Revista Portuguesa de Investigação Comportamental e Social 2025 Vol. 11(1): 1–19
Portuguese Journal of Behavioral and Social Research 2024 Vol. 11(1): 1–19
e-ISSN 2183-4938
Departamento de Investigação & Desenvolvimento • Instituto Superior Miguel Torga
REVIEW ARTICLE

Behavior analysts and COVID-19: A review of empirical and conceptual publications

Analistas do comportamento e o COVID-19: Uma revisão de publicações empíricas e conceituais
André Connor de Méo Luiz 1
Myenne Mieko Ayres Tsutsumi 1
Julia Röcker dos Santos 1,2
Carolina Rodrigues Ganêo Kislki 3
Wellington Bueno da Silva Kislki 3
Juliana Suemi Gomes Shirakawa 1,4
Murilo Nogueira Ramos 5
1 Instituto Continuum, Brasil
2 Universidade Estadual de Londrina, Brasil
3 Centro Universitário Filadélfia, Brasil
4 Universidade Positivo - Londrina, Brasil
5 Centro Integrado de Neuropsiquiatria e Psicologia Comportamental (CINP), Brasil
Received: 08/19/2024; Reviewed: 05/03/2025; Accepted: 05/12/2025.
https://doi.org/10.31211/rpics.2025.11.1.356
Abstract
Background: The COVID-19 pandemic emphasized the need for behavioral interventions in public health. Behavior analysts worldwide responded with research and practical strategies to address emerging challenges, particularly related to prevention, telehealth, and mental health.
Objective: This narrative review aimed to identify, organize, and synthesize behavior-analytic publications on the COVID-19 pandemic, thereby improving access to and use of this knowledge.
Method: The review included theoretical, basic, and applied studies published in Portuguese or English, available online without date restrictions. Sources were limited to peer-reviewed journals in behavior analysis.
Results: A total of 272 documents were screened, and 62 met the inclusion criteria. These publications addressed five key domains: the adaptation of services to telehealth, promotion of safety and prevention behaviors, general mental health, social and domestic contexts, and research proposals. Most studies emphasized remote service delivery and the implementation of protective health behaviors.
Conclusions: The findings demonstrate that behavior analysts made timely and relevant contributions during the pandemic, particularly by adapting clinical practices and promoting behavioral adherence to public health guidelines. These insights highlight the importance of behavioral science in shaping crisis responses and indicate promising avenues for future research and intervention.
Keywords: Behavior analysis; COVID-19; Telehealth; Preventive behavior; Narrative review.
Resumo
Contexto: A pandemia de COVID-19 evidenciou a necessidade de intervenções comportamentais em saúde pública. Analistas do comportamento em todo o mundo responderam com investigação e estratégias práticas para enfrentar os desafios emergentes, especialmente no que respeita à prevenção, à telessaúde e à saúde mental.
Objetivo: Esta revisão narrativa teve como objetivo identificar, organizar e sintetizar publicações analítico-comportamentais sobre a pandemia de COVID-19, de forma a melhorar o acesso e a utilização deste conhecimento.
Métodos: A revisão incluiu estudos teóricos, básicos e aplicados, publicados em português ou inglês, disponíveis online e sem restrição de data. As fontes foram limitadas a revistas com revisão por pares na área da análise do comportamento.
Resultados: Foram analisados 272 documentos, dos quais 62 cumpriram os critérios de inclusão. As publicações abordaram cinco domínios principais: adaptação de serviços para telessaúde, promoção de comportamentos de segurança e prevenção, saúde mental geral, contextos sociais e domésticos, e propostas de investigação. A maioria dos estudos enfatizou a prestação remota de serviços e a implementação de comportamentos protetores de saúde.
Conclusões: Os resultados demonstram que os analistas do comportamento contribuíram de forma oportuna e relevante durante a pandemia, especialmente ao adaptarem práticas clínicas e promoverem a adesão comportamental às orientações de saúde pública. Estes dados reforçam a importância da ciência do comportamento na resposta a crises e indicam caminhos promissores para futuras investigações e intervenções.
Palavras-Chave: Análise do comportamento; COVID-19; Telessaúde; Comportamento preventivo; Revisão narrativa.

