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Ray D, Dhami R, Lecouturier J, McGowan LJ, Mukherjee A, Vlaev I, Kelly MP, Sniehotta FF. Falsification of home rapid antigen lateral flow tests during the COVID-19 pandemic. Sci Rep 2024; 14:3322. [PMID: 38336852 PMCID: PMC10858045 DOI: 10.1038/s41598-024-53383-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
During the COVID-19 pandemic, lateral flow tests (LFTs) were used to regulate access to work, education, social activities, and travel. However, falsification of home LFT results was a concern. Falsification of test results during an ongoing pandemic is a sensitive issue. Consequently, respondents may not answer truthfully to questions about LFT falsification behaviours (FBs) when asked directly. Indirect questioning techniques such as the Extended Crosswise model (ECWM) can provide more reliable prevalence estimates of sensitive behaviors than direct questioning. Here we report the prevalence of LFT FBs in a representative sample in England (n = 1577) using direct questioning (DQ) and the ECWM. We examine the role of demographic and psychological variables as predictors of LFT FBs. We show that the prevalence estimates of the FBs in the DQ condition were significantly lower than the ECWM estimates, e.g., reporting a negative result without conducting a test: 5.7% DQ vs 18.4% ECWM. Moral norms, subjective norms, anticipated regret, perception of risk to self, and trust in government predicted some of the FBs. Indirect questioning techniques can help provide more realistic and higher quality data about compliance with behavioural regulations to government and public health agencies.
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Affiliation(s)
- Devashish Ray
- NIHR Policy Research Unit in Behavioural Science-Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK.
| | - Raenhha Dhami
- NIHR Policy Research Unit in Behavioural Science-Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Jan Lecouturier
- NIHR Policy Research Unit in Behavioural Science-Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Laura J McGowan
- NIHR Policy Research Unit in Behavioural Science-Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Aritra Mukherjee
- Biostatistics Research Group, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Ivo Vlaev
- NIHR Policy Research Unit in Behavioural Science-Behavioural Science Group, Warwick Business School, University of Warwick, Coventry, UK
| | - Michael P Kelly
- NIHR Policy Research Unit in Behavioural Science-Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Forvie Site, Cambridge, CB2 0SR, UK
| | - Falko F Sniehotta
- NIHR Policy Research Unit in Behavioural Science-Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Department of Public Health, Preventive and Social Medicine, Center for Preventive Medicine and Digital Health Baden-Wuerttemberg, Heidelberg University, Heidelberg, Germany
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2
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Arrahmani F, Gorter A, Elberse J, Buitenhuis AH, Kok G, Spruijt P. Crossroads of well-being and compliance: a qualitative cohort study of visitor restriction policy during the COVID-19 pandemic, the Netherlands, May 2020-December 2021. BMC Public Health 2024; 24:175. [PMID: 38218791 PMCID: PMC10787453 DOI: 10.1186/s12889-024-17665-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/04/2024] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND In this qualitative study we observed in-depth the impact of the visiting restriction policy (VRP, i.e. number of visitors allowed at home) on well-being and compliance during the COVID-19 pandemic to regulate infection rates. METHODS A cohort of 15 interviewees was followed throughout the COVID-19 pandemic in the Netherlands in 12 interview rounds (May 2020-December 2021). Every round semi-structured telephone interviews were conducted by a team of 8 researchers. In total 176 interviews were conducted. RESULTS This study showed that four categories can be identified when observing the impact of the VRP on well-being and compliance. For Resilient-Followers reasons for compliance were risk perception, following government rules, and for some having a small social circle. Because they accepted the situation, well-being was hardly affected. Resilient-Rulebreakers made their own risk assessment of people they met. Their well-being was hardly affected, because they experienced social rest and interpreted the measure in their own way. Suffering-Followers complied, because of risk perception, following government rules, and working in healthcare. However, the VRP had substantial impact on well-being, because social structures were disrupted. Suffering-Rulebreakers gave their own interpretation to the VRP, trying to find a balance between compliance and well-being. We observed that the categories were quite stable over time. CONCLUSIONS The VRP appeared to be a measure with substantial impact on well-being for some, mostly because social structures were disrupted. The measure showed fluctuating compliance, in which feasibility and frequent changes in the VRP played a role. Well-being seemed related to the number of visitors that was allowed; a restriction of four visitors was feasible, while one visitor resulted in a negative breaking-point in resilience, which had an impact on compliance, even among the most compliant. Taken together, this study provides valuable insights into the implications of and compliance to a VRP during different phases of the COVID-19 pandemic, which may contribute to policymaking during future pandemics.
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Affiliation(s)
- Fatima Arrahmani
- Corona Behavioural Unit, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, the Netherlands
| | - Annerike Gorter
- Corona Behavioural Unit, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, the Netherlands
| | - Janneke Elberse
- Corona Behavioural Unit, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, the Netherlands
| | - Anne H Buitenhuis
- Corona Behavioural Unit, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, the Netherlands
| | - Gerjo Kok
- Applied Psychology, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, the Netherlands.
| | - Pita Spruijt
- Corona Behavioural Unit, National Institute for Public Health and the Environment, Postbus 1, 3720 BA, Bilthoven, the Netherlands
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Hashim MJ, Jamil S, Masood M, Govender RD, Shamsi ARA, Al Zaabi A, AB Khan M, Aziz Saleem A, Jamil G. Attitudes and practices toward COVID-19 precautionary measures: A comparative study of health professionals and public. Brain Behav 2023; 13:e3267. [PMID: 37753788 PMCID: PMC10636383 DOI: 10.1002/brb3.3267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/27/2023] [Accepted: 09/11/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Containment of the COVID-19 pandemic has been impaired by the denial and defiance of preventive recommendations. AIMS We aimed to study the attitudes toward COVID-19 social measures among laypersons and healthcare professionals. METHODS We conducted a cross-sectional study in the United Arab Emirates using a self-administered online questionnaire. Both healthcare workers and laypersons were actively recruited. In addition to sociodemographic variables, the questionnaire included questions on anxiety, knowledge, and defiance related to COVID-19. RESULTS A total of 615 individuals with a mean age of 32 years (SD, 12) participated. Females comprised 69% and healthcare workers constituted 60% of the study sample. Among laypersons, over 42% reported having social gatherings at home, and 44% admitted to visiting crowded places. More than half of the respondents felt increased anxiety. Previous COVID-19 infection did not affect attitudes or anxiety levels. Knowledge about COVID-19 was higher among those who were more educated (r = .21). Healthcare workers had lower anxiety than laypersons (p = .002). COVID-19 anxiety was higher among older persons and did not decrease with more knowledge. COVID-19 defiance was higher among younger male respondents from larger households and did not correlate with knowledge. Multivariate analysis showed more defiant attitudes at younger ages. CONCLUSIONS Anxiety-related to the COVID-19 pandemic is more common in older individuals, whereas younger persons were more likely to deny and defy prevention recommendations despite having knowledge of viral transmission. Voluntary compliance by young individuals requires an engaging communication strategy to generate more compassionate attitudes.
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Affiliation(s)
- Muhammad Jawad Hashim
- Department of Family Medicine, College of Medicine and Health SciencesUnited Arab Emirates UniversityAl AinUnited Arab Emirates
| | - Sarah Jamil
- Department of MedicineTawam HospitalAl AinUnited Arab Emirates
| | - Murriam Masood
- Department of MedicineRashid HospitalDubaiUnited Arab Emirates
| | - Romona Devi Govender
- Department of Family Medicine, College of Medicine and Health SciencesUnited Arab Emirates UniversityAl AinUnited Arab Emirates
| | - Ali Rashed Al Shamsi
- Cardiology DivisionDepartment of MedicineTawam HospitalAl AinUnited Arab Emirates
| | - Anwar Al Zaabi
- Cardiology DivisionDepartment of MedicineTawam HospitalAl AinUnited Arab Emirates
| | - Moien AB Khan
- Department of Family Medicine, College of Medicine and Health SciencesUnited Arab Emirates UniversityAl AinUnited Arab Emirates
| | | | - Gohar Jamil
- Cardiology DivisionDepartment of MedicineTawam HospitalAl AinUnited Arab Emirates
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4
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Robin C, Reynolds R, Lambert H, Hickman M, Rubin GJ, Smith LE, Yardley L, Cai S, Zhang T, Mook P, McManus O, Lasseter G, Compston P, Denford S, Zhang J, Amlôt R, Oliver I. Understanding adherence to self-isolation in the first phase of the COVID-19 pandemic in England: a cross-sectional mixed-methods study. BMC Public Health 2023; 23:2074. [PMID: 37872611 PMCID: PMC10594856 DOI: 10.1186/s12889-023-16674-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/31/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND During the early "containment" phase of the COVID-19 response in England (January-March 2020), contact tracing was managed by Public Health England (PHE). Adherence to self-isolation during this phase and how people were making those decisions has not previously been determined. The aim of this study was to gain a better understanding of decisions around adherence to self-isolation during the first phase of the COVID-19 response in England. METHODS A mixed-methods cross sectional study was conducted, including an online survey and qualitative interviews. The overall pattern of adherence was described as never leaving home, leaving home for lower-contact reasons and leaving home for higher-contact reasons. Fisher's exact test was used to test associations between adherence and potentially predictive binary factors. Factors showing evidence of association overall were then considered in relation to the three aspects of adherence individually. Qualitative data were analysed using inductive thematic analysis. RESULTS Of 250 respondents who were advised to self-isolate, 63% reported not leaving home at all during their isolation period, 20% reported leaving only for lower-contact activities (dog walking or exercise) and 16% reported leaving for higher-contact, and therefore higher-risk, reasons. Factors associated with adherence to never going out included: the belief that following isolation advice would save lives, experiencing COVID-19 symptoms, being advised to stay in their room, having help from outside and having regular contact by text message from PHE. Factors associated with non-adherence included being angry about the advice to isolate, being unable to get groceries delivered and concerns about losing touch with friends and family. Interviews highlighted that a sense of duty motivated people to adhere to isolation guidance and where people did leave their homes, these decisions were based on rational calculations of the risk of transmission - people would only leave their homes when they thought they were unlikely to come into contact with others. CONCLUSIONS Understanding adherence to isolation and associated reasoning during the early stages of the pandemic is essential to pandemic preparedness for future emerging infectious disease outbreaks. Individuals make complex decisions around adherence by calibrating transmission risks, therefore treating adherence as binary should be avoided.
