Systematic review of interventions to promote the performance of physical distancing behaviours during infectious disease pandemics/epidemics

Abstract

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 papers 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 the gaps that should be focused on in future research.

KEYWORDS: Systematic review; physical distancing; COVID-19; social distancing

Highlights

•Evaluates the effectiveness of interventions to promote distancing in pandemics
•Six studies show that interventions can increase distancing
•Key techniques: feedback, information about consequences, restructuring
•Key delivery modes are posters and proximity buzzers
•Further research is required to test more techniques and modes of delivery

More information

Identifiers

ORCID for Lisa Ballard: orcid.org/0000-0003-1017-4322

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