The UK remains in the ‘containment’ phase of the coronavirus outbreak. For the majority of us who’ve not travelled to affected areas overseas, the NHS advice focuses on hand washing, sneezing into tissues, and avoiding touching our faces with unwashed hands.
These behavioural changes are crucial to slowing the virus’s spread. But while seemingly simple, these will be difficult to achieve at the scale required.
The NHS is planning a major public awareness campaign to supplement the considerable media coverage. While education and increased awareness are necessary, even the most effective campaign is likely to fall short of making the desired impact.
Changing behaviour is much easier said than done.
There are two reasons.
First, understanding and influencing human behaviour is difficult. Even people who know the NHS’s advice and fully intend to protect themselves from coronavirus may nonetheless not take the necessary action.
Second, the actions we’re asked to take may appear simple but are actually rather complex.
Understanding human behaviour
Let’s use the example of hand washing. The NHS’s advice is to “wash your hands with soap and water often” and to “use hand sanitiser gel if soap and water are not available”.
We’re not starting from scratch with hand washing, of course. There are already lots of pretty good reasons to wash hands regularly. And they’re not exactly a secret. Yet large minorities of us do not wash our hands properly – even after going to the loo.
This is even true of highly trained and conscientious doctors and nurses, for whom hand hygiene is an important way to prevent the spread of all sorts of infections. The World Health Organisation found that healthcare workers cleaned their hands only a third of the number of times they should while working.
Why is this? It’s not due to a lack of awareness – or not for most of us. Neither is it an intentional wish to spread faeces and viruses among our families and colleagues. No, instead its due to a range of nonconscious factors that drive most of our daily actions. These are the sorts of things we do when we’re not ‘paying attention’, when easily distracted, or stuck in our habits.
Coronavirus will grab attention and increase hand hygiene, but that extra attention is almost certain to be insufficient.
The complexity of apparently simple actions
Second, the actions we’re asked to take may appear simple but involve a lot more than at first glance i.e. what we’re asking people to do is complicated.
The full hand washing advice from the NHS is an eleven-step process that should take around 20 seconds. For example, step eight is to rub the tips of your fingers on the palm of your other hand, and to then do the same with other hand.
I’m not challenging the veracity of the advice. From what scientists know, thorough hand washing, rather than just a quick swipe under the tap, is required.
But it is true that an eleven-step process is a lot more complicated than we might expect from a seemingly simple “wash your hands” message. Try it (please!) – the 20 seconds seems an inordinate amount of time.
Achieving behavioural change
So, if awareness raising isn’t enough to change people’s behaviour, and what we’re asking of people is a lot more complex than it first appears, what’s to do?
There’s no single answer. But the latest insights from behavioural science can help identify successful strategies to both boost the efficacy of awareness campaigns and identify other effective behaviour change techniques.
It’s reassuring that expert behavioural scientists are among the scientific advisors to the Government’s emergency Cobra committee, alongside epidemiologists and virologists. To continue the focus on hand washing, here are some top tips from behavioural science you could try at home or at your workplace:
- Make hand washing desirable: treat yourself or your employees to fancy soaps, perhaps a selection of nice brands. This makes hand washing intrinsically more desirable and grabs attention to the special effort to control coronavirus
- Model good practice: we take our cues of the normal behaviour from what we see others do, especially people we perceive as similar to ourselves. Make regular hand washing as visible as possible – and ensure soaps and sanitiser gels are highly visible.
- Make hand hygiene easy: even minor hassle can be enough to make us put off an intended action. For example, Lloyds Bank has made hand hygiene easy by giving hand sanitiser gel to all its staff
- Create helpful rules of thumb: the NHS’s advice is to wash your hands for the amount of time it takes to sing “Happy Birthday” twice. That’s an easier way to track 20 seconds than counting.
- Celebrate spontaneous innovations: perhaps a colleague has a better way to track the 20 seconds. Or other ‘hacks’ to promote hand washing. If so, share and celebrate those. In emergency circumstances people like to actively ‘do something’, so let’s encourage that in a positive direction