COVID-19: Developing evidence-based messages to encourage preventive health behaviours

Lead Research Organisation: Queen's University Belfast
Department Name: Sch of Behavioural Sciences

Abstract

Variables such as a person's health beliefs, social support, culture, etc. influence the likelihood of undertaking a health behaviour. Therefore, these variables need to be addressed in any public health messages designed to encourage preventive behaviours (such as handwashing and social distancing). In times of a pandemic, when lives are at risk if certain behaviours are not followed, the careful design of public health messages becomes even more important. To help public health officials to design effective messages, we need to identify the specific variables that are most strongly related to each preventive behaviour so that these can be prioritised.

Our project will provide this information by rigorously reviewing the existing research literature about the variables that explain the likelihood of engaging in preventive behaviours (such as handwashing and social distancing). The research included in this review will have been conducted in the context of illnesses similar to COVID-19, such as severe acute respiratory syndrome (SARS), and pandemic and seasonal influenza. We will also include any relevant evidence about COVID-19 that emerges over the course of our review.

The findings of the review will be summarised for public health bodies and will help to optimise the effectiveness of any messages designed to encourage preventive behaviours for COVID-19 or any future similar situations.
 
Description Behaviour remains the most important means of controlling the spread of COVID-19 and is vital to protecting the population and reducing pressure on health services. Understanding what influences health protective behaviours can help us to design better policy and interventions to improve behaviour. The evidence identified in our review of existing research so far tells us that each behaviour is related to different factors.
We completed a comprehensive review of research that was published over the past few decades that examined the determinants of behaviours thought to minimise the spread of viruses similar to the Coronavirus that causes COVID-19. A total of 58 published peer-reviewed studies included in the review were identified through searches of various electronic databases. Most of the research we identified was conducted in the context of the influenza A (H1N1) pandemic in 2009. Most of the studies examined the determinants of wearing a face covering, handwashing and social or physical distancing. The results of this review suggest that public health messages to encourage preventive behaviours should emphasise the potential seriousness of COVID-19 to elicit appropriate concern, strengthen perceptions of risk or threat from COVID-19, enhance self-efficacy about preventive behaviours, and improve knowledge about SARS-CoV-2, how it is transmitted, and how preventive behaviours can reduce the risk of transmission.

As part of our review, we also identified the research that was emerging from the COVID-19 pandemic. The preliminary findings from this work suggested the following:
For social distancing, better knowledge of COVID may relate to better social distancing; women more likely to socially distance than men but the difference is small; older people are more likely to keep their distance from others than younger people; there is no consistent relationship with level of education; employed people are less likely to keep their distance from others.
In terms of wearing face coverings, older people are not more likely to wear masks than younger people; women are slightly more likely to wear masks than men.
For handwashing, a greater knowledge of COVID-19 was related to better hand hygiene; higher levels of education are related to better handwashing; there is o consistent effect of age.
Isolation / quarantining is more likely when government covers lost wages. Older people are more willing to isolate up to age 75. People over 75 years old are less willing to isolate. There is little difference between men and women.
For cleaning surfaces, teenagers are more likely to clean surfaces when they think COVID is serious; teenagers who value social responsibility cleaned more; teenage girls are slightly more likely than boys to clean surfaces; older teenagers are slightly more likely than younger teens to clean surfaces.
In addition, we found that women were slightly more likely to use a tissue or cough into elbow than men.

However, an important caveat about our review is that a considerable amount of research has been conducted since our review was completed. We are, therefore, currently undertaking a more comprehensive review of the research that has been published since the date of this review, to provide a fuller picture of the determinants of health behaviours during the COVID-19 pandemic.
Exploitation Route Ultimately, the project outcomes can assist the management of COVID-19 and other, similar viruses, by providing evidence-based advice on the design of public health messages that encourage behaviour change to prevent the spread of the virus.
Sectors Healthcare
 
Description Our findings have now been published in an open access journal and the final results have been presented to public health and policy groups, such as the Four Nations Public Health Group and the International Public Policy Observatory. On the basis of conversations with public health practitioners, we believe that our research will inform their thinking around future public health messaging.
Sector Healthcare
Impact Types Policy & public services
 
Description Membership of Behaviour Change Group, Public Health Agency Northern Ireland
Geographic Reach National 
Policy Influence Type Participation in a guidance/advisory committee
 
Description Contribution to IPPO website 
Form Of Engagement Activity Engagement focused website, blog or social media channel
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact We wrote a summary of our findings, in lay terms, for the International Public Policy Observatory (IPPO) website.
Year(s) Of Engagement Activity 2021
URL https://covidandsociety.com/covid-19-best-ways-encourage-people-adopt-preventive-health-behaviours/
 
Description Presentation for 4 Nations Public Health Group 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presented preliminary results of systematic review to 4 Nations Public Health Group, which includes public health practitioners from the UK and devolved administrations within the UK.
Year(s) Of Engagement Activity 2020