Social Distancing and Stigma: Association Between Compliance With Behavioral Recommendations, Risk Perception, and Stigmatizing Attitudes During the COVID-19 Outbreak

Abstract

Introduction: Following behavioral recommendations is key to successful containment of the COVID-19 pandemic. Therefore, it is important to identify causes and patterns of non-compliance in the population to further optimize risk and health communication. Methods: A total of 157 participants [80% female; mean age = 27.82 years (SD = 11.01)] were surveyed regarding their intention to comply with behavioral recommendations issued by the German government. Latent class analysis examined patterns of compliance, and subsequent multinomial logistic regression models tested sociodemographic (age, gender, country of origin, level of education, region, and number of persons per household) and psychosocial (knowledge about preventive behaviors, risk perception, stigmatizing attitudes) predictors. Results: Three latent classes were identified: high compliance (25%) with all recommendations; public compliance (51%), with high compliance regarding public but not personal behaviors; and low compliance (24%) with most recommendations. Compared to high compliance, low compliance was associated with male gender [relative risk ratio (RRR) = 0.08 (0.01; 0.85)], younger age [RRR = 0.72 (0.57; 0.93)], and lower public stigma [RRR = 0.21 (0.05; 0.88)]. Low compliers were also younger than public compliers [RRR = 0.76 (0.59; 0.98)]. Discussion: With 25% of the sample reporting full compliance, and 51% differing in terms of public and personal compliance, these findings challenge the sustainability of strict regulatory measures. Moreover, young males were most likely to express low compliance, stressing the need for selective health promotion efforts. Finally, the positive association between public stigma and compliance points to potential othering effects of stigma during a pandemic, but further longitudinal research is required to examine its impact on health and social processes throughout the pandemic.

Pathways Improving Compliance with Preventive Behaviors during the Remission Period of the COVID-19 Pandemic

“…The current study makes theoretical contributions to the existing literature on the relationship among cognitive, psychosocial factors, and compliance with preventive behaviors [ 12 , 13 , 14 , 21 , 26 , 27 , 28 , 29 , 30 ]. There are several different paths to predict compliance with preventive behaviors for COVID-19.…”

“…First, over the last few decades, the close association between risk perception and preventive behaviors has been recognized [ 8 , 9 , 10 , 11 ]. In the context of the COVID-19 pandemic, during the initial outbreak period, a positive direct relationship between perceived risk and compliance with COVID-19 preventive behaviors has also been empirically demonstrated [ 12 , 13 , 14 ]. However, as pointed out by Leventhal et al [ 15 ], variations in risk perceptions depend on the specific timeframe, leading to the necessity of considering the relationship between these two variables and potential underlying mechanisms during the remission period one year after the initial COVID-19 outbreak.…”

“…Several meta-analyses have shown that perception risk probability as a cognitive risk factor is a significant predictor of various health behaviors, which suggests that risk perceptions are important for health-related behavior [ 8 , 9 , 10 , 11 ]. In the case of the COVID-19 pandemic, research data collected starting at the beginning of the outbreak through April 1, 2020, have shown a positive relationship between perceived risk and compliance with COVID-19 preventive behaviors [ 12 , 13 , 14 ]. However, previous research has suggested that variations in risk perceptions depend on contextual factors [ 15 , 16 ], such as specific timeframes.…”

Risk Perception of COVID−19 Community Transmission among the Spanish Population

“…A preliminary analysis shows that people who put inadequate prevention measures in place scored higher in low risk perception. Many studies refer to the important role of risk perception when establishing behaviour which will protect health in a pandemic [36][37][38][39] Specifically, the review by Bish and Michie [40] shows the association between perceived personal and family susceptibility to the development of a disease and the presence of preventive behaviour (hand washing, household hygiene, wearing masks, etc.) and avoidance behaviour (avoiding going to public places, restaurants, shops, etc.).…”

COVID-19 and Stigmatisation Processes

“…The stigma caused by COVID-19 has profound implications in numerous dimensions, namely (i) the reinforcement of stereotypes and pre-existing ideas (Chopra & Arora, 2020); and (ii) the existence of rumours (Huda et al, 2020;Chopra & Arora, 2020), which hinders collaboration in controlling the disease (testing, maintaining isolation or prophylactic quarantine,…) (Huda et al, 2020;Imran et al, 2020;Tomczyk, Rahn, & Schmidt, 2020;Roelen et al, 2020;Adja, Golinelli, Lenzi, Fantini, & Wu, 2020).…”