Table 1 Examples of how to enrich the ten considerations with real-time data and further evidence and how to apply the evidence obtained to inform the transition phase
From: Ten considerations for effectively managing the COVID-19 transition
Consideration | How behavioural and cultural research can be applied* | Action examples (action should always be informed by an analysis of the situation**) |
|---|---|---|
1) Implement a phased approach to a ‘new normal’ | Conduct research to understand population acceptance and barriers to measures implemented or planned, and employ this research in planning and communication | • Plan a detailed transition: set goals for each phase with red, yellow and green signs for pandemic response adjustment scenarios, and transparently communicate these goals • Anticipate unwanted scenarios based on social, behavioural and cultural literature and previous crises in the country, and prepare prevention and mitigation measures for these scenarios • Provide tailored guidance to priority population groups as needed following segmentation |
2) Balance individual rights with the social good | Use evidence from regular surveys, hotline monitoring, social media monitoring and qualitative ethnographic studies to understand prevailing norms and values and the acceptability of implemented and planned measures and to detect shifts in acceptance or barriers to measures, and be guided by this evidence in planning | • Use existing research to identify elements of culture and history, social norms, beliefs and values, and gather multidisciplinary expert panels to provide input and scientific evidence; panels could include anthropologists, historians, social scientists and cultural studies specialists • Focus messages on identified prevailing norms and values; for example, emphasise the substantial impact of measures on protecting the community, individual families and/or workers • Consider fundamental issues regarding the individual versus the social good, privacy and protection of individual rights |
3) Prioritise people at highest risk of negative consequences | Conduct research to understand implications for people at highest risk, their mental and physical health needs and possible emerging discrimination and stigma and apply this to inform action | • Address basic needs and fundamental human rights, such as access to employment, education, housing, food and health care • Prioritise people who are most severely affected, either mentally, physically or financially • Ensure that prioritising certain groups will not increase stigma or discrimination and take action to prevent and/or decrease these effects • Coordinate closely and engage in reciprocal communication with traditional and social media outlets, influencers and mediators who work with these groups |
4) Provide special support for healthcare and caring staff | Conduct research to identify specific needs of healthcare and caring staff (for example, related to working hours, childcare, stress and protective equipment) and respond to these needs | • Express the gratitude of leadership and foster community support • Provide guidance on the rights and entitlements of healthcare and caring workers • Provide guidance on organising primary care and long-term care homes and supporting users in accessing them safely • Support working from home and video-conferencing where possible • Engage staff in protecting themselves and providing trusted public health advice to patients and the public • Start planning for inclusion of epidemic management basics and communication with patients in core curricula of medical and nursing schools |
5) Build, strengthen, and maintain trust | Conduct research to understand trust in specific institutions, spokespersons and influencers and to detect possible shifts in this area and how such shifts may be related to new events or new restrictions; use this research to inform planning | • Organise daily media briefings in which trusted spokespersons, identified through population surveys, are clear, humble and empathetic and people feel part of the process instead of feeling as if they are being lectured • Explain how evidence from population surveys are being considered as the voices of populations • Acknowledge uncertainty, be transparent about unanswered questions and balance the need for clarity with acknowledgement of uncertainty about the evolution of the outbreak • Respect all voices and respond to all questions |
6) Enlist existing social norms and foster healthy new norms | Conduct research to understand social norms and expectations related to COVID-19 and to detect shifts in these expectations and possible new emerging issues (for example, stigma, misperceptions and conspiracy theories) and leverage this evidence in communication and planning of the most socially acceptable measures | • Ensure that risk communication and community engagement occur to establish that measures are both scientifically accurate and acceptable by people • Engage citizens by providing community leaders with opportunities to co-create transition plans • Engage grassroots activists, local communities, university students and volunteers in measures such as psychosocial support, helplines, support for infected people, phone-based contact tracing and message development • Work with influencers to amplify messages about the transition aimed at different population groups • Engage influencers and community leaders in sharing guidance on how to cope with competing interests • Coordinate across sectors; activities could include working with the arts and culture sector to fund or support COVID19-specific arts activities |
7) Increase resilience and self-efficacy | Conduct research to understand the population’s capability to continue to adhere to restrictions and recommendations, which may signal the need for adjustment to restrictions | • Continue to focus on public health advice regarding COVID-19, including hand and respiratory hygiene, and adjust messages in accordance with transition phase stages • Produce proactive advice about the importance of self-care, stress management, healthy habits, social interactions and prioritising rest, sleep and exercise, taking into account diversity in health literacy • Communicate the availability of individual and family support (for example, education and schooling support, return-to-work support and guidelines related to alcohol and substance use, tobacco, weight gain and sedentary time, nutrition, stress, and safely accessing primary care) provided at national level or by the WHO • Engage with and support communities and organisations who work in the areas of domestic violence, child protection, temporary home offers, social isolation and other areas • Strengthen coping strategies for navigating competing interests (for example, guidance on how to respond to expectations of friends and family regarding social interactions) |
8) Use clear and positive language | Conduct research to understand general perceptions related to COVID-19 and trust in spokespersons and base strategies on these findings | • Communicate clearly and focus on the benefits and gains • Seek to communicate risk based on scientific evidence to prevent both under- and over-cautiousness among the public • Avoid using war language (for example, war against COVID-19, the frontline response), which may increase stigma and undermine people’s sense of collective support and care and lead to individualistic behaviours such as hoarding • Positive wording may include progress, advance, community, cohesion, improve, perspective, reasonable, resourceful, optimistic and generous • Refer to ‘people who have been infected with COVID-19’ rather than ‘cases’ |
9) Anticipate and manage misinformation | Conduct research to identify general perceptions related to COVID-19 and misperceptions and myths | • Anticipate unwanted scenarios and gain evidence from social, behavioural and cultural literature, including lessons that can be learned from previous pandemics and crises in the country • Advise people that they are likely to receive misinformation and inform them where they can access trustworthy facts • Communicate proactively regarding potential future waves of transmission and what these scenarios might entail |
10) Engage with media outlets | Conduct research to understand and detect shifts in trust in spokespersons and the use of various media outlets within the population and sub-segments of the population; use this to plan interactions with the media | • Proactively reach out to media outlets to engage them as partners in the response, respect their independence and highlight their role and potential influence • Use the power of the media to alleviate discomfort from the pandemic; appeal to the media to avoid feeding fear, stress, confusion, polarisation and stigmatisation • Appeal to the media to present authoritative information and avoid confusion with speculations and misinformation |
