Department of Economics, American University of Beirut, Beirut, Lebanon.
Center for Research on Population and Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon.
PLoS One. 2023 Jun 22;18(6):e0268851. doi: 10.1371/journal.pone.0268851. eCollection 2023.
Lebanon has battled the COVID-19 pandemic in the midst of an economic crisis. The evolution of the pandemic and a fragile health system have meant that public health policy has had to rely heavily on non-pharmaceutical interventions for disease control. However, changes in disease dynamics, an unraveling economy, and pandemic fatigue have meant that disease control policies need to be updated.
Using recent and timely data on older (50 years and above) Syrian refugees in Lebanon, this paper uses multivariate linear probability models to explore the determinants of adherence to two non-pharmaceutical COVID-19 prevention measures (wearing a mask and avoiding social gatherings) among this high-risk subgroup in a vulnerable population. Among respondents who report adhering to these measures, the paper also investigates the determinants of sustained adherence over a period of 6 months.
The findings suggest that no individual-level characteristics were robustly associated with mask wearing. For avoiding social gatherings, education was inversely associated with adherence to this preventive measure. Avoiding social gatherings was also significantly lower for residents of informal tented settlements (ITSs). Among initial adherents, and for both preventive practices, ITS dwellers were also significantly less likely to maintain adherence.
Identifying variables associated with adherence to non-pharmaceutical preventive practices, particularly for vulnerable groups, can help inform and refine interventions in the face of changing conditions. The material, physical, administrative and socio-economic constraints of life in an ITS suggest that avoiding social gatherings is hardly feasible. Yet despite the challenging conditions of ITSs, the indication to wear a mask is initially complied with, suggesting that tailoring policies to the limits and constrains of context can lead to successful outcomes even in very adverse settings.
黎巴嫩在经济危机中与 COVID-19 大流行作斗争。大流行的演变和脆弱的卫生系统意味着公共卫生政策必须高度依赖非药物干预措施来控制疾病。然而，疾病动态的变化、经济的崩溃和大流行的疲劳意味着疾病控制政策需要更新。
本文利用黎巴嫩最近和及时的老年（50 岁及以上）叙利亚难民数据，使用多元线性概率模型探讨了在这个脆弱人群中的高危亚组中，两个非药物 COVID-19 预防措施（戴口罩和避免社交聚会）的坚持性的决定因素。在报告遵守这些措施的受访者中，本文还调查了在 6 个月期间持续遵守的决定因素。
研究结果表明，没有个体特征与戴口罩有很强的相关性。对于避免社交聚会，教育与遵守这一预防措施呈负相关。对于居住在非正规帐篷定居点（ITS）的人来说，避免社交聚会的情况也明显较低。对于最初的遵守者来说，对于这两种预防措施，居住在 ITS 的人也不太可能保持遵守。
确定与非药物预防措施的遵守相关的变量，特别是对弱势群体而言，可以帮助在面对变化的条件下为干预措施提供信息和完善。在 ITS 中生活的物质、物理、行政和社会经济限制使得避免社交聚会几乎不可行。然而，尽管 ITS 条件具有挑战性，最初仍然遵守戴口罩的指示，这表明根据背景的限制和约束调整政策可以导致即使在非常不利的环境中也能取得成功的结果。
