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Wehling H, Weston D, Hall C, Mills F, Amlôt R, Dennis A, Forbes L, Armes J, Mohamed M, Buckley S, Dar OA, Mohamed A, Wurie F, Shafi S, Zumla SA, Ala A. Use of UK faith Centre as a COVID-19 community vaccination clinic: exploring a potential model for community-based health care delivery. Postgrad Med J 2024:qgae028. [PMID: 38702294 DOI: 10.1093/postmj/qgae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2023] [Accepted: 09/29/2023] [Indexed: 05/06/2024]
Abstract
INTRODUCTION Effective and safe vaccines against COVID-19 are essential to achieve global control of the coronavirus (SARS-CoV-2). Using faith centres may offer a promising route for promoting higher vaccine uptake from certain minority ethnic groups known to be more likely to be vaccine hesitant. METHODS This cross-sectional study explored attendees' perceptions, experiences of being offered, and receiving COVID-19 vaccination in a local mosque in Woking, Surrey, UK. About 199 attendees completed a brief questionnaire on experiences, views, motivations about attending the mosque and vaccination on site. RESULTS The most common ethnic groups reported were White British (39.2%) and Pakistani (22.6%); 36.2% identified as Christian, 23.6% as Muslim, 5.5% as Hindu, and 17.1% had no religion. Genders was relatively equal with 90 men (45.2%) and 98 women (49.2%), and 35-44-year-olds represented the most common age group (28.1%). Views and experiences around receiving vaccinations at the mosque were predominantly positive. Primary reasons for getting vaccinated at the mosque included convenience, accessibility, positive aspects of the venue's intercultural relations, and intentions to protect oneself against COVID-19, regardless of venue type. Negative views and experiences in regards to receiving the vaccination at the mosque were less common (7% expressed no intention of recommending the centre to others), and disliked aspects mostly referred to the travel distance and long waiting times. CONCLUSIONS Offering COVID-19 vaccination in faith centres appears acceptable for different faith groups, ensuring convenient access for communities from all religions and ethnic backgrounds.
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Affiliation(s)
- Helena Wehling
- Behavioural Science and Insights Unit (BSIU), Evaluation and Translation Directorate, UK Health Security Agency, London SP4 0JG, United Kingdom
| | - Dale Weston
- Behavioural Science and Insights Unit (BSIU), Evaluation and Translation Directorate, UK Health Security Agency, London SP4 0JG, United Kingdom
| | - Charlotte Hall
- Behavioural Science and Insights Unit (BSIU), Evaluation and Translation Directorate, UK Health Security Agency, London SP4 0JG, United Kingdom
| | - Freya Mills
- Behavioural Science and Insights Unit (BSIU), Evaluation and Translation Directorate, UK Health Security Agency, London SP4 0JG, United Kingdom
| | - Richard Amlôt
- Behavioural Science and Insights Unit (BSIU), Evaluation and Translation Directorate, UK Health Security Agency, London SP4 0JG, United Kingdom
| | - Amelia Dennis
- Behavioural Science and Insights Unit (BSIU), Evaluation and Translation Directorate, UK Health Security Agency, London SP4 0JG, United Kingdom
| | - Lindsay Forbes
- Centre for Health Services Studies, University of Kent, Canterbury CT2 7NF, United Kingdom
| | - Jo Armes
- School of Health Sciences, University of Surrey, Guildford GU2 7YH, United Kingdom
| | - Munira Mohamed
- Sheerwater Health Centre, Woking, Surrey GU21 5QJ, United Kingdom
