Adherence to COVID-19 Guidelines in Adolescents Mediated by Perceived Importance, Psychosocially Maturity

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The direct effect of psychosocial maturity on adherence to COVID-19 guidelines was attenuated by perceived importance. Credit: Getty Images
Participants of the Adolescent Social Development and Sleep study which recruited patients in Texas between 2019 and 2020 before local quarantine restrictions were asked to participate in this study about COVID-19 behaviors and opinions.

Adolescents who were more psychosocially mature were more likely to report adhering to COVID-19 safety guidelines, according to results of a study, published in Child: Care, Health and Development.

Participants (N=105) of the Adolescent Social Development and Sleep (ASDS) study which recruited patients in Texas between 2019 and 2020 before local quarantine restrictions were asked to participate in this study about COVID-19 behaviors and opinions. Adolescents (n=68) aged 13 to 17 years were evaluated for maturity using the Maturity of Judgement (MOJ) scale at baseline for the ASDS study and their thoughts about compliance with the United States Centers for Disease Prevention and Control (CDC) COVID-19 guidelines were surveyed over the phone.

Participants were aged a mean of 15.38 (SD, 1.05) years, 61.2% were boys, 94.1% were Hispanic, and 36.8% were involved with the juvenile justice system.

Out of the 7 recommendations from the CDC, 91.1% reported following 5 or more guidelines, and 42.6% reported following all 7. The most followed recommendations were washing hands or using sanitizer (97.1%) and covering coughs and sneezes (97.1%). Fewer endorsed avoiding touching their face (60.3%). Overall, the guidelines were viewed as “very” or “pretty” important.

Adherence to the CDC guidelines was correlated with perceived importance of the guidelines (r, 0.40; P ≤.01), suppression of aggression (r, 0.37; P ≤.01), and impulse control (r, 0.27; P ≤.05). Perceived importance of the guidelines was correlated with suppression of aggression (r, 0.41; P ≤.01), impulse control (r, 0.31; P ≤.05), and future outlook (r, 0.29; P ≤.05).

In the mediation model there was a direct effect of psychosocial maturity on the rating of CDC guideline importance (F[2,61], 4.167; P =.006), and a direct effect of perceived importance on adherence (F[3,60], 4.500; P =.008). In the final step of the model, the direct effect of psychosocial maturity on adherence was attenuated by perceived importance (F[2,64], 4.500; P =.186).

Psychosocial maturity had both a direct (0.259) and indirect (0.182) effect on adherence, indicating that nearly half (41.3%) of the impact of psychosocial maturity on adherence to CDC guidelines was mediated by the adolescent’s perceived importance of the guidelines.

The limitations of this study included the low sample size and the fact that these findings may not be generalizable, as these adolescents were recruited from a community at increased risk for COVID-19 outcomes.

The study authors concluded, “Adolescents’ beliefs about the importance of following the CDC guidelines are paramount to their adherence to the guidelines. The current study found that more psychosocially mature adolescents adhere to these guidelines better than less psychosocially mature adolescents because they are more likely to view the guidelines as important. Information that attempts to increase adolescent adherence to the guidelines — whether provided by parents, teachers, news outlets or elsewhere — should therefore emphasize not only that following the guidelines is important, but why following the guidelines is so important.”

Reference

Clough IM, Drozdova AD, Cavanagh C, Thomas AG. Adolescents’ adherence to Centers for Disease Control and Prevention guidelines during the COVID-19 pandemic. Child Care Health Dev. Published online April 6, 2022. doi:10.1111/cch.13012