Psychological Medicine: 应对COVID-19需要好的政府举措以及民众信任政府

2021-05-20 MedSci原创 MedSci原创

对政府在COVID-19防控方面的信任度越高,采取推荐的健康和亲社会行为的意愿越高,而且随着时间的推移,采取健康行为的意愿下降越慢。

为应对新冠肺炎大流行带来的日益严重的公共卫生危机,世界各国政府需要在预防和控制疾病的同时减轻其经济影响方面发挥关键作用。许多国家已经采取了相应的措施和条例来预防疾病的传播:保持社会距离、洗手、自我隔离和稳定经济。然而,这些措施的有效实施有赖于公众的高度遵守和支持。新的理论和经验证据表明,对政府的信任对公众遵守社会政策至关重要,而社会政策依赖于公众的行为反应。因此,理解对政府的信任与采取预防行为之间的关联,探索疫情期间信任政府的各种决定因素,对COVID-19的防控具有重要意义。

基于理论背景和经验证据,Qing Han等开展了一项大型国际调查,重点关注在前所未有的COVID-19大流行期间对政府的信任和公众纵向行为反应。研究的目的有三方面:(1)研究对政府对COVID-19的信任与采取对大流行控制至关重要的健康和亲社会行为之间的横断面关联;(2)探讨新冠肺炎相关政府信任的潜在决定因素,包括政府监管、对新冠肺炎的明确信息或知识、经济状况和大流行期间感知的公平;(3)基线调查时,调查公众对政府对COVID-19的信任程度与随访期间健康和亲社会行为变化之间的关系。该文发表在Psychological Medicine杂志。

该研究旨在调查对政府在COVID-19防控方面的信任与采用推荐的健康行为和亲社会行为之间的横断面和纵向联系,以及大流行期间对政府的信任的潜在决定因素。

该研究分析了来自PsyCorona调查的数据,这是一个关于COVID-19的国际项目,包括来自23个国家的23 733名参与者(按国家的年龄和性别分布具有代表性)的基线调查和7785名参与的后续调查。该研究采用规范曲线分析来检验政府信任与自我报告行为之间的并发关联。进一步利用结构方程模型探讨了政府信任的潜在决定因素。采用多水平线性回归分析基线信任度和纵向行为改变之间的关系。

SEM 分析结果。只绘制回归系数显著的路径(p<0.05)。标准化β系数显示在相应路径的右下侧。信任01-03指政府的三项信任;HB 01-03是指健康行为的三项;PB01 -04指亲社会行为的四个项目。

国家一级健康行为项目(a)和亲社会行为项目(b)的平均值与政府项目的平均信任值的散点图。五大洲23个国家的数据在每个图中用圆圈表示。每种颜色都对应着一个特定的大陆。三项关于政府信任的问题被分为7个等级,从3(非常不同意)到3(非常同意);关于健康行为的3个项目和关于亲社会行为的4个项目的比例大致相同,都是从3到3。

政府信任与亲社会行为的规范曲线分析结果。从所有90种规格(列在x轴上)中获得的政府信任与亲社会行为的标准化β系数绘制在图表的上半部分。每个点表示一种规格的标准化β系数,误差条(灰色)表示相应的标准误差。虚线表示中位数标准化β系数(中位数标准化β = 0.229,中位数标准误差= 0.006,中位数样本量= 23 693)。在图的下半部分,三个模型规格因子的每一级对应的规格以方形显示;由于数字大小的原因,这四个亲社会行为的项目被省略了。

健康和亲社会行为的纵向变化以及对政府的基线信任的影响。随访调查和基线调查在三个健康行为项目(a)的平均得分和两个亲社会行为项目(b)的平均得分上的平均差异与基线调查以来的时间成图。负值表示在后续调查中行为采纳率下降。关于行为的项目以7分的形式进行,从3(非常不同意)到3(非常同意)。图的下半部分显示了从多水平线性回归得到的跨时间健康行为(c)平均得分和亲社会行为(d)平均得分的预测值(边际平均值)。(c)和(d)中的实线代表对政府信任基准平均得分25%百分位的预测值(3至3的量表为0.5);虚线表示对政府信任的基线平均得分的75%百分位预测值(3至3量表为1.5)。

规范曲线分析显示,对政府COVID-19防控的信任程度与对卫生行为(洗手、避免拥挤空间、自我隔离)和亲社会行为(标准化β = 0.173和0.229,p<0.001) 较高的接受程度相关。认为政府组织良好、传播有关COVID-19的明确信息和知识,以及被认为公平,与人们对政府的信任呈正相关(标准化β = 0.358、0.230、0.056和0.249,p<0.01)。基线调查中较高的信任度与随着时间的推移健康行为下降率较低显著相关(相互作用p = 0.001)。

 

这一首个针对新冠肺炎相关政府信任的大规模跨国研究发现信任与个人预防行为之间存在较强相关关系。对政府在COVID-19防控方面的信任程度越高,遵守频繁洗手、避免拥挤场所和社会隔离/隔离措施的程度就越高。这一结果与以往的研究结果一致,即公众信任与坚持公共卫生干预措施有关。埃博拉疫情期间在利比里亚和刚果进行的两项具有代表性的调查也表明,对政府的信任与遵守疾病控制措施或采取个人预防行为(如保持社交距离和接受埃博拉疫苗)呈正相关。

总之,该研究表明,对政府在COVID-19防控方面的信任度越高,采取推荐的健康和亲社会行为的意愿越高,而且随着时间的推移,采取健康行为的意愿下降越慢。此外,更好地组织政府应对大流行、更明确的信息和对COVID-19的认知,以及更高的公平感,与对政府更高的信任度有关。旨在提高公众在抗击新冠肺炎和应对二次后果方面的信任度的相关公共政策对疫情防控具有巨大的推动作用。这些结果凸显了信任政府在疫情防控中的重要性

原文出处

Han, Q., Zheng, B., Cristea, M., Agostini, M., Bélanger, J., Gützkow, B., . . . Leander, N. (2021). Trust in government regarding COVID-19 and its associations with preventive health behaviour and prosocial behaviour during the pandemic: A cross-sectional and longitudinal study. Psychological Medicine, 1-11. doi:10.1017/S0033291721001306

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