- individual level health behaviors can be classified into two types: preventative and avoidant
- preventative behaviors: measures that serve to prevent transmission
- avoidant behaviors: measures that decrease contact with other individuals 

Types of health-protective measures: key definitions

- Predictor Variables (reported by participants): gender, ethnicity, religion, country of birth, marital status, education, house type, household size
- Outcome Variables (indicated by participants via yes/no answers): whether they:
1. washed hands more frequently (preventative)
2. used hand sanitizers more (preventative)
3. wore masks (preventative)
4. avoided crowded areas
5. voluntarily changed travel plans
6. missed/postponed social events
7. avoided visiting hospitals and/or healthcare settings
8. chose outdoor over indoor venues
9. distanced from people with recent travel to outbreak countries
10. distanced from people with possible contact with COVID-19 cases
11. avoided places where COVID-19 cases were reported
12. stored up more household or food supplied
13. relied more on online shopping
14. reduced physical contact
15. stayed home more than usual
16. distanced from people with flu symptoms
17. avoided public transport

Predictor and Outcome Variables used in Study

1145 survey participants, all were 21 years or older and had lived in Singapore for at least 2 years.

Survey Participant Demographics

- Overview of COVID-19 behavior changes
- Regression models based on survey results

Results: Summary of Behavioral Changes

- Types of health-protective measures: key definitions
- Survey Participant Demographics
- Predictor and Outcome Variables used in Study
- Results: Summary of Behavioral Changes

Northwestern University

 - Implementation of control strategies decreased R$_t$ in  China
 - Decreased effectiveness of COVID-19 prevention efforts in African American/Black and Latino populations
 - Association between decreased hospitalizations and stay-at-home orders in four states in U.S.
 - International travel restrictions have little-to-no effect on local COVID-19 epidemics
- Survey in Singapore reveals important information regarding public's adherence to COVID-19 preventative policies

Effectiveness of Control Strategies for COVID-19

Behavioral changes during the COVID-19 pandemic: Results of a national survey in Singapore. Long V., Liu J. 7 August 2020. BioRxiv. https://doi.org/10.1101/2020.08.06.20169870

Behavioral changes during the COVID-19 pandemic: Results of a national survey in Singapore

Shelter-in-place prevention efforts are less effective in preventing/controlling COVID-19 transmission in African American/black and Latino populations, possibly because these populations are more likely to 1) experience homelessness or to reside in areas of substandard air quality 2) be employed in service/ transportation positions 3) live in crowded urban areas and 4) have high rates of underlying conditions such as diabetes, cardiovascular disease, asthma, HIV, morbid obesity, liver disease, and kidney disease.

Decreased Effectiveness of COVID-19 Prevention Efforts in African American/Black and Latino Populations

The authors argue that unlike case count (which is a conservative estimate) and death count (which is a delayed and insufficient estimate), hospitalizations due to COVID-19 are a stronger metric for evaluating the effectiveness of stay-at-home measures. The study consisted of four states (Colorado, Minnesota, Ohio, and Virginia) that fit the inclusion criteria of having at least 7 consecutive days of cumulative hospitalization before and 17 days following the stay-at-home date.

Association between decreased hospitalizations and stay-at-home orders in four states in U.S.

Several studies found that R$_t$ decreased when control strategies were implemented.

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