Applying principles of behaviour change to reduce SARS-CoV-2 transmission
Open accessAbstract
Human behaviour is central to transmission of SARS-Cov-2, the virus that causes COVID-19, and changing behaviour is crucial to preventing transmission in the absence of pharmaceutical interventions. Isolation and social distancing measures, including edicts to stay at home, have been brought into place across the globe to reduce transmission of the virus, but at a huge cost to individuals and society. In addition to these measures, we urgently need effective interventions to increase adherence to behaviours that individuals in communities can enact to protect themselves and others: use of tissues to catch expelled droplets from coughs or sneezes, use of face masks as appropriate, hand-washing on all occasions when required, disinfecting objects and surfaces, physical distancing, and not touching one's eyes, nose or mouth. There is an urgent need for direct evidence to inform development of such interventions, but it is possible to make a start by applying behavioural science methods and models.
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A first step in understanding which interventions are appropriate to generating behaviour change is to identify the COM factors that the intervention needs to target.
“In line with the BCW intervention development tool, a first step in understanding which interventions are appropriate to generating behaviour change (in this context we refer to the change in or maintenance of social distancing behaviour) is to identify the COM factors that the intervention needs to target [10, 11].”
From Facilitators and barriers to social distancing for young people during the COVID-19 pandemic (2022) · cites this paper as [11]
The Behaviour Change Wheel can be used as a guiding tool to support systematic selection of intervention functions and allied policy supports.
“The Behaviour Change Wheel (BCW) can be used as a guiding tool to support this [10, 11].”
From Facilitators and barriers to social distancing for young people during the COVID-19 pandemic (2022) · cites this paper as [11]
The survey items were guided by the COM-B model to provide a theoretical framework a priori.
“The survey items were guided by the COM-B model [10], to provide a theoretical framework a priori, and were deemed relevant given the applications of the model in relevant contexts [11].”
From Facilitators and barriers to social distancing for young people during the COVID-19 pandemic (2022) · cites this paper as [11]
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“Until establishing collective immunity, guideline adherence is the only way to prevent virus transmission (e.g., West et al., 2020).”
Distinct genetic spectrums and evolution patterns of SARS-CoV-2Preprint
Liu, S., Shen, J.-K., Fang, S.-Y., Li, K., Liu, J., Yang, L., Hu, C.-D., & Wan, J. (2020) · medRxiv · doi:10.1101/2020.06.16.20132902 · Cited by 51 · see citing works
Chiauzzi, E. J., Clayton, A. R., & Huh, J. (2020) · JMIR Mental Health · doi:10.2196/24021 · Cited by 62 · see citing works
“Since many clinicians have backgrounds in behavior change techniques, they may also have a role in supporting the behavioral strategies used to prevent the transmission of SARS-CoV-2 (eg, mask use, hand washing, etc) [75].”
Risk compensation during COVID-19: The impact of face mask usage on social distancing.Preprint
Luckman, A., Zeitoun, H., Isoni, A., Loomes, G., Vlaev, I., Powdthavee, N., & Read, D. (2020) · Journal of experimental psychology. Applied · doi:10.31219/osf.io/rb8he · Cited by 49 · see citing works
“Future research should be testing behaviour change interventions (e.g., Bavel et al., 2020; West, Michie, Rubin, & Amlôt, 2020) that could make risk compensation less likely.”
Zhan, Z., Wei, Q., & Hong, J.-C. (2021) · Computers in Human Behavior · doi:10.1016/j.chb.2021.106790 · Cited by 49 · see citing works
“Although home quarantine has become an important preventative measure against the epidemic, it might cause social isolation and other side effects (West et al., 2020).”
BackgroundSocial cognition theories and behavior change in COVID-19: A conceptual review
Hagger, M. S., & Hamilton, K. (2022) · Behaviour Research and Therapy · doi:10.1016/j.brat.2022.104095 · Cited by 50 · see citing works
Factors affecting the mode choice behavior before and during COVID-19 pandemic in Pakistan
Abdullah, M., Ali, N., Aslam, A. B., Javid, M. A., & Hussain, S. A. (2021) · International Journal of Transportation Science and Technology · doi:10.1016/j.ijtst.2021.06.005 · Cited by 48
“The results of several studies in this regard have provided an evidence for the spread of the Coronavirus with increased mobility (West et al., 2020).”
COVID-19, smoking, vaping and quitting: A representative population survey in England
Tattan-Birch, H., Perski, O., Jackson, S., Shahab, L., West, R., & Brown, J. (2020) · medRxiv · doi:10.1101/2020.06.29.20142661 · Cited by 48
“Hand‐washing is an important behaviour in reducing the transmission of infectious diseases throughout the population, especially for those that are primarily spread through respiratory droplets [12].”
