title: Understanding QR Code Check-in and Compliance Behaviour in the COVID-19 Pandemic
Creators: name: Mac, Nhung T
Publisher: name: Griffith University
Year: 2024
Subjects: subject: COVID-19 pandemic
subject: compliance behaviour
subject: QR code check-in

description: Compliance behaviours, such as the attitudes and actions adopted to adhere to rules and regulations prescribed by government and health authorities, are critical across various sectors due to their essential role in addressing contemporary societal challenges and ensuring the proper functioning of systems and institutions. Previous observations have highlighted that compliance behaviours are fundamental in advancing public health objectives and reducing the transmission of communicable diseases. During pandemics, various compliance measures have been implemented to mitigate severe impacts, underscoring the importance of understanding compliance behaviours in such scenarios. In response to the COVID-19 pandemic, Australia implemented a range of compliance measures to prevent the spread of the virus, including a novel track and trace system of QR code check-ins. Despite evidence to support the use of track and trace strategies in the prevention of infection, research on the drivers to comply with such measures, like the QR code check-in system, is limited. Gaining this understanding is important given QR code check-in compliance significantly contributed to contact tracing efforts and the safety of the community during the COVID-19 pandemic, and that findings can also inform future pandemic preparedness. Thus, this PhD research program employed a mixed methods approach to identify and examine the beliefs and determinants of QR code check-in compliance behaviours as well as environmental scan methodology to systematically review online material within Australian Government communications regarding the target behaviour. This PhD research program consisted of three distinct stages: Stage 1 first qualitatively identified beliefs about QR code check-in compliance behaviour during the COVID-19 pandemic, and then quantitatively assessed these beliefs. Stage 2 quantitatively identified the determinants of QR code check-in compliance behaviour using an integrated social cognition model. Stage 3 involved an environmental scan of Australian Government strategies to inform future communication campaigns on compliance behaviours. As a thesis with publication, the findings of this research program are reported in three papers, each corresponding to one of the distinct stages of investigation that guided this research. Stage 1 of the PhD research program comprised a qualitative and quantitative investigation. An elicitation study using open-ended questions (Queensland; N = 93, Mage = 4.77 years, SD = 13.62 and Victoria; N = 76, Mage = 44.92 years, SD = 11.63) and a prospective correlational study using a two-wave online survey (Queensland; N = 290, Mage = 38.99, 46.6% female and Victoria; N = 290, Mage = 38.27, 53.4% female) were conducted. Paper 1 in Stage 1 aimed to identify the salient beliefs people hold toward complying with the QR code check-in using a Theory of Planned Behaviour (TPB) belief-based framework. Qualitative data was coded through an iterative content analysis, while quantitative data was analysed using linear multiple regression. Behavioural, normative, and control beliefs were associated with intention and behaviour in both samples. Variation in beliefs across the states also were observed. Across both samples, beliefs in positive outcomes consistently exhibited stronger associations with both intention and behaviour than the reported negative outcomes. Distinct differences emerged between the two samples in terms of regression effects. Findings in Paper 1 indicate individual experience may affect the beliefs which guide behaviour, supporting the potential efficacy of health promotion campaigns tapping into context specific beliefs and experiences if QR code check-in is to be implemented as an infection control measure in future. Stage 2 of the PhD research program comprised a quantitative examination to inform future behavioural interventions and pandemic preparedness in which Paper 2 aimed to identify the determinants of QR code check-in compliance intention and behaviour among individuals in the context of COVID-19 using an integrated social cognition model. Moral norm, anticipated regret, and habit were integrated with the TPB to predict QR code check-in compliance behaviour during the COVID-19 pandemic. Australian residents from Victoria (n=181) and Queensland (n=162) recruited from a panel company completed online measures of TPB constructs, moral norm, anticipated regret, and habit with respect to QR code check-in compliance behaviour, with prospective measures of habit and behaviour recorded two weeks later. Data in Paper 2 were analysed as a PLS-SEM model. In both samples, habit and intention predicted behaviour, while perceived behavioural control did not. Findings from Paper 2 of Stage 2 indicated that intention was predicted by baseline habit, attitude, subjective norm, and moral norm in the Victorian sample, while only baseline habit and moral norm predicted intention in the Queensland sample. Perceived behavioural control and anticipated regret did not predict intention in either sample. Paper 2 provides a first test of the determinants of QR code check-in compliance behaviour, indicating strong effects of norms and habit, but also highlighting potential differences in effects as a potential result of the varied experiences with the COVID-19 pandemic in each of the two Australian states. Stage 3 of the PhD research program acknowledged that compliance with COVID-19 preventive behaviours together with the urgency to contain the virus underscored the need for rapid yet effective public health massaging. While messages aimed to inform and protect the public, the evolving situation often precluded the use of theoretically-based and empirically-informed approaches. Paper 3 of Stage 3 aimed to assess the presence and prevalence of belief-based constructs and strategies known to foster behaviour change embedded within Australian Government communications regarding QR code check-in compliance behaviour during the COVID-19 pandemic using the TPB as a guiding framework. Six belief codes and five behaviour change techniques were identified in 17 communication messages. Findings from Paper 3 of Stage 3 highlight the use of potentially effective strategies in the messages to change behaviour; for example, drawing on attitudinal and self-efficacy beliefs. Yet, results identified gaps, such as a lack of strategies to highlight normative influences and build habits that can inform future messaging and pandemic preparedness. Overall, the findings from this PhD program of research make an important contribution to the compliance behaviour literature by exploring determinants of QR code check-in compliance behaviour in the COVID-19 pandemic and proposing recommendations for future communication campaigns. Multiple research methodologies and an integrated theoretical approach were applied for a nuanced understanding of the thesis topic. Although this thesis and the studies within are not without limitations, this PhD program of research contributes to empirical knowledge by providing insights into the determinants of QR code check-in compliance which can inform future messaging for compliance behaviours and pandemic preparedness.