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Abstract：
BACKGROUND: COVID-19 protective behaviors are key interventions advised by the World Health Organization (WHO) to prevent COVID-19 transmission. However, achieving compliance with this advice is often challenging, particularly among socially vulnerable groups.
OBJECTIVE: We developed a social vulnerability index (SVI) to predict individuals\' propensity to adhere to the WHO advice on protective behaviors against COVID-19 and identify changes in social vulnerability as Omicron evolved in African countries between January 2022 and August 2022 and Asia Pacific countries between August 2021 and June 2022.
METHODS: In African countries, baseline data were collected from 14 countries (n=15,375) during the first Omicron wave, and follow-up data were collected from 7 countries (n=7179) after the wave. In Asia Pacific countries, baseline data were collected from 14 countries (n=12,866) before the first Omicron wave, and follow-up data were collected from 9 countries (n=8737) after the wave. Countries\' socioeconomic and health profiles were retrieved from relevant databases. To construct the SVI for each of the 4 data sets, variables associated with COVID-19 protective behaviors were included in a factor analysis using polychoric correlation with varimax rotation. Influential factors were adjusted for cardinality, summed, and min-max normalized from 0 to 1 (most to least vulnerable). Scores for compliance with the WHO advice were calculated using individuals\' self-reported protective behaviors against COVID-19. Multiple linear regression analyses were used to assess the associations between the SVI and scores for compliance to WHO advice to validate the index.
RESULTS: In Africa, factors contributing to social vulnerability included literacy and media use, trust in health care workers and government, and country income and infrastructure. In Asia Pacific, social vulnerability was determined by literacy, country income and infrastructure, and population density. The index was associated with compliance with the WHO advice in both time points in African countries but only during the follow-up period in Asia Pacific countries. At baseline, the index values in African countries ranged from 0.00 to 0.31 in 13 countries, with 1 country having an index value of 1.00. The index values in Asia Pacific countries ranged from 0.00 to 0.23 in 12 countries, with 2 countries having index values of 0.79 and 1.00. During the follow-up phase, the index values decreased in 6 of 7 African countries and the 2 most vulnerable Asia Pacific countries. The index values of the least vulnerable countries remained unchanged in both regions.
CONCLUSIONS: In both regions, significant inequalities in social vulnerability to compliance with WHO advice were observed at baseline, and the gaps became larger after the first Omicron wave. Understanding the dimensions that influence social vulnerability to protective behaviors against COVID-19 may underpin targeted interventions to enhance compliance with WHO recommendations and mitigate the impact of future pandemics among vulnerable groups.
OBJECTIVE: We developed a social vulnerability index (SVI) to predict individuals\' propensity to adhere to the WHO advice on protective behaviors against COVID-19 and identify changes in social vulnerability as Omicron evolved in African countries between January 2022 and August 2022 and Asia Pacific countries between August 2021 and June 2022.
METHODS: In African countries, baseline data were collected from 14 countries (n=15,375) during the first Omicron wave, and follow-up data were collected from 7 countries (n=7179) after the wave. In Asia Pacific countries, baseline data were collected from 14 countries (n=12,866) before the first Omicron wave, and follow-up data were collected from 9 countries (n=8737) after the wave. Countries\' socioeconomic and health profiles were retrieved from relevant databases. To construct the SVI for each of the 4 data sets, variables associated with COVID-19 protective behaviors were included in a factor analysis using polychoric correlation with varimax rotation. Influential factors were adjusted for cardinality, summed, and min-max normalized from 0 to 1 (most to least vulnerable). Scores for compliance with the WHO advice were calculated using individuals\' self-reported protective behaviors against COVID-19. Multiple linear regression analyses were used to assess the associations between the SVI and scores for compliance to WHO advice to validate the index.
RESULTS: In Africa, factors contributing to social vulnerability included literacy and media use, trust in health care workers and government, and country income and infrastructure. In Asia Pacific, social vulnerability was determined by literacy, country income and infrastructure, and population density. The index was associated with compliance with the WHO advice in both time points in African countries but only during the follow-up period in Asia Pacific countries. At baseline, the index values in African countries ranged from 0.00 to 0.31 in 13 countries, with 1 country having an index value of 1.00. The index values in Asia Pacific countries ranged from 0.00 to 0.23 in 12 countries, with 2 countries having index values of 0.79 and 1.00. During the follow-up phase, the index values decreased in 6 of 7 African countries and the 2 most vulnerable Asia Pacific countries. The index values of the least vulnerable countries remained unchanged in both regions.
CONCLUSIONS: In both regions, significant inequalities in social vulnerability to compliance with WHO advice were observed at baseline, and the gaps became larger after the first Omicron wave. Understanding the dimensions that influence social vulnerability to protective behaviors against COVID-19 may underpin targeted interventions to enhance compliance with WHO recommendations and mitigate the impact of future pandemics among vulnerable groups.
