Interventions to Improve Adherence to Behaviours to Minimise the Spread of Covid-19: A Systematic Review

Objective: During the worldwide COVID-19 pandemic, a range of behavioural interventions was developed and tested (Nicola et al., 2020). These are interventions aiming to increase uptake of or adherence to health protective behaviours. This systematic review evaluates the characteristics and effects of these interventions. Methods: For the review, MEDLINE, PsycINFO and CINAHL were searched for studies on behavioural interventions. Out of 690 identified articles, 35 studies were considered relevant for this review. Study quality was assessed using the revised Cochrane risk-of-bias tool for randomised trials (RoB 2) (Higgins et al., 2019). Results: The majority of studies researched the effects of interventions on social or physical distancing, handwashing, or face coverings. Many studies explored the effects of different types of messages, for example, promoting health protective behaviours. Message-based, online interventions were most common, but largely showed small to negligible effects. Some studies explored other intervention types such as coaching sessions and found moderate to large effects. Conclusion: While the results of these studies indicate that some interventions increase adherence, large heterogeneity in study and intervention design make it difficult to interpret and compare the effects of different interventions. Both an improvement of methodological rigour and standardisation efforts are needed to make behavioural research usable for policy design.