Interventions to promote physical distancing behaviour during infectious disease pandemics or epidemics: A systematic review
Epton, Tracy
Ghio, Daniela
Ballard, Lisa M.
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Allen, Sarah F.
Kassianos, Angelos P.
Hewitt, Rachael
Swainston, Katherine
Fynn, Wendy Irene
Rowland, Vickie
Westbrook, Juliette
Jenkinson, Elizabeth
Morrow, Alison
McGeechan, Grant J.
Stanescu, Sabina
Yousuf, Aysha A.
Sharma, Nisha
Begum, Suhana
Karasouli, Eleni
Scanlan, Daniel
Shorter, Gillian W.
Arden, Madelynne A.
Armitage, Christopher J.
O'Connor, Daryl B.
Kamal, Atiya
McBride, Emily
Swanson, Vivien
Hart, Jo
Byrne-Davis, Lucie
Chater, Angel
Drury, John
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Epton, T (通讯作者),Univ Manchester, Manchester Ctr Hlth Psychol, Oxford Rd, Manchester M13 9PT, England.
Objectives: Physical distancing, defined as keeping 1-2m apart when co-located, can prevent cases of droplet or aerosol transmitted infectious diseases such as SARS-CoV2. During the COVID-19 pandemic, distancing was a recommendation or a requirement in many countries. This systematic review aimed to determine which interventions and behavior change techniques (BCTs) are effective in promoting adherence to distancing and through which potential mechanisms of action (MOAs).Methods: Six databases were searched. The review included studies that were (a) conducted on humans, (b) reported physical distancing interventions, (c) included any comparator (e.g., pre-intervention versus post intervention; randomized controlled trial), and (d) reported actual distancing or predictors of distancing behavior. Risk of bias was assessed using the Mixed Methods Appraisal Tool. BCTs and potential MoAs were identified in each intervention.Results: Six articles (with seven studies and 19 comparisons) indicated that distancing interventions could successfully change MoAs and behavior. Successful BCTs (MoAs) included feedback on behavior (e.g., motivation); information about health consequences, salience of health consequences (e.g., beliefs about consequences), demonstration (e.g., beliefs about capabilities), and restructuring the physical environment (e.g., environmental context and resources). The most promising interventions were proximity buzzers, directional systems, and posters with loss framed messages that demonstrated the behaviors.Conclusions: The evidence indicates several BCTs and potential MoAs that should be targeted in interventions and highlights gaps that should be the focus of future research.