Psychosocial determinants of adherence to public health and social measures (PHSMs) in 18 African Union Member States during the early phase of the COVID-19 pandemic: results of a cross-sectional survey
Objective The objective of this study was to gain a better understanding of the psychosocial and sociodemographic factors that affected adherence to COVID-19 public health and social measures (PHSMs), and to identify the factors that most strongly related to whether citizens followed public health g...
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BMJ Publishing Group
2022-06-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/12/6/e054839.full |
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| author | Andrew Johnson Amanda McClelland Nandita Murukutla Akhona Tshangela Ashish K Gupta Meena Maharjan Cecilia Fabrizio Emily W Myers Virginia Nkwanzi Colby A Wilkason Natalie Lacey Benjamin Djoudalbaye |
| author_facet | Andrew Johnson Amanda McClelland Nandita Murukutla Akhona Tshangela Ashish K Gupta Meena Maharjan Cecilia Fabrizio Emily W Myers Virginia Nkwanzi Colby A Wilkason Natalie Lacey Benjamin Djoudalbaye |
| author_sort | Andrew Johnson |
| collection | DOAJ |
| description | Objective The objective of this study was to gain a better understanding of the psychosocial and sociodemographic factors that affected adherence to COVID-19 public health and social measures (PHSMs), and to identify the factors that most strongly related to whether citizens followed public health guidance.Design Cross-sectional study.Setting and participants Nationally representative telephone surveys were conducted from 4–17 August 2020 in 18 African Union Member States. A total of 21 600 adults (mean age=32.7 years, SD=11.4) were interviewed (1200 in each country).Outcome measures Information including sociodemographics, adherence to PHSMs and psychosocial variables was collected. Logistic regression models examined the association between PHSM adherence (eg, physical distancing, gathering restrictions) and sociodemographic and psychosocial characteristics (eg, risk perception, trust). Factors affecting adherence were ranked using the Shapley regression decomposition method.Results Adherence to PHSMs was high, with better adherence to personal than community PHSMs (65.5% vs 30.2%, p<0.05). Psychosocial measures were significantly associated with personal and community PHSMs (p<0.05). Women and older adults demonstrated better adherence to personal PHSMs (adjusted OR (aOR): women=1.43, age=1.01, p<0.05) and community PHSMs (aOR: women=1.57, age=1.01, p<0.05). Secondary education was associated with better adherence only to personal PHSMs (aOR=1.22, p<0.05). Rural residence and access to running water were associated with better adherence to community PHSMs (aOR=1.12 and 1.18, respectively, p<0.05). The factors that most affected adherence to personal PHSMs were: self-efficacy; trust in hospitals/health centres; knowledge about face masks; trust in the president; and gender. For community PHSMs they were: gender; trust in the president; access to running water; trust in hospitals/health centres; and risk perception.Conclusions Psychosocial factors, particularly trust in authorities and institutions, played a critical role in PHSM adherence. Adherence to community PHSMs was lower than personal PHSMs since they can impose significant burdens, particularly on the socially vulnerable. |
| format | Article |
| id | doaj-art-bf202f5075c34e6f852b6141a5d712b0 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2022-06-01 |
| publisher | BMJ Publishing Group |
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| series | BMJ Open |
| spelling | doaj-art-bf202f5075c34e6f852b6141a5d712b02025-01-27T16:15:09ZengBMJ Publishing GroupBMJ Open2044-60552022-06-0112610.1136/bmjopen-2021-054839Psychosocial determinants of adherence to public health and social measures (PHSMs) in 18 African Union Member States during the early phase of the COVID-19 pandemic: results of a cross-sectional surveyAndrew Johnson0Amanda McClelland1Nandita Murukutla2Akhona Tshangela3Ashish K Gupta4Meena Maharjan5Cecilia Fabrizio6Emily W Myers7Virginia Nkwanzi8Colby A Wilkason9Natalie Lacey10Benjamin Djoudalbaye11Townsville Hospital and Health Service, Townsville, Queensland, AustraliaPrevent Epidemics, Resolve to Saves Lives, New York, New York, USAVital Strategies, New York, New York, USAAfrica Centres for Disease Control and Prevention, African Union, Addis Ababa, EthiopiaVital