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Survey data on adherence to COVID-19 prevention measures have often been used to inform policy makers and public health professionals. Although behavioural survey data are often considered to suffer from biases, there is a lack of studies critically examining the validity, reliability and responsiveness of population-survey data on behaviour throughout the COVID-19 pandemic. We studied the measurement properties of the COVID-19 Adherence to Prevention Advice Survey (CAPAS), a novel questionnaire implemented in a repeated cross-sectional (i.e., 'Trend') Study and a Cohort Study in the Netherlands during the COVID-19 pandemic. The CAPAS is a novel questionnaire developed in March 2020, with the aim to assess social activity and adherence to COVID-19 prevention measures. Items were formulated to minimise social desirability and aid memory retrieval. Based on the COSMIN framework, we selected the most suitable test for each behavioural question. We investigated criterion validity of vaccination, testing behaviour and mobility by comparing (aggregate) trends of self-reported behaviour to trends in objective data. Responsiveness of mobility and ventilation behaviour was assessed by studying whether self-reported behaviour changed following contextual (e.g., policy) changes. Test-retest reliability of hygienic behaviour, wearing face masks, ventilation behaviour and social distancing was examined during a period in which the context was stable. Overall, aggregate trends in self-reported behaviour closely corresponded to trends in external objective data. Self-reported behaviours were responsive to contextual changes and test-retest reliabilities were adequate. For infrequent behaviours reliability improved when measures were dichotomised. We were able to examine national representativeness for vaccination, which suggested a modest overestimation of on average 3.7%. This study supports the suitability of using carefully designed, self-reported surveys (and the CAPAS specifically) to study changes in protective behaviours in a dynamic context. • CAPAS was used to measure (changes in) preventive behavior of the Dutch population. • We studied its criterion validity, responsiveness and test-retest reliability. • Results support the validity, responsiveness and reliability of the survey. • Carefully designed surveys can be used to study (changes in) protective behavior. [ABSTRACT FROM AUTHOR]

From the start of the pandemic, questions were raised concerning how the pandemic could change or even transform relationships to our living environments. COVID-19 has had a disproportionate impact on the health and well-being of older people due to the increased risk of severity of the disease with both advancing age and associated co-morbidities. Restrictions on the movement of older people have also been more severe, with many countries imposing restrictions based on chronological age. In Portugal, confinement measures were targeted at older persons in terms of sheltering-at-home orders for those over 70. This paper looks at the impact of these restrictions on the lives of older people and asks what we can learn from the pandemic about the concept of age-friendly cities (WHO, 2007a). We look at the lived experience of older people to understand how their well-being and mobility were impacted during the crisis and its aftermath. The study was undertaken in four urban areas: Aveiro, Coimbra, Lisbon, and Faro. Data was collected using semi-structured interviews analysed using a process of thematic coding based on the eight pillars of the WHO's Age-Friendly City Checklist (WHO, 2007b). The results are discussed using conceptualisations from the new mobilities paradigm: existential mobility, connection and (im)mobility governance, offering new ways of thinking about age-friendliness in and out of crisis. • Measures to contain COVID-19 were aimed at older people. • Interview data was analysed to understand the impact in Portugal. • Participants reported an existential need to move and connect. • These findings are essential to understanding age-friendly places. • A multi-dimensional framework of mobility is a necessary starting point for AFCC. [ABSTRACT FROM AUTHOR]

