Moore Ryan C, Lee Angela, Hancock Jeffrey T, Halley Meghan, Linos Eleni
medRxiv. 2020 Apr 11:2020.04.08.20057067. doi: 10.1101/2020.04.08.20057067.
Our goal is to inform ongoing public health policy on the design and communication of COVID-19 social distancing measures to maximize compliance. We assessed the US publics early experience with the COVID-19 crisis during the period when shelter-in-place orders were widely implemented to understand non-compliance with those orders, sentiment about the crisis, and to compare across age categories associated with different levels of risk. We posted our survey on Twitter, Facebook, and NextDoor on March 14th to March 23rd that included 21 questions including demographics, impact on daily life, actions taken, and difficulties faced. We analyzed the free-text responses to the impact question using LIWC, a computational natural language processing tool, and performed a thematic content analysis of the reasons people gave for non-compliance with social distancing orders. Stanford Universitys IRB approved the study. In 9 days, we collected a total of 20,734 responses. 6,573 individuals provided a response (≥30 words) to the question, Tell us how the coronavirus crisis is impacting your life. Our data (Figure 1) show that younger people (18-31) are more emotionally negative, self-centered, and less concerned with family, while middle-aged people are group-oriented (32-44) and focused on family (32-64) (all values < .05 corrected for multiple comparisons). Unsurprisingly, the oldest and most at-risk group (65+) are more focused on biological terms (e.g., health-related topics), but were surprisingly low in anxiety and high in emotionally positive terms relative to those at lower risk. We also content-analyzed 7,355 responses (kappas > .75) to the question, What are the reasons you are not self-isolating more? Of these participants, 39.8% reported not being compliant, with the youngest group (18-31) having the lowest compliance rate (52.4%) compared to the other age groups (all > 60%; all p values < .01). Table 1 describes the seven primary themes for non-compliance. Non-essential work requirements, concerns about mental and physical health, and the belief that other precautions were sufficient were the most common reasons, although other rationales included wanting to continue everyday activities and beliefs that society is over-reacting. Childcare was an important concern for a subset of respondents. Overall, our findings suggest that public health messages should focus on young people and 1) address their negative affect, 2) refocus their self-orientation by emphasizing the importance of individual behavior to group-level health outcomes, and 3) target the specific rationales that different people have regarding the pandemic to maximize compliance with social distancing.
我们的目标是为正在制定的公共卫生政策提供信息，内容涉及新冠疫情社交距离措施的设计与宣传，以最大限度地提高民众的遵守率。我们评估了美国公众在广泛实施居家令期间应对新冠疫情危机的早期经历，旨在了解对这些命令的不遵守情况、对危机的看法，并比较不同风险水平的年龄组。我们于3月14日至23日在推特、脸书和邻里网发布了调查问卷，其中包含21个问题，涵盖人口统计学信息、对日常生活的影响、采取的行动以及面临的困难。我们使用计算自然语言处理工具LIWC分析了关于影响问题的自由文本回复，并对人们不遵守社交距离命令的原因进行了主题内容分析。斯坦福大学的机构审查委员会批准了该研究。在9天内，我们共收集到20734份回复。6573人对“告诉我们新冠病毒危机如何影响你的生活”这一问题给出了回复（≥30字）。我们的数据（图1）显示，年轻人（18 - 31岁）在情绪上更消极、以自我为中心，对家庭的关注度较低，而中年人则以群体为导向（32 - 44岁）且关注家庭（32 - 64岁）（所有值经多重比较校正后p <.05）。不出所料，年龄最大且风险最高的群体（65岁以上）更关注生物学方面的术语（如与健康相关的话题），但相对于风险较低的群体，他们的焦虑程度出奇地低，情绪积极程度较高。我们还对7355份回复（卡帕值>.75）进行了内容分析，这些回复针对的问题是“你不更多地进行自我隔离的原因是什么”。在这些参与者中，39.8%表示未遵守规定，最年轻的群体（18 - 31岁）的遵守率最低（52.4%），与其他年龄组相比（均>60%；所有p值<.01）。表1描述了不遵守规定的七个主要主题。非必要的工作要求、对身心健康的担忧以及认为其他预防措施已足够是最常见的原因，不过其他理由还包括想继续日常活动以及认为社会反应过度。儿童保育是一部分受访者的重要担忧。总体而言，我们的研究结果表明，公共卫生信息应关注年轻人，并且1）解决他们的负面影响，2）通过强调个人行为对群体层面健康结果的重要性来重新调整他们的自我导向，3）针对不同人群对疫情的具体理由，以最大限度地提高对社交距离的遵守率。
