Cognitive Factors Associated With Public Acceptance of COVID-19 Nonpharmaceutical Prevention Measures: Cross-sectional Study

Abstract

Background During the COVID-19 crisis, protests against restrictions emerged and rule violations increased, provoking peaks in new positive cases, forcing authorities in France to impose fines to slow down the spread of the disease. Due to these challenges, subsequent implementations of preventive measures in response to COVID-19 recurrences or other pandemics could present difficulties for decision makers. A better understanding of the factors underlying the public acceptance of COVID-19 nonpharmaceutical preventive measures may therefore contribute greatly to the design of more effective public communication during future pandemics. Objective The aim of this study was to evaluate the acceptance of COVID-19 nonpharmaceutical prevention measures in France. The specific objectives were (1) to examine the public’s acceptance of COVID-19 nonpharmaceutical prevention measures and (2) to assess the association of the public’s acceptance of these prevention measures and their perception of COVID-19. Methods Data were collected from 2004 individuals through an online survey conducted 6-8 weeks after the first lockdown in France. For objective 1, participants were asked the extent to which they supported 8 COVID-19 nonpharmaceutical preventive measures using a 4-point Likert scale. For objective 2, COVID-19–related perceptions were assessed using a 5-point Likert scale from an adapted version of Witte’s Extended Parallel Process Model. Sociodemographic and environmental variables were also collected. The public’s acceptance factors were estimated using an unweighted least squares factorial analysis, and their associations with perceptions of COVID-19, expressed as rate ratios (RR) and 95% CIs, were estimated using generalized linear Poisson regression models. Statistical analyses were performed using the SPSS statistical package. Results The acceptance rate reached 86.1% for individual protective measures, such as making masks mandatory in public open spaces, and 70.0% for collective restrictions, such as isolating the most vulnerable people (1604/2004, 80%) or forbidding public gatherings (n=1590, 79.3%). The least popular restrictions were closing all schools/universities and nonessential commerce such as bars and restaurants (n=1146, 57.2%). Acceptance of collective restrictions was positively associated with their perceived efficacy (RR 1.02, 95% CI 1.01-1.03), fear of COVID-19 (RR 1.04, 95% CI 1.03-1.05), and perceived severity of COVID-19 (RR 1.04, 95% CI 1.03-1.06), and negatively with age >60 years (RR 0.89, 95% CI 0.81-0.98). Acceptance of individual protective measures was associated with their perceived efficacy (RR 1.03, 95% CI 1.03-1.04), fear of COVID-19 (RR 1.02, 1.01-1.03), and perceived severity of COVID-19 (RR 1.03, 1.01-1.05). Conclusions Acceptance rates of COVID-19 nonpharmaceutical measures were rather high, but varied according to their perceived social cost, and were more related to collective than personal protection. Nonpharmaceutical measures that minimize social costs while controlling the spread of the disease are more likely to be accepted during pandemics.

Public acceptance of COVID-19 control measures and associated factors during Omicron-dominant period in China: a cross-sectional survey

“…Similar to the findings of Constant et al [ 24 ], in our study, different cognitions and overall attitudes towards COVID-19 control measures were also related to public acceptance. Those who perceived less fear of SARS-CoV-2 infection and believed that the CFR was extremely low were less acceptive.…”

“…In this survey, young people showed lower acceptance of control measures, which was similar to a study in Saudi Arabia [ 23 ]. Meanwhile, a French study also found that the pressure of study or work, and the pursuit of personal freedom and rich entertainment life made it more difficult for the young to accept strict control measures [ 24 ]. Unexpectedly, the rural residents (vs. urban residents) and undereducated population (vs. master’s degree or above), especially the high-school qualification or below, were more acceptive during the Omicron-dominated period.…”

Peer Review of "Cognitive Factors Associated With Public Acceptance of COVID-19 Nonpharmaceutical Prevention Measures: Cross-sectional Study"

“…The authors of the paper “Acceptance of COVID-19 preventive measures as a trade-off between health and social outcomes” [ 8 ] investigated the acceptance of COVID-19 preventive measures and its association with COVID-19 perception among 2004 subjects and found the acceptance rates for personal protective measures and collective measures to be 86.1% and 70%, respectively. They also found that acceptance of measures was positively associated with perceived efficacy, perceived severity, and fear.…”

“…The authors of the paper titled “Cognitive Factors Associated With Public Acceptance of COVID-19 Nonpharmaceutical Prevention Measures: Cross-sectional Study” [ 8 ] have implemented the recommendations to the letter. However, a new and close look warrants a few more modifications.…”

Peer Review of “Cognitive Factors Associated With Public Acceptance of COVID-19 Nonpharmaceutical Prevention Measures: Cross-sectional Study”

“…This paper [ 1 ] tried to explore the acceptance of the COVID-19 preventive measures and their relationship with perception of the disease via an online survey among the French population. The overall drafted manuscript is acceptable; however, the notion of the paper is a little outdated and numerous publications regarding the COVID-19 are available now that used this method.…”