Title: COHERE phase 2: Living systematic reviews and evidence and gap map on determinants of COVID-19 Health Related Behaviour
Funder: Economic and Social Research Council

Abstract: 1. To gather and synthesise all the evidence on things that influence people's health-protective behaviour in the context of COVID-19 and other similar outbreaks. By health-protective behaviour, we mean washing hands, wearing masks, social distancing and other related behaviour that aims to reduce the transmission of serious viral illnesses. 2. Rapidly publish and regularly update an evidence and gap map (EGM) detailing included studies and gaps in evidence. This will be an interactive open-access map of the evidence identified so far on the determinants of health-protective behaviours. We will update our EGM regularly to capture new evidence as it emerges. This will help decision-makers and researchers understand what evidence exists and where the gaps in our knowledge are. 3. Develop a suite of at least seven living systematic reviews (LSRs), one on each behaviour of interest and publish the first LSR within 12 months. 4. Disseminate all outputs through a newly established expert advisory group and our existing networks, conferences and to the general public as the opportunity arises, supported by the QUB press office. 5. Contribute to developing the methodology of rapid reviews and LSRs by comparing the evidence identified and conclusions reached through COHERE phase 1 (rapid review) and Phase 2 (full systematic reviews) 6. Identify resources to maintain the EGM and keep the reviews up to date after the project ends so that the evidence generated will be immediately usable in the context of any future similar pandemic.

Lay abstract: Health-protective behaviours, like washing your hands, wearing a facemask and social distancing, can help to protect people from contracting or transmitting COVID and other similar serious respiratory infections. This project aims to help us understand more about the factors that influence these behaviours in the general public. This project represents the second phase of our research. In phase one we conducted a rapid review of published studies that looked at the things that influenced uptake of these protective behaviours during COVID or during previous outbreaks of similar serious respiratory infections, for example SARS, MERS and H1N1 (swine flu). We quickly put the results of these studies together to understand what influences people's health protective behaviours. By putting the data from different studies together in a new analysis, a meta-analysis, we were also able to find out how strong these relationships are. Finally we assessed the quality of the studies we found so that we know how confident we can be that the evidence we have is good enough to support our conclusions. We completed the first phase quickly to provide answers to urgent questions about COVID. Working quickly meant that we only had time to look for published, peer-reviewed studies and not all the studies conducted that hadn't yet been published in scientific journals. As well as that, there has been a very large increase in the number of potentially relevant studies conducted in the context of COVID-19 over the last nine months, since we last searched for studies. In phase two, we are going to repeat this process of finding and putting evidence together but this time we have more time and resources to search more thoroughly. To begin with, we will publish an open access 'evidence and gap map' that will contain information on all of the studies we have already found (in phase 1). This will be open to anyone to use and allow other researchers, policy makers and those who fund research to see what evidence we already know about and where the gaps in our knowledge are. The next step will be to do a thorough search for any new studies and any unpublished work that we didn't find in phase 1. We will then check every study we find to see if it can tell us something about why people do, or do not, adopt the behaviours that help protect against getting or passing on COVID-19. When we find new relevant studies we will add them to our map. Once we have gathered up all of the relevant studies we will extract information about each study, such as who took part, how the behaviours of interest were measured, what factors related to relevant behaviours and any information on how strongly related each factor is to each behaviour. We will also assess the quality of each study we include. Finally, we will put all of the relevant information from the studies we find together in a new analysis and then publish a separate systematic review of the evidence on each behaviour of interest (washing hands, wearing masks, social distancing, physical distancing, self-isolation or quarantine, disinfecting surfaces). We will follow all of the established guidelines and best practices for conducting research of this kind, such as Cochrane and Campbell guidance. The last part of our project will be to update our searches to capture any new evidence as it emerges and integrate that into the reviews. This is called a 'living review' and the reviews will remain living for at least the life of the project (18 months). We will work on using technology to find ways to make this process as efficient as possible so that our reviews stays up to date and available to use. The main aim of our project is to understand what determines people's positive health protective behaviours. This in turn will help others to develop better ways to support people to protect themselves and others from contracting or passing on COVID and other similar serious respiratory viral infections.

Research activity codes: 3.2 INTERVENTIONS TO ALTER PHYSICAL AND BIOLOGICAL ENVIRONMENTAL RISKS
Health categories: INFECTION