Covid19 Clinical Trial
Official title:
Mental Imagery to Increase Face Covering Use in UK-based Public Places During the COVID-19 Pandemic
Wearing face coverings in enclosed public spaces is a key public health measure to limit viral spread during the 2020 Covid-19 pandemic. Health psychologists are interested in developing interventions that can increase the likelihood of health-adherent and protective behaviours being consistently undertaken at a general population level. Mental imagery interventions are one way in which behavioural scientists and health psychologists try to encourage behaviour change. Mental imagery involves thinking about, and then writing about, anticipated positive outcomes or key practical requirements of a defined health-related action (e.g. 'moderate alcohol consumption'; 'engaging in regular physical activity'). For this project, the investigators are exploring a mental imagery intervention created to encourage regular and consistent wearing of face coverings in public places where this is currently required in the UK. The investigators will test whether engaging in a mental imagery exercise results in any improvement in wearing a face covering (or intention to wear a face covering) one month later relative to reading a public health message about face coverings. In addition, the investigators will explore belief-based and personality-related factors that might make a difference to the effectiveness of the mental imagery intervention.
Background The 2020 Covid-19 pandemic has required wide-ranging efforts to minimize the
spread of the virus and to protect those most vulnerable to becoming unwell as a result of
viral infection. These measures include social distancing, regular hand washing and wearing
face coverings in public places where an individual is, inevitably, in closer proximity to
non-household others than when not in a public place.
The evidence base for using face coverings in the context of the Covid-19 virus has been
mixed and is applied in different ways in different countries. However, there is scientific
consensus has been that wearing a face covering is likely to decrease viral transmissibility
and, relatedly, substantially reduce the death toll and economic impact of the pandemic. The
scientific evidence suggests that face coverings primarily offer protection to other people
from the person wearing the face covering (who may, knowingly or not, been infected with the
virus) rather than offering the person wearing the face covering personal protection
themselves. In the UK, the most recent government advice (at time of writing, published on
7th August 2020) supports the use of face coverings.
Previous studies have suggested that varied demographic and belief-based factors (including
perceived benefits) may influence variation in individuals' willingness to wear a face
covering in the context of a viral epidemic/pandemic past and present. The Covid-19 pandemic
is particular in the sense that the risk of viral infection is understood to be greatest to
individuals other than the wearer of the face covering and, for this reason, psychological
theories concerned with risk susceptibility/vulnerability (e.g. Protection Motivation Theory;
Health Belief Model) may have less predictive utility in the context of the 2020 pandemic.
However, other social-cognitive psychological theory may offer valuable insights into factors
linked to face covering adherence. For example, variation in face covering wearing adherence
would be predicted by traditional behavioural science theory as closely linked to a range of
key beliefs about the target behaviour. Relevant belief-related factors include attitudes
towards face covering (i.e. whether an individual holds (un)favourable beliefs about face
covering are held), subjective norms towards face covering (e.g. whether an individual
believes that important others such as friends and family hold (un)favourable beliefs about
face covering), and perceived behavioural control towards face covering (i.e. the extent to
which an individual believes they possess control over deciding to wear a face covering).
Whether an individual believes they possess a high level of skill in using face coverings in
required situations (i.e. public places/spaces) would also be theorized to predict face
covering behaviour.
A further consideration linked to individual adherence to face covering requirements is what
'type' of person that individual is in terms of various relevant personality traits. For
example, a relatively conscientious person might be expected to be more likely to routinely
wear a face covering to protect individuals in close proximity from the risk of viral
infection. Similarly, face covering adherence might be more likely among individuals whose
personalities are characterised by humanistic, beneficent orientations towards other people.
By contrast, an individual who self-reports high levels of narcissism, may be less likely to
wear a face covering given that wearing a face covering might clash with their relatively
vain/egotistical self-image.
In summary, this study aims to determine if different types of mental imagery intervention
impact on face covering intentions and face covering adherence at a follow-up time point. The
second study aim is to explore, through exploratory analyses, whether individual differences
in light triad traits, conscientiousness, and narcissism will influence the impact of imagery
interventions. Thirdly, the moderating role of social-cognitive variables of intervention
effects will be explored. Fourthly, variation in 'imagery ability' (how capable individuals
are at visualizing future actions) will be examined as a mediator of potential intervention
effects.
Research questions
1. Do mental imagery exercises increase intentions to use face coverings in public where
required?
2. Do mental imagery exercises increase self-reported wearing of face coverings in public
where required?
3. Do light triad personality traits moderate the relationship between condition allocation
(imagery or not) and self-reported face covering wearing intention or action?
4. Do Theory of Planned Behaviour variables moderate/mediate the relationship between
condition allocation (imagery or not) and self-reported face covering wearing intention
or action?
5. Does imagery ability moderate/mediate the relationship between condition allocation
(imagery or not) and self-reported face covering wearing intention or action?
Hypotheses
It is hypothesised that individuals assigned to any imagery intervention condition will
report:
1. Significantly higher intentions to wear face coverings in public places where these are
required, relative to the control condition at T2 (primary outcome; hypothesis 1).
2. Significantly higher levels of self-reported face covering relative to the control
condition at T3 (primary outcome; hypothesis 2).
3. Significantly more favourable attitudes, subjective norms, barrier self-efficacy and
perceived behavioural control linked to face covering wearing at T2 and T3 (hypotheses 3
and 4).
4. Finally, it is hypothesied that imagery intervention effects on primary outcome
variables at T2 and T3 will be conditional on being more conscientious, less
narcissistic, and being characterised by higher levels of 'light triad' personality
traits (hypothesis 5).
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