Introduction

Preventing the spread of COVID-19 requires collective behavioral engagement across populations (Berkley, 2020). The pandemic, therefore, is not only a public health issue but also a profoundly behavioral one. Understanding how individuals behave—especially in conditions of uncertainty and risk—is fundamental to the design and implementation of effective prevention strategies.
Within this context, Behavior Analysis provides a robust conceptual and methodological framework for examining and modifying human behavior. The COVID-19 pandemic underscored the need for interdisciplinary collaboration and highlighted the value of behavior analysts in designing and implementing interventions to promote public health and reduce psychological distress. This study aimed to review the behavior-analytic literature on COVID-19, specifically focusing on publications in specialized behavior analysis journals.
The novel coronavirus, SARS-CoV-2 (causing COVID-19), was first identified in December 2019 in Wuhan, China. As it evolved into a global pandemic, numerous public health measures were developed and implemented to contain its spread (Schiffer, 2020), including the use of personal protective equipment, frequent hand and surface hygiene, and restrictive strategies such as physical distancing and quarantine (World Health Organization, 2020). These interventions contributed to reducing infection and mortality rates (Cruz, 2020; Flaxman et al., 2020; Prem et al., 2020).
Despite these efforts, the pandemic produced long-term consequences in multiple domains. Medically, many individuals experienced persistent symptoms and complications (Augustin et al., 2021). Economically, global and local markets suffered severe disruptions (Ponce, 2020). Psychologically, the pandemic triggered widespread emotional distress (Clemente-Suárez et al., 2021), including heightened levels fear and stress, anxiety, and depression (Elbay et al., 2020; Huang & Zhao, 2020; Meng et al., 2020; Ornell et al., 2020; Wang et al., 2020). These effects were observed not only in the general population but also among healthcare professionals (e.g., Allan et al., 2020; Li et al., 2020; Pollock et al., 2020; Serrano-Ripoll et al., 2020).
Given the widespread psychological and behavioral impact of the pandemic, the success of mitigation strategies has depended largely on how individuals and communities behaved. Understanding and influencing behavior, particularly in high-stress, uncertain conditions, is therefore essential for both public health protection and psychological well-being.
Behavior Analysis positions behavior—not internal states—as the primary object of scientific inquiry (Skinner, 1938). This perspective allows for the quantification, prediction, and control of behavior based on its functional relationship with environmental variables (Kuroda, 2020; Skinner, 1984). Identifying and manipulating these variables enables the design of interventions that increase or decrease the likelihood of specific behavioral responses (Kanfer & Grimm, 1977). Consequently, preventive strategies are more effective when paired with behavior-analytic technologies that foster sustained engagement and reduce pandemic-related psychological distress (e.g., Confer et al., 2021; Shawler & Blair, 2021).
To illustrate how behavior-analytic technologies can support public health, Heinicke et al. (2020) demonstrated the application of habit reversal training (HRT) in establishing preventive hygiene routines. Originally used in the treatment of problem behaviors, HRT was proposed as a strategy to reduce the frequency of face-touching behaviors, which increase the risk of viral contamination. Heinicke et al. (2020) systematically reviewed studies on HRT and outlined its potential for promoting safer behavioral patterns during health emergencies.
In parallel, other behavior-analytic interventions were adapted and delivered through information and communication technologies (ICTs), ensuring the continuity of essential services during lockdowns. Remote delivery proved effective in various contexts, including education (Fairlie & Loyalka, 2020; Root & Rehfeldt, 2021; Starkey et al., 2021), healthcare (Baron et al., 2022; Haddad et al., 2021), autism services (Bailey et al., 2022; Cleffi et al., 2022), physical activity interventions for sedentary environments (Erath & DiGennaro Reed, 2022), and online psychotherapy (Andrews et al., 2022; Schieltz & Wacker, 2020). These adaptations, made possible through the use of ICTs, demonstrate the flexibility of behavior-analytic interventions across multiple domains, even under the constraints of a global public health emergency.
Behavior Analysis offers a comprehensive theoretical and technological foundation for developing effective health protocols, as it focuses on identifying and manipulating the variables that influence human behavior. By analyzing the functional relationships between environmental conditions and behavioral responses, this science allows for the design of strategies aimed at promoting adherence to preventive measures and mitigating adverse psychological outcomes.
Given that pandemic situations are experienced behaviorally—through the actions individuals take in response to evolving risks and constraints—behavior plays a central role in shaping both the trajectory and the consequences of public health crises. Thus, a science of behavior can offer not only interpretations but also empirically grounded solutions to minimize harm and improve collective well-being across short-, medium-, and long-term horizons.
Organizing and synthesizing behavior-analytic literature supports the transformation of dispersed scientific findings into accessible and actionable knowledge for both health professionals and the broader public. In the context of a global health crisis such as the COVID-19 pandemic, timely access to evidence-based behavioral strategies can inform more effective public health responses.
Narrative reviews contribute to this process by consolidating fragmented evidence, identifying thematic patterns, highlighting gaps in the literature, and presenting interventions in formats that assist clinical and policy decision-making. For practitioners, such reviews offer a curated body of knowledge that supports evidence-informed action. For the general public, they help translate complex scientific data into insights that can promote adaptive behavior and well-being.
Given the increase of behavior-analytic publications during the pandemic and the range of topics addressed, a narrative synthesis offers a way to improve conceptual clarity and guide practical applications. Therefore, the present review aimed not merely to catalog relevant publications, but also to provide a structured, thematically organized, and accessible integration of the field's contributions to understanding and addressing behavioral challenges during public health emergencies.

