Episodic future thinking and compassion reduce public health guideline noncompliance urges: A randomised controlled trial

Background During the COVID-19 pandemic, public health departments have issued guidelines to limit viral transmission. In this environment, people will feel urges to engage in activities that violate these guidelines, but research on guideline adherence has been reliant on surveys asking people to self-report their typical behaviour, which may fail to capture these urges as they unfold. Guideline adherence could be improved through behaviour change interventions, but considering the wide range of behaviours that COVID-19 guidelines prescribe, there are few methods that allow observing changes of aggregate guideline adherence in the ‘wild’. Methods In order to administer interventions and to obtain contemporaneous data on a wide range of behaviours, we use ecological momentary assessment. In this preregistered parallel randomised trial, 95 participants aged 18-65 from the UK were assigned to three conditions using blinded block randomisation, and engage in episodic future thinking (n = 33), compassion exercises (n = 31), or a sham procedure (n = 31) and report regularly on the intensity of their occurrent urges (min. 1, max. 10) and their ability to control them. We investigate whether state impulsivity and vaccine attitudes predict guideline adherence, while assessing through which mechanism these predictors affect behaviour. Findings We found that episodic future thinking ( b = -1.60) and compassion exercises ( b = -1.40) reduce the intensity of urges. State impulsivity is associated with stronger urges, but we found no evidence that vaccine hesitancy predicts lesser self-control. Interpretation We conclude that episodic future thinking exercises and compassion training may be used to stimulate compliance of individuals who are a risk for the community, such as those in voluntary self-isolation.