Behavioral interventions and respiratory virus incidence in a two-cohort study

Behavioral interventions are a critical tool for managing novel and emerging pathogens. Examples include hand-washing, masking, or staying home when feeling ill. The dynamics of behavioral interventions have been difficult to measure and are poorly understood. This makes it difficult to assess their impact during outbreaks. In this study, we investigate the uptake, persistence, and waning, of behavioral interventions against respiratory viruses among two cohorts in Centre County, PA. We focused on the three years following the emergence of SARS-CoV-2. We detected clusters of behaviors that followed similar patterns of engagement and variations over time. We also identified novel behavioral interventions that were introduced to combat COVID-19 that coincided with a reduction in non-COVID-19 respiratory disease incidence. Additionally, we detected changes in risk perception and changes in behaviors over time. These findings strengthen our understanding of factors that may influence behavior and inform recommendations around behavioral interventions during outbreak management, including information dissemination and behavioral guidelines.