Method

Eligibility Criteria and Selection of Sources

The present study was designed as a narrative review of publications on the COVID-19 pandemic in behavior-analytic journals. The objective was to identify, organize, and classify relevant theoretical, basic, and applied studies that interpreted pandemic-related phenomena through the principles and conceptual framework of Behavior Analysis. To be eligible for inclusion, publications were required to meet the following criteria: (a) address topics related to the COVID-19 pandemic, (b) be available in full text and open access on the internet, (c) be published in Portuguese or English, and (d) present a clear behavior-analytic perspective. Publications were excluded if they consisted of editorials, tributes, conference abstracts, or letters to the editor.
A behavior-analytic perspective was defined as one that emphasized observable behavior and its environmental determinants, rather than internal states or hypothetical constructs. This included analyses of behaviors such as mask-wearing, hand hygiene, adherence to physical distancing, vaccine uptake, and the spread of misinformation, interpreted in terms of antecedents, consequences, contingencies of reinforcement, and rule-governed behavior.

Search Strategy

The search for relevant publications was conducted between 2019 and 2023 and included nine peer-reviewed journals and one publication series specializing in behavior analysis. The selected journals were: Revista Brasileira de Análise do Comportamento (REBAC), Revista Brasileira de Terapia Comportamental e Cognitiva (RBTCC), Perspectivas em Análise do Comportamento (PAC), Behavior Analysis in Practice (BAIP), Behavior and Social Issues (BSI), The Psychological Record (TPR), Perspectives on Behavior Science (PBS), The Analysis of Verbal Behavior (TAVB), and Education and Treatment of Children (ETC). These journals were chosen based on the indication of behavior-analytic journals described on the site of the Association of Behavior Analysis International (those that publishes articles on human behavior and social issues). In addition, Volumes 9 through 15 of the Comportamento em Foco collection were reviewed, as they were published from 2019 onward and include relevant behavior-analytic contributions.
These sources were selected based on their alignment with the scope of behavior analysis and their inclusion in the journal list maintained by the Association for Behavior Analysis International (ABAI), particularly those that focus on human behavior and social issues. The inclusion of Brazilian journals also reflected the dual-language scope of the review (Portuguese and English) and the relevance of these publications in the Latin American behavior-analytic community.

Search Terms and Retrieval Procedures

Searches were conducted using the journals' internal search engines when available, maintaining the scope as "all content." This applied to REBAC, RBTCC, PAC, BAIP, BSI, and TPR. Four keywords were used in English and combined using the Boolean operator OR: COVID-19, Coronavirus, SARS-CoV-2, and Pandemic. The same keywords were used to search Comportamento em Foco volumes through PDF reader word-search functions, applying each term individually due to the absence of a database system.
After identifying relevant publications, all documents containing at least one of the specified keywords were screened for eligibility. Texts that met the inclusion criteria were downloaded and read in full. For each eligible publication, the following information was extracted and organized into an Excel spreadsheet: (a) author(s), (b) year of publication, (c) title, (d) journal or collection, (e) type of study (theoretical, basic, or applied), and (f) primary research theme(s). These data served as the basis for thematic categorization in the subsequent analysis.

