Survey Tool and Guidance: Rapid, Simple, Flexible Behavioural Insights on COVID-19

"Monitoring knowledge, risk perceptions, preventive behaviours and trust to inform pandemic outbreak response..."

This document from the World Health Organization (WHO) Regional Office for Europe provides a questionnaire and guidance document for countries that wish to conduct behavioural insights studies related to COVID-19. Such a study would be initiated by health authorities in individual countries to gain insights into risk perception, health literacy, trusted sources of information, attitudes toward pandemic response initiatives (including future vaccines), and other variables to inform COVID-19 response policies and interventions, including messaging/communication.

The COVID-19 pandemic and its restrictions have affected various aspects of life, including mental and physical well-being, social cohesion, economic stability, and individual and community resilience and trust. Gaining insights into citizens' behaviours and perceptions allows authorities to implement pandemic response measures that are better informed, situated, and accepted, and thus more effective.

National pandemic response authorities can gather such insights through this quantitative, observational study with voluntary participation by the general population, with expected low risk for participants. A 20-minute online questionnaire in a serial cross-sectional design with multiple data collections is set forth as a standard approach, but this can be adapted as necessary. Computer-assisted telephone interviews (CATI) surveys may be used as additional or alternative data collection methods in countries where access to computers or smartphones is less widespread. (As long as social distancing regulations are in place, household surveys are not recommended). The WHO Regional Office for Europe suggests collecting data repeatedly (e.g., weekly or adapted to the epidemiological situation), which can allow authorities to:

• Identify developments over time (e.g., a decline in trust, or a decline in motivation to follow recommended behaviours);
• Recognise new issues as they emerge (e.g., related to conspiracy theories, new misperceptions, or stigma against certain groups) and address these, and;
• Detect adverse responses to new restrictions, messages, or actions taken.

Designed to help Member States undertake such a study, this tool is meant to be: evidence-informed; able to be regularly applied; flexible to adjust to the changing situation; and aligned with high ethical standards.

The approach presented in this guidance document was developed based on a framework initiated by the University of Erfurt, Germany, German national health authorities, and others (see Related Summaries, below). The document provides:

• Guidance on the recommended process and steps;
• A sample methodology;
• Advice for obtaining ethical clearance;
• A suggested sample questionnaire (Annex 1); and
• Codes for data analysis and establishment of a protected website for presentation of findings (Annex 2).