Guest blog: Why didn’t people follow the government’s advice on COVID-19?  

March 25th, 2020: governments around the world require citizens to take increasingly stringent measures to combat COVID-19. In a rapid response to  how Governments are communicating with us about how to limit the spread of the virus, Saul Albert and Charlotte Albury have compiled a report, based on a systematic review by a team led Albury, by on what CA can tell us about how medical advice is given and received. 

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Saul Albert, Loughborough University

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Charlotte Albury, University of Oxford

Since the 12th March The UK government has been advising people to avoid large gatherings and to practice social distancing. However, until the announcement of enforcement measures on the evening of Monday 23rd March there were regular reports of markets and pubs thronging with people and supermarkets packed with shoppers. So why didn’t the government’s advice work? And how do you get people to change their behaviour in response to serious and urgent medical advice?

The COVID-19 pandemic is an unprecedented public health challenge, but when formulating a strategy for giving public health advice, there are important lessons from research into how doctors deliver life-saving health advice in everyday settings such as primary care consultations. Of course one-to-one GP consultations are completely different situations from watching political broadcasts or written advice, but what we know about the ordinary social practices of giving and receiving advice can indicate the most appropriate strategy for helping people adapt their behaviour to this unusual situation. Even with the enhanced restrictions announced by the government last night [March 23rd 2020], it is still crucial to use effective techniques to advise friends, family, and co-workers to adopt careful hand-washing and social distancing measures, to stay at home, and to take all steps to avoid spreading the infection.

How to give live-saving behaviour-change advice

Giving behaviour-change advice can be delicate at the best times, and during a global pandemic the stakes are particularly high. Make sure you use an up-to-date, trustworthy source for your advice. The NHS has a very clear overview of COVID-19 health guidance that you can use to inform your advice. There is also official guidance on permitted reasons for leaving your home during at least three weeks of near-lockdown. A research group led by Charlotte Albury, gathered together what we know about how physicians give behaviour-change advice in interaction  This is what the review concluded about what is likely to be well-received and to lead to helpful discussions:

  1. Use a collaborative style of advice-delivery 

The most important thing is to be collaborative during advice giving, particularly if your advice is unsolicited. Rather than immediately telling someone what they should be doing, instead invite their perspective (something like ‘so what do you think about social distancing?’)  and then accommodate this throughout the conversation. We found that this strategy received responses that indicated receptivity to the advice being offered.

  1. Give specific risk-reduction advice

Advice about risks can seem daunting or scary without specific actionable things you can do to reduce those risks. For example, sharing a ‘worst case scenario’ to scare people into following advice is very unlikely to be received well, and vague unspecific advice doesn’t present any solutions. Instead, talk together about specific behaviours that reduce risk, such as hand-washing regularly and limiting social contact.

  1. Pin the advice to something relevant to the person 

If advice doesn’t seem personally relevant for people, they’re probably not going to follow it. Different things are relevant to different people, and finding out what is important to a person means you can tailor advice to be personal, specific, and meaningful to that person and the situation they are going to face in everyday life.

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You are welcome to share this graphic summary of behaviour-change advice, created by CARM and A Dozen Eggs.

How to tell if someone is taking advice, and what to try if they are not

In a health emergency, you don’t want to wait to find out if someone has followed your advice. Luckily, since advice-giving in interaction happens moment-by-moment, you don’t have to. Listening out for certain responses during the interaction will let you know how things are going.

  1. Elaborations & displays of marked positive stance (good)

Someone who shows they a responding positively to your advice (and may be agreeing) will go above and beyond neutrally acknowledging that you’ve spoken, and might elaborate further on what you’ve said, or display some positive assessment or acknowledgement, something like ‘Yes, I agree, I’ll probably stay in, like you said’ or ‘that sounds good’.

  1. Unelaborated acknowledgement tokens (bad)

If someone is responding with ‘unelaborated acknowledgement tokens’ (things like ‘mmm’ ‘right’ or ‘yeah’) at times in the conversation when it’s relevant for them to say a bit more, this could be a sign your advice has not been received positively. If you are noticing these sorts of responses, try and uncover the reason for resistance. It may be, for example, that the person doesn’t understand that individual behaviour can have such a strong effect in the current pandemic, and so your advice doesn’t make sense. If you can uncover the reason for resistance (such as disbelief, or lack of understanding), address and discuss it, before going back to advice-giving.