Results and Discussion

A total of 272 documents containing at least one of the selected keywords were retrieved and read in full. Of these, 210 were excluded for not meeting the eligibility criteria, resulting in a final sample of 62 publications. Most of the included studies were published in BAIP, indicating a predominance of applied contributions. In contrast, no relevant articles were identified in PBS or TAVB, suggesting limited publication activity related to COVID-19 in those domains. The selection process is illustrated in Figure 1, and the complete list of included manuscripts is presented in Table 1. The English titles, when available, were used as provided by the original authors.
Figure 1
Flow Diagram of the Publication Identification, Screening, and Inclusion Process
Flow Diagram
Note. Adapted from the PRISMA 2020 Statement flow diagram (Page et al., 2021). Sources included: Behavior Analysis in Practice (BAIP), Behavior and Social Issues (BSI), Comportamento em Foco collection (CEF), Education and Treatment of Children (ETC), Perspectivas em Análise do Comportamento (PAC), Revista Brasileira de Análise do Comportamento (REBAC), Revista Brasileira de Terapia Comportamental e Cognitiva (RBTCC), and The Psychological Record (TPR). No eligible publications were found in Perspectives on Behavior Science (PBS) or The Analysis of Verbal Behavior (TAVB).
Table 1
Descriptive Summary of Included Studies in the Behavior-Analytic Literature on COVID-19
Authors Year Title Journal Study type Thematic Category
Amaral et al. 2023 Depressive symptomatology, social skills and academic competence in children and adolescents in the context of resuming face-to-face classrooms RBTCC Empirical Mental health
Amorim et al. 2020 Promoting social isolation in the COVID-19 pandemic: Considerations of the behavioral analysis of culture REBAC Theoretical Safety behaviors
Andersen et al. 2021 A demonstration of Caregiver-Implemented Functional Analysis of Inappropriate Mealtime Behavior via Telehealth BAIP Empirical Telehealth
Araripe et al. 2019 New arrangements in times of COVID-19: Remote support to care for children with autism spectrum disorder REBAC Theoretical Telehealth
Ávila & de Matos 2023 Effects of remote Behavioral Skills Training on caregivers of a child with Autism Spectrum Disorder PAC Empirical Telehealth
Awasthi et al. 2021 Transitioning ABA services from clinic to telehealth: Case study of an Indian organization's response to COVID-19 lockdown BAIP Empirical Telehealth
Batton et al. 2022 Telehealth training in principles of Applied Behavior Analysis for caregivers of young children with Autism Spectrum Disorders during the COVID-19 pandemic ETC Empirical Telehealth
Baumes et al. 2020 Comparison of telehealth-related ethics and guidelines and a checklist for ethical decision making in the midst of the COVID-19 pandemic BAIP Theoretical Telehealth
Belisle et al. 2021 Developing remote delivery of language and cognitive training for use with children with autism: A technological report BAIP Empirical Telehealth
Belisle et al. 2022 Probability discounting in college students' willingness to isolate during COVID-19: Implications for behavior analysis and public health TPR Empirical Safety behaviors
Bergmann et al. 2021 Adapting direct services for telehealth: A practical tutorial BAIP Theoretical Telehealth
Bondy et al. 2020 Promoting functional communication within the home BAIP Theoretical Social & domestic
Borloti et al. 2020 Mental health and psychological interventions during the COVID-19 pandemic: A panorama REBAC Theoretical Mental health
Britwum et al. 2020 A University-based social services parent-training model: A telehealth adaptation during the COVID-19 pandemic BAIP Theoretical Telehealth
Cameron et al. 2021 Telehealth for family guidance: Acceptance and commitment therapy, parent-focused preference assessment, and activity-based instruction for the support of children with Autism Spectrum Disorder and their families BAIP Empirical Telehealth
Canovas et al. 2019 ABA service delivery for individuals with ASD: Continue in-person services during COVID-19 pandemic? REBAC Theoretical Telehealth
Carneiro et al. 2020 Parent Training via Telehealth to Implement ABA Procedures: A Literature Review and Recommendations During the COVID-19 Pandemic REBAC Theoretical Telehealth
Castro et al. 2020 Videos for remote instruction of caregivers of children with atypical development during the COVID-19 pandemic REBAC Theoretical Telehealth
Colombo et al. 2020 An essential service decision model for ABA providers during crisis BAIP Theoretical Telehealth
Confer et al. 2021 A behavior-analytic approach to antivaccination practices ETC Theoretical Social & domestic
Coon et al. 2022 Eight months of telehealth for a state-funded project in foster care and related services: Progress made and lessons learned BAIP Empirical Telehealth
Costa & De Souza 2019 Tutorial: construction of videos to coach caregivers in the implementation of behavior analytic interventions for individuals with autism spectrum disorder REBAC Theoretical Telehealth
