Vital Strategies, New York, New York, USA
Vital Strategies, New Delhi, India.
BMJ Open. 2022 Jun 21;12(6):e054839. doi: 10.1136/bmjopen-2021-054839.
The objective of this study was to gain a better understanding of the psychosocial and sociodemographic factors that affected adherence to COVID-19 public health and social measures (PHSMs), and to identify the factors that most strongly related to whether citizens followed public health guidance.
Cross-sectional study.
Nationally representative telephone surveys were conducted from 4-17 August 2020 in 18 African Union Member States. A total of 21 600 adults (mean age=32.7 years, SD=11.4) were interviewed (1200 in each country).
Information including sociodemographics, adherence to PHSMs and psychosocial variables was collected. Logistic regression models examined the association between PHSM adherence (eg, physical distancing, gathering restrictions) and sociodemographic and psychosocial characteristics (eg, risk perception, trust). Factors affecting adherence were ranked using the Shapley regression decomposition method.
Adherence to PHSMs was high, with better adherence to personal than community PHSMs (65.5% vs 30.2%, p<0.05). Psychosocial measures were significantly associated with personal and community PHSMs (p<0.05). Women and older adults demonstrated better adherence to personal PHSMs (adjusted OR (aOR): women=1.43, age=1.01, p0.05) and community PHSMs (aOR: women=1.57, age=1.01, p<0.05). Secondary education was associated with better adherence only to personal PHSMs (aOR=1.22, p<0.05). Rural residence and access to running water were associated with better adherence to community PHSMs (aOR=1.12 and 1.18, respectively, p0.05). The factors that most affected adherence to personal PHSMs were: self-efficacy; trust in hospitals/health centres; knowledge about face masks; trust in the president; and gender. For community PHSMs they were: gender; trust in the president; access to running water; trust in hospitals/health centres; and risk perception.
Psychosocial factors, particularly trust in authorities and institutions, played a critical role in PHSM adherence. Adherence to community PHSMs was lower than personal PHSMs since they can impose significant burdens, particularly on the socially vulnerable.
本研究旨在更好地了解影响 COVID-19 公共卫生和社会措施（PHSMs）遵守情况的社会心理和社会人口因素，并确定与公民是否遵循公共卫生指导最相关的因素。
横断面研究。
2020 年 8 月 4 日至 17 日，在非洲联盟 18 个成员国进行了全国代表性电话调查。共采访了 21600 名成年人（平均年龄=32.7 岁，标准差=11.4）（每个国家 1200 人）。
收集了包括社会人口统计学、PHSM 依从性和社会心理变量在内的信息。逻辑回归模型检查了 PHSM 依从性（例如，身体距离、聚会限制）与社会人口统计学和社会心理特征（例如，风险感知、信任）之间的关联。使用 Shapley 回归分解方法对影响依从性的因素进行了排名。
PHSM 的依从性很高，个人 PHSM 的依从性优于社区 PHSM（65.5%比 30.2%，p<0.05）。社会心理措施与个人和社区 PHSM 显著相关（p<0.05）。女性和老年人对个人 PHSM（调整后的 OR（aOR）：女性=1.43，年龄=1.01，p<0.05）和社区 PHSM（aOR：女性=1.57，年龄=1.01，p<0.05）的依从性更好。中等教育仅与个人 PHSM 的依从性相关（aOR=1.22，p<0.05）。农村居住和自来水供应与社区 PHSM 的依从性提高相关（aOR=1.12 和 1.18，分别为 p<0.05）。影响个人 PHSM 依从性的主要因素有：自我效能感；对医院/卫生中心的信任；对面罩的了解；对总统的信任；以及性别。对于社区 PHSM，它们是：性别；对总统的信任；获得自来水；对医院/卫生中心的信任；以及风险感知。
