Obligation or Desire: Variation in Motivation for Compliance With COVID-19 Public Health Guidance.
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ABSTRACT:
SUBMITTER: Ai T
PROVIDER: S-EPMC8290058 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveWe explored public perceptions about the COVID-19 pandemic to learn how those attitudes may affect compliance with health behaviors.MethodsParticipants were Central Pennsylvania adults from diverse backgrounds purposively sampled (based on race, gender, educational attainment, and healthcare worker status) who responded to a mixed methods survey, completed between March 25-31, 2020. Four open-ended questions were analyzed, including: "What worries you most about the COVID-19 pandemic?" We applied a pragmatic, inductive coding process to conduct a qualitative, descriptive content analysis of responses.ResultsOf the 5,948 respondents, 538 were sampled for this qualitative analysis. Participants were 58% female, 56% with ≥ bachelor's degree, and 50% from minority racial backgrounds. Qualitative descriptive analysis revealed four themes related to respondents' health and societal concerns: lack of faith in others; fears of illness or death; frustration at perceived slow societal response; and a desire for transparency in communicating local COVID-19 information. An "us-versus-them" subtext emerged; participants attributed non-compliance with COVID-19 behaviors to other groups, setting themselves apart from those Others.ConclusionOur study uncovered Othering undertones in the context of the COVID-19 pandemic, occurring between groups of like-minded individuals with behavioral differences in 'compliance' versus 'non-compliance' with public health recommendations. Addressing the 'us-versus-them' mentality may be important for boosting compliance with recommended health behaviors.
| S-EPMC8786185 | biostudies-literature
Project description:Public health measures such as spatial distancing and physical hygiene have been found effective in mitigating the spread of the coronavirus. However, there is considerable variability in individual compliance with such public health measures and factors contributing to these interindividual differences are currently still understudied. The present study set out to determine the role of risk perception and conspiracy theory endorsement on compliance with COVID-19 public health measures and explored variations in these associations across participant age and the developmental status of a country, leveraging a large multi-national data set (N = 45,772) across 66 countries/territories, collected via online survey during the early phase of the COVID-19 pandemic (between April and May 2020). Human Development Index (HDI), developed by the United Nations Development Program, was used as a proxy of a country's achievement in key dimensions of human development. Overall, higher risk perception was associated with greater compliance, particularly in individuals with greater conspiracy theory endorsement. Specifically, people from more developed countries who perceived themselves less at risk but showed stronger conspiracy theory endorsement reported the lowest compliance with COVID-19 public health measures. Findings from this study advance understanding of the interplay between risk perception and conspiracy theory endorsement in their effect on compliance with COVID-19 public health measures, under consideration of both individual-level and country-level demographic variables and have potential to inform the design of tailored interventions to fight the current and future global pandemics.
| S-EPMC10046644 | biostudies-literature
Project description:ObjectivesTo describe divergence between actionable statements issued by coronavirus disease 2019 (COVID-19) guideline developers cataloged on the "COVID-19 Recommendations and Gateway to Contextualization" platform.Study design and settingWe defined divergence as at least two comparable actionable statements with different explicit judgments of strength, direction, or subgroup consideration of the population or intervention. We applied a content analysis to compare guideline development methods for a sample of diverging statements and to evaluate factors associated with divergence.ResultsOf the 138 guidelines evaluated, 85 (62%) contained at least one statement that diverged from another guideline. We identified 223 diverging statements in these 85 guidelines. We grouped statements into 66 clusters. Each cluster addressed the same population, intervention, and comparator group or just similar interventions. Clinical practice statements were more likely to diverge in an explicit judgment of strength or direction compared to public health statements. Statements were more likely to diverge in strength than direction. The date of publication, used evidence, interpretation of evidence, and contextualization considerations were associated with divergence.ConclusionMore than half of the assessed guidelines issued at least one diverging statement. This study helps in understanding the types of differences between guidelines issuing comparable statements and factors associated with their divergence.