| | - Seema Buckley
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7YH, United Kingdom
| | - Osman A Dar
- Chatham House, Royal Institute of International Affairs, London SW1Y 4LE, United Kingdom
- Global Operations, UK Health Security Agency, London E14 4PH United Kingdom
| | - Amran Mohamed
- Department of Access and Medicine, Royal Surrey NHS FT, Guildford GU2 7XX, United Kingdom
| | - Fatima Wurie
- National Inclusion Health Division, Addictions and Inclusion Directorate, Office for Health Improvement and Disparities, London SW1H 0EU, United Kingdom
- Department of Health and Social Care, London SW1H 0EU, United Kingdom
- Public Health Advice Guidance and Expertise Function, UK Health Security Agency, London E14 4PH, United Kingdom
| | - Shuja Shafi
- Mass Gatherings and Global Health Network, London HA4 7AE, United Kingdom
| | - Sir Alimuddin Zumla
- Division of Infection and Immunity, University College London, London, WC1E 6BT, United Kingdom
| | - Aftab Ala
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, GU2 7YH, United Kingdom
- Department of Access and Medicine, Royal Surrey NHS FT, Guildford GU2 7XX, United Kingdom
- Instititute of Liver Studies, King's College Hospital NHS Foundation, London SE5 9RS, United Kingdom
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Smith LE, West R, Potts HWW, Amlôt R, Fear NT, Rubin GJ, Michie S. Factors associated with wearing a facemask in shops in England following removal of a legal requirement to do so during the COVID-19 pandemic. Br J Health Psychol 2024; 29:3-19. [PMID: 37537895 DOI: 10.1111/bjhp.12684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Revised: 05/30/2023] [Accepted: 07/21/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVES We aimed to identify psychological factors associated with the use of facemasks in shops in England following removal of legal requirements to do so, and to compare associations with and without legal restrictions. DESIGN Repeated cross-sectional online surveys (n ≈ 2000 adults) between August 2020 and April 2022 (68,716 responses from 45,682 participants) using quota sampling. METHODS The outcome measure was whether those who had visited a shop for essentials in the previous seven days reported always having worn a facemask versus sometimes or not at all. Psychological predictor variables included worry, perceived risk and severity of COVID-19 and the perceived effectiveness of facemasks. Socio-demographic variables and measures of clinical vulnerability were also measured. For the period following removal of legal restrictions, multivariable regression was used to assess associations between the primary outcome variable and predictors adjusting for socio-demographic and clinical vulnerability measures. The analysis was repeated including interactions between psychological predictors and presence versus absence of legal restrictions. RESULTS Worry about COVID-19, beliefs about risks and severity of COVID-19 and effectiveness of facemasks were substantially and independently associated with the use of facemasks. Removal of legal obligations to wear facemasks was associated with a 25% decrease in wearing facemasks and stronger associations between psychological predictors and wearing facemasks. CONCLUSIONS Legal obligations increase rates of wearing a facemask. Psychological factors associated with wearing a facemask could be targets for interventions aiming to alter rates of wearing a facemask. These interventions may be more effective when there are no legal obligations to wear a face covering in place.
