Public perceptions of non-pharmaceutical interventions for reducing transmission of respiratory infection: systematic review and synthesis of qualitative studies

Abstract

BackgroundNon-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.MethodsFive 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.ResultsSeventeen 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.ConclusionsPeople 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.

Public perceptions and experiences of social distancing and social isolation during the COVID-19 pandemic: A UK-based focus group study

“…[6] Another systematic review of the literature on NPIs in relation to pandemic influenza and SARS found that people actively evaluate NPIs in terms of criteria such as perceived necessity, efficacy, acceptability and feasibility. [7] Public views on social distancing and social isolation are ambivalent in some contexts because of their perceived adverse social and economic impacts and their ability to attract stigma, particularly amongst those required to self-isolate. [7] Existing research on social distancing and isolation highlights a number of .…”

“…[7] Public views on social distancing and social isolation are ambivalent in some contexts because of their perceived adverse social and economic impacts and their ability to attract stigma, particularly amongst those required to self-isolate. [7] Existing research on social distancing and isolation highlights a number of . CC-BY-NC-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.…”

Protection motivation theory and social distancing behaviour in response to a simulated infectious disease epidemic

“…hand hygiene, social distancing, mask wearing) in response to respiratory infectious diseases can have a significant impact on the course of an epidemic (Teasdale et al, 2014). Health behaviour models, such as, Protection Motivation Theory (PMT; Rogers, 1975;1983), or Theory of Planned Behaviour (Ajzen, 1991), provide useful frameworks for understanding behavioural choices during such epidemics.…”

“…The evidence suggests that social distancing may be a behaviour that individuals find difficult to perform (e.g., Teasdale et al, 2014). Therefore, increasing perceptions of efficacy surrounding this behaviour will be key in order to employ it as an effective behavioural intervention.…”

Increasing the intent to receive a pandemic influenza vaccination: Testing the impact of theory-based messages

“…Recent studies have suggested that highlighting the health-enhancing benefits of vaccination, such as strengthening the immune system, may be more effective than emphasising the reduced risk of infection (Rubinstein, et al, 2015;Teasdale, Santer, Geraghty, Little, & Yardley, 2014).…”