Periodic Reporting for period 1 - NONPHARM (The Psychological Underpinnings of Nonpharmaceutical Interventions)
Reporting period: 2022-12-01 to 2025-05-31
The viruses and bacteria that cause infectious diseases cripple well-being, batter economies, and kill millions annually. These negative consequences can be drastically reduced via nonpharmaceutical interventions (NPIs) – behaviors that reduce the spread of pathogens. A wealth of recent theoretical and empirical work has illuminated how and why disgust intuitively motivates some NPIs, such as avoiding bodily wastes and spoiled foods. However, disgust does little to inhibit transmission via aerosols, respiratory droplets, and fomites – key pathways for the respiratory pathogens that circulate seasonally, have caused recent pandemics, and will cause the pandemics of the future. Hence, even with advances in our understanding of disgust, the psychological underpinnings of the less-intuitive NPIs that inhibit respiratory pathogens – such as handwashing, barriers to respiratory droplets and aerosols, and self-isolation while infectious – remain mysterious. This project addresses the urgent need to better understand these NPIs using theory and methods that cut across social psychology, evolutionary psychology, health psychology, and behavioral genetics. First, it catalogs and explains cross-cultural differences and similarities in NPI practices with an unprecedented survey of 61 nations, and it uses a state-of-the-art approaches to assess the degree to which differences in NPIs within societies emerge from genetic versus environmental factors. Second, it uses experimental methods to test the roles of folk theories of immunity, moralization, and conflicts between individual and collective interests on NPI practices. Third, it develops novel, theory-based interventions for increasing handwashing and voluntary quarantining while sick and uses assessments of soap use and social contacts to evaluate those interventions. By providing groundbreaking data, theory development, and informing empirically-supported interventions, this project will arm science and society with critical new knowledge in our battle against infectious disease.
Activities within the project include the Global NPI Survey, assessments of NPIs in twins, psychological experiments/surveys, and observational studies. The Global NPI Survey compares 61 nations in adherence to NPIs (e.g. whether an individual always washes their hands after going to the bathroom), perceptions of what others in an individual's community do (e.g. what percentage of people in the community always wash their hands after going to the bathroom), objections to others not engaging in NPIs (e.g. whether an individual thinks it's inappropriate for someone to not wash their hands after going to the bathroom), and perceptions of others' objections to not engaging in NPIs (e.g. what perception of people in the community does an individual believe think it's inappropriate to not wash their hands after going to the bathroom). In addition to assessing adherence and norm perception of these types of NPIs, the Global NPI survey also assesses comfort with interpersonal actions that can transmit pathogens (e.g. drinking from the same water bottle) and physical contact during normative greetings. The assessment of twins allows us to compare similarities in NPIs across individuals who vary in their genetic and environmental similarities. The myriad psychological experiments and surveys allow us to assess the degree to which factors like shame, moralization, cooperation, knowledge of how infections spread, and desire to maintain close relationships facilitate or impede NPIs. And, finally, observational studies allow us to see how people behave while sick and, hence, while contagious.
Results from this project can provide an unprecedented picture of how everyday NPI behaviors and norms vary across the world. This information can be useful for understanding why cultures differ in terms of hygiene behaviors. Given the large number of nations sampled, we are able to test whether factors such as education, wealth, history of infectious disease, or even religious norms and practices relate to the prevalence and acceptance of everyday hygiene behaviors. Further, the results may set the stage for targeted interventions for different populations. Better understanding the psychological mechanisms underlying NPIs can also inform approaches for increasing their uptake. Results will reveal the degree to which NPIs flow from knowing more about infectious disease versus desires to avoid moral condemnation or shame. Further, they will reveal the degree to which people reduce NPI adherence around close relationship partners (e.g. spouses and relatives relative to acquaintances and strangers). This information can inform why infections spread within social networks and what types of behavioral interventions might be useful in impeding such within-network spread. Finally, results will give a new look at how people behave when they're sick versus when they are not.