COVID-19 prevention behaviour over time in Australia: Patterns and long-term predictors from April to July 2020

Ayre, J.; Cvejic, E.; McCaffery, K. J.; Copp, T.; Cornell, S.; Dodd, R. H.; Pickles, K.; Batcup, C.; Isautier, J. M.; Nickel, B.; Dakin, T.; Bonner, C.

Background: In Australia in March 2020 a national public health directive required that non-essential workers stay at home, except for essential activities. These restrictions began easing in May 2020 as community transmission slowed. Purpose: This study investigated changes in COVID-19 prevention behaviours from April-July 2020, and psychosocial predictors of these behaviours. Methods: 1,843 participants in Australia completed a national COVID-19 survey in April, with monthly follow-up over four months. Principal components analysis (PCA) combined self-reported adherence across seven prevention behaviours. Multivariable regression models explored baseline (April) correlates of behaviour in June (a period of low community transmission) and July (a period of increasing community transmission). Results: On average, participants agreed with statements of adherence for all behaviours (means all above 4 out of 7). PCA identified two behaviour types:'distancing' (e.g. staying 1.5m away) and 'hygiene' (e.g. washing hands), explaining 28.3% and 24.2% of variance, respectively. Distancing declined each month (p's<.001), whereas hygiene remained relatively stable. For distancing, stronger perceptions of societal risk, self-efficacy to maintain distancing, and greater perceived social obligation at baseline were associated with adherence in June and July (p's<0.05). For hygiene, the only significant correlate of adherence in June and July was belief that one's actions could prevent infection of family members (p<.001). Conclusions: High adherence to COVID-19 prevention behaviours were reported; however, distancing behaviours tended to decrease over time. Belief in social responsibility may be an important aspect to consider in encouraging distancing behaviours. Different policy approaches may be needed for different behavioural categories.