An online survey of a panel of 295 Anchorage residents 18 years old and older was conducted June 16-18, 2020. This was the fourth
survey since May 2020 conducted by the Municipality of Anchorage (MOA) regarding COVID-19 related knowledge, attitudes, and
behaviors. The first survey in the series was a population-based cell phone survey of Anchorage residents conducted May 6-10. The
second (May 20-22) third (June 2-4) and fourth (June 16-18) surveys were conducted online with a panel of participants from the first
survey. Key findings from the fourth survey included:
 Most respondents (72%) wore a mask most or all of the time outside their home.
 Most (90%) spent time outside their home the day before the survey.
 Most (64%) supported mandating wearing masks either “now” or “later.”
 Almost half (47%) had physical contact with someone not in their household.
 Most (76%) came within six feet of someone not from their household.
 Most (91%) felt somewhat knowledgeable or very knowledgeable about MOA COVID-19 emergency orders.
 COVID-19 related risk behaviors increased among those who:
o Had less than a college degree
o Were younger (<45 years)
o Had lower perceived threat of COVID-19
o Were less likely to bring a mask when they went out
o Were less likely to wash or sanitize hands when touching things touched by others.
Compared with previous surveys, more respondents are leaving their homes and coming into physical contact with others. However,
most survey respondents also reported wearing masks outside their home, supported a mandate to wear masks, and did not have
physical contact with others.
KEY MESSAGES
As a whole, panel respondents reported positive COVID-19 mitigation behaviors. Messaging could continue to employ the need for
personal responsibility to reduce risk, while emphasizing community/societal responsibility and benefit. Integrated communications with
key education partners (ASD, UAA, APU, etc.) could also help reach groups associated with COVID-19 related risk behaviors. To
encourage increased receptiveness to mitigation behaviors, messaging could try to incorporate affinity group imagery and rhetorical
framing

