The science behind behavior change

We’re all facing a lot of new directives these days: Physical distancing. Hand washing. Mask wearing. Refraining from face touching. With no vaccine or universally established treatment for COVID-19, changing such individual behaviors are important ways to help slow the spread of the virus.

Behavioral experts have some insights to help.

“Behavioral science helps us understand what drives our actions,” said behavioral scientist Dr. Michael Hallsworth. “Social distancing, hand washing and face touching can help reduce the spread of COVID-19, but they all present challenges for people. Behavioral science can help unlock ways of making those actions more likely.”

The stakes are high—COVID-19 is highly contagious, is transmitted via respiratory droplets that enter the body through our eyes, nose or mouth, and can also live on surfaces. Changing our own behavior can help us “flatten the curve,” ensuring we spread coronavirus cases over a longer period of time instead of triggering spikes that can overload the health care system.

What creates a habit?

There are three factors in behavior, Hallsworth says: capability, opportunity and motivation.

“If we lack one of these factors, then the behavior may not occur,” he said. For example, “if we are very motivated to wash our hands but do not have soap or water, the capability and opportunity are lacking.”

If we possess all three needed aspects of a behavior, we then need to change the entrenched mental models associated with it.

“We need to fight fire with fire—we need to consciously create new habits that become easy and automatic, so we don't have to try to do the right thing,” Hallsworth says.

Take face touching for example. This is perhaps the hardest behavior of the three to change because it feels automatic, is hard to visualize compared to standing six feet away from someone, and is a relatively new public health measure, unlike hand washing. Hallsworth says one study found that adults touched their eyes, nose or lips 15 times an hour on average while performing office-type tasks.

“Face touching appears to be one of the many activities that have become non-conscious in order to free our conscious minds to perform other tasks effectively,” he says.

How to change habits

The best way to change this type of deeply rooted behavior is through substitute behaviors, physical barriers and repetition. For example:

• If you must touch your face, Hallsworth suggests substitute behaviors such as using a tissue or rubbing your eyes or nose with the back of your wrist or arm, areas that may be less exposed to infection than fingers.
• He also advises creating physical barriers such as wearing glasses instead of contact lenses, wearing gloves, keeping your hands in your pockets or crossing your arms.
• Finally, Hallsworth recommends repetition: “Try making a rule such as, ‘If I am looking at my phone, I will put my other hand in my pocket,’ or ‘If I am in a meeting, I will cross my arms,’” he says. In the case of hand washing, make a rule that you wash your hands first thing when you get home from being outside and before you prepare a meal. “With repetition, the behavior becomes automatic, and a new habit is created,” he says.

Tech companies are working on ways to support these types of behavior changes, such as smart wristbands that vibrate every time you touch your face.

“Already we're seeing innovations to help people stand further apart in shops, and new devices to stop face touching. We need to be sharing those ideas quickly and rapidly assessing which ones seem to be working,” Hallsworth said.

Small, consistent steps and clear communication

Hallsworth adds that we need to guard against what he calls “‘licensing effects,’ where we make effort to do the right thing in one area and feel it frees us up to be less virtuous or sensible in another area.” For example, we may be so diligent about hand washing that we don’t feel we need to maintain a 6-foot distance from others.

“We may not even realize we are doing this—and the downsides of the license we give ourselves may be much greater than the original benefit,” he said.

His research also demonstrates the importance of urging people to perform a few simple behaviors when there’s a crisis: “When people are concerned about a perceived threat, their ability to process information effectively can become severely impaired, which means clear and precise communication is essential. Communicating simple instructions that are easy to remember makes it more likely people will follow them,” he says.

Hence the near-constant drumbeat of public health officials urging us to take simple steps such as mask-wearing, hand washing, social distancing and not touching our face to prevent further spread of the coronavirus. Changing these small behaviors now may help save us in the end.