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Factors associated with high compliance behaviour against COVID-19 in the early phase of pandemic: a cross-sectional study in 12 Asian countries

Chua CE 1 , Kew GS 2 , Demutska A 3 , Quek S 4 , Loo EXL 5 , Gui H 6 Show all authors , Wong S 7 , Lau HX 8 , Low EXS 7 , Loh TL 9 , Ooi SL 10 , Hung ECW 11 , Rahman MM 12 , Ghoshal U 13 , Wong H 14 , Cheung CKY 15 , Syam AF 16 , Tan N 17 , Xiao Y 18 , Liu JS 19 , Lu F 20 , Chen CL 20 , Lee YY 21 , Maralit RM 22 , Kim YS 23 , Oshima T 24 , Miwa H 24 , Pang J 25 , Siah KTH 2

Affiliations 

  • 1 Department of Medicine, Yong Loo Lin School of Medicine, National University Hospital, Singapore
  • 2 Division of Gastroenterology & Hepatology, Department of Medicine, National University Hospital, Singapore
  • 3 Department of Clinical Psychology, James Cook University, Singapore
  • 4 Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  • 5 Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
  • 6 Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
  • 7 Department of Medicine, Ng Teng Fong General Hospital, Singapore
  • 8 Singapore Institute for Clinical Sciences (SICS), Agency for Science Technology and Research, Singapore
  • 9 Department of Otorhinolarygology, Head and Neck Surgery, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
  • 10 Department of Anaesthesiology, Columbia Asia Hospitals Pvt Ltd, Sarawak, Malaysia
  • 11 Cambridge Paediatrics, Hong Kong
  • 12 Department of Gastroenterology, Sheikh Russel National Gastroliver Institute and Hospital, Dhaka, Bangladesh
  • 13 Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute Medical Science, India, India
  • 14 Medicine and Therapeutics, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong
  • 15 State Key Laboratory of Pharmaceutical Biotechnology, University of Hong Kong, Hong Kong
  • 16 Division of Gastroenterology, Department of Internal Medicine, University of Indonesia, Depok, Jawa Barat, Indonesia
  • 17 Departments of Gastroenterology and Hepatology, the First Affiliated Hospital, Sun Yat-sen University First Affiliated Hospital, Guangzhou, Guangdong, China
  • 18 Department of Gastroenterology, Wuhan Union Hospital of Huazhong University of Science and Technology, Wuhan, China
  • 19 China Academy of Chinese Medical Sciences, Xiyuan Hospital, Beijing, China
  • 20 Department of Medicine, Buddhist Tzu Chi Hospital and University School of Medicine, Hualien, Taiwan
  • 21 Gut Research Group, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Selangor, Malaysia
  • 22 Department of Medicine, The Medical City, Pasig City, Manila, Philippines
  • 23 Wonkwang Digestive Disease Research Institute, Gut and Food Healthcare, Wonkwang University School of Medicine Hospital, Iksan, Jeollabuk-do, Korea (the Republic of)
  • 24 Division of Gastroenterology and Hepatology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan
  • 25 Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore ephpjv@nus.edu.sg
BMJ Open, 2021 08 09;11(8):e046310.
PMID: 34373296 DOI: 10.1136/bmjopen-2020-046310

Abstract

INTRODUCTION: Regardless of having effective vaccines against COVID-19, containment measures such as enhanced physical distancing and good practice of personal hygiene remain the mainstay of controlling the COVID-19 pandemic. Countries across Asia have imposed these containment measures to varying extents. However, residents in different countries would have a differing degree of compliance to these containment measures potentially due to differences in the level of awareness and motivation in the early phase of pandemic.

OBJECTIVES: In our study, we aimed to describe and correlate the level of knowledge and attitude with the level of compliance with personal hygiene and physical distancing practices among Asian countries in the early phase of pandemic.

METHODS: A multinational cross-sectional study was carried out using electronic surveys between May and June 2020 across 14 geographical areas. Subjects aged 21 years and above were invited to participate through social media, word of mouth and electronic mail.

RESULTS: Among the 2574 responses obtained, 762 (29.6%) participants were from East Asia and 1812 (70.4%) were from Southeast Asia (SEA). A greater proportion of participants from SEA will practise physical distancing as long as it takes (72.8% vs 60.6%). Having safe distancing practices such as standing more than 1 or 2 m apart (AdjOR 5.09 95% CI (1.08 to 24.01)) or more than 3 or 4 m apart (AdjOR 7.05 95% CI (1.32 to 37.67)), wearing a mask when they had influenza-like symptoms before the COVID-19 pandemic, preferring online news channels such as online news websites/applications (AdjOR 1.73 95% CI (1.21 to 2.49)) and social media (AdjOR 1.68 95% CI (1.13 to 2.50) as sources of obtaining information about COVID-19 and high psychological well-being (AdjOR 1.39 95% CI (1.04 to 1.87)) were independent factors associated with high compliance.

CONCLUSIONS: We found factors associated with high compliance behaviour against COVID-19 in the early phase of pandemic and it will be useful to consider them in risk assessment, communication and pandemic preparedness.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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