Patterns of compliance with COVID-19 preventive measures in Armenia: results from a cross-sectional survey

While numerous studies have explored adherence to individual COVID-19 preventive behaviors and their predictors, their combinations and clustering have been less frequently investigated. We explored the patterns and socio-demographic correlates of mask-wearing, hand washing, maintaining social distance, avoiding gatherings and vaccination against COVID-19 in Armenia. We enrolled participants using stratified two-stage cluster sampling. Telephone interviews were conducted among 3,483 respondents in May-September 2021. A hierarchical cluster analysis and multivariable logistic regression were applied. The most common protective behavior was hand washing (91%), while the least common was maintaining 1.5 m distance (42%). About 12% of the sample was vaccinated. The respondents in the "low protection" cluster (42.3%) had lower engagement in preventive behaviors, while those in the "high protection" cluster (57.7%) mostly adhered to behavioral recommendations. "High protection" cluster membership was associated with increasing age (aOR = 1.03; 95% CI: 1.02-1.03) and being a female (aOR = 1.21; 95% CI: 1.01-1.44). Those with higher monthly family expenditures had lower odds of "high protection" cluster membership (aOR = 0.78; 95% CI: 0.63-0.96). This cross-sectional study stresses the importance of exploring patterns of compliance with multiple preventive behaviors and developing targeted interventions facilitating uptake of multiple behaviors in specific socio-demographic groups.