Strategies, New Delhi, IndiaVital Strategies, New Delhi, IndiaVital Strategies, New York, New York, USAVital Strategies, New York, New York, USAIpsos, Kampala, UgandaResolve To Save Lives, An initiative to Vital Strategies, New York, New York, USAIpsos, Washington, District of Columbia, USAAfrica Centres for Disease Control and Prevention, African Union, Addis Ababa, EthiopiaObjective The objective of this study was to gain a better understanding of the psychosocial and sociodemographic factors that affected adherence to COVID-19 public health and social measures (PHSMs), and to identify the factors that most strongly related to whether citizens followed public health guidance.Design Cross-sectional study.Setting and participants Nationally representative telephone surveys were conducted from 4–17 August 2020 in 18 African Union Member States. A total of 21 600 adults (mean age=32.7 years, SD=11.4) were interviewed (1200 in each country).Outcome measures Information including sociodemographics, adherence to PHSMs and psychosocial variables was collected. Logistic regression models examined the association between PHSM adherence (eg, physical distancing, gathering restrictions) and sociodemographic and psychosocial characteristics (eg, risk perception, trust). Factors affecting adherence were ranked using the Shapley regression decomposition method.Results Adherence to PHSMs was high, with better adherence to personal than community PHSMs (65.5% vs 30.2%, p<0.05). Psychosocial measures were significantly associated with personal and community PHSMs (p<0.05). Women and older adults demonstrated better adherence to personal PHSMs (adjusted OR (aOR): women=1.43, age=1.01, p<0.05) and community PHSMs (aOR: women=1.57, age=1.01, p<0.05). Secondary education was associated with better adherence only to personal PHSMs (aOR=1.22, p<0.05). Rural residence and access to running water were associated with better adherence to community PHSMs (aOR=1.12 and 1.18, respectively, p<0.05). The factors that most affected adherence to personal PHSMs were: self-efficacy; trust in hospitals/health centres; knowledge about face masks; trust in the president; and gender. For community PHSMs they were: gender; trust in the president; access to running water; trust in hospitals/health centres; and risk perception.Conclusions Psychosocial factors, particularly trust in authorities and institutions, played a critical role in PHSM adherence. Adherence to community PHSMs was lower than personal PHSMs since they can impose significant burdens, particularly on the socially vulnerable.https://bmjopen.bmj.com/content/12/6/e054839.full |
| spellingShingle | Andrew Johnson Amanda McClelland Nandita Murukutla Akhona Tshangela Ashish K Gupta Meena Maharjan Cecilia Fabrizio Emily W Myers Virginia Nkwanzi Colby A Wilkason Natalie Lacey Benjamin Djoudalbaye Psychosocial determinants of adherence to public health and social measures (PHSMs) in 18 African Union Member States during the early phase of the COVID-19 pandemic: results of a cross-sectional survey BMJ Open |
| title | Psychosocial determinants of adherence to public health and social measures (PHSMs) in 18 African Union Member States during the early phase of the COVID-19 pandemic: results of a cross-sectional survey |
| title_full | Psychosocial determinants of adherence to public health and social measures (PHSMs) in 18 African Union Member States during the early phase of the COVID-19 pandemic: results of a cross-sectional survey |
| title_fullStr | Psychosocial determinants of adherence to public health and social measures (PHSMs) in 18 African Union Member States during the early phase of the COVID-19 pandemic: results of a cross-sectional survey |
| title_full_unstemmed | Psychosocial determinants of adherence to public health and social measures (PHSMs) in 18 African Union Member States during the early phase of the COVID-19 pandemic: results of a cross-sectional survey |
| title_short | Psychosocial determinants of adherence to public health and social measures (PHSMs) in 18 African Union Member States during the early phase of the COVID-19 pandemic: results of a cross-sectional survey |
| title_sort | psychosocial determinants of adherence to public health and social measures phsms in 18 african union member states during the early phase of the covid 19 pandemic results of a cross sectional survey |
| url | https://bmjopen.bmj.com/content/12/6/e054839.full |
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