Review Behavioural Science Insights to Support COVID-19 Communications and Public Education Initiatives
Within the context of the unfolding COVID-19 pandemic, the Impact and Innovation Unit (IIU) has been executing a comprehensive program of research grounded in Behavioural Science (BeSci) to support the Government of Canada in driving the large-scale behaviour-change required to reduce the spread of the virus.
This report is the culmination of our knowledge and learning on effective COVID-19 communications that are behaviourally-informed, based on the state of knowledge as of Spring 2021. It presents a series of evidence-based recommendations for communicators which have been informed by the outcomes of research led by the IIU in the COVID-19 context (e.g., The COSMO Canada Study, online message testing, and in-field research and experiments), as well as the work of others within Canada and across the world (Government, NGOs, private-sector, academics). The recommendations fall within two categories:
- Understanding and connecting with your audience, and
- Framing your message.
For communication to be effective, it is important to connect with the recipients. We have outlined three key recommendations that should serve as the foundation of the development and implementation of any communication or public education campaign:
- focus on the target audience and prioritize equity;
- establish trust; and
- acknowledge hardships, mental health, and emotions.
These relate to some underlying factors that can influence how people interpret messages and make decisions within the context of their life.
A message can be interpreted differently depending on how it is framed. The COVID-19 pandemic has highlighted the need for effective and adaptable communication approaches that motivate people to follow public health guidelines and get vaccinated, even amidst the uncertainty and evolving information landscape. Behavioural science can help to design messages that relate to people’s psychological motivations and decision-making process. Therefore, we have outlined six recommendations for framing messaging related to the pandemic:
- demonstrate transparency;
- communicate credible information in a timely manner;
- calibrate risk and promote efficacy, autonomy and competence;
- employ trusted messengers and narrative approaches;
- consider relevant morals and values; and
- activate pro-social norms and collective action.
It is strongly recommended to rigorously test these evidence-based recommendations within your intended context and with your intended audience before applying them at scale. We hope that this will be a useful tool for any team or organization that is designing communications intended to promote behaviour change, in the COVID-19 context and beyond.
2. About Impact Canada
Impact Canada is part of a comprehensive set of initiatives launched by the Government of Canada in 2017 aimed at solving complex policy challenges using challenge prizes, pay-for-success, and behaviourally based models. Impact Canada enables the use of challenge prizes through a set of flexible Terms and Conditions (Ts&Cs) for Grants and Contributions that allow funding to be linked to outcomes achieved as well as funding rigorous, research based evaluations.
The Impact and Innovation Unit at the Privy Council Office helps departments develop innovative funding opportunities that bring together the best ideas and brightest talent, and reward those organizations and individuals that deliver high impact results for Canadians.
3. About Behavioural Science
The Behavioural Science (BeSci) team was established in 2015, and has been growing the practive of BeSci across the Government of Canada. Today, the team is composed of a a central group of researchers housed in the Privy Council Office, and multiple BeSci Impact Canada Fellows who are embedded within various Government of Canada departments, supporting the integration of BeSci insights and methods into priority program and policy areas.
While our team members have diverse academic backgrounds and an array of methodological specialities, we all share a passion for understanding human behaviour and using that understanding to drive change. Combining our knowledge of the literature with cutting-edge research and experimentation practice is what we do best.
3.1 Our approach: The behavioural design process
We are data-driven and evidence-based. Testing is integral to how we work. We conduct high-quality research to understand behaviour, and use a variety of rigorous experimental and quasi-experimental approaches to test - and scale - effective solutions.
Our projects often follow a multi-stage process, which we tailor to fit the needs and contexts of each project and partner.
- Consult with departmental leadership to identify priority target outcomes of interest and key behaviours to target
- Discuss current approaches and additional opportunities for innovation
- Conduct initial research (e.g. literature scans, stakeholder interviews) to inform hypotheses of drivers and barriers to behaviours
- Conduct additional mixed-methods research (e.g. interviews, observations, surveys, and analysis of administrative data) to test hypotheses
- Ideate solutions for confirmed hypotheses, referencing the behavioural science literature
- Present prototypes of solutions to partners for feedback
- Iterate to refine solutions and prepare priority solutions for testing
- Prepare plans for experimental or quasi-experimental tests of solutions and analysis of results
- Implement solutions in line with testing plan
- Collect data
- Analyse and present results
- Prepare plans for scaling (e.g. for broad dissemination of results, preparing policy memos, and supporting other key stakeholders to adapt and adopt provides solutions)
- Support plan execution
4. Recommendations for Understanding and Connecting with Your Audience
4.1 Focus on the Target Audience and Prioritize Equity
- Connect with members and leaders within the target audience(s). Specifically, engage in meaningful, two-way dialogue to identify and understand:
- who they are as people (e.g., their concerns, motivations, values, information needs),
- what barriers exist related to the desired behaviour (e.g., environmental, financial, cognitive, emotional, informational, etc.), and
- what structural factors and inequalities exist (e.g., systemic racism, social determinants of health, and historical injustices).
