The Influence of Dissonance Induction and Assessment Reactivity in Improving Adherence to COVID-19 Precautionary Measures: A Cluster Randomised Controlled Trial

Viswa Chaitanya Chandu; Krishna Prasad Lingamaneni; Srinivas Pachava; Venkat Ramana Reddy Baddam; Yamuna Marella

doi:10.1016/j.identj.2021.03.001

The Influence of Dissonance Induction and Assessment Reactivity in Improving Adherence to COVID-19 Precautionary Measures: A Cluster Randomised Controlled Trial

Int Dent J. 2022 Feb;72(1):141-148. doi: 10.1016/j.identj.2021.03.001. Epub 2021 Mar 20.

Authors

Viswa Chaitanya Chandu¹, Krishna Prasad Lingamaneni², Srinivas Pachava³, Venkat Ramana Reddy Baddam⁴, Yamuna Marella⁵

Affiliations

¹ Assistant Professor, Department of Public Health Dentistry, SIBAR Institute of Dental Sciences, Guntur, AP, India. Electronic address: viswachaitanya17@gmail.com.
² Professor and Head, Department of Oral & Maxillofacial Surgery, SIBAR Institute of Dental Sciences, Guntur, AP, India.
³ Professor and Head, Department of Public Health Dentistry, SIBAR Institute of Dental Sciences, Guntur, AP, India.
⁴ Professor and Head, Department of Oral Pathology & Microbiology, SIBAR Institute of Dental Sciences, Guntur, AP, India.
⁵ Assistant Professor, Department of Periodontics, SIBAR Institute of Dental Sciences, Guntur, AP, India.

Abstract

Background: During the coronavirus disease 2019 (COVID-19) pandemic, adherence to suggested precautionary measures has been emphasized as important in preventing and curtailing its spread. However, strict adherence to precautionary measures can be demanding.

Methods: This cluster randomised controlled trial done among 1517 undergraduate dental students tested the effectiveness of 'dissonance induction' (DI) and 'assessment reactivity' (AR) in improving adherence to World Health Organization (WHO) measures as compared to a control group. At baseline, participants in the DI group were tested for their knowledge of precautionary measures, immediately followed by assessment of their adherence to them. This methodology was adapted to systematically reveal the poor adherence of the participants in their self-held cognitions, should there be any. The magnitude of dissonance was measured as the proportion of such dissonant cognitions held by an individual. In the AR group, at baseline, participants were asked about their attitudes alone toward measures. The control group was neither assessed for knowledge and adherence nor for attitudes toward the measures at baseline. Two weeks after the administration of these interventions in the DI and AR groups, the 3 study groups were assessed for adherence.

Results: The follow-up adherence scores in the DI group were found to be significantly higher (15.11 ± 4.1) compared to the AR (13.13 ± 2.01) and control (12.87 ± 2.97) groups as analysed by Kruskal-Wallis analysis of variance (H = 243.5; P < .001). Wilcoxon signed-rank test showed that the adherence scores significantly improved in the DI group from baseline to follow-up (z = -8.84; P < .001). Magnitude of dissonance at baseline was found to be a significant predictor of follow-up adherence scores (R² = 0.255).

Conclusion: This study found that DI is an easy intervention to bring an immediate and significant change in adherence to precautionary measures.

Keywords: Cognitive dissonance; Coronavirus; Health behaviours.

Publication types

Randomized Controlled Trial

MeSH terms

COVID-19*
Humans
Pandemics
SARS-CoV-2