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Public perceptions of non-pharmaceutical interventions for reducing transmission of respiratory infection: systematic review and synthesis of qualitative studies
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BACKGROUND: Non-pharmaceutical public health interventions may provide simple, low-cost, effective ways of minimising the transmission and impact of acute respiratory infections in pandemic and non-pandemic contexts. Understanding what influences the uptake of non-pharmaceutical interventions such as hand and respiratory hygiene, mask wearing and social distancing could help to inform the development of effective public health advice messages. The aim of this synthesis was to explore public perceptions of non-pharmaceutical interventions that aim to reduce the transmission of acute respiratory infections. METHODS: Five online databases (MEDLINE, PsycINFO, CINAHL, EMBASE and Web of Science) were systematically searched. Reference lists of articles were also examined. We selected papers that used a qualitative research design to explore perceptions and beliefs about non-pharmaceutical interventions to reduce transmission of acute respiratory infections. We excluded papers that only explored how health professionals or children viewed non-pharmaceutical respiratory infection control. Three authors performed data extraction and assessment of study quality. Thematic analysis and components of meta-ethnography were adopted to synthesise findings. RESULTS: Seventeen articles from 16 studies in 9 countries were identified and reviewed. Seven key themes were identified: perceived benefits of non-pharmaceutical interventions, perceived disadvantages of non-pharmaceutical interventions, personal and cultural beliefs about infection transmission, diagnostic uncertainty in emerging respiratory infections, perceived vulnerability to infection, anxiety about emerging respiratory infections and communications about emerging respiratory infections. The synthesis showed that some aspects of non-pharmaceutical respiratory infection control (particularly hand and respiratory hygiene) were viewed as familiar and socially responsible actions to take. There was ambivalence about adopting isolation and personal distancing behaviours in some contexts due to their perceived adverse impact and potential to attract social stigma. Common perceived barriers included beliefs about infection transmission, personal vulnerability to respiratory infection and concerns about self-diagnosis in emerging respiratory infections. CONCLUSIONS: People actively evaluate non-pharmaceutical interventions in terms of their perceived necessity, efficacy, acceptability, and feasibility. To enhance uptake, it will be necessary to address key barriers, such as beliefs about infection transmission, rejection of personal risk of infection and concern about the potential costs and stigma associated with some interventions.
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“In conclusion, when SARS-CoV-2 was first identified, initial assessments of its potential epidemic impact and intervention options were informed by epidemiological and modelling analyses.”
From Severe acute respiratory syndrome (SARS) mathematical models and disease parameters: a systematic review (2025) · cites this paper as [25]
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“The analyses, in the absence of characterisation of the new coronavirus, assumed that its natural history and epidemiology (eg, degree of superspreading) would be similar to those of SARS-CoV-1 and MERS-CoV.25,26,129,130”
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Metadata
- Authors
- Teasdale, E., Santer, M., Geraghty, A. W. A., Little, P., & Yardley, L.
- Affiliations
- University of Southampton (GB)
- Corresponding author
- Teasdale, Emma
- Venue
- BMC Public Health
- Published
- 2014-06-11
- Volume
- 14
- Issue
- 1
- Pages
- 589-589
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC4063987
- OpenAlex
- W2002473926
- Semantic Scholar
- 8de9d69ff6d22a24e6e9af4cdff08a03d01a0f23
- Cited by
- 109
- References
- 69
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 7 · 2023: 10 · 2022: 25 · 2021: 30 · 2020: 23 · 2019: 1 · 2017: 2 · 2016: 6 · 2015: 1 · 2014: 1
- FWCI
- 1.12
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Funders
- National Institute for Health and Care Research (SPCR-048)
- NIHR School for Primary Care Research
- Topics
- Social Sciences › Sociology and Political Science › COVID-19 Prevention and Impact
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Infection Control and Ventilation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Public Health Policies and Education
- Keywords
- non-pharmaceutical interventions, acute respiratory infections, public perception, hand hygiene, respiratory hygiene, masking, social distancing, isolation, perceived barriers, stigma, self-diagnosis, public health recommendations
- MeSH terms
- Nonprescription Drugs, Humans, Influenza, Human, Health Knowledge, Attitudes, Practice, Respiratory Tract Infections, Randomized Controlled Trials as Topic
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