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    Views 5,387
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    Original Investigation
    Public Health
    July 8, 2020

    Association of a Public Health Campaign About Coronavirus Disease 2019 Promoted by News Media and a Social Influencer With Self-reported Personal Hygiene and Physical Distancing in the Netherlands

    Author Affiliations
    • 1Department of Cardiology, Amsterdam University Medical Center (VU University Medical Center), Amsterdam, the Netherlands
    • 2Center for Advanced Hindsight, Duke University, Durham, North Carolina
    • 3Econometric Institute, Erasmus University, Rotterdam, the Netherlands
    • 4Department of Clinical Neuropsychology, VU University, Amsterdam, the Netherlands
    • 5Department of Viroscience, Erasmus MC, Rotterdam, the Netherlands
    • 6Department of Cardiology, UMCU, Utrecht, the Netherlands
    • 7Icahn School of Medicine, Mount Sinai Hospital, St Luke’s Hospital, New York, New York
    JAMA Netw Open. 2020;3(7):e2014323. doi:10.1001/jamanetworkopen.2020.14323
    Key Points español 中文 (chinese)

    Question  Are evidence-based public health campaigns, aiming to contain the coronavirus disease 2019 pandemic and using digital news media and social media, associated with improvements in personal hygiene?

    Findings  In this survey study of hygiene awareness and behavior in the context of the coronavirus disease 2019 pandemic, exposure to a targeted campaign video and news article was associated with an approximately 2-fold increase in the odds of washing of all required hand areas and longer duration of handwashing.

    Meaning  These findings suggest that evidence-based campaigns using existing digital news and social media platforms may be an effective means to help combat critical health issues, such as the coronavirus disease 2019 pandemic.


    Importance  In the absence of a vaccine and therapeutic agent, personal hygiene and physical distancing are essential measures to contain the coronavirus disease 2019 pandemic.

    Objective  To determine whether a social media campaign, targeted at the gaps in behavior on personal hygiene and physical distancing and distributed nationwide via digital news media, may be an effective method to improve behavior and help to inhibit person-to-person transmission of severe acute respiratory syndrome coronavirus 2.

    Design, Setting, and Participants  This survey study was designed to uncover self-reported gaps in behavior regarding personal hygiene and physical distancing in the Netherlands. A diagnostic survey was distributed by a large national newspaper (De Telegraaf) and a popular social influencer (Govert Sweep) on March 17, 2020, and was completed by 16 072 participants. Analysis of these outcomes showed that coughing and sneezing in the elbow was done well, but that handwashing, face touching, and physical distancing showed serious gaps compared with advised behavior. This diagnostic information was used to design infographics and a video targeted at repairing these gaps in behavior. The video and infographics were distributed on a national level on March 21, 2020, followed by a postcampaign survey to measure the results on March 24, 2020. Data analysis was performed from March to April 2020.

    Exposure  Exposed participants were those who viewed the infographics and/or video.

    Main Outcomes and Measures  Improvement on the extent of handwashing in all areas, handwashing duration of 20 seconds or longer, awareness on face touching, and physical distancing were measured according to responses on the postcampaign survey.

    Results  A total of 17 189 participants (mean [SD] age, 47.61 [13.57] years; 9100 women [52.9%]) responded to the postcampaign survey. The news article in De Telegraaf was read more than 2 million times, and the influencer video was watched more than 80 000 times. Cross-sectional analysis of the postcampaign survey using logistic regression correcting for age, gender, and educational level showed that exposure to the video plus infographics (827 participants) (adjusted odds ratio [OR], 2.14; 95% CI, 1.83-2.50; P < .001) and to the infographics alone (11 348 participants) (adjusted OR, 1.31; 95% CI, 1.22-1.40; P < .001) were positively associated with washing hands in all areas compared with the unexposed group (4751 participants). In addition, exposure to the video plus infographics (adjusted OR, 1.86; 95% CI, 1.59-2.16; P < .001) and to the infographics alone (adjusted OR, 1.27; 95% CI, 1.19-1.36; P < .001) were positively associated with washing hands long enough compared with the unexposed group. Exposure to the video alone was not associated with improved handwashing. Compared with the unexposed group, exposure to the infographics alone and video plus infographics were associated with improvements in physical distancing when the participant had COVID-19 syptoms (infographics alone, adjusted OR, 1.10; 95% CI, 1.03-1.17; P = .006; video plus infographics, adjusted OR, 0.79; 95% CI, 0.69-0.91; P = .001) and face touching (infographics alone, adjusted OR, 1.29; 95% CI, 1.22-1.38; P < .001; infographics and video, adjusted OR, 1.49, 95% CI, 1.30-1.71; P < .001).

    Conclusions and Relevance  These findings suggest that a targeted behavioral change campaign, promoted by a news platform and social media, was associated with self-reported improvement in personal hygiene with the aim to prevent person-to-person transmission of severe acute respiratory syndrome coronavirus 2. This method of evidence-based campaigning may be an effective way to improve critical public health issues, such as the coronavirus disease 2019 pandemic.