Strengths and Limitations
One strength of this study is the relatively up-to-date data, which comes from a representative population-based survey. This allows to draw generalized conclusions about protective behavior in the German population and to identify factors that are related to individual behavior change until the end of March 2020. Another strength is the amount of different behaviors that were assessed. Other studies partially only assessed the numbers of protective practices or data was less detailed relating to the different measures (17, 38).
This study also has some limitations. Since protective behavior may depend on peoples' health status, one limitation of this survey is the lack of information on this aspect. We cannot rule out that part of the explanation why some people tend to adopt protective practices more intensively than other people might be due to their increased health risks. Furthermore, although we have educational status as an indicator for a person's socioeconomic status, the survey collected no data on income. This partly restricts comparisons of our results with other studies that found associations of socioeconomic position and COVID-19 related protective behavior. Another limitation is that the data is cross-sectional and stems from an early stage of the COVID-19 outbreak in Germany. Hence, we cannot predict how people would change their protective behavior during the later course of the pandemic, which would require a longitudinal survey. Finally, the survey questions assessed protective behavior only with a binary yes/no measure. Although this allows to analyze whether or not people have changed their behavior to response to the pandemic, it limits conclusions about the extent to which people have adopted protective practices. Moreover, these questions provide insufficient information about the perception of the different behaviors and measures like “social distancing.” It may be that people with certain socio-demographic background attribute a different importance to these behaviors and measures.