Attitudes, behaviours and barriers to public health measures for COVID-19: a survey
      to inform public health messaging

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Abstract

Background

Public support of public health measures including physical distancing, masking, staying home while sick, avoiding crowded indoor spaces and contact tracing/exposure notification applications remains critical for reducing spread of COVID-19. The aim of our work was to understand current behaviours and attitudes towards public health measures as well as barriers individuals face in following public health measures. We also sought to identify attitudes persons have regarding a COVID-19 vaccine and reasons why they may not accept a vaccine.

Methods

A cross-sectional online survey was conducted in August 2020, in Alberta, Canada in persons 18 years and older. This survey evaluated current behaviours, barriers and attitudes towards public health measures and a COVID-19 vaccine. Cluster analysis was used to identify key patterns that summarize data variations among observations.

Results

Of the 60 total respondents, the majority of persons were always or often physically distancing (73%), masking (65%) and staying home while sick (67%). Bars/pubs/lounges or nightclubs were visited rarely or never by 63% of respondents. Persons identified staying home while sick to provide the highest benefit (83%) in reducing spread of COVID-19. There were a large proportion of persons who had not downloaded or used a contact tracing/exposure notification app (77%) and who would not receive a COVID-19 vaccine when available (20%) or were unsure (12%). Reporting health authorities as most trusted sources of health information was associated with greater percentage of potential uptake of vaccine but not related to contact tracing app download and use. Individuals with lower concern of getting and spreading COVID-19 showed the least uptake of public health measures except for avoiding public places such as bars. Lower concern regarding COVID-19 was also associated with more negative responses to taking a potential COVID-19 vaccine.

Conclusion

These results suggest informational frames and themes focusing on individual risks, highlighting concern for COVID-19 and targeting improving trust for health authorities may be most effective in increasing public health measures. With the ultimate goal of preventing spread of COVID-19, understanding persons’ attitudes towards both public health measures and a COVID-19 vaccine remains critical to addressing barriers and implementing targeted interventions and messaging to improve uptake.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10790-0.

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Most cited references 18

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The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Samantha K. Brooks, Rebecca K Webster, Louise E. Smith … (2022)

Summary The December, 2019 coronavirus disease outbreak has seen many countries ask people who have potentially come into contact with the infection to isolate themselves at home or in a dedicated quarantine facility. Decisions on how to apply quarantine should be based on the best available evidence. We did a Review of the psychological impact of quarantine using three electronic databases. Of 3166 papers found, 24 are included in this Review. Most reviewed studies reported negative psychological effects including post-traumatic stress symptoms, confusion, and anger. Stressors included longer quarantine duration, infection fears, frustration, boredom, inadequate supplies, inadequate information, financial loss, and stigma. Some researchers have suggested long-lasting effects. In situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided. Appeals to altruism by reminding the public about the benefits of quarantine to wider society can be favourable.

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The behaviour change wheel: A new method for characterising and designing behaviour change interventions

Susan Michie, Maartje M. van Stralen, Robert H. West (2012)

Background Improving the design and implementation of evidence-based practice depends on successful behaviour change interventions. This requires an appropriate method for characterising interventions and linking them to an analysis of the targeted behaviour. There exists a plethora of frameworks of behaviour change interventions, but it is not clear how well they serve this purpose. This paper evaluates these frameworks, and develops and evaluates a new framework aimed at overcoming their limitations. Methods A systematic search of electronic databases and consultation with behaviour change experts were used to identify frameworks of behaviour change interventions. These were evaluated according to three criteria: comprehensiveness, coherence, and a clear link to an overarching model of behaviour. A new framework was developed to meet these criteria. The reliability with which it could be applied was examined in two domains of behaviour change: tobacco control and obesity. Results Nineteen frameworks were identified covering nine intervention functions and seven policy categories that could enable those interventions. None of the frameworks reviewed covered the full range of intervention functions or policies, and only a minority met the criteria of coherence or linkage to a model of behaviour. At the centre of a proposed new framework is a 'behaviour system' involving three essential conditions: capability, opportunity, and motivation (what we term the 'COM-B system'). This forms the hub of a 'behaviour change wheel' (BCW) around which are positioned the nine intervention functions aimed at addressing deficits in one or more of these conditions; around this are placed seven categories of policy that could enable those interventions to occur. The BCW was used reliably to characterise interventions within the English Department of Health's 2010 tobacco control strategy and the National Institute of Health and Clinical Excellence's guidance on reducing obesity. Conclusions Interventions and policies to change behaviour can be usefully characterised by means of a BCW comprising: a 'behaviour system' at the hub, encircled by intervention functions and then by policy categories. Research is needed to establish how far the BCW can lead to more efficient design of effective interventions.