Cueva, Katie

Garcia, Gabriel

Hennessy, Thomas

Mapaye, Joy

Meyer, Jennifer

Miller, Jenny

Snyder, Elizabeth

Van Wyck, Rebecca

ScholarWorks@UA

July 9, 2020    UA is an AA/EO employer and educational institution and prohibits illegal discrimination against any individual: www.alaska.edu/nondiscrimination www.uaa.alaska.edu/academics/college-of-health/departments/population-health-sciences COVID-19 Survey in the Municipality of Anchorage, June 16-18: Highlights Gabriel Garcia PhD MA MPH,1 Joy Chavez Mapaye PhD,2 Rebecca Van Wyck,3 Katie Cueva ScD MAT MPH,4 Elizabeth Hodges Snyder PhD MPH,5 Jennifer Meyer PhD MPH CPH RN,6 Jenny Miller DrPH, MS MPH,7 Thomas Hennessy MD MPH Captain USPHS (ret)8  Key Findings An online survey of a panel of 295 Anchorage residents 18 years old and older was conducted June 16-18, 2020. This was the fourth survey since May 2020 conducted by the Municipality of Anchorage (MOA) regarding COVID-19 related knowledge, attitudes, and behaviors. The first survey in the series was a population-based cell phone survey of Anchorage residents conducted May 6-10. The second (May 20-22) third (June 2-4) and fourth (June 16-18) surveys were conducted online with a panel of participants from the first survey. Key findings from the fourth survey included:  Most respondents (72%) wore a mask most or all of the time outside their home.  Most (90%) spent time outside their home the day before the survey.   Most (64%) supported mandating wearing masks either “now” or “later.”   Almost half (47%) had physical contact with someone not in their household.  Most (76%) came within six feet of someone not from their household.   Most (91%) felt somewhat knowledgeable or very knowledgeable about MOA COVID-19 emergency orders.  COVID-19 related risk behaviors increased among those who: o Had less than a college degree o Were younger (<45 years) o Had lower perceived threat of COVID-19 o Were less likely to bring a mask when they went out o Were less likely to wash or sanitize hands when touching things touched by others.  Compared with previous surveys, more respondents are leaving their homes and coming into physical contact with others. However, most survey respondents also reported wearing masks outside their home, supported a mandate to wear masks, and did not have physical contact with others.  KEY MESSAGES As a whole, panel respondents reported positive COVID-19 mitigation behaviors. Messaging could continue to employ the need for personal responsibility to reduce risk, while emphasizing community/societal responsibility and benefit. Integrated communications with key education partners (ASD, UAA, APU, etc.) could also help reach groups associated with COVID-19 related risk behaviors. To encourage increased receptiveness to mitigation behaviors, messaging could try to incorporate affinity group imagery and rhetorical framing.                                                                    1 Professor of Public Health, Division of Population Health Sciences, University of Alaska Anchorage 2 Professor, Department of Journalism and Public Communications, University of Alaska Anchorage 3 Research Associate, Institute for Circumpolar Health Studies, University of Alaska Anchorage 4 Assistant Professor of Health Policy, Institute of Social and Economic Research (ISER), University of Alaska Anchorage 5 Associate Professor of Public Health, Division of Population Health Sciences, University of Alaska Anchorage 6 Assistant Professor of Health Sciences, Division of Population Health Sciences, University of Alaska Anchorage 7 Associate Professor of Public Health, Division of Population Health Sciences, University of Alaska Anchorage 8 Adjunct Faculty, Division of Population Health Sciences, University of Alaska Anchorage July 9, 2020  UA is an AA/EO employer and educational institution and prohibits illegal discrimination against any individual: www.alaska.edu/nondiscrimination www.uaa.alaska.edu/academics/college-of-health/departments/population-health-sciences  Background and Context The Municipality of Anchorage conducted a total of four surveys related to COVID-19 in May and June 2020; a population-based cell phone survey in early May and three follow-up panel surveys each done two weeks apart online. The respondents on this fourth survey were demographically similar to the first three surveys, and demographically representative of the Anchorage population based on gender, geographic distribution, and race/ethnicity. This is a brief summary of highlights from the fourth survey conducted June 16 -18, 2020, with findings compared to the previous three surveys when appropriate. A detailed report will be created after all surveys have been completed.    The first survey was conducted by phone May 6-10, 2020, the second survey was done online May 20-22, the third survey was done online June 2-4, 2020, and the fourth survey was done online June 16-18, 2020.  In informing our correlational analysis for this fourth survey, we used the Health Belief Model (Champion & Skinner, 2008) as our framework. According to the Health Belief Model, behaviors that promote health or increase risk are a function of four constructs; perceived threat of the disease (i.e. how serious someone rates COVID-19), perceived susceptibility to the disease (i.e. how worried someone is about becoming infected or transmitting the virus), perceived benefits and barriers to engaging in a behavior (i.e. how much someone believes that wearing a mask reduces transmission), and self-efficacy (i.e. someone’s belief in their capacity to remember to bring a mask or wash their hands).   Limitations Only the population-based cell phone survey results are generalizable to the population of Anchorage. The panel survey respondents were demographically similar to the population-based survey (in terms of gender, education, race/ethnicity, and age), however, the opinions of the panelists do not necessarily represent the Anchorage population as a whole.       