Associations between individual-level factors and adherence to social distancing measures during the COVID-19 pandemic: a global meta-analysis.
4 affiliations
- 1Agent-Based Modelling Laboratory, Centre of Excellence in AI for Public Health Advancement, York University, Toronto, ON, M3J 1P3, Canada.
- 2Laboratory for Industrial and Applied Mathematics, Centre of Excellence in AI for Public Health Advancement, York University, Toronto, ON, M3J 1P3, Canada.
- 3National Laboratory for Health Security, University of Szeged, Szeged, 6720, Hungary.
- 4Agent-Based Modelling Laboratory, Centre of Excellence in AI for Public Health Advancement, York University, Toronto, ON, M3J 1P3, Canada. [email protected].
Abstract
Background
Social distancing was a cornerstone of the COVID-19 pandemic response, yet evidence on factors associated with adherence remains fragmented and context-specific. We conducted a global meta-analysis to quantify the associations between key individual-level determinants and adherence to social distancing measures.Methods
We systematically searched six electronic databases from inception to August 20, 2025 to identify studies reporting associations between individual-level determinants and adherence to social distancing measures. Effect estimates were transformed into Pearson's correlation coefficients (r) and pooled using random-effects meta-analysis. Subgroup analyses and meta-regression were conducted to examine regional and temporal variation.Results
Of 10,804 records identified, 58 cross‑sectional studies comprising 545,640 participants were included, and fourteen determinants of adherence to social distancing were assessed. Higher educational attainment (r = 0.09), female sex (r = 0.08), being married (r = 0.08), older age (r = 0.06), higher income (r = 0.07), and greater perceived risk and severity of COVID-19 (r = 0.10) were positively associated with adherence, whereas more conservative political ideology was negatively associated (r = -0.12). No significant associations were observed for perceived government response, comorbidity, place of residence, knowledge and awareness, smoking, employment status, or essential worker status. The magnitude and statistical significance of several associations varied across World Health Organization regions, with the European region showing the highest number of determinants significantly associated with adherence, whereas the African and Eastern Mediterranean regions exhibited the fewest.Conclusion
Adherence to social distancing during COVID-19 was associated with a set of demographic, socioeconomic, psychological, and political factors, with substantial regional heterogeneity. These findings underscore the importance of accounting for contextual and structural differences when interpreting behavioural evidence and designing public health responses to future disease outbreaks.
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BibTeX
@article{sumsuzzman2026associations,
title = {{Associations between individual-level factors and adherence to social distancing measures during the COVID-19 pandemic: a global meta-analysis.}},
author = {Dewan Md Sumsuzzman and Congjie Shi and Gergely Röst and Jianhong Wu and Seyed M Moghadas},
journal = {BMC public health},
year = {2026},
month = aug,
doi = {10.1186/s12889-026-28873-1},
url = {https://europepmc.org/article/MED/42972331},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Associations between individual-level factors and adherence to social distancing measures during the COVID-19 pandemic: a global meta-analysis.
AU - Dewan Md Sumsuzzman
AU - Congjie Shi
AU - Gergely Röst
AU - Jianhong Wu
AU - Seyed M Moghadas
PY - 2026
DA - 2026/08/05
JO - BMC public health
DO - 10.1186/s12889-026-28873-1
UR - https://europepmc.org/article/MED/42972331
AB - Background Social distancing was a cornerstone of the COVID-19 pandemic response, yet evidence on factors associated with adherence remains fragmented and context-specific. We conducted a global meta-analysis to quantify the associations between key individual-level determinants and adherence to social distancing measures.Methods We systematically searched six electronic databases from inception to August 20, 2025 to identify studies reporting associations between individual-level determinants and adherence to social distancing measures. Effect estimates were transformed into Pearson's correlation coefficients (r) and pooled using random-effects meta-analysis. Subgroup analyses and meta-regression were conducted to examine regional and temporal variation.Results Of 10,804 records identified, 58 cross‑sectional studies comprising 545,640 participants were included, and fourteen determinants of adherence to social distancing were assessed. Higher educational attainment (r = 0.09), female sex (r = 0.08), being married (r = 0.08), older age (r = 0.06), higher income (r = 0.07), and greater perceived risk and severity of COVID-19 (r = 0.10) were positively associated with adherence, whereas more conservative political ideology was negatively associated (r = -0.12). No significant associations were observed for perceived government response, comorbidity, place of residence, knowledge and awareness, smoking, employment status, or essential worker status. The magnitude and statistical significance of several associations varied across World Health Organization regions, with the European region showing the highest number of determinants significantly associated with adherence, whereas the African and Eastern Mediterranean regions exhibited the fewest.Conclusion Adherence to social distancing during COVID-19 was associated with a set of demographic, socioeconomic, psychological, and political factors, with substantial regional heterogeneity. These findings underscore the importance of accounting for contextual and structural differences when interpreting behavioural evidence and designing public health responses to future disease outbreaks.
SN - 1471-2458
ER -