Effect of prosocial public health messages for population behaviour change in relation to respiratory infections: a systematic review protocol

IntroductionThe COVID-19 pandemic represents a major societal challenge that requires large-scale behaviour change, widespread collective action and cooperation to reduce viral transmission. Existing literature indicates that several messaging approaches may be effective, including emphasising the benefits to the recipient, aligning with the recipient’s moral values and focusing on protecting others. Current research suggests that prosocial public health messages that highlight behaviours linked to societal benefits (eg, protecting ‘each other’), rather than focusing on behaviours that protect oneself (eg, protecting ‘yourself’), may be a more effective method for communicating strategies related to infectious disease. To investigate this we will conduct a systematic review that will identify what messages and behaviour change techniques have the potential to optimise the effect on population behaviour in relation to reducing transmission of respiratory infections.Methods and analysisA systematic literature search of published and unpublished studies (including grey literature) in electronic databases will be conducted to identify those that meet our inclusion criteria. The search will be run in four electronic databases: MEDLINE, EMBASE, PsycINFO and Scopus. We will also conduct supplementary searches in databases of ‘grey’ literature such as PsycEXTRA, Social Science Research Network and OSF PREPRINTS, and use the Google Scholar search engine. A systematic approach to searching, screening, reviewing and data extraction will be applied based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Titles, abstracts and full texts for eligibility will be examined independently by researchers. The quality of the included studies will be assessed using the Cochrane Risk of Bias Tool and the Risk of Bias in Non-randomized Studies-of Interventions tool. Disagreements will be resolved by a consensus procedure.Ethics and disseminationThis protocol has been registered with PROSPERO. No ethical approval is required, as there will be no collection of primary data. The synthesised findings will be disseminated through peer-reviewed publication.PROSPERO registration numberCRD42020198874.

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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

10.31234/osf.io/nz7tr ◽

2020 ◽

Cited By ~ 3

Author(s):

Daniela Ghio ◽

Sadie Lawes-Wickwar ◽

Mei Yee Tang ◽

Tracy Epton ◽

Neil Howlett ◽

...

Keyword(s):

Public Health ◽

Systematic Review ◽

Infectious Diseases ◽

Behaviour Change ◽

Population Level ◽

Personal Control ◽

Health Messages ◽

Public Health Messages ◽

Managing Risk ◽

Health Messaging

Background Population level behaviour change, requiring individual behaviour change such as hand hygiene and physical distancing, are central to reducing transmission of infectious diseases, including COVID-19, but little is known about how best to communicate this type of risk reducing information, and how populations might respond. We conducted a rapid systematic review to identify and synthesise evidence relating to: a) What characterises effective public-health messages for managing risk and preventing infectious disease, and b) What influences people’s responses to public-health messages.Methods Rapid systematic review methodology was used. We included all study designs and grey literature. Non-English language papers were excluded. Ovid Medline, Ovid PsycINFO and Healthevidence.org were searched alongside PsyarXiv and OSF Preprints up to May 2020. A narrative synthesis was conducted.Findings We identified 70 eligible papers: 3 systematic reviews, 54 individual papers and 14 pre-prints. To influence behaviour effectively at the population level, public-health messages need to be acceptable, credible and trustworthy, to increase the public’s understanding and perceptions of the threat. Interpretation Key recommendations are to: engage communities in the development of public-health messaging, use credible and legitimate sources, address uncertainty immediately and with transparency, focus on unifying messages from all sources, and develop messages aimed at increasing understanding, induce social responsibility and empower personal control. Embedding these principles of behavioural science into public-health messaging is an important step towards more effective health-risk communication for managing risk, promoting protective behaviours and preventing disease during epidemics/pandemics.

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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

BMJ Open ◽

10.1136/bmjopen-2021-048750 ◽

2021 ◽

Vol 11 (11) ◽

pp. e048750

Author(s):

Daniela Ghio ◽

Sadie Lawes-Wickwar ◽

Mei Yee Tang ◽

Tracy Epton ◽

Neil Howlett ◽

...

