. . "BACKGROUND: Social distancing is an effective preventative policy for the coronavirus disease (COVID-19) that is enforced by governments worldwide. However, significant variations are observed in following the policy across individuals and countries. Arguably, differences in citizens\u2019 adherence actions will be influenced by their perceptions about government\u2019s plans and the information available to guide their behaviors\u2014more so in the digital age in the realm of mass influence of social media on citizens. Insights into the underlying factors and dynamics involved with citizens\u2019 adherence process will inform the policy makers to follow appropriate communication and messaging approaches to influence citizens\u2019 willingness to adhere to the recommendations. OBJECTIVE: The aim of this study is a comparative evaluation of citizens\u2019 adherence process to COVID-19\u2013relevant recommendations by the government. The focus is on how three different countries\u2019 (United States, Kuwait, and South Korea) citizens, randomly sampled, respond to governments\u2019 pandemic guidance efforts. We draw insights into two categories of perceived government roles in managing the pandemic: (1) citizens\u2019 perceptions of government\u2019s role in responding to the pandemic and (2) citizens\u2019 perceptions of government\u2019s business reopening efforts. Undoubtedly, the internet and social media have burgeoned, with differing effects on shaping individuals\u2019 views and assessments of the COVID-19 situation; we argue and test for the effects of information sources, social media use, and knowledge on the adherence actions. METHODS: We randomly sampled web-based survey data collected by a global firm in May 2020 from citizens of the United States, Kuwait, and South Korea. A nonlinear ordered probit regression, controlling for several counterfactuals, was used for analysis. The focal estimated effects of the study were compared across countries using the weighted distance between the parameter estimates. RESULTS: The total sample size was 482 respondents, of which 207 (43%) lived in the United States, 181 (38%) lived in Kuwait, and 94 (20%) lived in South Korea. The ordered probit estimation results suggest that overall, perception of government response efforts positively influenced self-adherence (P<.001) and others\u2019 adherence (P<.001) to social distancing and sheltering. Perception of government business reopening efforts positively influenced others\u2019 adherence (P<.001). A higher intensity of general health information source for COVID-19 had a positive effect on self-adherence (P=.003). A higher intensity of social media source use for COVID-19 positively influenced others\u2019 adherence (P=.002). A higher intensity of knowledge on COVID-19 positively influenced self-adherence (P=.008) and negatively influenced others\u2019 adherence (P<.001). There were country-level variations\u2014broadly, the United States and Kuwait had better effects than South Korea. CONCLUSIONS: As the COVID-19 global pandemic continues to grow and governmental restrictions are ongoing, it is critical to understand people\u2019s frustration to reduce panic and promote social distancing to facilitate the control of the pandemic. This study finds that the government plays a central role in terms of adherence to restrictions. Governments need to enhance their efforts on publicizing information on the pandemic, as well as employ strategies for improved communication management to citizens through social media as well as mainstream information sources." .