  1. If people take it personally, frame it as a hypothetical

For some people being told what they ‘should’ be doing can make them upset, or angry, as it implies they’re not doing the right thing at the moment. One way to get around this, but still have a productive discussion, is to talk hypothetically about ‘people in general’ rather than giving ‘advice for you’. For example rather than saying ‘you shouldn’t be going to other people’s houses’ you could try ‘Some people have found that Netflix party has been great to stay in touch whilst social distancing’.

Legal threat rather than advice

Now that the government’s initial advice-giving strategy has ended with the announcement of enforcement measures, it is worth reflecting on its shortcomings. The government frequently changed its advice, and highlighted worst-case scenarios while giving non-specific advice that left inconsistencies open to interpretation. Even after the announcement of enforced measures, open questions remain. For example, precisely which jobs are classed as non-essential? It is still necessary for everyone to do their bit and reach out to offer advice to friends and relatives. A carrier of COVID-19 infects around three people, so take it upon yourself to reach out to at least three people, offer them some well-designed advice, then encourage them to do the same.

Reference

Albury, C., Hall, A., Syed, A. et al. Communication practices for delivering health behaviour change conversations in primary care: a systematic review and thematic synthesis. BMC Fam Pract 20, 111 (2019). https://doi.org/10.1186/s12875-019-0992-x

Guest blog: Elliott Hoey on sniffing

Issue 1 of volume 53 of the journal (the fist issue of 2020) is devoted to non-lexical things we do in interaction – whistling, clicking, moaning: things which are not language, but are deployed in language-like ways. From a wealth of fascinating articles, I’m delighted that Elliott Hoey has agreed to send in lively report of his investigation into the uses of the sniff.

Elliott Hoey

Elliott Hoey, Basel

For the current special issue of ROLSI on non-lexicals, edited by Leelo Keevallik and Richard OgdenI reported some findings about sniffing in conversational interaction in English. Continue reading

Guest blog: Who uses transcriptions of conversations as formal evidence?

Emma Richardson

Emma Richardson, Aston University

It’s not just researchers who go out with their taperecorders and bring back data to transcribe: formal transcripts are part and parcel of the work of Parliaments, law courts, the police, and many others. Emma Richardson has been looking into the reach and scope of official recordings, and asks us to compare officials’ practical interests with our more academic ones. Continue reading

Guest blog: Sharing CA with the public at a research festival

CA is blessed with some exceptionally able communicators, and there is a growing appetite to reach out to members of the public with a show of what CA can do (see the other blogs in this “CA Teaching” section). One now well-established tradition is for members of York’s Centre for Advanced Studies in Language and Communication (CASLC) to engage in York’s research festival (“Yornight“), and I’m delighted that Rose Rickford has sent in a report of what happened this year. Continue reading

Guest Blog: How does a market trader get customers?

In a recent paper in ROLSI, Kenan Hochuli reported a remarkable study of the complex world of the street market. I’m delighted that he’s prepared a guest blog on the subject, concentrating on the crucial step in the selling process: getting the passer-by to stop.

Kenan Hochuli

Kenan Hochuli, Neuchâtel and Zurich

Market stalls are unique service institutions. They are located in public spaces and approachable from different directions. There are no material or technical devices that determine the sequence of sales. Sometimes it is not clear whether a person is just passing by a stall or if they intend to buy something. And this often happens in the course of already ongoing sales interactions. In view of these conditions, my article deals with seller’s efforts in transforming passers-by into customers and, more generally, participants negotiation of co-presence in the course of emerging multi-party-encounters. Continue reading

Guest Blog: PeaceTalk – Talk and Interaction in Multinational Crisis Management Training

Conversation Analysis is finding application in all sorts of fields, and perhaps none so sensitive as military manouevres… but as Antti Kamunen explains, it can all be in the service of defusing a crisis and working towards peaceful resolution.

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Antti Kamunen, Oulu

What happens inside a patrol car when you notice you are about drive into a minefield? How do you act when you suddenly come across a life-threating situation and have to make decisions quickly? What happens when you get lost on your patrol route in a potentially hostile territory? Continue reading

Guest Blog: the Danish DanTIN group and The Grammar of Everyday Life

Denmark has a thriving EM/CA community, with faculty and students contributing to world-class initiatives across the range of interaction research. Here Magnus Hamann tells us how Danish Interaction Linguistics grew from a simple idea to an project that has generated activity and funding for generations of postgraduate students.

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Magnus Hamann

DanTIN project has its 10-year anniversary. in November 2019. Happy students from different stages of life (some still students, some already accomplished contributors to the work force) have met to celebrate something that has probably had a bigger influence on their linguistic studies and identity than they had initially realised. Continue reading