Currently, the COVID-19 outbreak is having a firm grip on the global population. To restrict further spread and increase preventive measures across the population, prevention science is called upon to complement medical actions. Being an interdisciplinary research field, prevention science comprises multiple perspectives that are coming together to strengthen resilience in crisis. Three of them (health psychology, communication science, implementation science) will be highlighted to underscore their potential for responding to this global challenge.
- From an individual behavioral perspective, health psychology provides useful frameworks and mechanisms to foster health behaviors
Health psychologists invoke behavioral change principles to build mental models, form social norms, utilize emotional incentives in public communication, offer behavioral alternatives and making them easy to implement.1 2 These principles are also prevalent in clinical psychology and psychotherapeutic interventions. While this process streamlines behavioral change, it does not sufficiently address the emergence and sustainability of social norms, especially regarding communication between individuals (micro level), social groups and institutions (meso level), as well as governments and supranational organizations (macro level). For example, behavior change models rarely address social dynamics of how and why health-related information (e.g., on infection dynamics and prevention) is perceived, processed and evaluated on a larger scale within social groups like families, neighborhoods, and communities (meso level) or even states, nations or supranational institutions (macro level).
With increasing measures of social distancing, quarantine and isolation being established worldwide, naturally, social norms will be affected, as social interaction moves from partially to almost entirely virtual and opportunities of staying physically and mentally healthy are even more strongly determined by one’s socio-economic capabilities. In addition, uncertainty about wide-ranging and fatal infection chains might lead to heated and potentially violent debates of causes and consequences that could affect interpersonal trust. Moreover, socio-economic consequences of the COVID-19 pandemic are yet to be determined. Manifold companies and industries are shut down and must cease business during quarantine times, with potentially dire consequences for many employees, particularly in less developed economies.3 When and how these challenges will translate from economical into interpersonal action remains to be seen.
- Communication science frameworks regarding risk and crisis inform communication processes and interactive action between governing bodies, informational entities and receiving public
Crises are recognized as complex and uncertain events that require constant monitoring and ongoing communication in a partnership with a multitude of vulnerable populations. In this respect, decades of research in the field of civil protection and crisis communication have proposed guidelines4 recommending an empathetic style of communication, strengthening trust by communicating openly and transparently to galvanize the population.5 6 These guidelines are very useful in the current situation, because they also cover the integration of different types of media (e.g., social networking sites, TV, online news) information formats and sources into overarching communication frameworks that enable governmental and non-governmental institutions to establish trustworthy and reliable communication with high compliance rates.7
However, several aspects of the COVID-19 crises can be considered as novelties. Vulnerability, in this aspect, transcends traditional conceptualizations of sociodemographic and psychosocial vulnerability, as it implies interactions between individual and event-related characteristics that possess unique properties. To clarify, personal vulnerabilities (e. g., increased exposure to COVID-19) and economic vulnerabilities (e.g., underfunded health systems, understaffed clinics) are intertwined, which leads to a more complex and unpredictable type of vulnerability. In addition, the aspect of uncertainty is pervasive, since medical research on COVID-19 is ongoing and therefore evidence on development, trajectories and treatment is still scarce. Moreover, infection dynamics are usually estimated upon epidemiological models and behavioral economics, which are unable to fully grasp real-world events (i.e. due to methodological and statistical limitations). Finally, communicating these uncertainties to the public presents a unique challenge, because public understanding and reaction cannot be fully predicted, but only approximated based on previous experiences and guidelines. Hence, recommendations on communication efforts can be useful for immediate crisis management, but they are not as clear on how to engage the public and create sustainable long-term policy-public partnerships, particularly with the issues of vulnerability and uncertainty in mind.
- Implementation science approaches that are popular in prevention practice can help to outline the implementation of infection-related prevention measures and mitigation across different cultures and societies
Implementation science, as an important part of prevention science, offers unique perspectives on building these partnerships between policymakers, researchers, practitioners, and the public. The Interactive Systems Framework8 , for instance, comprises three systems targeting synthesis and translation of prevention innovations, delivery focusing on concrete implementation of innovations in the field and support of the prevention workforce. To enhance uptake and sustainability, practice-based evidence is as important as evidence-based practice!
With regards to the COVID-19 pandemic, this framework includes the perspective of primary care workers and professionals on the implementation process of preventive measures. Prevention researchers accompany the translation process and deliver evidence-based recommendations on prevention strategies. Policymakers provide support for frontline workers and researchers alike to ensure crisis response and mitigation with a scientific background. Regarding the current COVID-19 outbreak, the following PEERS strategies are recommended:
- PERSPECTIVES: Capture and monitor implementation processes of primary care, secondary care (e.g., psychotherapy) and prevention practice with a focus on translating professional perspectives into publicly accessible information to complement media and governmental reports.
- EVALUATION: Evaluate and optimize implementation processes to balance efforts and rewards for frontline professionals, such as health care professionals, police officers, first responders, and volunteers. In addition, public health measures should be continuously monitored and evaluated on micro, meso, and (if feasible) macro levels.
- EVIDENCE: Select, dissect and disseminate evidence-based communication and prevention guidelines for the general population. Combining the state of the art in communication and behavioral sciences in this area can help to build global resilience.
- RELATIONSHIP BUILDING: Establish regular, open and transparent communication between representatives and the public and explicitly state uncertainties and preventive efforts to address them. Social media channels, such as Facebook or Twitter, for example, are a good opportunity to reach a large proportion of the population, however, traditional media is just as important, as it considered to be more trustworthy and has a farther reach than social media.
- SUPPORT: Extend funding for health care practice and research as well as for the general population, particularly, for vulnerable populations. Financial aid may be among the first options to come to mind, but immaterial support, for example, recognizing, presenting and discussing public needs and providing infrastructure for networking and peer-to-peer solutions are also invaluable in building and sustaining resilient, healthy communities.
In sum, uniting the expertise of researchers, practitioners and policymakers under the umbrella of prevention science holds promise for a swift and effective response to the current pandemic.
- Michie, S., West, R., & Amlôt, R. (2020). Behavioural strategies for reducing COVID-19 transmission in the general population. BMJ Opinion, March 3rd 2020.
- Michie, S., Rubin, G. J., & Amlôt, R. (2020). Behavioural science must be at the heart of the public health response to covid-19. BMJ Opinion, February 28th 2020.
- McKibbin, W. J., & Fernando, R. (2020). The Global Macroeconomic Impacts of COVID-19: Seven Scenarios. CAMA Working Paper, 19/2020, March 2, 2020.
- Seeger, M. W. (2006). Best practices in crisis communication: An expert panel process. Journal of Applied Communication Research, 34(3), 232-244.
- Reynolds, B., & Quinn, S. C. (2008). Effective Communication During an Influenza Pandemic: The Value of Using a Crisis and Emergency Risk Communication Framework. Health Promotion Practice, 9(4pp), 13-17.
- Veil, S., Reynolds, B., Sellnow, T. L., & Seeger, M. W. (2008). CERC as a theoretical framework for research and practice. Health Promotion Practice, 9(4), 26-34.
- Eriksson, M. (2018). Lessons for crisis communication on social media: A systematic review of what research tells the practice. International Journal of Strategic Communication, 12(5), 526-551.
- Wandersman, A., Duffy, J., Flaspohler, P., Noonan, R., Lubell, K., Stillman, L., … & Saul, J. (2008). Bridging the gap between prevention research and practice: the interactive systems framework for dissemination and implementation. American Journal of Community Psychology, 41(3-4), 171-181.