- Co‑develop and co-disseminate messages through meaningful partnerships with members of the target audienceFootnote 1Footnote 2. This can help develop messages that are accessible, culturally sensitive, tailored to their preferred methods of communication, and responsive to their needs.
- Abandon the “one-size-fits-all” approach to communicationFootnote 3Footnote 4. Generic messages may not be relevant to people’s informational needs and circumstances. More importantly, these messages may be perceived as ignoring or trivializing the challenges faced by different groups within a population.
Example of culturally-sensitive COVID-19 communications:
Women's College Hospital - MAAD'OOKIING MSHKIKI — SHARING MEDICINE
4.2 Establish Trust
- Prioritize building and maintaining trust between the communicator (e.g., Government agencies and representatives, health or science experts, etc.) and the audience. However, this is not a quick or easy task. In the case of low or broken trust, effort is required to identify root causes and rebuild trusting relationships from the ground up.
- Trust can be bolstered by perceptions of knowledge and expertise (e.g., credible information, trusted messengers), openness and honesty (e.g., transparency, calibrate risk), and concern and care (e.g., equity, mental health, prosocial messages)Footnote 5, which align with several of the recommendations in this report.
- Collaborate with trusted messengers within different subgroups of society to ensure accurate and valuable health information reaches the audience and promotes the desired behaviours (e.g., adherence to public health measures). See Employing Trusted Messengers and Narrative Approaches section for more.
4.3 Acknowledge Hardships, Mental Health, and Emotions
- The pandemic has been challenging for people’s mental health; don’t dismiss or ignore these feelings.
- Taking an emotionally-engaging and empathetic approach can reduce stigma associated with mental health, as well help people may feel recognized and validated. In turn, they may be more motivated to do their best to follow guidelines to keep themselves and those around them safeFootnote 6.
5. Recommendations for Framing Your Message
5.1 Demonstrate Transparency
- Communicate what is known, what remains uncertainFootnote 7, what evidence is informing the advice or recommendation, and what trade-offs are being made (if any)Footnote 8.
- Whenever possible, preemptively communicate if changes are likely to occur as knowledge evolves, and explain the reasons for changes as they are implementedFootnote 9.
- Avoid setting hard deadlines when uncertainty remains high; if these deadlines are not met, trust could be loweredFootnote 10.
- Pre-test transparent messaging among members of the target population(s). Notably, people may respond to transparency differently, particularly during periods of heightened emotions and uncertaintyFootnote 11; just because the messenger is being transparent does not guarantee people will perceive them as transparentFootnote 12.
- Do not make decisions or recommendations based on low-quality evidence as it can undermine the credibility of the decision or recommendation and people’s support of itFootnote 13.
Example of Demonstrating Transparency:
This informational video is an example of operational transparency integrated into communications and public education efforts so far.
5.2 Communicate Credible Information in a Timely Manner
- Provide clear communication to educate the public as the situation and information evolves. Mis- and dis-information (MIDI) are developed and spread quickly, so credible sources need to “be first” and respond proactively whenever possible.
- Credible information should be circulated through a variety of communication channels in a consistent and persistent manner, not a one-time eventFootnote 14Footnote 15.
- Leverage technology to connect credible health experts and the general public to help address their questions and provide updated information as soon as it becomes available (e.g., social media, government apps such as COVID Alert and ArriveCAN, daily/regular public briefings, live Q&A sessions with expertsFootnote 16).
- Debunk myths and MIDI; provide correct information rather than staying silent. Although some researchers have warned against myth-busting because it may backfire (e.g., when being confronted with counter-arguments, people may further strengthen their viewsFootnote 17), there is increasing evidence showing that the strength of the backfire effect is overstatedFootnote 18Footnote 19.
