Engaging the Public

New Guidance for Promoting Behavior Change to Fight COVID-19

Wearing face masks, avoiding crowds and staying 6 feet away from people are new habits everyone should develop and sustain until the COVID-19 epidemic is under control. As has been reported in the media, compliance with these recommendations varies across the country, but even in neighborhoods where most people follow the guidance, committing to a new habit and making it stick —behavior change — takes time and perseverance. Recommendations to make hand hygiene a habit are not new but also will require increased attention to become widely and reliably implemented.

A new report from the National Academies of Sciences, Engineering, and Medicine offers specific strategies for effective promotion of behavior change, which apply to any public health effort and are demonstrated in the report with examples for the current COVID-19 crisis.

Encouraging Adoption of Protective Behaviors to Mitigate the Spread of Covid-19 was produced by a panel of researchers in the social, behavioral, and economic sciences. They recommend avoiding negative messages and scare tactics; instead, focus on “increasing knowledge, reducing barriers, and emphasizing efforts that make healthier choices easier and rewarding….” Helping people follow through to develop and sustain these good habits involves positive support and often simply making the right thing the easy thing to do.

The report includes COVID-19 examples for five habit-promoting strategies:

  1. Make the behavior easy to start and repeat.
  2. Make the behavior rewarding to repeat.
  3. Tie the behavior to an existing habit.
  4. Alert people to behaviors that conflict with existing habits and provide alternative behaviors.
  5. Provide specific descriptions of desired behaviors.

In public spaces, placing hand sanitizer dispensers where people enter and exit spaces and keeping the dispensers clean and full will make them easy and inviting to use. At home, consciously washing your hands immediately after putting down your keys on entering the house or apartment, will over time develop into a subconscious habit. And specific instructions, such as to stay six feet away from other people, are easier to understand and follow than vague directive about “maintaining social distance.”

Another section of the report focuses on communication strategies most likely to encourage behavior change. Much of the advice focuses on what not to do, with examples of approaches that are likely to be counterproductive. While the report advocates clear, direct communication, it also emphasizes the complexity and delicacy of trying to influence behavior. For example, the report acknowledges that fear can be used to motivate behavior change but only when used in conjunction with other, more positive messages:

Appealing to fear can lead people to change their behavior if they feel capable of dealing with the threat but leads to defensive reactions when they feel helpless to act. Communications therefore need to couple messages about the harm of the virus with how to mitigate the risk of contracting COVID-19. (p.7-8)

Individuals and organizations — all of us — face the need to protect ourselves, our families and our communities from contracting COVID-19 for the foreseeable future. Many of us, in different roles, find ourselves needing to encourage others to take positive protective actions. The report is illuminating and helpful in this moment, and the lessons it describes have broad applicability.

Photo by Kate Trifo from Pexels

Susan Carr Susan Carr is a medical editor and writer specializing in patient safety and engagement. In addition to curating the EngagingPatients blog, she produces publications for the Betsy Lehman Center in Boston and the Society to Improve Diagnosis in Medicine. Susan lives and works in Lunenburg, Massachusetts.

Susan Carr has 185 post(s) at EngagingPatients.org

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