Understanding patterns of adherence to COVID-19 mitigation measures: A qualitative interview study

Sarah Denford*, Kate Morton, Helen S Lambert, Juan Zhang, Louise E Smith, G. James Rubin, Shenghan Cai, Charlotte Robin, Gemma Lasseter, Tingting Zhang, Matt Hickman, Isabel I Oliver, Lucy Yardley

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

43 Citations (Scopus)
205 Downloads (Pure)


Evidence highlights the disproportionate impact of measures that have been introduced to reduce the spread of coronavirus on individuals from Black, Asian and minority ethnic (BAME) communities, and among those on a low income. An understanding of barriers to adherence in these populations is needed. In this qualitative study we examined patterns of adherence to mitigation measures and reasons underpinning these behaviors.

Semi-structured interviews were conducted with 20 participants from BAME and low-income White backgrounds. The topic guide was designed to explore how individuals are adhering to social distancing and self-isolation during the pandemic, and to explore the reasons underpinning this behavior.

We identified three categories of adherence to lockdown measures 1) caution motivated super-adherence 2) risk-adapted partial-adherence and 3) necessity-driven partial-adherence. Decisions about adherence considered potential for exposure to the virus, ability to reduce risk through use of protective measures, and perceived importance of/need for the behavior.

This research highlights a need for a more nuanced understanding of adherence to lockdown measures. Provision of practical and financial support could reduce the number of people who have to engage in necessity-driven partial-adherence. More evidence is required on population level risks of people adopting risk-adapted partial-adherence.
Original languageEnglish
Article number fdab005
Pages (from-to)508-516
Number of pages9
JournalJournal of Public Health (United Kingdom)
Issue number3
Early online date9 Feb 2021
Publication statusPublished - 22 Sept 2021

Bibliographical note

Publisher Copyright:
© 2021 The Author(s) 2021. Published by Oxford University Press on behalf of Faculty of Public Health.

Structured keywords

  • Covid19


  • adherence
  • COVID-19
  • infection control
  • public involvment
  • qualitative
  • risk assessment


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