{"paper_id":"2a4eadeb-e70f-473f-a9b7-f28ab8eb2d68","body_text":"Assessment of the Effects of COVID-19 Prevention Interventions on Safe Behaviour Change among Boda-Boda Cyclists in Lira City, Northern Uganda: A Cross-Sectional Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Assessment of the Effects of COVID-19 Prevention Interventions on Safe Behaviour Change among Boda-Boda Cyclists in Lira City, Northern Uganda: A Cross-Sectional Study Rithwan Kalinaki, John Charles Okiria This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9219581/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 10 You are reading this latest preprint version Abstract Background The COVID-19 pandemic led governments worldwide to implement several public health interventions aimed at reducing transmission of the virus. In Uganda, preventive measures such as mask wearing, hand hygiene, social distancing, and public sensitization were implemented to mitigate the spread of the disease. Boda-boda cyclists represent a high-risk population due to their frequent interactions with passengers and mobility within urban environments. However, little empirical evidence exists regarding how these interventions influenced safe behavioural practices among informal transport operators. This study assessed the effects of COVID-19 prevention interventions on safe behaviour change among boda-boda cyclists in Lira City, Northern Uganda. Methods A cross-sectional study design employing mixed methods was conducted among boda-boda cyclists in Lira City. A sample of 366 respondents was selected from an estimated population of 4,325 riders using simple random sampling. Data were collected using structured questionnaires and key informant interviews. Quantitative data were analyzed using descriptive statistics, chi-square tests, and logistic regression to determine associations between COVID-19 interventions and safe behaviour change. Qualitative data were analyzed thematically to complement quantitative findings. Results The findings indicated that COVID-19 prevention interventions positively influenced safe behaviour change among boda-boda cyclists. High levels of adherence were observed in practices such as avoiding crowded places, wearing face masks, and practicing hand hygiene. However, inconsistent compliance was noted in proper mask usage and access to protective equipment due to affordability constraints. Social and economic factors, including reduced income during lockdowns and inconsistent enforcement of standard operating procedures, also influenced adherence to COVID-19 preventive measures. Conclusions COVID-19 prevention interventions significantly contributed to safe behavioural practices among boda-boda cyclists in Lira City. However, gaps remain in access to preventive resources, sustained compliance, and enforcement of public health guidelines. Strengthening community sensitization, improving accessibility to preventive materials, and enhancing enforcement mechanisms could further promote safe behaviour among high-risk occupational groups. COVID-19 interventions Safe behaviour change Boda-boda cyclists Non-pharmaceutical interventions Background In 2020, nations around the world implemented various containment strategies to control the spread of COVID-19, the virus responsible for SARS-CoV-2 infection. These measures led to a reported 113 million cases and over 2.5 million deaths globally Atzrodt, C.L., et al. , (2020) and Vitiello, L., et al., ( 2022 ). Containment strategies included practices such as social distancing, travel limitations, health screenings, border closures, and the use of personal protective measures, including masks, hand hygiene, and respiratory etiquette. Studies have shown that these interventions were effective in reducing transmission, preventing fatalities, and lessening strain on healthcare systems Wong, S.-C. et al. , (2022). According to Manikandan N. (2020), key COVID-19 prevention practices like handwashing, mask-wearing, restricted movement, closure of public venues, and social distancing were pivotal in lowering transmission rates in regions such as the European Union, the European Economic Area, and the United Kingdom Waleed Al-Salem, (2021). In the absence of a universally available and effective vaccine, these interventions became essential tools for public health. However, evaluating the impact of these measures is complex, as their economic and psychological costs sometimes bring about debates on balancing benefits against such impacts. There remains no universally accepted answer regarding the ideal timing for easing or intensifying these protective measures, leading to ongoing policy discussions Waleed Al-Salem (2021). While knowledge is a vital component of risk mitigation, it does not always translate into behaviour change. Ahmadi S et al., ( 2022 ) noted that several factors such as the economic implications of preventive actions, household decision- making dynamics, individual beliefs, life expectancy, and the authority issuing guidelines influence adherence to COVID-19 protocols. In settings where protective measures entail significant financial or social costs; individuals may struggle to consistently practice these precautions despite understanding their importance. Research indicates that mobility restrictions were generally less effective in low- and middle-income countries compared to wealthier nations Coetzee, B. J., & Kagee, A. (2020). There was also limited impact on overall transmission rates when time in non-residential locations decreased, which is commonly associated with lockdown measures Musoke D, et al., ( 2023 ). Demographic factors, such as higher proportions of elderly or young people (aged 5–14), showed some protective effects, although these findings were not statistically significant. COVID-19 containment measures have proven essential as first-line defense against SARS- CoV-2, with evidence from past pandemics reinforcing their value. Public discourse has centered on the effectiveness, economic burden, and social impact of these interventions a debate reminiscent of discussions from the 1918–1919 flu pandemic Juneau CE, et al. ( 2022 ). Public perception of these measures plays a crucial role in determining compliance, underscoring the need for community support in implementing robust public health strategies. Acceptance of COVID-19 interventions often varies by region, as shown by studies linking differences in intervention acceptance to cultural factors, such as responses to the severe acute respiratory syndrome (SARS) outbreaks Leung KK (2022). Other research has examined the effectiveness of specific COVID-19 measures, including antibiotics used as preventative treatments in past infectious disease outbreaks, like swine flu and Ebola. A society’s ability to respond to pandemics often depends on individuals adjusting their daily routines. Social media, in particular, can amplify behavior changes or, in some cases, resistances Coccia, M. 92021). Understanding how expectations influence adherence to COVID-19 measures is key: if people doubt the effectiveness of these measures, outreach and education can address this gap Castex G., (2020). However, if adherence challenges stem from perceptions of inconvenience or excessive demands, outreach efforts should focus on addressing these concerns rather than only emphasizing disease control benefits. This study, therefore, sought out to evaluate public attitudes and perceptions of COVID-19 interventions, focusing on self-reported adherence and the relationship between compliance and individual baseline characteristics. Such insights are valuable for public health strategies, as understanding what drives or impedes adherence to COVID-19 measures can lead to better- targeted communication, fostering behavior changes that ultimately support reduced disease transmission. In Uganda, basing on the fact that there is no conformed curative medicine and universal immunization for the infection, a variety of public health measures that are personal, environmental and community-based have been implemented to delay, reduce and mitigate local transmission of the infection hence reducing morbidity and mortality from the disease WHO (2020), (MoH, 2023), and Perez Kirya and Ismael Kawooya (2022). Boda-boda cyclists are a population at risk of contracting and transmitting the COVID-19 infection due to the close proximity between the riders and passengers. Given this risk of exposure, strict compliance to the COVID-19 interventions like wearing an element with mask, physical distancing as well as public sensitization using media and many more is encouraged (MoH, 2021). A significant reduction of COVID-19 cases and deaths with such interventions has been realised. However, the effectiveness of the COVID-19 intervention limited their contribution to people's behaviour over time. During the COVID-19 Pandemic in Uganda Boda-Boda riders were the primary mode of transport, delivering goods, patients, and essential services (Kaggwa Margaret, 2025). Thus, there is a daily exposure to potential infected clients. Not addressing the risky practices and behaviours including proximity between the Bodaboda rider, and or cyclist may lead to exposure, new infections or re-infection with the COVID-19 pandemic. Thus, this study was set out to assess effects of COVID-19 prevention interventions on safe behaviour change among Boda-Boda Cyclists in Lira City, Lira district, Uganda. Methods Study setting and design This study was conducted in Lira City in Northern Uganda, a rapidly urbanizing area characterized by extensive informal transport operations. Boda-boda transport serves as a major means of mobility for residents and plays an important role in local economic activities. The study employed a cross-sectional design integrating both quantitative and qualitative methods. The design enabled the researcher to examine the relationship between COVID-19 prevention interventions and safe behavioural practices among boda-boda cyclists at a specific point in time. Sample size and sampling procedure The sample size for the study was determined using the Yamane formula at a 95% confidence level and a margin of error of 5%. Based on an estimated population of 4,325 boda-boda cyclists operating in Lira City, the calculated sample size was 366 respondents. A simple random sampling technique was used to select participants from boda-boda stages across Lira City. In addition, key informants including stage managers and representatives of boda-boda associations were purposively selected to provide qualitative insights regarding the implementation and effectiveness of COVID-19 prevention interventions. Data collection and quality control measures The structured questionnaire and key informant interview guide used in this study were developed specifically for this study based on the study objectives, a review of relevant literature on COVID-19 preventive behaviors, and the Ugandan Ministry of Health COVID-19 standard operating procedures. The tools have not previously been published elsewhere. An English-language version of the questionnaire and interview guide has been prepared and uploaded as a supplementary file, and it has been cited in the main manuscript as Supplementary Material. Measurements The main outcome variable in this study was safe behaviour change among boda-boda cyclists. This included adherence to preventive practices such as wearing face masks, practicing hand hygiene, avoiding crowded areas, and complying with COVID-19 standard operating procedures. Independent variables included personal interventions (mask use, hand hygiene, use of sanitizers), community interventions (public sensitization, social distancing measures, travel restrictions), and environmental interventions (availability of hygiene facilities, regular cleaning of surfaces, and disinfection practices). Data analysis Quantitative data were analyzed using statistical software to generate descriptive statistics such as frequencies and percentages. Bivariate analysis using chi-square tests was conducted to determine associations between independent variables and safe behaviour change. Multivariate logistic regression analysis was performed to identify independent predictors of safe behaviour change among boda-boda cyclists. Results were presented using adjusted odds ratios (AORs) and 95% confidence intervals. Qualitative data obtained from key informant interviews were analyzed using thematic analysis to complement and explain quantitative findings. Results The findings in table.1 indicate that the majority of boda-boda cyclists 253 (69%) resided in Lira city, with males dominating the industry 357(97.5%) The low representation of female boda-boda riders 9 (2.5%) may be attributed to cultural norms, societal perceptions, safety concerns, or economic barriers that discourage women from engaging in the boda boda sector. Majority of the respondents belonged to the age group of 20–29 years 170(46%), followed by 30–39 years 140(38%), highlighting that the industry is mainly comprised of young and middle- aged individuals, likely due to the physical demands and mobility requirements of the job. In terms of marital status, 104(28.4%) were married, followed by cohabiting individuals 99(27.0%), suggesting that many boda-boda cyclists have family responsibilities. Education levels among boda-boda riders show that most have attained primary 108(29.5%) followed closely by 106(29%) who had reached secondary school, with only 66(18%) having tertiary education. This suggests that the industry mainly attracts individuals with basic to moderate education. Religious distribution shows that the majority of respondents 94(25.7%) were Catholics, followed by 22.1% who were Protestants. Additionally, 20% of respondents identified as Born- Again Christians, 65(18%) were Muslims, and 52(14%) belonged to other religious groups. This distribution suggests that Christianity is the dominant religion among boda boda cyclists in Lira city. The presence of Muslims and other religious groups highlights some level of religious diversity within the boda boda community Regarding work experience, Majority of 146(39.9%) respondents were in the boda-boda business for 1 to 5 years, making them the largest group followed by 131(35.8%) had been in the business for over five years, with minority of 89(24.3%) had been operating for less than a year. These results suggest that the majority of boda-boda riders had considerable experience (over a year) in the industry. Table 2 Multivariate: Nominal Regression Variables Likelihood Ratio Tests Chi-Square df Sig. Age group .000 0 . Marital_ status . 