Self-reported compliance with personal preventive measures among 3035 Chinese factory workers at the beginning of work resumption following COVID-19 outbreak: a cross-sectional online survey (Preprint)

BACKGROUND: Maintaining compliance with personal preventive measures is important to achieve the balance of COVID-19 pandemic control and work resumption. OBJECTIVE: This study investigated self-reported compliance with four personal preventive measures against COVID-19 among a sample of factory workers in Shenzhen, China at the beginning of work resumption in China following the COVID-19 outbreak. These preventive measures included consistent facemask wearing in any public spaces (workplace and other public settings), sanitizing hands using soaps/liquid soaps/alcohol-based hand rubs after returning from public spaces/touching public installations/equipment, avoiding meal/social gathering and avoiding crowded places. We also examined the effects of factors including socio-demographics, individual-level factors (knowledge, perception, and depressive symptoms), interpersonal-level factors (exposure to COVID-19 specific information through different media), and social structural-level factors (preventive measures implemented by the factories). METHODS: Participants were adult factory workers who had resumed work in Shenzhen, China. A stratified two-stage cluster sampling design was used. Fourteen out of 100 factories that had resumed work were randomly selected. All full-time employees aged ≥18 years who had resumed work in these factories were invited to complete an online survey. A designated coordinator responsible for COVID-19 control in each factory facilitated the data collection. Out of 4158 workers who had resumed work in these factories, 3035 (73.0%) completed the online survey during March 1-14, 2020. Multilevel logistic regression models were fitted. RESULTS: Among participants, 96.8% (n=2,938) and 98.7% (n=2,996) reported wearing a facemask every time in the workplace and in other public settings in the past month, respectively. However, self-reported sanitizing hands (70.9%, n=2,152), avoiding social/meal gathering (73.3%, n=2,225) and avoiding crowded places (65.8%, n=1,997) were relatively low. After adjusting for significant background characteristics, at the individual level, knowledge about COVID-19 (adjusted odds ratio [AOR]: 1.16-1.29), perceived risk (AOR: 0.58-0.85) and severity (AOR: 1.05 & 1.07) of COVID-19, perceived effectiveness of individual (AOR: 1.05-1.09), organizational (AOR: 1.30) and governmental preventive measures (AOR: 1.14-1.21), perceived preparedness to potential outbreak after work resumption (AOR: 1.10-1.50) and depressive symptoms (AOR: 0.87) were associated with self-reported compliance with at least one personal preventive measures. At interpersonal level, exposure to COVID-19 specific information through official media channels (AOR: 1.08) and face-to-face communication (AOR: 0.90) were associated with self-reported sanitizing hands. The number of preventive measures implemented within workplace was positively associated with self-reported compliance with all four preventive measures (AOR: 1.30-1.63). CONCLUSIONS: Measures to strengthen hand hygiene and physical distancing among factory workers are needed to reduce transmission following work resumption. Future programs within workplaces should address multilevel factors.