Social distancing measures: barriers to their implementation and how they can be overcome – a systematic review

Abstract

Background Despite their central role in the global response to the COVID-19 pandemic and previous infectious disease outbreaks, factors influencing the acceptability and implementation of social distancing measures are poorly understood. This systematic review aims to identify such factors drawing on qualitative literature. Methods A systematic search was carried out in eleven databases. Papers were included in the review if they reported on qualitative studies of factors influencing the implementation of social distancing measures in potentially epidemic infectious diseases. An adapted meta-ethnographical approach was used for synthesis. Review findings were assessed for strength and reliability using GRADE-CERQual. Results Twenty-nine papers were included from the systematic search that yielded 5620 results, and supplementary methods. The review identifies two broad categories of barriers to social distancing measures: individual- or community-level psychosocial phenomena, and shortcomings in governmental action or communication. Based on this, 25 themes are identified that can be addressed to improve the implementation of social distancing. Conclusion Among other findings, the review identifies the need for good communication as well as the need for authorities to provide comprehensive support as two key opportunities to increase acceptability and adherence. Further important enablers of adherence are adequate preparedness and appropriate legislation, the presence of community involvement, solidarity within communities and trust in governments and authorities.

Efficacy of COVID-19 vaccine booster doses in older people

“…The clinical evidence accumulated so far would hence suggest that older people should be especially protected from SARS-CoV-2 infection. Nonetheless, physical measures such as wearing face mask, social distancing, hand hygiene and so forth are only partially effective for preventing viral infection and COVID-19-related complications [ 7 ], so that widespread administration of COVID-19 vaccines is now regarded as the most effective preventive strategy in older persons [ 8 ], as already proven for other infectious diseases such as influenza, meningococcal and pneumococcal diseases, hepatitis, herpes zoster, diphtheria and tetanus [ 9 ].…”

Delay discounting of money and health outcomes, and adherence to policy guidelines during the COVID-19 pandemic

“…Several factors have been found to predict adherence to social distancing and other protective practices against COVID-19. For example, Sadjadi et al ( 40 ) found that communication and support were the strongest enablers of social distancing from an institutional perspective. Without neglecting the interaction of agents and institutions, the temporal discounting perspective of the present study takes a different stance than other psychological and social factors insofar as it considers primarily the relation between the agent and his or her future self.…”

Variability in Opioid-Related Drug Overdoses, Social Distancing, and Area-Level Deprivation during the COVID-19 Pandemic: a Bayesian Spatiotemporal Analysis

“…A recent review of research examining barriers to the implementation of social distancing measures implemented during COVID-19 uncovered two categories of barriers: individual-psychological/psychosocial and sociological phenomena, and shortcomings in governmental action or communication. Specific psychological and psychosocial barriers revealed include avoiding stigma, feelings of solidarity, perceived threat and value of the intervention, and alignment of messaging and lived experience, accounting for life circumstances and addressing social norms [ 27 ]. Government factors included providing support for people to adhere to social distancing mandates and trust in government, and involving the community in both the pandemic’s planning and response phase [ 27 ].…”

“…Specific psychological and psychosocial barriers revealed include avoiding stigma, feelings of solidarity, perceived threat and value of the intervention, and alignment of messaging and lived experience, accounting for life circumstances and addressing social norms [ 27 ]. Government factors included providing support for people to adhere to social distancing mandates and trust in government, and involving the community in both the pandemic’s planning and response phase [ 27 ]. The factors that are associated with either the inability or unwillingness to comply with stay-at-home mandates seem more closely related to socioeconomic marginalization (SEM).…”