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Behavioral Risk Factors and Adherence to Preventive Measures: Evidence From the Early Stages of the COVID-19 Pandemic.

ABSTRACT: Behavioral risk factors, such as smoking, excessive alcohol consumption, physical inactivity, obesity, and unhealthy food intake are added risk factors for severe outcomes of COVID-19 infections. Preventive measures to avoid infections are therefore particularly important for individuals engaging in behavioral risk factors. We seek to determine whether behavioral risk factors (BRFs) play a significant role in the adherence to preventive COVID-19 measures in a population aged 50 and above. The SHARE wave 8 (Survey of Health, Ageing and Retirement in Europe) and SHARE COVID-19 Survey served as the database, resulting in an analytical sample of 17,588 respondents from 23 European countries plus Israel. Of these 36.04% engaged in at least one BRF and 16.68% engaged in 3 or more BRFs. Multilevel logistic regressions revealed that engagement in one BRF was significantly associated with less adherence to hygiene preventive measures, i.e., hand-sanitizing, hand-washing and covering coughs and sneezes (OR: 0.86; 95% CI: 0.78; 0.94), as was engagement in two BRFs (OR: 0.85; 95% CI: 0.74; 0.97) and three or more BRFs (OR: 0.72; 95% CI: 0.59; 0.88). No such association was found between engagement in BRFs and adherences to social isolation preventive measures, i.e., avoiding meeting more than five people, visiting others or going shopping, or regulated preventive measures, i.e., wearing a mask and keeping physical distance. The found association was also stronger when three or more BRFs were engaged in (1 vs. 3 BRFs: χ² = 3.43, p = 0.06; 2 vs. 3 BRFs: χ² = 6.05; p = 0.01). The study gives insight into the protective behavior of a population with inherent vulnerability during a global health emergency. It lays the foundation for follow-up research about the evolution of adherence to preventive measures as the pandemic progresses and about long-term behavioral changes. In addition, it can aide efforts in increasing preventive compliance by raising awareness of the added risk behavioral risk factors pose.

SUBMITTER: Mendoza-Jimenez MJ

PROVIDER: S-EPMC8219917 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:ObjectivesTo identify evidence-based strategies to improve adherence to the preventive measures against the coronavirus disease (COVID-19) at the community level.MethodThis is an evidence brief for policy, combining research evidence specific to contextual knowledge from stakeholders. A systematic search was performed in 18 electronic databases, gray literature, and a handle search, including only secondary and tertiary studies that focused on the adherence of the general population to COVID-19 preventive measures in the community. Two reviewers, independently, performed the study selection, data extraction, and assessment of the quality of the studies. Relevant evidence has been synthesized to draft evidence-based strategies to improve adherence. These strategies were circulated for external endorsement by stakeholders and final refinement. Endorsement rates >80%, 60-80% and <60% were considered high, moderate, and low respectively.ResultsEleven studies, with varying methodological qualities were included: high (n = 3), moderate (n = 3), low (n = 1), and critically low (n = 4). Three evidence based strategies were identified: i. Risk communication; ii. Health education to the general public, and iii. Financial support and access to essential supplies and services. The rates of endorsement were: 83% for risk communication, 83% for health education, and 92% for financial support and access to essential supplies and services. The evidence showed that an increase in knowledge, transparent communication, and public awareness about the risks of COVID-19 and the benefits of adopting preventive measures results in changes in people's attitudes and behavior, which can increase adherence. In addition, the guarantee of support and assistance provides conditions for people to adopt and sustain such measures.ConclusionsThese strategies can guide future actions and the formulation of public policies to improve adherence to preventive measures in the community during the current COVID-19 pandemic and other epidemics.

Project description:BackgroundAdherence to preventive measures of Coronavirus disease 2019 (COVID-19) was among the means to tackle the transmission of the virus. However, reluctance to implement the recommended preventive measures has been reported to be a major problem everywhere including Oromia Regional State.PurposeThis research was aimed to assess the level of adherence to COVID-19 preventive measures and associated factors in the study area.Participants and methodsCommunity based cross-sectional study was conducted. Sample of 2751 adults aged ≥ 18 years were used for the quantitative study. Also, 20 FGDs and 30 KIIs were conducted in the qualitative approach. The collected data were entered into Epi info version 7.2.0.1 and analyzed using STATA 15. The qualitative data were entered into NVivo version 12 for its organization. Bivariate and multivariable binary logistic regression analyses were conducted to determine the association between the study variables. Odds Ratio with its 95%CI was calculated and P- Value < 0.05 was used as a cut off points to declare the significance.ResultsThe level of adherence to COVID-19 preventive measure was 8.3. Age [AOR, 4.00; 95% CI: 1.50, 10.45], Illiterate AOR, 0.38; 95% CI: 0.15, 0.93], read and write [AOR, 0.26; 95% CI: 0.10, 0.72], attended primary [AOR, 0.30; 95% CI: 0.13, 0.70], occupation (AOR; 95% CI: 0.29, 0.96] and knowledge [AOR, 0.20; 95% CI: 0.01, 0.11] were factors associated with level of adherence to COVID-19 preventive measures. Political context, unemployment, livelihoods, and social events were mentioned as reasons for the poor adherence to COVID-19 preventive measures.ConclusionsThe overall level of adherence to COVID-19 preventive measures in the study area was low. Age, level of education, occupation, and knowledge were factors associated with level of adherence to COVID-19 preventive measures. Activities to increase the adherence to COVID-19 preventive measures should be implemented by the concerned bodies.

