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A new approach could motivate individuals to take better and more consistent precautions against contracting SARS-CoV-2. filadendron/Getty Images
  • Princeton University researchers have developed a new approach for motivating people to more consistently follow safety measures against the spread of SARS-CoV-2.
  • Such measures include getting vaccinated, physical distancing, and wearing a mask while in public.
  • Their strategy specifically targets individuals who already believe these precautions can reduce their risk of infection, but they do not always behave in a manner that reflects those beliefs.

All data and statistics are based on publicly available data at the time of publication. Some information may be out of date.

The Understanding Coronavirus in America Study reported in January that between 80% and 90% of United States adults consistently believe that wearing a mask is an effective way to prevent the spread of SARS-CoV-2. The research consisted of an internet-based panel survey of approximately 9,500 people aged 18 years and older. Scientists at the Center for Economic and Social Research at the University of Southern California Dornsife College of Letters, Arts, and Sciences conducted the survey.

However, only about half of the participants surveyed wore a mask always or most of the time when coming in close contact — 6 feet or nearer — with people outside their immediate households.

In a study that appears in the journal Basic and Applied Social Psychology, the Princeton researchers set out to see whether they could use a specific approach to increase compliance with safety measures designed to decrease the likelihood of contracting SARS-CoV-2.

“I think what’s probably happened more right now is that people are just super tired of following COVID-19 [precautions],” Logan Pearce, a psychology graduate student at Princeton and the study’s first author, told Medical News Today. “It’s been a year and a half. […] When I see people who are wearing masks, but not over their noses, I think that’s something that people could easily fix.”

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Coined by Leon Festinger in 1957, cognitive dissonance theory refers to the discomfort felt by individuals who hold two beliefs that contradict one another or who harbor beliefs and behaviors that contradict. For example, a smoker who is well aware that smoking causes lung cancer yet continues to smoke.

Pearce and the study’s other co-author Joel Cooper, a professor of psychology at Princeton, write in their research that people can leverage dissonance to change human behavior.

For instance, in a 1994 study, researchers asked participants to publicly advocate for the importance of engaging in safe sex and then made them mindful of times they failed to use condoms in the past. After that part of the experiment was completed, those participants bought more condoms than participants in the control group.

Similarly, in a 2019 study by Cooper and Lauren Feldman, a psychology graduate student at Princeton, older participants were asked to advocate for the health benefits of exercising and then urged to remember times they personally avoided exercising. Participants then “increased their intention” to exercise in the future.

“It’s been used before, so I thought it could work in relation to COVID-19,” Pearce told MNT.

Using an online participant recruitment tool called Prolific, Pearce selected 101 participants. They came from 18 countries, including the United States, the United Kingdom, Poland, and Portugal, and ranged in age from 18 to 67 years.

All participants answered a prescreening questionnaire, which asked about their attitudes toward safety measures designed to protect against SARS-CoV-2 infections before being selected. The researchers removed several prospectives from consideration for responding that they did not believe it was important to follow the safety measures.

The participants were then divided into four categories. One cohort, which the researchers labeled the advocacy group, was asked to watch a video that the World Health Organization (WHO) created about safely wearing a fabric mask. The study authors then asked them to write sentences advocating for following precautions designed to prevent SARS-CoV-2 infections.

Another, labeled the mindfulness group, watched the video and then were asked to write sentences about a time they did not follow safety measures designed to ward off COVID-19. A third, labeled the dissonance group, watched the video, wrote statements advocating for others to follow safety precautions, then wrote about a time they did not follow safety measures.

The final cohort, the control group, only watched the video.

The researchers then evaluated participants from all four groups on their attitudes and intentions regarding COVID-19 safety measures and willingness to share COVID-19 resources with others.

About a week after completing those tasks, participants self-reported their recent behavior regarding safety measures they undertook to prevent SARS-CoV-2 infections.

Members of the dissonance cohort were much more likely to have complied with safety measures and sought out vaccination appointments than participants in one of the control groups.

Professor Stephanie Preston, a behavioral neuroscientist in the psychology department at the University of Michigan at Ann Arbor, who was not involved with this study, told MNT she agrees that cognitive dissonance theory can be a useful tool for shaping health-related behaviors.

“So, by writing down these things, it helps to cement in their mind that they [have] made a commitment. And when you think about times you didn’t wear your mask, for example, then you can engage [in] some sort of future planning process where you imagine ‘OK, what am I going to do next time?’ And you might think of it again, you might be reminded of it […] next time you’re in the situation, so it’s easier to follow through.”

In their paper, Pearce and Cooper include a dissonance-based plan, which state or federal governments could undertake to encourage individuals to practice consistent behavior designed to ward off SARS-CoV-2 infections.

They suggest leaders could do things, such as stage contests, where contestants compete by coming up with arguments about why everyone should get SARS-CoV-2 vaccines or follow safety precautions. There would also be a second, crucial step to the contests: those who enter would also be asked to talk about a time they did not follow precautions designed to ward off SARS-CoV-2 infections.

If their approach becomes deployed on a larger scale, the Princeton researchers would critically evaluate its impact. Even if this method is not as successful at encouraging individuals to follow safety measures as it was in their study, the researchers point out that even if it prompts a small percentage of people to change their behavior, it could save lives.

Pearce explained to MNT that she understands that battling the pandemic has been really trying for everyone. She believes many people just need a gentle reminder to be safe. “[I] think just something like this that reminds them that it is important to them and other people around them that they wear their mask properly will help.”

The limitations of this study include that it had a relatively small sample size and did not reflect the racial and ethnic diversity of the general population. “Unfortunately, most of the sample is white,” Pearce said.

The study relied solely on volunteers who the researchers recruited from a specific website. Preston told MNT that she believes recruiting participants off the internet represents the general population better than other methods.

“They still have a much broader range of people than if you just tested people at one university, for example,” Preston told MNT. “Usually, you get broader geographical distribution. And there are still people who have lower education or income who use the internet.”

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