Factors Associated With Adherence to COVID-19 Preventive Measures Among Saudi Arabians

Background A recent outbreak of COVID-19 which was initially reported in Wuhan City, China, has become a worldwide pandemic. This global public health threat drew the attention of the medical and scientific community to make the necessary research efforts to combat the spread of the virus. Predictors of preventive behaviors could be of considerable importance relevant to identifying high-risk groups to manage their behavior. We aimed to investigate the association between people's perception of COVID-19 adherence to preventive measures, susceptibility, seriousness, benefits, motivators, barriers, confidence, and information sources. Methods We conducted a cross-sectional study during the early phase of the COVID-19 pandemic, enrolling 1,568 participants from WhatsApp groups, aged 16 years and above from March to April 2020 in Saudi Arabia. We prepared an online Arabic self-administered questionnaire, which consisted of (1) sociodemographic characteristics; (2) compliance to preventive measures, including the perception of susceptibility, seriousness, benefits, motivation, barriers to preventive measures, self-confidence; and (3) sources of COVID-19 information. Results Of the 1,568 participants, 60% (n = 1,004) were women, 54.1% (n = 459) were unmarried, and 80.2% (n = 1,258) had earned university degrees. Regarding compliance and perception toward preventive measures, 64% of participants washed hands with soap and water; 50% followed the cough etiquette; 17.5% avoided touching their eyes, nose, and mouth; and 34.6% never shook hands with others. Approximately 52.2%-69.7% avoided going to crowded places and wore facial masks as needed. In addition, 24.3% of people observed social distancing. However, 52.4% did not receive the annual flu vaccine. Approximately 83% used banknotes, 69.8% made online payments, and 51.8% avoided ATM/credit card use. The perception of susceptibility and the seriousness of COVID-19 infection accounted for 8.5% and 50% of participants, respectively. Perceived benefits and motivation reached more than 90%. Barriers for not being able to practice preventive measures were the fear of nasal swabs, forgetfulness, and negligence, which rated 39% and 66%, respectively. Confidence in practicing the preventive measures and distinguishing the symptoms of COVID-19 accounted for 80% and 60% of the participants, respectively. The most used sources to retrieve information were the Ministry of Health (MOH) news and reports and social media, representing 53.5% and 24.6%, respectively. Conclusions During the early phase of the pandemic, people's perception of susceptibility was low, which resulted in a lack of awareness of some citizens to take the COVID-19 infection seriously. Thus, the benefits of preventive measures did not fully translate into practice. The current successful decline of COVID-19 cases should be accompanied by continuing health promotion and disease prevention programs utilizing all avenues and opportunities to remind people of scientific, religious, and cultural practices of handwashing, coughing etiquette. The persistent use of personal protective equipment (PPE), such as facial masks, gloves, and, for frontline workers, shields and protective garments is necessary. Family physicians and teams should play a vital role in this battle.