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Affiliation(s)
- Charlotte Robin
- Behavioural Science and Insights Unit, UK Health Security Agency, Liverpool, L3 1DS, UK.
| | - Rosy Reynolds
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Helen Lambert
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - G James Rubin
- Department of Psychological Medicine, King's College London, London, UK
| | - Louise E Smith
- Department of Psychological Medicine, King's College London, London, UK
| | - Lucy Yardley
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Psychology Department, University of Southampton, Southampton, UK
| | - Shenghan Cai
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Tingting Zhang
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Piers Mook
- UKHSA, Field Service, Health Protection Operations, London, UK
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Oliver McManus
- UKHSA, Field Service, Health Protection Operations, London, UK
| | - Gemma Lasseter
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Polly Compston
- UKHSA, Field Service, Health Protection Operations, Cambridge, UK
| | - Sarah Denford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Juan Zhang
- Department of Anthropology and Archaeology, University of Bristol, Bristol, UK
| | - Richard Amlôt
- Behavioural Science and Insights Unit, UK Health Security Agency, Salisbury, UK
| | - Isabel Oliver
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- UKHSA, Field Service, Health Protection Operations, Bristol, UK
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5
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Woodland L, Smith LE, Brooks SK, Webster RK, Amlôt R, Rubin A, Rubin GJ. Parent-reported child's close contact with non-household family members and their well-being during the COVID-19 pandemic: A cross-sectional survey. PLoS One 2023; 18:e0292344. [PMID: 37856464 PMCID: PMC10586646 DOI: 10.1371/journal.pone.0292344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 09/18/2023] [Indexed: 10/21/2023] Open
Abstract
In England (UK), at the start of the COVID-19 pandemic the public were required to reduce their physical contacts to slow the spread of COVID-19. We investigated the factors associated with children having: 1) close contact with family members from outside their household ('non-adherent behaviour'); and 2) low well-being (Revised Child Anxiety and Depression Scale). We conducted an online cross-sectional survey, completed at any location of the participant's choice between 8 and 11 June 2020 in parents (n = 2,010) who were aged eighteen years or over and had a school-aged child (4-18 years old). Parents reported that 15% (n = 309) of children had non-adherent contact and that 26% (n = 519) had low well-being. We used a series of binary logistic regressions to investigate associations between outcomes and child and parent characteristics. Children had higher odds of having non-household contact when they had special educational needs [adjusted odds ratio, 2.19 (95% CI, 1.47 to 3.27)], lower well-being [2.65 (95% CI, 2.03 to 3.46)], were vulnerable to COVID-19 [2.17 (95% CI, 1.45 to 3.25)], lived with someone who was over 70 years old [2.56 (95% CI, 1.55 to 4.24)] and their parent had low well-being [1.94 (95% CI, 1.45 to 2.58)]. Children had higher odds of lower well-being when they had special educational needs [4.13 (95% CI, 2.90 to 5.87)], were vulnerable to COVID-19 [3.06 (95% CI, 2.15 to 4.36)], lived with someone else who was vulnerable to COVID-19 [2.08 (95% CI, 1.64 to 2.64)], or lived with someone who was over 70 years old [2.41 (95% CI, 1.51 to 3.83)]. Many children came into contact with non-household family members, mainly for childcare. Factors relating to COVID-19, children's well-being and education were also important. If school closures are needed in future, addressing these issues may help reduce contact.
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Affiliation(s)
- Lisa Woodland
- Department of Psychological Medicine, King’s College London, London, United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, Bristol, United Kingdom
| | - Louise E. Smith
- Department of Psychological Medicine, King’s College London, London, United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, Bristol, United Kingdom
| | - Samantha K. Brooks
- Department of Psychological Medicine, King’s College London, London, United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, Bristol, United Kingdom
| | - Rebecca K. Webster
- Department of Psychology, University of Sheffield, Sheffield, United Kingdom
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, Bristol, United Kingdom
- Behavioural Science and Insights Unit, UK Health Security Agency, Salisbury, United Kingdom
| | - Antonia Rubin
- Trustee at Weald of Kent Grammar School, Tonbridge, Kent, United Kingdom
| | - G. James Rubin
- Department of Psychological Medicine, King’s College London, London, United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, Bristol, United Kingdom
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6
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Courdi C, Ramazan Ali S, Pelletier-Dumas M, Stolle D, Dorfman A, Lina JM, Lacourse É, de la Sablonnière R. How level of understanding and type of used sources relate to adherence to COVID-19 public health measures in Canada. Sci Rep 2023; 13:13065. [PMID: 37567899 PMCID: PMC10421852 DOI: 10.1038/s41598-023-38824-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 07/15/2023] [Indexed: 08/13/2023] Open
Abstract
Previous studies have highlighted the importance of promoting health literacy and minimizing misinformation to encourage higher adherence to key public health measures during the COVID-19 pandemic. This study explores how one's self-reported understanding of information and types of sources used to get information regarding COVID-19 can hinder adherence to public health measures implemented by the Canadian government. Data was collected following a longitudinal design of 11 time points for April 2020 to April 2021. The sub-sample used for this study included 2659 Canadians who completed the survey for at least four time points. Using Latent Class Growth Analysis, we modelled typical trajectories of adherence to three key public health measures: staying home, social distancing and mask wearing. Overall, a lower level of understanding was associated with lower adherence trajectories to public health measures, and vice-versa. Adjusted odds ratio (AOR) showed that the higher the level of understanding, the higher were the chances of following a high adherence trajectory. The type of used sources also showed a significant statistical association with adherence trajectories for social distancing and staying home (AOR: between 1.1 and 3.4). These results are discussed considering future policy implications.
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Affiliation(s)
| | | | | | - Dietlind Stolle
- Department of Political Science, McGill University, Quebec, Canada
| | - Anna Dorfman
- Departement of Psychology, Bar Ilan University, Ramat Gan, Israel
| | - Jean-Marc Lina
- Departement of Electrical Engineering, École de Technologie Supérieure, Montreal, Canada
| | - Éric Lacourse
- Department of Sociology, Université de Montréal, Montreal, Canada.
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7
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Zaildo T, Santino TA, Chaves G, da Silva BAK, Alchieri JC, Patino CM, Leite S, Luz KG, Guerra RO, da Penha THS, da Silva GR, Jácome AC, Monteiro KS, de Mendonça KMPP. Barriers to and facilitators of populational adherence to prevention and control measures of COVID-19 and other respiratory infectious diseases: a qualitative evidence synthesis. Eur Respir Rev 2023; 32:220238. [PMID: 37343960 DOI: 10.1183/16000617.0238-2022] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 04/03/2023] [Indexed: 06/23/2023] Open
Abstract
AIMS To summarise the evidence on barriers to and facilitators of population adherence to prevention and control measures for coronavirus disease 2019 (COVID-19) and other respiratory infectious diseases. METHODS A qualitative synthesis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis and the Cochrane Effective Practice and Organization of Care: Qualitative Evidence Synthesis. We performed an electronic search on MEDLINE, Embase and PsycINFO from their inception to March 2023. RESULTS We included 71 studies regarding COVID-19, pneumonia, tuberculosis, influenza, pertussis and H1N1, representing 5966 participants. The measures reported were vaccinations, physical distancing, stay-at-home policy, quarantine, self-isolation, facemasks, hand hygiene, contact investigation, lockdown, infection prevention and control guidelines, and treatment. Tuberculosis-related measures were access to care, diagnosis and treatment completion. Analysis of the included studies yielded 37 barriers and 23 facilitators. CONCLUSIONS This review suggests that financial and social support, assertive communication, trust in political authorities and greater regulation of social media enhance adherence to prevention and control measures for COVID-19 and infectious respiratory diseases. Designing and implementing effective educational public health interventions targeting the findings of barriers and facilitators highlighted in this review are key to reducing the impact of infectious respiratory diseases at the population level.
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Affiliation(s)
- Tácito Zaildo
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Thayla Amorim Santino
- Department of Physical Therapy, State University of Paraiba, Campina Grande, PB, Brazil
| | | | | | - João Carlos Alchieri
- Department of Psychology, Graduate Program in Science, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Cecilia M Patino
- Department of Population and Public Health Sciences, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Sarah Leite
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Kleber Giovanni Luz
- Department of Infectious Diseases, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ricardo Oliveira Guerra
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Tito Hugo Soares da Penha
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Gabriel Rodrigues da Silva
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Rio Grande do Norte, Natal, RN, Brazil
| | - Ada Cristina Jácome
- Public Health Department of the State of Rio Grande do Norte, Natal, RN, Brazil
| | - Karolinne Souza Monteiro
- Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Natal, RN, Brazil
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8
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Yardley L, Denford S, Kamal A, May T, Kesten JM, French CE, Weston D, Rubin GJ, Horwood J, Hickman M, Amlôt R, Oliver I. The Agile Co-production and Evaluation framework for developing public health interventions, messaging and guidance. Front Public Health 2023; 11:1094753. [PMID: 37435513 PMCID: PMC10331616 DOI: 10.3389/fpubh.2023.1094753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/05/2023] [Indexed: 07/13/2023] Open
Abstract
A lesson identified from the COVID-19 pandemic is that we need to extend existing best practice for intervention development. In particular, we need to integrate (a) state-of-the-art methods of rapidly coproducing public health interventions and messaging to support all population groups to protect themselves and their communities with (b) methods of rapidly evaluating co-produced interventions to determine which are acceptable and effective. This paper describes the Agile Co-production and Evaluation (ACE) framework, which is intended to provide a focus for investigating new ways of rapidly developing effective interventions and messaging by combining co-production methods with large-scale testing and/or real-world evaluation. We briefly review some of the participatory, qualitative and quantitative methods that could potentially be combined and propose a research agenda to further develop, refine and validate packages of methods in a variety of public health contexts to determine which combinations are feasible, cost-effective and achieve the goal of improving health and reducing health inequalities.
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Affiliation(s)
- Lucy Yardley
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- School of Psychology, University of Southampton, Southampton, United Kingdom
- NIHR Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Sarah Denford
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Atiya Kamal
- School of Social Sciences, Birmingham City University, Birmingham, United Kingdom
| | - Tom May
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Jo M. Kesten
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- NIHR Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Clare E French
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Dale Weston
- UK Health Security Agency, London, United Kingdom
| | - G. James Rubin
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, United Kingdom
| | - Jeremy Horwood
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- NIHR Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, United Kingdom
| | - Matthew Hickman
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
- UK Health Security Agency, London, United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, United Kingdom
| | - Isabel Oliver
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
- UK Health Security Agency, London, United Kingdom
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9
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Kyei-Arthur F, Agyekum MW, Afrifa-Anane GF, Larbi RT, Kisaakye P. Perceptions about COVID-19 preventive measures among Ghanaian women. PLoS One 2023; 18:e0284362. [PMID: 37043460 PMCID: PMC10096443 DOI: 10.1371/journal.pone.0284362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 03/29/2023] [Indexed: 04/13/2023] Open
Abstract
Though the advent of COVID-19 vaccines has significantly reduced severe morbidity and mortality, infection rates continue to rise. Therefore, adhering to COVID-19 preventive measures remains essential in the fight against the pandemic, particularly in Africa, where vaccination rates remain low. However, the perceived risk associated with COVID-19 and public education and awareness campaigns has waned over time. COVID-19 vaccine hesitancy is consistently high among women globally. This study, therefore, assessed the facilitators, and barriers to adherence to COVID-19 preventive measures. A qualitative descriptive study was conducted among Ghanaian women. Twenty-seven in-depth interviews were conducted with women in the Greater Accra and Ashanti regions. All interviews were audio-recorded and transcribed verbatim into English. The data were analysed using NVivo 10 software. While some participants found the use of face masks as the easiest, others found it as the most difficult. In addition, institutional and policy decisions such as access to water and the use of public transport impacted individual level adherence to preventive measures. In conclusion, the fight against COVID-19 is not over; hence public education and the provision of facilities that would enhance compliance with preventive measures should continue to be prioritised.