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Affiliation(s)
- Louise E Smith
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, UK
| | - Robert West
- Department of Behavioural Science and Health, University College London, London, UK
| | - Henry W W Potts
- Institute of Health Informatics, University College London, London, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, UK
- Behavioural Science and Insights Unit, UK Health Security Agency, London, UK
| | - Nicola T Fear
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- King's Centre for Military Health Research and Academic Department of Military Mental Health, King's College London, London, UK
| | - G James Rubin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
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Benny L, Smith C, Barnard M, Wolstenholme E, Panjwani M, Ionescu M, Aitken T, Davies J, Austin P, Watson L, Amlôt R. A randomized controlled trial of the impact of support visits on self-isolation compliance: The Havering winter/spring support trial. Br J Health Psychol 2024; 29:221-253. [PMID: 38105036 DOI: 10.1111/bjhp.12696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 04/22/2023] [Accepted: 09/25/2023] [Indexed: 12/19/2023]
Abstract
OBJECTIVES Limited evidence exists on the policies to increase self-isolation compliance, with no experimental evidence. This trial aimed to evaluate the effect of a home visiting intervention in the London Borough of Havering on compliance with self-isolation guidance, relative to positive COVID-19 cases who received no home visits. DESIGN Mixed method evaluation involving a two-arm randomized controlled trial (RCT) with an implementation and process evaluation. METHODS A total of 3878 cases who tested positive for COVID-19 were randomly allocated with equal probability to receive home visits from Havering outreach team staff (n = 1946) or to a control group (n = 1932) who did not receive home visits. Randomization was implemented through a spreadsheet consisting of random numbers generated online that was used to randomly allocate cases to treatment and control. Check-in calls were conducted by a separate blinded contact tracing team on day six of isolation to measure successful self-isolation compliance. The primary intention-to-treat (ITT) analysis was conducted on 3860 cases as 18 patients were excluded from analysis because of the missing outcome data. For the implementation and process evaluation, qualitative, semi-structured, one-to-one interviews were conducted with trial participants in the treatment arm of the RCT (n = 15) and stakeholders within the London Borough of Havering's Adult Social Care and Health Team (n = 8). Qualitative data was analysed thematically using a framework approach. RESULTS Positive cases who were allocated to receive the home visiting intervention (n = 1933) were more likely to report successful self-isolation compared to those allocated to the control group (n = 1927), an effect that was statistically significant (odds ratio 1.204 [95% CI: 1.052, 1.377]; absolute probability difference: 4.1 percentage points [95% CI: 1.2-6.9]). The implementation and process evaluation found that a key driver of compliance was altruistic motivation based on its perceived importance for protecting the community with some participants also reporting the potential of being caught not complying as a driving factor. Participants also reported that the intervention helped them 'feel supported', provided them with information about practical and financial support, and clarified their understanding or increased their awareness of self-isolation and COVID-19 guidance. No harms were reported from this trial. The trial was registered at the ISRCTN registry, number ISRCTN10030612. CONCLUSIONS A home-visiting intervention conducted between January and March 2022 increased the self-isolation compliance of positive COVID-19 cases allocated to receive home visits. The implementation and process evaluation highlighted that the intervention increased individuals' motivation to comply with guidance, and addressed some barriers associated with opportunity and capability to comply. This trial provides much-needed evidence to inform the policy and intervention design to support public health and social measures in future outbreak scenarios.
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Affiliation(s)
- Liza Benny
- Evaluation and Social Research Unit, UK Health Security Agency, London, UK
| | - Cameron Smith
- Evaluation and Social Research Unit, UK Health Security Agency, London, UK
| | - Matthew Barnard
- Evaluation and Social Research Unit, UK Health Security Agency, London, UK
| | - Emily Wolstenholme
- Evaluation and Social Research Unit, UK Health Security Agency, London, UK
| | - Mehr Panjwani
- Evaluation and Social Research Unit, UK Health Security Agency, London, UK
| | - Maria Ionescu
- Evaluation and Social Research Unit, UK Health Security Agency, London, UK
| | | | | | | | | | - Richard Amlôt
- Behavioural Science and Insights Unit, UK Health Security Agency, London, UK
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4
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Hall CE, Wehling H, Stansfield J, South J, Brooks SK, Greenberg N, Amlôt R, Weston D. Examining the role of community resilience and social capital on mental health in public health emergency and disaster response: a scoping review. BMC Public Health 2023; 23:2482. [PMID: 38082247 PMCID: PMC10714503 DOI: 10.1186/s12889-023-17242-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
The ability of the public to remain psychologically resilient in the face of public health emergencies and disasters (such as the COVID-19 pandemic) is a key factor in the effectiveness of a national response to such events. Community resilience and social capital are often perceived as beneficial and ensuring that a community is socially and psychologically resilient may aid emergency response and recovery. This review presents a synthesis of literature which answers the following research questions: How are community resilience and social capital quantified in research?; What is the impact of community resilience on mental wellbeing?; What is the impact of infectious disease outbreaks, disasters and emergencies on community resilience and social capital?; and, What types of interventions enhance community resilience and social capital?A scoping review procedure was followed. Searches were run across Medline, PsycInfo, and EMBASE, with search terms covering both community resilience and social capital, public health emergencies, and mental health. 26 papers met the inclusion criteria.The majority of retained papers originated in the USA, used a survey methodology to collect data, and involved a natural disaster. There was no common method for measuring community resilience or social capital. The association between community resilience and social capital with mental health was regarded as positive in most cases. However, we found that community resilience, and social capital, were initially negatively impacted by public health emergencies and enhanced by social group activities.Several key recommendations are proposed based on the outcomes from the review, which include: the need for a standardised and validated approach to measuring both community resilience and social capital; that there should be enhanced effort to improve preparedness to public health emergencies in communities by gauging current levels of community resilience and social capital; that community resilience and social capital should be bolstered if areas are at risk of disasters or public health emergencies; the need to ensure that suitable short-term support is provided to communities with high resilience in the immediate aftermath of a public health emergency or disaster; the importance of conducting robust evaluation of community resilience initiatives deployed during the COVID-19 pandemic.