Cox et al. 2020 A proposed process for risk mitigation during the COVID-19 pandemic BAIP Theoretical Safety behaviors
Coyne et al. 2020 First things first: Parent psychological flexibility and self-compassion during COVID-19 BAIP Theoretical Mental health
Crockett et al. 2020 Rapid conversation from clinic to telehealth behavioral services during the COVID-19 pandemic BAIP Empirical Safety behaviors
de-Farias et al. 2023 Mental health in the post-pandemic world: brief analytical-behavioral considerations for a multiprofessional intervention CEF Theoretical Mental health
Dubuque et al. 2020 Creating an automated health attestation system during the COVID-19 pandemic with Microsoft 365 BAIP Theoretical Safety behaviors
Dubuque et al. 2021 Creating an automated health attestation system during the COVID-19 global pandemic using Google's G Suite BAIP Theoretical Safety behaviors
Espinosa et al. 2020 A model of support for families with autism living in the COVID-19 lockdown: Lessons from Italy BAIP Theoretical Telehealth
Frank-Crawford et al. 2021 Mask compliance training for individuals with intellectual and developmental disabilities BAIP Theoretical Safety behaviors
Frederick et al. 2020 Advocacy, collaboration, and intervention: A model of distance special education support services amid COVID-19 BAIP Empirical Telehealth
Frederick et al. 2022 Commitment, collaboration, and problem resolution to promote and sustain access to multifaceted applied behavior-analytic services utilizing telepractice BAIP Theoretical Telehealth
Fronapfel & Demchack 2020 School's out for COVID-19: 50 ways BCBA trainees in special education settings can accrue independent fieldwork experience hours during the pandemic BAIP Theoretical Safety behaviors
Gingles 2022 Center the margin: Equity-based assessment and response strategies to reach underserved communities using a telehealth service delivery model BAIP Theoretical Social & domestic
Gotti et al. 2019 The use of nudges for hand hygiene as a community mitigation strategy in the face of the COVID-19 pandemic REBAC Theoretical Safety behaviors
Harman 2021 The effects of time framing on compliance to hypothetical social-distancing policies related to COVID-19 BAIP Theoretical Safety behaviors
Jimenez-Gomez et al. 2021 Impact of COVID-19 on the applied behavior analysis workforce: Comparison across remote and nonremote workers BAIP Empirical Mental health
King et al. 2020 Best practices: caregiver training resources derived from remote behavioral service delivery within the foster care system BAIP Theoretical Mental health
Kornack et al. 2020 Reopening the doors to center-based ABA services: Clinical and safety protocols during COVID-19 BAIP Theoretical Safety behaviors
Leblanc et al. 2020 The role of compassion and ethics in decision making regarding access to applied behavior analysis services during the COVID-19 crisis: A response to Cox, Plavnick and Brodhead BAIP Theoretical Telehealth
Luiz et al. 2020 A brief analysis of response-cost factors and of the use of safety equipment in preventing COVID-19 spread REBAC Theoretical Safety behaviors
Luiz et al. 2021 Contributions of the Operant Behavioral Economics to pandemic situations: A research proposal CEF Theoretical Research proposals
Maciel et al. 2019 Domestic violence (against women) in Brazil in pandemic times (COVID-19) REBAC Theoretical Social & domestic
Marques & Almeida 2021 Brazilian presidential pronouncements in the pandemic: Effectiveness in crisis communication and rule properties BSI Theoretical Safety behaviors
Mattson et al. 2020 Creating and sharing digital ABA instructional activities: A practical tutorial BAIP Theoretical Telehealth
Moran & Ming 2022 The Mindful action plan: Using the MAP to apply acceptance and commitment therapy to productivity and self-compassion for behavior analysts BAIP Theoretical Mental health
Ninci et al. 2021 Maintaining effective supervision systems for trainees pursuing a behavior analyst certification board certification during the COVID-19 pandemic BAIP Theoretical Telehealth
Nohelty et al. 2022 Effectiveness of telehealth direct therapy for individuals with autism spectrum disorder BAIP Empirical Telehealth
Nohelty et al. 2021 A measure for supporting implementation of telehealth direct therapy with treatment integrity BAIP Theoretical Telehealth
Pelaez & Novak 2020 Returning to school: separation problems and anxiety in the age of pandemics BAIP Theoretical Mental health
Ramírez-Cruz et al. 2023 Behavioral activation for Mexican woman victims of violence during the COVID-19 pandemic: A non-randomized pilot study RBTCC Empirical Social & domestic
Rocha & Hunziker 2023 Considerations on the role of behavioral sciences in policies to combat COVID-19 RBTCC Theoretical Social & domestic
Rodriguez 2020 Maintaining treatment integrity in the face of crisis: A treatment selection model for transitioning direct ABA services to telehealth BAIP Empirical Telehealth
