Interventions to promote physical distancing behaviour during infectious disease pandemics or epidemics: A systematic review

Tracy Epton, Daniela Ghio, Lisa M. Ballard, Sarah Allen, Angelos P. Kassianos, Rachael Hewitt, Katherine Swainston, Wendy I. Fynn, Vickie Rowland, Juliette Westbrook, Elizabeth Jenkinson, Alison Morrow, Grant McGeechan, Sabina Stanescu, Aysha A. Yousuf, Nisha Sharma, Sehuna Begum, Eleni Karasouli, Daniel Scanlon, Gillian ShorterMadelynne A. Arden, Christopher J. Armitage, Daryl B. O'Connor, Atiya Kamal, Emily McBride, Vivien Swanson, Jo Hart, Lucie Byrne-Davis, Angel Chater, John Drury

Research output: Contribution to journalReview articlepeer-review

18 Downloads (Pure)


Physical distancing, defined as keeping 1-2m apart when co-located, can prevent cases of droplet or aerosol transmitted infectious diseases such as SARS-CoV2. During the COVID-19 pandemic, distancing was a recommendation or a requirement in many countries. This systematic review aimed to determine which interventions and behavior change techniques (BCTs) are effective in promoting adherence to distancing and through which potential mechanisms of action (MOAs).
Six databases were searched. The review included studies that were (a) conducted on humans, (b) reported physical distancing interventions, (c) included any comparator (e.g., pre-intervention versus post-intervention; randomized controlled trial) and (d) reported actual distancing or predictors of distancing behavior. Risk of bias was assessed using the Mixed Methods Appraisal Tool. BCTs and potential MoAs were identified in each intervention.

Six papers indicated that distancing interventions could successfully change MoAs and behavior. Successful BCTs (MoAs) included feedback on behavior (e.g., motivation); information about health consequences, salience of health consequences (e.g., beliefs about consequences), demonstration (e.g., beliefs about capabilities) and restructuring the physical environment (e.g., environmental context and resources). The most promising interventions were proximity buzzers, directional systems and posters with loss-framed messages that demonstrated the behaviors.

The evidence indicates several BCTs and potential MoAs that should be targeted in interventions and highlights the gaps that should be focused on in future research.
Original languageEnglish
Article number114946
JournalSocial Science and Medicine
Early online date26 Mar 2022
Publication statusPublished - 1 Jun 2022

Bibliographical note

Funding Information:
This review received no funding. The work of John Drury on this paper was supported by a grant from the ESRC (reference number ES/V005383/1 ). The work of Christopher Armitage on this paper was supported by NIHR Manchester Biomedical Research Centre and NIHR Greater Manchester Patient Safety Translational Research Centre .

Publisher Copyright:
© 2022 The Authors


Dive into the research topics of 'Interventions to promote physical distancing behaviour during infectious disease pandemics or epidemics: A systematic review'. Together they form a unique fingerprint.

Cite this