Current infection control behaviour patterns in the UK, and how they can be improved by 'Germ Defence', an online behavioural intervention to reduce the spread of COVID-19 in the home.

Abstract

Background: Germ Defence (https://germdefence.org/) is a freely available website providing behavioural advice for infection control within households, using behaviour change techniques. This observational study reports current infection control behaviours in the home in UK and international users of the website, and examine how they might be improved to reduce the spread of COVID-19. Method: 28,285 users sought advice from four website pathways (to protect themselves generally, to protect others if the user was showing symptoms, to protect themselves if household members were showing symptoms, and to protect a household member who is at high risk) and completed outcome measures of current infection control behaviours within the home (self-isolation, social distancing, putting shopping/packages aside, wearing face-covering, cleaning and disinfecting, handwashing), and intentions to change these behaviours. Results: Current user behaviours mean scores varied across all infection control measures but were between 'sometimes' and 'quite often', except handwashing ('very often'). Behaviours were similar regardless of the website pathway used. After using Germ Defence, users recorded intentions to improve infection control behaviour across all website pathways and for all behaviours. Conclusions: Self-reported infection control behaviours other than handwashing are lower than is optimal for infection prevention, although reported handwashing is much higher. The advice using behaviour change techniques in Germ Defence led to intentions to improve these behaviours. This has been shown previously to reduce the incidence, severity and transmission of infections. These findings suggest that promoting Germ Defence within national and local public health guidance could reduce COVID-19 transmission.

Preventing within household transmission of COVID-19: Is the provision of accommodation feasible and acceptable?

“…Interventions aiming to reduce exposure to the virus in the home have been successful (31, 32). However, it is not easy to avoid contact with infected individuals, and more needs to be done to support vulnerable people (33). In particular, vulnerable individuals living in large households may be at risk of exposure to a high viral load from multiple sources if support is not available.…”

Effectiveness of digital interventions to improve household and community infection prevention and control behaviours and to reduce incidence of respiratory and/or gastro-intestinal infections: A rapid systematic review

“…This is underpinned by an increase in self-reported handwashing (see also [6]) and supported by objective data from medical notes. It has already been re-purposed for COVID-19 and disseminated in the UK, China, and other countries [4].…”

“…In the absence of a vaccine, we are particularly reliant on behavioural measures and there is an urgent need to design interventions to improve hygiene practices [2]. Self-reported infection control behaviours during the pandemic are lower than is optimal for infection prevention [4]. Digital interventions are particularly desirable because of the ease of implementing them at scale and because they operate remotely, so can be rolled out without contact during the pandemic.…”

Infection control in the home: A qualitative study exploring perceptions and experiences of adhering to protective behaviours in the home during the COVID-19 pandemic

“…Introduction: Behavioural measures have been recommended to help control the spread of the COVID-19 virus, and it is known that transmission within the home is a key risk (Wang et al 2020). However evidence suggests that adherence to these behaviours within the UK is mixed (Ainsworth et al 2020).…”

“…This study sought to explore perceptions of performing protective behaviours at home in order to identify possible barriers and facilitators for people and develop an understanding of how these behaviours are influenced by people's perceptions. We took the opportunity to analyse qualitative interview data that were already being collected to inform the optimisation of Germ Defence, a freely available website (www.germdefence.org) developed by the Universities of Bristol, Bath and Southampton to help people protect themselves at home from COVID-19 (Ainsworth et al 2020,Ainsworth et al 2016).…”