Sampaio & Haydu 2023 Cultural Milieu and group-rules in an elaborated account of metacontingencies: Conceptual analysis and an illustration in a COVID-19 Psychological Support Project ETC Theoretical Social & domestic
Shawler & Blair 2021 A proposed functional analysis of transmission prevention behaviors for a respiratory virus (SARS-CoV-2) BSI Theoretical Safety behaviors
Simmons et al. 2021 Acceptability and feasibility of virtual behavior analysis supervision BAIP Empirical Safety behaviors
Szabo et al. 2020 From Helpless to hero: Promoting values-based behavior and positive family interaction in the midst of COVID-19 BAIP Theoretical Safety behaviors
Tarbox et al. 2021 Taking ACTion: 18 simple strategies for supporting children with Autism during the COVID-19 pandemic BAIP Theoretical Telehealth
Tomaino et al. 2022 An assessment of the feasibility and effectiveness of distance learning for students with severe developmental disabilities and high behavioral needs BAIP Empirical Telehealth
Vascelli & Berardo 2022 Video self-modeling for a student with Dravet Syndrome: An intervention involving parents during COVID-19 pandemic in Italy ETC Empirical Telehealth
Yi & Dixon 2021 Developing and enhancing adherence to a telehealth ABA parent training curriculum for caregivers of children with autism BAIP Empirical Telehealth
Zoder-Martell et al. 2020 Technology to facilitate telehealth in applied behavior analysis BAIP Theoretical Telehealth
Note. BAIP = Behavior Analysis in Practice; BSI = Behavior and Social Issues; CEF = Comportamento em Foco collection; ETC = Education and Treatment of Children; PAC = Perspectivas em Análise do Comportamento; REBAC = Revista Brasileira de Análise do Comportamento; RBTCC = Revista Brasileira de Terapia Comportamental e Cognitiva; TPR = The Psychological Record; PBS = Perspectives on Behavior Science; TAVB = The Analysis of Verbal Behavior.
Figure 2
Distribution of Included Publications across Thematic Categories
Distribution Chart
Among the thematic categories identified in this review, remote service adaptation emerged as a dominant focus within the behavior-analytic literature on COVID-19 (Figure 2). A substantial proportion of the studies addressed the challenges and innovations associated with transitioning face-to-face behavioral services to telehealth modalities. This was particularly evident in research targeting interventions for individuals with Autism Spectrum Disorder (ASD) (e.g., Andersen et al., 2021; Tomaino et al., 2022; Araripe et al., 2019; Awasthi et al., 2021; Baumes et al., 2020; Belisle et al., 2021; Carneiro, 2020; Bergmann et al., 2021; Canovas et al., 2019) and their families or caregivers (e.g., Cameron et al., 2021; Carneiro et al., 2020; Castro et al., 2020; Costa & De Souza, 2019; Espinosa et al., 2020; Tarbox et al., 2021; Yi & Dixon, 2021). These services, typically delivered in person and requiring physical interaction, were significantly disrupted by pandemic-related restrictions. As a result, many studies focused on transitioning behavioral interventions to telehealth platforms to ensure service continuity during lockdowns.
These studies generally concluded that telehealth is a promising alternative for delivering behavioral services, especially during periods of restricted mobility. However, several limitations were noted. Chief among them was unequal access to the necessary technological infrastructure. In many regions, families lack reliable internet connections, appropriate digital devices, or sufficient privacy for conducting remote sessions. The digital divide, therefore, emerged as a significant barrier to equitable service provision. As such, although telehealth demonstrated potential for maintaining behavioral support during the pandemic, its scalability and accessibility remain contingent on broader social and structural supports.
The second most prominent theme within the reviewed literature concerned the promotion of safety behaviors to prevent viral transmission. These studies focused on strategies for increasing adherence to public health measures such as hand hygiene, mask use, and physical distancing. From a behavior-analytic perspective, the emphasis was placed on identifying and manipulating antecedents, consequences, and rules that could facilitate the acquisition and maintenance of these preventive responses (e.g., Belisle et al., 2022; Harman, 2021; Luiz et al., 2020; Marques & de Almeida, 2021; Szabo et al., 2020).
A notable strength of this literature was its focus on the role of environmental arrangements in shaping behavior. Interventions frequently included the specification of hygiene-related actions, verbal prompts, modeling, and contingency management (e.g., Frank-Crawford et al., 2021; Gotti et al., 2019; Shawler & Blair, 2021). Some authors also addressed the potential use of punishment or negative reinforcement procedures to suppress high-risk behaviors (e.g., Amorim et al., 2020), although these approaches were generally considered less sustainable or ethically problematic.