2 . Education level . 2 . Religion . 2 . Correct steps for hand washing with soap .000 0 . Covid19_infection_history .000 0 . Owning of facial mask and handwashing facility .000 1 1.000 Type of facial mask used . 1 . Mask wearing Frequency . 1 . Avoiding crowds .000 4 1.000 Limiting time outside . 2 . Avoiding physical activity outside . 1 . Avoidance of physical contact . 2 . Selfisolation_when_having_covid19_symptoms .000 2 1.000 Social distancing compliance .000 1 1.000 Respondents aware of self-protection measures . 1 . Use of soap & sanitizer . 1 . Perceived risk of infection . 1 . Availability of hand washing facility .000 2 1.000 Effectiveness of covid19 prevention measures 11.748 2 0.003**** Sanitization_ of_ surfaces .000 4 1.000 Hand washing frequency . 1 . Efforts to improve environmental hygiene . 2 . Challenges_ Implementing environmental hygiene measures .000 0 . Handwashing with soap .000 3 1.000 Access to facial mask liquid soap sanitizer . 2 . Importance of facial mask wearing .000 0 . Belief_in_mask_wearing_for_covid19_protection . 1 . Belief in handwashing with soap . 4 . Cost barrier for mask wearing or handwashing . 4 . Correct procedures for wearing mask 1.896 1 .169 Coughing and sneezing in tissue .000 0 . . 1 . The likelihood ratio tests assess the significance of different independent variables in predicting behaviour change due to COVID-19 interventions among boda-boda cyclists. The key variables analyzed include socio-demographics, behavioural interventions, and perceptions towards COVIDu-19 preventive measures. Effectiveness of COVID-19 prevention measures (χ² = 11.748, df = 2, p = 0.003). This variable was the only one showing a strong statistically significant relationship, indicating that the perceived effectiveness of COVID-19 interventions had a major impact on behaviour change. Respondents who believed that the measures were effective were more likely to adopt safe practices like handwashing and mask-wearing. Correct procedures for wearing a mask (χ² = 1.896, df = 1, p = 0.169). This variable shows a weak relationship with behaviour change, meaning that some respondents might have known the correct way to wear a mask but did not consistently follow the guidelines. This could be due to discomfort, misinformation, or enforcement issues. Insights from Key Informant Interviews To supplement the survey data, key informant interviews were conducted with boda-boda association leaders, health officials, and local government representatives. Their insights provided further depth to the study findings: COVID-19 trends among boda-boda riders in lira city. Key informants provided insights into the state of COVID-19 among boda-boda riders in Lira city in 2025: Infections in the Community: Reports indicate a significant decline in COVID-19 infection rates compared to the peak years of 2020–2022. However, sporadic cases continue to emerge, particularly among individuals who travel frequently. COVID-19 Related Deaths: The mortality rate among boda-boda riders has significantly reduced, attributed to increased immunity, improved healthcare access, and widespread vaccination efforts. Community Perceptions: Many boda-boda riders and community members now perceive COVID-19 as a manageable condition rather than a severe threat. However, a degree of complacency has developed, leading to reduced adherence to preventive measures such as mask-wearing and hand hygiene. Key informants emphasized that while the acute phase of the pandemic has passed, continued public health education and surveillance are essential to prevent potential resurgences. Boda-boda associations and local authorities should maintain minimum safety standards to protect riders and passengers from future outbreaks. Adherence to COVID-19 Prevention Measures Interviews with key informants revealed the following trends regarding adherence to COVID- 19 preventive measures: Face Mask Use: Boda-boda riders expressed mixed feelings about wearing masks. Some cited discomfort and difficulty breathing, while others felt that masks made them appear unapproachable to customers, leading to inconsistent use. Social Distancing: While riders understood the importance of social distancing, they found it impractical given the nature of their work, which involves close contact with passengers. Cleaning of Surfaces: Some boda-boda riders reported wiping their motorcycles regularly, but many lacked the resources to do so consistently. Hand Hygiene: While handwashing was widely acknowledged as important, access to soap and water at boda-boda stages remained a challenge. Key informants noted that boda-boda riders prioritized economic survival over strict adherence to COVID-19 preventive measures. They suggested interventions such as providing free masks, installing permanent handwashing stations at boda-boda stages, and enforcing safety guidelines to improve compliance. Changes in Adherence to COVID-19 Prevention Measures Over Time Key informants highlighted a decline in adherence to COVID-19 preventive measures over time: Decline in Face Mask Use: At the onset of the pandemic, boda-boda riders complied with mask mandates due to enforcement measures and penalties. However, compliance dropped significantly due to discomfort, economic hardship, and reduced enforcement. Reduced Social Distancing: Social distancing was more strictly observed in the early stages when government-imposed restrictions were in place. However, as restrictions eased, adherence significantly declined as riders prioritized maximizing their earnings. Declining Hand Hygiene: Initially, riders frequently washed their hands and used sanitizers, especially when sanitization materials were provided for free. However, over time, many abandoned this practice due to cost constraints and reduced fear of the virus. Decreased Cleaning of Surfaces: Many boda-boda riders regularly disinfected their motorcycles at the height of the pandemic due to heightened public health awareness. However, this practice declined as the urgency of the pandemic faded. Key informants attributed this decline in compliance to relaxed government policies, financial struggles, and general pandemic fatigue. They emphasized the need for continuous sensitization and reinforcement of preventive behaviors to sustain long-term public health benefits. Government Support in the Fight Against COVID-19 Key informants outlined various ways in which the government supported the boda-boda community during the COVID-19 pandemic: Provision of Face Masks and Sanitizers: At the height of the pandemic, the government distributed free face masks and hand sanitizers to boda-boda riders. However, this support declined over time, affecting consistent usage. Implementation of Standard Operating Procedures (SOPs): The government imposed and enforced SOPs that required boda-boda riders to wear masks, sanitize their hands, and practice social distancing while carrying passengers. Curfew Regulations and Movement Restrictions: To reduce movement and limit virus spread, the government introduced curfew measures, although these restrictions significantly impacted boda-boda riders' income. Public Sensitization Campaigns: The government, in collaboration with local leaders and the Ministry of Health, launched awareness campaigns to educate boda-boda riders on COVID-19 risks and preventive measures. Financial Relief Programs: Some boda-boda associations reported that their members received government cash relief and food supplies during lockdowns to mitigate economic hardships. Despite these efforts, key informants pointed out several challenges, including inconsistent enforcement of SOPs, a lack of sustained financial assistance, and the declining provision of essential protective equipment over time. They emphasized the need for continued government involvement to sustain compliance and promote public health safety. Effects Of Strict Covid-19 SOPs Enforcement on The Boda-Boda Business. Key informants provided insights into how the strict enforcement of COVID-19 OPs impacted the boda-boda business: Reduced Operating Hours: The implementation of curfews limited the time boda-boda riders could operate, significantly reducing their daily earnings. Decreased Customer Demand: Due to movement restrictions and fears of contracting COVID-19, many customers avoided using boda-bodas, opting for private transportation or staying at home. Increased Operational Costs: Riders had to spend extra money on face masks, sanitizers, and cleaning supplies to comply with health regulations, adding to their financial burden. Arrests and Fines: Some boda-boda riders were arrested or fined for failing to comply with SOPs, further straining their income and operations. Economic Hardship: Many boda-boda riders struggled to meet financial obligations such as rent and feeding their families, leading to an increase in loan defaults and reliance on government or community aid. Non-Compliance Due to Financial Pressure: Some riders deliberately ignored SOPs, such as carrying more than one passenger, to compensate for reduced income, leading to clashes with law enforcement. Key informants acknowledged that while SOP enforcement was necessary to curb COVID-19, it had severe economic implications for boda-boda riders. They recommended that future interventions include financial support, fewer operational restrictions, and sustained public sensitization to balance public health safety with economic survival. Community Awareness-Raising Interventions Key informant interviews provided insights into the various community awareness-raising interventions implemented among boda-boda riders: Mass Media Campaigns: The government and health agencies used radio, television, and social media platforms to educate boda-boda riders on COVID-19 prevention measures. Direct Information Sharing and Messaging: Health workers and boda-boda association leaders disseminated information through pamphlets, posters, and word-of-mouth campaigns. Home Visits: Community health workers visited boda-boda stages and riders' residences to provide COVID-19 education. Courtyard Meetings: Small group meetings at boda-boda stages allowed discussions on COVID-19 risks and preventive measures. Community Meetings: Local leaders and health officials conducted larger meetings to sensitize boda-boda riders on SOP adherence. Key informants emphasized that while awareness campaigns improved boda-boda riders' knowledge about COVID-19, sustained behaviour change was often hindered by economic pressures, misinformation, and social influences. They recommended continuous engagement and localized awareness-raising strategies to reinforce public health measures and ensure long-term adherence. Discussion The study found that most respondents (69.1%) lived in Lira City, and the boda-boda sector was largely male-dominated (97.5%). The most common age group was 20–29 years (46.4%), and many riders had primary (29.5%) or secondary education (29.0%). Marital status and religion also influenced compliance with COVID-19 preventive measures. Bivariate analysis showed a significant link between age and behaviour change (p = 0.0001), suggesting that younger riders were more likely to follow COVID-19 precautions. This supports research by Koh et al. ( 2020 ), which found that younger individuals were more compliant due to their higher exposure to health information, particularly through digital platforms. Findings from this study revealed that Community-based interventions such as public awareness campaigns, travel restrictions, and social distancing played a significant role in influencing boda-boda cyclists' behaviour. The study found that 72% of respondents practiced social distancing, while 63% actively engaged in community awareness programs. These findings align with studies by Deb et al. ( 2020 ) and Cowling et al. ( 2020 ), which show that public sensitization efforts reduce infection rates. However, economic hardships and inconsistent enforcement limited full compliance. Similar challenges were identified by Garcia & Duarte ( 2020 ), indicating the need for tailored interventions that address both health and financial concerns. Environmental measures, including handwashing stations and surface sanitization, were examined. The study found that 68% of respondents had access to handwashing facilities, but only 49% used them regularly. Similarly, 54% reported routine sanitization of surfaces. These findings support research by Cheng et al. (2020) and Rutala & Weber ( 2019 ), which emphasize the importance of environmental hygiene in reducing disease transmission. However, disparities in access to hygiene facilities and weak enforcement of sanitation protocols suggest the need for stronger policy implementation in informal transport settings Personal interventions such as wearing masks, handwashing, and self-isolation showed varying levels of adherence. While 78% of respondents owned face masks, only 52% wore them consistently. Handwashing compliance stood at 61%, with cost cited as a major barrier. These findings align with studies by Li et al. (2020) and Brainard et al. ( 2020 ), which show that affordability and accessibility influence adherence to safety measures. The Theory of Planned Behaviour (TPB) states that compliance is influenced by personal attitudes and perceived ease of behaviour change (Kitsanapun & Yamarat, 2019 ). In this study, financial constraints limited adherence, highlighting