COVID-19: Should authorities have prioritised the protective behaviours they targeted?

It is now well accepted that behaviour change is essential in tackling the Covid-19 pandemic; that changes in behaviour are critical for slowing and managing its spread. 

In response to this realisation, authorities began to extensively promote several protective behaviours. For instance, in March, the World Health Organisation (WHO) recommended:

• Staying home when sick.
• Covering the mouth and nose with flexed elbow or tissue when coughing or sneezing. Dispose of used tissue immediately.
• Washing hands often with soap and water.
• Cleaning frequently-touched surfaces and objects.

In contrast, in March, the Australian Government called for somewhat different behaviours:

• Good hygiene (which includes washing your hands, covering your coughs and cleaning your home or workplace).
• Social distancing (staying 1.5 meters apart in social settings).
• Avoiding public gatherings.
• Self-isolation and mask-wearing (if infected with COVID-19).

For now, let’s overlook the fact that it isn’t ideal for authorities to offer different recommendations and that WHO did not mention what is now recognised as one of the most critical behaviours - ‘staying home where possible’. Let’s instead just evaluate the set of behaviours suggested.

Are all the protective behaviours outlined equally critical and impactful? 

Almost certainly not. If everyone stayed at home and self-isolated when sick, it would almost definitely have a larger effect than if everyone instead cleaned frequently-touched surfaces and objects and immediately disposed of their used tissues.

However, the communications from authorities don’t convey that some protective behaviours are more important to do than others. Instead, they simply outline behaviours to resist the virus and imply that these are of equal importance. 

Suggesting that all behaviors are equal in importance increases the possibility of mistaken nonchalance about critical behaviours. Someone might reasonably think, “Oh well,l I don’t stay home when sick, but I do all the other three things the WHO recommends, so it’s probably not a big issue’. In fact, it could reasonably be argued that this is a worse situation than if the person stayed at home when sick and didn’t do any of the other three behaviours. 

Suggesting all behaviors are equal in importance also increases the risk of misallocation of related effort; for example, it might lead people to work on, or support, promoting handwashing, when promoting social distancing and related behaviours are actually much more crucial.

Finally, suggesting that all behaviors are equally important also increases the risk that people fail to retain and communicate critical information (e.g., to stay home/social distance) due to the fact that they need to remember less critical information (e.g., dispose of used tissues immediately). 

Should we have used behavioural prioritisation?

Could a behavioural prioritisation process have informed a better communication strategy? The authorities could have started by using an approach like the Impact-Likelihood Matrix to rank the options for behaviour change based on their probable impact and how likely they were to be adopted. 

The priorities developed could then have influenced a communications plan. This plan could use communication principles, such as those described in the BWA INSPIRE framework, to ensure that priority behaviours were made more salient and easier to understand/remember than less important behaviours. For example, communicators might use graphics,  or differences in font, colouring or sizing, to indicate differences in importance between protective behaviours. Similarly, they might maximise ease of memory and processing for the highest importance behaviours by producing messages and copy focused on a single high-impact behaviour rather than all desired behaviours.

What do you think? Have authorities prioritised promoting the right behaviours? Have they communicated effectively? How should they have done things differently?

See the article on the Behaviour Works Australia website

Wave 2 of the Survey of COVID-19 Responses to Understand Behaviour (SCRUB) project has been launched. Please help us to provide policy relevant snapshots of the COVID-19 pandemic by taking part here.