Reducing touching eyes, nose and mouth (‘T‐zone’) to reduce the spread of infectious disease: A prospective study of motivational, volitional and non‐reflective predictors

Abstract

AbstractBackgroundThe route into the body for many pathogens is through the eyes, nose and mouth (i.e., the ‘T‐zone’) via inhalation or fomite‐based transfer during face touching. It is important to understand factors that are associated with touching the T‐zone to inform preventive strategies.PurposeTo identify theory‐informed predictors of intention to reduce facial ‘T‐zone’ touching and self‐reported ‘T‐zone’ touching.MethodsWe conducted a nationally representative prospective questionnaire study of Canadians. Respondents were randomized to answer questions about touching their eyes, nose, or mouth with a questionnaire assessing 11 factors from an augmented Health Action Process Approach at baseline: intention, outcome expectancies, risk perception, individual severity, self‐efficacy, action planning, coping planning, social support, automaticity, goal facilitation and stability of context. At 2‐week follow‐up, we assessed HAPA‐based indicators of self‐regulatory activities (awareness of standards, effort, self‐monitoring) and self‐reported behaviour (primary dependent variable).ResultsOf 656 Canadian adults recruited, 569 responded to follow‐up (87% response rate). Across all areas of the ‘T‐zone’, outcome expectancy was the strongest predictor of intention to reduce facial ‘T‐zone’ touching, while self‐efficacy was a significant predictor for only the eyes and mouth. Automaticity was the strongest predictor of behaviour at the 2‐week follow‐up. No sociodemographic or psychological factors predicted behaviour, with the exception of self‐efficacy, which negatively predicted eye touching.ConclusionFindings suggest that focusing on reflective processes may increase intention to reduce ‘T‐zone’ touching, while reducing actual ‘T‐zone’ touching may require strategies that address the automatic nature of this behaviour.