Keyword(s):

Public Health ◽

Systematic Review ◽

Infectious Diseases ◽

Grey Literature ◽

Personal Control ◽

Health Messages ◽

Disease Spread ◽

Route Of Transmission ◽

Public Health Messages ◽

Health Messaging

BackgroundIndividual 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.ObjectiveTo 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.DesignA rapid systematic review was conducted. Protocol is published on Prospero CRD42020188704.Data sourcesElectronic databases were searched: Ovid Medline, Ovid PsycINFO and Healthevidence.org, and grey literature (PsyarXiv, OSF Preprints) up to May 2020.Study selectionAll 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.SynthesisDue 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.ResultsSixty-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.DiscussionThere 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.

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Public health messages on arboviruses transmitted by Aedes aegypti in Brazil

BMC Public Health ◽

10.1186/s12889-021-11339-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

India L. Clancy ◽

Robert T. Jones ◽

Grace M. Power ◽

James G. Logan ◽

Jorge Alberto Bernstein Iriart ◽

...

Keyword(s):

Public Health ◽

Health Belief Model ◽

Behaviour Change ◽

Health Belief ◽

Health Messages ◽

Breeding Sites ◽

Potential Effectiveness ◽

Public Health Messages ◽

Belief Model ◽

The Health Belief Model

Abstract Background The outbreak of Zika virus in Brazil in 2015 followed the arrival of chikungunya in 2014 and a long history of dengue circulation. Vital to the response to these outbreaks of mosquito-borne pathogens has been the dissemination of public health messages, including those promoted through risk communication posters. This study explores the content of a sample of posters circulated in Brazil towards the end of the Zika epidemic in 2017 and analyses their potential effectiveness in inducing behaviour change. Methods A content analysis was performed on 37 posters produced in Brazil to address outbreaks of mosquito-borne pathogens. The six variables of the Health Belief Model were used to assess the potential effectiveness of the posters to induce behaviour change. Results Three overarching key messages emerged from the posters. These included (i) the arboviruses and their outcomes, (ii) a battle against the mosquito, and (iii) a responsibility to protect and prevent. Among the six variables utilised through the Health Belief Model, cues to action were most commonly featured, whilst the perceived benefits of engaging in behaviours to prevent arbovirus transmission were the least commonly featured. Conclusions The posters largely focused on mosquito-borne transmission and the need to eliminate breeding sites, and neglected the risk of the sexual and congenital transmission of Zika and the importance of alternative preventive actions. This, we argue, may have limited the potential effectiveness of these posters to induce behaviour change.

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Behaviour change interventions for the management of Raynaud's phenomenon: a systematic review protocol

BMJ Open ◽

10.1136/bmjopen-2017-017039 ◽

2017 ◽

Vol 7 (8) ◽

pp. e017039 ◽

Cited By ~ 1

Author(s):

Jo Daniels ◽

John D Pauling ◽

Christopher Eccelston

Keyword(s):

Systematic Review ◽

Behaviour Change ◽

Raynaud’S Phenomenon ◽

Meta Analysis ◽

Grey Literature ◽

Raynaud's Phenomenon ◽

Risk Of Bias ◽

Bias Assessment ◽

Behaviour Change Interventions

IntroductionRaynaud's phenomenon (RP) describes excessive peripheral vasospasm to cold exposure and/or emotional stress. RP episodes are associated with digital colour changes, pain and reduced quality of life. Pharmacological interventions are of low to moderate efficacy and often result in adverse effects such as facial flushing and headaches. Recommended lifestyle and behavioural interventions have not been evaluated. The objectives of the proposed systematic review are to assess the comparative safety and efficacy of behaviour change interventions for RP and identify what we can learn to inform future interventions.Methods and analysisStudies eligible for inclusion include randomised controlled trials testing behaviour change interventions with a control comparator. A comprehensive search strategy will include peer review and grey literature up until 30 April 2017. Search databases will include Medline, Embase, PsychINFO and Cochrane. Initial sifting, eligibility, data extraction, risk of bias and quality assessment will be subject to review by two independent reviewers with a third reviewer resolving discrepancies. Risk of bias assessment will be performed using Cochrane risk of a bias assessment tool with quality of evidence assessed using Grading of Recommendations Assessment, Development and Evaluation(GRADE). A meta-analysis will be performed if there are sufficient data. Two subgroup analyses are planned: primary versus secondary RP outcomes; comparison of theoretically informed interventions with pragmatic interventions.Ethics and disseminationThis review does not require ethical approval as it will summarise published studies with non-identifiable data. This protocol complies with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines. Findings will be disseminated in peer-reviewed articles and reported according to PRISMA. This review will make a significant contribution to the management of RP where no review of behaviour-change interventions currently exist. The synopsis and protocol for the proposed systematic review is registered in the International Prospective Register of Systematic Reviews (registration number CRD42017049643).