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Grants
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- NIHR20008900 National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King's College London and the University of East Anglia
- National Institute for Health Research Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King’s College London and the University of East Anglia
- Office for Health Improvement and Disparities, Department of Health and Social Care, as part of a Collaborative Agreement with Leeds Beckett University.
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Affiliation(s)
- C E Hall
- Behavioural Science and Insights Unit, Evaluation & Translation Directorate, Science Group, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, UK
- Health Protection Research Unit, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - H Wehling
- Behavioural Science and Insights Unit, Evaluation & Translation Directorate, Science Group, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, UK
| | - J Stansfield
- School of Health and Community Studies, Leeds Beckett University, Portland Building, PD519, Portland Place, Leeds, LS1 3HE, UK
| | - J South
- School of Health and Community Studies, Leeds Beckett University, Portland Building, PD519, Portland Place, Leeds, LS1 3HE, UK
| | - S K Brooks
- Health Protection Research Unit, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - N Greenberg
- Health Protection Research Unit, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK
- King's Centre for Military Health Research, Institute of Psychology, Psychiatry and Neuroscience, King's College London, 10 Cutcombe Road, London, SE5 9RJ, UK
| | - R Amlôt
- Behavioural Science and Insights Unit, Evaluation & Translation Directorate, Science Group, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, UK
| | - D Weston
- Behavioural Science and Insights Unit, Evaluation & Translation Directorate, Science Group, UK Health Security Agency, Porton Down, Salisbury, SP4 0JG, UK.
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Ainsworth B, Horwood J, Walter SR, Miller S, Chalder M, De Vocht F, Denison-Day J, Elwenspoek MMC, Curtis HJ, Bates C, Mehrkar A, Bacon S, Goldacre B, Craggs P, Amlôt R, Francis N, Little P, Macleod J, Moore M, Morton K, Rice C, Sterne J, Stuart B, Towler L, Willcox ML, Yardley L. Implementing Germ Defence digital behaviour change intervention via all primary care practices in England to reduce respiratory infections during the COVID-19 pandemic: an efficient cluster randomised controlled trial using the OpenSAFELY platform. Implement Sci 2023; 18:67. [PMID: 38049846 PMCID: PMC10694966 DOI: 10.1186/s13012-023-01321-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 11/15/2023] [Indexed: 12/06/2023] Open
Abstract
BACKGROUND Germ Defence ( www.germdefence.org ) is an evidence-based interactive website that promotes behaviour change for infection control within households. To maximise the potential of Germ Defence to effectively reduce the spread of COVID-19, the intervention needed to be implemented at scale rapidly. METHODS With NHS England approval, we conducted an efficient two-arm (1:1 ratio) cluster randomised controlled trial (RCT) to examine the effectiveness of randomising implementation of Germ Defence via general practitioner (GP) practices across England, UK, compared with usual care to disseminate Germ Defence to patients. GP practices randomised to the intervention arm (n = 3292) were emailed and asked to disseminate Germ Defence to all adult patients via mobile phone text, email or social media. Usual care arm GP practices (n = 3287) maintained standard management for the 4-month trial period and then asked to share Germ Defence with their adult patients. The primary outcome was the rate of GP presentations for respiratory tract infections (RTI) per patient. Secondary outcomes comprised rates of acute RTIs, confirmed COVID-19 diagnoses and suspected COVID-19 diagnoses, COVID-19 symptoms, gastrointestinal infection diagnoses, antibiotic usage and hospital admissions. The impact of the intervention on outcome rates was assessed using negative binomial regression modelling within the OpenSAFELY platform. The uptake of the intervention by GP practice and by patients was measured via website analytics. RESULTS Germ Defence was used 310,731 times. The average website satisfaction score was 7.52 (0-10 not at all to very satisfied, N = 9933). There was no evidence of a difference in the rate of RTIs between intervention and control practices (rate ratio (RR) 1.01, 95% CI 0.96, 1.06, p = 0.70). This was similar to all other eight health outcomes. Patient engagement within intervention arm practices ranged from 0 to 48% of a practice list. CONCLUSIONS While the RCT did not demonstrate a difference in health outcomes, we demonstrated that rapid large-scale implementation of a digital behavioural intervention is possible and can be evaluated with a novel efficient prospective RCT methodology analysing routinely collected patient data entirely within a trusted research environment. TRIAL REGISTRATION This trial was registered in the ISRCTN registry (14602359) on 12 August 2020.
