Motivational effectiveness of prosocial public health messaging to reduce respiratory infection risk: A network meta-analysis

Abstract Clear communication is vital for adopting public health interventions that promote protective behaviours against respiratory infections. This systematic review and network meta-analysis 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). The interventions primarily focused on social distancing, mask-wearing, handwashing, diverse-behavioural intentions, and actual behaviours. The network meta-analysis revealed that prosocial messages, especially those involving loved ones, significantly reduced the risk of respiratory infections (d=0.09; 95% CrI=0.06-0.14; CINeMA: Low). Interventions typically included three contextual influencers (salience, affect, ego) and five BCTs (Information about health consequences; Salience of consequences; Information about social and environmental consequences; Demonstration of the behaviour; Avoidance/reducing exposure to cues for the behaviour). Behaviour intention was the most common MoA. Although further research is needed, this review provides insights into designing effective public health messages for respiratory infection control.