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Affiliation(s)
- Frank Kyei-Arthur
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana
| | - Martin Wiredu Agyekum
- Institute for Educational Research and Innovation Studies, University of Education Winneba, Winneba, Ghana
| | - Grace Frempong Afrifa-Anane
- Department of Environment and Public Health, University of Environment and Sustainable Development, Somanya, Ghana
| | - Reuben Tete Larbi
- Regional Institute for Population Studies, University of Ghana, Legon, Ghana
| | - Peter Kisaakye
- Department of Population Studies, Makerere University, Kampala, Uganda
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10
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Sundiam TGD, Sy JCA, Berdida DJE, Talampas PYR, Suillan HAA, Sumangil EAV, Sunga AME, Sy Juco SNT, Talastas KC. Adherence to COVID-19 health protocols in an online news context in the Philippines: A manifest content analysis. Public Health Nurs 2023; 40:382-393. [PMID: 36805622 DOI: 10.1111/phn.13179] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 01/06/2023] [Accepted: 02/05/2023] [Indexed: 02/23/2023]
Abstract
OBJECTIVES Globally, adherence to COVID-19 health and safety protocols played a crucial role in preventing the spread of the virus. Thus, this study analyzed online news articles reporting adherence to COVID-19 health and safety protocols in the Philippines. DESIGN Manifest content analysis. SAMPLE News articles (n = 192) from three major online news portals in the Philippines. MEASUREMENT Published online news articles were collected during the peak of the COVID-19 pandemic (March 2020 to March 2021). Bengtsson's content analysis approach was used to analyze the data. Member-checking and intercoder reliability validated the study's results. RESULTS Three main themes emerged: (a) adherence, (b) non-adherence, and (c) partial adherence. The subthemes were labeled who, what, when, where, and why. The same behavior, social distancing, was the most adhered to and non-adhered COVID-19 health protocol. This protocol has the highest occurrences in political protest, religious-related activities, and self-initiated quarantine. Leisure activities both showed non-adherence and partial adherence. CONCLUSIONS Online news articles depicted Filipinos' adherence to health and safety protocols. Their adherence was primarily determined by one's group or community, social norms, and values. The government and its public health agencies should strengthen current efforts and continuously re-evaluate existing policies to modify ineffective and confusing safety health protocols.
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11
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Li L, Taeihagh A, Tan SY. A scoping review of the impacts of COVID-19 physical distancing measures on vulnerable population groups. Nat Commun 2023; 14:599. [PMID: 36737447 PMCID: PMC9897623 DOI: 10.1038/s41467-023-36267-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 01/23/2023] [Indexed: 02/05/2023] Open
Abstract
Most governments have enacted physical or social distancing measures to control COVID-19 transmission. Yet little is known about the socio-economic trade-offs of these measures, especially for vulnerable populations, who are exposed to increased risks and are susceptible to adverse health outcomes. To examine the impacts of physical distancing measures on the most vulnerable in society, this scoping review screened 39,816 records and synthesised results from 265 studies worldwide documenting the negative impacts of physical distancing on older people, children/students, low-income populations, migrant workers, people in prison, people with disabilities, sex workers, victims of domestic violence, refugees, ethnic minorities, and people from sexual and gender minorities. We show that prolonged loneliness, mental distress, unemployment, income loss, food insecurity, widened inequality and disruption of access to social support and health services were unintended consequences of physical distancing that impacted these vulnerable groups and highlight that physical distancing measures exacerbated the vulnerabilities of different vulnerable populations.
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Affiliation(s)
- Lili Li
- Policy Systems Group, Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore
| | - Araz Taeihagh
- Policy Systems Group, Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore.
| | - Si Ying Tan
- Alexandra Research Centre for Healthcare in The Virtual Environment (ARCHIVE), Department of Healthcare Redesign, Alexandra Hospital, National University Health System, Singapore, Singapore
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12
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Twamley K, Faircloth C, Iqbal H. COVID labour: Making a 'livable' life under lockdown. THE SOCIOLOGICAL REVIEW 2023; 71:85-104. [PMID: 38603380 PMCID: PMC9713535 DOI: 10.1177/00380261221138203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Drawing on qualitative longitudinal data from 38 families with children in the UK collected between May 2020 and June 2021, this article discusses the extra everyday labour which individuals experienced in going about their daily lives during COVID-19. In particular, we examine in detail the everyday practices of negotiating risk and caring for self and others within the context of the pandemic. We call this COVID labour - the work involved in living through and adjusting to a pandemic. We identify this as constituting three main aspects: seeking and interpreting information; assessing risk; and minimising risk. Like other forms of labour, it is stratified by gender, class and ethnicity. Overall, the analysis contributes to a greater understanding of everyday life 'under lockdown' for families with children, and how 'livable' lives are made under times of great risk.
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Affiliation(s)
| | | | - Humera Iqbal
- Social Research Institute, University College
London, UK
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13
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Balsamo M, Murdock KK, Carlucci L. Psychological factors in adherence to COVID-19 public health restrictions in Italy: A path model testing depressed mood, anxiety, and co-rumination via cellphone. PLoS One 2022; 17:e0278628. [PMID: 36459533 PMCID: PMC9718386 DOI: 10.1371/journal.pone.0278628] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022] Open
Abstract
During the COVID-19 pandemic, the success of major non-pharmaceutical interventions, such as quarantine orders, has depended upon robust rates of citizens' adherence to protocols. Thus, it is critical to public health for research to illuminate factors that affect compliance with contagion-mitigating practices. Previous research has examined sociodemographic factors and aspects of psychological distress as correlates of adherence to public health guidelines. The current study expanded this research to investigate the psychosocial process of co-rumination, which has been identified in previous research as a maladaptive type of social interaction that is associated with elevated levels of anxiety and depression. Data were collected from 932 Italian adults during the initial stages of the highly stressful COVID-19 pandemic and lockdown. A path model was tested to examine multivariate relationships among sociodemographic characteristics, symptoms of psychological distress (i.e., depression and anxiety), co-rumination via cellphone, and self-reported adherence to COVID-19-related public health restrictions. Results revealed that higher rates of co-rumination via cellphone were associated with lower levels of adherence to public health restrictions. Symptoms of depression and anxiety were differentially related to co-rumination processes and adherence to public health restrictions. Higher levels of depression symptoms were directly associated with poorer adherence to public health restrictions, and this path was mediated through higher levels of co-rumination via cellphone. On the contrary, higher levels of state anxiety were directly associated with greater adherence to public health guidelines. This path was also mediated through co-rumination via cellphone. Higher levels of anxiety were correlated with lower levels of co-rumination, which in turn were correlated with lower levels of adherence. These results suggest fruitful directions for future research examining co-rumination as a maladaptive coping behavior that may be addressed within public health interventions.
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Affiliation(s)
- Michela Balsamo
- University of “G. d’Annunzio” Chieti-Pescara, Chieti, Italy
- * E-mail:
| | - Karla Klein Murdock
- Washington and Lee University, Lexington, Virginia, United States of America
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14
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MacNeil S, Deschênes S, Knäuper B, Carrese-Chacra E, Dialahy IZ, Suh S, Durif F, Gouin JP. Group-based trajectories and predictors of adherence to physical distancing during the COVID-19 pandemic. Psychol Health 2022; 37:1492-1510. [PMID: 34951559 DOI: 10.1080/08870446.2021.2014486] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Objective: This study sought to identify psychosocial predictors of trajectories of adherence to physical distancing alongside changes in public health measures during the COVID-19 pandemic. Design: A three-time point longitudinal survey during the first two waves of the COVID-19 pandemic. Methods: Participants (N = 1003) completed self-report measures of adherence to physical distancing over an 8-month period at the start (T1) and end (T2) of the first wave of the pandemic, and the start of the second wave of the pandemic (T3). Participants also completed measures of their health beliefs related to the self and others, social norms, emotional distress, and sociodemographic characteristics. Results: Using group-based trajectory modeling, four trajectories of adherence to physical distancing emerged: a high-adherence trajectory, a slow-declining trajectory, a fluctuating trajectory, and a fast-declining trajectory. The most important psychosocial predictors of poorer adherence trajectories included perceptions of lower self-efficacy and higher barriers to adherence, as well as lower prosocial attitudes towards physical distancing. Conclusion: Public health messages targeting these factors may be most relevant to promote sustained adherence to physical distancing over time in the context of a pandemic.
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Affiliation(s)
- Sasha MacNeil
- Psychology Department, Concordia University, Montreal, Canada
| | - Sonya Deschênes
- School of Psychology, University College Dublin, Dublin, Ireland
| | - Bärbel Knäuper
- Department of Psychology, McGill University, Montreal, Canada
| | | | - Isaora Zefania Dialahy
- Centre Intégré Universitaire de Santé et des Services Sociaux du Nord de l'île de Montréal, Montréal, Canada
| | - Sooyeon Suh
- Department of Psychology, Sungshin Women's University, South Korea
| | - Fabien Durif
- School of Management, Université du Québec à Montreal, Montreal, Canada
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15
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Mchunu GG, Harris O, Nxumalo CT. Exploring primary healthcare practitioners' experiences regarding the coronavirus disease 2019 (COVID-19) pandemic in KwaZulu-Natal, South Africa. Prim Health Care Res Dev 2022; 23:e67. [PMID: 36330843 PMCID: PMC9641673 DOI: 10.1017/s1463423622000536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 06/23/2022] [Accepted: 09/03/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) has spread rapidly around the world since the initial outbreak in Wuhan, China. With the emergence of the Omicron variant, South Africa is presently the epicentre of the COVID-19 pandemic in sub-Saharan Africa. Healthcare workers have been at the forefront of the pandemic in terms of screening, early detection and clinical management of suspected and confirmed COVID-19 cases. Since the beginning of the outbreak, little has been reported on how healthcare workers have experienced the COVID-19 pandemic in South Africa, particularly within a low-income, rural primary care context. METHODS The purpose of the present qualitative study design was to explore primary healthcare practitioners' experiences regarding the COVID-19 pandemic at two selected primary healthcare facilities within a low-income rural context in KwaZulu-Natal, South Africa. Data were collected from a purposive sample of 15 participants, which consisted of nurses, physiotherapists, pharmacists, community caregivers, social workers and clinical associates. The participants were both men and women who were all above the age of 20. Data were collected through individual, in-depth face-to-face interviews using a semi-structured interview guide. Audio recordings were transcribed verbatim. Data were analysed manually by thematic analysis following Tech's steps of data analysis. RESULTS Participants reported personal, occupational and community-related experiences related to the COVID-19 pandemic in South Africa. Personal experiences of COVID-19 yielded superordinate themes of psychological distress, self-stigma, disruption of the social norm, Epiphany and conflict of interest. Occupational experiences yielded superordinate themes of staff infections, COVID-19-related courtesy stigma, resource constraints and poor dissemination of information. Community-related experiences were related to struggles with societal issues, clinician-patient relations and COVID-19 mismanagement of patients. CONCLUSION The findings of this study suggest that primary healthcare practitioners' experiences around COVID-19 are attributed to the catastrophic effects of the COVID-19 pandemic with the multitude of psychosocial consequences forming the essence of these experiences. Ensuring availability of reliable sources of information regarding the pandemic as well as psychosocial support could be valuable in helping healthcare workers cope with living and working during the pandemic.
