School of Population Health

Improving the impact of non-pharmaceutical interventions during COVID-19: examining the factors that influence engagement and the impact on individuals

Image Covid-19 non-harmaceutical interventions

A research article has been published this week by Dr Holly Seale from the School of Population Health and her students in collaboration with NSW Health, focusing on improving the success of non-pharmaceutical interventions (NPIS) (e.g. physical distancing, isolation and quarantine, personal protective behaviours etc.) in flattening the curve.
The article reviews a range of literature in order to identify the key determinants impacting engagement with NPIs, with emphasis on community understanding and motivation.
Complex demographic, social, psychological, and economic factors underpin engagement with non-pharmaceutical interventions, and these factors, the authors say, must be addressed and incorporated into a community-based strategy of engagement with NPIs.

PhD student Ikram Abdi, who worked on the research, explains, “When we were writing the paper, we noticed how rapidly the coronavirus pandemic was evolving and mitigation measures such as social distancing were only beginning to come into effect. Based on past events, we knew that for such measures to be implemented effectively it’d require a great deal of cooperation from the general public. We felt it was important to explore the factors that impact engagement and compliance with community mitigation strategies in light of previous pandemics.”
One key factor is the prevalence of misinformation and fear-based messaging spread by media (particularly social media), which can make appropriate engagement with NPIs into a cloudy concept, and even encourage optimism bias; that is, a general attitude of “It won’t happen to me.”

Mask use, for example, is rife with uncertainty regarding when and where to wear a mask, why to wear a mask and who for, and what type of mask to wear. There are also the issues of physical discomfort and aversion to being seen wearing a mask, which, in combination with unclear messaging, can impair effective mask use. The promotion of targeted mask use may be a solution, with emphasis placed on mask-wearing in situations that make physical distancing less feasible, and in shorter, more risk-intensive situations rather than universally.
Master’s student Clare Dyer, who co-authored it, elaborates, “Our paper touches on social practice in the current pandemic context, and provides evidence on the psychological and social factors that underpin an individual’s willingness to adopt interventions, such as mask usage to minimise virus transmission. It is important to understand how social practice influences our willingness to embrace particular interventions or behavioural changes, rather than, simply shaming or blaming those who do not comply.”

The review also addresses hand hygiene, an oft-stressed topic from the outset of the pandemic. Studies have shown that messaging promoting more diligent and effective hand-washing results in little change in behaviour, and that a fear-based approach to promoting better hand hygiene may be less favourable than attempting to establish proper hand hygiene as a social norm.
NPI use regarding young children is also fraught with uncertainty, in large part due to the murkiness of messaging and policy surrounding personal protective equipment and physical distancing measures in schools, and school closures. Many parents may be unsure of whether to require their children to physically distance or to enforce mask-wearing.
The key message of the article is that a more tailored, community-focused strategy of engagement is needed, rather than a stream of potentially contradictory and ineffective information dispersed via mass media. As Master’s student Alex Dowell-Day, who worked on the study, explains, “One of the most important takeaways from this research is the need to move away from fear-based messaging in favour of promoting health literacy and acknowledging that practicing physical distancing and other measures to flatten the curve can be hard. We've seen people on social media shaming others and using fear or sometimes misinformation to frighten people into staying home. I think this article highlights that such approaches aren't constructive and have the potential to be harmful.”
Such an approach is essential in addressing the variance in health literacy across different demographics and ensuring a universal reduction in transmissions. “Using this lens, we hope that the findings of our review can help in the development of appropriate communication strategies to promote the acceptance of such measures.” Abdi adds.

Photo by Vera Davidova on Unsplash

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Dr Holly Seale