Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Veterinary Clinical and Diagnostic Sciences, University of Calgary, Calgary, AB, Canada.
PLoS One. 2022 Oct 25;17(10):e0276746. doi: 10.1371/journal.pone.0276746. eCollection 2022.
Public health measures (PHMs) proactively and reactively reduce the spread of disease. While these measures target individual behaviour, they require broad adherence to be effective. Consequently, the World Health Organization issued a special appeal to young adults, a known non-adherent population, for increased adherence with COVID-19 guidelines. However, little is known about why these low-risk individuals do or do not adhere to PHMs. This study investigates why young adults in a low-risk setting adhered to PHMs implemented during the COVID-19 pandemic. A qualitative research approach was chosen to gain an in-depth understanding of participants' thoughts and experiences related to PHM adherence. Semi-structured interviews were conducted in April-May 2021 with 30 young adults living in Prince Edward Island (PEI), the province with the lowest COVID-19 case rate in Canada at that time. Thematic analysis was used to create a codebook based on the Theoretical Domains Framework, which was then inductively modified. The analysis identified eight themes that explained the adherence of young adults: (1) clear, purpose-driven adherence rationale, (2) developing trust in the local leadership, (3) adapting to novel measures, (4) manageable disruption, (5) adhering to reduce anxiety, (6) collective duty towards one's community, (7) moral culpability and (8) using caution rather than compliance. Together, these themes demonstrate that young adults adhered to PHMs because of their sense of connection to their community, public health leadership, and concerns over stigma. We further argue that clear guidelines and communication from public health officials during both periods of high and low COVID-19 cases facilitate adherence. These findings are important for mitigating future public health emergencies as they explain why young adults, an important segment of the population whose adherence is critical to the success of PHMs, follow PHMs. Further, these findings can inform public health officials and other stakeholders aiming to develop successful adherence strategies.
公共卫生措施（PHMs）主动和被动地减少疾病传播。虽然这些措施针对个人行为，但要想有效，就需要广泛的遵守。因此，世界卫生组织向年轻人发出特别呼吁，年轻人是已知的不遵守规定的人群，呼吁他们更加遵守 COVID-19 指导方针。然而，对于这些低风险人群为什么遵守或不遵守 PHMs，我们知之甚少。本研究调查了在 COVID-19 大流行期间，低风险环境中的年轻人为什么遵守 PHMs。选择定性研究方法是为了深入了解参与者与 PHM 遵守相关的想法和经验。2021 年 4 月至 5 月，在当时加拿大 COVID-19 病例率最低的爱德华王子岛（PEI），对 30 名年轻成年人进行了半结构式访谈。使用主题分析方法根据理论领域框架创建一个代码本，然后进行归纳修改。分析确定了八个主题，解释了年轻人的遵守情况：（1）清晰、有目的的遵守理由，（2）对当地领导层的信任，（3）适应新措施，（4）可管理的干扰，（5）遵守以减轻焦虑，（6）对社区的集体责任，（7）道德责任，（8）谨慎而不是遵守。总的来说，这些主题表明，年轻人之所以遵守 PHMs，是因为他们与社区、公共卫生领导人和对污名的关注有关。我们进一步认为，在 COVID-19 高、低病例时期，公共卫生官员发布明确的指导方针和信息有助于遵守规定。这些发现对于减轻未来的公共卫生紧急情况很重要，因为它们解释了为什么年轻人作为人口中的一个重要部分，他们的遵守对于 PHMs 的成功至关重要，他们会遵守 PHMs。此外，这些发现可以为旨在制定成功的遵守策略的公共卫生官员和其他利益相关者提供信息。
