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Home Health & Fitness Managing Expectations Is Critical to Ensure Compliance with Stay-at-Home Measures

Managing Expectations Is Critical to Ensure Compliance with Stay-at-Home Measures

A study of a representative sample of Italians finds that 50 percent of respondents reported having adopted all recommended actions, including staying at home, not meeting people, and going to the grocery store as infrequently as possible. People’s intentions to comply depend on whether the length of the extension matches their expectations (or not)

As of today, 30 US states and the District of Columbia have issued “Stay-at-Home” orders in an effort to mitigate the spread of Covid-19, and similar provisions are in place in many countries around the world. By helping to slow down contagion and alleviating the pressure on health systems, social distancing is an essential tool to fight epidemics.

Compliance with these norms is as essential as it is difficult to achieve.

Social distancing can be highly disruptive to people’s lives and is economically and psychologically costly. Moreover, although the costs are immediate and salient to individuals, the benefits, for individuals and society, materialize with a delay.

In China, where the virus originated and first spread, authorities imposed stay-at-home measures without setting a defined end date, and they strictly enforced the rules. In democratic countries, however, strict enforcement and tight limits to people’s freedom are costly and controversial. In these systems, therefore, the role of communication and expectations management is critically important.

 

The Study

We conducted a study of a representative sample of Italians to understand the role of people’s expectations about the duration of stay-at-home measures.

After the emergence of the first cases of community transmission, the Italian government ordered school closures and stay-at-home measures in the affected areas at first and then extended them to the whole country. Authorities set April 3rd as the end date of the stay-at-home measures. However, as the number of Covid-19 cases and deaths continued to climb, extensions of the end date became very likely.

The media was indeed discussing an extension when we ran our survey on March 18-20, although there had not been any formal announcements. We began by measuring respondents’ current compliance with social distancing rules and their expectations about the duration of the restrictive measures.

The Results

About 50 percent of respondents reported having adopted all recommended actions (including not meeting people, going to the grocery stores as infrequently as possible, and leaving home only in case of emergencies), whereas the remaining half had not adopted some of these practices. Most respondents were aware of the official end date of the measures, and almost everyone expected an extension.

However, expectations about the length of the extension varied widely: 43 percent expected the measures to continue for a few additional weeks, 20 percent for a few months, and 34 percent indefinitely (“until necessary”). The elderly population—the cohort most at-risk for serious complications from the virus—on average expected the provisions to end sooner than younger respondents did.

Next, we asked respondents about their intentions to comply with the social distancing restrictions if the measures were extended (i) by a few weeks, (ii) a few months, or (iii) indefinitely (“until deemed necessary”). Most respondents indicated an intention to “maintain their current behavior,” regardless of the length of the extension.

Moreover, more respondents reported that they would “increase” rather than “decrease” their self-isolation efforts. We did not find differences in reported intentions between Italy’s “red zones” (regions in the North that have been the most severely affected by the coronavirus) and the rest of the country.

However, we found that people’s intentions to comply depend on whether the length of the extension matches with their expectations (or not). In particular, respondents who would be positively surprised (i.e. extensions are shorter than they expected) are more willing to increase their isolation efforts and less likely to report an intention to decrease them compared to those who would be negatively surprised (i.e. extensions longer than expected).

These results are driven by respondents who are “fully compliant,” i.e. those who have adopted the recommended self-isolation measures. This finding is worrisome, because it is consistent with “social isolation fatigue,” and suggests that the efforts of compliant individuals should not be taken for granted.

Our results suggest that to maximize compliance with self-isolation, public authorities should make an effort to manage the public’s expectations regarding the duration of these measures.

Health experts have pointed out that the situation in most countries might not return to full normalcy until effective medication and a vaccine are available on a large scale, and that might take a while.

Stay-at-home measures with a specified end-date might be easier to accept by the public. However, unexpectedly long extensions could reduce people’s willingness to comply.

Public authorities should help the public to form accurate expectations, transparently communicating that self-isolation is likely to be a long-term endeavor. Yesterday, the Italian government extended the Covid-19 stay-at-home measures until April 13th.

However, Italian Prime Minister Giuseppe Conte also added: “We are not in a position to say that on April 14 we will ease the measures.” This approach seems to balance an attempt to enhance the effort to self-isolate for “a little longer” while leaving the door open to the possibility of extending further. This may reduce the likelihood of a backlash if an extension actually occurs.

How authorities announce new deadlines could be as important as other existing policy levers at their disposal.

SourcePROMARKET

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