Psychological distress and compliance with sanitary measures during the Covid-19 pandemic: effect modification by participant gender and socioeconomic characteristics, an IPD meta-analysis.

BackgroundThis study aims to understand how psychological distress is related to compliance with COVID-19 sanitary measures. In addition, we explored whether gender and socioeconomic status (i.e educational level and employment status) can modify this relationship. MethodsData from four European cohort studies (n=13,635), were analysed using an Individual Participant Data (IPD) meta-analytic approach. Mixed effect models were employed to examine associations between mental health difficulties and compliance with sanitary measures, as well as effect modification by socioeconomic status. Statistical models were additionally stratified by gender. ResultsWe found a statistically significant positive association between mental health difficulties and compliance with sanitary measures in women, while amongst men the statistically significant association observed was negative. Moreover, there was a statistically significant interaction between participants educational level and mental health difficulties amongst men only, indicating even lower compliance levels with COVID-19 sanitary measures amongst individuals with only primary schooling. ConclusionThe association between psychological distress and compliance with sanitary measures is complex - positive in women, negative in male. Men experiencing mental health difficulties, especially those with lower educational attainment, exhibit low levels of compliance with sanitary measures.