BACKGROUND The outbreak of novel viruses like COVID-19 creates many uncertainties for scientists, political leaders, and communities alike. In the absence of an effective vaccine or treatment for COVID-19, it is population-level behavioural changes, such as hand washing or self-isolation when symptomatic that are central to reducing transmission. Health authorities are faced with the challenge of how best to communicate appropriate behaviours to mitigate the risk to the public. It is crucial to understand not only the best ways of communicating this information but also how populations might respond. AIMS To conduct a rapid review to identify and synthesise evidence relating to: a) What characterises effective public health messages for managing risk and preventing disease during public health crises? and b) What influences people’s responses to public health messages about health risk communication? FINDINGS AND CONCLUSIONS Key recommendations should be considered when designing and delivering public health messages: engage communities in the development of public health messaging, using credible and legitimate sources, address uncertainty immediately and with transparency, focus on unified messages from all sources, and develop messages aimed at increasing understanding, inducing social responsibility and empowering personal control. Embedding the principles of behavioural science into public health messaging is an important step towards more effective health risk communication.

Public health teams need to understand how the public responds to vaccination messages in a pandemic or epidemic to inform successful campaigns encouraging the uptake of new vaccines as they become available. A rapid systematic review was performed by searching PsycINFO, MEDLINE, healthevidence.org, OSF Preprints and PsyArXiv Preprints in May 2020 for studies including at least one health message promoting vaccine uptake of airborne-, droplet- and fomite-spread viruses. Included studies were assessed for quality using the Mixed Methods Appraisal Tool (MMAT) or the Assessment of Multiple Systematic Reviews (AMSTAR), and for patient and public involvement (PPI) in the research. Thirty-five articles were included. Most reported messages for seasonal influenza (n = 11; 31%) or H1N1 (n = 11; 31%). Evidence from moderate to high quality studies for improving vaccine uptake included providing information about virus risks and vaccination safety, as well as addressing vaccine misunderstandings, offering vaccination reminders, including vaccination clinic details, and delivering mixed media campaigns across hospitals or communities. Behavioural influences (beliefs and intentions) were improved when: shorter, risk-reducing or relative risk framing messages were used; the benefits of vaccination to society were emphasised; and beliefs about capability and concerns among target populations (e.g., vaccine safety) were addressed. Clear, credible, messages in a language target groups can understand were associated with higher acceptability. Two studies (6%) described PPI in the research process. Future campaigns should consider the beliefs and information needs of target populations in their design, including ensuring that vaccine eligibility and availability is clear, and messages are accessible. More high quality research is needed to demonstrate the effects of messaging interventions on actual vaccine uptake.

BackgroundIndividual behaviour changes, such as hand hygiene and physical distancing, are required on a population scale to reduce transmission of infectious diseases such as COVID-19. However, little is known about effective methods of communicating risk reducing information, and how populations might respond.ObjectiveTo synthesise evidence relating to what (1) characterises effective public health messages for managing risk and preventing infectious disease and (2) influences people’s responses to messages.DesignA rapid systematic review was conducted. Protocol is published on Prospero CRD42020188704.Data sourcesElectronic databases were searched: Ovid Medline, Ovid PsycINFO and Healthevidence.org, and grey literature (PsyarXiv, OSF Preprints) up to May 2020.Study selectionAll study designs that (1) evaluated public health messaging interventions targeted at adults and (2) concerned a communicable disease spread via primary route of transmission of respiratory and/or touch were included. Outcomes included preventative behaviours, perceptions/awareness and intentions. Non-English language papers were excluded.SynthesisDue to high heterogeneity studies were synthesised narratively focusing on determinants of intentions in the absence of measured adherence/preventative behaviours. Themes were developed independently by two researchers and discussed within team to reach consensus. Recommendations were translated from narrative synthesis to provide evidence-based methods in providing effective messaging.ResultsSixty-eight eligible papers were identified. Characteristics of effective messaging include delivery by credible sources, community engagement, increasing awareness/knowledge, mapping to stage of epidemic/pandemic. To influence intent effectively, public health messages need to be acceptable, increase understanding/perceptions of health threat and perceived susceptibility.DiscussionThere are four key recommendations: (1) engage communities in development of messaging, (2) address uncertainty immediately and with transparency, (3) focus on unifying messages from sources and (4) frame messages aimed at increasing understanding, social responsibility and personal control. Embedding principles of behavioural science into public health messaging is an important step towards more effective health-risk communication during epidemics/pandemics.