Importantly, the studies underscored that safety behavior interventions must be culturally responsive. Factors such as trust in authorities, access to hygiene materials, community norms, and literacy levels were identified as moderators of intervention effectiveness. For example, Luiz et al. (2020) and Marques and de Almeida (2021) demonstrated that even well-designed behavioral contingencies may fail without congruent communication strategies and structural support. Accordingly, the literature advocates for an intersectional approach that considers cultural values, verbal communities, and social inequities in the design of behavior-change technologies.
The remaining three thematic categories—general mental health, domestic violence, and research proposals—accounted for a smaller but conceptually significant portion of the reviewed publications. These topics addressed behavioral phenomena with broad societal relevance and highlighted the capacity of behavior analysis to interpret and intervene in complex social contexts. Early in the pandemic, public health mandates required that individuals remain at home, which, while necessary for virus containment, intensified exposure to aversive contingencies. Several studies documented increases in domestic violence and deteriorations in interpersonal relationships during this period (e.g., Maciel et al., 2019; Bondy et al., 2020), as well as elevated levels of psychological distress, including anxiety, depression, and fear (e.g., Borloti et al., 2020; Jimenez-Gomez et al., 2021; Moran & Ming, 2022; Pelaez & Novak, 2020).
From a behavior-analytic perspective, these effects were interpreted as the result of disrupted reinforcement schedules, limited access to positive social stimuli, and heightened exposure to aversive events in the home environment. The reviewed studies emphasized the need for further empirical investigation into the contingencies maintaining these behaviors and the development of scalable interventions to reduce their occurrence. Luiz et al. (2021), for example, proposed avenues for exploring how motivational operations and discriminative stimuli function during prolonged isolation. Together, these publications underscored the relevance of behavior analysis not only in service delivery but also in generating conceptual and empirical contributions to address the psychosocial dimensions of public health emergencies.
Several reviewed studies approached domestic violence and pandemic-related mental health deterioration through the lens of behavioral contingencies. The removal of access to positively reinforcing environments—such as workplaces, schools, and social gatherings—combined with prolonged exposure to aversive stimuli (e.g., financial instability, overcrowded housing, uncertainty) likely altered reinforcement patterns and increased escape-maintained and aggression-related behaviors (Jimenez-Gomez et al., 2021; Pelaez & Novak, 2020). In particular, coercive family dynamics may have intensified under conditions of restricted mobility, increasing the likelihood of conflict and violence in the home.
Maciel et al. (2019) emphasized that external protective contingencies—such as school attendance, workplace interactions, and legal aid access—serve as critical buffers against domestic violence. During lockdowns, these contingencies were substantially weakened or eliminated. Similarly, the literature pointed to the reduced availability of socially mediated reinforcement as a factor contributing to increased isolation and psychological distress. As such, behavior analysts have proposed interventions aimed at restoring or substituting these reinforcement sources through remote technologies (e.g., virtual support systems, teleconsultation) and through skill-based interventions such as behavioral skills training.
Luiz et al. (2021) further highlighted the relevance of investigating the role of discriminative stimuli and motivating operations in the emergence of psychological symptoms during long-term isolation. Understanding how these variables modulate behavior could facilitate the development of more precisely targeted interventions. Overall, the reviewed studies reinforced the capacity of behavior analysis to provide conceptually coherent, empirically grounded, and socially significant interpretations of psychological phenomena emerging under crisis conditions.
Because the behavioral challenges posed by the COVID-19 pandemic concern human behavior at individual, community, and institutional levels, understanding the environmental variables that promote protective actions and mitigate adverse psychological effects remains a critical scientific objective. This review contributes to that effort by systematizing the existing behavior-analytic literature on the pandemic. The thematic categorization presented in Table 2 facilitates access to relevant findings for both researchers and practitioners by organizing publications according to target populations and applied domains, such as atypical development, preventive behaviors, mental health, and domestic violence.

