Episodic future thinking and compassion reduce non-compliance urges regarding public health guidelines: a randomised controlled trial

Background: People often feel urges to engage in activities that violate pandemic public health guidelines. Research on these urges has been reliant on measures of typical behaviour, which fail to capture these urges as they unfold. Guideline adherence could be improved through interventions, but few methods allow for ecologically valid observation of the range of behaviours that pandemic guidelines prescribe. Methods: In this preregistered parallel randomised trial, 95 participants aged 18–65 from the UK were assigned to three groups using blinded block randomisation, and engaged in episodic future thinking (n = 33), compassion exercises (n = 31), or a control procedure (n = 31). Following an ecological momentary assessment procedure, participants report on the intensity of their occurrent urges (min. 1, max. 10) and their ability to control them. The study further investigates whether, and through which mechanism, state impulsivity and vaccine attitudes affect guideline adherence. Results: Episodic future thinking (b = -1.80) and compassion exercises (b = -1.45) reduced the intensity of urges. State impulsivity is associated with stronger urges, but we found no evidence that vaccine hesitancy predicts lesser self-control. Conclusions: We conclude that episodic future thinking exercises and compassion training may be used to decrease non-compliance urges of individuals who are an acute public health risk for the community, such as those in voluntary isolation.