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Effectiveness of personal letters to healthcare professionals in changing professional behaviours: a systematic review protocol

Systematic Reviews ◽

10.1186/s13643-021-01650-4 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Aikaterini Grimani ◽

Louis Goffe ◽

Mei Yee Tang ◽

Fiona Beyer ◽

Falko F. Sniehotta ◽

...

Keyword(s):

Systematic Review ◽

Randomised Controlled Trials ◽

Healthcare Professionals ◽

Grey Literature ◽

Behavioural Change ◽

Risk Of Bias ◽

Cochrane Library ◽

Controlled Trials ◽

Behaviour Change Techniques ◽

Randomised Controlled

Abstract Background Letters are regularly sent by healthcare organisations to healthcare professionals to encourage them to take action, change practice or implement guidance. However, whether letters are an effective tool in delivering a change in healthcare professional behaviour is currently uncertain. In addition, there are currently no evidence-based guidelines to support health providers and authorities with advice on how to formulate the communication, what information and behaviour change techniques to include in order to optimise the potential effect on the behaviour of the receivers. To address this research gap, we seek to inform such guidance through this systematic review, which aims to provide comprehensive evidence of the effectiveness of personal letters to healthcare professionals in changing their professional behaviours. Methods/design A comprehensive literature search of published and unpublished studies (the grey literature) in electronic databases will be conducted to identify randomised controlled trials (RCTs) that meet our inclusion criteria. We will include RCTs evaluating the effectiveness of personal letters to healthcare professionals in changing professional behaviours. The primary outcome will be behavioural change. The search will be conducted in five electronic databases (from their inception onwards): MEDLINE, Embase, PsycINFO, the Cochrane Library and CINAHL. We will also conduct supplementary searches in Google Scholar, hand search relevant journals, and conduct backward and forward citation searching for included studies and relevant reviews. A systematic approach to searching, screening, reviewing and data extraction will be applied in accordance with the process recommended by the Cochrane Collaboration. Two researchers will examine titles, abstracts, full-texts for eligibility independently. Risk of bias will be assessed using the Cochrane Risk of Bias 2 (RoB 2) tool for randomised controlled trials. Disagreements will be resolved by a consensus procedure. Discussion Health policy makers across government are expected to benefit from being able to increase compliance in clinical settings by applying theories of behaviour to design of policy communications. The synthesised findings will be disseminated through peer-reviewed publication. Systematic review registration PROSPERO CRD42020167674

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Behaviour change techniques in personalised care planning for older people: systematic review

British Journal of General Practice ◽

10.3399/bjgp20x714017 ◽

2020 ◽

pp. bjgp20X714017

Author(s):

Sadia Ahmed ◽

Anne Heaven ◽

Rebecca Lawton ◽

Gregg H Rawlings ◽

Claire Sloan ◽

...

Keyword(s):

Systematic Review ◽

Older People ◽

Behaviour Change ◽

Adult Population ◽

Risk Of Bias ◽

Care Practice ◽

Behaviour Change Techniques ◽

Planning Problem ◽

Care Planning ◽

Long Term Conditions

Abstract Background: Personalised care planning (PCP) interventions have potential to provide better outcomes for older people and are a key focus in primary care practice. Behaviour change techniques (BCTs) can maximise effectiveness of such interventions, but it is uncertain which BCTs are most appropriate in PCP for older adults. Aim: To identify BCTs used in successful PCP interventions for older people aged 65+. Design and setting: Systematic review. Method: We searched 12 databases from date of inception to September 31st 2017. We identified randomised controlled trials (RCTs) of interventions involving participants aged 65+ and contextually related to PCP. Five areas of risk of bias were assessed. The Michie et al. BCT Taxonomy was used for coding. Results: Twenty-three RCTs involving 6489 participants (average age 74) described PCP interventions targeting the general older adult population and older people with specific long-term conditions (e.g. heart disease, diabetes, stroke). Just over half of the studies were deemed low risk of bias. Eleven ‘promising’ BCTs were identified in five trials reporting significant improvements in quality of life (QoL). Six BCTs were reported in all five of these trials: ‘goal setting’, ‘action planning’, ‘problem solving’, ‘social support’, ‘instructions on how to perform a behaviour’ and ‘information on health consequences’. Modes of delivery varied. Conclusion: Future PCP interventions to improve QoL for people aged 65+ may benefit from focusing on six specific BCTs. Better reporting of BCTs would enhance future design and implementation of such interventions.

