Group-based trajectories and predictors of adherence to physical distancing during the COVID-19 pandemic

Trajectories of health behaviors during the COVID-19 pandemic: a longitudinal analysis of handwashing, mask wearing, social contact limitations, and physical distancing

AIM

This study aimed to investigate the associations between health behavior adherence and psychological factors during the COVID-19 pandemic, with a particular focus on identifying trajectories of handwashing, mask wearing, social contact limitations, and physical distancing.

METHODS

We employed a multi-trajectory group-based approach to analyze data from 6026 Belgian residents, including 60% women, with an average age of 52.65. Data were collected over six waves spanning from April 2021 to December 2021.

RESULTS

Participants were categorized into trajectory groups based on persistently low (11.9%), moderate-low (20.9%), moderate-high (39.1%), and high (28.1%) levels of adherence to the specified health behaviors. Our findings indicate a declining trend in health behavior adherence over the study period. Additionally, we observed that females, older individuals, and those with prior COVID-19 infection had a higher likelihood of belonging to trajectory groups characterized by the highest levels of health behavior adherence. Similarly, individuals with positive vaccination intentions, a heightened perception of consequences, and increased health anxiety demonstrated greater adherence to health behaviors over time. Furthermore, our investigation into the relationship between health behaviors and mental health revealed that participants in trajectory groups with higher levels of adherence to social contact limitations and physical distancing reported increased feelings of loneliness and decreased life satisfaction.

CONCLUSIONS

The COVID-19 pandemic has reshaped our lives, and while vaccines have marked progress, maintaining health behaviors is crucial for virus prevention. To address potential mental health challenges from sanitary measures, policies and communication should promote health behaviors while acknowledging their psychological impact.

How level of understanding and type of used sources relate to adherence to COVID-19 public health measures in Canada

Previous studies have highlighted the importance of promoting health literacy and minimizing misinformation to encourage higher adherence to key public health measures during the COVID-19 pandemic. This study explores how one's self-reported understanding of information and types of sources used to get information regarding COVID-19 can hinder adherence to public health measures implemented by the Canadian government. Data was collected following a longitudinal design of 11 time points for April 2020 to April 2021. The sub-sample used for this study included 2659 Canadians who completed the survey for at least four time points. Using Latent Class Growth Analysis, we modelled typical trajectories of adherence to three key public health measures: staying home, social distancing and mask wearing. Overall, a lower level of understanding was associated with lower adherence trajectories to public health measures, and vice-versa. Adjusted odds ratio (AOR) showed that the higher the level of understanding, the higher were the chances of following a high adherence trajectory. The type of used sources also showed a significant statistical association with adherence trajectories for social distancing and staying home (AOR: between 1.1 and 3.4). These results are discussed considering future policy implications.

Psychometric properties of the Korean version of questionnaires on adherence to physical distancing and health beliefs about COVID-19 in the general population

Introduction

We aimed to examine the psychometric properties of the Korean version of the questionnaires on adherence to physical distancing and health beliefs about COVID-19 in the general population in South Korea. In addition, we investigated how the various sections interacted with each other and with viral anxiety and depression, and ultimately affected adherence to physical distancing.

Methods

An anonymous online survey was conducted among members of the general population in South Korea between 10 and 18 January 2022. We recruited 400 respondents and measured their demographic information, symptoms, and responses to questions about COVID-19. First, we examined the reliability and validity of the questionnaires, which included questions about people's adherence to physical distancing guidelines and COVID-19-related health beliefs. Second, we examined the relationship between physical distancing and viral anxiety or depression, as assessed using the six-item Stress and Anxiety to Viral Epidemics (SAVE-6) scale and the Patient Health Questionnaire-9 (PHQ-9).

Results

All 400 participants (204 men, age 41.6 ± 10.8) completed the survey. Confirmatory factor analysis revealed a good model fit for adherence to physical distancing (CFI = 1.000, TLI = 1.019, RMSEA = 0.000, and SRMR = 0.034) and health beliefs about COVID-19 (CFI = 0.993, TLI = 0.991, RMSEA = 0.030, and SRMR = 0.052). It also showed good reliability for Factor I (Cronbach's α = 0.826) and Factor II (α = 0.740). Four categories of the COVID-19 health beliefs questionnaire also showed good reliability for perceived susceptibility (α = 0.870), perceived severity (α = 0.901), perceived benefit (α = 0.935), and barriers to following physical distancing (α = 0.833). Structural equation models showed that the effects of health beliefs and viral anxiety and depression were mediated mostly by personal injunctive norms. Goodness-of-fit measures indicated a good fit. (Chi-square = 24.425, df = 7, p < 0.001; CFI = 0.966; RMSEA = 0.079).

Conclusion

The Korean version of the COVID-19 adherence to physical distancing and health beliefs questionnaires showed good reliability and validity in the Korean general population. In addition, the effects of health beliefs, along with viral anxiety and depression, were mainly mediated by personal injunctive norms.

Empathy moderates the relationship between cognitive load and prosocial behaviour

Cognitive load reduces both empathy and prosocial behaviour. However, studies demonstrating these effects have induced cognitive load in a temporally limited, artificial manner that fails to capture real-world cognitive load. Drawing from cognitive load theory, we investigated whether naturally occurring cognitive load from the ongoing COVID-19 pandemic moderated the relationship between empathy and prosocial behaviour (operationalised as support for public health measures). This large study in an Australian sample (N = 600) identified negative relationships between pandemic fatigue, empathy for people vulnerable to COVID-19, and prosocial behaviour, and a positive relationship between empathy and prosocial behaviour. Additionally, we found that the negative effect of the pandemic on prosocial behaviour depended on empathy for vulnerable others, with pandemic fatigue's effects lowest for those with the highest empathy. These findings highlight the interrelationships of cognitive load and empathy, and the potential value of eliciting empathy to ease the impact of real-world cognitive load on prosocial behaviour.