Non-adherence to COVID-19 lockdown: who are they? A cross-sectional study in Portugal

N de Noronha; M Moniz; A Gama; P A Laires; A R Goes; A R Pedro; S Dias; P Soares; C Nunes

doi:10.1016/j.puhe.2022.07.001

Non-adherence to COVID-19 lockdown: who are they? A cross-sectional study in Portugal

Public Health. 2022 Oct:211:5-13. doi: 10.1016/j.puhe.2022.07.001. Epub 2022 Jul 11.

Authors

N de Noronha¹, M Moniz², A Gama², P A Laires², A R Goes², A R Pedro², S Dias², P Soares², C Nunes²

Affiliations

¹ NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal. Electronic address: nunodenoronha@gmail.com.
² NOVA National School of Public Health, Public Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal; Comprehensive Health Research Center, Universidade NOVA de Lisboa, Lisboa, Portugal.

Abstract

Objectives: The SARS-CoV-2 virus has spread worldwide, leading governments to implement mitigation measures. Understanding the reluctance to adhere to non-pharmacological interventions might help promote adherence to these measures. This study aimed to identify factors associated with non-adherence to the first lockdown in Portugal.

Study design: Cross-sectional study.

Methods: This study used data from a Portuguese community-based survey entitled 'COVID-19 Barometer: Social Opinion'. Data were collected on risk perception, health status and social experiences using a snowball sampling technique. The event of interest corresponded to participants who reported not staying home during the lockdown period, serving as a proxy for non-adherence to lockdown. Logistic regression was used to identify factors associated with non-adherence to the first lockdown.

Results: Responses from 133,601 individual questionnaires that were completed during the first week of the first lockdown in 2020 were analysed. A minority of participants (5.6%) reported non-adherence to lockdown (i.e. leaving home for reasons other than essential situations). Working in the workplace was the factor with the strongest association of non-adherence to the lockdown. Several other factors were also associated with non-adherence to the first lockdown; namely, being a man, being a student, having a low level of education, having a low income, living alone or with a high-infection-risk professional (e.g. doctor, nurse, pharmaceutical, health technician, firefighter, police officer, military, essential services worker), perceiving the risk of getting COVID-19 to be high, not having social support in case of infection, feeling agitated, sad or anxious every day, and considering the preventive measures to be unimportant or inadequate.

Conclusions: Non-adherence to lockdown was associated with socio-economic, trust and perception factors. Future research should investigate the mechanisms underlying these associations to help identify the population groups who are most at risk of non-adherence.

Keywords: Adherence; COVID-19; Lockdown; Non-pharmacological interventions; Prevention.

MeSH terms

COVID-19* / prevention & control
Communicable Disease Control
Cross-Sectional Studies
Humans
Male
Portugal / epidemiology
Quarantine / methods
SARS-CoV-2
Social Isolation