the need for subsidised hygiene resources. Abbreviations COVID-19 Coronavirus Disease 2019 NPIs Non-Pharmaceutical Interventions WHO World Health Organization MoH Ministry of Health VHTs Village Health Teams Declarations Acknowledgements The authors would like to acknowledge the management of Clarke International University for their academic support. Appreciation is also extended to the Lira City authorities, boda-boda association leaders, and all study participants who contributed valuable information during the study. Authors’ Contributions Kalinaki Rithwan conceptualized and designed the study and conducted data collection and analysis. Prof. John Charles Okiria provided overall technical supervision and research guidance throughout the study process. Both authors contributed to the development and finalization of the manuscript. Funding This study did not receive any external funding and was self-funded by the researcher. Availability of Data and Materials The dataset generated and analyzed during this study is available from the corresponding author upon reasonable request. Ethics approval and consent to participate Ethical approval to conduct this study was obtained from the Clarke International University Research Ethics Committee (CIUREC). The study was conducted in accordance with the ethical principles of the Declaration of Helsinki. Administrative clearance was obtained from Lira City authorities and boda‑boda association leaders. Participation was voluntary, and written informed consent was obtained from all participants prior to data collection. Confidentiality and anonymity of participants were maintained throughout the study. Consent for publication Not applicable. Competing interests The authors declare that there are no competing interests regarding the publication of this manuscript. Author details 1 School of Public Health and Management, Clarke International University, Kampala, Uganda. References Ahmed MZ, Ahmed O, Aibao Z, Hanbin S, Siyu L, Ahmad A. Epidemic of COVID-19 in China and associated psychological problems. Asian J Psychiatry. Alimohamadi Y, Naieni KH, Sepandi M, Taghdir M. Effect of social distancing on Covid- 19 incidence and mortality in Iran since February 20 to May 13, 2020: an interrupted time series analysis. Risk Manag Healthc Policy. 2020;13:1695–700. Alimohamadi Y, Taghdir M, Sepandi M. The estimate of the basic reproduction number for novel coronavirus disease (COVID-19): a systematic review and meta-analysis. J Prev Med Public Health. 2020;53(3):151–7. Ammendolia J, Saturno J, Brooks AL, Jacobs S, Jambeck JR. An emerging source of plastic pollution: environmental presence of plastic personal protective equipment (PPE) debris related to COVID-19 in a metropolitan city. Anderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD. Ow will country-based mitigation measures influence the course of the COVID-19 epidemic? Lancet. 2020;391(10228):931–4. Ardusso M, Forero-López AD, Buzzi NS, Spetter CV, Fernández-Severini MD. COVID- 19 pandemic repercussions on plastic and antiviral polymeric textile causing pollution on beaches and coasts of South America. Beiu C, Mihai M, Popa L, Cima L, Popescu MN. Frequent hand washing for COVID- 19 prevention can cause hand dermatitis: management tips. Cureus. 2020;12(4):e7506. Berger DW, Herkenhoff KF, Mongey S. An seir infectious disease model with testing and conditional quarantine. No. w26901. National Bureau of Economic Research; 2020. Brainard JS, Jones N, Lake I, Hooper L, Hunter P. Facemasks and similar barriers to prevent respiratory illness such as COVID-19: a rapid systematic review. medRxiv. 2020. 10.1101/2020.04.01.20049528 . Brotherhood L, Kircher P, Santos C, Tertilt M. An economic model of the COVID-19 epidemic: the importance of testing and age-specific policies. CEPR Discuss. 2020. Carlsson-Szlezak P, Reeves M, Swartz P. Understanding the Economic Shock of Coronavirus. Harv. Bus; 2020. Castex G, Dechter E, Lorca M. Covid-19: the impact of social distancing policies, cross- country analysis. Econ Disaster Clim Chang. 2020. 10.1007/s41885-020-00076-x . Chen X, Ran L, Liu Q, Hu Q, Du X, Tan X, Cheng VCC, Wong S-C, Chen JHK, Yip CCY, Chuang VWM, Tsang. O.T.Y., 2020. Escalating infection control. response to the rapidly evolving epidemiology of the coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong. Infect Control Hosp Epidemiol 41, 493–8. Chin AWH, Chu JTS, Perera MRA, Hui KPY, Yen H-L, Chan. M.C.W., 2020. Stability of SARS. -CoV2 in different environmental conditions. Lancet Microbe S2666524720300033. Cowling B, Ali S, Ng Y, Tsang T, Li J, Fong M, Liao Q, Kwan M, Lee S, Chiu S, Wu J, Wu P, Leung G. Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study. Lancet Public Health. 2020;5(5):E279–88. Deb P, Furceri D, Ostry J, Tawk N. 2020. The Effect of Containment Measures on the COVID- 19 Pandemic. IMF Working Paper WP/20/159, 53–86. Duc Huynh T. The Covid-19 containment in Vietnam: what are we doing? J Glob Health. 2020; 10(1). Eikenberry SE, Mancuso M, Iboi E, Phan T, Eikenberry K, Kuang Y, Gumel AB. , 2020. To mask or not to mask: modeling the potential for face mask use by the general public to curtail the COVID-19 pandemic. Infect Dis Model 5: 293–308. Fang H, Wang L, Yang Y. Human mobility restrictions and the spread of the novel coronavirus (2019-ncov) in China. J Public Econ. 2020;191:104272. Fang H, Wang L, Yang Y. 2020. Human Mobility Restrictions and the Spread of the Novel Coronavirus (2019-nCOV) in China. NBER Working Paper 26906. Garcia LP, Duarte E. Nonpharmaceutical interventions for tackling the COVID-19 epidemic in Brazil. Epidemiol Serv Saúde. 2020;29(2):1–3. Glass RJ, Glass LM, Beyeler WE, Min HJ. Targeted social distancing designs for pandemic influenza. Emerg Infect Dis. 2006;12(1):1671–81. Gourinchas PO. Flattening the Pandemic and Recession Curves. In: Baldwin R, Mauro B, editors. Mitigating the COVID Economic Crisis. Act Fast and Do Whatever; 2020. Hsiang S, Annan-Phan AD, Bell S, Bolliger K, Chong I, Druckenmiller T, Huang H, Hultgren LY, Krasovich A, Lau E. The effect of large-scale anti-contagion policies on the COVID- 19 pandemic. Nature. 2020;584(7820):262–7. Jang WM, Jang DH, Lee JY. (2020) Social distancing and transmission-reducing practices during the 2019 coronavirus disease and 2015 middle east respiratory syndrome coronavirus outbreaks in korea. J Korean Med Sci. Jayaweera M, Perera H, Gunawardana B, Manatunge J. Transmission of COVID- 19 virus by droplets and aerosols: A critical review on the unresolved dichotomy. Environ Res. 2020;188:109819. 10.1016/j.envres.2020.109819 . Jefferson T, Mar D, Dooley CB, Ferroni L, Al-Ansary E, Bawazeer LA, van Driel GA, Nair ML, Jones S, Thorning MA, S.&, Conly JM. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev. 2011;7:CD006207. 10.1002/14651858.CD006207.pub4 . Kissler S, Tedijanto C, Goldstein E, Grad Y, Lipsitch M. Projecting the transmission dynamics of SARS-Cov-2 through the post pandemic period. Science. 2020;368(6493):860–8. Kitsanapun A, Yamarat K. Handwashing determinants and practices among public health students in Thailand. Pakistan J Public Health. 2019;9(2):57–60. Klompas M, Morris CA, Sinclair J, Pearson M, Shenoy ES. Universal masking in hospitals in the COVID-19 era. N Engl J Med. 2020;382:e63. Koh W, Naing L, Wong J. Estimating the impact of physical distancing measures in containing COVID-19: an empirical analysis. Int J Infect Dis. 2020;100:42–9. Koh D. Occupational risks for COVID-19 infection. Occup Med. 2020;70:3–5. Kucharski A, Russell T, Diamond C, Liu Y, Edmunds J, Funk S, Rosalind ME. Early dynamics of transmission and control of Covid-19: a mathematical modelling study. Lancet Infect Dis. 2020;20(5):553–8. Kucharski AJ, Russell TW, Diamond C, Liu Y, Edmunds J, Funk S, et al. Early dynamics of transmission and control of COVID-19: a mathematical modelling study. Lancet Infect Dis. 2020;20(5):553–8. https://doi.org/10.1016/S1473-3099(20)30144-4 . Lai S, Ruktanonchai N, Zhou L, Prosper O, Luo W, Floyd J, Wesolowski A, Santillana M, Zhang C, Du X, Yu H, Tatem A. Effect of non-pharmaceutical interventions to contain Covid- 19 in China. Nature. 2020;585:410–3. Lu H, Nie P, Qian L. 2020. Do Quarantine Experiences and Attitudes Towards COVID-19 Affect the Distribution of Psychological Outcomes in China? A Quantile Regression Analysis (WP512). GLO Discussion Paper. Middleton JD, Lopes H. 2020. Face masks in the COVID-19 crisis: caveats, limits, and priorities. BMJ 369: m2030. Milne GJ, Kelso JK, Kelly HA, Huband ST, McVernon J. A small community model for the transmission of infectious diseases: comparison of school closure as an intervention in individual- based models of an influenza pandemic. PLoS ONE. 2008; 3. Moosa I. The effectiveness of social distancing in containing Covid-19. Appl Econ. 2020;52(58):6292–305. Nkengasong JN, Mankoula W. Looming threat of COVID-19 infection in Africa: act collectively, and fast. Lancet (London England). 2020;395(10227):841–2. OceansAsia. COVID-19 Facemasks & Marine Plastic Pollution [WWW Document]. OceansAsia. 2020. Okuku E, Kiteresi L, Owato G, Otieno K, Mwalugha C, Mbuche M, Gwada B, Nelson A, Chepkemboi P, Achieng Q, Wanjeri V, Ndwiga J, Mulupi L. Omire J. The impacts of. COVID- 19 pandemic. on marine litter pollution along the Kenyan coast: a synthesis after 100 days following the first reported case in Kenya. Mar. Prata JC, Silva ALP, Walker TR, Duarte AC, Rocha-Santos T. COVID-19 pandemic repercussions on the use and management of plastics. Environ Sci Technol. 2020;54:7760–5. 10.1021/acs.est.0c02178 . Prem K, Liu Y, Russell T, Kucharski A, Eggo R, Davies N. The effect of control strategies to reduce social mixing on outcomes of the Covid-19 epidemic in Wuhan, China: a modelling study. Lancet Public Health. 2020;5(5):E261–70. Ramesh N, Siddaiah A, Joseph B. Tackling corona virus disease 2019 (COVID 19) in workplaces. Indian J Occup Environ Med. 2020;24:16. Report of the WHO-China. Joint Mission on Coronavirus Disease 2019 (COVID-19). Geneva: World Health Organization; 2020. Rutala WA, Weber DJ. Best practices for disinfection of noncritical environmental surfaces and equipment in health care facilities: A bundle approach. Am J Infect Control. 2019;47:A96–105. Ryan PG, Maclean K, Weideman EA. The impact of the COVID-19 lockdown on urban street litter in South Africa. Environ. Process. Santarpia JL, Rivera DN, Herrera V, Morwitzer MJ, Creager H, Santarpia GW, Crown KK, Brett-Major D, Schnaubelt E, Broadhurst MJ, Lawler JV. Reid, S. P. Lowe JJ. (2020). Aerosol and Surface Transmission Potential of SARS-CoV‐2. 10.1101/2020.03.23.20039446 Sposato W. Japan’s Half-hearted Coronavirus Measures are Working Anyway. Volume 14. Foreign Policy; 2020. Torres FG, De-la-Torre GE. Face mask waste generation and management during the COVID- 19 pandemic: an overview and the Peruvian case. Sci Total Environ. 2021;786. 10.1016/J.SCITOTENV.2021.147628 . Torres FG, De-La-Torre GE, Gonzales KN, Troncoso OP. Bacterial-polymer-based electrolytes: recent progress and applications. ACS Appl Energy Mater. 2020;3:11500–15. 10.1021/acsaem.0c02195 . Torres FG, Dioses-Salinas DC, Pizarro-Ortega CI, De-la-Torre GE. Sorption of chemical contaminants on degradable and non-degradable microplastics: recent progress and research trends. Sci Total Environ. 2021;757. 10.1016/j.scitotenv.2020.143875 . Tubadji A, Boy F, Webber D. Narrative economics, public policy and mental health. Cent Econ Policy Res. 2020;20:109–31. Tuncer N, Mohanakumar C, Swanson S, Martcheva M. Efficacy of control measures in the control of Ebola, Liberia 2014–2015. J Biol Dyn. 2018;12(1):913–37. Ullah A, Ajala O. Do lockdown and testing help in curbing Covid-19 transmission? Covid Econ. 2020; 13. Wong S, Kwok K, Chan F. What can countries learn from Hong Kong’s response to the COVID- 19 pandemic? Can. Med Assoc J. 2020;192(19):E511–5. World Health Organization. 2020. Advice on the Use of Masks in the Community, during Home Care and in Health Care Settings in the Context of the Novel Coronavirus (2019-nCoV) Outbreak. Ye G, Lin H, Chen L, Wang S, Zeng Z, Wang W et al. 2020. Environmental contamination of the SARS-CoV-2 in healthcare premises: An urgent call for protection for healthcare workers (preprint). Infectious Diseases (except HIV/AIDS). Youth do it. (2019) sensitization: awareness raising. Perez Kirya I, Kawooya. Strategies to control the transmission of SARS-CoV-2 in Schools in Uganda, Feb 2022. A Rapid Response Brief. The Center for Rapid Evidence Synthesis, Makerere University College of Health Sciences. Coccia M. Pandemic Prevention: Lessons from COVID-19. Encyclopedia. 2021;1:433–44. https://doi.org/10.3390/encyclopedia1020036 . Leung KK, Zhang R, Hashim MJ, Fang M, Xu J, Sun D, Li X, Liu Y, Deng H, Zeng D, Lin Z, He P, Zhang Y, Zhu X, Liang D, Xing A, Lee SS, Memish ZA, Jiang G, Khan G. Effectiveness of containment strategies in preventing SARS-CoV-2 transmission. J Infect Public Health. 2022;15(6):609–14. Epub 2022 Apr 29. PMID: 35537237; PMCID: PMC9052634. Juneau CE, Pueyo T, Bell M, Gee G, Collazzo P, Potvin L. Lessons from past pandemics: a systematic review of evidence-based, cost-effective interventions to suppress COVID-19. Syst Rev. 2022;11(1):90. 10.1186/s13643-022-01958-9 . PMID: 35550674; PMCID: PMC9096744. Musoke D, Nalinya S, Lubega GB, Deane K, Ekirapa-Kiracho E, McCoy D. The effects of COVID-19 lockdown measures on health and healthcare services in Uganda. PLOS Glob Public Health. 2023;3(1):e0001494. https://doi.org/10.1371/journal.pgph.0001494 . Coetzee BJ, Kagee A. Structural barriers to adhering to health behaviours in the context of the COVID-19 crisis: Considerations for low- and middle-income countries. Glob Public Health. 