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Affiliation(s)
- Ben Ainsworth
- School of Psychology, University of Southampton, Southampton, UK
- Department of Psychology, University of Bath, Bath, UK
| | - Jeremy Horwood
- NIHR Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK.
- Centre for Academic Primary Care (CAPC), Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK.
- NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation at University of Bristol, Bristol, UK.
| | - Scott R Walter
- NIHR Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Sascha Miller
- School of Psychology, University of Southampton, Southampton, UK
| | - Melanie Chalder
- Centre for Academic Primary Care (CAPC), Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Frank De Vocht
- NIHR Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | | | - Martha M C Elwenspoek
- NIHR Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Helen J Curtis
- Nuffield Department of Primary Care Health Sciences, The Bennett Institute for Applied Data Science, University of Oxford, Oxford, UK
| | | | - Amir Mehrkar
- Nuffield Department of Primary Care Health Sciences, The Bennett Institute for Applied Data Science, University of Oxford, Oxford, UK
| | - Seb Bacon
- Nuffield Department of Primary Care Health Sciences, The Bennett Institute for Applied Data Science, University of Oxford, Oxford, UK
| | - Ben Goldacre
- Nuffield Department of Primary Care Health Sciences, The Bennett Institute for Applied Data Science, University of Oxford, Oxford, UK
| | - Pippa Craggs
- NIHR Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Richard Amlôt
- NIHR Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Behavioural Science and Insights Unit, UK Health Security Agency, London, UK
| | - Nick Francis
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Paul Little
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - John Macleod
- NIHR Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Centre for Academic Primary Care (CAPC), Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
- Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Michael Moore
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Kate Morton
- School of Psychology, University of Southampton, Southampton, UK
| | | | - Jonathan Sterne
- Centre for Academic Primary Care (CAPC), Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
| | - Beth Stuart
- Faculty of Medicine and Dentistry, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Lauren Towler
- School of Psychology, University of Southampton, Southampton, UK
| | | | - Lucy Yardley
- School of Psychology, University of Southampton, Southampton, UK
- NIHR Applied Research Collaboration West (NIHR ARC West), University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK
- Centre for Academic Primary Care (CAPC), Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK
- NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation at University of Bristol, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
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6
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Woodland L, Smith LE, Webster RK, Amlôt R, Rubin JG. Why do children attend school, engage in other activities or socialise when they have symptoms of an infectious illness? A cross-sectional survey. BMJ Open 2023; 13:e071599. [PMID: 37977857 PMCID: PMC10660639 DOI: 10.1136/bmjopen-2023-071599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 09/08/2023] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVES To prevent the spread of infectious disease, children are typically asked not to attend school, clubs or other activities, or socialise with others while they have specific symptoms. Despite this, many children continue to participate in these activities while symptomatic. DESIGN AND SETTING We commissioned a national cross-sectional survey with data collected between 19 November and 18 December 2021. PARTICIPANTS Eligible parents (n=941) were