COVID-19 Pandemic
Individual feedback on behavioral risk assessments did not change future risk behaviors during the COVID-19 pandemic in Japan Shuko Takahashi* Shuko Takahashi Naomi Takahashi Masaru Nohara Ichiro Kawachi
Background: We examined prospectively whether feedback of behavioral risk assessments to individuals changed their behavioral risks across five sequential surveys during the COVID-19 pandemic in Japan.
Methods: Five waves of rapid online surveys of residents in Iwate Prefecture were conducted from late 2020 to early 2022. Each individual’s risk of acquiring SARS-CoV-2 infection was calculated using a quantitative assessment tool (the microCOVID) which classified each individual’s risk level into low, middle, and high risk for acquiring infection. We provided feedback to individual respondents who requested information about their behavioral risks for acquiring COVID-19. After grouping individual risk levels into two groups: low risk versus middle/high risk, we calculated trajectories of behavior change between survey waves. Multinominal logistic regression was used to determine whether individual feedback was associated with behavior change, i.e., transitioning from high risk to low risk.
Results: We received responses from 9190, 11907, 9635, and 10636 individuals over follow-up survey waves. Contrary to our hypothesis, individuals who requested and received feedback on their risk of contracting COVID showed significantly higher ORs of transitioning to high risk between the 2nd and 3rd surveys conducted in February and April 2021 (OR 1.48, 95% CI: 1.04, 2.09). Although subsequently individuals who received feedback were more likely to improve to low risk between the 4th and 5th survey conducted in July to October 2021 (OR 1.29, 95% CI: 1.03, 1.62), they were again less likely to improve to low risk between the 5th and 6th survey conducted in October 2021 and January 2022 (OR 0.50, 95% CI: 0.26, 0.98).
Conclusion: Overall, feedback of individualized risk assessments was not associated with improvements in individual behavioral risk behaviors during the pandemic, and in some cases appeared to have the opposite effect.
