The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
Health Educ Behav. 2022 Apr;49(2):231-241. doi: 10.1177/10901981221076408. Epub 2022 Feb 22.
COVID-19 was the third leading cause of death in the United States in 2020. Prior to the wide dissemination of SARS-CoV-2 vaccines, individual prevention behaviors, such as wearing face masks, have been the primary non-pharmaceutical interventions to reduce infections. We surveyed 404 North Carolina residents recruited through Amazon MTurk in July 2020 to assess adherence to key prevention behaviors (6-foot distancing, mask wearing, and gathering limits) and barriers to and facilitators of adherence. Participants reported past 7-day prevention behaviors and behavioral barriers and facilitators informed by the Integrated Behavior Model and the Health Belief Model (perceived risk, perceived severity, behavioral attitudes, injunctive and descriptive norms, and personal agency). Reported adherence to each behavior in the past 7 days was generally high, with lower adherence to 6-foot distancing and mask wearing in the work context. The most commonly endorsed barriers to 6-foot distancing included physical impediments, forgetting, and unfavorable descriptive norms. For mask wearing, ability to keep a distance, discomfort/inconvenience, and forgetting were most commonly endorsed. In logistic regression models, injunctive social norms followed by perceived personal agency were the strongest independent correlates of 6-foot distancing. Behavioral attitudes and injunctive social norms were independently associated with mask wearing. For gathering size limit adherence, perceived personal agency was the strongest independent predictor followed by perceived severity of COVID-19. Messaging campaigns targeting these barriers and facilitators should be tested. Interventions improving the convenience and salience of physical distancing and mask wearing in high-density public places and places of work may also promote prevention behaviors.
2020 年，COVID-19 是美国的第三大死因。在 SARS-CoV-2 疫苗广泛传播之前，个体预防行为（如佩戴口罩）一直是减少感染的主要非药物干预措施。我们调查了 2020 年 7 月通过亚马逊 MTurk 招募的 404 名北卡罗来纳州居民，以评估他们对关键预防行为（6 英尺距离、戴口罩和聚会限制）的遵守情况以及遵守和阻碍遵守的障碍。参与者报告了过去 7 天的预防行为以及行为障碍和促进因素，这些障碍和促进因素来自综合行为模型和健康信念模型（感知风险、感知严重程度、行为态度、规范和描述性规范以及个人能动性）。过去 7 天内，每种行为的报告遵守率通常都很高，但在工作环境中，6 英尺距离和戴口罩的遵守率较低。阻碍 6 英尺距离的最常见障碍包括身体障碍、忘记和不利的描述性规范。对于戴口罩，保持距离的能力、不适/不便和忘记是最常被认可的障碍。在逻辑回归模型中，规范的社会规范其次是感知的个人能动性是 6 英尺距离的最强独立相关因素。行为态度和规范的社会规范与戴口罩独立相关。对于聚会规模限制的遵守，感知的个人能动性是最强的独立预测因素，其次是 COVID-19 的严重程度感知。应该测试针对这些障碍和促进因素的信息传递活动。改善高密度公共场所和工作场所物理隔离和戴口罩便利性和显著性的干预措施也可能促进预防行为。
