Motivational effectiveness of prosocial public health messaging to reduce respiratory infection risk: a systematic review and meta-analysis.

Aikaterini Grimani, Vivi Antonopoulou, Nicholas Meader, Chris Bonell, Susan Michie, Michael P Kelly, Ivo Vlaev

Abstract read

In one paragraph

Article in Communications medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it

0cells of the map it votes in

3citing papers in PubMed

–field-weighted citation impact

1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

"Do Health Messages Come from Mars or Venus?" The Effectiveness of Health Communication Depends on Gender Stereotypes in Messages.Behavioral sciences (Basel, Switzerland) · 2026
Article
Self-reported handwashing frequency among pet and non-pet owners in the German adult population in 2023: a post-pandemic replication study.BMC public health · 2026
Article
Adherence to mask wearing and social distancing and use of lateral flow tests during the COVID19 pandemic in England and Wales based on the virus watch community cohort study.Discover public health · 2026
Article

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Aikaterini GrimaniNIHR Policy Research Unit in Behavioural Science - Behavioural Science Group, Warwick Business School, University of Warwick, Coventry, UK. aikaterini.grimani@wbs.ac.uk.ORCID http://orcid.org/0000-0002-2076-6199

Vivi AntonopoulouNIHR Policy Research Unit in Behavioural Science - Health Psychology Research Group, Department of Clinical, Education and Health Psychology, University College London, London, UK.

Nicholas MeaderPopulation Health Sciences Institute, Newcastle University, Newcastle, UK.

Chris BonellNIHR Policy Research Unit Behavioural Science - Department of Public Health, Environments and Society, London School of Hygiene and Tropical Medicine, London, UK.

Susan MichieNIHR Policy Research Unit in Behavioural Science - Health Psychology Research Group, Department of Clinical, Education and Health Psychology, University College London, London, UK.ORCID http://orcid.org/0000-0003-0063-6378

Michael P KellyDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, UK.ORCID http://orcid.org/0000-0002-2029-5841

Ivo VlaevCentre for Behavioural and Implementation Science Interventions (BISI), Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Funding

DH | National Institute for Health Research (NIHR) PR-PRU-1217-20501

6 · The paper itself

Abstract

backgroundClear communication is essential for the effective uptake of public health interventions promoting protective behaviours for respiratory infection control. The emergence of novel infectious diseases, particularly the COVID-19 pandemic, has highlighted the need for rapid adaptation of established and new behavioural practices. However, there remains limited knowledge concerning effective strategies for disseminating risk-reduction information and predicting population responses.

methodsThis systematic review and meta-analysis (PROSPERO: CRD42020198874) assessed the effectiveness of these interventions using behavioural science frameworks, including MINDSPACE contextual influencers and behaviour change techniques (BCTs), to identify key components and mechanisms of action (MoAs). Twenty-four full-text articles, comprising 36 randomised controlled trials (RCTs) across 11 countries, were included via electronic databases (MEDLINE, EMBASE, PsycINFO, Scopus) and other sources (grey literature, Google Scholar, and reference lists) searched to March 2022.

resultsHere, we show that interventions mainly target social distancing, mask wearing, hand washing, and various behavioural intentions and actual behaviours, using a median of three-arm study designs with passive comparators. Interventions include a median of two contextual influencers and four BCTs. Behaviour intention is the most frequently applied mechanism of action. Study quality is moderate. Narrative synthesis of 16 full-texts (26 RCTs) shows significant effects, while network meta-analysis of 16 full-texts (21 RCTs) indicates that prosocial messages, particularly those referencing loved ones, are effective in reducing the risk of respiratory infections (d = 0.09; 95% CrI=0.06-0.14; CINeMA: Low).

conclusionsAlthough further research is needed, the review provides insight into designing public health messages that effectively improve protective behaviours for respiratory infection control.

Identifiers

PMID41444380

DOI10.1038/s43856-025-01296-6

PMCPMC12820126

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.