Preferences and patterns of response to public health advice during the COVID-19 pandemic

Oded Nov,Katharine Lawrence,Devin Mann,Martina Balestra,Graham Dove,Batia Wiesenfeld

doi:10.1038/s41598-021-01186-6

Abstract

With recurring waves of the Covid-19 pandemic, a dilemma facing public health leadership is whether to provide public advice that is medically optimal (e.g., most protective against infection if followed), but unlikely to be adhered to, or advice that is less protective but is more likely to be followed. To provide insight about this dilemma, we examined and quantified public perceptions about the tradeoff between (a) the stand-alone value of health behavior advice, and (b) the advice’s adherence likelihood. In a series of studies about preference for public health leadership advice, we asked 1061 participants to choose between (5) strict advice that is medically optimal if adhered to but which is less likely to be broadly followed, and (2) relaxed advice, which is less medically effective but more likely to gain adherence—given varying infection expectancies. Participants’ preference was consistent with risk aversion. Offering an informed choice alternative that shifts volition to advice recipients only strengthened risk aversion, but also demonstrated that informed choice was preferred as much or more than the risk-averse strict advice.

Highlights

With recurring waves of the Covid-19 pandemic, a dilemma facing public health leadership is whether to provide public advice that is medically optimal, but unlikely to be adhered to, or advice that is less protective but is more likely to be followed
Using one-proportion z-tests with respect to the ‘indifference’ level (50%) within each condition we found that there was a significant preference for the strict advice strategy ( Nstrict = 51, 75% [64.7%, 85.3%]) over the relaxed advice (Nrelaxed = 17, 25% [14.7%, 35.3%]) when the projected infection rates for ‘strict advice’ were lower than for ‘relaxed advice’ (z = 4.761, p = 0.000)
When infection rates for strict advice were higher than for relaxed advice, there was no significant preference for either advice type (z = 0.948, p = 0.34); Nrelaxed = 40, 56.3% [44.8%, 67.9%]; Nstrict = 31, 43.7% [32.1%, 55.2%])

Summary

Introduction

With recurring waves of the Covid-19 pandemic, a dilemma facing public health leadership is whether to provide public advice that is medically optimal (e.g., most protective against infection if followed), but unlikely to be adhered to, or advice that is less protective but is more likely to be followed. A dilemma facing public health leadership is whether to provide public advice that is medically optimal (e.g., most protective against infection if followed), but unlikely to be adhered to, or advice that is less protective but is more likely to be followed. To provide insight about this dilemma, we examine and quantify public perceptions about the tradeoff between (a) the stand-alone value of health behavior advice (e.g. its efficacy in protecting against infection), and (b) the advice’s adherence likelihood Following the scientific evidence supporting mask wearing[4,5], in a series of studies we asked 1061 participants to indicate their opinion about the appropriate public health advice strategies to be used by public health leadership, given different infection rates (i.e., the product of advice’s efficacy and adherence with it)

Methods

Results

Conclusion