Social Distancing Compliance under COVID-19 Pandemic and Mental Health Impacts: A Population-Based Study

• Published in: International journal of environmental research and public health Vol. 17; no. 18; p. 6692
• Main Authors: Zhao, Sheng Zhi, Wong, Janet Yuen Ha, Wu, Yongda, Choi, Edmond Pui Hang, Wang, Man Ping, Lam, Tai Hing
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 14.09.2020; MDPI
• Subjects: Adolescent; Adult; Anxiety; Anxiety disorders; Betacoronavirus; Cellular telephones; Compliance; Confidence intervals; Contact tracing; Coronavirus Infections - prevention & control; Coronavirus Infections - psychology; Coronaviruses; COVID-19; Disease control; Disease transmission; Female; Hong Kong; Humans; Interviews; Male; Masks; Mental depression; Mental Health; Middle Aged; Pandemics; Pandemics - prevention & control; Patient Compliance - statistics & numerical data; Pneumonia, Viral - prevention & control; Pneumonia, Viral - psychology; Population studies; Population-based studies; Psychology; Public health; Quarantine; Questionnaires; Regression analysis; Response rates; SARS-CoV-2; Signs and symptoms; Social distancing; Social interactions; Social Isolation - psychology; Statistical analysis; Stress; Surveys; Viral diseases; Young Adult; Hong Kong; Hong Kong China; China; COVID-19; public health intervention; stay-at-home; compliance; mental health; social distancing
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph17186692

The success of public health measures for controlling the coronavirus disease 2019 (COVID-19) pandemic relies on population compliance. We analyzed compliance with social distancing and its associations with mental health. The Hong Kong COVID-19 Health Information Survey was conducted from 9-23 April 2020 on 1501 adults randomly sampled for landline telephone interviews ( = 500) and online surveys ( = 1001). Compliance with social distancing and staying-at-home, stress (Perceived Stress Scale-4), anxiety (General Anxiety Disorders-2), and depressive symptoms (Patient Health Questionnaire-2) were collected. The associations between mental health symptoms and compliance were examined by multivariable regression models. Of the 1501 respondents (52.5% female, 72.3% aged 18-59 years), 74.2%, 72.7%, and 59.7% reported avoiding going out, going to crowded places, and attending social gatherings of more than four people, respectively. Most respondents had stayed-at-home for at least four of the past seven days (58.4%; mean 4.12, Standard Deviation 2.05). Adoption, perceived effectiveness, and perceived compliance with social distancing were associated with lower stress levels and less anxiety and depressive symptoms (all < 0.01). However, more days stayed-at-home were associated with more depressive symptoms (adjusted Odds Ratio 1.09; 95%Confidence Interval 1.00, 1.18). The long-term psychological impact in relation to social distancing and staying-at-home requires further investigation.