Interventions to promote physical distancing behaviour during infectious disease pandemics or epidemics: A systematic review

Tracy Epton, Daniela Ghio, Lisa M. Ballard, Sarah F. Allen, Angelos P. Kassianos, Rachael Hewitt, Katherine Swainston, Wendy Irene Fynn, Vickie Rowland, Juliette Westbrook, Elizabeth Jenkinson, Alison Morrow, Grant J. McGeechan, Sabina Stanescu, Aysha A. Yousuf, Nisha Sharma, Suhana Begum, Eleni Karasouli, Daniel Scanlan, Gillian W. ShorterMadelynne A. Arden, Christopher J. Armitage, Daryl B. O'Connor, Atiya Kamal, Emily McBride, Vivien Swanson, Jo Hart, Lucie Byrne-Davis, Angel Chater, John Drury

Research output: Contribution to journalReview articlepeer-review

Abstract

OBJECTIVES: Physical distancing, defined as keeping 1–2m apart when co-located, can prevent cases of droplet or aerosol transmitted infectious diseases such as SARS-CoV2. During the COVID-19 pandemic, distancing was a recommendation or a requirement in many countries. This systematic review aimed to determine which interventions and behavior change techniques (BCTs) are effective in promoting adherence to distancing and through which potential mechanisms of action (MOAs). METHODSSix databases were searched. The review included studies that were (a) conducted on humans, (b) reported physical distancing interventions, (c) included any comparator (e.g., pre-intervention versus post-intervention; randomized controlled trial), and (d) reported actual distancing or predictors of distancing behavior. Risk of bias was assessed using the Mixed Methods Appraisal Tool. BCTs and potential MoAs were identified in each intervention. RESULTSSix reports (with seven studies and 19 comparisons) indicated that distancing interventions could successfully change MoAs and behavior. Successful BCTs (MoAs) included feedback on behavior (e.g., motivation); information about health consequences, salience of health consequences (e.g., beliefs about consequences), 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 behaviors. CONCLUSIONSThe evidence indicates several BCTs and potential MoAs that should be targeted in interventions and highlights gaps that should be the focus of future research.
Original languageEnglish
JournalSocial Science & Medicine
Volume303
Early online date20 May 2022
DOIs
Publication statusPublished - Jun 2022

Keywords

  • COVID-19/epidemiology
  • Communicable Diseases
  • Humans
  • Pandemics/prevention & control
  • Physical Distancing
  • RNA, Viral
  • SARS-CoV-2

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