A Qualitative Study Evaluating the Factors Affecting Families' Adherence to the First COVID-19 Lockdown in England Using the COM-B Model and TDF

Lisa Woodland; Ava Hodson; Rebecca K Webster; Richard Amlôt; Louise E Smith; James Rubin

doi:10.3390/ijerph19127305

A Qualitative Study Evaluating the Factors Affecting Families' Adherence to the First COVID-19 Lockdown in England Using the COM-B Model and TDF

Int J Environ Res Public Health. 2022 Jun 14;19(12):7305. doi: 10.3390/ijerph19127305.

Authors

Lisa Woodland¹, Ava Hodson², Rebecca K Webster³, Richard Amlôt⁴, Louise E Smith¹, James Rubin¹

Affiliations

¹ Department of Psychological Medicine, King's College London, NIHR Health Protection Unit in Emergency Preparedness and Response, London SE5 9RJ, UK.
² Department of War Studies, King's College London, NIHR Health Protection Unit in Emergency Preparedness and Response, London WC2R 2LS, UK.
³ Department of Psychology, University of Sheffield, Sheffield S10 2LT, UK.
⁴ Behavioural Science and Insights Unit, UK Health Security Agency, Porton Down, NIHR Health Protection Unit in Emergency Preparedness and Response, Salisbury SP4 0JG, UK.

Abstract

The ability of families to adhere to public health guidance is critical to controlling a pandemic. We conducted qualitative interviews with 30 parents of children aged 18 and under, between 16 and 21 April 2020 when schools in England were closed due to the COVID-19 pandemic. Using the Theoretical Domains Framework, we classified the factors that influenced adherence to seven non-pharmaceutical interventions. We found 40 factors that influenced a family's ability to adhere. Parents generally indicated they could adhere and reported how their family had changed their behaviour to comply with the guidance. Parents primarily reported they were motivated to adhere out of concern for the health consequences of COVID-19, and because the guidance was delivered by the government. However, we found that reduced access to resources (e.g., technology, transport, and outside space) and social influences that encouraged non-adherent behaviour, decreased adherence. Furthermore, we suggest that families with low psychological and physical ability may face additional challenges to adherence and need to be supported. During future school closures, public health agencies should account for these factors when developing guidance.

Keywords: COM-B; COVID-19; England; adherence; children; non-pharmaceutical intervention; parents; theoretical domains framework.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

COVID-19* / epidemiology
Child
Communicable Disease Control
England / epidemiology
Humans
Pandemics
Qualitative Research

Grants and funding

This study was funded by the Economic and Social Research Council [grant number ES/P000703/1] and the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) [grant number NIHR200890] in Emergency Preparedness and Response, a partnership between UK Health Security Agency, King’s College London and the University of East Anglia. The views expressed are those of the authors and not necessarily those of the NIHR, UK Health Security Agency or the Department of Health and Social Care.