2020;15(8):1093–102. https://doi.org/10.1080/17441692.2020.1779331 . Wong S-C et al. (2022) Evolution and Control of COVID-19 Epidemic in Hong Kong. Viruses 2022, 14, 2519. https://doi.org/10.3390/v14112519 Viruses 2022, 14, 2519. https://doi.org/10.3390/v14112519. Atzrodt CL et al. (2020). A Guide to COVID-19: a global pandemic caused by the novel coronavirus SARS-CoV-2. FEBS J, 287: 3633–3650. https://doi.org/10.1111/febs.15375 The FEBS Journal 287 (2020) 3633–3650 ª 2020 Federation of European Biochemical Societies. Vitiello L et al. (2022). Preventive Measures against Pandemics from the Beginning of Civilization to Nowadays—How Everything Has Remained the Same over the Millennia. Journal of Clinical Medicine , 11 (7), 1960. https://doi.org/10.3390/jcm11071960 Manikandan N. Are social distancing, hand washing and wearing masks appropriate measures to mitigate transmission of COVID-19? Vacunas. 2020 Jul-Dec;21(2):136–137. 10.1016/j.vacun.2020.09.001 . Epub 2020 Sep 12. PMID: 32952487; PMCID: PMC7486867. Moraga WA-SP, Ghazi H, Madad S, Peter J, Hotez. The emergence and transmission of COVID-19 in European countries, 2019–2020: a comprehensive review of timelines, cases and containment. Int Health. September 2021;13(5):383–98. https://doi.org/10.1093/inthealth/ihab037 . Ahmadi S, Jorjoran Shushtari Z, Shirazikhah M, et al. Social Determinants of Adherence to COVID-19 Preventive Guidelines in Iran: A Qualitative Study. INQUIRY: J Health Care Organ Provis Financing. 2022;59. 10.1177/00469580221084185 . Table 1 Table 1 is available in the Supplementary Files section. Additional Declarations No competing interests reported. Supplementary Files questionaire.pdf Table1.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 17 May, 2026 Reviews received at journal 15 May, 2026 Reviewers agreed at journal 28 Apr, 2026 Reviewers agreed at journal 23 Apr, 2026 Reviewers agreed at journal 23 Apr, 2026 Reviewers invited by journal 21 Apr, 2026 Editor assigned by journal 20 Apr, 2026 Editor invited by journal 30 Mar, 2026 Submission checks completed at journal 30 Mar, 2026 First submitted to journal 30 Mar, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {\"props\":{\"pageProps\":{\"initialData\":{\"identity\":\"rs-9219581\",\"acceptedTermsAndConditions\":true,\"allowDirectSubmit\":false,\"archivedVersions\":[],\"articleType\":\"Research Article\",\"associatedPublications\":[],\"authors\":[{\"id\":631772896,\"identity\":\"3e94ffb3-aef5-4d2a-b0fd-225fb5eee9c7\",\"order_by\":0,\"name\":\"Rithwan Kalinaki\",\"email\":\"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAxklEQVRIiWNgGAWjYDACZgY2EGXADyITCojSwgzRItkA0mJAnDUQLQYHwBQRGszb+Y895qm5Y2x8fnXihwcGDPL8Ygfwa5E5zMxuzHPsmZnZjbebJYAOM5w5OwG/FgmgX6Rz2A7bmN04uwGkJcHgNlFa/h22MZ5xdvMP4rXkth02M+Dv3Ua0LWbSf/sOG0vc4N1mkWAgQYRf+A8+k5zx7bBhf//ZzTd/VNjI80sT0IKkGaxSgljlIMB/gBTVo2AUjIJRMJIAAGFKPQswEpb3AAAAAElFTkSuQmCC\",\"orcid\":\"\",\"institution\":\"Clarke International University\",\"correspondingAuthor\":true,\"prefix\":\"\",\"firstName\":\"Rithwan\",\"middleName\":\"\",\"lastName\":\"Kalinaki\",\"suffix\":\"\"},{\"id\":631772897,\"identity\":\"9af8e4a0-f601-4e8b-a9a3-efed90c04b1e\",\"order_by\":1,\"name\":\"John Charles Okiria\",\"email\":\"\",\"orcid\":\"\",\"institution\":\"Clarke International University\",\"correspondingAuthor\":false,\"prefix\":\"\",\"firstName\":\"John\",\"middleName\":\"Charles\",\"lastName\":\"Okiria\",\"suffix\":\"\"}],\"badges\":[],\"createdAt\":\"2026-03-25 07:26:22\",\"currentVersionCode\":1,\"declarations\":\"\",\"doi\":\"10.21203/rs.3.rs-9219581/v1\",\"doiUrl\":\"https://doi.org/10.21203/rs.3.rs-9219581/v1\",\"draftVersion\":[],\"editorialEvents\":[],\"editorialNote\":\"\",\"failedWorkflow\":false,\"files\":[{\"id\":108246087,\"identity\":\"42f11a50-76cf-406d-86b5-b71d96195561\",\"added_by\":\"auto\",\"created_at\":\"2026-04-30 23:47:33\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"manuscript-pdf\",\"size\":324688,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"manuscript.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9219581/v1/82f0d584-f731-4d8f-8c8b-5e2872f8939c.pdf\"},{\"id\":108246086,\"identity\":\"bde7fa78-9e9d-4960-a46e-2df608f0207a\",\"added_by\":\"auto\",\"created_at\":\"2026-04-30 23:47:29\",\"extension\":\"pdf\",\"order_by\":0,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":194060,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"questionaire.pdf\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9219581/v1/d790aba53cd8ef63c2a02e3b.pdf\"},{\"id\":108246085,\"identity\":\"c2a3dc17-e760-4206-9c27-562bd4158c61\",\"added_by\":\"auto\",\"created_at\":\"2026-04-30 23:47:29\",\"extension\":\"docx\",\"order_by\":2,\"title\":\"\",\"display\":\"\",\"copyAsset\":false,\"role\":\"supplement\",\"size\":16833,\"visible\":true,\"origin\":\"\",\"legend\":\"\",\"description\":\"\",\"filename\":\"Table1.docx\",\"url\":\"https://assets-eu.researchsquare.com/files/rs-9219581/v1/70b5d04fb2b6b7f5c9e94222.docx\"}],\"financialInterests\":\"No competing interests reported.\",\"formattedTitle\":\"Assessment of the Effects of COVID-19 Prevention Interventions on Safe Behaviour Change among Boda-Boda Cyclists in Lira City, Northern Uganda: A Cross-Sectional Study\",\"fulltext\":[{\"header\":\"Background\",\"content\":\"\\u003cp\\u003eIn 2020, nations around the world implemented various containment strategies to control the spread of COVID-19, the virus responsible for SARS-CoV-2 infection. These measures led to a reported 113\\u0026nbsp;million cases and over 2.5\\u0026nbsp;million deaths globally Atzrodt, C.L., \\u003cem\\u003eet al.\\u003c/em\\u003e, (2020) and Vitiello, L., et al., (\\u003cspan citationid=\\\"CR74\\\" class=\\\"CitationRef\\\"\\u003e2022\\u003c/span\\u003e). Containment strategies included practices such as social distancing, travel limitations, health screenings, border closures, and the use of personal protective measures, including masks, hand hygiene, and respiratory etiquette. Studies have shown that these interventions were effective in reducing transmission, preventing fatalities, and lessening strain on healthcare systems Wong, S.-C. \\u003cem\\u003eet al.\\u003c/em\\u003e, (2022).\\u003c/p\\u003e \\u003cp\\u003eAccording to Manikandan N. (2020), key COVID-19 prevention practices like handwashing, mask-wearing, restricted movement, closure of public venues, and social distancing were pivotal in lowering transmission rates in regions such as the European Union, the European Economic Area, and the United Kingdom Waleed Al-Salem, (2021). In the absence of a universally available and effective vaccine, these interventions became essential tools for public health. However, evaluating the impact of these measures is complex, as their economic and psychological costs sometimes bring about debates on balancing benefits against such impacts. There remains no universally accepted answer regarding the ideal timing for easing or intensifying these protective measures, leading to ongoing policy discussions Waleed Al-Salem (2021).\\u003c/p\\u003e \\u003cp\\u003eWhile knowledge is a vital component of risk mitigation, it does not always translate into behaviour change. Ahmadi S et al., (\\u003cspan citationid=\\\"CR77\\\" class=\\\"CitationRef\\\"\\u003e2022\\u003c/span\\u003e) noted that several factors such as the economic implications of preventive actions, household decision- making dynamics, individual beliefs, life expectancy, and the authority issuing guidelines influence adherence to COVID-19 protocols. In settings where protective measures entail significant financial or social costs; individuals may struggle to consistently practice these precautions despite understanding their importance. Research indicates that mobility restrictions were generally less effective in low- and middle-income countries compared to wealthier nations Coetzee, B. J., \\u0026amp; Kagee, A. (2020). There was also limited impact on overall transmission rates when time in non-residential locations decreased, which is commonly associated with lockdown measures Musoke D, et al., (\\u003cspan citationid=\\\"CR70\\\" class=\\\"CitationRef\\\"\\u003e2023\\u003c/span\\u003e). Demographic factors, such as higher proportions of elderly or young people (aged 5\\u0026ndash;14), showed some protective effects, although these findings were not statistically significant.\\u003c/p\\u003e \\u003cp\\u003eCOVID-19 containment measures have proven essential as first-line defense against SARS- CoV-2, with evidence from past pandemics reinforcing their value. Public discourse has centered on the effectiveness, economic burden, and social impact of these interventions a debate reminiscent of discussions from the 1918\\u0026ndash;1919 flu pandemic Juneau CE, et al. (\\u003cspan citationid=\\\"CR69\\\" class=\\\"CitationRef\\\"\\u003e2022\\u003c/span\\u003e). Public perception of these measures plays a crucial role in determining compliance, underscoring the need for community support in implementing robust public health strategies. Acceptance of COVID-19 interventions often varies by region, as shown by studies linking differences in intervention acceptance to cultural factors, such as responses to the severe acute respiratory syndrome (SARS) outbreaks Leung KK (2022). Other research has examined the effectiveness of specific COVID-19 measures, including antibiotics used as preventative treatments in past infectious disease outbreaks, like swine flu and Ebola.\\u003c/p\\u003e \\u003cp\\u003eA society\\u0026rsquo;s ability to respond to pandemics often depends on individuals adjusting their daily routines. Social media, in particular, can amplify behavior changes or, in some cases, resistances Coccia, M. 92021). Understanding how expectations influence adherence to COVID-19 measures is key: if people doubt the effectiveness of these measures, outreach and education can address this gap Castex G., (2020). However, if adherence challenges stem from perceptions of inconvenience or excessive demands, outreach efforts should focus on addressing these concerns rather than only emphasizing disease control benefits.\\u003c/p\\u003e \\u003cp\\u003eThis study, therefore, sought out to evaluate public attitudes and perceptions of COVID-19 interventions, focusing on self-reported adherence and the relationship between compliance and individual baseline characteristics. Such insights are valuable for public health strategies, as understanding what drives or impedes adherence to COVID-19 measures can lead to better- targeted communication, fostering behavior changes that ultimately support reduced disease transmission.\\u003c/p\\u003e \\u003cp\\u003eIn Uganda, basing on the fact that there is no conformed curative medicine and universal immunization for the infection, a variety of public health measures that are personal, environmental and community-based have been implemented to delay, reduce and mitigate local transmission of the infection hence reducing morbidity and mortality from the disease WHO (2020), (MoH, 2023), and Perez Kirya and Ismael Kawooya (2022).\\u003c/p\\u003e \\u003cp\\u003eBoda-boda cyclists are a population at risk of contracting and transmitting the COVID-19 infection due to the close proximity between the riders and passengers. Given this risk of exposure, strict compliance to the COVID-19 interventions like wearing an element with mask, physical distancing as well as public sensitization using media and many more is encouraged (MoH, 2021). A significant reduction of COVID-19 cases and deaths with such interventions has been realised. However, the effectiveness of the COVID-19 intervention limited their contribution to people's behaviour over time.\\u003c/p\\u003e \\u003cp\\u003eDuring the COVID-19 Pandemic in Uganda Boda-Boda riders were the primary mode of transport, delivering goods, patients, and essential services (Kaggwa Margaret, 2025). Thus, there is a daily exposure to potential infected clients. Not addressing the risky practices and behaviours including proximity between the Bodaboda rider, and or cyclist may lead to exposure, new infections or re-infection with the COVID-19 pandemic.\\u003c/p\\u003e \\u003cp\\u003eThus, this study was set out to assess effects of COVID-19 prevention interventions on safe behaviour change among Boda-Boda Cyclists in Lira City, Lira district, Uganda.\\u003c/p\\u003e\"},{\"header\":\"Methods\",\"content\":\"\\u003cdiv id=\\\"Sec3\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eStudy setting and design\\u003c/h2\\u003e \\u003cp\\u003eThis study was conducted in Lira City in Northern Uganda, a rapidly urbanizing area characterized by extensive informal transport operations. Boda-boda transport serves as a major means of mobility for residents and plays an important role in local economic activities.\\u003c/p\\u003e \\u003cp\\u003eThe study employed a cross-sectional design integrating both quantitative and qualitative methods. The design enabled the researcher to examine the relationship between COVID-19 prevention interventions and safe behavioural practices among boda-boda cyclists at a specific point in time.\\u003c/p\\u003e \\u003c/div\\u003e\\n\\u003ch3\\u003eSample size and sampling procedure\\u003c/h3\\u003e\\n\\u003cp\\u003eThe sample size for the study was determined using the Yamane formula at a 95% confidence level and a margin of error of 5%. Based on an estimated population of 4,325 boda-boda cyclists operating in Lira City, the calculated sample size was 366 respondents.\\u003c/p\\u003e \\u003cp\\u003eA simple random sampling technique was used to select participants from boda-boda stages across Lira City. In addition, key informants including stage managers and representatives of boda-boda associations were purposively selected to provide qualitative insights regarding the implementation and effectiveness of COVID-19 prevention interventions.\\u003c/p\\u003e\\n\\u003ch3\\u003eData collection and quality control measures\\u003c/h3\\u003e\\n\\u003cp\\u003eThe structured questionnaire and key informant interview guide used in this study were developed specifically for this study based on the study objectives, a review of relevant literature on COVID-19 preventive behaviors, and the Ugandan Ministry of Health COVID-19 standard operating procedures.