Lessons from a longitudinal community-based investigation of adherence to guidelines and intent to vaccinate during the COVID-19 pandemic

Abstract

BackgroundThe COVID-19 pandemic is a major public health challenge. The US Centers for Disease Control published guidelines early in the pandemic emphasizing practicing good hygiene and staying at home, which were later modified. PurposeUsing a community sample of 2152 participants in the state of Florida who responded to a series of online surveys, we tested a prediction model of adherence to guidelines and intent to vaccinate during the COVID-19 pandemic. MethodsParticipants were assessed in May 2020, June 2020, and January 2021. Predictors included sociodemographic and psychological variables. ResultsA slight decrease in adherence was reported over time. In multivariate models, older age, female sex, having health insurance, greater knowledge about COVID-19, more worry, less loneliness, and greater confidence and trust in COVID-19 information were all significantly and consistently associated with greater adherence to guidelines. Significant predictors of intent to vaccinate were male sex, greater knowledge, higher socioeconomic status, identifying as White, and greater guideline adherence (p's < 0.05). ConclusionsOur findings highlight a number of significant predictors, including knowledge, loneliness, and confidence/trust. Critically these variables are modifiable and could therefore serve as targets in public health interventions to improve adherence to pandemic guidelines in the general population, as well as certain demographic characteristics that may influence intent to vaccinate. COVID-19 knowledge appears to play a central role in both adherence to guidelines and intent to vaccinate suggesting that having accurate information is critical for appropriate behavior.