A thread on "behavioural fatigue". This letter calls for more evidence on behavioural fatigue in relation to the management of #COVID19. This is welcome, but to me at least, seems to suggest its a novel concept that no-one has heard of in health studies. 1/
This is surprising, because, well, its a cornerstone of approaches to understanding health behaviours and decisions. Its just not been called behaviour fatigue before as far as I can see 2/
Take Geoffrey Rose's concept of the prevention paradox. Central to the failure of population medicine is that people dont see they are getting better (or contributing to others health) and give up. You can read that here 3/ academic.oup.com/ije/article-ab…
Charlie Davison et al use the concept of the prevention paradox to explain people's understanding of heart disease. Here they talk about the role of 'fatalism' (ie behavioural fatigue in all but name) and luck in guiding health decisions 4/
This is because we rely a system of 'candidates' likely people to die from a disease to make sense of it, but increasingly we see exceptions to these candidate rules (because of media coverage etc). Read that here 5/ onlinelibrary.wiley.com/doi/pdf/10.111…
So the more exceptions we see, the more likely we are to believe in luck and chance and become fatalistic about health interventions and drop out. So fatalism, is a well-used concept in health studies 6/
I also use fatalism to explain farmers' responses to disease management. But what is also important there is the context in which decisions are being made; scientific uncertainty; and relationships with government. 7/ Read that here rgs-ibg.onlinelibrary.wiley.com/doi/10.1111/j.…
That isnt that far away from the current situation, only the breakdown in politics and trust is probably even worse now. When its hard to see things working, giving up is easy 8/
You might say that in an emergency things are different. This might be true. There is good evidence that an (animal) disease outbreaks act as triggers for new routines and behaviours. But the longevity of those changes is questionable when other priorities get in the way 9/
Our current work suggests that when that happens, no amount of behavioural science shifts those behaviours because context and personal experience count for more 10/
I could be wrong on this of course, and some of the scenes from Italy of the conviviality of isolation are fascinating and unexpected. The question is how long will that last and then what? /ends
Also: a review on the evidence of the psycho-social impacts of quarantine. Not isolation, but still relevant. thelancet.com/journals/lance…
