As of January 2021, COVID-19 has infected approximately 85.2 million people and killed more than 1.84 million people worldwide. Given the importance of individual behavior change in containing the spread of a pandemic, individuals must learn, trust, and apply various recommended health behaviors. In Ghana, researchers are measuring the impact of a quiz-style information strategy on people’s learning and adherence to COVID-19 health protocols. This study is part of a three-country research program aiming to find evidence on the best strategies to communicate health measures.

Policy Issue 

As of January 2021, COVID-19 has infected approximately 85.2 million people and killed more than 1.84 million people worldwide.[1] Human behavior is a critical factor in determining the severity of epidemics and pandemics, since individuals and societies can either fuel or slow the spread of contagious diseases.[2] To decrease the rates of infection, people must change their behaviors in accordance with health recommendations. This requires that they learn, trust, and apply various health measures. How can this information be communicated in such a way that people effectively adjust their behavior? In the United States, Ghana, and Zambia, researchers are conducting three randomized evaluations to test different information campaign strategies to promote adherence to preventive health guidelines during the COVID-19 pandemic. Because the evaluations are being conducted in high-, middle-, and low-income countries, the studies will analyze how individuals’ knowledge and decision-making shape different public health patterns and will provide evidence applicable across a range of contexts.

Context of the Evaluation 

In Ghana, 55,168 cases of COVID-19 and 334 deaths have been reported as of January 2021.[3] COVID-19 infection causes a contagious respiratory disease whose severity varies among individuals: some people do not have symptoms but can transmit the virus, while others have serious medical complications that can lead to death. Despite the discovery of new COVID-19 vaccines, access in Ghana is limited. The best way to prevent the disease is to wear a mask, wash one’s hands frequently, and keep a distance from others.[4] Governments have adopted different strategies to promote these measures, but there is limited evidence as to which are most effective at promoting behavioral change.

Details of the Intervention 

Researchers are testing the impact of a quiz-style information strategy on people’s learning and adherence to COVID-19 health protocols. The study consists of 20,000 adults who will be randomly assigned to receive quiz-style text messages or a text message with direct statements. Both groups will receive the same information related to: COVID-19 contagion and symptoms; avoiding unnecessary outings and crowded places; use of protective equipment; at-risk populations; and myths about COVID-19 and how to treat it. Those in the direct statements group will receive a text message with a simple fact, such as: “Some people with COVID-19 don’t show any symptoms, but they can still spread the virus.” Those in the quiz-style group will receive a question-based text message like: “Does everyone with COVID-19 have symptoms?” Upon responding to this message, they will receive the text: “Some people with COVID-19 don’t show any symptoms, but they can still spread the virus.” Text message exchanges will occur twice per week for four weeks.

Researchers will test whether the quiz strategy is more effective based on the hypothesis that the questions stimulate curiosity and therefore attention[5]. The quiz style and stimulated curiosity could raise the likelihood that the recipient will remember the information and then act on it. Researchers will measure participants’ knowledge, adherence to health measures, and desire for additional COVID-19 information on a weekly basis. This intervention is being tested in the United States as well, to examine the effectiveness of the information strategy across different economic, political, and cultural contexts. Because the strategies rely on text messages, they have the potential to support a scalable, cost-effective information dissemination strategy. Read the details here

Results and Policy Lessons 

Project ongoing; results forthcoming.

Sources

1Johns Hopkins University (JHU) “COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE)”.

2Glanz & Bishop, 2010

3 Johns Hopkins University (JHU) “COVID-19 Dashboard by the Center for Systems Science and Engineering (CSSE)”.

4 World Health Organization (WHO). “Coronavirus disease (COVID-19) advice for the public”.

 

[5] Loewenstein, 1994