July 9, 2020  UA is an AA/EO employer and educational institution and prohibits illegal discrimination against any individual: www.alaska.edu/nondiscrimination www.uaa.alaska.edu/academics/college-of-health/departments/population-health-sciences  Google analytics mobility data9 indicates that residents of Anchorage have become more mobile over the past month, although are still below pre-COVID-19 mobility levels for workplaces and transit stations:                                                                    9 https://www.gstatic.com/covid19/mobility/2020-07-03_US_Alaska_Mobility_Report_en.pdf July 9, 2020  UA is an AA/EO employer and educational institution and prohibits illegal discrimination against any individual: www.alaska.edu/nondiscrimination www.uaa.alaska.edu/academics/college-of-health/departments/population-health-sciences  Results PHYSICAL DISTANCING Physical distancing has generally decreased since the first survey, done May 6-10.       Most respondents (53%) did not have physical contact with people not in their household. This is a decline from 84% of those surveyed May 6-10, 65% surveyed May 20-22, and 64% surveyed June 2-4.      Most (68%) said that no one visited their home the day before the survey; however, this percentage has decreased over time; 81% of respondents to the first survey did not have a visitor, 77% on the second survey, and 76% on the third survey.    About a quarter (24%) of respondents said they stayed at least six feet away from people not in their household. This percentage remains low; 36% on the first survey, 25% on the second survey, 13% on the third survey.  *Question asked on the third and fourth survey   When people left their homes the day before the survey, their most frequent destination was a walk of physical exercise near their homes (54%), followed by visiting grocery stores (46%) and going to work (50%). About 25% visited friends and 19% went to a bar.  July 9, 2020  UA is an AA/EO employer and educational institution and prohibits illegal discrimination against any individual: www.alaska.edu/nondiscrimination www.uaa.alaska.edu/academics/college-of-health/departments/population-health-sciences  HYGIENE     Most (72%) wore a mask all or most of the time outside their home, similar to the previous three surveys (68% first survey; 65% second survey; and 69% third survey).       Most (64%) supported a government mandate to wear a mask, either now or later.  Most (81%) touched things outside their home that may have recently been touched by others not from their household  Most (62%) washed or sanitized their hands every time or most of the time when they touched things that may have recently been touched by others.  PERCEIVED BENEFITS OF WEARING A MASK  Most (74%) said that wearing a mask was necessary even if they were not sick.   Most (71%) believed that wearing a mask reduced others’ risk of getting COVID-19.  47% believed that wearing a mask reduced their risk of getting COVID-19.   PERCEIVED BARRIERS TO WEARING A MASK  Most (61%) strongly agreed/agreed that they found it hard to breathe with a mask on.   Most (52%) strongly agreed/agreed that wearing a mask was inconvenient.   54% forgot to bring their mask when they went out.    PERCEIVED THREAT OF COVID-19   Most (59%) felt that COVID-19 was a serious threat to public health in Alaska, compared with 57% on the first survey, 48% on the second survey, and 62% on the third survey.    Most (60%) felt that COVID-19 was a serious threat to public health in Anchorage, compared with 58% on the first survey, 48% on the second survey, and 61% on the third survey.    PERCEIVED SUSCEPTIBILITY TO COVID-19  44% were worried/very worried about themselves or members of their households being infected by COVID-19.  46% were worried/very worried about their friends or family members being infected by COVID-19.  36% were worried/very worried about spreading COVID-19 to others.     July 9, 2020  UA is an AA/EO employer and educational institution and prohibits illegal discrimination against any individual: www.alaska.edu/nondiscrimination www.uaa.alaska.edu/academics/college-of-health/departments/population-health-sciences  ACTIVITY COMFORT LEVEL   These questions were not asked on the first survey. Most panel respondents were not comfortable returning to at least some activities that had been previously limited, although a lower percentage were uncomfortable than on previous surveys:   68% were not comfortable going to a bar (compared with 74% on the second survey and 76% on the third).  66% were not comfortable shaking someone’s hand (compared with 73% on the second survey and 74% on the third).  64% were not comfortable going to the movies (compared with 67% on the second survey and 70% on the third).  64% were not comfortable exercising at an athletic club (compared with 63% on the second survey and 71% on the third).  62% were not comfortable sending their children to school (compared with 70% on the third survey, where it was asked for the first time).  60% were not comfortable going to a religious service (compared with 60% on the second survey and 66% on the third).  57% were not comfortable going to dinner at a restaurant (compared with 56% on the second survey and 59% on the third).  53% were not comfortable having a business meeting around a conference table (compared with 54% on the second survey and 56% on the third).  47% were not comfortable going to work in an office environment (compared with 45% on the second survey and 48% on the third).  42% were not comfortable going into a grocery or hardware store (compared with 43% on the second survey and 43% on the third). July 9, 2020  UA is an AA/EO employer and educational institution and prohibits illegal discrimination against any individual: www.alaska.edu/nondiscrimination www.uaa.alaska.edu/academics/college-of-health/departments/population-health-sciences  MENTAL HEALTH Worry was generally low among Anchorage residents:  Most (93%) were not worried or slightly worried about transportation, as compared with 88% on the first survey, 91% on the second survey, and 89% on the third survey.   Most (93%) were not worried or slightly worried about not having enough to eat, as compared with 90% on the first survey, 94% on the second survey, and 95% on the third survey.   Most (79%) were not worried or slightly worried about their finances due to COVID-19, as compared with 68% on the first survey, 74% on the second survey, and 80% on the third survey.  