Systematic review of interventions to promote the performance of physical distancing behaviours during pandemics/epidemics of infectious diseases spread via aerosols or droplets

Abstract

ObjectivesPhysical-distancing (i.e., keeping 1-2m apart when co-located) can prevent cases of infectious-diseases spread by droplets/aerosols (i.e. SARS-COV2). Distancing is a recommendation/requirement in many countries. This systematic-review aimed to determine which interventions and behaviour change techniques (BCTs) are effective in promoting adherence to physical-distancing and through which potential mechanisms of action (MOAs). MethodsSix databases were searched for studies of physical-distancing interventions. A narrative synthesis included any design that included a comparator (e.g., pre-intervention versus post-intervention; randomised controlled trial), for any population and year. Risk-of-bias was assessed using the Mixed Methods Appraisal Tool. BCTs and potential MoAs were identified in each intervention.. ResultsSix papers of moderate/high quality indicated that distancing interventions could successfully change MoAs/behaviour. Successful BCTs (MoAs) included feedback on behaviour (e.g., motivation); information about/ salience of health consequences (e.g., beliefs about consequences) and demonstration (e.g., beliefs about capabilities) and restructuring the physical environment (e.g., environmental context and resources). The most promising interventions were proximity buzzers, directional systems and posters with loss-framed messages that demonstrated the behaviours. ConclusionsHigh quality RCTs that measure behaviour, have representative samples and specify/test a larger range of BCTs /MoAs are needed.

Ethical preparedness in health research and care: the role of behavioural approaches

“…To apply our conceptualisation of ethical preparedness to our case studies we drew on published methodologies that apply COM-B [29,30]. LMB has extensive experience with this methodological approach.…”

Predictors of physical distance in the context of the COVID-19 pandemic | Fact-sheets collection from the Portuguese COVID-19 pandemic Task Force on Behavioral Sciences

“…• The most often cited facilitators of the adoption of physical distancing behaviours are: concern with the protection of others, concern regarding own's protection, feeling of social responsibility, and trust in science and politics. On the contrary, barriers to this behaviour include: having family or friends who need help with tasks, the perception that there are too many people on the street (i.e., "if others can be in the street, so the risk must be low"), not trusting government messages about the pandemic, and feeling anxious or depressed when one is alone (Coroiu et al, 2020;Epton et al, 2021;Taylor et al, 2020). • Health beliefs are important determinants of emotions and health-related behaviours.…”

“…So, intensified risk beliefs for health tend to function as predictors of negative stress and avoidance (therefore, of maintenance of physical distance), while beliefs of lower risk related to health tend to predict non-adherence to recommendations of physical distancing (Coroiu et al, 2020;Epton et al, 2021;Taylor et al, 2020). • Evidence is unclear regarding the effect of using masks on maintaining physical distancing: it can both increase a feeling of security/protection and promote proximity, but it can also increase the perceived need for physical distancing (Coroiu et al, 2020;Epton et al, 2021;Taylor et al, 2020). • Men and younger people (18-24 years old) tend to adhere less to physical distancing recommendations (Coroiu et al, 2020;Epton et al, 2021;Taylor et al, 2020).…”

“…• Evidence is unclear regarding the effect of using masks on maintaining physical distancing: it can both increase a feeling of security/protection and promote proximity, but it can also increase the perceived need for physical distancing (Coroiu et al, 2020;Epton et al, 2021;Taylor et al, 2020). • Men and younger people (18-24 years old) tend to adhere less to physical distancing recommendations (Coroiu et al, 2020;Epton et al, 2021;Taylor et al, 2020). • Formal (e.g., newspapers, press releases, and educational messages), but mainly informal (e.g., social networks, opinion articles, family models, and peers) sources of information tend to affect the perception of a public health emergency, which, in turn, can determine physical distancing behaviours.…”