Infection Control Behavior at Home During the COVID-19 Pandemic: Observational Study of a Web-Based Behavioral Intervention (Germ Defence)

• DOI: 10.2196/22197
• Publication Date: 2021-01-24T15:48:14Z
• Authors: Ben Ainsworth; Sascha Miller; James Denison-Day; Beth Stuart; Julia Groot; Cathy Rice; Jennifer Bostock; Xiao-Yang Hu; Katherine Morton; Lauren Towler; Michael Moore; Merlin Willcox; Tim Chadborn; Natalie Gold; Richard Amlôt; Paul Little; Lucy Yardley
• Keywords: behavior change; digital medicine; infectious disease; /dk/atira/pure/subjectarea/asjc/2700/2718; name=Health Informatics; Computer applications to medicine. Medical informatics; Health Behavior; coronavirus; novel coronavirus; digital health; R858-859.7; name=Physical and Mental Health; 610; Infection control; /dk/atira/pure/core/keywords/physical_and_mental_health; 03 medical and health sciences; 0302 clinical medicine; Behavior change; Surveys and Questionnaires; Disease Transmission, Infectious; Humans; /dk/atira/pure/sustainabledevelopmentgoals/good_health_and_well_being; name=SDG 3 - Good Health and Well-being; 2. Zero hunger; Infectious disease; Original Paper; Family Characteristics; Infection Control; Protection; Novel coronavirus; SARS-CoV-2; Digital medicine; COVID-19; 600; Covid19; protection; infection control; United Kingdom; /dk/atira/pure/core/keywords/physical_and_mental_health; name=Physical and Mental Health; 3. Good health; /dk/atira/pure/core/keywords/uob_covid19; /dk/atira/pure/core/keywords/uob_covid19; name=Covid19; Cross-Sectional Studies; name=Covid19; Physical and Mental Health; Public aspects of medicine; RA1-1270; Covid-19; Digital health; Internet-Based Intervention

Background To control the COVID-19 pandemic, people should adopt protective behaviors at home (self-isolation, social distancing, putting shopping and packages aside, wearing face coverings, cleaning and disinfecting, and handwashing). There is currently limited support to help individuals conduct these behaviors.

Objective This study aims to report current household infection control behaviors in the United Kingdom and examine how they might be improved.

Methods This was a pragmatic cross-sectional observational study of anonymous participant data from Germ Defence between May 6-24, 2020. Germ Defence is an open-access fully automated website providing behavioral advice for infection control within households. A total of 28,285 users sought advice from four website pathways based on household status (advice to protect themselves generally, to protect others if the user was showing symptoms, to protect themselves if household members were showing symptoms, and to protect a household member who is at high risk). Users reported current infection control behaviors within the home and intentions to change these behaviors.

Results Current behaviors varied across all infection control measures but were between sometimes (face covering: mean 1.61, SD 1.19; social distancing: mean 2.40, SD 1.22; isolating: mean 2.78, SD 1.29; putting packages and shopping aside: mean 2.75, SD 1.55) and quite often (cleaning and disinfecting: mean 3.17, SD 1.18), except for handwashing (very often: mean 4.00, SD 1.03). Behaviors were similar regardless of the website pathway used. After using Germ Defence, users recorded intentions to improve infection control behavior across all website pathways and for all behaviors (overall average infection control score mean difference 0.30, 95% CI 0.29-0.31).

Conclusions Self-reported infection control behaviors other than handwashing are lower than is optimal for infection prevention, although handwashing is much higher. Advice using behavior change techniques in Germ Defence led to intentions to improve these behaviors. Promoting Germ Defence within national and local public health and primary care guidance could reduce COVID-19 transmission.