BackgroundSelf-citationWhite, S. J., Barello, S., Marco, E. C. D. S., Colombo, C., Eeckman, E., Gilligan, C., Graffigna, G., Jirasevijinda, T., Mosconi, P., Mullan, J., et al. (2020) · Patient Education and Counseling · doi:10.1016/j.pec.2020.12.025 · Cited by 64 · see citing works
Namazova-Baranova, L. S., & Aa, B. (2020) · PULMONOLOGIYA · doi:10.18093/0869-0189-2020-30-5-609-628 · Cited by 35 · see citing works
“Although some scientists doubt these numbers and continue their research [50].”
BackgroundDaoust, J.-F., Bélanger, É., Dassonneville, R., Lachapelle, E., Nadeau, R., Becher, M., Brouard, S., Foucault, M., Hönnige, C., & Stegmueller, D. (2021) · PLoS ONE · doi:10.1371/journal.pone.0249914 · Cited by 46 · see citing works
Kahnbach, L., Lehr, D., Brandenburger, J., Mallwitz, T., Jent, S., Hannibal, S., Funk, B., & Janneck, M. (2021) · Journal of Medical Internet Research · doi:10.2196/27989 · Cited by 51 · see citing works
“Besides inspiration from existing apps and features, recommendations for further development could be driven by either the literature [36-38] or upcoming challenges over the course of the pandemic.”
BackgroundPairing facts with imagined consequences improves pandemic-related risk perception
Sinclair, A., Hakimi, S., Stanley, M. L., Adcock, R. A., & Samanez-Larkin, G. (2021) · Proceedings of the National Academy of Sciences of the United States of America · doi:10.1073/pnas.2100970118 · Cited by 46 · see citing works
Liekefett, L., & Becker, J. C. (2021) · British Journal of Social Psychology · doi:10.1111/bjso.12439 · Cited by 48 · see citing works
Masser, B., Hyde, M. K., & Ferguson, E. (2020) · Transfusion · doi:10.1111/trf.16067 · Cited by 45 · see citing works
Incidence of common infectious diseases in Japan during the COVID-19 pandemic
Hibiya, K., Iwata, H., Kinjo, T., Shinzato, A., Tateyama, M., Ueda, S., & Fujita, J. (2022) · PLoS ONE · doi:10.1371/journal.pone.0261332 · Cited by 45
“Considering that SARS-CoV-2 is primarily transmitted through respiratory droplets and contact [3], these behaviors might decrease the spread of COVID-19 and other common infectious diseases [4].”
BackgroundElhadi, M., Alsoufi, A., Msherghi, A. A. A., Alshareea, E. A. A., Ashini, A., Nagib, T., Abuzid, N., Abodabos, S., Alrifai, H., Gresea, E., et al. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.632496 · Cited by 42 · see citing works
“To reduce the transmission of COVID-19, preventative techniques included restricting physical interaction to the point of home lockdowns and curfews, reducing the number of passengers on public transport, restrictions, banning public gathering events and places, and social distancingmeasures (3, 4).”
Background3D‐Printing to Mitigate COVID‐19 Pandemic
Padinjareveetil, A. K. K., & Pumera, M. (2021) · Advanced Functional Materials · doi:10.1002/adfm.202100450 · Cited by 68 · see citing works
Understanding building-occupant-microbiome interactions toward healthy built environments: A review
Li, S., Yang, Z., Hu, D., Cao, L., & He, Q. (2020) · Frontiers of Environmental Science & Engineering · doi:10.1007/s11783-020-1357-3 · Cited by 51 · see citing works
“Accordingly, these behavioral patterns could be influenced by BE attributes including indoor temperatures conducive to mask wearing, availability of handwashing facilities, and adequate occupant capacity (West et al., 2020).”
BackgroundBacon, S., Lavoie, K., Boyle, J., Stojanović, J., & Joyal-Desmarais, K. (2021) · BMJ Open · doi:10.1136/bmjopen-2020-046127 · Cited by 44 · see citing works
Alivernini, F., Manganelli, S., Girelli, L., Cozzolino, M., Lucidi, F., & Cavicchiolo, E. (2020) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsaa122 · Cited by 40 · see citing works
Kumar, P., Sah, A., Tripathi, G., Kashyap, A., Tripathi, A., Rao, R., Mishra, P., Mallick, K. C. B., Husain, A., & Kashyap, M. (2020) · Molecular and Cellular Biochemistry · doi:10.1007/s11010-020-03924-2 · Cited by 40 · see citing works
Kontogiannis, T. (2021) · Safety Science · doi:10.1016/j.ssci.2020.105077 · Cited by 39 · see citing works
Benefit of COVID-19 vaccination accounting for potential risk compensation
Ioannidis, J. (2021) · npj Vaccines · doi:10.1038/s41541-021-00362-z · Cited by 39 · see citing works
Krutikov, M., Palmer, T., Donaldson, A., Lorencatto, F., Forbes, G., Copas, A., Robson, J., Hopkins, S., Moss, P., Farrar, J., et al. (2020) · Wellcome Open Research · doi:10.12688/wellcomeopenres.16193.2 · Cited by 39
Implementation Science to Address Health Disparities During the Coronavirus Pandemic
Galaviz, K. I., Breland, J. Y., Sanders, M., Breathett, K. K., Cerezo, A., Gil‐García, Ó. F., Hollier, J. M., Marshall, C. J., Wilson, J., & Essien, U. R. (2020) · Health Equity · doi:10.1089/heq.2020.0044 · Cited by 45 · see citing works
“tering in place, mask wearing, and physical distancing behaviors among minority populations.(17) Metrics to assess gaps in the reach and adoption of interventions in minority communities and settings are also available.”
