Objectives: To test whether public knowledge and confidence in one's understanding of the local restrictions, motivation to adhere to local restrictions, and self-reported behaviour (going out for exercise, to work, socially) differed according to tier level. Study design: Cross-sectional, nationally representative, online survey of 1728 participants living in England (data collection: 26 to 28 October 2020).
Methods: We conducted logistic regression analyses to investigate whether knowledge of restrictions, confidence in knowledge of restrictions, motivation to adhere to restrictions, and self-reported behaviour were associated with personal characteristics and tier.
Results: Between 81% (tier 2) and 89% (tier 3) of participants correctly identified which tier they lived in. Knowledge of specific restrictions was variable. 73% were confident that they understood which tier was in place in their local area, whereas 71% were confident they understood the guidance in their local area. Confidence was associated with being older and living in a less deprived area. 73% were motivated to adhere to restrictions in their local area. Motivation was associated with being female and older. People living in tiers with greater restrictions were less likely to report going out to meet people from another household socially; reported rates of going out for exercise and for work did not differ.
Conclusions: Although recognition of local tier level was high, knowledge of specific guidance for tiers was variable. There was some indication that nuanced guidance (e.g. behaviour allowed in some settings but not others) was more poorly understood than guidance which was absolute (i.e. behaviour is either allowed or not allowed).
Bibliographical noteFunding Information: This work was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme. LS, RA, and GJR are supported by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between the UK Health Security Agency, King's College London and the University of East Anglia. RA is also supported by the NIHR HPRU in Behavioural Science and Evaluation, a partnership between the UK Health Security Agency and the University of Bristol. The views expressed are those of the authors and not necessarily those of the NIHR, the UK Health Security Agency, the Department of Health and Social Care or the Ministry of Defence. Surveys were commissioned and funded by Department of Health and Social Care (DHSC), with the authors providing advice on the question design and selection. DHSC had no role in analysis, decision to publish, or preparation of the manuscript. Preliminary results were made available to DHSC and the UK's Scientific Advisory Group for Emergencies.
All authors had financial support from NIHR for the submitted work. RA is an employee of the UK Health Security Agency; HWWP has received additional salary support from Public Health England and NHS England; HWWP receives consultancy fees to his employer from Ipsos MORI and has a PhD student who works at and has fees paid by Astra Zeneca; NTF is a participant of an independent group advising NHS Digital on the release of patient data. All authors are participants of the UK's Scientific Advisory Group for Emergencies or its subgroups. There are no other financial relationships with any organizations that might have an interest in the submitted work in the previous three years and no other relationships or activities that could appear to have influenced the submitted work.
Open Access: This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Publisher Copyright: © 2021 The Author(s). Published by Elsevier Ltd on behalf of The Royal Society for Public Health.
Citation: Smith, Louise E., et al. "Tiered restrictions for COVID-19 in England: knowledge, motivation, and self-reported behaviour." Public Health (2022).
- Physical distancing
- Social distancing