Systematic review of interventions to promote the performance of physical distancing behaviours during pandemics/epidemics of infectious diseases spread via aerosols or droplets

ObjectivesPhysical distancing, that is keeping 1-2m apart when co-located, can prevent cases of droplet or aerosol transmitted infectious diseases such as SARS-COV2. During the COVID-19 pandemic, distancing was a recommendation or a requirement in many countries. This systematic review aimed to determine which interventions and behaviour change techniques (BCTs) are effective in promoting adherence to distancing and through which potential mechanisms of action (MOAs). MethodsSix databases were searched. The review included studies that were (a) conducted on humans, (b) reported physical distancing interventions, (c) included any comparator (e.g., pre-intervention versus post-intervention; randomised controlled trial) and (d) reported actual distancing or predictors of distancing behaviour. Risk of bias was assessed using the Mixed Methods Appraisal Tool. BCTs and potential MoAs were identified in each intervention. ResultsSix moderate or high quality papers indicated that distancing interventions could successfully change MoAs and behaviour. Successful BCTs (MoAs) included feedback on behaviour (e.g., motivation); information about health consequences, salience of health consequences (e.g., beliefs about consequences), demonstration (e.g., beliefs about capabilities) and restructuring the physical environment (e.g., environmental context and resources). The most promising interventions were proximity buzzers, directional systems and posters with loss-framed messages that demonstrated the behaviours. ConclusionsThe evidence indicates several BCTs and potential MoAs that should be targeted in interventions and highlights the gaps that should be focused on in future research.