| S-EPMC8942881 | biostudies-literature
Project description:BACKGROUND:The rapid global spread of the coronavirus disease (COVID-19) has compelled national governments to issue guidance on the use of face masks for members of the general public. To date, no work has assessed how this guidance differs across governments. OBJECTIVE:This study seeks to contribute to a rational and consistent global response to infectious disease by determining how guidelines differ across nations and regions. METHODS:A content analysis of health agency mask guidelines on agency websites was performed in late March 2020 among 25 countries and regions with large numbers of COVID-19 cases. Countries and regions were assigned across the coding team by language proficiency, with Google Translate used as needed. When available, both the original and English language version of guidance were reviewed. RESULTS:All examined countries and regions had some form of guidance online, although detail and clarity differed. Although 9 countries and regions recommended surgical, medical, or unspecified masks in public and poorly ventilated places, 16 recommended against people wearing masks in public. There were 2 countries that explicitly recommended against fabric masks. In addition, 12 failed to outline the minimum basic World Health Organization guidance for masks. CONCLUSIONS:Online guidelines for face mask use to prevent COVID-19 in the general public are currently inconsistent across nations and regions, and have been changing often. Efforts to create greater standardization and clarity should be explored in light of the status of COVID-19 as a global pandemic.
| S-EPMC7252198 | biostudies-literature
Project description:When the unprecedented COVID-19 pandemic first spread, governments could implement a wide range of measures to tackle the outbreaks. Conventional wisdom holds that public health policy should be made on the basis of empirical demonstrations, while little research has probed on how to safeguard the expected policy utility in the case of evidence shortage on novel contagious diseases. In particular, the fight against COVID-19 cannot succeed without public compliance as well as the support of people who have not tested positive. Based on the data from the first wave of COVID-19, by using a random effect estimator, fixed effect method, and hierarchical technique, we specified the efficiency of particular social distancing policies by contextualizing multiple factors. We found that adopting gathering restrictions decreased new case growth but were conditional on its interaction with population density, while mitigation effects constantly corresponded to policy magnitude in a given time; for which the effective patterns varied from three days to sixty days. Overall, policies encouraging social distancing exerted a positive effect on mitigating the first wave of COVID-19. Both the enforcing duration and public compliance constrained the expected impact of nonpharmaceutical intervention according to degrees of policy level. These findings suggest that, when evidence is incomplete, the effectiveness of public health crisis management depends on the combination of policy appropriateness and, accordingly, public compliance.
| S-EPMC8997917 | biostudies-literature
Project description:One of the main determinants of the spread of epidemics in human population centres is the degree of compliance with public health regulations. The aim of this study was to investigate the relationships between time perspective and compliance with public health regulations concerning the COVID-19 pandemic. The participants were 500 adults (275 women, 225 men) aged 18 to 82 years. Sociodemographic surveys, surveys concerning knowledge about COVID-19 and compliance with public health regulations, the Polish Short Version of the Zimbardo Time Perspective Inventory, the Present-Fatalistic Scale, the Dark Future Scale, and the Carpe Diem Scale were used. Female gender and Carpe Diem were predictors of compliance with public health regulations. Men complied with public health regulations significantly less often than women. The results of our study suggest that in announcements communicating public health regulations concerning COVID-19 pandemic, emphasis should be placed on stressing the significance of focusing on 'here and now' and the importance of current behaviours for the future.
| S-EPMC7537628 | biostudies-literature
Project description:BackgroundDevelopment and dissemination of public health (PH) guidance to healthcare organizations and the general public (e.g., businesses, schools, individuals) during emergencies like the COVID-19 pandemic is vital for policy, clinical, and public decision-making. Yet, the rapidly evolving nature of these events poses significant challenges for guidance development and dissemination strategies predicated on well-understood concepts and clearly defined access and distribution pathways. Taxonomies are an important but underutilized tool for guidance authoring, dissemination and updating in such dynamic scenarios.ObjectiveTo design a rapid, semi-automated method for sampling and developing a PH guidance taxonomy using widely available Web crawling tools and streamlined manual content analysis.MethodsIterative samples of guidance documents were taken from four state PH agency websites, the US Center for Disease Control and Prevention, and the World Health Organization. Documents were used to derive and refine a preliminary taxonomy of COVID-19 PH guidance via content analysis.ResultsEight iterations of guidance document sampling and taxonomy revisions were performed, with a final corpus of 226 documents. The preliminary taxonomy contains 110 branches distributed between three major domains: stakeholders (24 branches), settings (25 branches) and topics (61 branches). Thematic saturation measures indicated rapid saturation (≤5% change) for the domains of "stakeholders" and "settings", and "topic"-related branches for clinical decision-making. Branches related to business reopening and economic consequences remained dynamic throughout sampling iterations.ConclusionThe PH guidance taxonomy can support public health agencies by aligning guidance development with curation and indexing strategies; supporting targeted dissemination; increasing the speed of updates; and enhancing public-facing guidance repositories and information retrieval tools. Taxonomies are essential to support knowledge management activities during rapidly evolving scenarios such as disease outbreaks and natural disasters.
