Citizens' adherence to COVID-19 mitigation recommendations by the government: A three-country comparative evaluation using online cross-sectional survey data.

BACKGROUND: Social distancing is an effective preventative policy for COVID-19 that is enforced by governments worldwide. However, significant variations are observed in following the policy across individuals and countries. Arguably, differences in citizens' adherence actions will be influenced by their perceptions about government's plans and the information available to guide their behaviors-more so in the digital age in the realm of mass influence of social media on citizens. Insights into the underlying factors and dynamics involved with citizens' adherence process will inform the policymakers to follow appropriate communication and messaging approaches to influence citizens' willingness to adhere to the recommendations.

OBJECTIVE: The study's objective is a comparative evaluation of citizens' adherence process to COVID-19 relevant recommendations by the government. The focus is on how three different countries' (United States, Kuwait, and South Korea) citizens, randomly sampled, respond to governments' pandemic guidance efforts. We draw insights into two categories of perceived government roles in managing the pandemic: (1) citizens' perceptions of government's role in responding to the pandemic (2) citizens' perceptions of government's business reopening efforts. Undoubtedly, the internet and social media have burgeoned, yet differing effects on shaping individuals' views and assessments of the COVID-19 situation, we argue and test for the effects of information sources, social media use, and knowledge on the adherence actions.

METHODS: Randomly sampled online survey data collected by a global firm in May 2020, from citizens of the United States, Kuwait, and South Korea. A nonlinear ordered probit regression, controlling for several counterfactuals, was used for analysis. The focal estimated effects of the study were compared across countries using the weighted distance between the parameter estimates.

RESULTS: The total sample size is 482 respondents, of which 207 (43%) lived in US, 181 (38%) lived in Kuwait, and 94 (20%) lived in South Korea. Ordered probit estimation results suggest that overall, perception of government response efforts positively influences self-adherence (P<.001) and others'-adherence (P<.001) to social distancing and sheltering. Perception of government business reopening efforts positively influences others'-adherence (P<.001). Higher intensity of general health information source for COVID-19 has a positive effect on self-adherence (P=.003). Higher intensity of social media source use for COVID-19 positively influences others'-adherence (P=.002). Higher intensity of knowledge on COVID-19 positively influences self-adherence (P=.008) and negatively influences others'-adherence (P<.001). There are country-level variations - broadly, the United States and Kuwait has better effects than South Korea.

CONCLUSIONS: As the COVID-19 global pandemic continues to grow, and governmental restrictions are ongoing, it is critical to understand people's frustration to reduce panic and promote social distancing to facilitate the control of the pandemic. The study finds that the government plays a central role in terms of adherence to restrictions. Governments need to enhance their efforts on publicizing information on the pandemic, as well as employ strategies for improved communication management to citizens through social media as well as mainstream information sources.