Mental Imagery Interventions to Promote Face Covering Use During the COVID-19 Pandemic: Study Protocol for a Randomized Controlled Trial.

Abstract

\n BackgroundThe 2020 COVID-19 pandemic has witnessed wide-ranging efforts to minimize the spread of the virus and to protect those most vulnerable to becoming unwell following viral infection. Core COVID-19 preventive measures include social distancing, regular hand washing and wearing face coverings in public places. Understanding links between social cognitive factors relating to beliefs/skills is important in the context of the COVID-19 pandemic, as this can suggest which factors might be targeted via behavior change interventions to promote adherence to COVID-19 preventative behaviors. In this context, mental imagery exercises - self-directed imagining an anticipated outcome or processes linked to a defined behavior/activity - offer a well evidenced, relatively simple behavior change intervention. In the mental imagery invention reported in this protocol, individuals will be randomly assigned to one of four separate conditions (outcome imagery, process imagery, outcome and process imagery, control).MethodsThe primary objective of this randomized controlled study is to assess the effectiveness of a mental imagery intervention on face covering behavior, as a defined core COVID-19 preventative behavior. Participants will consist of UK-based adults of any age. Participants will be randomized to complete an ‘outcome imagery’ or a ‘process imagery’ exercise, both exercises (i.e. a combined condition) or neither exercise (i.e. a control condition). A total of 260 individuals will be recruited into the study. Outcomes for all study condition arms will be assessed at baseline (T1), immediately post-intervention (T2), and at a 1-month follow-up (T3). The primary outcome is frequency of face covering behavior at T2 and T3. Secondary outcomes include intervention effects on face covering attitudes, social norms, perceived behavioral control and barrier self-efficacy at T2 and T3. Putative moderators of intervention effects are conscientiousness, narcissism and ‘light triad’ personality traits. DiscussionThis trial will contribute toward the currently sparse evidence base concerning behavior change techniques designed to promote COVID-19 preventative behaviors in general population and targeted settings. Trial registrationClinicalTrials.gov (U.S. National Library of Medicine), NCT04583449. Retrospectively registered on 20 October 2020.