During the pre-vaccine period, the success of containing the spread of COVID-19 depends upon how communities respond to non-pharmaceutical mitigation policies such as social distancing, wearing of masks, retail and dining constraints, crowd limitation, and shelter-in-place orders. Of these policies, shelter-in-place and social distancing are of central importance. By using county-level mobility data as a measure of a community's voluntary compliance with social distancing policies, this study found that counties who received strong state social distancing policy directives and who had a high pro-social character showed lower mobility on retail and recreation mobility and grocery and pharmacy mobility (better social distancing) after states reopened from shelter-in-place orders. Counties that experienced a longer duration of shelter-in-place orders showed higher mobility (less social distancing), implying that the duration of the shelter-in-place order deteriorated social distancing response after reopening. This may be because reopening sent a "safe" signal to these counties or resulted in a response to the pent-up demand inducing higher mobility. The results indicate that implementing shelter-in-place and social distancing policies to slow down the transmission of COVID-19 were not necessarily effective in motivating a county to reduce mobility voluntarily. A county's pro-social character and the duration of shelter-in-place order should be considered when designing COVID-19 mitigation policies. • This study explores factors affecting voluntary compliance behavior after lockdowns. • A community's pro-social intention needs to be separated from community capital. • A longer duration of lockdowns leads to people not adhering to social distancing. • Pro-social intention increases voluntary compliance behavior after lockdowns. [ABSTRACT FROM AUTHOR]

Investigating the spatial epidemic dynamics of COVID-19 is crucial in understanding the routine of spatial diffusion and in surveillance, prediction, identification and prevention of another potential outbreak. However, previous studies attempting to evaluate these spatial diffusion dynamics are limited. Using city as the research unit and spatial association analysis as the primary strategy, this study explored the changing primary risk factors impacting the spatial spread of COVID-19 across Chinese cities under various diffusion assumptions and throughout the epidemic stage. Moreover, this study investigated the characteristics and geographical distributions of high-risk areas in different epidemic stages. The results empirically indicated rapid intercity diffusion at the early stage and primarily intracity diffusion thereafter. Before countermeasures took effect, proximity, GDP per capita, medical resources, outflows from Wuhan and intercity mobility significantly affected early diffusion. With speedily effective countermeasures, outflows from the epicenter, proximity, and intracity outflows played an important role. At the early stage, high-risk areas were mainly cities adjacent to the epicenter, with higher GDP per capita, or a combination of higher GDP per capita and better medical resources, with more outflow from the epicenter, or more intercity mobility. After countermeasures were effected, cities adjacent to the epicenter, or with more outflow from the epicenter or more intracity mobility became high-risk areas. This study provides an insightful understanding of the spatial diffusion of COVID-19 across cities. The findings are informative for effectively handling the potential recurrence of COVID-19 in various settings. • Changing risk factors of spatial diffusion throughout the whole stage are considered. • A transfer diffusion at early stage and a local diffusion later are verified. • At early stage, developed cities with more inter-city mobilities had higher risk. • With effective interventions, cities with more intra-city mobilities had higher risk. • Proximity and outflows from epicenter were significant factors all the time. [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, some countries introduced early evening curfews. Several studies try to measure the effectiveness of such measures across different countries, but disentangling competing effects can be elusive. We examined the impact of an early evening curfew on mobility by studying a shift in curfews from 9pm to 6pm in Greece using Google mobility data. We followed a difference-in-differences (DiD) econometric approach, where we compared trends in mobility in residential spaces as well as groceries and pharmacies, before and after the introduction of the 6pm curfew in Attica with trends in three other comparable Regions. We found little or no evidence of an effect of the early curfew on daily mobility relating to groceries and pharmacies, and that an 18.75% reduction in hours where people were allowed to leave home led to a relatively small increase in time spent in residential spaces. This less-than-proportionate reduction in mobility outside the household suggests a possibility that the curfew led to more people coinciding in indoor public spaces, such as grocery shops – which constitutes a contagion risk factor. Results should be treated with caution, especially with regards to the magnitude of any effect, as Google mobility data do not report the time of the day, so the time density of activities cannot be estimated. Lockdowns and other measures are necessary to tackle Covid-19, but it is important to avoid substitution by activities that contribute further to spreading the virus. Interventions should therefore be based on a thorough analysis of human behaviour. • A shift from 9pm to 6pm curfews were introduced in Attica, Greece, to fight COVID-19. • We used a difference-in-differences approach using other regions as control groups. • There was a small relative increase in time spent in residential spaces. • The early curfew had little or no effect on daily grocery and pharmacy mobility. • This might have led to more people coinciding in indoor spaces, such as supermarkets. [ABSTRACT FROM AUTHOR]