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Lifestyle behaviour change for preventing the progression of chronic kidney disease: a systematic review

BMJ Open ◽

10.1136/bmjopen-2019-031625 ◽

2019 ◽

Vol 9 (10) ◽

pp. e031625 ◽

Cited By ~ 3

Author(s):

Nicole Evangelidis ◽

Jonathan Craig ◽

Adrian Bauman ◽

Karine Manera ◽

Valeria Saglimbene ◽

...

Keyword(s):

Physical Activity ◽

Social Support ◽

Systematic Review ◽

Chronic Kidney Disease ◽

Kidney Disease ◽

Goal Setting ◽

Behaviour Change ◽

Risk Of Bias ◽

Behaviour Change Techniques ◽

Lifestyle Behaviour

ObjectivesModifying lifestyle can prevent the progression of chronic kidney disease (CKD) but the specific elements which lead to favourable behaviour change are not well understood. We aimed to identify and evaluate behaviour change techniques and functions in lifestyle interventions for preventing the progression of CKD.DesignSystematic review.Data sourcesMEDLINE, EMBASE, CINAHL and PsycINFO.Eligibility criteriaTrials of lifestyle behaviour change interventions (including diet, physical activity, smoking and/or alcohol) published to September 2018 in adults with CKD stages 1–5.Data extraction and synthesisTrial characteristics including population, sample size, study setting, intervention, comparator, outcomes and study duration, were extracted. Study quality was independently assessed by two reviewers using the Cochrane risk of bias tool. The Behaviour Change Technique Taxonomy v1 was used to identify behaviour change techniques (eg, goal setting) and the Health Behaviour Change Wheel was used to identify intervention functions (eg, education). Both were independently assessed by three reviewers.ResultsIn total, 26 studies involving 4263 participants were included. Risk of bias was high or unclear in most studies. Interventions involved diet (11), physical activity (8) or general lifestyle (7). Education was the most frequently used function (21 interventions), followed by enablement (18), training (12), persuasion (4), environmental restructuring (4), modelling (2) and incentivisation (2). The most common behaviour change techniques were behavioural instruction (23 interventions), social support (16), behavioural demonstration (13), feedback on behaviour (12) and behavioural practice/rehearsal (12). Eighteen studies (69%) showed a significant improvement in at least one primary outcome, all of which included education, persuasion, modelling and incentivisation.ConclusionLifestyle behaviour change interventions for CKD patients frequently used education, goal setting, feedback, monitoring and social support. The most promising interventions included education and used a variety of intervention functions (persuasion, modelling and incentivisation).PROSPERO registration numberCRD42019106053.

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Increasing physical activity by four legs rather than two: systematic review of dog-facilitated physical activity interventions

British Journal of Sports Medicine ◽

10.1136/bjsports-2019-101156 ◽

2020 ◽

Vol 54 (20) ◽

pp. 1202-1207 ◽

Cited By ~ 2

Author(s):