\\u003c/p\\u003e \\u003cp\\u003eThe tools have not previously been published elsewhere. An English-language version of the questionnaire and interview guide has been prepared and uploaded as a supplementary file, and it has been cited in the main manuscript as Supplementary Material.\\u003c/p\\u003e\\n\\u003ch3\\u003eMeasurements\\u003c/h3\\u003e\\n\\u003cp\\u003eThe main outcome variable in this study was safe behaviour change among boda-boda cyclists. This included adherence to preventive practices such as wearing face masks, practicing hand hygiene, avoiding crowded areas, and complying with COVID-19 standard operating procedures.\\u003c/p\\u003e \\u003cp\\u003eIndependent variables included personal interventions (mask use, hand hygiene, use of sanitizers), community interventions (public sensitization, social distancing measures, travel restrictions), and environmental interventions (availability of hygiene facilities, regular cleaning of surfaces, and disinfection practices).\\u003c/p\\u003e \\u003cdiv id=\\\"Sec7\\\" class=\\\"Section2\\\"\\u003e \\u003ch2\\u003eData analysis\\u003c/h2\\u003e \\u003cp\\u003eQuantitative data were analyzed using statistical software to generate descriptive statistics such as frequencies and percentages. Bivariate analysis using chi-square tests was conducted to determine associations between independent variables and safe behaviour change.\\u003c/p\\u003e \\u003cp\\u003eMultivariate logistic regression analysis was performed to identify independent predictors of safe behaviour change among boda-boda cyclists. Results were presented using adjusted odds ratios (AORs) and 95% confidence intervals.\\u003c/p\\u003e \\u003cp\\u003eQualitative data obtained from key informant interviews were analyzed using thematic analysis to complement and explain quantitative findings.\\u003c/p\\u003e \\u003c/div\\u003e\"},{\"header\":\"Results\",\"content\":\"\\u003cp\\u003eThe findings in table.1 indicate that the majority of boda-boda cyclists 253 (69%) resided in Lira city, with males dominating the industry 357(97.5%) The low representation of female boda-boda riders 9 (2.5%) may be attributed to cultural norms, societal perceptions, safety concerns, or economic barriers that discourage women from engaging in the boda boda sector. Majority of the respondents belonged to the age group of 20–29 years 170(46%), followed by 30–39 years 140(38%), highlighting that the industry is mainly comprised of young and middle- aged individuals, likely due to the physical demands and mobility requirements of the job.\\u003c/p\\u003e\\n\\u003cp\\u003eIn terms of marital status, 104(28.4%) were married, followed by cohabiting individuals 99(27.0%), suggesting that many boda-boda cyclists have family responsibilities.\\u003c/p\\u003e\\n\\u003cp\\u003eEducation levels among boda-boda riders show that most have attained primary 108(29.5%) followed closely by 106(29%) who had reached secondary school, with only 66(18%) having tertiary education. This suggests that the industry mainly attracts individuals with basic to moderate education.\\u003c/p\\u003e\\n\\u003cp\\u003eReligious distribution shows that the majority of respondents 94(25.7%) were Catholics, followed by 22.1% who were Protestants. Additionally, 20% of respondents identified as Born- Again Christians, 65(18%) were Muslims, and 52(14%) belonged to other religious groups. This distribution suggests that Christianity is the dominant religion among boda boda cyclists in Lira city. The presence of Muslims and other religious groups highlights some level of religious diversity within the boda boda community\\u003c/p\\u003e\\n\\u003cp\\u003eRegarding work experience, Majority of 146(39.9%) respondents were in the boda-boda business for 1 to 5 years, making them the largest group followed by 131(35.8%) had been in the business for over five years, with minority of 89(24.3%) had been operating for less than a year. These results suggest that the majority of boda-boda riders had considerable experience (over a year) in the industry.\\u003c/p\\u003e\\n\\u003ctable float=\\\"Yes\\\" id=\\\"Tab2\\\" border=\\\"1\\\"\\u003e\\n \\u003ccaption language=\\\"En\\\"\\u003e\\n \\u003cdiv\\u003eTable 2\\u003c/div\\u003e\\n \\u003cdiv\\u003e\\n \\u003cp\\u003eMultivariate: Nominal Regression\\u003c/p\\u003e\\n \\u003c/div\\u003e\\n \\u003c/caption\\u003e\\n \\u003cthead\\u003e\\n \\u003ctr\\u003e\\n \\u003cth align=\\\"left\\\" colname=\\\"c1\\\" morerows=\\\"1\\\" rowspan=\\\"2\\\"\\u003e\\n \\u003cp\\u003eVariables\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\" colspan=\\\"3\\\" nameend=\\\"c4\\\" namest=\\\"c2\\\"\\u003e\\n \\u003cp\\u003eLikelihood Ratio Tests\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003cth align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003eChi-Square\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003edf\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003cth align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003eSig.\\u003c/p\\u003e\\n \\u003c/th\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/thead\\u003e\\n \\u003ctbody\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eAge group\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e0\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eMarital_ status\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eEducation level\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eReligion\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eCorrect steps for hand washing with soap\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e0\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eCovid19_infection_history\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e0\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eOwning of facial mask and handwashing facility\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e1.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eType of facial mask used\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eMask wearing Frequency\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eAvoiding crowds\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e1.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eLimiting time outside\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eAvoiding physical activity outside\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eAvoidance of physical contact\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eSelfisolation_when_having_covid19_symptoms\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e1.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eSocial distancing compliance\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e1.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eRespondents aware of self-protection measures\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eUse of soap \\u0026amp; sanitizer\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003ePerceived risk of infection\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eAvailability of hand washing facility\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e1.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eEffectiveness of covid19 prevention measures\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e11.748\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e0.003****\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eSanitization_ of_ surfaces\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e1.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eHand washing frequency\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eEfforts to improve environmental hygiene\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eChallenges_ Implementing environmental hygiene\\u003c/p\\u003e\\n \\u003cp\\u003emeasures\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e0\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eHandwashing with soap\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e3\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e1.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eAccess to facial mask liquid soap sanitizer\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e2\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eImportance of facial mask wearing\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e0\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eBelief_in_mask_wearing_for_covid19_protection\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eBelief in handwashing with soap\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eCost barrier for mask wearing or handwashing\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e4\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eCorrect procedures for wearing mask\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e1.896\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.169\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\n \\u003cp\\u003eCoughing and sneezing in tissue\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.000\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e0\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003ctr\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c1\\\"\\u003e\\u0026nbsp;\\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c2\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"char\\\" char=\\\".\\\" colname=\\\"c3\\\"\\u003e\\n \\u003cp\\u003e1\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003ctd align=\\\"left\\\" colname=\\\"c4\\\"\\u003e\\n \\u003cp\\u003e.\\u003c/p\\u003e\\n \\u003c/td\\u003e\\n \\u003c/tr\\u003e\\n \\u003c/tbody\\u003e\\n\\u003c/table\\u003e\\n\\u003cp\\u003eThe likelihood ratio tests assess the significance of different independent variables in predicting behaviour change due to COVID-19 interventions among boda-boda cyclists. The key variables analyzed include socio-demographics, behavioural interventions, and perceptions towards COVIDu-19 preventive measures.\\u003c/p\\u003e\\n\\u003cp\\u003eEffectiveness of COVID-19 prevention measures (χ² = 11.748, df = 2, p = 0.003). This variable was the only one showing a strong statistically significant relationship, indicating that the perceived effectiveness of COVID-19 interventions had a major impact on behaviour change. Respondents who believed that the measures were effective were more likely to adopt safe practices like handwashing and mask-wearing.\\u003c/p\\u003e\\n\\u003cp\\u003eCorrect procedures for wearing a mask (χ² = 1.896, df = 1, p = 0.169). This variable shows a weak relationship with behaviour change, meaning that some respondents might have known the correct way to wear a mask but did not consistently follow the guidelines. This could be due to discomfort, misinformation, or enforcement issues.\\u003c/p\\u003e\\n\\u003ch3\\u003eInsights from Key Informant Interviews\\u003c/h3\\u003e\\n\\u003cp\\u003eTo supplement the survey data, key informant interviews were conducted with boda-boda association leaders, health officials, and local government representatives. Their insights provided further depth to the study findings:\\u003c/p\\u003e\\n\\u003cp\\u003eCOVID-19 trends among boda-boda riders in lira city.\\u003c/p\\u003e\\n\\u003cp\\u003eKey informants provided insights into the state of COVID-19 among boda-boda riders in Lira city in 2025:\\u003c/p\\u003e\\n\\u003cp\\u003eInfections in the Community: Reports indicate a significant decline in COVID-19 infection rates compared to the peak years of 2020–2022. However, sporadic cases continue to emerge, particularly among individuals who travel frequently.\\u003c/p\\u003e\\n\\u003cp\\u003eCOVID-19 Related Deaths: The mortality rate among boda-boda riders has significantly reduced, attributed to increased immunity, improved healthcare access, and widespread vaccination efforts.\\u003c/p\\u003e\\n\\u003cp\\u003eCommunity Perceptions: Many boda-boda riders and community members now perceive COVID-19 as a manageable condition rather than a severe threat. However, a degree of complacency has developed, leading to reduced adherence to preventive measures such as mask-wearing and hand hygiene.\\u003c/p\\u003e\\n\\u003cp\\u003eKey informants emphasized that while the acute phase of the pandemic has passed, continued public health education and surveillance are essential to prevent potential resurgences.\\u003c/p\\u003e\\n\\u003cp\\u003eBoda-boda associations and local authorities should maintain minimum safety standards to protect\\u003c/p\\u003e\\n\\u003cp\\u003eriders and passengers from future outbreaks.\\u003c/p\\u003e\\n\\u003cp\\u003eAdherence to COVID-19 Prevention Measures\\u003c/p\\u003e\\n\\u003cp\\u003eInterviews with key informants revealed the following trends regarding adherence to COVID- 19 preventive measures:\\u003c/p\\u003e\\n\\u003cp\\u003eFace Mask Use: Boda-boda riders expressed mixed feelings about wearing masks. Some cited discomfort and difficulty breathing, while others felt that masks made them appear unapproachable to customers, leading to inconsistent use.\\u003c/p\\u003e\\n\\u003cp\\u003eSocial Distancing: While riders understood the importance of social distancing, they found it impractical given the nature of their work, which involves close contact with passengers.\\u003c/p\\u003e\\n\\u003cp\\u003eCleaning of Surfaces: Some boda-boda riders reported wiping their motorcycles regularly, but many lacked the resources to do so consistently.\\u003c/p\\u003e\\n\\u003cp\\u003eHand Hygiene: While handwashing was widely acknowledged as important, access to soap and water at boda-boda stages remained a challenge.\\u003c/p\\u003e\\n\\u003cp\\u003eKey informants noted that boda-boda riders prioritized economic survival over strict adherence to COVID-19 preventive measures. They suggested interventions such as providing free masks, installing permanent handwashing stations at boda-boda stages, and enforcing safety guidelines to improve compliance.\\u003c/p\\u003e\\n\\u003cp\\u003eChanges in Adherence to COVID-19 Prevention Measures Over Time\\u003c/p\\u003e\\n\\u003cp\\u003eKey informants highlighted a decline in adherence to COVID-19 preventive measures over time:\\u003c/p\\u003e\\n\\u003cp\\u003eDecline in Face Mask Use: At the onset of the pandemic, boda-boda riders complied with mask mandates due to enforcement measures and penalties. However, compliance dropped significantly due to discomfort, economic hardship, and reduced enforcement.