Social Factors Associated With Adherence to Preventive Behaviors Related to COVID-19 Among Rural and Semi-urban Communities in Western Maharashtra, India

Abstract

Background: To control the transmission of the coronavirus disease 2019 (COVID-19) infection, the Government of India (GoI) had taken stringent precautionary measures during the lockdown period. This study aimed to explore determinants affecting adherence to protective measures against COVID-19 infection among rural and semi-urban settings of Maharashtra, India.Methods: A cross-sectional telephonic survey among 1,016 adults from randomly selected households was conducted between June 5 and July 16, 2020. The data were explored for knowledge, awareness, practices related to protective measures, and self-risk perception. Socio-demographic and attitudinal correlates of failure to use protective measures against COVID-19 were measured.Results: In the survey, 72% of the participants were men. The mean age was 46 years (SD: 13.8). The main source of information was television (91%); however, information from healthcare providers (65%) and mass media announcements (49%) was trustworthy. Washing hands immediately with soap after returning from outdoors was reported by 95% of the respondents, always using a mask while outdoors by 94%, never attended social gatherings by 91%, always using hand sanitizer while outside by 77%, and 68% of the respondents followed all protective measures. The knowledge score [mean score 20.3 (SD: 2.4) out of 24] was independently associated with the risk of not using protective measures, with each unit increase in knowledge score, the risk of not using protective measures reduced by 16%. No source of income was independently associated with not using protective measures [AOR 1.5 95% CI (1.01–2.3)].Conclusions: The COVID-19 public health interventions and behavior change communication strategies should be specifically directed towards the low socio-economic populations through trusted sources. The association between knowledge and practices demonstrates the importance of accurate public health communication to optimally follow preventive measures, such as structural interventions to address poverty and employment policies to address the unemployment crisis are required. Surveillance activity is needed to understand the actual behavior change among the population.

Why Do We Not Follow Lifesaving Rules? Factors Affecting Nonadherence to COVID-19 Prevention Guidelines in Indonesia: Healthcare Professionals’ Perspectives

“…These included notions that COVID-19 was a manufactured phenomenon to manipulate the insurance reimbursement system for additional profits from testing and treatment, and that COVID-19 tests are not trustworthy and misdiagnose and amplify case numbers without (symptomatic) evidence. This aligns with other studies in Indonesia and elsewhere which demonstrated that communities with low access to COVID-19 information, or expressing beliefs of disease causation which do not align with the dominant biomedical explanations often have low levels of trust and poor adherence to pandemic restrictions [ 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 ].…”

“…As per HCP narratives, the community was suspicious of the dominant biomedical explanation for the phenomenon, evidenced by the fact that many community members have no empirical experience with sick patients despite nonadherence to preventive protocols. This suspicion and mistrust of health authorities have been reported elsewhere in the scholarly literature [40][41][42][43][44][45]. HCPs reported hearing rumours and second-hand information from the community expressing incorrect and conspiratorial beliefs about the origin and nature of COVID-19.…”

“…The TPB outlines the influence of ‘perceived behavioural control’ on individual behaviours; in this case, HCPs identify external factors or structural constraints such as poverty and lack of PPEs and other commodities as impacting the community adherence to preventive behaviours. Previous findings have reported that poverty due to unemployment and lack of income prevent people from purchasing PPEs and influence adherence to preventive guidelines [ 42 , 43 , 46 , 55 ]. Poverty also drives the need to engage socially for work which influences community adherence to preventive guidelines, such as maintaining physical distancing or avoiding gathering, as reported in previous studies [ 40 , 46 ].…”

Associated factors with adherence to preventive behaviors related to COVID-19 among medical students in the university of Monastir, Tunisia

“…The same finding is also consistent with other studies examining the influence of gender on practices related to other health conditions [37,38]. However, some studies have not found this association [39,40]. Regarding the relationship with tobacco consumption, we found that adherence to preventive practices varied according to the form of tobacco use: the use of chicha negatively affected the score of good practices.…”

“…The distribution of scores by smoking status is described in Fig 3 . The lowest scores were recorded among students who use chicha (33 [27-39]), E cigarette (35 [31][32][33][34][35][36][37][38][39][40]) and especially those who use several forms of tobacco at the same time (31 [23-38.5]).…”