Determinants of self-reported adherence to COVID-19 regulations in Spain: social norms, trust and risk perception.

Failure of individuals to voluntarily observe regulations and recommendations around mitigating COVID-19 (e.g. social distancing; frequent handwashing) is often cited as a reason why some countries struggled to curtail the spread of the virus. Understanding the factors that are associated with people's willingness to comply with COVID-19 regulations and recommendations is an important step in helping policy makers and health officials reduce the impact of this (and future) pandemics. In the current study we examined this question in one of the countries hardest hit by the pandemic: Spain. A large, representative survey (N = 2100) revealed that several factors were positively associated with willingness to comply to COVID-19 regulations and recommendations. In decreasing order of predictive value, these were: (i) perceptions of whether friends and family were complying (i.e. norms), (ii) trust in science as a basis for lawmaking, (iii) perceived effectiveness of regulations and (iv) perception of risk of infection. These results point to the importance of influencing social norms as the primary way to improve adherence to the health regulations of COVID-19; more important than intrapsychic considerations such as efficacy and risk.

Responding effectively to a pandemic such as COVID-19 requires citizens to voluntarily comply with certain recommendations and regulations; for example, social distancing and frequent handwashing. The current study examined a large, representative sample of over 2000 residents of Spain to find out what factors are associated with compliance (or non-compliance) with COVID-19 regulations and recommendations. The factor most closely associated with compliance was perceptions of whether friends and family were complying (i.e. the 'social norm'). The second most important factor was trust in science as a basis for lawmaking. Two psychological factors that are normally considered important in driving health behaviours­perceived effectiveness of regulations and perception of risk of infection­had a much weaker relationship with compliance behaviours. The data suggest that social norms are a more important driver of compliance behaviour than individualistic, cost-benefit analyses such as whether the recommended strategies are perceived to be effective in reducing virus spread, and whether people feel they are personally at risk of contracting SARS-CoV-2. In sum, the results point to the importance of influencing social norms as a key way to improve adherence to health regulations associated with COVID-19.

Resolving the small-pockets problem helps clarify the role of education and political ideology in shaping vaccine scepticism.

Understanding the factors associated with vaccine scepticism is challenging because of the 'small-pockets' problem: The number of highly vaccine-sceptical people is low, and small subsamples such as these can be missed using traditional regression approaches. To overcome this problem, the current study (N = 5,200) used latent profile analysis to uncover six profiles, including two micro-communities of vaccine-sceptical people who have the potential to jeopardize vaccine-led herd immunity. The most vaccine-sceptical group (1.14%) was highly educated and expressed strong liberal tendencies. This group was also the most sceptical about genetically modified crops and nuclear energy, and most likely to receive news about science from the Internet. The second-most vaccine-sceptical group (3.4%) was young, poorly educated, and politically extreme (both left and right). In resolving the small-pockets problem, the current analyses also help reconcile competing theoretical perspectives about the role of education and political ideology in shaping anti-vaccination views.

Scientific Appearance and Homeopathy. Determinants of Trust in Complementary and Alternative Medicine.

Several studies have investigated the motivations driving the use of complementary and alternative medicines (CAM). Nevertheless, the general public view of these therapies remains relatively unexplored. Our study identifies the social factors that determine a person's trust in alternative therapies, like homeopathy or acupuncture, drawing conclusions from the results of the Spanish National Survey on the Social Perception of Science and Technology (N = 6,357). We show that trust in the effectiveness of CAM therapies is not mutually exclusive with a belief in science for the general public, pointing to a certain level of disinformation. The comparison with superstitions confirms a clear differentiation with the drivers of trust in analyzed CAM therapies. We argue that scientific appearance of these alternative therapies, in terms of prescription, communication and marketing, may play an important role in determining trust in them for a large part of the population. Furthermore, we confirm that women and those with higher socio-economic status are more likely to express trust in the effectiveness of CAM therapies. Additionally, distrust of the influence of big pharma on health policies seems to have an effect on viewing CAM therapies as more effective. Finally, we argue that media and pharmacies may have an effect on the scientific-like perception of CAM therapies, contributing to the social construction of trust in its effectiveness. Therefore, widespread confusion about the scientific validation of homeopathy may be among the main factors driving its successful extension as a practice.

Vaccine hesitancy is strongly associated with distrust of conventional medicine, and only weakly associated with trust in alternative medicine.

RATIONALE AND OBJECTIVE: It is well established that people who use complementary and alternative medicines (CAM) are, on the whole, more vaccine hesitant. One possible conclusion that can be drawn from this is that trusting CAM results in people becoming more vaccine hesitant. An alternative possibility is that vaccine hesitancy and use of CAM are both downstream consequences of a third factor: distrust in conventional treatments. We conducted analyses designed to disentangle these two possibilities. METHOD: We measured vaccine hesitancy and CAM use in a representative sample of Spanish residents (N = 5200). We also measured their trust in three CAM interventions (acupuncture, reiki, homeopathy) and two conventional medical interventions (chemotherapy and antidepressants). RESULTS: Vaccine hesitancy was strongly associated with (dis)trust in conventional medicine, and this relationship was particularly strong among CAM users. In contrast, trust in CAM was a relatively weak predictor of vaccine hesitancy, and the relationship was equally weak regardless of whether or not participants themselves had a history of using CAM. CONCLUSIONS: The implication for practitioners and policy makers is that CAM is not necessarily a major obstacle to people's willingness to vaccinate, and that the more proximal obstacle is people's mistrust of conventional treatments.