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Affiliation(s)
- Gugu Gladness Mchunu
- Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Orlando Harris
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Fransisco, CA, USA
| | - Celenkosini Thembelenkosini Nxumalo
- Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
- College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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16
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Daily use of lateral flow devices by contacts of confirmed COVID-19 cases to enable exemption from isolation compared with standard self-isolation to reduce onward transmission of SARS-CoV-2 in England: a randomised, controlled, non-inferiority trial. THE LANCET. RESPIRATORY MEDICINE 2022; 10:1074-1085. [PMID: 36228640 PMCID: PMC9625116 DOI: 10.1016/s2213-2600(22)00267-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/19/2022] [Accepted: 07/12/2022] [Indexed: 11/05/2022]
Abstract
Background In the UK, during the study period (April to July, 2021), all contacts of people with COVID-19 were required to self-isolate for 10 days, which had adverse impacts on individuals and society. Avoiding the need to self-isolate for those who remain uninfected would be beneficial. We investigated whether daily use of lateral flow devices (LFDs) to test for SARS-CoV-2, with removal of self-isolation for 24 h if negative, could be a safe alternative to self-isolation as a means to minimise onward transmission of the virus. Methods We conducted a randomised, controlled, non-inferiority trial in adult contacts identified by COVID-19 contact tracing in England. Consenting participants were randomly assigned to self-isolation (single PCR test, 10-day isolation) or daily contact testing (DCT; seven LFD tests, two PCR tests, no isolation if negative on LFD); participants from a single household were assigned to the same group. Participants were prospectively followed up, with the effect of each intervention on onward transmission established from routinely collected NHS Test and Trace contact tracing data for participants who tested PCR-positive for SARS-CoV-2 during the study period and tertiary cases arising from their contacts (ie, secondary contacts). The primary outcome of the study was the attack rate, the percentage of secondary contacts (close contacts of SARS-CoV-2-positive study participants) who became COVID-19 cases (tertiary cases) in each group. Attack rates were derived from Bernoulli regression models using Huber-White (robust) sandwich estimator clustered standard errors. Attack rates were adjusted for household exposure, vaccination status, and ability to work from home. The non-inferiority margin was 1·9%. The primary analysis was a modified intention-to-treat analysis excluding those who actively withdrew from the study as data from these participants were no longer held. This study is registered with the Research Registry (number 6809). Data collection is complete; analysis is ongoing. Findings Between April 29 and July 28, 2021, 54 923 eligible individuals were enrolled in the study, with final group allocations (following withdrawals) of 26 123 (52·6%) participants in the DCT group and 23 500 (47·4%) in the self-isolation group. Overall, 4694 participants tested positive for SARS-CoV-2 by PCR (secondary cases), 2364 (10·1%) in the self-isolation group and 2330 (8·9%) in the DCT group. Adjusted attack rates (among secondary contacts) were 7·5% in the self-isolation group and 6·3% in the DCT group (difference of –1·2% [95% CI –2·3 to –0·2]; significantly lower than the non-inferiority margin of 1·9%). Interpretation DCT with 24 h exemption from self-isolation for essential activities appears to be non-inferior to self-isolation. This study, which provided evidence for the UK Government's daily lateral flow testing policy for vaccinated contacts of COVID-19 cases, indicated that daily testing with LFDs could allow individuals to reduce the risk of onward transmission while minimising the adverse effects of self-isolation. Although contacts in England are no longer required to isolate, the findings will be relevant for future policy decisions around COVID-19 or other communicable infections. Funding UK Government Department of Health and Social Care.
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17
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McNulty C, Sides E, Thomas A, Kamal A, Syeda RB, Kaissi A, Lecky DM, Patel M, Campos-Matos I, Shukla R, Brown CS, Pareek M, Sollars L, Nellums L, Greenway J, Jones LF. Public views of and reactions to the COVID-19 pandemic in England: a qualitative study with diverse ethnicities. BMJ Open 2022; 12:e061027. [PMID: 35977758 PMCID: PMC9388716 DOI: 10.1136/bmjopen-2022-061027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVES To explore public reactions to the COVID-19 pandemic across diverse ethnic groups. DESIGN Remote qualitative interviews and focus groups in English or Punjabi. Data were transcribed and analysed through inductive thematic analysis. SETTING England and Wales, June to October 2020. PARTICIPANTS 100 participants from 19 diverse 'self-identified' ethnic groups. RESULTS Dismay, frustration and altruism were reported across all ethnic groups during the first 6-9 months of the COVID-19 pandemic. Dismay was caused by participants' reported individual, family and community risks, and loss of support networks. Frustration was caused by reported lack of recognition of the efforts of ethnic minority groups (EMGs), inaction by government to address COVID-19 and inequalities, rule breaking by government advisors, changing government rules around: border controls, personal protective equipment, social distancing, eating out, and perceived poor communication around COVID-19 and the Public Health England COVID-19 disparities report (leading to reported increased racism and social isolation). Altruism was felt by all, in the resilience of National Health Service (NHS) staff and their communities and families pulling together. Data, participants' suggested actions and the behaviour change wheel informed suggested interventions and policies to help control COVID-19. CONCLUSION To improve trust and compliance future reports or guidance should clearly explain any stated differences in health outcomes by ethnicity or other risk group, including specific messages for these groups and concrete actions to minimise any risks. Messaging should reflect the uncertainty in data or advice and how guidance may change going forward as new evidence becomes available. A contingency plan is needed to mitigate the impact of COVID-19 across all communities including EMGs, the vulnerable and socially disadvantaged individuals, in preparation for any rise in cases and for future pandemics. Equality across ethnicities for healthcare is essential, and the NHS and local communities will need to be supported to attain this.
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Affiliation(s)
- Cliodna McNulty
- Antimicrobial Resistance and Healthcare Associated Infections Reference Unit, Public Health England, London, UK
- Primary Care and Interventions Unit, Public Health England, Gloucester, UK
| | - Eirwen Sides
- Primary Care and Interventions Unit, Public Health England, Gloucester, UK
| | - Amy Thomas
- Primary Care and Interventions Unit, Public Health England, Gloucester, UK
| | - Atiya Kamal
- Department of Psychology, Birmingham City University, Birmingham, UK
| | - Rowshonara B Syeda
- Primary Care and Interventions Unit, Public Health England, Gloucester, UK
| | - Awatif Kaissi
- Primary Care and Interventions Unit, Public Health England, Gloucester, UK
| | - Donna M Lecky
- Primary Care and Interventions Unit, Public Health England, Gloucester, UK
| | | | - Ines Campos-Matos
- Migration Health, Health Improvement Directorate, Public Health England, London, UK
| | | | - Colin S Brown
- Department of Bacteria Reference, National Infection Service, Public Health England Colindale, London, UK
| | | | | | | | | | - Leah Ffion Jones
- Behavioural Science and Insights Unit, UK Health Security Agency, Cheltenham, UK
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18
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Wright L, Steptoe A, Fancourt D. Trajectories of Compliance With COVID-19 Related Guidelines: Longitudinal Analyses of 50,000 UK Adults. Ann Behav Med 2022; 56:781-790. [PMID: 35759288 PMCID: PMC9278256 DOI: 10.1093/abm/kaac023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Governments have implemented a range of measures focused on changing citizens' behaviors to lower the transmission of COVID-19. While international data shows that compliance did decline from the start of the pandemic, average trends could mask considerable heterogeneity in compliance behaviors. PURPOSE To explore trajectories of compliance with COVID-19 guidelines. METHODS We used longitudinal data on self-reported compliance from 50,851 adults in the COVID-19 Social Study collected across two waves of the pandemic in the UK (April 01, 2020-February 22, 2021). We modeled typical compliance trajectories using latent class growth analysis (LCGA) and used multinomial logistic regression to examine whether individual personality and demographic characteristics were related to compliance trajectories. RESULTS We selected a four-class LCGA solution. Most individuals maintained high levels of compliance and reported similar levels of compliance across the first and second waves. Approximately 15% of participants had decreasing levels of compliance across the pandemic, reporting noticeably lower levels of compliance in the second wave. Individuals with declining compliance levels were younger on average, in better physical health, had lower empathy and conscientiousness and greater general willingness to take risks. CONCLUSIONS While a minority, not all individuals have maintained high compliance across the pandemic. Decreasing compliance is related to several psychological traits. The results suggest that targeting of behavior change messages later in the pandemic may be needed to increase compliance.
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Affiliation(s)
- Liam Wright
- Centre for Longitudinal Studies, Institute of Education, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK
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19
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Love NK, Ready DR, Turner C, Yardley L, Rubin GJ, Hopkins S, Oliver I. The acceptability of testing contacts of confirmed COVID-19 cases using serial, self-administered lateral flow devices as an alternative to self-isolation. J Med Microbiol 2022; 71. [PMID: 35947525 DOI: 10.1099/jmm.0.001567] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
Introduction. Evidence suggests that although people modify their behaviours, full adherence to self-isolation guidance in England may be suboptimal, which may have a detrimental impact on COVID-19 transmission rates.Hypothesis. Testing asymptomatic contacts of confirmed COVID-19 cases for the presence of SARS-CoV-2 could reduce onward transmission by improving case ascertainment and lessen the impact of self-isolation on un-infected individuals.Aim. This study investigated the feasibility and acceptability of implementing a 'test to enable approach' as part of England's tracing strategy.Methodology. Contacts of confirmed COVID-19 cases were offered serial testing as an alternative to self-isolation using daily self-performed lateral flow device (LFD) tests for the first 7 days post-exposure. Asymptomatic participants with a negative LFD result were given 24 h of freedom from self-isolation between each test. A self-collected confirmatory PCR test was performed on testing positive or at the end of the LFD testing period.Results. Of 1760 contacts, 882 consented to daily testing, of whom 812 individuals were within 48 h of exposure and were sent LFD testing packs. Of those who declined to participate, 39.1% stated they had already accessed PCR testing. Of the 812 who were sent LFD packs, 570 (70.2%) reported one or more LFD results; 102 (17.9%) tested positive. Concordance between reported LFD result and a supplied LFD image was 97.1%. In total, 82.8% of PCR-positive samples and 99.6% of PCR-negative samples were correctly detected by LFD. The proportion of secondary cases from contacts of those who participated in the study and tested positive (6.3%; 95% CI: 3.4-11.1%) was comparable to a comparator group who self-isolated (7.6%; 95% CI: 7.3-7.8%).Conclusion. This study shows a high acceptability, compliance and positivity rates when using self-administered LFDs among contacts of confirmed COVID-19 cases. Offering routine testing as a structured part of the contact tracing process is likely to be an effective method of case ascertainment.
