Cilović-Lagarija Šeila, Eitze Sarah, Skočibušić Siniša, Musa Sanjin, Stojisavljević Stela, Šabanović Haris, Dizdar Faris, Palo Mirza, Nitzan Dorit, de Arriaga Miguel Telo, Scherzer Martha, Curtis Benjamin, Habersaat Katrine Bach
Institute for Public Health FB&H, Sarajevo, Bosnia and Herzegovina.
Institute for Planetary Health Behavior, University of Erfurt, Germany.
PLoS One. 2025 Apr 17;20(4):e0320433. doi: 10.1371/journal.pone.0320433. eCollection 2025.
Public health and social measures (PHSM) are critical aspects of limiting the spread of infections in pandemics. Compliance with PHSM depends on a wide range of factors, including behavioral determinants such as emotional response, trust in institutions or risk perceptions. This study examines self-reported compliance with PHSM during the COVID-19 pandemic in the Federation of Bosnia and Herzegovina (FBIH).
We analyze the association between compliance and behavioral determinants, using data from five cross-sectional surveys that were conducted between June 2020 and August 2021 in FBIH. Quota-based sampling ensured that the 1000 people per wave were population representative regarding age, sex, and education level based on the data from the latest census in Bosnia and Herzegovina. One-way analysis of variance (ANOVA) was used to identify significant changes between studies on determinants and PHSM measures. Regression was used to find relations between behavioral determinants and PHSM.
Participants reported strong emotional responses to the rapid spread of the virus and its proximity to them. Risk perception was spiking in December 2020 when rates of infection and death were particularly high. Trends in policy acceptance were divergent; participants did not rate PHSM as exaggerated, but perceived fairness was low. Trust in institutions was low across all waves and declined for specific institutions such as the health ministry. In five wave-specific regression analyses, emotional response (βmin/max = .11*/.21*), risk perception (βmin/max = .06/.18*), policy acceptance (βmin/max = .09/.20*), and trust in institutions (βmin/max = .06/.21*) emerged as significant predictors of PHSM.
This study contributes to the body of research on factors influencing compliance with PHSM. It emphasizes the importance of behavioral monitoring through repeated surveys to understand and improve compliance. The study also affirms the impact of public trust on compliance, the risk of eroding compliance over time, and the need for health literacy support to help reinforce protective behaviors.
公共卫生和社会措施（PHSM）是在大流行期间限制感染传播的关键方面。对PHSM的遵守取决于多种因素，包括行为决定因素，如情绪反应、对机构的信任或风险认知。本研究调查了波斯尼亚和黑塞哥维那联邦（波黑联邦）在新冠疫情期间自我报告的对PHSM的遵守情况。
我们使用2020年6月至2021年8月在波黑联邦进行的五项横断面调查数据，分析了遵守情况与行为决定因素之间的关联。基于配额的抽样确保了每轮调查的1000人在年龄、性别和教育水平方面根据波斯尼亚和黑塞哥维那最新人口普查数据具有人口代表性。单向方差分析（ANOVA）用于确定关于决定因素和PHSM措施的研究之间的显著变化。回归分析用于找出行为决定因素与PHSM之间的关系。
参与者报告了对病毒快速传播及其与自身接近程度的强烈情绪反应。2020年12月，当感染率和死亡率特别高时，风险认知急剧上升。政策接受度的趋势各不相同；参与者并不认为PHSM被夸大，但感知到的公平性较低。在所有轮次中，对机构的信任度都很低，并且对卫生部等特定机构的信任度有所下降。在五项特定轮次的回归分析中，情绪反应（β最小值/最大值=0.11*/0.21*）、风险认知（β最小值/最大值=0.06/0.18*）、政策接受度（β最小值/最大值=0.09/0.20*）和对机构的信任（β最小值/最大值=0.06/0.21*）成为PHSM的显著预测因素。
本研究为影响对PHSM遵守情况的因素研究做出了贡献。它强调了通过重复调查进行行为监测以理解和提高遵守情况的重要性。该研究还肯定了公众信任对遵守情况的影响、随着时间推移遵守情况被侵蚀的风险，以及提供健康素养支持以帮助强化保护行为的必要性。
