Determinants of adherence to public health and social measures (PHSM) against COVID-19 among the general population in South Korea: A national survey.

Abstract

The COVID-19 pandemic has created devastating health, social, economic, and political effects that will have long-lasting effects. Public health efforts to reduce the spread of COVID-19 are the priority of national policy to respond to it globally. The public health and social measures (PHSM) are shown to be effective when used alone or in combination with other measures, reducing the risk of spreading COVID-19. However, there is insufficient evidence on the status of compliance of PHSM in the general population for the prevention of COVID-19 in public areas, including Korea. The aim of this study is to assess the level of compliance with the recommended PHSM against COVID-19 infection and its predictors among the general population using national data. This study is a secondary data analysis using an Infectious Disease Prevention Behaviors in Community Survey conducted by the Korea Disease Control and Prevention Agency (KDCA) between October 12 and October 30, 2020. The primary study was cross-sectional, using stratified sampling with an adjusted proportional allocation method to select representative samples and secure the stability of samples. The data were collected through a phone interview conducted by trained enumerators using a structured questionnaire. The PHSM was measured using a 10-item Comprehensive Infectious Disease Preventive Behavior (CIDPB) scale and each of the socio-cognitive factors, such as perceived susceptibility to COVID-19 infection, perceived severity of COVID-19 infection, perceived confidence in performing preventive behaviors related to COVID-19, information comprehensive ability, and trust in information from the KDCA, were measured. A total of 4,003 cases were included in the final analysis. A Tobit regression and decision tree were performed to identify the predictors of preventive measures and the targeted group for intervention. We discovered that women had a 1.34 point higher CIDPB score than men (P<.001). Compared to the group aged 19-29 years, those aged 50-59 years and those older than 60 years scored 1.89 and 2.48 points higher on the CIDPB (P<.001) respectively. The perceived severity of infection, confidence in preventive behaviors, information comprehensive ability, and trust in information from the KDCA were significant positive determinants related to the CIDPB (P<.001) while the perceived susceptibility to infection showed a significant negative relationship with the CIDPB (P<.001). Being female, older in age, having a lower income, and socio-cognitive factors were found to be significant determinants to adhere to PHSM. The findings suggest tailored interventions for the targeted groups; specifically, the most active age group at work indicating the highest potential to spread infection. Adequate public health education and health communication for promoting the adherence of PHSM should be emphasized and the priority of behavior change strategies should be given for those with low perceived confidence in performing PHSM.