ArticleBMC public health2026
A global assessment of the level of trust in information sources and adherence to COVID-19 related preventive health behaviors: cross-sectional survey study.
Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundInitial management of coronavirus disease 2019 (COVID-19) focused on preventing spread and providing supportive care. Authorities disseminated disease information and enforced preventive measures. This intricate task was affected by factors such as initial emotional distress or perceived risk, which influenced adherence to public health recommendations. This study examined the association between trust in local health authorities and national/regional leaders who have provided information about COVID-19 and adherence to COVID-19 preventive behaviors.
methodsData from the International COVID-19 Awareness and Responses Evaluation (iCARE) study was used for the analyses (surveys 5-15, n = 14,453) from 116 countries (September 2020-January 2022). The main predictor was participants' trust, which was categorized into four levels. The primary outcome was adherence to preventive behaviors: (1) handwashing, (2) mask wearing, (3) physical distancing, (4) avoiding gatherings, and (5) self-quarantining. Additional variables included demographics, socioeconomic status, health history and COVID-19 perceptions. We conducted multivariable logistic regressions to determine the association between the level of trust in local health authorities and national/regional leaders and adherence to COVID-19-related preventive health behaviors.
results14,453 respondents worldwide, 2852 (25.43%) reported no trust or no trust at all in political authorities, and 1847 (16.84%) reported no trust or no trust at all in healthcare authorities. The unadjusted regression models revealed that those without trust in political and health authorities were less likely to adhere to all the included preventive behaviors. Multivariable models indicated that those who did not trust at all in political leaders had lower odds of adopting self-quarantine (OR = 0.70, 95% CI: 0.49-0.99) and of avoiding gatherings (OR = 0.59, 95% CI: 0.42-0.84). Distrust in healthcare authorities also lowered the odds of adherence to protective behaviors, particularly avoiding gatherings (OR = 0.37, 95% CI: 0.25-0.53), and self-quarantine (OR = 0.49, 95% 0.33- 0.72).
conclusionOur findings revealed a positive association between trust in health and political authorities, and adherence to preventive health behaviors, independent of demographic, socioeconomic, or perceptual/belief factors. Therefore, prioritizing trust between public health institutions and people is crucial for effectively managing infectious disease outbreaks. Future steps must be tailored to each population, addressing privacy concerns, enhancing community communication, and encouraging public engagement in health policy.
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