Gootjes Frank C, de Wit John B F, de Ridder Denise D T, Stok F Marijn, Kroese Floor M, de Bruin Marijn
Programme Group Challenges to Democratic Representation, Faculty of Social and Behavioural Sciences, University of Amsterdam, PO Box 15578, 1001, NB Amsterdam, the Netherlands.
Department of Interdisciplinary Social Science, Utrecht University, PO Box 80140, 3508, TC Utrecht, the Netherlands.
SSM Popul Health. 2025 Jul 24;31:101847. doi: 10.1016/j.ssmph.2025.101847. eCollection 2025 Sep.
Behavioral measures played a critical role in mitigating the COVID-19 pandemic, and their success hinged on continued public support and adherence. This study provides novel evidence on changes in support and adherence to behavioral mitigation measures and appraises the role of pandemic fatigue to provide robust guidance for effective governance of future public health and safety crises. Data were collected from a population cohort study in the Netherlands. This study used data from six assessments (December 2020-March 2022) at 12-week intervals, aligned with differences in pandemic severity and policy stringency. The analytic sample consisted of participants (N = 20,475) randomly allocated to answer questions on support and adherence to measures, focusing on physical distancing, avoiding crowds, mask-wearing on public transport, COVID-19 testing when symptomatic, and staying home when symptomatic. Changes in adherence and support and their interplay across time were assessed using random intercept cross-lagged panel models, controlling for age, gender and education. At the end of 2020, support for mitigation measures was found to be high, with little difference between measures. Subsequent changes in support for most measures broadly paralleled changes in pandemic severity and policy stringency. Adherence was less responsive to pandemic severity and policy stringency, and was mostly stable, albeit with differences between behavioral measures. Support and adherence to COVID-19 testing steadily increased after this was recommended as of early 2021. Changes in support and adherence did not reflect the notion of pandemic fatigue as a monotonic decline in support and adherence across behaviors. Findings highlight the need to better understand and address the factors influencing differing dynamics in support and adherence to specific protective behaviors.
行为措施在缓解新冠疫情大流行中发挥了关键作用，其成功取决于公众的持续支持和遵守。本研究提供了关于对行为缓解措施的支持和遵守情况变化的新证据，并评估了疫情疲劳的作用，以为未来公共卫生和安全危机的有效治理提供有力指导。数据来自荷兰的一项人群队列研究。本研究使用了六项评估（2020年12月至2022年3月）的数据，间隔为12周，与疫情严重程度和政策严格程度的差异相一致。分析样本包括随机分配的参与者（N = 20475），他们被要求回答关于对措施的支持和遵守情况的问题，重点是保持社交距离、避免人群聚集、在公共交通上佩戴口罩、出现症状时进行新冠病毒检测以及出现症状时居家。使用随机截距交叉滞后面板模型评估了遵守情况和支持情况的变化及其随时间的相互作用，并控制了年龄、性别和教育程度。2020年底，对缓解措施的支持度很高，但各项措施之间差异不大。随后，对大多数措施的支持度变化大致与疫情严重程度和政策严格程度的变化平行。遵守情况对疫情严重程度和政策严格程度的反应较小，且大多保持稳定，尽管不同行为措施之间存在差异。自2021年初建议进行新冠病毒检测后，对其的支持和遵守情况稳步上升。支持和遵守情况的变化并未反映出疫情疲劳是各种行为的支持和遵守情况呈单调下降的观点。研究结果凸显了需要更好地理解和解决影响对特定保护行为的支持和遵守情况不同动态的因素。
