Exploring self-identity to improve adherence to Covid-19 preventive behaviours

While we have vaccines being rolled out, the need to prevent the spread of Covid-19 is not over. Immunity takes times and we don’t know how long immunity lasts yet (Madad et al., 2021).

In several countries, adherence to the key protective behaviours (handwashing, physical distancing and mask-wearing) is declining (see figures below from KAP Covid). This means that we need to think of new ways to design behavioural interventions to promote these behaviours. 

When we design a behaviour change intervention, we first look at what is driving the behaviour, that is, what the underlying beliefs and thereby the behavioural determinants are. While we could do a better job at identifying the behavioural drivers for each the Covid-19 preventive behaviour, we generally know that risk perception, attitudes towards the behaviours, social norms, perceptions of response efficacy and self-efficacy are key.

Now that adherence is declining, we need to think differently and do more in-depth research to understand what else is driving non-adherence. One behavioural driver we may want to explore more closely is self-identity. In a recent paper, (Snippe et al., 2021) systematically reviewed the available research on the role that self-identity plays in intention and behaviour. One of their findings was that self-identity is different from attitudes, subjective norm and group identity, and so it clearly has a separate function on our decision-making process.

In a recent event, Jay Van Bavel described how political affiliation (Republican versus Democrat) in the United States was linked to adherence to protective behaviours (Nesterak, 2021). Those who identified as Republican were less likely to take the necessary precautions to avoid infection. This identity had more impact than seeing the virus spread in their communities and neighbourhoods, resulting in no behaviour change.

Bicchieri et al. (2021) showed that whether a person had high or low trust in science played a significant role on whether they chose to follow social norms around the key protective behaviours. In other words, the self-identity of believing in science or not was more decisive on the final behaviour, overriding social expectations. This provides us more impetus to explore these types of self-identities.

Another reason we need to take a closer look at self-identity to design better interventions is that we need to understand how one’s self-identity would cause different groups of people to respond to the different interventions we design. For example, we generally assume that messages framed positively is the way to go when designing health communications. But a study by Sherman & Updegraff (2012)  showed that while white men responded better to gain-framed messages, East-Asian men responded better to loss-framed messages.

A final reason to dig deeper into what is driving risky behaviour is that we may simply not be asking the right questions. In many African countries for instance, there are livelihood and vulnerability challenges that we need to address alongside our Covid-19 strategies (Meffe, 2021). And these issues will be just as relevant when we start mass vaccine roll out in the Global South.

We can leverage our better understanding of self-identity to design better interventions. We should associate the positive attributes of self-identity with handwashing, mask-wearing, physical distancing and vaccination.

Bicchieri, C., Fatas, E., Aldama, A., Casas, A., Deshpande, I., Lauro, M., Parilli, C., Spohn, H. M., Pereira, P., & Wen, R. (2021). In Science we (should) trust: expectations and compliance during the Covid-19 pandemic. Not Published, 1–27. 

Madad, S., Bajaj, K., & Popescu, S. (2021). 3 doctors explain why COVID-19 prevention doesn’t stop at immunization. Business Insider

Meffe, D. (2021). Ethiopia is an Early Symptom of Africa’s Impending Covid Crises. African Arguments

Nesterak, B. E. (2021). Four Things I Learned About Behavior Change During a Pandemic from Katy Milkman and Jay Van Bavel. Behavioral Scientist

Sherman, D. K., & Updegraff, J. A. (2012). The Role of the Self in Responses to Health Communications: A Cultural Perspective. Self Identity, 10(3), 284–294. 

Snippe, M. H. M., Peters, G. Y., & Kok, G. (2021). The operationalization of self-identity in reasoned action models : a systematic review of self-identity operationalizations in three decades of research. Health Psychology and Behavioral Medicine