| S-EPMC8236411 | biostudies-literature
Project description:IntroductionThe rapidly evolving COVID-19 pandemic required systemic change in how healthcare was delivered to minimize virus transmission whilst maintaining safe service delivery. Deemed at 'moderate-high risk', maternity patients are an important patient group that require consideration. Public Health England (PHE) issued national guidance on how to adjust these services.AimTo explore how maternity units in England implemented PHE guidance.MethodsAn online survey of 22 items was distributed to individuals that had worked on an England-based maternity unit during the COVID-19 pandemic. The questionnaire was designed and tested by the multidisciplinary research team. Data was collected from November 2020 to July 2021.FindingsForty-four participants across 33 maternity units responded. Ninety-three percent were able to test all women requiring an overnight stay for COVID-19. Only 27% reported birth partners were tested for COVID-19. Only 73% reported they were able to isolate all COVID-19-positive patients in single rooms. Eighty-four percent stated they were aware of current PHE guidance on personal protective equipment (PPE) and 82% felt 'confident' in donning/doffing of PPE. Priorities for the future include rapid testing and a focus on community service provision.ConclusionsPHE COVID-19 guidance was implemented differently in maternity units across England due to the varying resources available at each trust leading to variable ability to test and isolate patients as recommended. More specific, tailored guidance for infection control measures against COVID-19 is needed for maternity settings due to their unique position.
| S-EPMC9107387 | biostudies-literature
Project description:BackgroundIt has been observed that people become gradually exhausted by receiving COVID-19-related information and adhering to the corresponding preventive measures as the pandemic unfolds. This phenomenon is known as pandemic burnout. Emerging evidence shows that pandemic burnout is related to poor mental health. This study extended the trendy topic by examining the idea that moral obligation, a crucial motivation driving people to follow the preventive measures, would amplify the mental health cost of pandemic burnout.MethodsParticipants were 937 Hong Kong citizens (88 % females, 62.4 % aged 31-40 years). They participated in a cross-sectional online survey reporting on pandemic burnout, moral obligation, and mental health problems (i.e., depressive symptoms, anxiety, and stress).ResultsFindings of moderation model analyses showed that higher levels of pandemic burnout and moral obligation were related to more mental health problems. Importantly, the "pandemic burnout-mental health problems" links were moderated by moral obligation, with those who felt more morally obliged to follow the measures reporting poorer mental health than those who felt less morally obliged to do so.LimitationsThe cross-sectional design of the study may constrain the evidence about the directions and causality of the relationships. Participants were only recruited from Hong Kong and females were over-represented, thus limiting the generalizability of the findings.ConclusionsPeople who experience pandemic burnout while feeling more morally obliged to follow the anti-COVID-19 measures are at greater risk of mental health problems. They might need more mental health support from medical professionals.
| S-EPMC9940470 | biostudies-literature
Project description:We examine the extent to which exposure to higher relative COVID-19 mortality (RM), influences health system trust (HST), and whether changes in HST explain the perceived ease of compliance with pandemic restrictions during the COVID-19 pandemic. Drawing on evidence from two representative surveys covering all regions of 28 European countries before and after the first COVID-19 wave, and using a difference in differences strategy together with Coarsened Exact Matching (CEM), we document that living in a region with higher RM during the first wave of the pandemic increased HST. However, the positive effect of RM on HST is driven by individuals over 45 years of age, and the opposite effect is found among younger cohorts. Furthemore, we find that a higher HST reduces the costs of complying with COVID-19 restrictions, but only so long as excess mortality does not exceed the average by more than 20%, at which point the ease of complying with COVID-19 restrictions significantly declines, offsetting the positive effect of trust in the healthcare system. Our interpretation of these estimates is that a higher RM is interpreted as a risk signal among those over 45, and as a signal of health-care system failure among younger age individuals.
| S-EPMC9946735 | biostudies-literature