What influences people’s responses to public health messages for managing risks and preventing infectious diseases? A rapid systematic review of the evidence and recommendations
Elizabeth Jenkinson,
Sarah Hotham,
Tracy Epton,
Lucie Byrne-Davis,
Angelos P Kassianos,
Angel Chater,
Daniela Ghio,
Neil Howlett,
Mei Yee Tang,
Daniella Watson,
Sadie Lawes-Wickwar,
Sabina Stanescu,
Juliette Westbrook,
Lisa Sutherland,
Natalia Stanulewicz,
Ella Guest,
Daniel Scanlan,
Natalie Carr,
Rachael Thorneloe,
Christopher J. Armitage,
Madelynne Arden,
Jo Hart,
Christopher Keyworth
Affiliations
Elizabeth Jenkinson
Department of Health and Social Sciences, University of West England, Bristol, UK
Sarah Hotham
Centre for Health Services Studies, University of Kent, Canterbury, UK
Tracy Epton
Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
Lucie Byrne-Davis
Health Workforce Group, Division of Medical Education, The University of Manchester, Manchester, UK
Angelos P Kassianos
Department of Applied Health Research, University College London, London, UK
Angel Chater
Centre for Health, Wellbeing and Behaviour Change, University of Bedfordshire, Bedfordshire, UK
Daniela Ghio
Department of Psychology, Faculty of Health and Society, University of Salford, Manchester, UK
Neil Howlett
Department of Psychology, Sports, and Geography, School of Life and Medical Sciences, University of Hertfordshire, Hertfordshire, UK
Mei Yee Tang
NIHR Policy Research Unit in Behavioural Science, Newcastle University, Newcastle upon Tyne, UK
Daniella Watson
Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
Sadie Lawes-Wickwar
Department of Primary Care and Population Health, University College London, London, UK
Sabina Stanescu
School of Psychology, University of Southampton, Southampton, UK
Juliette Westbrook
Department of Psychology, University of Bath, Bath, UK
Lisa Sutherland
Behavioural Insight for Public Affairs, Ipsos Mori, Edinburgh & London, UK
Natalia Stanulewicz
Faculty of Health and Life Sciences, School of Applied Social Sciences, De Montfort University, Leicester, UK
Ella Guest
Centre for Appearance Research,Faculty of Health and Applied Sciences, University of the West of England, Bristol, UK
Daniel Scanlan
Department of Communication, Policy, and Research, Education Support, London, UK
Natalie Carr
Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Manchester, UK
Rachael Thorneloe
Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, UK
Christopher J. Armitage
Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
Madelynne Arden
Centre for Behavioural Science and Applied Psychology, Sheffield Hallam University, Sheffield, UK
Jo Hart
Health Workforce Group, Division of Medical Education, The University of Manchester, Manchester, UK
Christopher Keyworth
Manchester Centre for Health Psychology, University of Manchester, Manchester, UK
Background Individual 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.Objective To 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.Design A rapid systematic review was conducted. Protocol is published on Prospero CRD42020188704.Data sources Electronic databases were searched: Ovid Medline, Ovid PsycINFO and Healthevidence.org, and grey literature (PsyarXiv, OSF Preprints) up to May 2020.Study selection All 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.Synthesis Due 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.Results Sixty-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.Discussion There 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.