Community vulnerability is widely viewed as an important aspect to consider when modeling disease. Although COVID-19 does disproportionately impact vulnerable populations, human behavior as measured by community mobility is equally influential in understanding disease spread. In this research, we seek to understand which of four composite measures perform best in explaining disease spread and mortality, and we explore the extent to which mobility account for variance in the outcomes of interest. We compare two community mobility measures, three composite measures of community vulnerability, and one composite measure that combines vulnerability and human behavior to assess their relative feasibility in modeling the US COVID-19 pandemic. Extensions – via temporally dependent fixed effect coefficients – of the commonly used Bayesian spatio-temporal Poisson disease mapping models are implemented and compared in terms of goodness of fit as well as estimate precision and viability. A comparison of goodness of fit measures nearly unanimously suggests the human behavior-based models are superior. The duration at residence mobility measure indicates two unique and seemingly inverse relationships between mobility and the COVID-19 pandemic: the findings indicate decreased COVID-19 presence with decreased mobility early in the pandemic and increased COVID-19 presence with decreased mobility later in the pandemic. The early indication is likely influenced by a large presence of state-issued stay at home orders and self-quarantine, while the later indication likely emerges as a consequence of holiday gatherings in a country under limited restrictions. This study implements innovative statistical methods and furnishes results that challenge the generally accepted notion that vulnerability and deprivation are key to understanding disparities in health outcomes. We show that human behavior is equally, if not more important to understanding disease spread. We encourage researchers to build upon the work we start here and continue to explore how other behaviors influence the spread of COVID-19. • Shows vulnerability coupled with mobility are most effective for modeling COVID-19. • Demonstrates social distancing limits the spread of COVID-19. • Challenges using vulnerability and deprivation to explain disparities in health. • Confirms that capturing human behavior is crucial for understanding disease spread. • Elucidates the value of using novel spatiotemporal methods to model disease spread. [ABSTRACT FROM AUTHOR]

During the early 2020 COVID-19 pandemic, several US states had implemented stay-in-place orders (SIPOs) with varying degrees of stringency which resulted in inter-state differences in mobility (i.e., longer presence at home). We test whether the inter-state differences in mobility influenced changes in reported psychological distress. Our study is not on the surge in COVID-19 in the later part of 2020. To identify whether the change in state-level mobility is associated with the change in individuals' reported psychological distress during the early COVID-19 pandemic and whether the intensity of the association varies by older individuals, females, and nonwhites. We use differences in state-level mobility and change in reported psychological distress between the two dates of interviews of 5,132 individuals who participated in March and April 2020 waves of Understanding America Study (UAS). We find support for modest effects, i.e., a one standard deviation decline in mobility was associated with a 3.02% higher psychological distress [95% CI: 0.4%–5.64%], and the effects are robust to controlling for reported changes in exercise intensity, alcohol consumption, cannabis use, recreational drug use, and meditation intensity. We also find support for a stronger association for females, but not for older individuals or non-whites. Further, we do not find support for the mediation effects from change in chance of running out of money or change in chance of getting COVID-19. Our findings show that reduced mobility from lockdowns during the early COVID-19 wave in the US is associated with a modest increase in reported psychological distress, especially for females. However, these conclusions should not be construed as a small increase in psychological distress in general, as a variety of non-mobility related factors associated with COVID-19 could have exacerbated psychological distress during the early COVID-19 wave in the US. • Did reduced mobility early in 2020 COVID-19 pandemic affect psychological distress? • Used two waves of Understanding America Study individual survey for analysis. • Found that decline in mobility is associated with modest increase in distress. • Found evidence of stronger association especially among females. [ABSTRACT FROM AUTHOR]