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

THORNELOE, Rachael (2021). 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.

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    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: a) characterises effective public health messages for managing risk and preventing infectious disease, b) 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 were included that: (a) evaluated public health messaging interventions targeted at adults, (b) concerned a communicable disease spread via primary route of transmission of respiratory and/or touch. 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. Strengths and Limitations Whilst we conducted a rapid review, we ensured that we completed it in a systematic manner with a broad initial search (e.g. no restriction on study design) to develop recommendations from lessons in risk communication that we can translate to the current pandemic. The rapid review included all study designs with high heterogeneity, some of which were low quality, so findings should be interpreted tentatively. The focus of most the studies included in the review was on determinants of intention and not behaviour, therefore we acknowledge that the recommendations may not lead to successful enactment of target behaviours (e.g. handwashing) even though they may be helpful in increasing intentions. We were unable to conduct backward and forward citation searching on the included studies, this may have resulted in relevant literature not being captured. We had strong stakeholder engagement as part of the team with different expertise of behaviour science and public health that provided feedback from initial design through to development of recommendations to be used by public health practitioners.

    Item Type: Article
    Uncontrolled Keywords: 1103 Clinical Sciences; 1117 Public Health and Health Services; 1199 Other Medical and Health Sciences
    SWORD Depositor: Symplectic Elements
    Depositing User: Symplectic Elements
    Date Deposited: 12 Oct 2021 11:47
    Last Modified: 12 Oct 2021 11:47
    URI: http://shura.shu.ac.uk/id/eprint/29158

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