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Affiliation(s)
| | - Derren R Ready
- UK Health Security Agency, England, UK.,Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
| | | | - Lucy Yardley
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,School of Psychological Science, University of Bristol, Bristol, UK.,Department of Psychology, University of Southampton, Southampton, UK
| | - G James Rubin
- Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
| | | | - Isabel Oliver
- UK Health Security Agency, England, UK.,Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
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20
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Hyun WI, Son YH, Jung SO. Infection preventive behaviors and its association with perceived threat and perceived social factors during the COVID-19 pandemic in South Korea: 2020 community health survey. BMC Public Health 2022; 22:1381. [PMID: 35854280 PMCID: PMC9294775 DOI: 10.1186/s12889-022-13755-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 07/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND This study examined why some individuals have not properly performed health prevention behavior during the coronavirus disease 2019 (COVID-19) pandemic. We used data from a community health survey conducted by public health centers in South Korea to identify factors affecting COVID-19 prevention behavior in urban and rural areas. Also, we examined whether individual-level demographic, socio-psychological, and structural variables affected COVID-19 prevention behavior by referring to a model explaining individuals' health prevention behavior. In particular, the study is significant as not many other measures were suggested besides compliance with personal quarantine rules during the early phase of the pandemic in 2020. We hope that the results of this study will be considered in further analysis of infection preventive behavior and in future health crises. METHODS Probability proportional and systematic sampling were used to collect data in 2020 from 229,269 individuals. After exclusion, the valid data from 141,902 adults (86,163 urban and 44,739 rural) were analyzed. We performed t-tests and analyses of variance to ascertain the differences in COVID-19 preventive behaviors according to demographic characteristics, and a post-hoc analysis was conducted using Scheffé's test. Factors that affected participants' COVID-19 preventive behaviors were analyzed using multiple regression analyses. RESULTS The variables significantly influencing COVID-19 preventive behaviors in urban areas were age, gender, living with two or more people, educational level, monthly household income, working status, influenza vaccination, daily life stress, and perceived threat. In rural areas, age, gender, living with two or more people, education level, influenza vaccination, daily life stress, perceived threat, and perceived social factors were significantly associated with increased COVID-19 preventive behaviors. CONCLUSIONS Several demographic characteristics were associated with urban and rural residents' COVID-19-related preventive behaviors. A different approach is needed for the two regions in future policy. Future studies should aim to improve the power of the model and include other factors that may be related to COVID-19 preventive behavior.
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Affiliation(s)
- Woo In Hyun
- College of Nursing, Ewha Woman's University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, Republic of Korea
| | - Yoon Hee Son
- College of Nursing, Ewha Woman's University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, Republic of Korea.
| | - Sun Ok Jung
- College of Nursing, Ewha Woman's University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul, 03760, Republic of Korea
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21
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Woodland L, Hodson A, Webster RK, Amlôt R, Smith LE, Rubin J. A Qualitative Study Evaluating the Factors Affecting Families' Adherence to the First COVID-19 Lockdown in England Using the COM-B Model and TDF. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19127305. [PMID: 35742548 PMCID: PMC9223726 DOI: 10.3390/ijerph19127305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 06/08/2022] [Accepted: 06/13/2022] [Indexed: 12/04/2022]
Abstract
The ability of families to adhere to public health guidance is critical to controlling a pandemic. We conducted qualitative interviews with 30 parents of children aged 18 and under, between 16 and 21 April 2020 when schools in England were closed due to the COVID-19 pandemic. Using the Theoretical Domains Framework, we classified the factors that influenced adherence to seven non-pharmaceutical interventions. We found 40 factors that influenced a family’s ability to adhere. Parents generally indicated they could adhere and reported how their family had changed their behaviour to comply with the guidance. Parents primarily reported they were motivated to adhere out of concern for the health consequences of COVID-19, and because the guidance was delivered by the government. However, we found that reduced access to resources (e.g., technology, transport, and outside space) and social influences that encouraged non-adherent behaviour, decreased adherence. Furthermore, we suggest that families with low psychological and physical ability may face additional challenges to adherence and need to be supported. During future school closures, public health agencies should account for these factors when developing guidance.
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Affiliation(s)
- Lisa Woodland
- Department of Psychological Medicine, King’s College London, NIHR Health Protection Unit in Emergency Preparedness and Response, London SE5 9RJ, UK; (L.E.S.); (J.R.)
- Correspondence:
| | - Ava Hodson
- Department of War Studies, King’s College London, NIHR Health Protection Unit in Emergency Preparedness and Response, London WC2R 2LS, UK;
| | - Rebecca K. Webster
- Department of Psychology, University of Sheffield, Sheffield S10 2LT, UK;
| | - Richard Amlôt
- Behavioural Science and Insights Unit, UK Health Security Agency, Porton Down, NIHR Health Protection Unit in Emergency Preparedness and Response, Salisbury SP4 0JG, UK;
| | - Louise E. Smith
- Department of Psychological Medicine, King’s College London, NIHR Health Protection Unit in Emergency Preparedness and Response, London SE5 9RJ, UK; (L.E.S.); (J.R.)
| | - James Rubin
- Department of Psychological Medicine, King’s College London, NIHR Health Protection Unit in Emergency Preparedness and Response, London SE5 9RJ, UK; (L.E.S.); (J.R.)
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22
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Bodas M, Adini B, Jaffe E, Kaim A, Peleg K. Lockdown Efficacy in Controlling the Spread of COVID-19 May Be Waning Due to Decline in Public Compliance, Especially among Unvaccinated Individuals: A Cross-Sectional Study in Israel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:4943. [PMID: 35564341 PMCID: PMC9104357 DOI: 10.3390/ijerph19094943] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 02/01/2023]
Abstract
Public compliance is paramount for the success of public health measures and decision making, such as lockdowns, in controlling the spread of diseases. The aim of this population-based cross-sectional study was to investigate the level of reported compliance with home isolation among the adult Israeli population (n = 940) during the first three national lockdowns, compliance with a potential fourth national lockdown if enacted, risk perception of COVID-19, vaccination uptake status, perceived effectiveness of the vaccine, and compliance with additional protective health behaviors (e.g., mask wearing and social distancing). Following widespread compliance with initial lockdowns (90.7% reported "high" or "very high" compliance), as few as 60.1% of participants indicated that they would comply with a fourth lockdown if the government decides to enact it. Non-vaccinated individuals reported the lowest levels of compliance with previous lockdowns, compared to participants who received one or two vaccines and participants vaccinated with three doses. Adjusted for gender and age, the results suggest that fearing being infected with COVID-19, perceiving the vaccine to be effective, and reporting being compliant with other health behaviors-such as mask wearing and maintaining social distance from others-are predictors of lockdown compliance. Considering the effect of pandemic lockdown fatigue, there is little support for additional lockdowns among the Israeli public, unless dramatic changes occur in the characteristics of the COVID-19 pandemic. Compliance with lockdowns is reduced among individuals who are at higher risk of contracting COVID-19, therefore rendering this non-pharmaceutical intervention even less effective in reducing the spread of the disease.
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Affiliation(s)
- Moran Bodas
- Department of Emergency & Disaster Management, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, P.O. Box 39040, Tel Aviv 6139001, Israel; (B.A.); (A.K.); (K.P.)
- Israel National Center for Trauma & Emergency Medicine Research, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Ramat-Gan 5266202, Israel
| | - Bruria Adini
- Department of Emergency & Disaster Management, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, P.O. Box 39040, Tel Aviv 6139001, Israel; (B.A.); (A.K.); (K.P.)
| | - Eli Jaffe
- Public Relations, Training and Volunteers Division, Magen David Adom, Igal Alon 70, Tel Aviv 6706215, Israel;
| | - Arielle Kaim
- Department of Emergency & Disaster Management, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, P.O. Box 39040, Tel Aviv 6139001, Israel; (B.A.); (A.K.); (K.P.)
- Israel National Center for Trauma & Emergency Medicine Research, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Ramat-Gan 5266202, Israel
| | - Kobi Peleg
- Department of Emergency & Disaster Management, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, P.O. Box 39040, Tel Aviv 6139001, Israel; (B.A.); (A.K.); (K.P.)
- Israel National Center for Trauma & Emergency Medicine Research, The Gertner Institute for Epidemiology and Health Policy Research, Sheba Medical Center, Tel Hashomer, Ramat-Gan 5266202, Israel
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23
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Public opinion about the UK government during COVID-19 and implications for public health: A topic modeling analysis of open-ended survey response data. PLoS One 2022; 17:e0264134. [PMID: 35421112 PMCID: PMC9009625 DOI: 10.1371/journal.pone.0264134] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/03/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Confidence in the central UK Government has declined since the beginning of the COVID-19 pandemic, and while this may be linked to specific government actions to curb the spread of the virus, understanding is still incomplete. Examining public opinion is important, as research suggests that low confidence in government increases the extent of non-compliance with infection-dampening rules (for instance, social distancing); however, the detailed reasons for this association are still unclear. METHODS To understand public opinion on the central UK government during the first phase of the COVID-19 pandemic, we used structural topic modeling, a text mining technique, to extract themes from over 4000 free-text survey responses, collected between 14 October and 26 November 2020. RESULTS We identified eleven topics, among which were topics related to perceived government corruption and cronyism, complaints about inconsistency in rules and messaging, lack of clear planning, and lack of openness and transparency. Participants reported that elements of the government's approach had made it difficult to comply with guidelines (e.g., changing rules) or were having impacts on mental wellbeing (e.g., inability to plan for the future). CONCLUSIONS Results suggested that consistent, transparent communication and messaging from the government is critical to improving compliance with measures to contain the virus, as well as protecting mental health during health emergencies.
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24
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Understanding Barriers and Facilitators to Compliance with UK Social Distancing Guidelines During the COVID-19 Pandemic: A Qualitative Interview Study. BEHAVIOUR CHANGE 2022. [DOI: 10.1017/bec.2021.27] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
When followed, there is evidence that social distancing measures play a major role in reducing the transmission of viruses such as COVID-19. However, not all individuals follow the guidance. We explored barriers and facilitators to compliance with UK social distancing guidelines during the COVID-19 pandemic through semi-structured interviews with 116 adults. Data were analysed using reflexive thematic analysis and themes mapped to the Capability, Opportunity and Motivation Model of Behaviour (COM-B). Barriers to compliance included inconsistent rules, caring responsibilities, fatigue, unintended consequences of control measures, and the need for emotional support. Facilitators were informational support and social responsibility. Six themes were both a barrier and a facilitator: lived environment, beliefs about consequences of non-compliance, influence of others, practical support, and trust in government. Reflective motivation, psychological capability, and social opportunity were important drivers for compliance. Measures that enable social support alongside strategies to maintain motivation to comply, provide clear guidance and optimise social cohesion should be promoted.
