Durham research: optimising public health messaging

By Waseem Mohamed

In any crisis, messaging matters. Throughout the Covid-19 pandemic, ordinary citizens have navigated a plethora of public health messages, as authorities encourage people to alter their behaviours to contain the spread of disease. At times, this messaging can feel overwhelming and confusing, with governments and health bodies themselves having to make tough decisions on the tone through which these messages should be delivered to us.

Recent research led by Durham University suggests that there is an optimal way to convey public health messages. Over 25,000 people from across 89 countries were surveyed about their motivations to follow public health messaging, with the study concluding that people were less likely to defy health guidance if it were delivered in an “autonomy-supportive” tone, rather than a “controlling” tone. In other words, people are more likely to follow the rules during a pandemic if the messaging around the crisis is more positive in nature, where the messaging focuses on the proactive ways in which individuals can help stop disease from spreading.

According to the study, in places where “controlling” messaging is used, people will be motivated to follow the rules, but only out of fear of having “guilt and social punishment” if they are seen to be breaking such rules. Hence, using “controlling” messaging is not sustainable long-term, since people are not made fully aware of how their actions are actually helping to prevent illness. Eventually, people give up on altering their behaviours to supress the pandemic, as they lose hope in the effectiveness of their actions.

“Autonomy-supportive”, by contrast messaging emphasises how individual agency and ownership of behaviour can have a positive impact on reducing a pandemic’s severity, with people feeling more inclined to engage with the messaging. Hence, over a longer time period, people subject to the “autonomy-supportive” messaging are much less likely to defy the rules, as they are given an optimistic outlook of how the pandemic can end. This means that they become more enthusiastic about protecting one another from illness.

The implications of this study are potentially huge

New Zealand provides an ideal case study of how an “autonomy-supportive” approach to messaging can result in better health outcomes. Led by Jacinda Ardern, the government elected to use a more optimistic and upbeat tone to their Covid-19 messaging, spotlighting how individual actions can help save lives. Messaging focused on the “dos” rather than “don’ts”, with the government also being proactive in explaining how individuals’ actions can prevent the spread of disease (e.g. how washing hands kills germs).

Contrast New Zealand’s approach to that of the UK, where the Boris Johnson-led government took a far more “controlling” approach to its Covid-19 messaging. Campaigns such as the use of posters showing Covid-19 patients and asking people if they had the followed rules dominated the government’s strategy, but this arguably was a detriment to the pandemic response as the UK struggled to enforce social distancing as the pandemic dragged on. The outcomes of the Covid-19 pandemic speak for themselves – New Zealand is credited as having one of the best responses to the pandemic; the UK is ranked as having one of the worst.

The implications of this study are potentially huge in terms of planning for future pandemics and general crises.

In almost every previous pandemic ranging from SARS to Ebola, a key lesson that public health experts want us to learn is that fostering trust is essential to ensure people are motivated to follow public health guidance. Messaging is therefore critical in encouraging people to trust health authorities, especially if the required response to the pandemic results in a substantial rupture in an individual’s life (such as social distancing and wearing face masks). While previous inquiries into pandemics accept that any messaging is important, this study provides extra detail on how messages should be constructed to achieve the goal of supressing a pandemic – something which will become more critical if the future holds more global diseases.

And it is not just pandemics where “autonomous-supportive” messaging could be beneficial. In all crises that require people to undertake behavioural change, individuals need reassurance that their actions will have a positive impact on the situation.

Take the environmental crisis for example – while there are plenty of campaigns and messages out there about what individual actions people can take to reduce their carbon footprint (ranging from recycling to having fewer children), there is still potential for the messaging to better follow the “autonomous-supportive” tone promoted by the study, where people are told more clearly about how their actions can make a difference. In situations where it may be easy to despair at the crisis and think that nothing can be done to resolve it, proper messaging can help alleviate those feelings and promote hope and trust – and now we have a guide on what type of message works best.

Phil Hearing via Unsplash

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