Predictors of social distancing and hand washing among adults in five countries during COVID-19.

The purpose of this cross-sectional study is to examine disparities in hand washing and social distancing among 2,509 adults from the United States, Italy, Spain, the Kingdom of Saudi Arabia, and India. Respondents were recruited via Qualtrics' participant pool and completed an online survey in the most common language spoken in each country. In hierarchical linear regression models, living in a rural area (β = -0.08, p = .001), older age (β = 0.07, p < .001), identifying as a woman (β = 0.07, p = .001), and greater educational attainment (β = 0.07, p = .017) were significantly associated with hand washing. Similar results were found regarding social distancing, in which living in a rural area (β = -0.10, p < .001), country of residence (β = 0.11, p < .001), older age (β = 0.17, p < .001), identifying as a woman (β = 0.11, p < .001), and greater educational attainment (β = 0.06, p = .019) were significant predictors. Results from the multivariable linear regression models demonstrate more nuanced findings with distinct and significant disparities across the five countries found with respect to hand washing and social distancing. Taken together, the results suggest multiple influencing factors that contribute to existing disparities regarding social distancing and hand washing among adults internationally. As such, more tailored public interventions are needed to promote preventive measures to mitigate existing COVID-related disparities.