AUTHOR=Ye Ruixue , Wu Yuju , Sun Chang , Wang Qingzhi , Mao Yuping , Chang Wei , Zhou Huan 

TITLE=What Prompted the Adoption of Self-Protective Behaviors in Response to COVID-19? Evidence From Women Living in the Rural Areas of Western China

JOURNAL=Frontiers in Public Health

VOLUME=Volume 9 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2021.756933

DOI=10.3389/fpubh.2021.756933

ISSN=2296-2565

ABSTRACT=Background: Self-protective behaviors, such as handwashing and mask-wearing, are effective to reduce the spread of COVID-19, but few studies have focused on women living in rural areas who bear the brunt of the impacts of the pandemic due to their economic and social vulnerabilities. This study aims to explore what prompted the adoption of self-protective behaviors in response to COVID-19 among women living in rural areas of western China. 

Methods: The study sample consists of 1524 women from 116 townships across ten counties in rural western China. We collected data in May and August 2020 on women’s socioeconomic characteristics, exposure to COVID-19-related information, psychological response to COVID-19, and adoption of self-protective behaviors. Structural equation modeling analyses were conducted to analyze the relations among the variables.

Results: During the lockdown, 1221 (80.12%) of the 1524 women in the study sample reported wearing a mask every time when they went outside and 1021 (66.99%) reported handwashing with soap every time after they came home. Perceived efficacy had the strongest association with self-protective behaviors (β = 0.38; P < 0.001). Receiving public health guidance (β = 0.18; P < 0.001) was indirectly associated with more self-protective behaviors via greater perceived efficacy. Higher socioeconomic status was also directly associated with increased adoption of self-protective behaviors (β = 0.24; P < 0.001). Other variables, including receiving surveillance and risk information, communication channels, perceived risks, and fear, were indirectly associated with adoption of self-protective behaviors with smaller effect sizes (all β were lower than 0.10).  

Conclusions: Not all women were able to adopt self-protective behaviors such as mask-wearing and handwashing during the COVID-19 pandemic in western China. To further encourage behavioral changes in response to public health crises, government should develop clear and actionable guidelines and adopt targeted health communication strategies to reach the most disadvantaged groups of the society. These findings may inform tailored responses to COVID-19 in other low- and middle-income countries.