While there is evidence of the importance of these measures in reducing disease transmission, one of the unknowns is the degree to which people are willing to follow these more stringent measures. There is much media coverage of the experience of those in quarantine and isolation, much of which has focused on the difficulties that people have faced. In these circumstances, it is easy to imagine there simply not being the willingness to adhere to the new requirements if they are in place for a long period of time.
The psychology of behaviour maintenance
But just what do we know about the psychology of this? Much of the focus in the literatures is on starting new behaviours such as hand-washing. There is much less about the psychology of maintaining these behaviours. As Dominika Kwasnicka and colleagues identified in a review of the literature on the topic, few studies evaluate the degree to which longer-term behaviour change has taken place. What information there is available is not promising; for weight loss programs, smoking cessations and reduced alcohol consumption. Given the long-term behaviour changes that are needed from both a public health as well as commercial perspective, it is critical to understand how long-term behaviour change can be motivated. Kwasnicka and colleagues offers a wide range of guidance but one of the key issues at this stage is planning how to keep people motivated. The key recommendations are as follows:
Make activities enjoyable: While initial behaviour change for COVID-19 will be motivated by a desire to avoid possible negative outcomes (such as exercising regularly to reduce health risks), the motivations for long term adherence are quite different. In terms of long term maintenance of the behaviour, simply avoiding negative outcomes is not sufficient, more positive motivation is needed (as suggested by the precaution adoption process model). People tend to engage more strongly with behaviours that they enjoy (or where there are outcomes that are enjoyable). In terms of public health advice, we recommend that they suggest ways in which people can find positives from the new behaviours. A period of self-isolation, whilst difficult, may have positive aspects (such as time to do activities that often we don’t have time for (such as reading or catching up on correspondence) can be accentuated. In terms of brands, they need to work to make sure that the new channels to market, that will inevitably be required, are well designed and involve positive experiences. The user design or development of new services will be critical to help achieve this.
Help build internalized motivation: Being obliged to do actions only works for a limited period of time, people need to feel personally motivated to do these actions. The literature suggests that when these protective behaviours are congruent with existing beliefs and engagement then they are more likely to be maintained. In the context of COVID-19 for policy makers this suggests it is important to reference prior beliefs such as the importance of social responsibility and the value of good hygiene. For brands it may be to emphasize the value of new behaviours such as moving to digital channels; there will be a host of pre-existing beliefs and attitudes towards the perceived value of digital channels that need to be referenced.
Build positive identities: People are much more likely to maintain behaviours if they are consistent with the way they see themselves. At times, the required behaviours for COVID-19 protection may be inconsistent with the dominant identity a person has. So, for example, the need for low contact may be inconsistent with the identity that someone has of themselves as a friendly, social person. But they also have an identity as a responsible citizen, so it is a matter of bringing this identity to the fore. Both brands and policy makers will need to understand how to draw on the positive identities for people to make sense of and adopt these behaviours.
Helping people to self-regulate
Kwasnicka and colleagues identified a number of important factors beyond keeping people motivationed that are important for maintaining behaviours. One of these is self-regulation, helping people to successful monitor and regulate their new behaviours. We suspect that one of the most challenging aspects of self-regulation will be that of maintaining a self-isolation behaviours over a long period not least as it is externally enforced and individuals are typically under stress.
We consider that an understanding of rituals provides some insight into how routines could be developed to be long-lasting. Rituals pervade our lives, involving anything from setting of the table for an everyday family meal to getting married. The important point is that a very specific set of behaviours is undertaken a very consistent way, embedded in a larger system of meaning. If our behaviours are guided by ritual then we are more likely to self-regulate and not stop them, clearly essential for long term maintenance of being motivated to continue COVID-19 protection.
Two aspects of rituals are particularly relevant here. First, they are behavioural patterns that are segmented into chunks that become arranged into a specific sequence and adhered to in a strict way. Applying this to maintaining self-isolation behaviours over a longer period, public health guidance could well suggest creating defined chunks of behaviours within a specific day (e.g., sitting at a specific table for working at home) or across a number of days (e.g., decluttering different rooms of a house) to help people maintain being housebound without developing poor psychological outcomes.
Related to this point is a second relevant aspect of rituals, the psychological meaning ascribed to that behaviour. As mentioned earlier, aligning the behaviour with pre-existing beliefs and attitudes can help to motivate those behaviours, but by linking these to shared social meanings there is a potential to build affiliation and develop an understanding of shared knowledge and norms. Hence, providing communications that focus on how self-isolating behaviours is a shared activity that we all can do to contribute to reducing disease transmission or developing ways for individuals to share their experience in maintaining these activities it could potentially build a deeper meaning around these behaviours.
The role of social forces
Before government restrictions were put in much of the behaviour change focus was on direct appeals from experts to citizens through the media, supported by emerging social normative pressure. Pandemics like this are both an immunological problem, but also a social problem—social in both a causal role, but also as core to the solution. Social forces can spark, accelerate and support the behaviour maintenance strategies already outlined in a variety of ways. Social facilitation and co-action can make activities more enjoyable. A sense of relatedness from the influence from trusted others helps speed the internalization of motivation. Our social identities from these connections are an essential sustaining our personal identities. And social influence and normative pressure can trigger inhibitory control and other self-regulatory process as these norms are internalized. In many ways, channeling these social forces can function as a “power-up” for behaviour maintenance strategies.
There is much guidance given on the need to consistently practice protective behaviours to reduce the spread of COVID-19. There is a significant body of work on the formation of habit for health protection behaviour but many of the motivational and regulatory dimensions that underpin maintenance of behaviour are social and cultural in nature. Much of the work related to these has often been the domain of broad macro-level accounts from cultural analyses and ethnographic research. There has been less focus on the way these characteristics operate at the micro-level of the individual. The shared, social nature of COVID-19 means we urgently need to bring these dimensions into the behavioural science guidance given to policy makers and brands.
This article was published on ResearchWorld.com