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. 2023 Jul 5:11:1130875.
doi: 10.3389/fpubh.2023.1130875. eCollection 2023.

Understanding a constellation of eight COVID-19 disease prevention behaviours using the COM-B model and the theoretical domains framework: a qualitative study using the behaviour change wheel

Angel M Chater  1   2 , Phoebe Brook-Rowland  1 , Foyeke Tolani  3 , Emily Christopher  3 , Jo Hart  4 , Lucie M T Byrne-Davis  4 , Abby Moffat  1 , Gillian W Shorter  5 , Tracy Epton  6 , Atiya Kamal  7 , Daryl B O'Connor  8 , Eleanor Whittaker  9 , Lesley J M Lewis  10 , Emily McBride  11 , Vivien Swanson  12 , Madelynne A Arden  13
Affiliations

Understanding a constellation of eight COVID-19 disease prevention behaviours using the COM-B model and the theoretical domains framework: a qualitative study using the behaviour change wheel

Angel M Chater et al. Front Public Health. .

Abstract

Background: The use of behavioural science and behaviour change within local authorities and public health has supported healthful change; as evidenced by its importance and contribution to reducing harm during the COVID-19 pandemic. It can provide valuable information to enable the creation of evidence-based intervention strategies, co-created with the people they are aimed at, in an effective and efficient manner.

Aim: This study aimed to use the COM-B model to understand the Capability, Opportunity and Motivation of performing a constellation of eight COVID-19 disease prevention behaviours related to the slogans of 'Hands, Face, Space, Fresh Air'; 'Find, Isolate, Test, (FIT), and Vaccinate' in those employed in workplaces identified as high risk for transmission of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) to support intervention development.

Methods: This qualitative study recruited twenty-three participants (16 female, 7 male), who were interviewed from three environments (schools, care homes, warehouses) across three local authorities. Semi-structured interviews were analysed using thematic analysis.

Findings: Ten core themes were identified inductively; (1) knowledge and skills, (2) regulating the behaviour, (3) willingness to act, (4) necessity and concerns, (5) emotional impact, (6) conducive environment, (7) societal influence, (8) no longer united against COVID-19, (9) credible leadership, and (10) inconsistent adherence to COVID-19 prevention behaviours. Themes were then deductively mapped to the COM-B model of behaviour change and the theoretical domains framework and a logic model using the behaviour change wheel (BCW) was produced to inform intervention design.

Conclusion: This study offers a novel approach to analysis that has included eight behaviours within a single thematic analysis and COM-B diagnosis. This will enable local authorities to direct limited resources to overarching priorities. Of key importance, was the need for supportive and credible leadership, alongside developing interventions collaboratively with the target audience. COVID-19 has had an emotional toll on those interviewed, however, promoting the value of disease prevention behaviours, over and above their costs, can facilitate behaviour. Developing knowledge and skills, through education, training, marketing and modelling can further facilitate behaviour. This supports guidance produced by the British Psychological Society COVID-19 behavioural science and disease prevention taskforce.

Keywords: COM-B; COVID-19; behaviour change; face covering; hand hygiene; physical-distancing; testing; vaccination.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Mapping the theoretical domains framework (12) to the COM-B (4, 5) from Chater et al., (14).
Figure 2
Figure 2
Thematic mapping of inductive themes to the theoretical domains framework and COM-B model in relation to a constellation of COVID-19 prevention behaviours.
See this image and copyright information in PMC

References

    1. Chater A, Arden M, Armitage C, Byrne-Davis L, Chadwick P, Drury J, et al. . Behavioural Science and Disease Prevention: Psychological Guidance. Leicester: British Psychological Society; (2020).
    1. McBride E, Arden M, Chater A, Chilcot J. The impact of COVID-19 on health behaviour, well-being, and long-term physical health. Br J Health Psychol. (2021) 26:259–70. doi: 10.1111/bjhp.12520, PMID: - DOI - PMC - PubMed
    1. McBride E, Hart J, O’Connor D, Shorter G, Arden MA, Armitage CJ, et al. . Behavioural Science Investment Needed to Mitigate Long-Term Health Impacts of COVID-19. Leicester: British Psychological Society; (2021).
    1. Michie S, van Stralen MM, West R. The behaviour change wheel: a new method for characterising and designing behaviour change interventions. Implement Sci. (2011) 6:42. doi: 10.1186/1748-5908-6-42, PMID: - DOI - PMC - PubMed
    1. Michie S, Atkins L, West R. The Behaviour Change Wheel. A Guide to Designing Interventions. 1st ed. Great Britain: Silverback Publishing; (2014).

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