Abstract
Policies to promote social distancing can minimize COVID-19 transmission but come with substantial social and economic costs. Quantifying relative preferences among the public for such practices can inform locally relevant policy prioritization and optimize uptake. To evaluate relative utilities (ie, preferences) for COVID-19 pandemic social distancing strategies against the hypothetical risk of acquiring COVID-19 and anticipated income loss. This survey study recruited individuals living in the Missouri area from May to June 2020 via randomly distributed unincentivized social media advertisements and local recruitment platforms for members of minority racial and ethnic groups. Participants answered 6 questions that asked them to choose between 2 hypothetical counties where business closures, social distancing policy duration, COVID-19 infection risk, and income loss varied. Reweighted population-level relative preferences (utilities) for social distancing policies, subgroups, and latent classes. The survey had a 3% response rate (3045 of 90 320). Of the 2428 respondents who completed the survey, 1669 (75%) were 35 years and older, 1536 (69%) were women, and 1973 (89%) were White. After reweighting to match Missouri population demographic characteristics, the strongest preference was for the prohibition of large gatherings (mean preference, -1.43; 95% CI, -1.67 to -1.18), with relative indifference to the closure of social and lifestyle venues (mean preference, 0.05; 95% CI, -0.08 to 0.17). There were weak preferences to keep outdoor venues (mean preference, 0.50; 95% CI, 0.39 to 0.61) and schools (mean preference, 0.18; 95% CI, 0.05 to 0.30) open. Latent class analysis revealed 4 distinct preference phenotypes in the population: risk averse (48.9%), conflicted (22.5%), prosocial (14.9%), and back to normal (13.7%), with men twice as likely as women to belong to the back to normal group than the risk averse group (relative risk ratio, 2.19; 95% CI, 1.54 to 3.12). In this survey study using a discrete choice experiment, public health policies that prohibited large gatherings, as well as those that closed social and lifestyle venues, appeared to be acceptable to the public. During policy implementation, these activities should be prioritized for first-phase closures. These findings suggest that policy messages that address preference heterogeneity (eg, focusing on specific preference subgroups or targeting men) could improve adherence to social distancing measures for COVID-19 and future pandemics.
Highlights
In this survey study using a discrete choice experiment, public health policies that prohibited large gatherings, as well as those that closed social and lifestyle venues, appeared to be acceptable to the public. These activities should be prioritized for first-phase closures. These findings suggest that policy messages that address preference heterogeneity could improve adherence to social distancing measures for COVID-19 and future pandemics
Meaning The findings suggest that social distancing policies that prohibit large gatherings and close social and lifestyle venues would be well aligned with public preferences, but public health campaigns will need to develop targeted strategies to improve acceptability and adherence in specific subgroups
Nonpharmaceutical means of stemming the COVID-19 pandemic were a necessary component of the public health response throughout the United States during the last year and, in many parts of the world, may remain a consideration for the foreseeable future
Summary
Nonpharmaceutical means of stemming the COVID-19 pandemic were a necessary component of the public health response throughout the United States during the last year and, in many parts of the world, may remain a consideration for the foreseeable future Many of these practices carry formidable economic and social costs, giving rise to complicated considerations about potential benefits and harms for individuals as well as society at large. The research that does exist to date indicates general support for social distancing policies.[1,2] these studies do not capture the relative desirability (or undesirability) of different types of distancing policies, nor do they capture the public’s willingness to trade between different preferences Without such data, information for setting priorities, when no single solution will be sufficient and all come with costs and harms, is incomplete. The significant heterogeneity of social distancing policy implementation and adherence across the United States means that there is a need for locally relevant data
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call