Limitations and Directions for Future Research

Despite its utility, the present review has a clear limitation: its scope was restricted to behavior analysis journals. While this ensures conceptual consistency and relevance to the field, it excludes important contributions published in general psychology, interdisciplinary, and public health journals. This focus may limit the visibility of potentially impactful behavior-analytic work published outside specialized outlets and underrepresents integrative or cross-disciplinary efforts. Additionally, the review was limited to publications in Portuguese and English, which may have excluded relevant research in other languages.
Future reviews should consider expanding the scope to include behavior-analytic studies published in broader psychological and interdisciplinary journals. Incorporating perspectives from other areas of psychology could enrich our understanding of how psychologists conceptualized and addressed the behavioral impacts of the COVID-19 crisis.
Furthermore, the present review revealed a relative paucity of empirical studies beyond theoretical or conceptual analyses. Although basic research during public health emergencies is inherently challenging, analog conditions can be created to simulate pandemic-related behavioral contexts—for example, through operant behavioral economics frameworks, as proposed by Luiz et al., 2021. Studies by Harman (2021) and Belisle et al. (2022) demonstrate how such research can be conducted using online survey methods to examine compliance with hypothetical public health policies.
Likewise, applied case reports documenting service adaptations (e.g., telehealth) provide valuable contributions to the development and evaluation of behavior-change technologies under real-world constraints (e.g., Awasthi et al., 2021; Belisle et al., 2021; Cameron et al., 2021; Crockett et al., 2020; Frederick et al., 2020; Jimenez-Gomez et al., 2021; Nohelty et al., 2022; Rodriguez, 2020; Root & Rehfeldt, 2021; Simmons et al., 2021; Tomaino et al., 2022; Yi & Dixon, 2021). These lines of inquiry will be essential for preparing the field to respond effectively to future public health challenges.

Conclusion

This narrative review synthesized behavior-analytic publications on the COVID-19 pandemic, with the aim of organizing existing knowledge to support both scholarly advancement and practical application. The majority of studies addressed the rapid adaptation of behavioral health services to telehealth formats and the promotion of preventive health behaviors. These emphases reflected the urgent demands placed on clinicians and researchers to sustain ethical and effective interventions during a global crisis.
The thematic analysis also revealed contributions related to general mental health, domestic violence, and conceptual frameworks for future inquiry. Collectively, these findings underscore the flexibility of behavior-analytic principles in responding to complex, real-time challenges across multiple domains. However, the review also identified a scarcity of empirical studies, particularly in basic research, and a limited integration of behavior analysis with broader psychological or public health discourses.
The insights presented here may inform the design of scalable, context-sensitive behavioral interventions in future crises. Expanding access to telehealth, leveraging culturally informed behavior-change strategies, and addressing structural barriers—such as digital exclusion and professional scarcity—will be critical. Furthermore, interdisciplinary engagement with other subfields of psychology, including community, health, and cultural-clinical psychology, may enhance both the conceptual depth and practical reach of behavior-analytic science.
Future research should explore how behavior-analytic models can be integrated with systemic approaches to improve public health outcomes in under-resourced settings. By consolidating and critically examining the field's response to COVID-19, this review contributes to building a more responsive, inclusive, and empirically grounded behavioral science.

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Acknowledgements and Authorship
Acknowledgements: The authors did not indicate any acknowledgments.
Conflict of interest: The authors did not indicate any conflicts of interest.
Funding sources: This study received no specific funding.
Contributions: ACML: Conceptualization; Methodology; Formal analysis; Investigation; Resources; Writing — Original Draft; Writing — Review & Editing. MMAT: Conceptualization; Methodology; Formal analysis; Investigation; Resources; Writing — Original Draft; Writing — Review & Editing. JRDS: Conceptualization; Methodology; Formal analysis; Investigation; Resources; Writing — Original Draft; Writing — Review & Editing. CRGK: Methodology. WBSK: Methodology. JSGS: Methodology. MNR: Writing — Original Draft; Writing — Review & Editing.