Researchers explore non-adherence to COVID-19 public health measures by parents

By Tarun Sai LomteReviewed by Aimee MolineuxMar 8 2023

In a recent study published in JAMA Network Open, researchers analyzed parents' non-adherence to public health measures (PHMs) against coronavirus disease 2019 (COVID-19) for their children.

People do not always adhere to medical recommendations, including COVID-19-related PHMs; for example, breaking quarantine or not reporting symptoms. Moreover, they are only sometimes honest about medical information. Parents experienced more stress during the COVID-19 pandemic than non-parents due to additional PHMs for children, such as school closures and quarantine rules.

The study and findings

In the present study, researchers investigated the prevalence of misrepresentations of COVID-19-associated PHMs and non-adherence to these measures by parents. They recruited a non-probability sample of adults between December 8 and 23, 2021, in the United States (US) for an online survey about experiences with COVID-19.

The survey queried whether parents ever engaged in seven types of misrepresentations and non-adherence behaviors regarding PHMs for their children. These were breaking quarantine rules, not mentioning that they knew/thought their child had COVID-19 to someone the child was with, lying about vaccination status or children’s age to get them vaccinated, avoiding COVID-19 tests, and not quarantining when they were supposed to.

Given the disproportionate impact of COVID-19 and PHMs on underserved populations, data on ethnicity and race were obtained. The prevalence of misrepresentation and non-adherence was examined using descriptive statistics. Multiple logistic regression explored the potential associations between characteristics and misrepresentations/non-adherence.

The final sample comprised 1733 adults and 580 parents with children younger than 18 years were included in the analyses. Participants were, on average, aged 35.9. Most subjects were females (70.2%) and non-Hispanic White (67.1%). Nearly 26% of individuals reported misrepresentation or non-adherence to one of the seven behaviors.

The most common behaviors were allowing children to break quarantine rules and not mentioning the person their child was with that they knew/thought the child was infected. Wanting to exercise freedom as a parent was the most common reason for these behaviors. Other reasons were wanting to ensure a normal life for their children and the inability to miss work. No associations were observed between characteristics and misrepresentation/non-adherence.

Conclusions

In sum, the researchers observed that a quarter of participants engaged in non-adherence or misrepresentation regarding COVID-19-related PHMs for their children. Preserving parental autonomy was the most common reason. Additional reasons were not being able to miss work/other responsibilities to stay home and wanting a normal life for their children.  

The findings suggest that PHMs to curb COVID-19 spread might have been compromised by parents, contributing to morbidity and mortality. Moreover, some children might have been vaccinated when it was not evaluated/approved for their age. The study’s limitations were the exploratory nature of regression and the non-probability sample, which may underestimate the prevalence of non-adherence and misrepresentation.

Future studies are required to identify people at the highest risk of misrepresentation/non-adherence, address parents’ concerns for such behaviors, and implement improved support mechanisms, such as paid sick leave for family illness, so that they feel non-adherence and misrepresentation are less necessary.