Associations between psychological dispositions, pandemic-related variables and protection motivation theory determinants: a cross-sectional study

Background Improving the understanding of the factors influencing COVID-19 health intentions is important for pandemic preparedness and public health promotion, as such insights can inform effective communication and policy strategies. With respect to this goal, protection motivation theory (PMT) is a prominent framework for understanding health-protective behavior, but it largely overlooks intrapersonal variables that may be linked to cognitive appraisals. This exploratory study investigated how pandemic-related factors (risk group self-identification, prior infection) and psychological dispositions (perceived infectability, general self-efficacy, risk propensity, life satisfaction, and subjective health) may be associated with PMT determinants (perceived vulnerability, perceived severity, self-efficacy, response efficacy, and response costs) and protective health intentions during the COVID-19 pandemic. The aim was to identify patterns that could inform future confirmatory studies, thereby generating hypotheses that may ultimately guide the development of effective interventions and strategies to strengthen public health and pandemic preparedness. Methods A cross-sectional online survey was conducted in Germany in January 2024 (n = 1,050; quota sample by age, gender, region, education). Hierarchical linear regressions were performed for each PMT determinant, sequentially entering (1) sociodemographic variables, (2) pandemic-specific factors, and (3) psychological dispositions. Results Intrapersonal factors contributed substantially to model fit (R² = 6%–28%). Threat appraisal was most closely associated with pandemic-specific variables and perceived infectability, whereas an unexpected inverse relationship emerged with life satisfaction. Coping appraisals were most strongly associated with lower risk propensity and higher life satisfaction. General self-efficacy and subjective health were also linked to various PMT constructs. These findings are best viewed as exploratory in nature and may serve to generate hypotheses for future research. Conclusion Incorporating intrapersonal variables into PMT was associated with greater explanatory power and provided a more nuanced understanding of health-protective behavior. This extended framework may not only broaden explanatory power but also guide the design of more targeted health interventions, a proposition that warrants further longitudinal and experimental testing.