COVID-19: Why aren't health guidelines always followed?
Protecting oneself to avoid getting sick and putting one’s life at risk should be second nature to everyone. However, according to the survey we conducted between March 17 and April 15 among 5,800 French people, on the day of the municipal elections (i.e., March 15), only 23% of those surveyed were following all the health guidelines set by the government in response to the COVID-19 pandemic. Later, during the lockdown, the proportion of those who followed them systematically did not exceed 37%—and only 17 out of the 5,800 said they had not followed the guidelines at all during that period.
Patrice Cottet, University of Reims Champagne-Ardenne (URCA); Jean-Marc Ferrandi, University of Nantes; Marie-Christine Lichtlé, University of Montpellier and Véronique Plichon, University of Tours
Specifically, several measures are not widely followed: the use of disposable tissues (only 77.1% say they do so), handwashing (59.6%), and sneezing into the crook of the elbow (76.1%). Conversely, even though a significant number of people do not follow them, other measures are better observed: the requirement to carry an exemption certificate whenever leaving home (93.6% do so), limiting travel (81.3%), maintaining social distancing (84.8%), refraining from kissing anyone (86.5%), and not shaking hands (96.9%). While the government has been stepping up its messaging on health guidelines, how can we explain that some of us are not following these instructions to the letter?
A matter of psychological distance
Numerous factors (sociodemographic, cultural, environmental, etc.) have been identified as explaining why health guidelines are—or are not—followed. But it is also possible that this reflects the priority people place on the present rather than the future, particularly when it comes to health: the more abstract and psychologically distant the disease and its consequences seem from your daily life and personal experience, the fewer precautions you take to avoid a future risk.
This trend can be explained by the theory of construct levels developed by Yaacov Trope and Nira Liberman. It provides a better understanding of how individuals think, conceptualize their actions, and make decisions: they are said to form “mental constructs” that vary according to the perceived psychological distance (spatial, temporal, social, hypothetical) from objects.
In short, according to this theory, the more distant the disease seems from your own life, the more abstract it becomes, and the less you feel the need to take action. Our survey confirms this for COVID-19: if none of your loved ones have been affected, if there are no sick people near you, and if the likelihood of contracting the disease seems low to you, then you will be less inclined to follow health guidelines.
Three types of behavior
In practice, before and during the lockdown, this psychological distance manifested itself in our survey as three types of behavior—that is, three groups of people whom we will compare.
The first group (37.18% of respondents)—comprising men and women who were slightly younger than the average age of those surveyed and had a relatively high level of education—felt more concerned once the lockdown was announced. For these individuals, the disease then became more tangible: the psychological distance from it decreased. Whereas before—and particularly on March 15—they felt they had nothing to fear, were not afraid, and perceived COVID-19 as a disease that could not affect them. As a result, hygiene and social distancing rules were followed less strictly than in the other two groups, and these individuals did not hesitate to leave their homes to find a more suitable place to self-isolate.
With the lockdown, the situation has changed. After experiencing symptoms, some people feared they might be carriers of the virus or have COVID-19. In their minds, the disease has become more tangible, but also more serious. The psychological distance has therefore decreased significantly, and in this first group, the perceived risk to oneself and others is above average compared to the rest of our sample population. These individuals therefore stay more informed, avoid contact within their households, while also experiencing higher levels of stress and anxiety.
In the second group (42.19% of respondents), which had the lowest level of education, psychological distance from COVID-19 did not change during the lockdown. These individuals have felt fairly detached from the disease since the start of the crisis. While they generally followed health guidelines starting on March 15, they experienced less stress. Furthermore, they have not experienced any symptoms of the disease. During lockdown, they did not hesitate to engage in outdoor physical activity or have face-to-face contact, as they considered the likelihood of being a carrier of the virus or having the disease to be lower than others.
In the third group (20.63% of respondents), consisting mainly of women younger than the sample average, psychological distance from COVID-19 increased during the lockdown. Viewing themselves as at-risk individuals, these people were initially the most anxious and stressed. They feared the disease, which they perceived as very real and imminent. They therefore welcomed the health guidelines very favorably and followed them strictly. However, while the perceived risk to themselves and others remains very high in this group (compared to the other two), no symptoms of the disease were experienced during lockdown—which is why COVID-19 is now perceived as a distant threat.
However, these individuals continue to disinfect their homes and minimize contact as much as possible, both inside and outside the home. But because they follow the guidelines and practice these preventive measures, they estimate the likelihood of having the disease and of being carriers of the virus to be lower than average.
Ultimately, this study sheds light on how people are responding to COVID-19. However, its findings can be applied to other diseases as well. It offers insights into communication strategies, whether for implementing public health prevention policies or for risk management.
Simply informing the public, using rational arguments, about the preventive measures they should take is not enough on its own: we must also help everyone feel that the danger is imminent. To encourage people to take action—and thus follow the guidelines—the disease must become tangible and/or be perceived as present in their immediate surroundings.
This article was written in response to a call for rapid submissions from the Revue française de gestion in the context of the health crisis caused by the virus responsible for COVID-19.
Patrice Cottet, Associate Professor of Management Sciences, University of Reims Champagne-Ardenne (URCA); Jean-Marc Ferrandi, Professor of Marketing and Innovation at Oniris, University of Nantes; Marie-Christine Lichtlé, University Professor, University of Montpellier and Véronique Plichon, University Professor of Management Sciences, University of Tours
This article is republished from The Conversation under a Creative Commons license. Readthe original article.