BackgroundHabeebullah, T., el-Rahim, I. A. A., & Morsy, E. (2021) · Journal of Environmental Management · doi:10.1016/j.jenvman.2021.112392 · Cited by 38 · see citing works
COVID‐19, smoking, vaping and quitting: a representative population survey in England
Tattan-Birch, H., Perski, O., Jackson, S., Shahab, L., West, R., & Brown, J. (2020) · Addiction · doi:10.1111/add.15251 · Cited by 38
“Hand‐washing is an important behaviour in reducing the transmission of infectious diseases throughout the population, especially for those that are primarily spread through respiratory droplets [12].”
BackgroundSelf-citationFirth, J. A., Hellewell, J., Klepac, P., Kissler, S. M., CMMID COVID-19 working group, Kucharski, A. J., & Spurgin, L. G. (2020) · medRxiv · doi:10.1101/2020.05.26.20113720 · Cited by 27 · see citing works
Mental Health during COVID-19 Pandemic
Yogitha, J. (2021) · International Journal of Science and Research (IJSR) · doi:10.21275/sr21705130917 · Cited by 1 · see citing works
“This kind of information negatively impacts people's mental health [20, 110, 111].”
BackgroundExploring the Effect of Collective Cultural Attributes on Covid-19-Related Public Health Outcomes
Erman, A., & Medeiros, M. (2021) · Frontiers in Psychology · doi:10.3389/fpsyg.2021.627669 · Cited by 55 · see citing works
Dixon, D., Johnston, M., Hubbard, G., & den Daas, C. (2021) · British Journal of Health Psychology · doi:10.1111/bjhp.12533 · Cited by 35 · see citing works
“West, Michie, Rubin, and Amlôt (2020) have identified the many points at which behaviour could prevent transmission of the virus ranging from physical distancing to avoiding face touching and governments have developed advice, guidelines and laws to persuade, encourage, enable or coerce transmission-reducing behaviour…”
Nguyen, P., Tsai, J.-F., Dang, T.-T., Lin, M.-H., Pham, H., & Nguyen, K. (2021) · Mathematics · doi:10.3390/math9202626 · Cited by 35 · see citing works
“In 8].”
Management of COVID-19: current status and future prospects
Kabir, M., Ahmed, R., Chowdhury, R., Iqbal, S. M., Paulmurugan, R., Demirci, U., & Asghar, W. (2021) · Microbes and infection · doi:10.1016/j.micinf.2021.104832 · Cited by 32 · see citing works
“Isolation of the infected patients and maintaining social distancing actions, including mandating “shelter in place”, have been adopted to mitigate the spread of the virus globally, but at a huge cost to society and economy [19].”
Visualising SARS-CoV-2 transmission routes and mitigations
Rutter, H., Parker, S. T., Stahl-Timmins, W., Noakes, C. J., Smyth, A., Macbeth, R., Fitzgerald, S., & Freeman, A. L. J. (2021) · BMJ · doi:10.1136/bmj-2021-065312 · Cited by 25 · see citing works
Jung, S.-M., Endo, A., Akhmetzhanov, A. R., & Nishiura, H. (2021) · International Journal of Infectious Diseases · doi:10.1016/j.ijid.2021.10.007 · Cited by 31
Jalloh, M. F., Nur, S. A., Nur, S. A., Winters, M., Bedson, J., Pedi, D., Prybylski, D., Namageyo-Funa, A., Hageman, K., Baker, B. J., et al. (2021) · BMJ Global Health · doi:10.1136/bmjgh-2020-004450 · Cited by 31 · see citing works
Lucas, T. L., Mustain, R., & Goldsby, R. E. (2020) · Pediatric Blood & Cancer · doi:10.1002/pbc.28593 · Cited by 34 · see citing works
Grano, C., Solorzano, C. S., & Pucchio, A. D. (2022) · Psychology and Health · doi:10.1080/08870446.2022.2062355 · Cited by 30 · see citing works
“Following this period of total quarantine, the Italian government and other governments around the world approved laws and developed orders, suggestions, and guidelines to reduce transmission behaviours (International Monetary Fund, 2020; Michie et al., 2020; West et al., 2020).”
