Public perceptions of the effectiveness of recommended non-pharmaceutical intervention behaviors to mitigate the spread of SARS-CoV-2

Abstract

Background The COVID-19 pandemic is an unprecedented public health threat, both in scope and response. With no vaccine available, the public is advised to practice non-pharmaceutical interventions (NPI) including social distancing, mask-wearing, and washing hands. However, little is known about public perceptions of the effectiveness of these measures, and high perceived effectiveness is likely to be critical in order to achieve widespread adoption of NPI. Methods In May 2020, we conducted a cross-sectional survey among U.S. adults (N = 3,474). The primary outcome was a six-item measure assessing perceived effectiveness of recommended behaviors to prevent SARS-CoV-2 infection from 1 (not at all effective) to 5 (extremely effective). The sample was divided into “higher” and “lower” perceived effectiveness groups. Covariates included demographics, healthcare characteristics, and health beliefs. Variables that were significant at p<0.01 in bivariate analyses were entered into a multivariable logistic regression and a best-fit model was created using a cutoff of p<0.01 to stay in the model. Results Mean age was 45.5 years and most participants were non-Hispanic White (63%) and female (52.4%). The high perceived effectiveness group was slightly larger than the low perceived effectiveness group (52.7% vs. 47.3%). Almost all health belief variables were significant in the best-fit regression model. COVID-19-related worry (aOR = 1.82; 95% CI = 1.64–2.02), and perceived threat to physical health (aOR = 1.32; 95% CI = 1.20–1.45) were positively associated with perceived effectiveness while perceived severity of COVID-19 (0.84; 95% CI = 0.73–0.96) and perceived likelihood of infection (0.85; 95% CI = 0.77–0.94) switched directions in the adjusted model and were negatively associated with perceived effectiveness. Conclusions This research indicates people generally believe NPI are effective, but there was variability based on health beliefs and there are mixed rates of engagement in these behaviors. Public health efforts should focus on increasing perceived severity and threat of SARS-CoV-2-related disease, while promoting NPI as effective in reducing threat.

Public perceptions of non-adherence to COVID-19 measures by self and others in the United Kingdom

“…As discussed above, the nascent literature on COVID-19 policy adherence has found a range of other factors which have not been identified or discussed in the present study (e.g. Carlucci et al 2020; Kasting et al 2020; Selby et al 2020). Also, although this study did not identify any patterns by demographic variables, this is potentially a result of relatively small sample size of a qualitative study with a diverse group of participants.…”

“…There is a rapidly growing body of research exploring factors associated with (non-)adherence to coronavirus measures. Surveys of public behaviours suggests that some of the main factors contributing to high adherence include: high perception of risk of contracting coronavirus (Carlucci et al 2020; Kasting et al 2020; Selby et al 2020), perceived social support (Paykani et al 2020), seeing others’ adhere (Coroiu et al 2020), believing that you have already had COVID-19 (Smith, Marteau et al 2020), greater accessing of health-related information (Al-Hasan et al 2020), trust in government (Coroiu et al 2020) and political ideology (Rothgerber et al 2020). Also demographic factors have been found to predict high adherence, including: older age (Selby et al 2020; Fancourt et al 2020), female gender (Carlucci et al 2020), higher education (Carlucci et al 2020; Al-Hasan et al 2020).…”

Non-pharmaceutical interventions during the COVID-19 pandemic: A review

“…The subset of participants with a higher perception of risk was found to be more likely to adopt NPIs in both. Interestingly, several surveys confirm the expectation coming from the health belief model pointing to the fact that knowledge about the disease and perceived risks are predictors behavioral changes [198] , [204] , [206] , [208] , [214] , [215] , [216] . The adoption of face masks has been found to be negatively affected by perception of shortage in New Zealand [206] , and positively influenced by national guidelines in the USA [211] .…”

Understanding patterns of adherence to COVID-19 mitigation measures: a qualitative interview study

“…Current understanding of adherence to social distancing and self-isolation has viewed adherence as a dichotomy, with the majority of research focusing on prediction rather than understanding adherence. Indeed, numerous surveys have identified influences such as age, 13 gender, 13 and ethnicity, 2 perceptions of risk, 14 behavior of others, 15 access to help and support, 3 trust in the government and the effectiveness of mitigation measures 15 , 16 and already having had COVID-19 17 on behavior. However, to date, research has not focused on exploring, in detail, what people are doing, why, and how safe it is.…”