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25
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Covid-19 Coping Survey: an In-depth Qualitative Analysis of Free-Text Responses from People With and Without Existing Health Conditions in the UK. Int J Behav Med 2022; 29:743-751. [PMID: 35132540 PMCID: PMC8821867 DOI: 10.1007/s12529-022-10055-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2021] [Indexed: 11/20/2022]
Abstract
Background There is currently a lack of qualitative research exploring how cognitive and emotional reactions to the threat of SARS-CoV-2 affected the health behaviours of people living with and without pre-existing mental and physical health conditions. We aimed to investigate how the threat of SARS-CoV-2 influenced the thoughts, feelings and health behaviours of people with and without pre-existing health conditions in the UK. Methods A cross-sectional online survey of UK adults (aged 18 and over). Free-text responses were analysed using a qualitative framework approach guided by the Common-Sense Model of Self-Regulation. Results Of the 9110 respondents, 2763 participants provided at least one free-text response. Three main themes were derived from the data. Theme one, locus of control, reports on the extent to which people felt in control during the first wave of the pandemic. Theme two, emotional impact, conveys how individuals felt and how people’s personal circumstances made them more vulnerable to experiencing negative emotions during the pandemic. Theme three, coping strategies, describes common health-protective and health-threatening behaviours performed by individuals, as well as the importance of social connectedness, the social context and the need for collective action during the first national lockdown. Conclusion Complex psychological interventions including behaviour change are required to mitigate the psychological burden of the SARS-CoV-2 pandemic and increase autonomy in people with and without pre-existing conditions during this highly uncertain time. Behavioural scientists can support governments and public health agencies to develop evidence-based communication and behaviour change strategies that support people to address unhelpful beliefs and emotions and strengthen coping abilities as the UK moves through and beyond the SARS-CoV-2 pandemic. Supplementary Information The online version contains supplementary material available at 10.1007/s12529-022-10055-z.
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26
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Wright L, Steptoe A, Mak HW, Fancourt D. Do people reduce compliance with COVID-19 guidelines following vaccination? A longitudinal analysis of matched UK adults. J Epidemiol Community Health 2022; 76:109-115. [PMID: 34244309 PMCID: PMC8275358 DOI: 10.1136/jech-2021-217179] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/22/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION COVID-19 vaccines do not confer immediate immunity and vaccinated individuals may still be at risk of transmitting the virus. Governments have not exempted vaccinated individuals from behavioural measures to reduce the spread of COVID-19, such as practising social distancing. However, vaccinated individuals may have reduced compliance with these measures, given lower perceived risks. METHODS We used monthly panel data from October 2020 to March 2021 in the UK COVID-19 Social Study to assess changes in compliance following vaccination. Compliance was measured with two items on compliance with guidelines in general and compliance with social distancing. We used matching to create comparable groups of individuals by month of vaccination (January, February or not vaccinated by February) and fixed effects regression to estimate changes in compliance over the study period. RESULTS Compliance increased between October 2020 and March 2021, regardless of vaccination status or month of vaccination. There was no clear evidence that vaccinated individuals decreased compliance relative to those who were not yet vaccinated. CONCLUSION There was little evidence that sample members vaccinated in January or February reduced compliance after receiving vaccination for COVID-19. Continued monitoring is required as younger individuals receive the vaccine, lockdown restrictions are lifted and individuals receive second doses of the vaccine.
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Affiliation(s)
- Liam Wright
- Institute of Education, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Hei Wan Mak
- Department of Behavioural Science and Health, University College London, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, University College London, London, UK
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27
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Morton K, Towler L, Groot J, Miller S, Ainsworth B, Denison-Day J, Rice C, Bostock J, Willcox M, Little P, Yardley L. Infection control in the home: a qualitative study exploring perceptions and experiences of adhering to protective behaviours in the home during the COVID-19 pandemic. BMJ Open 2021; 11:e056161. [PMID: 34853116 PMCID: PMC8637310 DOI: 10.1136/bmjopen-2021-056161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVES We sought to explore people's experiences and perceptions of implementing infection control behaviours in the home during the COVID-19 pandemic, guided by an online behavioural intervention. DESIGN Inductive qualitative study. SETTING UK public during the COVID-19 pandemic. PARTICIPANTS Thirteen people took part in telephone interviews, and 124 completed a qualitative open-text survey. All were recruited from the public. Most survey participants were aged over 60 years, while interview participants were more distributed in age. Most reported being at increased risk from COVID-19, and were white British. INTERVENTION Online behavioural intervention to support infection control behaviours in the home during the COVID-19 pandemic. DATA COLLECTION Telephone think-aloud interviews and qualitative survey data. DATA ANALYSIS The think-aloud interview data and qualitative survey data were analysed independently using inductive thematic analysis. The findings were subsequently triangulated. RESULTS Thematic analysis of the telephone interviews generated seven themes: perceived risk; belief in the effectiveness of protective behaviours; acceptability of distancing and isolation; having capacity to perform the behaviours; habit forming reduces effort; having the confidence to perform the behaviours; and social norms affect motivation to engage in the behaviours. The themes identified from the survey data mapped well onto the interview analysis. Isolating and social distancing at home were less acceptable than cleaning and handwashing, influenced by the need for intimacy with household members. This was especially true in the absence of symptoms and when perceived risk was low. People felt more empowered when they understood that even small changes, such as spending some time apart, were worthwhile to reduce exposure and lessen viral load. CONCLUSIONS The current study provided valuable insight into the acceptability and feasibility of protective behaviours, and how public health guidance could be incorporated into a behaviour change intervention for the public during a pandemic.
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Affiliation(s)
- Katherine Morton
- School of Psychology, University of Southampton, Southampton, Hants, UK
| | - Lauren Towler
- School of Psychology, University of Southampton, Southampton, Hants, UK
| | - Julia Groot
- Department of Psychology, University of Bath, Bath, UK
| | - Sascha Miller
- School of Psychology, University of Southampton, Southampton, Hants, UK
| | - Ben Ainsworth
- Department of Psychology, University of Bath, Bath, UK
- NIHR Biomedical Research Centre, Faculty of Medicine, University of Southampton, Southampton, UK
| | - James Denison-Day
- School of Psychology, University of Southampton, Southampton, Hants, UK
| | - Cathy Rice
- The Quality Safety and Outcomes Policy Research Unit, University of Kent, Canterbury, UK
| | - Jennifer Bostock
- The Quality Safety and Outcomes Policy Research Unit, University of Kent, Canterbury, UK
| | - Merlin Willcox
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Paul Little
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Lucy Yardley
- School of Psychology, University of Southampton, Southampton, Hants, UK
- School of Psychological Science, University of Bristol, Bristol, UK
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28
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Smith LE, Potts HWW, Amlȏt R, Fear NT, Michie S, Rubin GJ. Intention to adhere to test, trace, and isolate during the COVID-19 pandemic (the COVID-19 Rapid Survey of Adherence to Interventions and Responses study). Br J Health Psychol 2021; 27:1100-1118. [PMID: 34846088 PMCID: PMC9542361 DOI: 10.1111/bjhp.12576] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 10/29/2021] [Indexed: 12/17/2022]
Abstract
Objectives (1) To investigate factors associated with intention to self‐isolate, request a test, and share details of close contacts when required. (2) To determine whether associations were stronger during periods when less stringent national COVID‐19 restrictions were in place. Design Series of cross‐sectional nationally representative surveys. We selected survey waves where different national restrictions were in place in England (first lockdown, summer release, second lockdown, third lockdown). Methods We investigated whether psychological factors and increased out‐of‐home activity in the last week were associated with intention to self‐isolate and request a test if you were to develop COVID‐19 symptoms, and intention to share details of contacts if you were to test positive. We also investigated whether the strength of associations differed by timepoint in the pandemic. Results Intention to self‐isolate, request a test and share details of contacts were associated with greater perceived risk of COVID‐19 to people in the United Kingdom, knowing that COVID‐19 transmission can be asymptomatic, and agreeing that personal behaviour has an impact on COVID‐19 transmission. There were few differences in strength of associations by timepoint suggesting these effects are broadly stable over time. Conclusions Psychological factors were associated with intention to adhere to key components of the contact tracing system; there was no evidence for an association with increased out‐of‐home activity. Messages that increase knowledge that COVID‐19 can be transmitted even if someone does not have symptoms and that an individual’s actions can contribute to the spread of the virus may promote engagement with the test, trace, and isolate system.
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Affiliation(s)
- Louise E Smith
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.,NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, UK
| | - Henry W W Potts
- Institute of Health Informatics, University College London, UK
| | - Richard Amlȏt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, UK.,Behavioural Science and Insights Unit, UK Health Security Agency, Salisbury, UK
| | - Nicola T Fear
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.,Academic Department of Military Mental Health, King's Centre for Military Health Research, London, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, UK
| | - G James Rubin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK.,NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, UK
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29
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Wang R, Peñuelas J. Monitoring Compliance in Pandemic Management with Air Pollution Data: A Lesson From COVID-19. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:13571-13574. [PMID: 34623155 PMCID: PMC8524960 DOI: 10.1021/acs.est.1c03818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Indexed: 05/07/2023]
Affiliation(s)
- Rong Wang
- Integrated
Research on Disaster Risk, International Center of Excellence (IRDR-ICoE),
Risk Interconnectivity and Governance on Weather/Climate Extremes
Impact and Public Health, Fudan University, Shanghai 200438, China
- Shanghai
Key Laboratory of Atmospheric Particle Pollution and Prevention, Department
of Environmental Science and Engineering, Fudan University, Shanghai 200438, China
| | - Josep Peñuelas
- CREAF,
Cerdanyola del Vallès 08193, Catalonia, Spain
- CSIC,
Global Ecology Unit CREAF-CSIC-UAB, Bellaterra 08193, Catalonia Spain
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30
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Torensma M, Harting J, Boateng L, Agyemang C, Lassooy Tekle Y, Jacob Y, van den Muijsenbergh M, el Fakiri F, Prins M, Stronks K. Contextual factors that shape uptake of COVID-19 preventive measures by persons of Ghanaian and Eritrean origin in the Netherlands: A focus group study. J Migr Health 2021; 4:100070. [PMID: 34693384 PMCID: PMC8520828 DOI: 10.1016/j.jmh.2021.100070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/08/2021] [Accepted: 10/11/2021] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVES To explore the contextual factors that shape uptake of COVID-19 preventive measures, in specific migrant and ethnic minority populations, with a focus on migration-related, sociocultural and socioeconomic conditions. DESIGN A qualitative design, consisting of three online focus group discussions. SETTING This study was conducted amongst smaller, albeit substantial, migrant and minority ethnic populations in the Netherlands. PARTICIPANTS A total of 25 participants (12 male; 13 female) of Ghanaian and Eritrean origin, purposively sampled to ensure diversity within groups, with regards to sex, age, educational level, occupation, household size and length of stay in the Netherlands. Focus group discussions were held online, therefore, experience in the use of video conferencing software was a prerequisite. RESULTS Participants' awareness and knowledge of COVID-19 and COVID-19 preventive measures was shaped by migration-related factors, such as limited Dutch proficiency, by access to understandable information and interference of misinformation. Participants' engagement by COVID-19 preventive measures was subject to COVID-19 threat appraisal and the ease with which complex behavioural messages could be translated to individual situations. Lastly, a strong social norm to keep with cultural and religious practices, and limited opportunity for preventive behaviour in the work and home context hinder the uptake of preventive behaviour following a decision to act according to measures. CONCLUSIONS Migration-related, sociocultural, and socioeconomic factors shape uptake of COVID-19 preventive measures amongst persons of Ghanaian and Eritrean origin in The Netherlands. To ensure equitable uptake our results suggest the importance of timely spread of multilingual information tailored to literacy needs; as well as, education and modelling delivered through online platforms and by leading figures in respective communities; and, regulations to ensure continued access to financial and material resources to minimise negative spill-over effects and exacerbation of inequality.
