A rapid ride on the 'coronacoaster'

Jon Sutton reports from the British Psychological Society's Division of Health Psychology online conference.

I was very much looking forward to heading to Bristol for this year’s Division of Health Psychology conference. As I rather controversially suggested on Twitter before this replacement webinar, Health Psychologists have the best real-world meetings – although I’m more than happy to be invited along to other events and proved wrong. In the end, this virtual offering turned out to be a super-concentrated and timely version of the physical gathering. 

Opening proceedings, Professor Jo Hart (University of Manchester) noted that Covid-19 has changed what we all do on a day-to-day basis, and that health psychologists are the experts on behaviour change. Understanding why people are complying with the government guidelines, or not, is the only way to ensure the public continue to act in a way that will reduce the risk of the virus. Professors Maddy Arden (Sheffield Hallam University) and Chris Armitage (University of Manchester) noted Office of National Statistics figures that around 80 per cent of people are in fact complying, and then on behalf of the Behavioural Science Consortium recruited a large sample through YouGov to ask (at the end of April) ‘How closely are you following the UK government guidelines?’ 

Using the famous COM-B model, addressing people’s Capabilities, Opportunities, and Motivations and their impact on Behaviour, the researchers found that automatic motivation, which reflects people’s habits and emotional reactions, was particularly low – meaning that interventions designed to establish new habits and regulate emotions may need to be prioritised.

Arden said that they had written to Chief Medical Officer Chris Whitty concerning tests for antibodies. Their research had suggested people would have reduced intentions to adhere to preventative behaviours if they had a hypothetical positive test. That’s problematic, as it’s unclear to what extent antibodies produce immunity, and even with immunity there are risks of passing on infection, and false positive tests. Not for the last time, ‘careful communication’ was recommended. But Armitage ended on a positive note: ‘At the minute, behaviour change is the rapid response that is needed. Although we had never seen a lockdown before, we were able to provide sound scientific advice to policy makers at pace, because of a strong evidence base.’ 

Providing sound scientific advice throughout has been Professor Susan Michie (University College London), appearing here via a showreel of media interviews. These included the webinar I hosted at the end of April. [As a sidenote, if you’re ever on a Zoom webinar and your own face pops up unexpectedly, it’s a very disconcerting experience.] In her interviews, Michie repeatedly pleaded for clear instructions as to what people need to do, noting that if everyone just did four simple behaviours the virus would die out. But it’s difficult to do the right behaviour at the right time, and this is where health psychology theory and research can help. For example, it turns out that we love touching our face, and do it all the time. Just telling people ‘stop touching your face’ is unlikely to be effective: we need an alternative behaviour that is incompatible with touching your face (for example, keep your hands below your shoulders). ‘If-then plans’ can also help to make a behaviour a routine, a habit.  

Michie also gave an insight into the reality behind the government’s ‘led by the science’ mantra. ‘We submit our evidence, and it is taken on board, but alongside other sources [from epidemiologists, modellers etc]… all of that gets put into a pot and combined with other political and economic decisions we’re not party to.’ 

Professor Marie Johnston, from the University of Aberdeen, noted that the experience around trust between the government and public had perhaps not been the same in Scotland as in England. Giving an overview of ongoing research projects, she expressed surprise over how much was about managing the impact of the guidelines, particularly in terms of mental and physical health and wellbeing, rather than targeting behaviours that will reduce the spread of the virus. Johnston pondered how health psychologists might have more impact in the event of a ‘second wave’, and noted the importance of writing lay summaries of research. ‘What should they include?’, she asked.  

Reflecting on the ‘coronacoaster’, Eleanor Bull (Manchester Metropolitan University) highlighted the experiences of frustration, anxiety, sadness, guilt, excitement, pride/confidence, and professional identity and support which many of us have had. Psychologists have needed new ways of working in practice: ‘breathing techniques are not relaxing if you think every breath could be a cloud of covid,’ Bull noted as one example. However, she felt that ‘people appreciate even our imperfect efforts to connect’, and that many clients are managing better than perhaps we might have anticipated. The pandemic has at least offered, in some circumstances, a ‘chance to slow down and refocus.’

The focus then shifted to new ways of researching and teaching. Professor Neil Coulson (University of Nottingham) has long been an advocate of online data collection, and he considered whether experiences during lockdown might bring other converts to that method. He warned that online interviews, focus groups, surveys, and social media as a research environment must never be viewed as an ethical shortcut: ‘the dimensions along which we consider online research are the same – there might be nuances, but scientific integrity, social responsibility and minimising harm remain key considerations.’ 

Dr Michael Smith and Professor Mark Wetherell then gave what the latter termed ‘glass half full and glass half empty’ perspectives respectively. ‘Student engagement is key,’ noted Smith. How do we foster a community? Not just replicating what we do in the classroom, but redesigning the learning experience to take advantage of learning and teaching technologies. Wetherell worried that practicals (e.g. around the impact of cortisol) could already be logically challenging and time consuming in a physical environment, and may become impossible in an online or blended environment. It may be particularly difficult to recreate the ‘over the shoulder support’ that he likes to give in such sessions. 

Finally we heard about more efforts to influence policy, including from Dr Angel Chater (University of Bedfordshire) on the British Psychological Society’s Behavioural Science and Disease Prevention Taskforce. Key health psychology principles have been required, for example messages from credible sources in relatable terms, the need to create worry but not fear, and to clearly specify behaviours in terms of the reason for them and the intended outcome. ‘Stay home, protect the NHS, save lives’ is a classic in terms of that ‘behaviour, reason, outcome’ rhythm. ‘Stay alert, control the virus, save lives’… less so.

Emily McBride (UCL) flagged up the BPS’ psychological government programme, and Jo Hart and Dr Lucie Byrne-Davis (University of Manchester, and Chair Elect of the Division) talked about the Health Psychology Exchange; there are currently 139 willing volunteers in the collective, ready to translate the health psychology evidence into concrete best evidence advice. It has been a great experience, we heard, for learning about collective efficacy and informal mentoring. As with so much of the work on show in this whistlestop tour, the work was ‘raising the profile of health psychology’, ‘developing a strategic legacy’, and ‘making science policy ready’. That represents a decent conference.

But what about the social side? Well, there followed a pretty good approximation of a conference bar, complete with ‘famous people I live near / met once / am related to’, and jokes from Chris Armitage. For example: SAGE are constantly seeking ‘rapid reviews’. What’s that about? You’d have thought they have plenty of thyme on their hands. 

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