The Relation between Perceived and Actual Understanding and Adherence: Results from a National Survey on COVID-19 Measures in Belgium.

Kirsten Vanderplanken,Joris Adriaan Frank van Loenhout,Stephan Van den Broucke,Isabelle Aujoulat

doi:10.3390/ijerph181910200

Kirsten Vanderplanken, Joris Adriaan Frank van Loenhout + Show 2 more

Open Access

https://doi.org/10.3390/ijerph181910200

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Abstract

To reduce the spread of COVID-19 among the population, Belgium has implemented various infection prevention and control measures over time. This study investigated the extent to which understanding of the COVID-19 measures contributed to adherence, and which personal characteristics were considered risk factors for lower adherence. It consisted of a large online survey among a sample of the population (n = 2008), representative of citizens of Belgium in terms of gender, age, province and socio-economic status. The survey was conducted in September 2020, and included questions on perceived and actual understanding of COVID-19 protective measures in place during that time, as well as past and future adherence to those measures. The results showed that both perceived and actual understanding contributed significantly to past as well as future adherence. Risk factors for perceived understanding included being male and belonging to a younger age group, while risk factors for actual understanding were speaking French (versus Dutch) and belonging to a lower socio-economic level. Communication about COVID-19 measures should put more focus on trying to improve the understanding of the measures, instead of only making them known, particularly for those who are less health literate and as such at risk of poor understanding.

Highlights

Since the first case of COVID-19 was detected in December 2019, human-to-human transmission of the virus has become a global concern
Our study identified several characteristics that are associated with lower levels of perceived and actual understanding of the protective measures against COVID-19
Since a poor understanding of information can be considered as an element of poor health literacy, the fact that, in our study, men reported lower perceived understanding of the measures against COVID-19 than women is in line with the often-reported finding that men show lower health literacy levels [12]

Summary

Introduction

Since the first case of COVID-19 was detected in December 2019, human-to-human transmission of the virus has become a global concern. Countries were advised to take measures to limit transmission. Given that no vaccines were available until the end of 2020, countries had to implement non-medical infection prevention and control measures to limit the number of new infections and ease the burden on healthcare systems. These measures enforced or advised behavioural changes at the individual level, such as frequent hand washing, wearing face masks, restricting or avoiding social contact, avoiding international travel, etc. The number and type of measures implemented varied over time and between countries, and frequent adaptations were made based on the severity of the outbreak a country was experiencing at a given moment [6].

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