Ryan E Rhodes ◽

Maria Baranova ◽

Hayley Christian ◽

Carri Westgarth

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Behaviour Change ◽

Controlled Trial ◽

Grey Literature ◽

Future Research ◽

Behaviour Change Techniques ◽

Eligibility Criteria ◽

Dog Owners

ObjectivesRegular walking is a critical target of physical activity (PA) promotion, and dog walking is a feasible PA intervention for a large segment of the population. The purpose of this paper was to review PA interventions that have involved canine interactions and to evaluate their effectiveness. A secondary aim of this review was to highlight the populations, settings, designs and intervention components that have been applied so as to inform future research.DesignSystematic review.Data sourcesWe carried out literature searches to August 2019 using six common databases.Eligibility criteriaStudies included published papers in peer-reviewed journals and grey literature (theses and dissertations) in the English language that included any PA behaviour change design (ie, randomised controlled trial, quasi-experimental) that focused on canine-related intervention. We grouped findings by population, setting, medium, research design and quality, theory and behaviour change techniques applied.ResultsThe initial search yielded 25 010 publications which were reduced to 13 independent studies of medium and high risks of bias after screening for eligibility criteria. The approaches to intervene on PA were varied and included loaner dogs, new dog owners and the promotion of walking among established dog owners. Findings were consistent in showing that canine-assisted interventions do increase PA (82% of the studies had changes favouring the canine-facilitated intervention). Exploratory subanalyses showed that specific study characteristics and methods may have moderated the effects. Compared with studies with longer follow-up periods, studies with shorter follow-up favoured behaviour changes of the canine intervention over the control condition.ConclusionCanine-based PA interventions appear effective, but future research should move beyond feasibility and proof of concept studies to increase rigour, quality and generalisability of findings.

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Social norms, social identities and the COVID-19 pandemic: Theory and recommendations

10.31234/osf.io/m9afs ◽

2021 ◽

Author(s):

Fergus Gilmour Neville ◽

Anne Templeton ◽

Joanne Smith ◽

Winnifred R Louis

Keyword(s):

Public Health ◽

Social Norms ◽

Behaviour Change ◽

Social Norm ◽

Social Processes ◽

Social Identities ◽

Health Messages ◽

The Public ◽

Public Health Messages ◽

Health Guidance

Sustained mass behaviour change is needed to tackle the COVID-19 pandemic, but many of the required changes run contrary to existing social norms (e.g., physical closeness with ingroup members). This paper explains how social norms and social identities are critical to explaining and changing public behaviour. Recommendations are presented for how to harness these social processes to maximise adherence to COVID-19 public health guidance. Specifically, we recommend that public health messages clearly define who the target group is, are framed as identity-affirming rather than identity-contradictory, include complementary injunctive and descriptive social norm information, are delivered by ingroup members and that support is provided to enable the public to perform the requested behaviours.

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Effectiveness of web-based and mobile health interventions designed to enhance adherence to physical activity for people with inflammatory arthritis: a systematic review

Rheumatology Advances in Practice ◽

10.1093/rap/rkab016 ◽

2021 ◽

Author(s):

Mandeep Sekhon ◽

Claire White ◽

Emma Godfrey ◽

Aliya Amirova ◽

Åsa Revenäs ◽

...

Keyword(s):

Physical Activity ◽

Systematic Review ◽

Inflammatory Arthritis ◽

Risk Of Bias ◽

Health Interventions ◽

Behaviour Change Techniques ◽

Post Intervention ◽

Web Based ◽

Intervention Content ◽

Secondary Outcomes

Abstract Objective The aim of this systematic review was to assess the evidence from randomised controlled trials (RCT) and cohort studies for the effectiveness of digital interventions designed to enhance adherence to physical activity (PA) for people with inflammatory arthritis (IA) and describe the intervention content using established coding criteria. Methods Six electronic databases were searched for published and unpublished studies. Independent data extraction and quality assessment (Cochrane risk of bias II or ROBIN I) were conducted by two reviewers. The primary outcome was self-reported adherence to PA post-intervention. Secondary outcomes included self-reported adherence to PA at other timepoints, level of PA or engagement with intervention at any follow-up timepoint. Intervention content was assessed using the Consensus on Exercise Reporting Template and the Behaviour Change Techniques taxonomy version 1. Results From 11,136 reports, four moderate risk of bias studies (three RCTs, one cohort study) including 1,160 participants with rheumatoid arthritis or juvenile inflammatory arthritis were identified. Due to heterogeneity of outcomes, a narrative synthesis was conducted. Only one RCT reported a small between group difference in adherence to PA [mean difference (95% confidence intervals) -0.46 (-0.82. -0.09)] in favour of the intervention. There were no between group differences in any secondary outcomes. Interventions included between 3–11 behaviour change techniques but provided minimal exercise prescription information. Conclusion There is currently limited moderate quality evidence available to confidently evaluate the effect of web-based and mobile health interventions on adherence to PA or level of PA post intervention in people with IA.

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