Current infection control behaviour patterns in the UK, and how they can be improved by ’Germ Defence’, an online behavioural intervention to reduce the spread of COVID-19 in the home.

Ben Ainsworth, Sascha Miller, James Denison-Day, Beth Stuart, Julia Groot, Cathy Rice, Jennifer Bostock, Xiao-Yang Hu, Kate Morton, Lauren Towler, Michael Moore, Merlin L Willcox, Tim Chadborn, Natalie Gold, Richard Amlot, Paul Little, Lucy Yardley

Research output: Contribution to journalArticle (Academic Journal)


Background: Germ Defence ( is a freely available website providing behavioural advice for infection control within households, using behaviour change techniques. This observational study reports current infection control behaviours in the home in UK and international users of the website, and examine how they might be improved to reduce the spread of COVID-19. Method: 28,285 users sought advice from four website pathways (to protect themselves generally, to protect others if the user was showing symptoms, to protect themselves if household members were showing symptoms, and to protect a household member who is at high risk) and completed outcome measures of current infection control behaviours within the home (self-isolation, social distancing, putting shopping/packages aside, wearing face-covering, cleaning and disinfecting, handwashing), and intentions to change these behaviours. Results: Current user behaviours mean scores varied across all infection control measures but were between ’sometimes’ and ’quite often’, except handwashing (’very often’). Behaviours were similar regardless of the website pathway used. After using Germ Defence, users recorded intentions to improve infection control behaviour across all website pathways and for all behaviours. Conclusions: Self-reported infection control behaviours other than handwashing are lower than is optimal for infection prevention, although reported handwashing is much higher. The advice using behaviour change techniques in Germ Defence led to intentions to improve these behaviours. This has been shown previously to reduce the incidence, severity and transmission of infections. These findings suggest that promoting Germ Defence within national and local public health guidance could reduce COVID-19 transmission.Competing Interest StatementThe authors have declared no competing interest.Funding StatementThe study was funded by the UKRI/MRC Rapid Response Call: UKRI CV220-009. The Germ Defence intervention was hosted by the Lifeguide Team, supported by the NIHR Biomedical Research Centre, University of Southampton. LY is a National Institute for Health Research (NIHR) Senior Investigator and theme lead for University of Southampton Biomedical Research Centre. LY and RA are affiliated to the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Behavioural Science and Evaluation of Interventions at the University of Bristol in partnership with Public Health England (PHE). MLW is a NIHR Academic Clinical Lecturer, under grant CL-2016-26-005. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR, the Department of Health or Public Health England. The funders had no role in the design of the study, collection, analysis, and interpretation of data or in writing the manuscript.Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study received ethical approval from University of Bath (PREC reference 20-088).All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.YesAll time-stamped data files used in analysis (and analysis scripts) will be made available upon final manuscript publication.
Original languageEnglish
Publication statusSubmitted - 2020

Structured keywords

  • Physical and Mental Health

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