5.3 Calibrate Risk and Promote Efficacy, Autonomy, and Competence
- Use both words and whole numbers to communicate risk (not fractions or decimals), and keep denominators constant (e.g. one in 10,000; 25 in 10,000). Focus on the critical information and why it is important that people understand this information in order to make informed decisionsFootnote 20.
- Perceived severity of the COVID-19 virus and perceived efficacy of public health measures both predicted the frequency of engaging in those measuresFootnote 21.
- Prioritize harm-reduction approaches that demonstrate how to carry on with life while reducing risk. Clearly communicate the What people need to do to stay safe and the Why (e.g., What is important to do, and how does it help?). Clear guidelines and principles are more sustainable than outright restrictions for longer-term public health measures. When presented with all-or-nothing scenarios, restrictive public health measures, or daunting success standards, people are more likely to give up or revert to risky behaviour.
Example of clear guidance for how to isolate more safely in shared living spaces:
Johns Hopkins Center for American Indian Health and the CDC
5.4 Employ Trusted Messengers and Narrative Approaches
- Identify and engage with leaders of groups and organizations that are meaningful to the target audience to help motivate their members and peers. Ask them how recommendations could be effectively implemented. Similarly, peers, friends, and family can help to advocate for public health measures and share credible information.
- Use narrative approaches and other creative mediums to reiterate evidence-based recommendations in new and engaging waysFootnote 22Footnote 23Footnote 24Footnote 25Footnote 26.
- Personal narratives or stories are likely to be more effective at bolstering intentions to vaccinate, compared to basic safety messaging approaches.
- People are particularly influenced by the source of the information, possibly even more so than the content. As with many health behaviours, Canadians will likely look to friends within their localized peer networks, and model their attitudes and behaviours accordingly.
5.5 Consider Relevant Morals and Values
- There is a growing body of data that reveals values and ideologies are determinants of people’s attitudes to health protection behavioursFootnote 27,and values-based communication is relevant to the pandemic responseFootnote 28.
- Consider which morals and values may be relevant to the desired behaviour or intention and use them to inform the content or framing of your messagingFootnote 29. This approach can help you to effectively connect with your target audience by creating a “common ground” that is meaningful to them, which may help increase their receptivity to information.
5.6 Activate Pro-Social Norms and Collective Action
- Highlight and praise examples of adherence to public health measures and emphasize them as normative behaviour. If cases of non-adherence are heavily publicized, it can create a biased view that many people are not following the rules (e.g., the Availability HeuristicFootnote 30), which may decrease motivation to continue to follow public health measuresFootnote 31Footnote 32.
- Bolster group and community identities and emphasize the need for a collective response (rather than individual action) to promote stronger public engagement in public health measuresFootnote 33Footnote 34. Importantly, avoid in-group/out-group messaging and war metaphors as they can promote ethnocentrism and xenophobiaFootnote 35Footnote 36Footnote 37Footnote 38.
6. Additional Tips
6.1 Use Clear, Actionable Messaging
- Reduce the cognitive load of your audience by using simple language and presenting the key message early and saliently. Information is more likely to be remembered when it can be processed easily.
- Avoid the use of jargon or unfamiliar terms - it can make it more difficult for people to process scientific information, even if definitions are providedFootnote 39.
- Make recommendations concrete, accessible, and actionable, and ensure they are tailored to different audiences through culturally-appropriate language and examples.
6.2 Implement Visuals to Convey Your Message
- Visuals can help to capture attention as well as ease interpretation and retention.
- Visuals can also increase the shareability of the information/resources for individuals to participate as messengers of accurate information (e.g., on social media).
To get through this together, we must all stay apart. #PhysicalDistancing means you can still connect with loved ones, but do it virtually. #StayHomeSaveLives. https://t.co/c6P9IcTdu7 #COVID19 #FlattenTheCurve pic.twitter.com/wRCra8vvDJ— Shared Services Canada (@SSC_CA) April 4, 2020
Acceptance of public health measures can be dynamic overtime and across different groups within society. This means that messaging will also have to evolve overtime as the pandemic continues and as concerns, questions, and possible decisions change. By using behavioural science insights to inform and test communication approaches and content, it is possible to 1) capture people’s perceptions of public health measures and related aspects of the pandemic and 2) adapt messages and methods to your audience(s) on an ongoing basis to improve adherence in empirically-informed ways.