Infection Control Behavior at Home During the COVID-19 Pandemic: Observational Study of a Web-Based Behavioral Intervention (Germ Defence)

Abstract

Background To control the COVID-19 pandemic, people should adopt protective behaviors at home (self-isolation, social distancing, putting shopping and packages aside, wearing face coverings, cleaning and disinfecting, and handwashing). There is currently limited support to help individuals conduct these behaviors. Objective This study aims to report current household infection control behaviors in the United Kingdom and examine how they might be improved. Methods This was a pragmatic cross-sectional observational study of anonymous participant data from Germ Defence between May 6-24, 2020. Germ Defence is an open-access fully automated website providing behavioral advice for infection control within households. A total of 28,285 users sought advice from four website pathways based on household status (advice to protect themselves generally, to protect others if the user was showing symptoms, to protect themselves if household members were showing symptoms, and to protect a household member who is at high risk). Users reported current infection control behaviors within the home and intentions to change these behaviors. Results Current behaviors varied across all infection control measures but were between sometimes (face covering: mean 1.61, SD 1.19; social distancing: mean 2.40, SD 1.22; isolating: mean 2.78, SD 1.29; putting packages and shopping aside: mean 2.75, SD 1.55) and quite often (cleaning and disinfecting: mean 3.17, SD 1.18), except for handwashing (very often: mean 4.00, SD 1.03). Behaviors were similar regardless of the website pathway used. After using Germ Defence, users recorded intentions to improve infection control behavior across all website pathways and for all behaviors (overall average infection control score mean difference 0.30, 95% CI 0.29-0.31). Conclusions Self-reported infection control behaviors other than handwashing are lower than is optimal for infection prevention, although handwashing is much higher. Advice using behavior change techniques in Germ Defence led to intentions to improve these behaviors. Promoting Germ Defence within national and local public health and primary care guidance could reduce COVID-19 transmission.

Adapting Behavioral Interventions for a Changing Public Health Context: A Worked Example of Implementing a Digital Intervention During a Global Pandemic Using Rapid Optimisation Methods

“…Comparing self-reported current behavioral frequency and behavioral intentions after using the intervention helped confirm that the intervention was successfully increasing people's intentions to perform protective behaviors more frequently (24). Self-reported goal-setting data also provided insights into which of the target behaviors users intended to perform most frequently (cleaning and putting things aside), and which they intended to do least often (wearing face-coverings at home) (24), which helped inform ongoing optimisations to the intervention 1 .…”

“…At the onset of the Covid-19 pandemic, an additional core component (called "Reducing Illness") was added to Germ Defense which aimed to promote engagement in additional protective behaviors at home when acceptable and appropriate (for example, if symptomatic or vulnerable), including selfisolation, social-distancing, wearing face-coverings, cleaning, and leaving deliveries aside. After a brief introduction to increase awareness of risk from Covid-19 and increase self-efficacy to manage risk, users could choose between the core components of Reducing Illness or Handwashing (24). The intervention is described in full elsewhere (24).…”

“…After a brief introduction to increase awareness of risk from Covid-19 and increase self-efficacy to manage risk, users could choose between the core components of Reducing Illness or Handwashing (24). The intervention is described in full elsewhere (24).…”

“…By April 2020, further evidence had emerged about the importance of opening windows for improving infection control (24), and the stakeholder group agreed that this protective behavior needed to be promoted in its own right. In the next iteration of Germ Defense, opening windows was suggested as an effective protective behavior independently from self-isolation, and a rationale was added to increase positive beliefs about the consequences of opening windows: "Opening windows stops the virus collecting in the air".…”

SARS-CoV-2 genome datasets analytics for informed infectious disease surveillance

“…The COVID-19 pandemic has presented the urgent need for governments, healthcare decision makers, providers, and others, to refocus on balancing their response with wider health needs. The increased availability of novel web-based data sources can substantially improve infectious disease surveillance (Choi et al, 2016;Ainsworth et al, 2021). Globally, web-based surveillance tools and epidemic intelligence methods are providing new prospects to facilitate risk assessment and timely outbreak detection.…”