{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:08:56Z","timestamp":1789193336432,"version":"build-2803163510"},"reference-count":25,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T00:00:00Z","timestamp":1788998400000},"content-version":"unspecified","delay-in-days":71,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2026,8,19]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>To examine adherence to COVID-19 public health measures among culturally and linguistically diverse (CALD) and low socioeconomic status (SES) populations in the Australian state of Victoria using a unique longitudinal cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>The Optimise Study was a mixed-methods longitudinal cohort and social networks study (September 2020\u2013December 2023) assessing the impact of COVID-19 and related public health measures in Victoria, Australia. We used a serial cross-sectional design to analyse adherence to public health recommendations, restrictions and requirements. The study examines two 28-day periods during the COVID-19 pandemic in Victoria: 23 April\u201320 May 2021 (\u2018non-lockdown\u2019) and 13 September\u201310 October 2021 (\u2018lockdown\u2019). We explored adherence to three categories of COVID-19 public health measures\u2014Recommendations (non-enforced, longer-term), Restrictions (mandated during lockdown periods) and Requirements (mandated, longer-term)\u2014among participants who completed questionnaires during these periods. Participants were grouped as (1) non-CALD high SES (did not meet CALD or low-SES criteria), (2) CALD or (3) non-CALD low-SES. Primary outcomes were adherence to recommendations, restrictions and requirements during the two study periods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 782 participants recruited, 579 (75%) completed a survey or diary during at least one study period and were included in the analysis. Of these, 275 (47%) were in the \u2018non-CALD high-SES\u2019 group, 114 (20%) in the CALD group and 190 (33%) in the \u2018non-CALD low-SES\u2019 group. Across all groups, risk-reduction behaviours increased during the lockdown. CALD participants showed higher adherence to some recommendations and restrictions compared with the other groups. Overall, 28% left home while awaiting a COVID-19 test result, commonly due to work.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>High adherence among CALD and \u2018non-CALD low-SES\u2019 groups suggest structural barriers, rather than behavioural non-compliance, contributed to higher COVID-19 impacts, highlighting the need for tailored support. During future public health emergencies, better supports are needed for individuals working outside of home to remain in isolation while awaiting a test result.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-004176","type":"journal-article","created":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T05:10:23Z","timestamp":1789189823000},"page":"e004176","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Adherence to public health recommendations, restrictions and requirements among priority populations at risk for COVID-19 mortality and infection in Victoria, Australia: a serial cross-sectional study"],"prefix":"10.1136","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6667-2868","authenticated-orcid":false,"given":"Shanti","family":"Narayanasamy","sequence":"first","affiliation":[{"name":"Burnet Institute, Melbourne, Victoria, Australia"},{"name":"Department of Infectious Diseases and Immunology, Austin Health, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3617-2413","authenticated-orcid":false,"given":"Aim\u00e9e","family":"Altermatt","sequence":"additional","affiliation":[{"name":"Burnet Institute, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4475-5224","authenticated-orcid":false,"given":"Anna","family":"Wilkinson","sequence":"additional","affiliation":[{"name":"Burnet Institute, Melbourne, Victoria, Australia"},{"name":"Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4752-9732","authenticated-orcid":false,"given":"Katherine","family":"Heath","sequence":"additional","affiliation":[{"name":"Burnet Institute, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine B","family":"Gibney","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Peter Doherty Institute for Infection and Immunity, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Hellard","sequence":"additional","affiliation":[{"name":"Burnet Institute, Melbourne, Victoria, Australia"},{"name":"Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alisa","family":"Pedrana","sequence":"additional","affiliation":[{"name":"Burnet Institute, Melbourne, Victoria, Australia"},{"name":"Monash University School of Public Health and Preventive Medicine, Melbourne, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,11]]},"reference":[{"key":"2026091122101479000_4.3.e004176.1","unstructured":"Commonwealth of Australia . 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The impact of a new disease: COVID-19 from 2020, 2021 and into 2022. 2023."},{"key":"2026091122101479000_4.3.e004176.25","unstructured":"Victorian government gazette no. s 495 Friday 10 September 2021. 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