\\u003c/p\\u003e\\n\\u003cp\\u003eReduced Social Distancing: Social distancing was more strictly observed in the early stages when government-imposed restrictions were in place. However, as restrictions eased, adherence significantly declined as riders prioritized maximizing their earnings.\\u003c/p\\u003e\\n\\u003cp\\u003eDeclining Hand Hygiene: Initially, riders frequently washed their hands and used sanitizers, especially when sanitization materials were provided for free. However, over time, many abandoned this practice due to cost constraints and reduced fear of the virus.\\u003c/p\\u003e\\n\\u003cp\\u003eDecreased Cleaning of Surfaces: Many boda-boda riders regularly disinfected their motorcycles at the height of the pandemic due to heightened public health awareness. However, this practice declined as the urgency of the pandemic faded.\\u003c/p\\u003e\\n\\u003cp\\u003eKey informants attributed this decline in compliance to relaxed government policies, financial struggles, and general pandemic fatigue. They emphasized the need for continuous sensitization and reinforcement of preventive behaviors to sustain long-term public health benefits.\\u003c/p\\u003e\\n\\u003cp\\u003eGovernment Support in the Fight Against COVID-19\\u003c/p\\u003e\\n\\u003cp\\u003eKey informants outlined various ways in which the government supported the boda-boda community during the COVID-19 pandemic:\\u003c/p\\u003e\\n\\u003cp\\u003eProvision of Face Masks and Sanitizers: At the height of the pandemic, the government distributed free face masks and hand sanitizers to boda-boda riders. However, this\\u003c/p\\u003e\\n\\u003cp\\u003esupport declined over time, affecting consistent usage.\\u003c/p\\u003e\\n\\u003cp\\u003eImplementation of Standard Operating Procedures (SOPs): The government imposed and enforced SOPs that required boda-boda riders to wear masks, sanitize their hands, and practice social distancing while carrying passengers.\\u003c/p\\u003e\\n\\u003cp\\u003eCurfew Regulations and Movement Restrictions: To reduce movement and limit virus spread, the government introduced curfew measures, although these restrictions significantly impacted boda-boda riders' income.\\u003c/p\\u003e\\n\\u003cp\\u003ePublic Sensitization Campaigns: The government, in collaboration with local leaders and the Ministry of Health, launched awareness campaigns to educate boda-boda riders on COVID-19 risks and preventive measures.\\u003c/p\\u003e\\n\\u003cp\\u003eFinancial Relief Programs: Some boda-boda associations reported that their members received government cash relief and food supplies during lockdowns to mitigate economic hardships.\\u003c/p\\u003e\\n\\u003cp\\u003eDespite these efforts, key informants pointed out several challenges, including inconsistent enforcement of SOPs, a lack of sustained financial assistance, and the declining provision of essential protective equipment over time. They emphasized the need for continued government involvement to sustain compliance and promote public health safety.\\u003c/p\\u003e\\n\\u003cp\\u003eEffects Of Strict Covid-19 SOPs Enforcement on The Boda-Boda Business.\\u003c/p\\u003e\\n\\u003cp\\u003eKey informants provided insights into how the strict enforcement of COVID-19 OPs impacted the boda-boda business:\\u003c/p\\u003e\\n\\u003cp\\u003eReduced Operating Hours: The implementation of curfews limited the time boda-boda riders could operate, significantly reducing their daily earnings.\\u003c/p\\u003e\\n\\u003cp\\u003eDecreased Customer Demand: Due to movement restrictions and fears of contracting COVID-19, many customers avoided using boda-bodas, opting for private transportation or staying at home.\\u003c/p\\u003e\\n\\u003cp\\u003eIncreased Operational Costs: Riders had to spend extra money on face masks, sanitizers, and cleaning supplies to comply with health regulations, adding to their financial burden.\\u003c/p\\u003e\\n\\u003cp\\u003eArrests and Fines: Some boda-boda riders were arrested or fined for\\u003c/p\\u003e\\n\\u003cp\\u003efailing to comply with SOPs, further straining their income and operations.\\u003c/p\\u003e\\n\\u003cp\\u003eEconomic Hardship: Many boda-boda riders struggled to meet financial obligations such as rent and feeding their families, leading to an increase in loan defaults and reliance on government or community aid.\\u003c/p\\u003e\\n\\u003cp\\u003eNon-Compliance Due to Financial Pressure: Some riders deliberately ignored SOPs, such as carrying more than one passenger, to compensate for reduced income, leading to clashes with law enforcement.\\u003c/p\\u003e\\n\\u003cp\\u003eKey informants acknowledged that while SOP enforcement was necessary to curb COVID-19, it had severe economic implications for boda-boda riders. They recommended that future interventions include financial support, fewer operational restrictions, and sustained public sensitization to balance public health safety with economic survival.\\u003c/p\\u003e\\n\\u003cp\\u003eCommunity Awareness-Raising Interventions\\u003c/p\\u003e\\n\\u003cp\\u003eKey informant interviews provided insights into the various community awareness-raising interventions implemented among boda-boda riders:\\u003c/p\\u003e\\n\\u003cp\\u003eMass Media Campaigns: The government and health agencies used radio, television, and social media platforms to educate boda-boda riders on COVID-19 prevention measures.\\u003c/p\\u003e\\n\\u003cp\\u003eDirect Information Sharing and Messaging: Health workers and boda-boda association leaders disseminated information through pamphlets, posters, and word-of-mouth campaigns.\\u003c/p\\u003e\\n\\u003cp\\u003eHome Visits: Community health workers visited boda-boda stages and riders' residences to provide COVID-19 education.\\u003c/p\\u003e\\n\\u003cp\\u003eCourtyard Meetings: Small group meetings at boda-boda stages allowed discussions on COVID-19 risks and preventive measures.\\u003c/p\\u003e\\n\\u003cp\\u003eCommunity Meetings: Local leaders and health officials conducted larger meetings to sensitize boda-boda riders on SOP adherence.\\u003c/p\\u003e\\n\\u003cp\\u003eKey informants emphasized that while awareness campaigns improved boda-boda riders' knowledge about COVID-19, sustained behaviour change was often hindered by economic pressures, misinformation, and social influences. They recommended continuous engagement and localized awareness-raising strategies to reinforce public health measures and ensure long-term adherence.\\u003c/p\\u003e\"},{\"header\":\"Discussion\",\"content\":\"\\u003cp\\u003eThe study found that most respondents (69.1%) lived in Lira City, and the boda-boda sector was largely male-dominated (97.5%). The most common age group was 20\\u0026ndash;29 years (46.4%), and many riders had primary (29.5%) or secondary education (29.0%). Marital status and religion also influenced compliance with COVID-19 preventive measures.\\u003c/p\\u003e \\u003cp\\u003eBivariate analysis showed a significant link between age and behaviour change (p\\u0026thinsp;=\\u0026thinsp;0.0001), suggesting that younger riders were more likely to follow COVID-19 precautions. This supports research by Koh et al. (\\u003cspan citationid=\\\"CR34\\\" class=\\\"CitationRef\\\"\\u003e2020\\u003c/span\\u003e), which found that younger individuals were more compliant due to their higher exposure to health information, particularly through digital platforms.\\u003c/p\\u003e \\u003cp\\u003eFindings from this study revealed that Community-based interventions such as public awareness campaigns, travel restrictions, and social distancing played a significant role in influencing boda-boda cyclists' behaviour. The study found that 72% of respondents practiced social distancing, while 63% actively engaged in community awareness programs. These findings align with studies by Deb et al. (\\u003cspan citationid=\\\"CR18\\\" class=\\\"CitationRef\\\"\\u003e2020\\u003c/span\\u003e) and Cowling et al. (\\u003cspan citationid=\\\"CR17\\\" class=\\\"CitationRef\\\"\\u003e2020\\u003c/span\\u003e), which show that public sensitization efforts reduce infection rates. However, economic hardships and inconsistent enforcement limited full compliance. Similar challenges were identified by Garcia \\u0026amp; Duarte (\\u003cspan citationid=\\\"CR24\\\" class=\\\"CitationRef\\\"\\u003e2020\\u003c/span\\u003e), indicating the need for tailored interventions that address both health and financial concerns.\\u003c/p\\u003e \\u003cp\\u003eEnvironmental measures, including handwashing stations and surface sanitization, were examined. The study found that 68% of respondents had access to handwashing facilities, but only 49% used them regularly. Similarly, 54% reported routine sanitization of surfaces.\\u003c/p\\u003e \\u003cp\\u003eThese findings support research by Cheng et al. (2020) and Rutala \\u0026amp; Weber (\\u003cspan citationid=\\\"CR51\\\" class=\\\"CitationRef\\\"\\u003e2019\\u003c/span\\u003e), which emphasize the importance of environmental hygiene in reducing disease transmission. However, disparities in access to hygiene facilities and weak enforcement of sanitation protocols suggest the need for stronger policy implementation in informal transport settings\\u003c/p\\u003e \\u003cp\\u003ePersonal interventions such as wearing masks, handwashing, and self-isolation showed varying levels of adherence. While 78% of respondents owned face masks, only 52% wore them consistently. Handwashing compliance stood at 61%, with cost cited as a major barrier.\\u003c/p\\u003e \\u003cp\\u003eThese findings align with studies by Li et al. (2020) and Brainard et al. (\\u003cspan citationid=\\\"CR9\\\" class=\\\"CitationRef\\\"\\u003e2020\\u003c/span\\u003e), which show that affordability and accessibility influence adherence to safety measures. The Theory of Planned Behaviour (TPB) states that compliance is influenced by personal attitudes and perceived ease of behaviour change (Kitsanapun \\u0026amp; Yamarat, \\u003cspan citationid=\\\"CR32\\\" class=\\\"CitationRef\\\"\\u003e2019\\u003c/span\\u003e). In this study, financial constraints limited adherence, highlighting the need for subsidised hygiene resources.\\u003c/p\\u003e\"},{\"header\":\"Abbreviations\",\"content\":\"\\u003cp\\u003eCOVID-19\\u0026nbsp; \\u0026nbsp; \\u0026nbsp;\\u0026nbsp;Coronavirus Disease 2019\\u003c/p\\u003e\\n\\u003cp\\u003eNPIs\\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp;\\u0026nbsp;Non-Pharmaceutical Interventions\\u003c/p\\u003e\\n\\u003cp\\u003eWHO\\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp;World Health Organization\\u003c/p\\u003e\\n\\u003cp\\u003eMoH\\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp;\\u0026nbsp;Ministry of Health\\u003c/p\\u003e\\n\\u003cp\\u003eVHTs \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp; \\u0026nbsp;Village Health Teams\\u003c/p\\u003e\\n\"},{\"header\":\"Declarations\",\"content\":\"\\u003cp\\u003e\\u003cstrong\\u003eAcknowledgements\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe authors would like to acknowledge the management of Clarke International University for their academic support. Appreciation is also extended to the Lira City authorities, boda-boda association leaders, and all study participants who contributed valuable information during the study.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthors\\u0026rsquo; Contributions\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eKalinaki Rithwan conceptualized and designed the study and conducted data collection and analysis. Prof. John Charles Okiria provided overall technical supervision and research guidance throughout the study process. Both authors contributed to the development and finalization of the manuscript.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eFunding\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThis study did not receive any external funding and was self-funded by the researcher.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAvailability of Data and Materials\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe dataset generated and analyzed during this study is available from the corresponding author upon reasonable request.\\u003c/p\\u003e\\n\\n\\u003cp\\u003e\\u003cstrong\\u003eEthics approval and consent to participate\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eEthical approval to conduct this study was obtained from the Clarke International University Research Ethics Committee (CIUREC). The study was conducted in accordance with the ethical principles of the Declaration of Helsinki. Administrative clearance was obtained from Lira City authorities and boda‑boda association leaders. Participation was voluntary, and written informed consent was obtained from all participants prior to data collection. Confidentiality and anonymity of participants were maintained throughout the study.\\u003c/p\\u003e\\n\\n\\u003cp\\u003e\\u003cstrong\\u003eConsent for publication\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eNot applicable.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eCompeting interests\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003eThe authors declare that there are no competing interests regarding the publication of this manuscript.\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003cstrong\\u003eAuthor details\\u003c/strong\\u003e\\u003c/p\\u003e\\n\\u003cp\\u003e\\u003csup\\u003e1\\u003c/sup\\u003eSchool of Public Health and Management, Clarke International University, Kampala, Uganda.\\u003c/p\\u003e\"},{\"header\":\"References\",\"content\":\"\\u003col\\u003e\\u003cli\\u003e\\u003cspan\\u003eAhmed MZ, Ahmed O, Aibao Z, Hanbin S, Siyu L, Ahmad A. Epidemic of COVID-19 in China and associated psychological problems. Asian J Psychiatry.