Behavioural Change & Pandemics
- Joe Prince K
- May 16, 2020
- 3 min read
The COVID-19 pandemic represents a massive global health crisis. Because the crisis requires large-scale behaviour change and places significant psychological burdens on individuals, insights from the social and behavioural sciences can be used to help align human behaviour with the recommendations of epidemiologists and public health experts.
Individuals who value the perceived effects of changed lifestyles (incentives) will attempt to change if they believe that:
(a) their current lifestyles pose threats to any personally valued outcomes, such as health or appearance (environmental cues);
(b) that particular behavioural changes will reduce the threats (outcome expectations); and
(c) that they are personally capable of adopting the new behaviours (efficacy expectations).
Here we discuss evidence from a selection of research topics relevant to pandemics, including work on navigating threats, social and cultural influences on behaviour, science communication, moral decision-making, leadership, and stress and coping. In each section, we note the nature and quality of prior research, including uncertainty and unsettled issues. We identify several insights for effective response to the COVID-19 pandemic and highlight important gaps researchers should move quickly to fill in the coming weeks and months.
The Health Belief Model (HBM) IÓ-18 hypothesizes that health-related action depends upon the simultaneous occurrence of three classes of factors:
(1) The existence of sufficient motivation (or health concern) to make health issues salient or relevant.
(2) The belief that one is susceptible (vulnerable) to a serious health problem or to the sequelae of that illness or condition. This is often termed perceived threat.
(3) The belief that following a particular health recommendation would be beneficial in reducing the perceived threat, and at a subjectively-acceptable cost. Cost refers to perceived barriers that must be overcome in order to follow the health recommendation; it includes, but is not restricted to, financial outlays.
The fear experiences during the COVID-19 pandemic are organised on the psychological level around four interrelated domains, namely
fear of the body/fear for the body,
fear of significant others/fear for significant others,
fear of not knowing/fear of knowing, and
fear of taking action/fear of inaction.
These domains represent the bodily, interpersonal, cognitive, and behavioural features of fear, respectively. I propose ways of addressing these fears and minimising their impact by improving appraisal of the body, fostering attachment security, improving emotion regulation, adopting acceptance and promoting responsibility.
Improving appraisal of the body:
It is crucial for people in the midst of a pandemic to be able to accurately appraise the physiological signals of their bodies and to neither underestimate nor overestimate their susceptibility to infections and the associated physical threat. Most people find useful physical and mental exercises that increase the feelings of safety and control over the body, such as improving posture (Weineck, Messner, Hauke, & Pollatos, 2019), tracking the body autonomic response (Porges & Dana, 2018) and practicing mindfulness (Gibson, 2019).
The World Health Organization (WHO) classified physical inactivity as the fourth leading risk factor accounting for 6% of global mortality, following hypertension (13%), smoking (9%) and diabetes (6%). The relationship between physical inactivity and obesity trends was quite evident since 1953 when the London Busmen Study showed that bus drivers who mainly sat during work presented with larger waist circumferences, higher levels of adiposity (over-weighting) and increased risk of coronary events than bus conductors, who walked the aisles and climbed the stairs of double-decker buses.
Physical inactivity levels are rising in many countries with significant implications for the prevalence of non-communicable diseases and the general health of the population worldwide. The WHO recommends that adults need to accumulate at least 150 min of moderate to vigorous-intensity physical activity (MVPA) or 75 min of vigorous-intensity physical activity (VPA) throughout the week, cumulated in bouts lasting ≥10 min. This volume of physical activity (PA) is associated with a lower risk of cardiovascular (CV) morbidity and mortality and a number of other healthcare benefits (5). Unfortunately, attained levels of daily PA are largely insufficient, especially in western countries.
Citations:
Bavel, J.J.V., Baicker, K., Boggio, P.S.et al.Using social and behavioural science to support COVID-19 pandemic response.Nat Hum Behav(2020). https://doi.org/10.1038/s41562-020-0884-z
Social Learning Theory and the Health Belief Model Irwin M. Rosenstock, PhD Victor J. Strecher, PhD, MPH Marshall H. Becker, PhD, MPH. https://deepblue.lib.umich.edu/bitstream/handle/2027.42/67783/10.1177_109019818801500203.pdf;sequence=2
Porges, Stephen. (2009). The polyvagal theory: New insights into adaptive reactions of the autonomic nervous system. Cleveland Clinic journal of medicine. 76 Suppl 2. S86-90. 10.3949/ccjm.76.s2.17.
Ricci F, Izzicupo P, Moscucci F, Sciomer S, Maffei S, Di Baldassarre A, Mattioli AV and Gallina S (2020) Recommendations for Physical Inactivity and Sedentary Behavior During the Coronavirus Disease (COVID-19) Pandemic.Front. Public Health8:199. doi: 10.3389/fpubh.2020.00199
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