An Integrated Model of Compliance with COVID-19 Prescriptions: Instrumental, Normative, and Affective Factors Associated with Health-Protective Behaviors

Abstract

Background The efficacy of public measures for reducing the transmission of the COVID-19 infection relies on citizens’ voluntary adherence with prescribed actions. Drawing on prior literature about compliant behavior, this study aimed to identify factors associated with people engagement in health-protective behaviors by including a conjoint complement of instrumental/self-oriented, normative/community-based, and affective variables. Method A cross-sectional study involving a non-representative sample of 4045 Italian citizens was carried out during the first stage of the pandemic (April–May 2020). Variables associated with health-protective behaviors were perceived personal and societal concerns and perceived effectiveness of the institutional response to the outbreak (instrumental dimensions), and family and friends perceived norms and sense of community responsibility (normative dimensions). Two negative emotions (anxiety and fear) were included as mediators between personal and societal concerns and outcome behaviors. Results Results showed the importance of both self-interest and community-based factors. Indeed, self-interest concerns, family perceived norms, and sense of community responsibility were significant predictors of people’s decisions to engage in health-protective behaviors. Conclusions The research findings show that compliance with public health prescriptions is a multimodal phenomenon and integrating self-interest and community-based factors can offer a better understanding of people’s decision to engage in health-protective behaviors. Further, this study unveils that a shared sense of community is effective in encouraging adherence to recommended behaviors so as behavioral changes can be sustained by targeting the recommendations not only on risk minimization for oneself but also on the allocation of personal responsibility toward the belonging community.

The selective effect of lockdown experience on citizens' perspectives: A multilevel, multiple informant approach to personal and community resilience duringCOVID‐19 pandemic

“…Lastly, the perception of susceptibility to COVID‐19 may have overwhelmed citizens, impacting their current concerns and ability to rather focus on the foreseen opportunities for personal growth (Barni et al, 2020 ; Fiorillo et al, 2020 ; Prati & Mancini, 2021 ; Rochira et al, 2022 ). Thus, the perception of susceptibility to COVID‐19 was taken into account as a control variable at both individual (i.e., knowing someone who got infected with COVID‐19) and province (i.e., the severity of local COVID‐19 impact, as reported by the Istat and Iss report, 2020 ) levels.…”

Escaping the Reality of the Pandemic: The Role of Hopelessness and Dissociation in COVID-19 Denialism

“…It is interesting that, although the sense of community was negatively predicted by levels of hopelessness, it did not appear to be associated with COVID-19 denialism. Conversely, previous studies have reported that a feeling of belongingness and attachment to a place, accompanied by a sense of connection with other members of the community, could promote adherence to norms and prosocial behaviours [ 27 , 40 , 41 , 42 , 43 ]. Although the concept of a sense of community is generally analysed by referring to a geographically defined community, it is possible that a sense of belonging and a connection to one’s city are not sufficient to explain the complex phenomenon of denialism.…”

COVID‐19 in our lives: Sense of community, sense of community responsibility, and reflexivity in present concerns and perception of the future

“…Consistent with previous empirical and validation studies, the results showed a one-factor model for SoC Mannarini et al, 2020) and SoC-R (Prati et al, 2020), as well as for the effectiveness of institutional response (Compare et al, 2021) and reflexivity. Two first-order factors emerged for current personal and social concerns (Rochira et al, 2021) and for perceptions of a postpandemic future (i.e., personal growth and return to pre-COVID life). Current personal and social concerns, perceptions of a postpandemic future, seen as restoring life as it was before the pandemic or as personal growth were entered as separate dimensions in the model (see Figure 1).…”

“…Respondents indicated their level of concern about the impact of the COVID-19 pandemic on their personal safety and on society at large. The eight ad-hoc items derived from the main findings of the Brooks et al's (2020) review, investigated concerns about how COVID-19 affected their safety (personal concerns, five items, e.g., "The possibility of being infected") and society at large (social concerns, three items, e.g., "The possibility of the economic downturn because of inactive time") (Rochira et al 2021). Respondents rated on a 5-point Likert scale ranging from 1 (nothing) to 5 (at all) how concerned they were about what was stated in each item.…”

“…Sphericity was checked using Bartlett's test and adequacy of sampling using the Kaiser-Meyer-Olkin measure. Confirmatory factor analysis (CFA) was performed to investigate the measurement properties for each measure, including the ones expected for SoC Mannarini et al, 2020;Prati et al, 2020), SoC-R (Prati et al, 2020), effectiveness of institutional response (Compare et al, 2021), and personal and social concerns (Rochira et al, 2021). We calculated the alpha (α) and the omega (ω; McDonald, 1999) coefficients to evaluate scale reliability.…”