Department of Cardiology, Amsterdam University Medical Center (VU University Medical Center), Amsterdam, the Netherlands.
Center for Advanced Hindsight, Duke University, Durham, North Carolina.
JAMA Netw Open. 2020 Jul 1;3(7):e2014323. doi: 10.1001/jamanetworkopen.2020.14323.
IMPORTANCE: In the absence of a vaccine and therapeutic agent, personal hygiene and physical distancing are essential measures to contain the coronavirus disease 2019 pandemic. OBJECTIVE: To determine whether a social media campaign, targeted at the gaps in behavior on personal hygiene and physical distancing and distributed nationwide via digital news media, may be an effective method to improve behavior and help to inhibit person-to-person transmission of severe acute respiratory syndrome coronavirus 2. DESIGN, SETTING, AND PARTICIPANTS: This survey study was designed to uncover self-reported gaps in behavior regarding personal hygiene and physical distancing in the Netherlands. A diagnostic survey was distributed by a large national newspaper (De Telegraaf) and a popular social influencer (Govert Sweep) on March 17, 2020, and was completed by 16 072 participants. Analysis of these outcomes showed that coughing and sneezing in the elbow was done well, but that handwashing, face touching, and physical distancing showed serious gaps compared with advised behavior. This diagnostic information was used to design infographics and a video targeted at repairing these gaps in behavior. The video and infographics were distributed on a national level on March 21, 2020, followed by a postcampaign survey to measure the results on March 24, 2020. Data analysis was performed from March to April 2020. EXPOSURE: Exposed participants were those who viewed the infographics and/or video. MAIN OUTCOMES AND MEASURES: Improvement on the extent of handwashing in all areas, handwashing duration of 20 seconds or longer, awareness on face touching, and physical distancing were measured according to responses on the postcampaign survey. RESULTS: A total of 17 189 participants (mean [SD] age, 47.61 [13.57] years; 9100 women [52.9%]) responded to the postcampaign survey. The news article in De Telegraaf was read more than 2 million times, and the influencer video was watched more than 80 000 times. Cross-sectional analysis of the postcampaign survey using logistic regression correcting for age, gender, and educational level showed that exposure to the video plus infographics (827 participants) (adjusted odds ratio [OR], 2.14; 95% CI, 1.83-2.50; P < .001) and to the infographics alone (11 348 participants) (adjusted OR, 1.31; 95% CI, 1.22-1.40; P < .001) were positively associated with washing hands in all areas compared with the unexposed group (4751 participants). In addition, exposure to the video plus infographics (adjusted OR, 1.86; 95% CI, 1.59-2.16; P < .001) and to the infographics alone (adjusted OR, 1.27; 95% CI, 1.19-1.36; P < .001) were positively associated with washing hands long enough compared with the unexposed group. Exposure to the video alone was not associated with improved handwashing. Compared with the unexposed group, exposure to the infographics alone and video plus infographics were associated with improvements in physical distancing when the participant had COVID-19 syptoms (infographics alone, adjusted OR, 1.10; 95% CI, 1.03-1.17; P = .006; video plus infographics, adjusted OR, 0.79; 95% CI, 0.69-0.91; P = .001) and face touching (infographics alone, adjusted OR, 1.29; 95% CI, 1.22-1.38; P < .001; infographics and video, adjusted OR, 1.49, 95% CI, 1.30-1.71; P < .001). CONCLUSIONS AND RELEVANCE: These findings suggest that a targeted behavioral change campaign, promoted by a news platform and social media, was associated with self-reported improvement in personal hygiene with the aim to prevent person-to-person transmission of severe acute respiratory syndrome coronavirus 2. This method of evidence-based campaigning may be an effective way to improve critical public health issues, such as the coronavirus disease 2019 pandemic.
重要性:在缺乏疫苗和治疗药物的情况下,个人卫生和身体距离是控制 2019 年冠状病毒病大流行的重要措施。
目的:确定针对个人卫生和身体距离行为差距的社交媒体运动,通过数字新闻媒体在全国范围内分发,是否可能是一种有效改善行为的方法,并有助于抑制严重急性呼吸系统综合征冠状病毒 2 的人际传播。
设计、设置和参与者:本调查研究旨在揭示荷兰自我报告的个人卫生和身体距离行为差距。3 月 17 日,一家大型全国性报纸(《电讯报》)和一位受欢迎的社交媒体影响者(戈弗特·斯威普)发布了一项诊断性调查,共有 16072 名参与者完成了调查。对这些结果的分析表明,在肘部咳嗽和打喷嚏做得很好,但与建议的行为相比,洗手、触摸面部和保持身体距离存在严重差距。这些诊断信息被用来设计针对行为差距的图表和视频。3 月 21 日,视频和图表在全国范围内发布,3 月 24 日发布了一项运动后的调查,以衡量 3 月 24 日的结果。数据分析于 2020 年 3 月至 4 月进行。
暴露:暴露参与者是观看图表和/或视频的人。
主要结果和措施:根据运动后的调查回答,衡量手洗的范围、洗手时间 20 秒或更长时间、对手触脸的认识以及身体距离的改善程度。
结果:共有 17189 名参与者(平均[SD]年龄 47.61[13.57]岁;9100 名女性[52.9%])回答了运动后的调查。《电讯报》上的新闻文章阅读量超过 200 万次,影响者视频观看量超过 8 万次。使用逻辑回归对年龄、性别和教育水平进行横断面分析,显示观看视频加图表(827 名参与者)(调整后的优势比[OR],2.14;95%置信区间[CI],1.83-2.50;P<.001)和仅观看图表(11348 名参与者)(调整后的 OR,1.31;95%CI,1.22-1.40;P<.001)与未暴露组(4751 名参与者)相比,在所有区域洗手的可能性更高。此外,观看视频加图表(调整后的 OR,1.86;95%CI,1.59-2.16;P<.001)和仅观看图表(调整后的 OR,1.27;95%CI,1.19-1.36;P<.001)与长时间洗手有关,与未暴露组相比。仅观看视频与改善洗手无关。与未暴露组相比,当参与者出现 COVID-19 症状时,仅观看图表和视频加图表与身体距离的改善有关(仅观看图表,调整后的 OR,1.10;95%CI,1.03-1.17;P=0.006;视频加图表,调整后的 OR,0.79;95%CI,0.69-0.91;P=0.001)和触摸面部(仅观看图表,调整后的 OR,1.29;95%CI,1.22-1.38;P<.001;观看图表和视频,调整后的 OR,1.49,95%CI,1.30-1.71;P<.001)。
结论和相关性:这些发现表明,有针对性的行为改变运动,由新闻平台和社交媒体推动,与自我报告的个人卫生改善有关,目的是防止严重急性呼吸系统综合征冠状病毒 2 的人际传播。这种基于证据的运动方法可能是改善重大公共卫生问题(如 2019 年冠状病毒病)的有效途径。
Int J Environ Res Public Health. 2020-8-10
JMIR Public Health Surveill. 2020-9-15
J Med Internet Res. 2023-7-14
BMJ Glob Health. 2023-3
Lancet Public Health. 2020-5
Lancet. 2019-7-13
Psychol Health Med. 2017-6-7
Appl Psychol Health Well Being. 2014-3
Annu Rev Psychol. 2004