Easier said than done: behavioral conflicts in following social-distancing recommendations for influenza prevention.

Preventing transmission of H1N1 and other infectious diseases can require individuals to change behaviors, but recommendations to change behavior can run counter to other powerful influences. For example, instructions to not shake hands or avoid certain public gatherings can run counter to substantial social pressures to shake hands or be in attendance. These behavioral conflicts are illustrated with an experience of the relative ineffectiveness of voluntary recommendations, which highlights the importance of considering these social pressures when determining what recommendations to make and how to make them. An analysis of how social pressures influence behaviors relevant to preventing disease transmission can aid public health officials in considering how to make effective recommendations concerning H1N1 and other infectious disease situations.