摘要：
背景：COVID-19保护行为是世界卫生组织（WHO）建议的预防COVID-19传播的关键干预措施。然而,实现遵守这一建议通常是具有挑战性的，特别是在社会弱势群体中。
目的：我们制定了社会脆弱性指数（SVI），以预测个人遵守世卫组织关于COVID-19保护性行为建议的倾向，并确定随着Omicron在2022年1月至2022年8月期间在非洲国家和2021年8月至2022年6月期间在亚太国家的演变，社会脆弱性的变化。
方法：在非洲国家，在第一次Omicron波期间，从14个国家(n=15,375)收集了基线数据，随访数据来自7个国家(n=7179)。在亚太国家,在第一次Omicron波之前，从14个国家(n=12,866)收集了基线数据，随访数据来自9个国家(n=8737)。从相关数据库检索国家的社会经济和健康概况。要为4个数据集中的每个数据集构建SVI，与COVID-19保护行为相关的变量被纳入使用多脉络线相关性和varimax旋转的因子分析中.对影响因素进行了基数调整，求和,和最小值-最大值从0归一化到1(最脆弱到最不脆弱)。遵守世卫组织建议的分数是使用个人自我报告的针对COVID-19的保护行为计算的。使用多元线性回归分析来评估SVI与对WHO建议的依从性评分之间的关联，以验证该指数。
结果：在非洲，导致社会脆弱性的因素包括识字和媒体使用，对医护人员和政府的信任，国家收入和基础设施。在亚太地区,社会脆弱性是由识字决定的，国家收入和基础设施，和人口密度。该指数与非洲国家在两个时间点遵守世卫组织建议有关，但仅在亚太国家的后续行动期间。在基线,非洲国家的指数值在13个国家从0.00到0.31之间，1个国家的指数值为1.00。亚太国家的指数值在12个国家从0.00到0.23之间，2个国家的指数值为0.79和1.00。在后续阶段，7个非洲国家中的6个和2个最脆弱的亚太国家的指数值下降。两个区域最脆弱国家的指数值保持不变。
结论：在这两个地区，在基线时观察到社会对遵守世卫组织建议的脆弱性存在显著不平等，在第一次Omicron波之后，间隙变得更大。了解影响社会对COVID-19保护性行为的脆弱性的维度可能会支持有针对性的干预措施，以增强对WHO建议的遵守，并减轻弱势群体未来大流行的影响。
目的：我们制定了社会脆弱性指数（SVI），以预测个人遵守世卫组织关于COVID-19保护性行为建议的倾向，并确定随着Omicron在2022年1月至2022年8月期间在非洲国家和2021年8月至2022年6月期间在亚太国家的演变，社会脆弱性的变化。
方法：在非洲国家，在第一次Omicron波期间，从14个国家(n=15,375)收集了基线数据，随访数据来自7个国家(n=7179)。在亚太国家,在第一次Omicron波之前，从14个国家(n=12,866)收集了基线数据，随访数据来自9个国家(n=8737)。从相关数据库检索国家的社会经济和健康概况。要为4个数据集中的每个数据集构建SVI，与COVID-19保护行为相关的变量被纳入使用多脉络线相关性和varimax旋转的因子分析中.对影响因素进行了基数调整，求和,和最小值-最大值从0归一化到1(最脆弱到最不脆弱)。遵守世卫组织建议的分数是使用个人自我报告的针对COVID-19的保护行为计算的。使用多元线性回归分析来评估SVI与对WHO建议的依从性评分之间的关联，以验证该指数。
结果：在非洲，导致社会脆弱性的因素包括识字和媒体使用，对医护人员和政府的信任，国家收入和基础设施。在亚太地区,社会脆弱性是由识字决定的，国家收入和基础设施，和人口密度。该指数与非洲国家在两个时间点遵守世卫组织建议有关，但仅在亚太国家的后续行动期间。在基线,非洲国家的指数值在13个国家从0.00到0.31之间，1个国家的指数值为1.00。亚太国家的指数值在12个国家从0.00到0.23之间，2个国家的指数值为0.79和1.00。在后续阶段，7个非洲国家中的6个和2个最脆弱的亚太国家的指数值下降。两个区域最脆弱国家的指数值保持不变。
结论：在这两个地区，在基线时观察到社会对遵守世卫组织建议的脆弱性存在显著不平等，在第一次Omicron波之后，间隙变得更大。了解影响社会对COVID-19保护性行为的脆弱性的维度可能会支持有针对性的干预措施，以增强对WHO建议的遵守，并减轻弱势群体未来大流行的影响。
