The novel coronavirus spreads through human interactions with people who are infected. Therefore, changing human behavior is a powerful, low cost, immediate intervention to stem the pandemic. The immediacy is critically important as advancements in medical sciences take substantial periods of time before safety and effectiveness can be documented. By contrast, behavioral scientists have amassed a large repertoire of techniques that may be used to change behavior.

Our working group has developed evidence-based recommendations to promote handwashing which are displayed in the infographic below.

It may appear to be common sense that all we need to do is tell people to wash their hands. But human behavior is fallible. Our recommendations are based on behavior modification research that specifically targets hand washing. In addition, we drew on insights from social discounting, prospective memory, and persuasion science to develop our recommendations. Some examples of hand-washing demonstrations are linked here and here.

As localities begin to open parts of the economy that were shut down, it is likely that individuals will be exposed to the virus as we increase our contact with others. Maintaining social distancing will help, but we might nonetheless get the virus on our hands as we increase our contact outside of our homes. Reducing face touching is a key method to prevent the virus on the hands from gaining entry via eyes, mouth, and nose. Yet, we will be safer if we are effective in washing hands.

The Members of the Behavioral Science Response to COVID-19 Working Group

The members of the Behavioral Science Response to COVID-19 Working Group includes expertise in perception, action, and cognition, as well as in learning and behavior modification. The group is comprised of the following academics:

• Jonathon Crystal (Chair)
• Jim Pomerantz (Co-Chair)
• Kate Bruce
• Andy Delamater
• Claudia Dozier
• Wayne Fuqua
• Mark Galizio
• Rachel Jess
• Megan Heinicke
• Debbie Kelly
• Olga Lazareva
• Linda LeBlanc
• Mark McDaniel
• Laura Mickes
• Raymond Miltenberger
• Matthew Normand
• Amy Odum
• Danielle Panoz-Brown
• Gordon Pennycook
• Penny Pexman
• Suparna Rajaram
• Timothy Raymond
• Phil Reed
• Sachiko Koyama
• Crystal Slanzi
• Carole Van Camp
• Wendy Donlin Washington
• Doug Woods
• Jessica Witt

References

The following are many of the references to the scientific papers that informed the above recommendations.

Aiello, A. E., Coulborn, R. M., Perez, V., & Larson, E. L. (2008). Effect of hand hygiene on infectious disease risk in the community setting: A meta-analysis. American Journal of Public Health, 98(8), 1372-1381. https://doi.org/10.2105/AJPH.2007.124610

Boldt, A., & Gilbert, S. J. (2019). Confidence guides spontaneous cognitive offloading. Cognitive Research: Principles and Implications. https://doi.org/10.1186/s41235-019-0195-y

Cialdini, R.B. (2001). Harnessing the Science of Persuasion. Harvard Business Review, October 2001, Reprint r0109d.

Cialdini, R.B. (2006). Influence: The Psychology of Persuasion, Revised Edition. Harper Business.

Cialdini, R. B. (2020). Reducing Undesirable COVID-19 Behaviors. https://www.influenceatwork.com/inside-influence-report/advice-for-reducing-undesirable-covid-19-behaviors/

Charbonneau, D. L., Ponte, J. M., & Kochanowski, B. A. (2000). A method of assessing the efficacy of hand sanitizers: Use of real soil encountered in the food service industry. Journal of Food Protection, 63(4), 495-501. https://doi.org/10.4315/0362-028X-63.4.495

Deochand, N., Hughes, H. C., & Fuqua, R. W. (2019). Evaluating visual feedback on the handwashing behavior of students with emotional and developmental disabilities. Behavior Analysis: Research and Practice, 19(3), 232-240. https://doi.org/10.1037/bar0000154

Fuls, J.L., Rodgers, N.D., Fischler, G.E., Howard, J.M., Patel, M. et al. Alternative hand contamination technique to compare the activities of antimicrobial and nonantimicrobial soaps under different test conditions. Applied and Environmental Microbiology, 2008, 3739-3744. doi:10.1128/AEM.02405-07

Gollwitzer, P. M. (1999). Implementation intentions: strong effects of simple plans. American psychologist, 54(7), 493. https://doi.org/10.1037/0003-066X.54.7.493

Liu, L. L., & Park, D. C. (2004). Aging and medical adherence: the use of automatic processes to achieve effortful things. Psychology and aging, 19(2), 318. https://doi.org/10.1037/0882-7974.19.2.318

Locey, M. L., & Rachlin, H. (2015). Altruism and anonymity: A behavioral analysis. Behavioural Processes, 118, 71–75. https://doi.org/10.1016/j.beproc.2015.06.002

Jensen, D.A., Macinga, D.R., Shumaker, D.J., Bellino, R., Arbogast, J.W., Schaffner, D.W. Quantifying the effects of water temperature, soap volume, lather time, and antimicrobial soap as variables in the removal of Eschericia coli ATCC 11229 from hands. Journal of Food Protection, 2017, 80(6), 1022-1031.

Jess, R. L., Dozier, C. L., & Foley, E. A. (2019). Effects of a handwashing intervention package on handwashing in preschool children. Behavioral Interventions, 34(4), 475-486. https://doi.org/10.1002/bin.1684

Jones, B. A., & Rachlin, H. (2009). Delay, probability, and social discounting in a public goods game. Journal of the Experimental Analysis of Behavior, 91(1), 61–73. https://doi.org/10.1901/jeab.2009.91-61

Meacham, J. A., & Leiman, B. (1982). Remembering to perform future actions. In U. Neisser (Ed.), Memory observed: Remembering in natural contexts (pp. 327-336). San Francisco: Freeman.

Martin S. J., Goldstein, N., & Cialdini, R. B. (2014), The small BIG: small changes that spark big influence. Grand Central Publishing.

McFarland, C., & Glisky, E. (2012). Implementation intentions and imagery: Individual and combined effects on prospective memory among young adults. Memory & Cognition, 40(1), 62-69. https://doi.org/10.3758/s13421-011-0126-8

Rabie, T. & Curtis, V. (2006). Handwashing and risk of respiratory infections: A quantitative systematic review. Tropical Medicine & International Health, 11(3), 258-267. https://doi.org/10.1111/j.1365-3156.2006.01568.x

Suchomel, M., Koller, W., Kundi, M., Rotter, M.L. Surgical hand rub: Influence of duration of application on the immediate and 3-hours effects of n-propanol and isopropanol. American Journal of Infection Control, 2009, 37, 289-293.