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Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing

Luca Ferretti, Chris Wymant, Michelle L. Kendall … (2020)

The newly emergent human virus SARS-CoV-2 is resulting in high fatality rates and incapacitated health systems. Preventing further transmission is a priority. We analyzed key parameters of epidemic spread to estimate the contribution of different transmission routes and determine requirements for case isolation and contact-tracing needed to stop the epidemic. We conclude that viral spread is too fast to be contained by manual contact tracing, but could be controlled if this process was faster, more efficient and happened at scale. A contact-tracing App which builds a memory of proximity contacts and immediately notifies contacts of positive cases can achieve epidemic control if used by enough people. By targeting recommendations to only those at risk, epidemics could be contained without need for mass quarantines (‘lock-downs’) that are harmful to society. We discuss the ethical requirements for an intervention of this kind.

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Author and article information

Contributors

Jia Hu: jia.hu@albertahealthservices.ca

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 21 April 2021

Publication date PMC-release: 21 April 2021

Publication date Collection: 2021

Volume: 21

Electronic Location Identifier: 765

Affiliations

[1 ]GRID grid.22072.35, ISNI 0000 0004 1936 7697, Department of Medicine, Cumming School of Medicine, , University of Calgary, ; Calgary, AB Canada

[2 ]GRID grid.22072.35, ISNI 0000 0004 1936 7697, Department of Community Health Sciences, Cumming School of Medicine, , University of Calgary, ; Calgary, AB Canada

[3 ]GRID grid.22072.35, ISNI 0000 0004 1936 7697, Department of Economics, Faculty of Arts, , University of Calgary, ; Calgary, AB Canada

[4 ]GRID grid.413574.0, ISNI 0000 0001 0693 8815, Primary Data Support, Data & Analytics, Alberta Health Services, ; Calgary, AB Canada

[5 ]GRID grid.17089.37, School of Public Health, , University of Alberta, ; Edmonton, AB Canada

[6 ]GRID grid.17063.33, ISNI 0000 0001 2157 2938, Department of Family and Community Medicine, , University of Toronto, ; Toronto, ON Canada

[7 ]GRID grid.22072.35, ISNI 0000 0004 1936 7697, School of Public Policy and Department of Political Science, , University of Calgary, ; Calgary, AB Canada

[8 ]GRID grid.22072.35, ISNI 0000 0004 1936 7697, Haskayne School of Business, , University of Calgary, ; Calgary, AB Canada

Article

Publisher ID: 10790

DOI: 10.1186/s12889-021-10790-0

PMC ID: 8058588

PubMed ID: 33882896

SO-VID: 465c0fae-29d8-4888-9136-9af1cb74b8ef

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 7 December 2020

Date accepted : 24 March 2021

Custom metadata

ScienceOpen disciplines: Public health

Keywords: coronavirus,covid-19,public health,marketing,behavior,risk reduction,attitudes,compliance

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ScienceOpen disciplines: Public health

Keywords: coronavirus, covid-19, public health, marketing, behavior, risk reduction, attitudes, compliance

Attitudes, behaviours and barriers to public health measures for COVID-19: a survey to inform public health messaging

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Abstract

Background

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Supplementary Information

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Novel Coronavirus Disease COVID-19

Most cited references 18

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

The behaviour change wheel: A new method for characterising and designing behaviour change interventions

Quantifying SARS-CoV-2 transmission suggests epidemic control with digital contact tracing

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