How to Improve Compliance with Protective Health Measures during the COVID-19 Outbreak: Testing a Moderated Mediation Model and Machine Learning Algorithms

Abstract

In the wake of the sudden spread of COVID-19, a large amount of the Italian population practiced incongruous behaviors with the protective health measures. The present study aimed at examining psychological and psychosocial variables that could predict behavioral compliance. An online survey was administered from 18–22 March 2020 to 2766 participants. Paired sample t-tests were run to compare efficacy perception with behavioral compliance. Mediation and moderated mediation models were constructed to explore the association between perceived efficacy and compliance, mediated by self-efficacy and moderated by risk perception and civic attitudes. Machine learning algorithms were trained to predict which individuals would be more likely to comply with protective measures. Results indicated significantly lower scores in behavioral compliance than efficacy perception. Risk perception and civic attitudes as moderators rendered the mediating effect of self-efficacy insignificant. Perceived efficacy on the adoption of recommended behaviors varied in accordance with risk perception and civic engagement. The 14 collected variables, entered as predictors in machine learning models, produced an ROC area in the range of 0.82–0.91 classifying individuals as high versus low compliance. Overall, these findings could be helpful in guiding age-tailored information/advertising campaigns in countries affected by COVID-19 and directing further research on behavioral compliance.

Risk Perception of COVID-19 Infection and Adherence to Preventive Measures among Adolescents and Young Adults

“…This is consistent with other studies showing that, for both adolescents and adults, the main motivations for social distancing include social responsibility and desire to protect others ([ 31 ], Coroiu, 2020 #6246, Oosterhoff, 2020 #6214). These results are further confirmed by another study conducted among Italian adults that showed that in the context of COVID-19, civic attitudes, including the feeling of involvement in the community, have an impact on adherence to preventive measures [ 32 ]. Therefore, promoting altruism and community attachment could be a potential strategy to enhance AYAs’ uptake of current preventive measures, and could also encourage vaccination once it will be available.…”

A 2-Month Follow-Up Study of Psychological Distress among Italian People during the COVID-19 Lockdown

“…For instance, taking advantage of the more widespread use of Web technologies, experts might utilize online assessments to evaluate depression, stress, personality features, and coping style, especially in younger Italians. Such a screening process could reach a high number of people at risk for mental disease in a short span of time, and thereby prevent the spread of psychopathologies in the coming years and promote compliance with the government-recommended health measures [38].…”

Coronavirus disease 2019 (COVID-19) and psychological distress in China: Does neighbourhood matter?

“…Interventions, such as promoting public compliance with government health recommendations to control the spread of a virus should also be included. Such research could focus on the public perceptions and efficacy of a range of interventions ( Roma et al, 2020 ). Meanwhile, physical characteristics such as green space should be taken into account in a future study since previous studies have indicated that the percentage of green space.…”