between 18 and 75 years of age, lived in the UK and had at least one child aged between 4 and 17 years. Parents were recruited from a pre-existing pool of potential respondents who had already expressed an interest in receiving market research surveys. OUTCOME MEASURES Parents were asked whether their children had exhibited either recent vomiting, diarrhoea, high temperature/fever, a new continuous cough, a loss or change to their sense of taste or smell in the absence of a negative (PCR) COVID-19 test ('stay-at-home symptoms') since September 2021 and whether they attended school, engaged in other activities outside the home or socialised with members of another household while symptomatic ('non-adherent'). We also measured parent's demographics and attitudes about illness. RESULTS One-third (33%, n=84/251, 95% CI: 28% to 39%) of children were 'non-adherent' in that they had attended activities outside the home or socialised when they had stay-at-home symptoms. Children were significantly more likely to be non-adherent when parents were aged 45 and younger; they allowed their children to make their own decisions about school attendance; they agreed that their child should go to school if they took over-the-counter medication; or they believed that children should go to school if they have mild symptoms of illness. CONCLUSION To reduce the risk of spreading disease, parents and teenagers need guidance to help them make informed decisions about engaging in activities and socialising with others while unwell.
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Affiliation(s)
- Lisa Woodland
- Psychological Medicine, King's College London, London, UK
| | - Louise E Smith
- Psychological Medicine, King's College London, London, UK
| | | | - Richard Amlôt
- Behavioural Science and Insights Unit (BSIU), UK Health Security Agency, London, UK
| | - James G Rubin
- Psychological Medicine, King's College London, London, UK
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May T, Towler L, Smith LE, Horwood J, Denford S, Rubin GJ, Hickman M, Amlôt R, Oliver I, Yardley L. Mpox knowledge, behaviours and barriers to public health measures among gay, bisexual and other men who have sex with men in the UK: a qualitative study to inform public health guidance and messaging. BMC Public Health 2023; 23:2265. [PMID: 37978506 PMCID: PMC10655366 DOI: 10.1186/s12889-023-17196-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 11/09/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The 2022-23 mpox epidemic is the first-time sustained community transmission had been reported in countries without epidemiological links to endemic areas. During that period, the outbreak almost exclusively affected sexual networks of gay, bisexual, or other men who have sex with men (GBMSM) and people living with HIV. In efforts to control transmission, multiple public health measures were implemented, including vaccination, contact tracing and isolation. This study examines knowledge, attitudes, and perceptions of mpox among a sample of GBMSM during the 2022-23 outbreak in the UK, including facilitators for and barriers to the uptake of public health measures. METHODS Interviews were conducted with 44 GBMSM between May and December 2022. Data were analysed using reflexive thematic analysis. Positive and negative comments pertaining to public health measures were collated in a modified version of a 'table of changes' to inform optimisations to public health messages and guidance. RESULTS Most interviewees were well informed about mpox transmission mechanisms and were either willing to or currently adhering to public health measures, despite low perceptions of mpox severity. Measures that aligned with existing sexual health practices and norms were considered most acceptable. Connections to GBMSM networks and social media channels were found to increase exposure to sexual health information and norms influencing protective behaviours. Those excluded or marginalized from these networks found some measures challenging to perform or adhere to. Although social media was a key mode of information sharing, there were preferences for timely information from official sources to dispel exaggerated or misleading information. CONCLUSIONS There are differential needs, preferences, and experiences of GBMSM that limit the acceptability of some mitigation and prevention measures. Future public health interventions and campaigns should be co-designed in consultation with key groups and communities to ensure greater acceptability and credibility in different contexts and communities.
