Infection prevention behaviour and infectious disease modelling: a review of the literature and recommendations for the future

Abstract

Background: Given the importance of person to person transmission in the spread of infectious diseases, it is critically important to ensure that human behaviour with respect to infection prevention is appropriately represented within infectious disease models. This paper presents a large scale scoping review regarding the incorporation of infection prevention behaviour in infectious disease models. The outcomes of this review are contextualised within the psychological literature concerning health behaviour and behaviour change, resulting in a series of key recommendations for the incorporation of human behaviour in future infectious disease models.

Methods: The search strategy focused on terms relating to behaviour, infectious disease and mathematical modelling. The selection criteria were developed iteratively to focus on original research articles that present an infectious disease model with human-human spread, in which individuals' self-protective health behaviour varied endogenously within the model. Data extracted included: the behaviour that is modelled; how this behaviour is modelled; any theoretical background for the modelling of behaviour, and; any behavioural data used to parameterise the models.

Results: Forty-two papers from an initial total of 2987 were retained for inclusion in the final review. All of these papers were published between 2002 and 2015. Many of the included papers employed a multiple, linked models to incorporate infection prevention behaviour. Both cognitive constructs (e.g., perceived risk) and, to a lesser extent, social constructs (e.g., social norms) were identified in the included papers. However, only five papers made explicit reference to psychological health behaviour change theories. Finally, just under half of the included papers incorporated behavioural data in their modelling.

Conclusions: By contextualising the review outcomes within the psychological literature on health behaviour and behaviour change, three key recommendations for future behavioural modelling are made. First, modellers should consult with the psychological literature on health behaviour/ behaviour change when developing new models. Second, modellers interested in exploring the relationship between behaviour and disease spread should draw on social psychological literature to increase the complexity of the social world represented within infectious disease models. Finally, greater use of context-specific behavioural data (e.g., survey data, observational data) is recommended to parameterise models.

Keywords: Human behaviour; Infectious disease; Literature review; Mathematical modelling; Protective behaviour.

Fig. 1

PRISMA diagram detailing the stages of the review process (adapted from [18]). Note that as this was a scoping review, an iterative process was followed (both within the ‘records screened’ stage and subsequent dashed lines) to identify papers for inclusion in the final review

Fig. 2

Number of papers presenting infectious disease transmission models with endogenous behaviour change, by year of publication

Fig. 3

The number of papers included within the review (n = 42) that cite: a) psychological behaviour change theory; b) economics literature relating to human behaviour, and/ or; c) previous mathematical models that have incorporated human behaviour. Note: individual papers included in the review may have incorporated more than one of these categories of literature and so may be numerically represented multiple times