Patterns of compliance with COVID-19 preventive behaviours: a latent class analysis of 20 000 UK adults

Abstract

BackgroundGovernments have implemented a range of measures to tackle COVID-19, primarily focusing on changing citizens’ behaviours in order to lower the transmission of the virus. Few studies have looked at the patterns of compliance with different measures within individuals: whether people comply with all measures or selectively choose some but not others. Such research is important for designing interventions to increase compliance.MethodsWe used cross-sectional data from 20 947 UK adults in the COVID-19 Social Study collected from 17 November to 23 December 2020. Self-report compliance was assessed with six behaviours: mask wearing, hand washing, indoor household mixing, outdoor household mixing, social distancing and compliance with other guidelines. Patterns of compliance behaviour were identified using latent class analysis, and multinomial logistic regression was used to assess demographic, socioeconomic and personality predictors of behaviour patterns.ResultsWe selected a four-latent class solution. Most individuals reported similar levels of compliance across the six behaviour measures. High level of compliance was the modal response. Lower self-reported compliance was related to young age, high risk-taking behaviour, low confidence in government and low empathy, among other factors. Looking at individual behaviours, mask wearing had the highest level of compliance while compliance with social distancing was relatively low.ConclusionResults suggest that individuals choose to comply with all guidelines, rather than some but not others. Strategies to increase compliance should focus on increasing general motivations to comply alongside specifically encouraging social distancing.

Who is engaging with lateral flow testing for COVID-19 in the UK? The COVID-19 Rapid Survey of Adherence to Interventions and Responses (CORSAIR) study

“…Socio-demographic factors associated with uptake of lateral flow testing included being younger, living with a dependent child, lower socioeconomic grade and thinking that you have had COVID-19 before. Previous research has found these factors to be consistently associated with non-adherence to behaviours that prevent the spread of COVID-19 11 18 36. However, the association between increased lateral flow testing and lower age has also been found in other data, largely driven by those of working age being more likely to complete a test 8 22.…”

Knowledge of self-isolation rules in the UK for those who have symptoms of Covid-19: a repeated cross-sectional survey study

“…These groups have consistently been found to have lower adherence to rules throughout the pandemic. (3,4,23) Lack of knowledge may be contributing to lower adherence. Congruent with this idea is our finding that knowledge of self-isolation rules was lower among people who disagreed that they had enough information about self-isolation.…”

How have patterns of social mixing changed during the pandemic? A series of cross-sectional nationally representative surveys

“…This is in line with other evidence on internal health locus of control and uptake of health behaviours, 20,21 but not with another study which found that internal locus of control was associated with decreased self-reported adherence to Government guidance on social mixing. 11 This study measured self-reported adherence, which necessarily depends on participants' knowledge of guidance; evidence suggests that knowledge is sub-optimal. 8,22 Increasing knowledge about SARS-CoV-2 transmission and emphasising that an individual's behaviour can affect the spread of the virus may encourage uptake of protective behaviours such as lower risk social mixing.…”

“…Research suggests that women, older people, those with chronic illnesses, people who perceived measures to be more effective, people who perceived COVID-19 to be a more severe illness, and those who thought that others were also adhering to measures were more likely to adopt physical distancing behaviours. [8][9][10][11] A study investigating close contacts during the pandemic found that people who reported more contacts were less likely to think that COVID-19 would be a serious illness for them, were more likely to agree that they were likely to catch COVID-19, and were more concerned that they might spread COVID-19 to others. 4 These studies investigated factors associated with individual dimensions of social mixing, for example the number of times people had met up with friends or family socially, whether they came into close contact with others, or selfreported adherence to Government guidelines.…”

“…Furthermore, most studies investigated mixing at the start of the pandemic (May 2020), with one study analysing data collected up to December 2020, 11 and another analysing data up to March 2021. 4 At the time of writing, there were no available data investigating social mixing after the release of all legal restrictions in the UK on 19 July 2021.…”