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Affiliation(s)
- Marieke Torensma
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Janneke Harting
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Linda Boateng
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Charles Agyemang
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Yordi Lassooy Tekle
- Cultuur in Harmonie (RLO), consultancy on migration and integration, cultural mediation and translation services, Zeewolde, the Netherlands
| | - Yodit Jacob
- Pharos, Centre of expertise on health disparities, Utrecht, the Netherlands
| | - Maria van den Muijsenbergh
- Pharos, Centre of expertise on health disparities, Utrecht, the Netherlands
- Department of Primary and Community care, Radboud University Medical Centre, Nijmegen, the Netherlands
| | - Fatima el Fakiri
- Department of Epidemiology, Health Promotion and Care Innovation, Public Health Service of Amsterdam, Amsterdam, the Netherlands
| | - Maria Prins
- Department of Infectious Diseases, Public Health Service of Amsterdam, Amsterdam, the Netherlands
- Department of Infectious Diseases, Amsterdam Infection and Immunity (AII), Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Karien Stronks
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
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31
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Mowbray F, Woodland L, Smith LE, Amlôt R, Rubin GJ. Is My Cough a Cold or Covid? A Qualitative Study of COVID-19 Symptom Recognition and Attitudes Toward Testing in the UK. Front Public Health 2021; 9:716421. [PMID: 34485238 PMCID: PMC8416344 DOI: 10.3389/fpubh.2021.716421] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 07/26/2021] [Indexed: 01/09/2023] Open
Abstract
Objective: Key to reducing the spread of COVID-19 in the UK is increased use of the NHS Test and Trace (NHSTT) system. This study explored one of the main issues that determine whether people engage with NHSTT, how people understand symptoms that may indicate the presence of COVID-19 and that should trigger a request for a test. Methods: In this qualitative study, a series of semi-structured telephone interviews were conducted with 40 people (21 members of the general population, 19 students). There was nearly an equal split between male and female participants in both samples. Data were collected between 30 November and 11 December 2020 and explored using thematic analysis. There was substantial similarity in responses for both populations so we combined our results and highlighted where differences were present. Results: Participants generally had good knowledge of the main symptoms of COVID-19 (high temperature, new, persistent cough, anosmia) but had low confidence in their ability to differentiate them from symptoms of other illnesses. Attribution of symptoms to COVID-19 was most likely where the symptoms were severe, many symptoms were present, symptoms had lasted for some time and when perceived risk of exposure to infection was high due to previous contact with others. Participants felt encouraged to engage in testing where symptoms were present and had persisted for several days, though, many had concerns about the safety of testing centres and the accuracy of test results. Students had mixed feelings about mass asymptomatic testing, seeing it as a way to access a more normal student experience, but also a potential waste of resources. Conclusions: This study offers novel insights into how people attribute symptoms to COVID-19 and barriers and facilitators to engaging with NHSTT. Participants had positive views of testing, but there is a need to improve not just recognition of each main symptom, but also understanding that even single, mild symptoms may necessitate a test rather than a “wait and see” approach, and to address concerns around test accuracy to increase testing uptake.
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Affiliation(s)
- Fiona Mowbray
- Weston Education Centre, King's College London, London, United Kingdom
| | - Lisa Woodland
- Weston Education Centre, King's College London, London, United Kingdom
| | - Louise E Smith
- Weston Education Centre, King's College London, London, United Kingdom
| | - Richard Amlôt
- Emergency Response Department, Public Health England, Salisbury, United Kingdom
| | - G James Rubin
- Weston Education Centre, King's College London, London, United Kingdom
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32
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Denford S, Martin AF, Love N, Ready D, Oliver I, Amlôt R, Yardley L, Rubin GJ. Engagement With Daily Testing Instead of Self-Isolating in Contacts of Confirmed Cases of SARS-CoV-2: A Qualitative Analysis. Front Public Health 2021; 9:714041. [PMID: 34414160 PMCID: PMC8369371 DOI: 10.3389/fpubh.2021.714041] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 07/08/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: In December 2020 and January 2021 Public Health England (PHE) with NHS Test and Trace conducted a study to explore the feasibility and acceptability of daily testing as an alternative to self-isolation following close contact with a confirmed COVID-19 case. This qualitative paper aims to identify factors influencing uptake among those offered daily testing, and the subsequent impact on behaviour. Methods: We conducted in-depth interviews with 52 participants who had taken part in the feasibility study. Participants were asked about their experiences of daily testing or self-isolating, their reasons for choosing to test or isolate, and their behaviour during the study period. Data were analysed using inductive thematic analysis. Results: Results are presented under two main headings: (1) factors influencing acceptance of testing and (2) impact of test results. Participants appeared highly motivated to engage in behaviours that would protect others from the virus. Factors influencing the decision to accept testing included (1) needing to avoid self-isolation, (2) concerns about test sensitivity, and (3) perceived benefits of detecting infection. Participants who were taking tests reported: (1) positive consequences following confirmation of COVID status, (2) engaging in essential activities, (3) uncertainty, and (4) self-isolating whilst testing. Conclusions: This study has identified a range of factors that appear to influence the decision to engage in daily testing or to self-isolate following close contact with a positive case, many of which could be addressed by clear communications. Covid-19 infection rates and government restrictions influenced experiences, and so further research is needed to explore perceptions of daily testing and behaviour following close contact with a positive case among a wider range of individuals, in the context of lower rates of COVID-19, few government restrictions on general population behaviour and more widespread testing.
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Affiliation(s)
- Sarah Denford
- Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Alex F. Martin
- Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, United Kingdom
| | - Nicola Love
- National Infection Service, Public Health England, Bristol, United Kingdom
| | - Derren Ready
- Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
- National Infection Service, Public Health England, Bristol, United Kingdom
| | - Isabel Oliver
- Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
- National Infection Service, Public Health England, Bristol, United Kingdom
| | - Richard Amlôt
- Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
- Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, United Kingdom
- Behavioural Science Team, Emergency Response Department Science and Technology, Public Health England, Salisbury, United Kingdom
| | - Lucy Yardley
- Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, United Kingdom
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
- School of Psychology, University of Southampton, Southampton, United Kingdom
| | - G. James Rubin
- Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, United Kingdom
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Gerotziafas GT, Catalano M, Theodorou Y, Dreden PV, Marechal V, Spyropoulos AC, Carter C, Jabeen N, Harenberg J, Elalamy I, Falanga A, Fareed J, Agathaggelou P, Antic D, Antignani PL, Bosch MM, Brenner B, Chekhonin V, Colgan MP, Dimopoulos MA, Douketis J, Elnazar EA, Farkas K, Fazeli B, Fowkes G, Gu Y, Gligorov J, Ligocki MA, Indran T, Kannan M, Kantarcioglu B, Kasse AA, Konstantinidis K, Leivano F, Lewis J, Makatsariya A, Mbaye PM, Mahé I, Panovska-Stavridis I, Olinic DM, Papageorgiou C, Pecsvarady Z, Pillon S, Ramacciotti E, Abdel-Razeq H, Sabbah M, Sassi M, Schernthaner G, Siddiqui F, Shiomura J, Slama-Schwok A, Wautrecht JC, Tafur A, Taher A, Klein-Wegel P, Zhai Z, Zoubida TM. The COVID-19 Pandemic and the Need for an Integrated and Equitable Approach: An International Expert Consensus Paper. Thromb Haemost 2021; 121:992-1007. [PMID: 34169495 PMCID: PMC8322591 DOI: 10.1055/a-1535-8807] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND One year after the declaration of the coronavirus disease 2019 (COVID-19) pandemic by the World Health Organization (WHO) and despite the implementation of mandatory physical barriers and social distancing, humanity remains challenged by a long-lasting and devastating public health crisis. MANAGEMENT Non-pharmacological interventions (NPIs) are efficient mitigation strategies. The success of these NPIs is dependent on the approval and commitment of the population. The launch of a mass vaccination program in many countries in late December 2020 with mRNA vaccines, adenovirus-based vaccines, and inactivated virus vaccines has generated hope for the end of the pandemic. CURRENT ISSUES The continuous appearance of new pathogenic viral strains and the ability of vaccines to prevent infection and transmission raise important concerns as we try to achieve community immunity against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) and its variants. The need of a second and even third generation of vaccines has already been acknowledged by the WHO and governments. PERSPECTIVES There is a critical and urgent need for a balanced and integrated strategy for the management of the COVID-19 outbreaks organized on three axes: (1) Prevention of the SARS-CoV-2 infection, (2) Detection and early diagnosis of patients at risk of disease worsening, and (3) Anticipation of medical care (PDA). CONCLUSION The "PDA strategy" integrated into state policy for the support and expansion of health systems and introduction of digital organizations (i.e., telemedicine, e-Health, artificial intelligence, and machine-learning technology) is of major importance for the preservation of citizens' health and life world-wide.
