Abstract
BackgroundGiven the importance of person to person transmission in the spread of infectious diseases, it is critically important to ensure that human behaviour with respect to infection prevention is appropriately represented within infectious disease models. This paper presents a large scale scoping review regarding the incorporation of infection prevention behaviour in infectious disease models. The outcomes of this review are contextualised within the psychological literature concerning health behaviour and behaviour change, resulting in a series of key recommendations for the incorporation of human behaviour in future infectious disease models.MethodsThe search strategy focused on terms relating to behaviour, infectious disease and mathematical modelling. The selection criteria were developed iteratively to focus on original research articles that present an infectious disease model with human-human spread, in which individuals’ self-protective health behaviour varied endogenously within the model. Data extracted included: the behaviour that is modelled; how this behaviour is modelled; any theoretical background for the modelling of behaviour, and; any behavioural data used to parameterise the models.ResultsForty-two papers from an initial total of 2987 were retained for inclusion in the final review. All of these papers were published between 2002 and 2015. Many of the included papers employed a multiple, linked models to incorporate infection prevention behaviour. Both cognitive constructs (e.g., perceived risk) and, to a lesser extent, social constructs (e.g., social norms) were identified in the included papers. However, only five papers made explicit reference to psychological health behaviour change theories. Finally, just under half of the included papers incorporated behavioural data in their modelling.ConclusionsBy contextualising the review outcomes within the psychological literature on health behaviour and behaviour change, three key recommendations for future behavioural modelling are made. First, modellers should consult with the psychological literature on health behaviour/ behaviour change when developing new models. Second, modellers interested in exploring the relationship between behaviour and disease spread should draw on social psychological literature to increase the complexity of the social world represented within infectious disease models. Finally, greater use of context-specific behavioural data (e.g., survey data, observational data) is recommended to parameterise models.
Highlights
Given the importance of person to person transmission in the spread of infectious diseases, it is critically important to ensure that human behaviour with respect to infection prevention is appropriately represented within infectious disease models
As our primary concern is to explore the extent to which psychological constructs and theories have been incorporated into infectious disease models, all papers were examined to determine whether they cited psychological health behaviour theories (e.g., [12])
Our included papers seem to reflect a relatively recent increase in infectious disease models incorporating endogenous human protective behaviour that is likely related to the A/H1N1 pandemic
Summary
Given the importance of person to person transmission in the spread of infectious diseases, it is critically important to ensure that human behaviour with respect to infection prevention is appropriately represented within infectious disease models. Recent epidemiological research has noted a limitation of traditional mathematical models of disease spread: they often do not allow for heterogeneous behavioural responses within a population (e.g., [9]) This emphasis on homogenous behaviour is broadly inconsistent with what we know about human behaviour from decades of psychological research and theory in the context of health-related behaviour change. These five papers cite a range of different theories (including one review of cognitive behaviour theories generally [46], the Theory of Planned Behaviour (TPB) [44], Theory of Reasoned Action (TRA) [44], Prospect Theory (PT) [54], and the Transtheoretical Model (TTM) [44]). The most commonly cited theory of behaviour change (cited by four of the five identified papers [44, 48, 54, 55]) is the Health Belief Model (HBM)
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