{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T09:29:20Z","timestamp":1771234160757,"version":"3.50.1"},"reference-count":55,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T00:00:00Z","timestamp":1629849600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Swiss Federal Office of Public Health"},{"name":"Health Promotion Switzerland"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Switzerland has a liberal implementation of Coronavirus mitigation measures compared to other European countries. Since March 2020, measures have been evolving and include a mixture of central and federalistic mitigation strategies across three culturally diverse language regions. The present study investigates a hypothesised heterogeneity in health, social behavior and adherence to mitigation measures across the language regions by studying pre-specified interaction effects. Our findings aim to support the communication of regionally targeted mitigation strategies and to provide evidence to address longterm population-health consequences of the pandemic by accounting for different pandemic contexts and cultural aspects.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We use data from from the COVID-19 Social Monitor, a longitudinal population-based online survey. We define five mitigation periods between March 2020 and May 2021. We use unadjusted and adjusted logistic regression models to investigate a hypothesized interaction effect between mitigation periods and language regions on selected study outcomes covering the domains of general health and quality of life, mental health, loneliness\/isolation, physical activity, health care use and adherence to mitigation measures.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>We analyze 2,163 (64%) participants from the German\/Romansh-speaking part of Switzerland, 713 (21%) from the French-speaking part and 505 (15%) from the Italian-speaking part. We found evidence for an interaction effect between mitigation periods and language regions for adherence to mitigation measures, but not for other study outcomes (social behavior, health). The presence of poor quality of life, lack of energy, no physical activity, health care use, and the adherence to mitigation measures changed similarly over mitigation periods in all language regions.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Discussion<\/jats:title>\n<jats:p>As the pandemic unfolded in Switzerland, also health and social behavior changed between March 2020 to May 2021. Changes in adherence to mitigation measures differ between language regions and reflect the COVID-19 incidence patterns in the investigated mitigation periods, with higher adherence in regions with previously higher incidence. Targeted communcation of mitigation measures and policy making should include cultural, geographical and socioeconomic aspects to address yet unknown long-term population health consequences caused by the pandemic.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0256253","type":"journal-article","created":{"date-parts":[[2021,8,25]],"date-time":"2021-08-25T17:41:43Z","timestamp":1629913303000},"page":"e0256253","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":21,"title":["Health and social behaviour through pandemic phases in Switzerland: Regional time-trends of the COVID-19 Social Monitor panel study"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7178-6539","authenticated-orcid":true,"given":"Andr\u00e9","family":"Moser","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Viktor","family":"von Wyl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2743-2199","authenticated-orcid":true,"given":"Marc","family":"H\u00f6glinger","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,8,25]]},"reference":[{"key":"pone.0256253.ref001","article-title":"COVID-19 epidemic in Switzerland: on the importance of testing, contact tracing and isolation.","author":"M Salath\u00e9","year":"2020","journal-title":"Swiss Med Wkly."},{"key":"pone.0256253.ref002","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1038\/s41586-020-2405-7","article-title":"Estimating the effects of non-pharmaceutical interventions on COVID-19 in Europe.","volume":"584","author":"S Flaxman","year":"2020","journal-title":"Nature."},{"key":"pone.0256253.ref003","doi-asserted-by":"crossref","first-page":"1303","DOI":"10.1038\/s41562-020-01009-0","article-title":"Ranking the effectiveness of worldwide COVID-19 government interventions","volume":"4","author":"N Haug","year":"2020","journal-title":"Nat Hum Behav."},{"key":"pone.0256253.ref004","article-title":"Social and regional variations in health status and health behaviours among Swiss young adults","author":"T Abel","year":"2013","journal-title":"Swiss Med Wkly."},{"key":"pone.0256253.ref005","article-title":"Tobacco-related cancer mortality: projections for different geographical regions in Switzerland","author":"V J\u00fcrgens","year":"2013","journal-title":"Swiss Med Wkly"},{"key":"pone.0256253.ref006","first-page":"1163","volume":"9","author":"A Chatelan","year":"2017","journal-title":"Results from the First National Nutrition Survey"},{"key":"pone.0256253.ref007","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.aap.2010.06.009","article-title":"Mortality from road traffic accidents in Switzerland: Longitudinal and spatial analyses","volume":"43","author":"A Spoerri","year":"2011","journal-title":"Accid Anal Prev"},{"key":"pone.0256253.ref008","article-title":"Trends in influenza vaccination uptake in Switzerland: Swiss Health Survey 2007 and 2012","author":"K Z\u00fcrcher","year":"2019","journal-title":"Swiss Med Wkly."},{"key":"pone.0256253.ref009","doi-asserted-by":"crossref","first-page":"e021006","DOI":"10.1136\/bmjopen-2017-021006","article-title":"Exploring variation in human papillomavirus vaccination uptake in Switzerland: a multilevel spatial analysis of a national vaccination coverage survey","volume":"8","author":"M Riesen","year":"2018","journal-title":"BMJ Open"},{"key":"pone.0256253.ref010","doi-asserted-by":"crossref","first-page":"200245","DOI":"10.5888\/pcd17.200245","article-title":"Culture Matters in Communicating the Global Response to COVID-19","volume":"17","author":"CO Airhihenbuwa","year":"2020","journal-title":"Prev Chronic Dis."},{"key":"pone.0256253.ref011","doi-asserted-by":"crossref","first-page":"e0242129","DOI":"10.1371\/journal.pone.0242129","article-title":"The COVID-19 Social Monitor longitudinal online panel: Real-time monitoring of social and public health consequences of the COVID-19 emergency in Switzerland. 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