Most (78%) were not worried or slightly worried, about losing employment due to COVID-19, as compared with 74% on the first survey, 80% on the second survey, and 82% on the third survey.  Most (75%) were not worried or slightly worried about not being able to connect with family and friends, as compared with 68% on the first survey, 74% on the second survey, and 76% on the third survey. Household morale remained high and stress remained low among Anchorage respondents:   Most (75%) felt their household morale was good or very good, compared with 90% on the first survey, 85% on the second survey, and 70% on the third survey.  Over half (58%) reported having low or moderate stress in their household, compared to 70% on the first survey, 69% on the second survey, and 62% on the third survey.  SELF-EFFICACY OF WEARING MASKS AND CLEANING HANDS   46% did not forget to bring their mask when they went out.  Most (62%) washed or sanitized their hands when they touched things that others outside their household might have touched  PERCEPTION OF THE MUNICIPALITY’S RESPONSE   About 44% felt that Anchorage was opening up at the right pace, while 38% felt that Anchorage was opening up too quickly and 18% felt it wasn’t opening up quickly enough.  Most (75%) ranked the MOA’s response to COVID-19 as good to very good. This was a decrease from the first (88%), second (82%), and third (76%) surveys.  Most (75%) felt that MOA’s policies were clear/very clear. This was a decrease from the second (84%) and third (76%) surveys.  Most (68%) felt they were somewhat knowledgeable about the MOA’s emergency orders and changes related to COVID-19. The percent feeling somewhat or very knowledgeable was 91% on this survey, as compared with 92% on the second survey and 88% on the third.  Most (65%) felt they were somewhat knowledgeable about the State of Alaska’s mandates and changes related to COVID-19, with 30% very knowledgeable and 5% not knowledgeable. The percent feeling somewhat or very knowledgeable was 95% on this survey, as compared with 96% on the second survey and 93% on the third.  July 9, 2020  UA is an AA/EO employer and educational institution and prohibits illegal discrimination against any individual: www.alaska.edu/nondiscrimination www.uaa.alaska.edu/academics/college-of-health/departments/population-health-sciences  COVID-19 RELATED RISK BEHAVIORS  COVID-related risk behaviors included: (1) having a visitor at home; (2) having physical contact with someone; (3) getting within six feet of someone who didn’t live in their household; (4) touching things outside the home that may have been recently touched by others; and (5) not wearing a mask all or most of the time when outside the home. Respondents were given one “point” for each of the risk behaviors that they reported.   60% of respondents had 3 to 5 risk behaviors, an increase when compared with 30% of respondents on the first survey; 47% on the second survey; and 50% on the third survey.  Factors independently associated with increased COVID-19 related risk behaviors included respondents who:  o Had less than a college degree o Were younger (<45 years) o Had lower perceived threat to COVID-19 o Were less likely to bring a mask when they went out o Were less likely to wash or sanitize hands when touching things touched by others.   Factors independently associated with lower perceived threat to COVID-19 included respondents who:  o Were younger (<45 years) o Had more people in their households o Had children o Identified as Republican o Identified as “other” or no political party affiliation o Had low levels of perceived susceptibility to COVID-19.  Recommendations  Among respondents, perceived susceptibility to COVID-19 remained low. However, the majority of respondents engaged in COVID-19 mitigation behaviors. Most respondents also reported wearing masks and understanding the benefit of masks to protect others.   Messaging and communication strategies could continue to focus on personal responsibility to reduce risk and how personal responsibility translates into societal responsibility and benefit. The data continues to show the need for targeted messaging among groups engaging in COVID-19 related risk behaviors. Messaging among these groups could take into account affinity bias in order to increase receptiveness to messages. Integrated communication plans could try to involve key stakeholders such as the Anchorage School District, the University of Alaska Anchorage, Alaska Pacific University, etc. in order to reach targeted audiences engaging in risky COVID-19 behaviors. Other considerations for messaging and communications strategies could include:  Rhetorical framing of COVID-19 as the common enemy/opponent/opposition, not each other.  Use of affinity in-group members, symbols, strong visual imagery and rhetoric to reach target audiences.  Use of understated emotional appeals to combat message fatigue and help with audience message retention.  Use of context for masks as part of behavioral scripting and integrated prevention strategy, rather than as a standalone preventative measure. o Dr. Tom Friedman 3Ws: wear a mask, watch your distance, wash your hands  o Other examples: Seat belt + airbag + speed limit  Use of SPACE behavioral scripting to reinforce COVID-19 mitigation strategies.  Use of past successful public health campaigns/strategies/interventions to connect current strategies with successful outcomes now considered the norm.   As the Municipality of Anchorage develops and implements its communication strategies, it is recommended that evaluation be conducted to assess effectiveness and to adjust messaging, if necessary. Finally, given the limitations of panel surveys in generalizing to the Anchorage population, it is highly recommended that the MOA considers conducting another population-based survey. 

COVID-19 Survey in the Municipality of Anchorage, June 16-18: Highlights

https://scholarworks.alaska.edu/bitstream/11122/12949/1/20200709_UAA_COVID19_Survey_4.pdf

COVID-19 Survey in the Municipality of Anchorage, June 16-18: Highlights

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