National variability in Americans’ COVID-19 protective behaviors: Implications for vaccine roll-out

Abstract

Protective behaviors such as mask wearing and physical distancing are critical to slow the spread of COVID-19, even in the context of vaccine scale-up. Understanding the variation in self-reported COVID-19 protective behaviors is critical to developing public health messaging. The purpose of the study is to provide nationally representative estimates of five self-reported COVID-19 protective behaviors and correlates of such behaviors. In this cross-sectional survey study of US adults, surveys were administered via internet and telephone. Adults were surveyed from April 30-May 4, 2020, a time of peaking COVID-19 incidence within the US. Participants were recruited from the probability-based AmeriSpeak® national panel. Brief surveys were completed by 994 adults, with 73.0% of respondents reported mask wearing, 82.7% reported physical distancing, 75.1% reported crowd avoidance, 89.8% reported increased hand-washing, and 7.7% reported having prior COVID-19 testing. Multivariate analysis (p critical value .05) indicates that women were more likely to report protective behaviors than men, as were those over age 60. Respondents who self-identified as having low incomes, histories of criminal justice involvement, and Republican Party affiliation, were less likely to report four protective behaviors, though Republicans and individuals with criminal justice histories were more likely to report having received COVID-19 testing. The majority of Americans engaged in COVID-19 protective behaviors, with low-income Americans, those with histories of criminal justice involvement, and self-identified Republicans less likely to engage in these preventive behaviors. Culturally competent public health messaging and interventions might focus on these latter groups to prevent future infections. These findings will remain highly relevant even with vaccines widely available, given the complementarities between vaccines and protective behaviors, as well as the many challenges in delivering vaccines.

Adherence to Coronavirus Disease 2019 Preventive Measures in a Representative Sample of the Population of the Canton of Vaud, Switzerland

“…Adherence to simple hygiene practices was even higher in other countries than in our survey, with 86% in the United Kingdom [ 13 ], 98% in Saudi Arabia [ 11 ], approximately 89% in the United States (with no difference between rural and urban areas) [ 10 , 14 ], 90% in Spain [ 15 ], and more than 92% in Hong Kong [ 9 ]. High level of adherence in some of these countries could be explained by the previous epidemics of MERS in Saudi Arabia [ 22 ] and SARS in Hong Kong [ 23 ], as suggested by Alkahldi and al [ 11 ].…”

“…However, these studies did not use a representative sample of the population. Few population-based studies were conducted on COVID-19 preventive behaviours so far [9][10][11][12][13][14][15]. One nationally representative survey administered to 5009 adults in the United States looked at the difference in COVID-19 preventive behaviours between rural and urban areas, finding that rural residents were less likely to follow preventive health measures [10].…”

Behaviors Associated With Household Transmission of SARS-CoV-2 in California and Colorado, January 2021–April 2021

“…41−43 Mitigation should therefore complement effective preventive behaviors and vaccination. 44,45 Engaging in healthy behavior can be complex, and different factors play a role in motivating individuals. 46 Although half of the household contacts who were secondary cases never used masks in the same room or had direct physical contact with the primary case, the findings showed no association with secondary transmission.…”

Endorsement of COVID-19 misinformation among criminal legal involved individuals in the United States: Prevalence and relationship with information sources

“…In analyzing COVID-19 protective behaviors among various populations, Schneider et al [31] indicate that CLI individuals are overall less likely to report protective behaviors, which may be a result of employment factors, limited access to personal protective equipment, and crowded housing or homelessness. Notably, CLI individuals are less likely to use face coverings but more likely to be tested than other populations of the study.…”