Perceived Social support and compliance with stay-at-home orders during the COVID-19 outbreak: Evidence from Iran

Abstract

Background: Strong evidence demonstrates that social support plays a key role in facilitating preventive health behaviors. The major aim of the current study was to assess the effects of perceived social support on compliance with stay-at-home advice in response to a COVID-19 outbreak during the Persian New Year (Nowruz) holydays, since Nowruz holidays of 2020 coincided with the peak of the coronavirus epidemic in Iran. Methods: This cross-sectional survey was carried out based on phone interviews of 1073 adults aged over 18 years from 4 to 12 April 2020 in Mashhad, Khorasan-Razavi Province, as the second largest city of Iran. A systematic random sampling was carried out using fixed phone number lists provided by Telecommunication Company of Khorasan-Razavi Province. Phone interviews were carried out by four trained interviewers from the Iranian Students Polling Agency (ISPA) at various times of the day. The survey included sociodemographic questions, perceived social support scale (MSPSS) and questions about self-isolation. Statistical analysis included Chi-square test, Kruskal-Wallis and multivariate logistic regression. Results: 20.5% of participants reported poor compliance with self-isolation during the first two weeks of Nowruz. Clear social gradients were not found in people’s compliance with self-isolation. When controlling sociodemographic factors, perceived social support, interestingly, both fostered and hindered personal compliance with self-isolation, depending on the source of support from family members (OR = .875, 95% CI = .800, .957, p < .005), friends (OR = 1.147, 95% CI = 1.073, 1.223, p < .001) and a significant other person (OR = .916, 95% CI = .833, 1.007, p = .069). Conclusions: Public health messaging may need to emphasize the role that friends and families can play in helping to protect those in their friendship/family groups by promoting compliance with social distancing. Further in-depth studies are recommended to evaluate how this kind of messaging can most effectively encourage people to engage in social distancing practices.