Dataset Information

The social determinants of health as predictors of adherence to public health preventive measures among parents and young children during the COVID-19 pandemic: a longitudinal cohort study.

ABSTRACT:

Objectives

To investigate whether social determinants of health (SDOH) are predictive of adherence to public health preventive measures and to describe changes in adherence over time among parents and children.

Methods

A longitudinal study was conducted in children aged 0-10 years and their parents through the TARGet Kids! COVID-19 Study in the Greater Toronto Area, Canada (April-July 2020). This study included 335 parents (2108 observations) and 416 children (2632 observations). Parents completed weekly questionnaires on health, family functioning, socio-demographics, and public health practices. The outcome was adherence to public health preventive measures measured separately for parents and children. Marginal log-binomial models were fitted using repeated measures of the outcome and predictors.

Results

Unemployment (RR 0.67, 95% CI: 0.47, 0.97), apartment living (RR 0.72, 95% CI: 0.53, 0.99), and essential worker in the household (RR 0.74, 95% CI: 0.55, 1.00) were associated with decreased likelihood of adherence among parents; however, no associations were observed for other SDOH, including family income and ethnicity. Furthermore, there was no strong evidence that SDOH were associated with child adherence. The mean number of days/week that parents and children adhered at the start of the study was 6.45 (SD = 0.93) and 6.59 (SD = 0.86), respectively, and this decreased to 5.80 (SD = 1.12) and 5.84 (SD = 1.23) by study end. Children consistently had greater adherence than parents.

Conclusion

SDOH were predictive of adherence to public health preventive measures among parents but less so in children among our sample of relatively affluent urban families. Adherence was high among parents and children but decreased over time. Equitable approaches to support the implementation of public health guidelines may improve adherence.

SUBMITTER: Yoshida-Montezuma Y

PROVIDER: S-EPMC8161716 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:RationaleAdolescents and young adults were identified internationally as a group with potentially low compliance rates with public health measures aimed at curbing the spread of coronavirus disease 2019 (COVID-19). Although non-compliance research during pandemics has typically focused on concurrent correlates, less is known about how prior social and psychological risk factors are associated with non-compliance during pandemics.ObjectiveThis paper leverages a prospective-longitudinal cohort study with data before and during the pandemic to describe patterns of non-compliance with COVID- 19 related public health measures in young adults and to identify which characteristics increase the risk of non-compliance.MethodsData came from an ongoing cohort study in Zurich, Switzerland (n=737). Non-compliance with public health measures and concurrent correlates were measured at age 22. Antecedent sociodemographic, social, and psychological factors were measured at ages 15-20. Young adults generally complied with COVID-19 public health measures, although non-compliance with some measures (e.g., cleaning/disinfecting mobile phones, standing 1.5-2 meters apart) was relatively higher.ResultsNon-compliance, especially with hygiene-related measures, was more prevalent in males, and in individuals with higher education, higher SES, and a nonmigrant background. Non-compliance was higher in young adults who had previously scored high on indicators of "antisocial potential," including low acceptance of moral rules, pre-pandemic legal cynicism, low shame/guilt, low self-control, engagement in delinquent behaviors, and association with delinquent peers. Young adults with low trust, including in the government's measures for fighting the virus, also complied less.ConclusionsIn order to increase voluntary compliance with COVID-19 measures, public health campaigns should implement strategies that foster moral obligation and trust in authorities, or leverage trustworthy individuals in the community to disseminate information. For young adults with low self-control, self-monitoring, environmental restructuring, or nudging may increase compliance. Long-term investments into integrating youth with antisocial potential into society may decrease rule-breaking behaviors, including during pandemics when compliance saves lives.