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAlimohamadi Y, Naieni KH, Sepandi M, Taghdir M. Effect of social distancing on Covid- 19 incidence and mortality in Iran since February 20 to May 13, 2020: an interrupted time series analysis. Risk Manag Healthc Policy. 2020;13:1695\\u0026ndash;700.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAlimohamadi Y, Taghdir M, Sepandi M. The estimate of the basic reproduction number for novel coronavirus disease (COVID-19): a systematic review and meta-analysis. J Prev Med Public Health. 2020;53(3):151\\u0026ndash;7.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAmmendolia J, Saturno J, Brooks AL, Jacobs S, Jambeck JR. An emerging source of plastic pollution: environmental presence of plastic personal protective equipment (PPE) debris related to COVID-19 in a metropolitan city.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAnderson RM, Heesterbeek H, Klinkenberg D, Hollingsworth TD. Ow will country-based mitigation measures influence the course of the COVID-19 epidemic? Lancet. 2020;391(10228):931\\u0026ndash;4.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eArdusso M, Forero-L\\u0026oacute;pez AD, Buzzi NS, Spetter CV, Fern\\u0026aacute;ndez-Severini MD. COVID- 19 pandemic repercussions on plastic and antiviral polymeric textile causing pollution on beaches and coasts of South America.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBeiu C, Mihai M, Popa L, Cima L, Popescu MN. Frequent hand washing for COVID- 19 prevention can cause hand dermatitis: management tips. Cureus. 2020;12(4):e7506.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBerger DW, Herkenhoff KF, Mongey S. An seir infectious disease model with testing and conditional quarantine. No. w26901. National Bureau of Economic Research; 2020.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBrainard JS, Jones N, Lake I, Hooper L, Hunter P. Facemasks and similar barriers to prevent respiratory illness such as COVID-19: a rapid systematic review. medRxiv. 2020. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1101/2020.04.01.20049528\\u003c/span\\u003e\\u003cspan address=\\\"10.1101/2020.04.01.20049528\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eBrotherhood L, Kircher P, Santos C, Tertilt M. An economic model of the COVID-19 epidemic: the importance of testing and age-specific policies. CEPR Discuss. 2020.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCarlsson-Szlezak P, Reeves M, Swartz P. Understanding the Economic Shock of Coronavirus. Harv. Bus; 2020.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCastex G, Dechter E, Lorca M. Covid-19: the impact of social distancing policies, cross- country analysis. Econ Disaster Clim Chang. 2020. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1007/s41885-020-00076-x\\u003c/span\\u003e\\u003cspan address=\\\"10.1007/s41885-020-00076-x\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eChen X, Ran L, Liu Q, Hu Q, Du X, Tan X, Cheng VCC, Wong S-C, Chen JHK, Yip CCY, Chuang VWM, Tsang. O.T.Y., 2020.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eEscalating infection control. response to the rapidly evolving epidemiology of the coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 in Hong Kong. Infect Control Hosp Epidemiol 41, 493\\u0026ndash;8.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eChin AWH, Chu JTS, Perera MRA, Hui KPY, Yen H-L, Chan. M.C.W., 2020.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eStability of SARS. -CoV2 in different environmental conditions. Lancet Microbe S2666524720300033.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCowling B, Ali S, Ng Y, Tsang T, Li J, Fong M, Liao Q, Kwan M, Lee S, Chiu S, Wu J, Wu P, Leung G. Impact assessment of non-pharmaceutical interventions against coronavirus disease 2019 and influenza in Hong Kong: an observational study. Lancet Public Health. 2020;5(5):E279\\u0026ndash;88.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDeb P, Furceri D, Ostry J, Tawk N. 2020. The Effect of Containment Measures on the COVID- 19 Pandemic. IMF Working Paper WP/20/159, 53\\u0026ndash;86.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eDuc Huynh T. The Covid-19 containment in Vietnam: what are we doing? J Glob Health. 2020; 10(1).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eEikenberry SE, Mancuso M, Iboi E, Phan T, Eikenberry K, Kuang Y, Gumel AB.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003e, 2020. To mask or not to mask: modeling the potential for face mask use by the general public to curtail the COVID-19 pandemic. Infect Dis Model 5: 293\\u0026ndash;308.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eFang H, Wang L, Yang Y. Human mobility restrictions and the spread of the novel coronavirus (2019-ncov) in China. J Public Econ. 2020;191:104272.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eFang H, Wang L, Yang Y. 2020. Human Mobility Restrictions and the Spread of the Novel Coronavirus (2019-nCOV) in China. NBER Working Paper 26906.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eGarcia LP, Duarte E. Nonpharmaceutical interventions for tackling the COVID-19 epidemic in Brazil. Epidemiol Serv Sa\\u0026uacute;de. 2020;29(2):1\\u0026ndash;3.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eGlass RJ, Glass LM, Beyeler WE, Min HJ. Targeted social distancing designs for pandemic influenza. Emerg Infect Dis. 2006;12(1):1671\\u0026ndash;81.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eGourinchas PO. Flattening the Pandemic and Recession Curves. In: Baldwin R, Mauro B, editors. Mitigating the COVID Economic Crisis. Act Fast and Do Whatever; 2020.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eHsiang S, Annan-Phan AD, Bell S, Bolliger K, Chong I, Druckenmiller T, Huang H, Hultgren LY, Krasovich A, Lau E. The effect of large-scale anti-contagion policies on the COVID- 19 pandemic. Nature. 2020;584(7820):262\\u0026ndash;7.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eJang WM, Jang DH, Lee JY. (2020) Social distancing and transmission-reducing practices during the 2019 coronavirus disease and 2015 middle east respiratory syndrome coronavirus outbreaks in korea. J Korean Med Sci.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eJayaweera M, Perera H, Gunawardana B, Manatunge J. Transmission of COVID- 19 virus by droplets and aerosols: A critical review on the unresolved dichotomy. Environ Res. 2020;188:109819. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1016/j.envres.2020.109819\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.envres.2020.109819\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eJefferson T, Mar D, Dooley CB, Ferroni L, Al-Ansary E, Bawazeer LA, van Driel GA, Nair ML, Jones S, Thorning MA, S.\\u0026amp;, Conly JM. Physical interventions to interrupt or reduce the spread of respiratory viruses. Cochrane Database Syst Rev. 2011;7:CD006207. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1002/14651858.CD006207.pub4\\u003c/span\\u003e\\u003cspan address=\\\"10.1002/14651858.CD006207.pub4\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKissler S, Tedijanto C, Goldstein E, Grad Y, Lipsitch M. Projecting the transmission dynamics of SARS-Cov-2 through the post pandemic period. Science. 2020;368(6493):860\\u0026ndash;8.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKitsanapun A, Yamarat K. Handwashing determinants and practices among public health students in Thailand. Pakistan J Public Health. 2019;9(2):57\\u0026ndash;60.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKlompas M, Morris CA, Sinclair J, Pearson M, Shenoy ES. Universal masking in hospitals in the COVID-19 era. N Engl J Med. 2020;382:e63.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKoh W, Naing L, Wong J. Estimating the impact of physical distancing measures in containing COVID-19: an empirical analysis. Int J Infect Dis. 2020;100:42\\u0026ndash;9.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKoh D. Occupational risks for COVID-19 infection. Occup Med. 2020;70:3\\u0026ndash;5.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKucharski A, Russell T, Diamond C, Liu Y, Edmunds J, Funk S, Rosalind ME. Early dynamics of transmission and control of Covid-19: a mathematical modelling study. Lancet Infect Dis. 2020;20(5):553\\u0026ndash;8.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eKucharski AJ, Russell TW, Diamond C, Liu Y, Edmunds J, Funk S, et al. Early dynamics of transmission and control of COVID-19: a mathematical modelling study. Lancet Infect Dis. 2020;20(5):553\\u0026ndash;8. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.1016/S1473-3099(20)30144-4\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/S1473-3099(20)30144-4\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eLai S, Ruktanonchai N, Zhou L, Prosper O, Luo W, Floyd J, Wesolowski A, Santillana M, Zhang C, Du X, Yu H, Tatem A. Effect of non-pharmaceutical interventions to contain Covid- 19 in China. Nature. 2020;585:410\\u0026ndash;3.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eLu H, Nie P, Qian L. 2020. Do Quarantine Experiences and Attitudes Towards COVID-19 Affect the Distribution of Psychological Outcomes in China? A Quantile Regression Analysis (WP512). GLO Discussion Paper.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMiddleton JD, Lopes H. 2020. Face masks in the COVID-19 crisis: caveats, limits, and priorities. BMJ 369: m2030.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMilne GJ, Kelso JK, Kelly HA, Huband ST, McVernon J. A small community model for the transmission of infectious diseases: comparison of school closure as an intervention in individual- based models of an influenza pandemic. PLoS ONE. 2008; 3.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMoosa I. The effectiveness of social distancing in containing Covid-19. Appl Econ. 2020;52(58):6292\\u0026ndash;305.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eNkengasong JN, Mankoula W. Looming threat of COVID-19 infection in Africa: act collectively, and fast. Lancet (London England). 2020;395(10227):841\\u0026ndash;2.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eOceansAsia. COVID-19 Facemasks \\u0026amp; Marine Plastic Pollution [WWW Document]. OceansAsia. 2020.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eOkuku E, Kiteresi L, Owato G, Otieno K, Mwalugha C, Mbuche M, Gwada B, Nelson A, Chepkemboi P, Achieng Q, Wanjeri V, Ndwiga J, Mulupi L. Omire J. The impacts of.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCOVID- 19 pandemic. on marine litter pollution along the Kenyan coast: a synthesis after 100 days following the first reported case in Kenya. Mar.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePrata JC, Silva ALP, Walker TR, Duarte AC, Rocha-Santos T. COVID-19 pandemic repercussions on the use and management of plastics. Environ Sci Technol. 2020;54:7760\\u0026ndash;5. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1021/acs.est.0c02178\\u003c/span\\u003e\\u003cspan address=\\\"10.1021/acs.est.0c02178\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePrem K, Liu Y, Russell T, Kucharski A, Eggo R, Davies N. The effect of control strategies to reduce social mixing on outcomes of the Covid-19 epidemic in Wuhan, China: a modelling study. Lancet Public Health. 2020;5(5):E261\\u0026ndash;70.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eRamesh N, Siddaiah A, Joseph B. Tackling corona virus disease 2019 (COVID 19) in workplaces. Indian J Occup Environ Med. 2020;24:16.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eReport of the WHO-China. Joint Mission on Coronavirus Disease 2019 (COVID-19). Geneva: World Health Organization; 2020.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eRutala WA, Weber DJ. Best practices for disinfection of noncritical environmental surfaces and equipment in health care facilities: A bundle approach. Am J Infect Control. 2019;47:A96\\u0026ndash;105.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eRyan PG, Maclean K, Weideman EA. The impact of the COVID-19 lockdown on urban street litter in South Africa. Environ. Process.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSantarpia JL, Rivera DN, Herrera V, Morwitzer MJ, Creager H, Santarpia GW, Crown KK, Brett-Major D, Schnaubelt E, Broadhurst MJ, Lawler JV. Reid, S. P.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eLowe JJ. (2020). Aerosol and Surface Transmission Potential of SARS-CoV‐2. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1101/2020.03.23.20039446\\u003c/span\\u003e\\u003cspan address=\\\"10.1101/2020.03.23.20039446\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eSposato W. Japan\\u0026rsquo;s Half-hearted Coronavirus Measures are Working Anyway. Volume 14. Foreign Policy; 2020.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTorres FG, De-la-Torre GE. Face mask waste generation and management during the COVID- 19 pandemic: an overview and the Peruvian case. Sci Total Environ. 2021;786. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1016/J.SCITOTENV.2021.147628\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/J.SCITOTENV.2021.147628\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTorres FG, De-La-Torre GE, Gonzales KN, Troncoso OP. Bacterial-polymer-based electrolytes: recent progress and applications. ACS Appl Energy Mater. 2020;3:11500\\u0026ndash;15. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1021/acsaem.0c02195\\u003c/span\\u003e\\u003cspan address=\\\"10.1021/acsaem.0c02195\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTorres FG, Dioses-Salinas DC, Pizarro-Ortega CI, De-la-Torre GE. Sorption of chemical contaminants on degradable and non-degradable microplastics: recent progress and research trends. Sci Total Environ. 2021;757. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1016/j.scitotenv.2020.143875\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.scitotenv.2020.143875\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTubadji A, Boy F, Webber D. Narrative economics, public policy and mental health. Cent Econ Policy Res. 2020;20:109\\u0026ndash;31.