BackgroundInfluentialAinsworth, B., Miller, S., Denison-Day, J., Stuart, B., Groot, J., Rice, C., Bostock, J., Hu, X.-Y., Morton, K., Towler, L., et al. (2021) · Journal of Medical Internet Research · doi:10.2196/22197 · Cited by 29 · see citing works
“To interrupt these transmission pathways, individuals must adopt personal protective behaviors [4].”
BackgroundSelf-citationCOVID-19 Related Knowledge and Mental Health: Case of Croatia
Galić, M., Mustapić, L., Šimunić, A., Sić, L., & Cipolletta, S. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.567368 · Cited by 28 · see citing works
“Moreover, only a few studies (Du et al., 2020; Wang et al., 2020; Yı ldırım and Güler, 2020) have explored the relationship between knowledge and mental health during the COVID-19 pandemic, and no study has yet explored the relationship with optimism and pessimism.”
BackgroundPredicting physical distancing over time during COVID-19: testing an integrated model
Hagger, M. S., Smith, S. R., Keech, J. J., Moyers, S. A., & Hamilton, K. (2021) · Psychology and Health · doi:10.1080/08870446.2021.1968397 · Cited by 28 · see citing works
“campaigns and interventions aimed at stemming infections (West et al., 2020).”
BackgroundLee, B., Lee, M., Mogk, J. P., Goldstein, R., Bibliowicz, J., Brudy, F., & Tessier, A. (2021) · Conference on Designing Interactive Systems · doi:10.1145/3461778.3462030 · Cited by 28 · see citing works
“, physical distancing, hand washing, mask wearing) are commonly recommended to reduce the risk of transmission [69].”
BackgroundInfluentialTracing the Pace of COVID-19 Research: Topic Modeling and Evolution
Liu, J., Nie, H., Li, S., Chen, X., Cao, H., Ren, J. F., Lee, I., & Xia, F. (2021) · Big Data Research · doi:10.1016/j.bdr.2021.100236 · Cited by 28 · see citing works
Does the Covid-19 Pandemic Disproportionately Affect the Poor? Evidence from a Six-Country Survey
Dang, H.-A. H., Huynh, T., & Nguyen, M. (2020) · Social Science Research Network · doi:10.2139/ssrn.3627054 · Cited by 28
“This latter result indicates that cultural factors may take an important role in common hygiene practice and are consistent with recent findings in the public health literature (e.g., West et al. (2020)).”
ResultGeoepidemiological perspective on COVID-19 pandemic review, an insight into the global impact
Vallée, A. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1242891 · Cited by 31 · see citing works
“Individual behaviors have significant roles in COVID-19 transmission (85, 86).”
Background
- Authors
- West, R., Michie, S., Rubin, G. J., & Amlôt, R.
- Affiliations
- University College London (GB)
- King's College London (GB)
- Public Health England (GB)
- Corresponding author
- West, Robert
- Venue
- Nature Human Behaviour
- Published
- 2020-05-06
- Volume
- 4
- Issue
- 5
- Pages
- 451-459
- ISSN
- 2397-3374 (ISSN-L)
- OpenAlex
- W3021447918
- Cited by
- 658
- References
- 0
- Citations by year
- 2026: 26 · 2025: 37 · 2024: 50 · 2023: 96 · 2022: 133 · 2021: 206 · 2020: 109
- FWCI
- 21.79
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Nature Human Behaviour (publishedVersion)
- PubMed (publishedVersion)
- RePEc: Research Papers in Economics (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- National Institute for Health Research Health Protection Research Unit
- National Institute for Health and Care Research
- Department of Health and Social Care
- University of East Anglia
- King's College London
- Public Health England
- Topics
- Social Sciences › Sociology and Political Science › COVID-19 Prevention and Impact
- Social Sciences › Psychology › Applied Psychology › Behavioral Health and Interventions
- Physical Sciences › Mathematics › Modeling and Simulation › COVID-19 epidemiological studies
- Keywords
- SARS-CoV-2 transmission, COVID-19 pandemic, behaviour change interventions, face masks, hand washing, social distancing, behavioral science, droplet transmission
- MeSH terms
- Betacoronavirus, COVID-19, SARS-CoV-2, Communicable Disease Control, Disease Outbreaks, Hand Disinfection, Humans, Pneumonia, Viral, Quarantine, Health Behavior, Coronavirus, Coronavirus Infections, Disease Transmission, Infectious, Severe Acute Respiratory Syndrome, Pandemics, Hand Hygiene
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