Background
UNICEF commissioned CARES members to undertake research into factors that predicted adherence to protective behaviours during the COVID-19 pandemic, so to inform strategies that can empower people to protect themselves during a health emergency.
About the project
The London Met team carried out research to understand the required capabilities, opportunities and motivations to engage in protective behaviours during the COVID-19 pandemic, specifically looking at vaccine hesitancy, mask wearing, social distancing and self-isolation. This knowledge was used to inform how UNICEF’s stakeholders and partners could support their communities to stay safe during a health emergency.
The key deliverables of the project were:
- Four rapid evidence assessment reports – for vaccine hesitancy, mask wearing, social distancing and self-isolation.
- A behaviour change wheel toolkit to teach stakeholders how to design interventions to empower their communities to protect themselves.
- Presentations to UNICEF and their stakeholders online and at their conference in Istanbul, Turkey.
How the research was carried out
In undertaking the research, our CARES team:
- Defined the scope: Established the context, purpose, and research question and determined the inclusion criteria for relevant studies.
- Searched and selected studies: Developed and executed a search strategy and selected studies that met the inclusion criteria.
- Appraised and extracted data: Critically assessed the quality of the selected studies and extracted relevant data.
- Synthesised findings: Summarised and integrated the results to establish the practical implications of supporting communities to stay safe during a health emergency.
More information
During the COVID-19 pandemic UNICEF sought to support their global stakeholders and partners, such as UNICEF’s country offices with evidence to inform how they could empower their local communities to protect themselves during the COVID-19 pandemic.
Dr Stephen Hills was invited to bid for the project after UNICEF read his study on factors predicting adherence to social distance measures, which was published in the BMC Public Health Journal. Along with fellow CARES member Associate Professor Justin Webb, a successful bid from London Metropolitan University was submitted.
Rapid evidence assessments
As vaccine availability has increased in much of the world, challenges remain related to acceptance and uptake of COVID-19 vaccines, further compounded by global inequities in vaccine access and the emergence of new variants. As such, non-pharmaceutical interventions (NPIs) continue to be an important tool in slowing and preventing the spread of SARS-CoV-2.
This series of rapid evidence assessments (REA), using the COM-B model as a theoretical framework, sought to understand the existing evidence about who delays or refuses COVID-19 vaccination and who does not adhere to NPI measures, why and in what contexts. The objective is to inform tailored policies and interventions that support vaccination acceptance and adoption of recommended NPI measures, drawing in the COM-B Behaviour Change Wheel.
Demographics did not consistently predict non-adherence to protective behaviours during the COVID-19 pandemic. In terms of psychological capability, people with less COVID-19 knowledge are more likely to delay or refuse vaccination and not adhere to social distancing. In terms of social opportunities, people who perceive less social normative pressure to engage in protective behaviours are more likely to not adhere to social distancing and mask wearing recommendations. In terms of reflective motivations, people who perceive the protective behaviour to be less effective are more likely to delay or refuse vaccination and avoid mask wearing; people who perceive themselves to have less control over protective behaviours are less likely to adopt social distancing and mask wearing behaviours; and people who perceive themselves to be less susceptible to catching COVID-19 are more likely to avoid or refuse vaccination and to not adhere to mask wearing recommendations.
See the REAs on the UNICEF Innocenti website.
Toolkit
The series of REAs was used to develop an evidence-informed practical toolkit for policy makers and practitioners to inform decision making around future efforts to promote uptake and maintenance of some or all recommended NPIs to mitigate the spread of outbreaks of transmissible respiratory diseases, including potential new and emerging pandemic threats.
The outputs of the research informed UNICEF’s partners and stakeholders strategies and interventions to empower their communities to engage in protective behaviours during the COVID-19 pandemic.
