Intentional and unintentional non-adherence to social distancing measures during COVID-19: A mixed-methods analysis.

Eraso, Y.; Hills, S.

Social distancing measures implemented by governments worldwide during the COVID-19 pandemic have proven an effective intervention to control the transmission of SARS-CoV-2. There is a growing literature on predictors of adherence behaviours to social distancing measures, however, there are no comprehensive insights into the nature and types of non-adherence behaviours. To address this gap in the literature, we studied non-adherence in terms of counts of infringements and people's accounts on their behaviours in a representative sample of North London residents. We focused on the following social distancing rules: keeping 2 mts. distancing, meeting family and friends, and going out for non-essential reasons. A mixed-methods explanatory sequential design was used comprising an online survey (1st - 31st May 2020) followed by semi-structured in-depth interviews held with a purposive sample of survey respondents (5th August - 21st September 2020). A negative binomial regression model (quantitative) and Framework Analysis (qualitative) were undertaken. 681 individuals completed the survey, and 30 individuals were interviewed. We integrated survey and interview findings following three levels of the Social Ecological model: individual, interpersonal and community levels. We identified non-adherence behaviours as unintentional (barriers beyond individual's control) and intentional (deliberate decision). Unintentional adherence was associated with and reported as emotional inability to stay at home, lack of controllability in keeping 2 mts. distancing, social responsibility towards the community and feeling low risk. Intentional non-adherence included individual risk assessment and decision-making on the extent to following the rules, support from friends, and perceived lack of adherence in the local area. Our findings indicate that unintentional and intentional non-adherence should be improved by Government partnerships with local communities to build trust in social distancing measures; tailored messaging to young adults emphasising the need of protecting others whilst clarifying the risk of transmission; and ensuring COVID-secured environments by working with environmental health officers.