Project description:IntroductionInternationally, countries have reacted to the COVID-19 outbreak by introducing key public health non-pharmaceutical interventions to protect vulnerable population groups. In response to COVID-19, the Government of Ethiopia has been taking a series of policy actions beyond public health initiatives alone. Therefore, this study was aimed to assess the applicability of basic preventive measures of the pandemic COVID-19 and associated factors among the residents of Guraghe Zone from 18th to 29th September, 2020.MethodsCommunity based cross sectional study was conducted at Guraghe Zone from 18th to 29th September, 2020. Systematic random sampling method was applied among the predetermined 634 samples. Variables which had p-value less than 0.25 in bivariate analysis were considered as candidate for multivariable logistic regression model. P-value <0.05 was used as a cutoff point to determine statistical significance in multiple logistic regressions for the final model.ResultIn this study, 17.7% (95% CI: 14.7, 20.5) of the respondents apply the basic preventive measures towards the prevention of the pandemic COVID-19. In addition, being rural resident (AOR: 4.78,; 95%CI: 2.50, 8.90), being studied grade 1-8 (AOR: 3.70; 95%CI: 1.70, 7.90), being a farmer (AOR: 4.10; 95%CI: 1.25, 13.35), currently not married (AOR: 2.20, 95%CI: 1.24, 4.06), having family size 1-3(AOR: 6.50; 95%CI: 3.21, 3.35), have no diagnosed medical illness (AOR: 6.40; 95%CI: 3.85, 10.83) and having poor knowledge (AOR: 3.50; 95%CI: 1.60, 7.40) were factors which are statistically significant in multivariable logistic regression model.ConclusionDespite the application of preventive measures and vaccine delivery, the applicability of the pandemic COVID-19 preventive measures was too low, which indicate that the Zone is at risk for the infection. Rural residents, those who have lower educational level, farmers, non-marrieds, those who have lower family size, those who have diagnosed medical illnesses and those who have poor knowledge were prone to the infection with the pandemic COVID-19 due to the lower practice of applying the basic preventive measures. In addition, awareness creation should be in practice at all levels of the community especially lower educational classes and rural residents.

Project description:BackgroundSince the start of the global COVID-19 pandemic, countries have been mirroring each other's policies to mitigate the spread of the virus. Whether current measures alone will lead to behavioral change such as social distancing, washing hands, and wearing a facemask is not well understood. The objective of this study is to better understand individual variation in behavioral responses to COVID-19 by exploring the influence of beliefs, motivations and policy measures on public health behaviors. We do so by comparing The Netherlands and Flanders, the Dutch speaking part of Belgium.Methods and findingsOur final sample included 2,637 respondents from The Netherlands and 1,678 from Flanders. The data was nationally representative along three dimensions: age, gender, and household income in both countries. Our key outcome variables of interest were beliefs about policy effectiveness; stated reasons for complying with public rules; and changes in behavior. For control variables, we included a number of measures of how severe the respondent believed Covid-19 to be and a number of negative side effects that the person may have experienced: loneliness, boredom, anxiety, and conflicts with friends and neighbors. Finally, we controlled for socio-demographic factors: age, gender, income (categorical), education (categorical) and the presence of Covid-19 risk factors (diabetes, high blood pressure, heart disease, asthma, allergies). The dependent variable for each of the estimation models is dichotomous, so we used Probit models to predict the probability of engaging in a given behavior. We found that motivations, beliefs about the effectiveness of measures, and pre-pandemic behavior play an important role. The Dutch were more likely to wash their hands than the Flemish (15.4%, p<0.01), visit family (15.5%, p < .01), run errands (12.0%, p<0.05) or go to large closed spaces such as a shopping mall (21.2%, p<0.01). The Dutch were significantly less likely to wear a mask (87.6%, p<0.01). We also found that beliefs about the virus, psychological effects of the virus, as well as pre-pandemic behavior play a role in adherence to recommendations.ConclusionsOur results suggest that policymakers should consider behavioral motivations specific to their country in their COVID-19 strategies. In addition, the belief that a policy is effective significantly increased the probability of the behavior, so policy measures should be accompanied by public health campaigns to increase adherence.

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Behavioral Risk Factors and Adherence to Preventive Measures: Evidence From the Early Stages of the COVID-19 Pandemic.

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