Theoretical models applied to understand infection prevention and control practices of healthcare workers during the COVID-19 pandemic: a systematic review

Background: Effective infection prevention and control (IPC) practices among healthcare workers are crucial to prevent the spread of COVID-19 and other infections in healthcare settings. 

Aim: To synthesise evidence on behaviour change theories, models, or frameworks applied to understand healthcare workers’ IPC practices during the COVID-19 pandemic. 

Methods: PubMed, EBSCOhost interface, ProQuest interface, MEDLINE (Ovid), and grey literature were searched for primary studies published between December 2019 and May 2023. The Mixed Method Appraisal Tool evaluated the methodological quality of the studies. Two reviewers independently completed study selection, data extraction, and quality assessment. 

Results: The search yielded 2110 studies, of which 19 were included. Seven behaviour change theories, models, and frameworks were identified, with the Health Belief Model and Theoretical Domains Framework being the most employed. Based on these theories, models, and frameworks, the included studies identified cognitive, environmental, and social factors influencing healthcare workers’ compliance with COVID-19 IPC practices. 

Discussion: This review offers insights into the critical role of behavioural change theories, models, or frameworks in understanding the factors influencing healthcare workers’ compliance with IPC practices during COVID-19. It also highlights the potential of these theories in guiding the development of evidence-based interventions to improve healthcare workers’ compliance with IPC practices.