Levels and factors of social and physical distancing based on the Theory of Planned Behavior during the COVID-19 pandemic among Chinese adults

Social and physical distancing is important in controlling the COVID-19 pandemic and it impacts people's financial/social well-being tremendously. This study tested the application of the Theory of Planned Behaviors (TPB) to three types of social/physical distancing indicators (i. e., the number of close physical contacts on a single day in public venues, the frequencies of avoiding social gathering, and the levels of physical distancing in public venues). A population-based random telephone survey interviewed 300 Hong Kong Chinese adults in April 2020 when gatherings involving >4 people were banned. The participants on average made 15.3 close physical contacts (<1.5 m and for >3 min) in a day (5.0 in public transportation). About 80% practiced social distancing (avoided/reduced social gatherings) and physical distancing in public spaces (e. g., avoidance of going out, visiting crowded places, and gatherings of >4 people) but only 35.4% avoided using public transportations. Positive but not negative attitudes (inconvenience and lack of necessity), perceived behavioral control, and subjective norm were significantly associated with the three social/physical distancing outcomes. The data suggest that the levels of social/physical distancing were relatively high in the Hong Kong general population, and it, in general, supports the application of TPB to understand factors of social distancing for preventing COVID-19. Health promotion should take the findings into account. Furthermore, cross-cultural and time-series studies are warranted to compare the levels of social/physical distancing across countries and further explore their effectiveness in controlling the COVID-19 pandemic.