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eTuncer N, Mohanakumar C, Swanson S, Martcheva M. Efficacy of control measures in the control of Ebola, Liberia 2014\\u0026ndash;2015. J Biol Dyn. 2018;12(1):913\\u0026ndash;37.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eUllah A, Ajala O. Do lockdown and testing help in curbing Covid-19 transmission? Covid Econ. 2020; 13.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eWong S, Kwok K, Chan F. What can countries learn from Hong Kong\\u0026rsquo;s response to the COVID- 19 pandemic? Can. Med Assoc J. 2020;192(19):E511\\u0026ndash;5.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eWorld Health Organization. 2020. Advice on the Use of Masks in the Community, during Home Care and in Health Care Settings in the Context of the Novel Coronavirus (2019-nCoV) Outbreak.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eYe G, Lin H, Chen L, Wang S, Zeng Z, Wang W et al. 2020. Environmental contamination of the SARS-CoV-2 in healthcare premises: An urgent call for protection for healthcare workers (preprint). Infectious Diseases (except HIV/AIDS).\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eYouth do it. (2019) sensitization: awareness raising.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003ePerez Kirya I, Kawooya. Strategies to control the transmission of SARS-CoV-2 in Schools in Uganda, Feb 2022. A Rapid Response Brief. The Center for Rapid Evidence Synthesis, Makerere University College of Health Sciences.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCoccia M. Pandemic Prevention: Lessons from COVID-19. Encyclopedia. 2021;1:433\\u0026ndash;44. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.3390/encyclopedia1020036\\u003c/span\\u003e\\u003cspan address=\\\"10.3390/encyclopedia1020036\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eLeung KK, Zhang R, Hashim MJ, Fang M, Xu J, Sun D, Li X, Liu Y, Deng H, Zeng D, Lin Z, He P, Zhang Y, Zhu X, Liang D, Xing A, Lee SS, Memish ZA, Jiang G, Khan G. Effectiveness of containment strategies in preventing SARS-CoV-2 transmission. J Infect Public Health. 2022;15(6):609\\u0026ndash;14. Epub 2022 Apr 29. PMID: 35537237; PMCID: PMC9052634.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eJuneau CE, Pueyo T, Bell M, Gee G, Collazzo P, Potvin L. Lessons from past pandemics: a systematic review of evidence-based, cost-effective interventions to suppress COVID-19. Syst Rev. 2022;11(1):90. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1186/s13643-022-01958-9\\u003c/span\\u003e\\u003cspan address=\\\"10.1186/s13643-022-01958-9\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e. PMID: 35550674; PMCID: PMC9096744.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMusoke D, Nalinya S, Lubega GB, Deane K, Ekirapa-Kiracho E, McCoy D. The effects of COVID-19 lockdown measures on health and healthcare services in Uganda. PLOS Glob Public Health. 2023;3(1):e0001494. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.1371/journal.pgph.0001494\\u003c/span\\u003e\\u003cspan address=\\\"10.1371/journal.pgph.0001494\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eCoetzee BJ, Kagee A. Structural barriers to adhering to health behaviours in the context of the COVID-19 crisis: Considerations for low- and middle-income countries. Glob Public Health. 2020;15(8):1093\\u0026ndash;102. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.1080/17441692.2020.1779331\\u003c/span\\u003e\\u003cspan address=\\\"10.1080/17441692.2020.1779331\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eWong S-C et al. (2022) Evolution and Control of COVID-19 Epidemic in Hong Kong. Viruses 2022, 14, 2519. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.3390/v14112519\\u003c/span\\u003e\\u003cspan address=\\\"10.3390/v14112519\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e Viruses 2022, 14, 2519. https://doi.org/10.3390/v14112519.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAtzrodt CL et al. (2020). A Guide to COVID-19: a global pandemic caused by the novel coronavirus SARS-CoV-2. FEBS J, 287: 3633\\u0026ndash;3650. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.1111/febs.15375\\u003c/span\\u003e\\u003cspan address=\\\"10.1111/febs.15375\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e The FEBS Journal 287 (2020) 3633\\u0026ndash;3650 \\u0026ordf; 2020 Federation of European Biochemical Societies.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eVitiello L et al. (2022). Preventive Measures against Pandemics from the Beginning of Civilization to Nowadays\\u0026mdash;How Everything Has Remained the Same over the Millennia. \\u003cem\\u003eJournal of Clinical Medicine\\u003c/em\\u003e, \\u003cem\\u003e11\\u003c/em\\u003e(7), 1960. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.3390/jcm11071960\\u003c/span\\u003e\\u003cspan address=\\\"10.3390/jcm11071960\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eManikandan N. Are social distancing, hand washing and wearing masks appropriate measures to mitigate transmission of COVID-19? Vacunas. 2020 Jul-Dec;21(2):136\\u0026ndash;137. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1016/j.vacun.2020.09.001\\u003c/span\\u003e\\u003cspan address=\\\"10.1016/j.vacun.2020.09.001\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e. Epub 2020 Sep 12. PMID: 32952487; PMCID: PMC7486867.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eMoraga WA-SP, Ghazi H, Madad S, Peter J, Hotez. The emergence and transmission of COVID-19 in European countries, 2019\\u0026ndash;2020: a comprehensive review of timelines, cases and containment. Int Health. September 2021;13(5):383\\u0026ndash;98. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003ehttps://doi.org/10.1093/inthealth/ihab037\\u003c/span\\u003e\\u003cspan address=\\\"10.1093/inthealth/ihab037\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e \\u003cli\\u003e\\u003cspan\\u003eAhmadi S, Jorjoran Shushtari Z, Shirazikhah M, et al. Social Determinants of Adherence to COVID-19 Preventive Guidelines in Iran: A Qualitative Study. INQUIRY: J Health Care Organ Provis Financing. 2022;59. \\u003cspan class=\\\"ExternalRef\\\"\\u003e\\u003cspan class=\\\"RefSource\\\"\\u003e10.1177/00469580221084185\\u003c/span\\u003e\\u003cspan address=\\\"10.1177/00469580221084185\\\" targettype=\\\"DOI\\\" class=\\\"RefTarget\\\"\\u003e\\u003c/span\\u003e\\u003c/span\\u003e.\\u003c/span\\u003e\\u003c/li\\u003e\\u003c/ol\\u003e\"},{\"header\":\"Table 1\",\"content\":\"\\u003cp\\u003eTable 1 is available in the Supplementary Files section.\\u003c/p\\u003e\\n\"}],\"fulltextSource\":\"\",\"fullText\":\"\",\"funders\":[],\"hasAdminPriorityOnWorkflow\":false,\"hasManuscriptDocX\":true,\"hasOptedInToPreprint\":true,\"hasPassedJournalQc\":\"\",\"hasAnyPriority\":false,\"hideJournal\":false,\"highlight\":\"\",\"institution\":\"\",\"isAcceptedByJournal\":false,\"isAuthorSuppliedPdf\":false,\"isDeskRejected\":\"\",\"isHiddenFromSearch\":false,\"isInQc\":false,\"isInWorkflow\":false,\"isPdf\":false,\"isPdfUpToDate\":true,\"isWithdrawnOrRetracted\":false,\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"bmc-public-health\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"pubh\",\"sideBox\":\"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)\",\"snPcode\":\"\",\"submissionUrl\":\"https://www.editorialmanager.com/pubh/default.aspx\",\"title\":\"BMC Public Health\",\"twitterHandle\":\"@BMC_series\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"BMC Series\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true},\"keywords\":\"COVID-19 interventions, Safe behaviour change, Boda-boda cyclists, Non-pharmaceutical interventions\",\"lastPublishedDoi\":\"10.21203/rs.3.rs-9219581/v1\",\"lastPublishedDoiUrl\":\"https://doi.org/10.21203/rs.3.rs-9219581/v1\",\"license\":{\"name\":\"CC BY 4.0\",\"url\":\"https://creativecommons.org/licenses/by/4.0/\"},\"manuscriptAbstract\":\"\\u003cp\\u003e\\u003cb\\u003eBackground\\u003c/b\\u003e\\u003c/p\\u003e \\u003cp\\u003eThe COVID-19 pandemic led governments worldwide to implement several public health interventions aimed at reducing transmission of the virus. In Uganda, preventive measures such as mask wearing, hand hygiene, social distancing, and public sensitization were implemented to mitigate the spread of the disease. Boda-boda cyclists represent a high-risk population due to their frequent interactions with passengers and mobility within urban environments. However, little empirical evidence exists regarding how these interventions influenced safe behavioural practices among informal transport operators. This study assessed the effects of COVID-19 prevention interventions on safe behaviour change among boda-boda cyclists in Lira City, Northern Uganda.\\u003c/p\\u003e\\u003cp\\u003e\\u003cb\\u003eMethods\\u003c/b\\u003e\\u003c/p\\u003e \\u003cp\\u003eA cross-sectional study design employing mixed methods was conducted among boda-boda cyclists in Lira City. A sample of 366 respondents was selected from an estimated population of 4,325 riders using simple random sampling. Data were collected using structured questionnaires and key informant interviews. Quantitative data were analyzed using descriptive statistics, chi-square tests, and logistic regression to determine associations between COVID-19 interventions and safe behaviour change. Qualitative data were analyzed thematically to complement quantitative findings.\\u003c/p\\u003e\\u003cp\\u003e\\u003cb\\u003eResults\\u003c/b\\u003e\\u003c/p\\u003e \\u003cp\\u003eThe findings indicated that COVID-19 prevention interventions positively influenced safe behaviour change among boda-boda cyclists. High levels of adherence were observed in practices such as avoiding crowded places, wearing face masks, and practicing hand hygiene. However, inconsistent compliance was noted in proper mask usage and access to protective equipment due to affordability constraints. Social and economic factors, including reduced income during lockdowns and inconsistent enforcement of standard operating procedures, also influenced adherence to COVID-19 preventive measures.\\u003c/p\\u003e\\u003cp\\u003e\\u003cb\\u003eConclusions\\u003c/b\\u003e\\u003c/p\\u003e \\u003cp\\u003eCOVID-19 prevention interventions significantly contributed to safe behavioural practices among boda-boda cyclists in Lira City. However, gaps remain in access to preventive resources, sustained compliance, and enforcement of public health guidelines. Strengthening community sensitization, improving accessibility to preventive materials, and enhancing enforcement mechanisms could further promote safe behaviour among high-risk occupational groups.\\u003c/p\\u003e\",\"manuscriptTitle\":\"Assessment of the Effects of COVID-19 Prevention Interventions on Safe Behaviour Change among Boda-Boda Cyclists in Lira City, Northern Uganda: A Cross-Sectional Study\",\"msid\":\"\",\"msnumber\":\"\",\"nonDraftVersions\":[{\"code\":1,\"date\":\"2026-04-30 23:47:19\",\"doi\":\"10.21203/rs.3.rs-9219581/v1\",\"editorialEvents\":[{\"type\":\"communityComments\",\"content\":0},{\"type\":\"editorInvitedReview\",\"content\":\"\",\"date\":\"2026-05-17T20:23:58+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"editorInvitedReview\",\"content\":\"\",\"date\":\"2026-05-15T15:42:43+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"285170042218536461203776615423298759003\",\"date\":\"2026-04-28T19:12:36+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"102852794173275242614604945670617789235\",\"date\":\"2026-04-24T03:06:50+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewerAgreed\",\"content\":\"92450852934167354463670327300445321412\",\"date\":\"2026-04-24T00:26:14+00:00\",\"index\":\"hide\",\"fulltext\":\"\"},{\"type\":\"reviewersInvited\",\"content\":\"\",\"date\":\"2026-04-21T18:02:40+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorAssigned\",\"content\":\"\",\"date\":\"2026-04-20T12:47:25+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"editorInvited\",\"content\":\"\",\"date\":\"2026-03-30T15:34:49+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"checksComplete\",\"content\":\"\",\"date\":\"2026-03-30T11:45:35+00:00\",\"index\":\"\",\"fulltext\":\"\"},{\"type\":\"submitted\",\"content\":\"BMC Public Health\",\"date\":\"2026-03-30T11:41:03+00:00\",\"index\":\"\",\"fulltext\":\"\"}],\"status\":\"published\",\"journal\":{\"display\":true,\"email\":\"info@researchsquare.com\",\"identity\":\"bmc-public-health\",\"isNatureJournal\":false,\"hasQc\":true,\"allowDirectSubmit\":false,\"externalIdentity\":\"pubh\",\"sideBox\":\"Learn more about [BMC Public Health](http://bmcpublichealth.biomedcentral.com/)\",\"snPcode\":\"\",\"submissionUrl\":\"https://www.editorialmanager.com/pubh/default.aspx\",\"title\":\"BMC Public Health\",\"twitterHandle\":\"@BMC_series\",\"acdcEnabled\":true,\"dfaEnabled\":false,\"editorialSystem\":\"em\",\"reportingPortfolio\":\"BMC Series\",\"inReviewEnabled\":true,\"inReviewRevisionsEnabled\":true}}],\"origin\":\"\",\"ownerIdentity\":\"d422b4ae-36ff-49ff-a251-5955a1de212c\",\"owner\":[],\"postedDate\":\"April 30th, 2026\",\"published\":true,\"recentEditorialEvents\":[{\"type\":\"editorInvitedReview\",\"content\":\"\",\"date\":\"2026-05-17T20:23:58+00:00\",\"index\":65,\"fulltext\":\"\"},{\"type\":\"editorInvitedReview\",\"content\":\"\",\"date\":\"2026-05-15T15:42:43+00:00\",\"index\":64,\"fulltext\":\"\"}],\"rejectedJournal\":[],\"revision\":\"\",\"amendment\":\"\",\"status\":\"under-review\",\"subjectAreas\":[],\"tags\":[],\"updatedAt\":\"2026-04-30T23:47:19+00:00\",\"versionOfRecord\":[],\"versionCreatedAt\":\"2026-04-30 23:47:19\",\"video\":\"\",\"vorDoi\":\"\",\"vorDoiUrl\":\"\",\"workflowStages\":[]},\"version\":\"v1\",\"identity\":\"rs-9219581\",\"journalConfig\":\"researchsquare\"},\"__N_SSP\":true},\"page\":\"/article/[identity]/[[...version]]\",\"query\":{\"redirect\":\"/article/rs-9219581\",\"identity\":\"rs-9219581\",\"version\":[\"v1\"]},\"buildId\":\"XKTyCvWXoU3ODBz1xrDgd\",\"isFallback\":false,\"isExperimentalCompile\":false,\"dynamicIds\":[84888],\"gssp\":true,\"scriptLoader\":[]}","source_license":"CC-BY-4.0","license_restricted":false}