Public Health England Behavioural Insights, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK.
Centre for Philosophy of Natural and Social Science, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
BMC Public Health. 2021 May 10;21(1):892. doi: 10.1186/s12889-021-10787-9.
In the COVID-19 pandemic, it is imperative that people understand and comply with self-isolation guidelines. We tested whether a simplified version of the guidelines and a simplified version with visual aids would affect comprehension and intention to self-isolate during the containment phase of the pandemic in the UK, in March 2020, compared to the standard guidelines.
We conducted an online, three-armed parallel randomized controlled trial. Participants were English and over 18. The survey software randomized them into conditions; they were blind to condition. The control group read the 7-page standard guidelines (the current version at the time of the trial). The intervention groups were given either a 3-page simplified version, with a summary box on the front page and numbered bullet points, or the same simplified version with pictograms illustrating the points in the box. Primary outcomes were comprehension of the guidelines, as measured by the number of correct answers given to six questions about the content, and the proportion who answered that they would 'definitely' stay at home for 7 days if symptomatic.
Recruitment was from 13 to 16 March 2020, with 1845 participants randomised and all data analysed. The Control group averaged 4.27 correct answers, the Simplified 4.20, and the Simplified + visual aids 4.13, out of a possible total of 6 correct answers. There were no differences in comprehension in the unadjusted models; however, when the model was adjusted for demographic variables, there was lower comprehension in the simplified + visual aids condition than in the control, (ß = - 0.16, p = 0.04998). There were no statistically significant differences in intention to stay home: Control was 85%, Simplified 83%, and Simplified + visual aids condition 84%.
Simplified guidance did not improve comprehension compared to the standard guidance issued in the containment phase of the COVID-19 pandemic in March 2020, and simplified guidance with visual aids may even have worsened comprehension. Simplified guidance had no effect on intention to stay home if symptomatic. This trial informed COVID-19 policy and provides insights relevant to guidance production in the acute phase of a major public health emergency.
在 COVID-19 大流行期间，人们理解并遵守自我隔离指南至关重要。我们测试了在 2020 年 3 月英国大流行的遏制阶段，与标准指南相比，简化版指南和带有视觉辅助的简化版指南是否会影响理解和自我隔离的意愿。
我们进行了一项在线三臂平行随机对照试验。参与者为英语使用者且年龄在 18 岁以上。调查软件将他们随机分配到条件中；他们对条件不知情。对照组阅读 7 页的标准指南（试验时的当前版本）。干预组分别接受 3 页简化版指南，首页有一个摘要框和带编号的项目符号，或带有说明框中要点的象形图的相同简化版指南。主要结果是通过回答关于内容的六个问题的正确答案数量来衡量对指南的理解程度，以及回答如果出现症状“肯定”会在家中呆 7 天的比例。
招募工作于 2020 年 3 月 13 日至 16 日进行，共有 1845 名参与者被随机分配，所有数据均进行了分析。对照组平均答对 4.27 个正确答案，简化组答对 4.20 个，简化+视觉辅助组答对 4.13 个，共 6 个正确答案。在未调整的模型中，理解程度没有差异；然而，当模型调整为人口统计学变量时，简化+视觉辅助条件下的理解程度低于对照组，（β=−0.16，p=0.04998）。在家中停留的意愿没有统计学上的显著差异：对照组为 85%，简化组为 83%，简化+视觉辅助组为 84%。
与 2020 年 3 月 COVID-19 大流行遏制阶段发布的标准指南相比，简化指南并未提高理解程度，而带有视觉辅助的简化指南甚至可能降低理解程度。简化指南对出现症状时是否留在家中没有影响。本试验为 COVID-19 政策提供了信息，并为重大公共卫生紧急事件的急性阶段提供了指导制作方面的见解。
