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Citation

Epton T, Ghio D, Ballard LM, Allen SF, Kassianos AP, Hewitt R, Swainston K, Fynn WI, Rowland V, Westbrook J, Jenkinson E, Morrow A, McGeechan GJ, Stanescu S & Swanson V (2022) Interventions to promote physical distancing behaviour during infectious disease pandemics or epidemics: A systematic review. Social Science and Medicine, 303, Art. No.: 114946. https://doi.org/10.1016/j.socscimed.2022.114946

Abstract
Objectives Physical distancing, defined as 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 behavior change techniques (BCTs) are effective in promoting adherence to distancing and through which potential mechanisms of action (MOAs). Methods Six 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; randomized controlled trial), and (d) reported actual distancing or predictors of distancing behavior. Risk of bias was assessed using the Mixed Methods Appraisal Tool. BCTs and potential MoAs were identified in each intervention. Results Six articles (with seven studies and 19 comparisons) indicated that distancing interventions could successfully change MoAs and behavior. Successful BCTs (MoAs) included feedback on behavior (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 behaviors. Conclusions The evidence indicates several BCTs and potential MoAs that should be targeted in interventions and highlights gaps that should be the focus of future research.

Keywords
Systematic review; Physical distancing; COVID-19; Social distancing

Notes
Additional co-authors: Aysha A. Yousuf, Nisha Sharma, Suhana Begum, Eleni Karasouli, Daniel Scanlan. Gillian W. Shorter, Madelynne A. Arden, Christopher J. Armitage, Daryl B. O'Connor, Atiya Kamal, Emily McBride, Jo Hart, Lucie Byrne-Davis, Angel Chater, John Drury

Journal
Social Science and Medicine: Volume 303

• Published version