Background: Public health teams need to understand how the public responds to vaccination messages in a pandemic or epidemic to inform successful campaigns encouraging the uptake of new vaccines as they become available. Methods: A rapid systematic review was performed by searching PsycINFO, MEDLINE, healthevidence.org, OSF Preprints and PsyArXiv Preprints in May 2020 for studies including at least one health message promoting vaccine uptake of droplet spread viruses. Non-English language studies and dissertations were excluded in line with using rapid review methodology. Included studies were assessed for quality using the MMAT or AMSTAR, and for patient and public involvement (PPI) in designing and/or conducting the research. Results: Thirty-five articles were included. Most reported messages for seasonal influenza (n=11; 31%) or H1N1 (n = 11; 31%) and only seven studies (20%) sampled vulnerable populations at higher risk of mortality/morbidity from viruses, e.g. older adults. Evidence from moderate to high quality studies for improving vaccine uptake included providing: information about virus risks, vaccination safety, and addressing misunderstandings about vaccination, vaccination reminders, detail about vaccination clinics and their locations, and mixed media campaigns at scale across hospitals or communities. Behavioural influences (beliefs and intentions) were improved when shorter messages, risk-reducing, or relative risk framing was used, the benefits of vaccination to society were emphasised, and beliefs about capability to be vaccinated and concerns among target populations (e.g. about vaccine safety) were addressed. Clear, credible, messages in language target groups can understand were found acceptable. Two studies (6%) described PPI in the research process. Conclusions: This review has identified effective messages to encourage vaccination and improve vaccination beliefs and intentions. Future campaigns should consider the beliefs and information needs of target populations in their design. Findings were inconclusive whether the medium through which the message was delivered, e.g. text message, affected outcomes. More high quality research is needed to demonstrate the behavioural outcomes of messaging interventions.

Background Negative self-perceptions is one of the most common symptoms of depression in young people, and has been found to be strongly associated with severity of depression symptoms. Psychological treatments for adolescent depression are only moderately effective. Understanding the role and importance of these self-perceptions may help to inform and improve treatments. The aim of this review was to examine self-evaluation as a characteristic of adolescent depression, and as an active ingredient in treatment for adolescent depression. Methods We conducted a scoping review which included quantitative and qualitative studies of any design that reported on self-evaluation as a characteristic of, or focus of treatment for, adolescent depression. Participants were required to be 11–24 years and experiencing elevated symptoms of depression or a diagnosis. We also met with 14 expert advisory groups of young people with lived experience, clinicians, and researchers, for their input. Findings from 46 peer-reviewed research studies are presented alongside views of 64 expert advisors, to identify what is known and what is missing in the literature. Results Three overarching topics were identified following the review and reflections from advisors: 1) What does it look like? 2) Where does it come from? and 3) How can we change it? The literature identified that young people view themselves more negatively and less positively when depressed, however expert advisors explained that view of self is complex and varies for each individual. Literature identified preliminary evidence of a bidirectional relationship between self-evaluation and depression, however, advisors raised questions regarding the influences and mechanisms involved, such as being influenced by the social environment, and by the cognitive capacity of the individual. Finally, there was a consensus from the literature and expert advisors that self-evaluation can improve across treatment. However, research literature was limited, with only 11 identified studies covering a diverse range of interventions and self-evaluation measures. Various barriers and facilitators to working on self-evaluation in treatment were highlighted by advisors, as well as suggestions for treatment approaches. Conclusions Findings indicate the importance of self-evaluation in adolescent depression, but highlight the need for more research on which treatments and treatment components are most effective in changing self-evaluation.