“People are more likely to adhere to physical distancing behaviours when their motivations were that they wanted to protect other people, and they wanted to protect themselves. That they want to contribute to the overall well-being of their community. Given that information, although we can’t say for sure, theoretically public health messaging that incorporates those pieces can increase adherence.”
Okay…neat. So public health messaging should focus on keeping the individual safe and keeping their community and everyone around them safe. Seems reasonable. But what is the alternative? What other messaging could there possibly be during a global pandemic if it isn’t to keep your friends and neighbours and yourself safe from the virus? It turns out there is a lot more nuance that that!
Chelsea Moran is a PhD student in Clinical Psychology at the University of Calgary. Along with her supervisor Dr. Tavis Campbell, the bulk of her research has been about behavioural medicine – adherence to health behaviours. Before March of 2020, that meant things like finding ways to promote physical activity and encourage sticking to medication regimens among people with chronic illnesses, like heart disease.
When the pandemic hit, Chelsea and Dr. Campbell thought that the work they had been doing on adherence to personal health behaviours could be applied to adherence to public health behaviours. What makes a person stick to a plan? What motivates them to continue doing the thing that will keep them alive? And how does that translate from the individual level to a community, public space?
Chelsea’s focus is now on the factors that promote adherence to COVID-19 public health guidelines, like physical distancing, mask wearing, and the like.
“We’re looking at individuals, and their day-to-day decision-making processes surrounding these things, and then using that to inform some of the wider public health campaigns that everyone is being exposed to.”
In their research, Chelsea, Dr. Campbell and collaborators Dr. Adina Coroiu and Professor Alan Geller discovered that adherence to physical distancing guidelines was motivated by two main factors. In a survey of more than 2,000 people globally, they found that the desire to protect oneself and the desire to protect other people were (surprisingly to the researchers) almost equally motivating factors.
So back to the messaging. Showing people that wearing a mask and sticking to a tight bubble keeps them, and other people, safer seems to be the way to go. This messaging can work. But what are the alternative messages? What might the media, public health officials, and politicians be saying that doesn’t work? What other message IS there?
What Chelsea has been seeing, and what Dr. Campbell has been showing in some of his own work, is that much of the public messaging can sometimes have a fear-based component. There’s a big difference, as Chelsea points out, between a message that says, “wearing a mask makes you less likely to infect your neighbour”, and “not wearing a mask could kill your neighbour”. The message often is that if the guidelines are not followed, the cases will go up and there will be more death as a result.
While fear can be a motivating factor in the short term, in the long term it doesn’t help. This is true of individual health behaviours as well. It’s much easier to get someone to be healthier by emphasizing the positive benefits to their well-being that come from exercise, rather than telling them “if you don’t exercise you will have a heart attack”.
Another thing Chelsea, Dr. Campbell and their team discovered in their survey was one of the sources of motivation to break the rules – to go against public health guidelines. It wasn’t surprising, but it was good to have it quantified in data, that loneliness was a significant factor in people eschewing physical distancing rules. Chelsea lives alone, and she has been feeling that loneliness as well. Her family is in Ottawa, her partner is in Toronto, and while they connect on Zoom and Skype and FaceTime and all that, it’s tough not to feel a little disconnected.
Chelsea’s practicum placement is at a hospital – one in which she has never set foot since she provides clinical services virtually or over the phone. She has met her clinical supervisor in person once, in September. Chelsea has to stay in Alberta, because that’s one of the provincial rules – even virtually, you must physically BE in Alberta to see clients in Alberta. And so she does. She says she’s grateful for the way the University of Calgary has made online learning accessible so quickly, and once she’s done,she may move to Toronto to be with her partner. For now, they make do.
“We have a standing phone date. He has about an hour commute on the way home from work, so we connect over the phone, catch up, and debrief on how our days went. And then FaceTime and Zoom are good because they provide that visual feedback, the non-verbal support from people.”
Chelsea is staying put. As a trainee, she’s seeing people via virtual platforms, doing school online, and generally coping with a solitary existence for the time being. She wants to keep herself safe, and wants those around her to stay safe as well. That motivation thing is really working!