Measuring and increasing rates of self-isolation in the context of infectious diseases: A systematic review with narrative synthesis

Abstract

AbstractBackgroundSelf-isolation was used to prevent the spread of COVID-19 and will likely be used in future infectious disease outbreaks.MethodWe conducted a systematic review following PRISMA and SWiM guidelines. MEDLINE, PsycINFO, Embase, Web of Science, PsyArXiv, medRxiv, and grey literature sources were searched (1 January 2020 to 13 December 2022) using terms related to COVID-19, isolation, and adherence. Studies were included if they contained original, quantitative data of self-isolation adherence during the COVID-19 pandemic. We extracted definitions of self-isolation, measures used to quantify adherence, adherence rates, and factors associated with adherence. The review was registered on PROSPERO (CRD42022377820).FindingsWe included 45 studies. Self-isolation was inconsistently defined. Only four studies did not use self-report to measure adherence. Of 41 studies using self-report measures, only one reported reliability; another gave indirect evidence for a lack of validity of the measure. Rates of adherence to self-isolation ranged from 0% to 100%. There was little evidence that self-isolation adherence was associated with socio-demographic or psychological factors.InterpretationThere was no consensus in defining, operationalising, or measuring self-isolation. Only one study presented evidence of the psychometric properties of the measure highlighting the significant risk of bias in included studies. This, and the dearth of scientifically rigorous studies evaluating the effectiveness of interventions to increase self-isolation adherence, is a fundamental gap in the literature.FundingThis study was funded by Research England Policy Support Fund 2022-23; authors were supported by the NIHR Health Protection Research Unit in Emergency Preparedness and Response.