The impact of social distancing on community case count in the United States: Testing the efficacy of protection motivation theory during early stages of the COVID-19 pandemic.

Centuries of practice and an array of public health literature support social distancing (SD), or self-quarantine, as a valuable nonpharmaceutical intervention. To convince individuals to engage in behaviors that limit infection, public health professionals communicate risk and hazard based on application of protection motivation theory (PMT). The COVID-19 pandemic presents an opportunity to explore the efficacy of PMT in the context of a novel coronavirus with unique public health implications. We test an integrative conceptual model of social distancing compliance in U.S. counties and examine the mediating impact of SD on community spread of infection. We find that PMT does impact individual behavior, observing that the proportion of vulnerable populations affects social distancing compliance. However, actions to protect individual health are made within the context of economic concerns and priorities. While results indicate that PMT influences behavior, the expected relationship between that behavior and spread of disease in the community is not found. We do not repudiate SD or the value of PMT, but we suggest that these results may indicate that communication of risk in the context of COVID-19 may need community, as well as individual, framing.