more worried (H3) about the COVID-19 pandemic, but also to engage in behaviors that allow them to protect their health (H4). By acting in accordance with their security motivations, these people should experience less anxiety (H5) and feel more physically healthy (H6). Lastly, we explored whether these expected effects remained even after controlling for two variables. First, life satisfaction and well-being has been associated with regulatory focus [e.g., 25,26], and has been shown to predict health outcomes [e.g., 27–29]. Second, differences in health policies and government restrictions [24] might have impacted how participants perceived and behaved during the 6 COVID-19 pandemic. Hence, we tested our main hypotheses controlling for perceived life satisfaction before the COVID-19 pandemic and for country of residence. Method Procedure We recruited a sample of people residing in the UK and the US through Clickworker in November 2019 (T1). Interested participants were invited to take part in a longitudinal study and were told that this study was focused on understanding people’s sexual attitudes and behaviors. To participate, people had to be over the age of 18 and sexually active. At the onset of the study, potential participants were informed about their rights as participants (e.g., confidentiality, anonymity, possibility to withdraw from the study without penalties) and had to provide informed consent (e.g., indicate their agreement to participate) to be enrolled in the study. Among those who completed T1, on June 2020 (T2), we invited the same participants through Clickworker to take part in a follow-up study about sexuality in the times of COVID- 19. Participants were asked to report their regulatory focus (at T1 and T2), their perceived risk of infection, how worried they were about
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