Beyond What Meets the Eye: Unveiling Dynamics of Compliance with Preventive Measures in the COVID-19 Era

Abstract

Background Previous longitudinal studies have identified variability in compliance with COVID-19 preventive measures, noting the heightened sensitivity of the least compliant groups to situational factors like easing restrictions. However, they overlooked other forms of variability inherent in compliance behaviour. Hence, we investigated compliance with social distancing and staying-at-home measures, and its dynamic nature, along with its association with social and individual factors. Methods Data from a longitudinal study involving 3617 Canadians across twelve measurement times from April 2020 to April 2022 were analysed. Compliance levels were assessed through self-reported items, alongside social and individual factors like trust in science and government, perception of social norms, and health literacy. Results Joint-Trajectory analysis revealed three compliance trajectories during mandatory and lifting measures periods: "Low and constant" (shifting to "Low and decreasing" during lifting measures), "High and decreasing," and "High and constant." Transition movements between trajectories mostly showed stability (between 85.83% and 90.44% for social distancing; between 80.68% and 87.71% for staying-at-home), with health literacy consistently predicting trajectory membership (social distancing: mandatory measures period- Odds = 1.67; 95% CI [1.20, 2.32], lifting measures period- Odds = 1.43; 95% CI [0.93, 2.37]; staying-at-home: mandatory measures period- Odds = 1.75; CI [1.24, 2.56], lifting measures period- Odds = 1.90; 95% CI [0.26, 1.01]). Perception of provincial norms (social distancing: comparison 1- Odds = 4.10; 95% CI [1.30, 17.54], comparison 2- Odds = 0.38; 95% CI [0.12, 1.04]; staying-at-home: comparison 1- Odds = 2.22; 95% CI [1.13, 4.51], comparison 2- Odds = 0.74; 95% CI [0.55, 1.00]) and trust in science (social distancing: Odds = 3.57; 95% CI [1.29, 10.91], comparison 2- Odds = 3.00; 95% CI [1.26, 7.96]; staying-at-home: comparison 3- Odds = 0.77; 95% CI [0.58, 1.02]) moderately predicted trajectory change. Conclusions Our study not only reaffirms variability within the lowest compliance group but also unveils variability among higher compliance groups, notably in trajectory transition movements. Health literacy consistently emerged as a strong indicator of trajectory membership, while perception of provincial norms and trust in science moderately influenced trajectory change.