ABSTRACT
Introduction - The growing number of cases and deaths due to Covid-19 has prompted the lockdown of the French population from 17th March 2020. This epidemic crisis and containment conditions are likely to impact the mental health of the population. Sant.. publique France has thus set up a behavioural and psychological surveillance with one of the objectives being to assess the state of the mental health of the population, identify its determinants and monitor its evolution. Methods - Samples of the general population are issued from an access panel of the BVA polling institute. For each wave, an independent sample of 2,000 people aged 18 and over residing in metropolitan France are interviewed via Internet. The data presented here are from the first two waves that took place from March 23 to 25 and March 30 to April 1, 2020. Results - In wave 1, the prevalence of anxiety was 26.7%, i.e. twice the rate observed in the general population (13.5% in 2017). In wave 2, the prevalence of anxiety had significantly decreased to 21.5%. Higher risks for anxiety are associated with 1/Socio-demographic characteristics: being a woman, being a parent of children aged 16 years or younger, declaring a difficult financial situation;2/Living conditions related to the epidemic situation: working from home and having a friend or relative who has been ill or has had symptoms of Covid-19;3/Knowledge, attitudes and practices about Covid-19: seeing Covid-19 as a serious disease and feeling vulnerable to the disease. Conversely, having a good understanding of the disease transmission route, respecting containment measures, feeling able to adopt protective measures and having confidence in the government action reduce the risk of having anxiety. Moreover, the decrease in anxiety between the two waves has not been observed in people who report a difficult financial situation, in the least advantaged socio-professional categories, or in people living in promiscuity, thus reflecting the widening gap of health inequalities during the lockdown. Conclusions - These first results helped strengthen and adjust the response for mental health promotion and prevent the development of psychological disorders. They also highlight the need to protect and support the most vulnerable households. Finally, they suggest a protective effect of the lockdown on anxiety and question a possible upward trend of anxiety level after the lockdown.
ABSTRACT
Introduction - In the context of the Covid-19 outbreak, as soon as the government announced a general lockdown on 17 March, the French national public health agency set up a surveillance system to monitor the adoption of preventive behaviors by the population. The objective was to estimate the level of systematic adoption of the prevention measures recommended by the public authorities according to the characteristics of the population (socio-demographic, living conditions related to the Covid-19 epidemic and lockdown), identify the associated cognitive and affective factors (perceptions and knowledge) and monitor their trends during the lockdown period. Methods - Independent samples of 2,000 people aged 18 and over living in metropolitan France were interviewed via the Internet. The data presented are from five waves of surveys. A total of 10,013 participants were interviewed between 30 March and 6 May 2020. The main variable of interest was the number of measures systematically adopted out of the 7 recommended by the public authorities. The explanatory variables were grouped into three distinct blocks of variables: 1/sociodemographic variables;2/living conditions related to the Covid-19 outbreak and lockdown variables;3/cognitive and affective variables. In order to quantify the strength of the association between the number of measures systematically adopted and the explanatory variables, multiple linear regressions, adjusted for sex, age, SPC, and waves of survey were performed. Results - Our results showed that the French adopted, during the lockdown period, a high number of preventive measures, whatever the population profiles, with on average over the 5 waves of survey, more than 5 measures systematically adopted out of the 7 recommended by the public authorities. Some differences according to the population profiles were observed. Men, younger people, SPC- and inactive people, people with lower health literacy, people who reported continuing to work outside their home, people who did not have a relative with Covid-19 symptoms took fewer preventive measures. During the lockdown period, the number of systematically adopted measures decreased. The systematic adoption of these measures was mainly explained by cognitive and affective determinants. The three main ones were the subjective norms (approval and adoption of measures by relatives), the perceived ability to adopt the preventive measures and, to a lesser extent, the perceived severity of the disease. Conclusions - In order to promote the adoption of preventive behaviors in the population, our data suggest that priority should be given to strengthening the social norms of adoption of these behaviors and the capacities of individuals to implement them. To this end, it will be important to communicate clearly and simply on the modes of transmission of the virus, on preventive measures to be adopted, and to create opportunities in the physical and social environment to facilitate their implementation (access to protective equipment, organization of physical distancing). According to a social marketing approach, the communication strategy would benefit from valuing a social norm for adopting prevention measures for oneself and for others, targeting in particular young adults and men.