The Nethersole School of Nursing, Faculty of Medicine, The Chinese University of Hong Kong, New Territories, Hong Kong SAR, China.
Department of Health Sciences, European University Cyprus, 1516, Nicosia, Cyprus.
Global Health. 2023 Apr 17;19(1):25. doi: 10.1186/s12992-023-00928-7.
Identifying common factors that affect public adherence to COVID-19 containment measures can directly inform the development of official public health communication strategies. The present international longitudinal study aimed to examine whether prosociality, together with other theoretically derived motivating factors (self-efficacy, perceived susceptibility and severity of COVID-19, perceived social support) predict the change in adherence to COVID-19 containment strategies.
In wave 1 of data collection, adults from eight geographical regions completed online surveys beginning in April 2020, and wave 2 began in June and ended in September 2020. Hypothesized predictors included prosociality, self-efficacy in following COVID-19 containment measures, perceived susceptibility to COVID-19, perceived severity of COVID-19 and perceived social support. Baseline covariates included age, sex, history of COVID-19 infection and geographical regions. Participants who reported adhering to specific containment measures, including physical distancing, avoidance of non-essential travel and hand hygiene, were classified as adherence. The dependent variable was the category of adherence, which was constructed based on changes in adherence across the survey period and included four categories: non-adherence, less adherence, greater adherence and sustained adherence (which was designated as the reference category).
In total, 2189 adult participants (82% female, 57.2% aged 31-59 years) from East Asia (217 [9.7%]), West Asia (246 [11.2%]), North and South America (131 [6.0%]), Northern Europe (600 [27.4%]), Western Europe (322 [14.7%]), Southern Europe (433 [19.8%]), Eastern Europe (148 [6.8%]) and other regions (96 [4.4%]) were analyzed. Adjusted multinomial logistic regression analyses showed that prosociality, self-efficacy, perceived susceptibility and severity of COVID-19 were significant factors affecting adherence. Participants with greater self-efficacy at wave 1 were less likely to become non-adherence at wave 2 by 26% (adjusted odds ratio [aOR], 0.74; 95% CI, 0.71 to 0.77; P < .001), while those with greater prosociality at wave 1 were less likely to become less adherence at wave 2 by 23% (aOR, 0.77; 95% CI, 0.75 to 0.79; P = .04).
This study provides evidence that in addition to emphasizing the potential severity of COVID-19 and the potential susceptibility to contact with the virus, fostering self-efficacy in following containment strategies and prosociality appears to be a viable public health education or communication strategy to combat COVID-19.
确定影响公众遵守 COVID-19 防控措施的常见因素，可以直接为制定官方公共卫生沟通策略提供信息。本项国际纵向研究旨在检验亲社会行为以及其他理论上推导的激励因素（自我效能感、对 COVID-19 的感知易感性和严重性、感知社会支持）是否可以预测对 COVID-19 防控策略的遵守程度的变化。
在数据收集的第 1 波中，来自 8 个地理区域的成年人于 2020 年 4 月开始在线调查，第 2 波于 2020 年 6 月开始，并于 9 月结束。假设的预测因素包括亲社会行为、遵循 COVID-19 防控措施的自我效能感、对 COVID-19 的感知易感性、对 COVID-19 的感知严重性和感知社会支持。基线协变量包括年龄、性别、COVID-19 感染史和地理区域。报告遵守特定防控措施（包括保持身体距离、避免非必要旅行和手部卫生）的参与者被归类为遵守者。因变量是基于整个调查期间的遵守情况变化而构建的遵守类别，包括 4 个类别：不遵守、较少遵守、更多遵守和持续遵守（指定为参考类别）。
共分析了来自东亚（217[9.7%]）、西亚（246[11.2%]）、北美和南美（131[6.0%]）、北欧（600[27.4%]）、西欧（322[14.7%]）、南欧（433[19.8%]）、东欧（148[6.8%]）和其他地区（96[4.4%]）的 2189 名成年参与者（82%为女性，57.2%年龄在 31-59 岁）。调整后的多变量逻辑回归分析显示，亲社会行为、自我效能感、对 COVID-19 的感知易感性和严重性是影响遵守的重要因素。第 1 波时自我效能感较高的参与者，第 2 波时不太可能变为不遵守者，降低了 26%（调整后的优势比[aOR]，0.74；95%CI，0.71 至 0.77；P<0.001），而第 1 波时亲社会行为较高的参与者，第 2 波时不太可能变为较少遵守者，降低了 23%（aOR，0.77；95%CI，0.75 至 0.79；P=0.04）。
本研究提供的证据表明，除了强调 COVID-19 的潜在严重性和接触病毒的潜在易感性外，培养遵循防控策略的自我效能感和亲社会行为似乎是对抗 COVID-19 的可行的公共卫生教育或沟通策略。