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Affiliation(s)
- Grigoris T Gerotziafas
- Sorbonne Université, INSERM, UMR_S 938, Research Group Cancer, Biology and Therapeutics, Centre de recherche Saint-Antoine (CRSA), Institut Universitaire de Cancérologie, Paris, France.,Thrombosis Center, Tenon-Saint Antoine, Hôpitaux Universitaires de l'Est Parisien, Assistance Publique Hôpitaux de Paris (APHP), France
| | - Mariella Catalano
- Research Center on Vascular Disease & Angiology Unit, Department of Biomedical Science, L Sacco Hospital, University of Milan, Milan, Italy
| | - Yiannis Theodorou
- Centre d'Immunologie et des Maladies Infectieuses UPMC UMRS CR7, Inserm U1135, CNRS ERL 8255, Paris, France
| | - Patrick Van Dreden
- Sorbonne Université, INSERM, UMR_S 938, Research Group Cancer, Biology and Therapeutics, Centre de recherche Saint-Antoine (CRSA), Institut Universitaire de Cancérologie, Paris, France
| | - Vincent Marechal
- Sorbonne Université, INSERM, UMR_S 938, Research Group Cancer, Biology and Therapeutics, Centre de recherche Saint-Antoine (CRSA), Institut Universitaire de Cancérologie, Paris, France
| | - Alex C Spyropoulos
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, United States.,Department of Obstetrics and Gynecology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Charles Carter
- Department of Clinical Research, College of Pharmacy & Health Sciences, Campbell University, Buies Creek, North Carolina, United States
| | - Nusrat Jabeen
- Department of Microbiology, University of Karachi, Karachi, Pakistan
| | - Job Harenberg
- Department for Physical Chemistry, Heidelberg University, Heidelberg, Germany.,DOASENSE GmbH, Heidelberg, Germany
| | - Ismail Elalamy
- Sorbonne Université, INSERM, UMR_S 938, Research Group Cancer, Biology and Therapeutics, Centre de recherche Saint-Antoine (CRSA), Institut Universitaire de Cancérologie, Paris, France.,Thrombosis Center, Tenon-Saint Antoine, Hôpitaux Universitaires de l'Est Parisien, Assistance Publique Hôpitaux de Paris (APHP), France.,Department of Obstetrics and Gynecology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | - Anna Falanga
- Immunohematology and Transfusion Medicine Department, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy.,School of Medicine, University of Milan Bicocca, Monza, Italy
| | - Jawed Fareed
- Department of Pathology and Laboratory Medicine, Cardiovascular Research Institute, Health Sciences Division, Loyola University Chicago, Maywood, Illinois, United States.,Department of Pharmacology and Neuroscience, Cardiovascular Research Institute, Health Sciences Division, Loyola University Chicago, Maywood, Illinois, United States
| | - Petros Agathaggelou
- Cyprus Department of Interventional Cardiology, American Heart Institute of Cyprus, Nicosia, Cyprus
| | - Darko Antic
- Clinic of Hematology, Clinical Center of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | | | - Manuel Monreal Bosch
- Department of Internal Medicine, Hospital Universitario Germans Trias i Pujol de Badalona, Universidad Católica de Murcia, Murcia, Spain
| | - Benjamin Brenner
- Thrombosis and Hemostasis Unit, Department of Hematology and Bone Marrow Transplantation, Rambam Health Care Campus, Haifa, Israel.,Bruce Rappaport Faculty of Medicine, The Technion-Israel Institute of Technology, Haifa, Israel
| | - Vladimir Chekhonin
- Department of Fundamental and Applied Neurobiology, V. P. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Mary-Paula Colgan
- Department of Vascular Surgery, St. James's Hospital/Trinity College Dublin, Dublin, Ireland
| | | | - Jim Douketis
- Division of Hematology and Thromboembolism, Department of Medicine, McMaster University, Hamilton, Ontario, Canada.,Division of Thoracic Surgery, St. Joseph's Healthcare Hamilton, Firestone Institute for Respiratory Health, Hamilton, Ontario, Canada
| | | | - Katalin Farkas
- Department of Angiology, St. Imre University Teaching Hospital, Budapest, Hungary
| | - Bahare Fazeli
- Immunology Department, Avicenna (Bu-Ali) Research Institute, Mashhad University of Medical Sciences, Iran
| | - Gerry Fowkes
- Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom
| | - Yongquan Gu
- Department of Vascular Surgery, Xuan Wu Hospital, Capital Medical University and Institute of Vascular Surgery, Capital Medical University, Beijing, China
| | - Joseph Gligorov
- Sorbonne Université, INSERM, UMR_S 938, Research Group Cancer, Biology and Therapeutics, Centre de recherche Saint-Antoine (CRSA), Institut Universitaire de Cancérologie, Paris, France.,Medical Oncology Department, CLIP(2) Galilée, Hôpital Tenon, Hôpitaux Universitaires de l'Est Parisien, Assistance Publique Hôpitaux de Paris (APHP), France
| | - Mark A Ligocki
- Department of Pathology and Laboratory Medicine, Cardiovascular Research Institute, Health Sciences Division, Loyola University Chicago, Maywood, Illinois, United States.,Department of Pharmacology and Neuroscience, Cardiovascular Research Institute, Health Sciences Division, Loyola University Chicago, Maywood, Illinois, United States
| | - Tishya Indran
- Australia Department of Haematology, Monash Health, Clayton, Victoria, Australia
| | - Meganathan Kannan
- Division of Blood and Vascular Biology, Department of Life Sciences, School of Life Sciences, Central University of Tamil Nadu, Thiruvarur, India
| | - Bulent Kantarcioglu
- Department of Hematology, Okmeydani Training and Research Hospital, Istanbul, Turkey
| | - Abdoul Aziz Kasse
- Institut du Cancer UCAD, Centre International de Cancérologie de Dakar, Dakar, Senegal
| | - Kostantinos Konstantinidis
- 5th Surgical Department, Group of Vascular Surgery, Hippokrateio General University Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Fabio Leivano
- Department of Pharmacology and Neuroscience, Cardiovascular Research Institute, Health Sciences Division, Loyola University Chicago, Maywood, Illinois, United States
| | - Joseph Lewis
- Department of Surgery, Stony Brook Southampton Hospital, Southampton, New York, United States
| | - Alexander Makatsariya
- Department of Obstetrics and Gynecology, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation (Sechenov University), Moscow, Russia
| | | | - Isabelle Mahé
- Innovative Therapies in Haemostasis, Hôpital Louis Mourier, APHP, Colombes, Université de Paris, INSERM, F-75006 Paris, France
| | | | - Dan-Mircea Olinic
- Medical Clinic No. 1, University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | - Chryssa Papageorgiou
- Service Anesthésie, Réanimation et Médecine Périopératoire, Hôpital Tenon, Hôpitaux Universitaires de l'Est Parisien, Assistance Publique Hôpitaux de Paris, Faculté de médecine, Sorbonne Université, Paris, France
| | - Zsolt Pecsvarady
- Department of Vascular Medicine, Flor Ferenc Teaching Hospital, Kistarcsa, Hungary
| | - Sergio Pillon
- UOSD Angiology, San Camillo-Forlanini Hospital, National Health Institute ISS, AO San Camillo Forlanini, Rome, Italy
| | - Eduardo Ramacciotti
- Hemostasis & Thrombosis Research Laboratories, Loyola University Medical Center, Maywood, Illinois, United States.,Brazilian Clinical Research Institute, São Paulo, Brazil; Science Valley Research Institute, São Paulo, Brazil
| | - Hikmat Abdel-Razeq
- Department of Internal Medicine, King Hussein Cancer Center, Amman, Jordan
| | - Michele Sabbah
- Sorbonne Université, INSERM, UMR_S 938, Research Group Cancer, Biology and Therapeutics, Centre de recherche Saint-Antoine (CRSA), Institut Universitaire de Cancérologie, Paris, France
| | - Mouna Sassi
- Laboratoire de Biologie, Centre de Maternité et de Néonatologie, Hôpital Fattouma Bourguiba, Monastir, Tunisia
| | - Gerit Schernthaner
- Division of Angiology, Department of Internal Medicine 2, Medical University of Vienna, Vienna, Austria
| | - Fakiha Siddiqui
- Cardiovascular Research Institute, Health Sciences Divisions, Loyola University Chicago, Maywood, Illinois, United States
| | | | - Anny Slama-Schwok
- Sorbonne Université, INSERM, UMR_S 938, Research Group Cancer, Biology and Therapeutics, Centre de recherche Saint-Antoine (CRSA), Institut Universitaire de Cancérologie, Paris, France
| | - Jean Claude Wautrecht
- Service de Pathologie Vasculaire, Hôpital ERASME, Université Libre de Bruxelles, Brussels, Belgium
| | - Alfonso Tafur
- Vascular Medicine, Northshore Cardiovascular Institute, Skokie, Illinois, United States
| | - Ali Taher
- Division of Hematology-Oncology, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Peter Klein-Wegel
- Klinik für Angiologie, Zentrum für Innere Medizin II, Ernst von Bergmann Klinikum, Potsdam, Germany
| | - Zenguo Zhai
- Center of Respiratory Medicine, Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Peking University Health Science Center, Capital Medical University, Beijing, China.,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Tazi Mezalek Zoubida
- Clinical Hematology - Internal Medicine, Ibn Sina hospital, Mohammed V University, -Rabat, Morocco
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Martin AF, Denford S, Love N, Ready D, Oliver I, Amlôt R, Rubin GJ, Yardley L. Engagement with daily testing instead of self-isolating in contacts of confirmed cases of SARS-CoV-2. BMC Public Health 2021; 21:1067. [PMID: 34090404 PMCID: PMC8178661 DOI: 10.1186/s12889-021-11135-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Accepted: 05/19/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND In December 2020, Public Health England with NHS Test and Trace initiated a pilot study in which close contacts of people with confirmed COVID-19 were given the option to carryout lateral flow device antigen tests at home, as an alternative to self-isolation for 10-14 days. In this study, we evaluated engagement with daily testing, and assessed levels of adherence to the rules relating to behaviour following positive or negative test results. METHODS We conducted a service evaluation of the pilot study, examining survey responses from a subset of those who responded to an evaluation questionnaire. We used an online cross-sectional survey offered to adult contacts of confirmed COVID-19 cases who consented to daily testing. We used a comparison group of contacts who were not offered testing and instead self-isolated. RESULTS Acceptability of daily testing was lower among survey respondents who were not offered the option of testing and among people from ethnic minority groups. Overall, 52% of respondents reported being more likely to share details of people that they had been in contact with following a positive test result, if they knew that their contacts would be offered the option of daily testing. Only 2% reported that they would be less likely to provide details of their contacts. On the days that they were trying to self-isolate, 19% of participants reported that they left the house, with no significant group differences. Following a negative test, 13% of respondents reported that they increased their contacts, but most (58%) reported having fewer risky contacts. CONCLUSIONS Our data suggest that daily testing is potentially acceptable, may facilitate sharing contact details of close contacts among those who test positive for COVID-19, and promote adherence to self-isolation. A better understanding is needed of how to make this option more acceptable for all households. The impact of receiving a negative test on behaviour remains a risk that needs to be monitored and mitigated by appropriate messaging. Future research should examine attitudes and behaviour in a context where infection levels are lower, testing is more familiar, and restrictions on activity have been reduced.
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Affiliation(s)
- Alex F Martin
- Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, UK.
- Department of Psychology, King's College London, Institute of Psychiatry, Psychology and Neuroscience, 16 De Crespigny Park, London, SE5 8AF, UK.
| | - Sarah Denford
- Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Nicola Love
- National Infection Service, Public Health England, Bristol, UK
| | - Derren Ready
- Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol, Bristol, UK
- National Infection Service, Public Health England, Bristol, UK
| | - Isabel Oliver
- Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol, Bristol, UK
- National Infection Service, Public Health England, Bristol, UK
| | - Richard Amlôt
- Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, UK
- Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol, Bristol, UK
- Behavioural Science Team, Emergency Response Department Science and Technology, Public Health England, Porton Down, Salisbury, UK
| | - G James Rubin
- Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, UK
| | - Lucy Yardley
- Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
- School of Psychology, University of Southampton, Southampton, UK
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