Perceptions and factors associated with COVID Appropriate Behavior (CAB) obedience among general public in India: A mixed methods research

J Educ Health Promot. 2023 Oct 31:12:355. doi: 10.4103/jehp.jehp_1838_22. eCollection 2023.

Abstract

Background: The purpose of the study was to analyze the public perception toward COVID Appropriate Behavior (CAB) obedience and to identify the factors associated with declining CAB.

Materials and methods: It is a mixed methods study conducted from November 2021 to September 2022 in Pune city, India. A set of 15-CAB guidelines published by the Ministry of Health and Family Welfare, Government of India (GoI), were used as a base document to design the instruments of qualitative and quantitative study. Using a one-sample Kolmogorov-Smirnov test, CAB scores were tested for normality and distribution. Comparisons of various parameters were done using z test for proportion and paired t-test (statistical significance level was 0.05). Thematic content analysis was conducted for qualitative data analysis and verbatims are reported where applicable.

Results: The main motivation for people to get vaccinated was family and personal safety and a higher proportion of people felt safer post-vaccination which was linked to a reduced likelihood of CAB obedience. Qualitative results showed that people's lack of empathy and concern for others leads to undesirable personal behaviors such as spitting in public places, not wearing masks, etc., The need for socialization is high but discomfort with the use of masks/face shields and habituation with the disease were prominent causes of CAB disobedience.

Conclusion: We conclude that reduced fear and gradual habituation have led to reduced CAB obedience. There is a need to reinforce empathy and concern for others to improve adherence to CAB like maintaining social distancing and wearing masks in public places for personal and social safety from the disease.

Keywords: CAB; CAB obedience; COVID Appropriate Behavior; perception; qualitative; safety.