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Background <p>Initial management of coronavirus disease 2019 (COVID-19) focused on preventing spread and providing supportive care. Authorities disseminated disease information and enforced preventive measures. This intricate task was affected by factors such as initial emotional distress or perceived risk, which influenced adherence to public health recommendations. This study examined the association between trust in local health authorities and national/regional leaders who have provided information about COVID-19 and adherence to COVID-19 preventive behaviors.</p> Methods <p>Data from the International COVID-19 Awareness and Responses Evaluation (iCARE) study was used for the analyses (surveys 5–15, <i>n</i> = 14,453) from 116 countries (September 2020-January 2022). The main predictor was participants' trust, which was categorized into four levels. The primary outcome was adherence to preventive behaviors: (1) handwashing, (2) mask wearing, (3) physical distancing, (4) avoiding gatherings, and (5) self-quarantining. Additional variables included demographics, socioeconomic status, health history and COVID-19 perceptions. We conducted multivariable logistic regressions to determine the association between the level of trust in local health authorities and national/regional leaders and adherence to COVID-19-related preventive health behaviors.</p> Results <p>14,453 respondents worldwide, 2852 (25.43%) reported no trust or no trust at all in political authorities, and 1847 (16.84%) reported no trust or no trust at all in healthcare authorities. The unadjusted regression models revealed that those without trust in political and health authorities were less likely to adhere to all the included preventive behaviors. Multivariable models indicated that those who did not trust at all in political leaders had lower odds of adopting self-quarantine (OR = 0.70, 95% CI: 0.49–0.99) and of avoiding gatherings (OR = 0.59, 95% CI: 0.42–0.84). Distrust in healthcare authorities also lowered the odds of adherence to protective behaviors, particularly avoiding gatherings (OR = 0.37, 95% CI: 0.25–0.53), and self-quarantine (OR = 0.49, 95% 0.33- 0.72).</p> Conclusion <p>Our findings revealed a positive association between trust in health and political authorities, and adherence to preventive health behaviors, independent of demographic, socioeconomic, or perceptual/belief factors. Therefore, prioritizing trust between public health institutions and people is crucial for effectively managing infectious disease outbreaks. Future steps must be tailored to each population, addressing privacy concerns, enhancing community communication, and encouraging public engagement in health policy.</p>

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A global assessment of the level of trust in information sources and adherence to COVID-19 related preventive health behaviors: cross-sectional survey study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月8日

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  • Mishell Barreno Caicedo,
  • Maximilien V. Dialufuma,
  • Rubee Dev,
  • Kim L. Lavoie,
  • Simon L. Bacon,
  • Nora Granana,
  • Jacqueline Boyle,
  • Margie Danchin,
  • Joanne Enticott,
  • Jessica Kaufman,
  • Alexandra Kautzky-Willer,
  • Eduardo Caputo,
  • Mohamad Baydoun,
  • Andrea Gershon,
  • Ariane Bélanger-Gravel,
  • Tavis Campbell,
  • Linda Carlson,
  • Kim Corace,
  • Olivier Drouin,
  • Gary Garber,
  • Samir Gupta,
  • Catherine Herba,
  • Jack Jedwab,
  • Joanne Liu,
  • Sandra Pelaez,
  • Paul Poirier,
  • Justin Presseau,
  • Eli Puterman,
  • Joshua Rash,
  • Johanne Saint-Charles,
  • Jovana Stojanovic,
  • Michael Spivock,
  • Geneviève Szczepanik,
  • Michael Vallis,
  • Vincent Gosselin Boucher,
  • Claudia Trudel-Fitzgerald,
  • Tamara Cohen,
  • Alysha Deslippe,
  • Nazeem Muhajarine,
  • Rachel Burns,
  • Tristan Renaud,
  • Sean Locke,
  • Mariantonia Lemos-Hoyos,
  • Angelos Kassianos,
  • Mauricio Hincapié Montoya,
  • Biviana Marcela Suárez Sierra,
  • Gregory Ninot,
  • Mathieu Beraneck,
  • Beate Ditzen,
  • Theodora Skoura,
  • Delfin Lovelina Francis,
  • Beatrix Oroszi,
  • Annamária Ferenczi,
  • Hannah Durand,
  • Oonagh Meade,
  • Gerry Molloy,
  • Chris Noone,
  • Stefania Paduano,
  • Valeria Raparelli,
  • Hildah Oburu,
  • Niroj Bhandari,
  • Abu Zeeshan Bari,
  • Iveta Nagyova,
  • Susanne Fischer,
  • Ceprail Şimşek,
  • Keven Joyal-Desmarais,
  • Joanne Hart,
  • Lucie Byrne-Davis,
  • Nicola Paine,
  • Susan Michie,
  • Michele Okun,
  • Sherri Sheinfeld Gorin,
  • Johannes Thrul,
  • Abebaw Yohannes,
  • Shrinkhala Dawadi,
  • Kushan Ranakombu,
  • Daisuke Hayashi Neto,
  • Frédérique Deslauriers,
  • Amandine Gagnon-Hébert,
  • Mahrukh Jamil,
  • Camille Léger,
  • Callum MacLeay,
  • Ariany Marques Vieira,
  • Sarah O’Connor,
  • Zackary van Allen,
  • Susana Torres,
  • Sophie Duval,
  • Johanne O’Malley,
  • Katherine Séguin,
  • Kyle Warkentin,
  • Sarah Tanishka Nethan

摘要

Background

Initial management of coronavirus disease 2019 (COVID-19) focused on preventing spread and providing supportive care. Authorities disseminated disease information and enforced preventive measures. This intricate task was affected by factors such as initial emotional distress or perceived risk, which influenced adherence to public health recommendations. This study examined the association between trust in local health authorities and national/regional leaders who have provided information about COVID-19 and adherence to COVID-19 preventive behaviors.

Methods

Data from the International COVID-19 Awareness and Responses Evaluation (iCARE) study was used for the analyses (surveys 5–15, n = 14,453) from 116 countries (September 2020-January 2022). The main predictor was participants' trust, which was categorized into four levels. The primary outcome was adherence to preventive behaviors: (1) handwashing, (2) mask wearing, (3) physical distancing, (4) avoiding gatherings, and (5) self-quarantining. Additional variables included demographics, socioeconomic status, health history and COVID-19 perceptions. We conducted multivariable logistic regressions to determine the association between the level of trust in local health authorities and national/regional leaders and adherence to COVID-19-related preventive health behaviors.

Results

14,453 respondents worldwide, 2852 (25.43%) reported no trust or no trust at all in political authorities, and 1847 (16.84%) reported no trust or no trust at all in healthcare authorities. The unadjusted regression models revealed that those without trust in political and health authorities were less likely to adhere to all the included preventive behaviors. Multivariable models indicated that those who did not trust at all in political leaders had lower odds of adopting self-quarantine (OR = 0.70, 95% CI: 0.49–0.99) and of avoiding gatherings (OR = 0.59, 95% CI: 0.42–0.84). Distrust in healthcare authorities also lowered the odds of adherence to protective behaviors, particularly avoiding gatherings (OR = 0.37, 95% CI: 0.25–0.53), and self-quarantine (OR = 0.49, 95% 0.33- 0.72).

Conclusion

Our findings revealed a positive association between trust in health and political authorities, and adherence to preventive health behaviors, independent of demographic, socioeconomic, or perceptual/belief factors. Therefore, prioritizing trust between public health institutions and people is crucial for effectively managing infectious disease outbreaks. Future steps must be tailored to each population, addressing privacy concerns, enhancing community communication, and encouraging public engagement in health policy.