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Affiliation(s)
- Tom May
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK.
- School of Psychological Science, University of Bristol, Bristol, UK.
- Bristol Medical School, University of Bristol, Bristol, UK.
| | - Lauren Towler
- School of Psychological Science, University of Bristol, Bristol, UK
- School of Psychology, University of Southampton, Southampton, UK
| | - Louise E Smith
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jeremy Horwood
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
- Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Applied Research Collaboration West, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Sarah Denford
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
- School of Psychological Science, University of Bristol, Bristol, UK
- Bristol Medical School, University of Bristol, Bristol, UK
| | - G James Rubin
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Matthew Hickman
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
- Bristol Medical School, University of Bristol, Bristol, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
- United Kingdom Health Security Agency, Chief Scientific Officer's Group, London, UK
| | - Isabel Oliver
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
- United Kingdom Health Security Agency, Chief Scientific Officer's Group, London, UK
| | - Lucy Yardley
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, 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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Towler L, Bondaronek P, Papakonstantinou T, Amlôt R, Chadborn T, Ainsworth B, Yardley L. Applying machine-learning to rapidly analyze large qualitative text datasets to inform the COVID-19 pandemic response: comparing human and machine-assisted topic analysis techniques. Front Public Health 2023; 11:1268223. [PMID: 38026376 PMCID: PMC10644111 DOI: 10.3389/fpubh.2023.1268223] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 10/16/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Machine-assisted topic analysis (MATA) uses artificial intelligence methods to help qualitative researchers analyze large datasets. This is useful for researchers to rapidly update healthcare interventions during changing healthcare contexts, such as a pandemic. We examined the potential to support healthcare interventions by comparing MATA with "human-only" thematic analysis techniques on the same dataset (1,472 user responses from a COVID-19 behavioral intervention). Methods In MATA, an unsupervised topic-modeling approach identified latent topics in the text, from which researchers identified broad themes. In human-only codebook analysis, researchers developed an initial codebook based on previous research that was applied to the dataset by the team, who met regularly to discuss and refine the codes. Formal triangulation using a "convergence coding matrix" compared findings between methods, categorizing them as "agreement", "complementary", "dissonant", or "silent". Results Human analysis took much longer than MATA (147.5 vs. 40 h). Both methods identified key themes about what users found helpful and unhelpful. Formal triangulation showed both sets of findings were highly similar. The formal triangulation showed high similarity between the findings. All MATA codes were classified as in agreement or complementary to the human themes. When findings differed slightly, this was due to human researcher interpretations or nuance from human-only analysis. Discussion Results produced by MATA were similar to human-only thematic analysis, with substantial time savings. For simple analyses that do not require an in-depth or subtle understanding of the data, MATA is a useful tool that can support qualitative researchers to interpret and analyze large datasets quickly. This approach can support intervention development and implementation, such as enabling rapid optimization during public health emergencies.
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Affiliation(s)
- Lauren Towler
- School of Psychology, University of Southampton, Southampton, United Kingdom
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
| | - Paulina Bondaronek
- Department of Health and Social Care, Office for Health Improvement and Disparities, London, United Kingdom
- Institute for Health Informatics, University College London, London, United Kingdom
| | - Trisevgeni Papakonstantinou
- Department of Health and Social Care, Office for Health Improvement and Disparities, London, United Kingdom
- Department of Experimental Psychology, Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Richard Amlôt
- Behavioural Science and Insights Unit, UK Health Security Agency, London, United Kingdom
| | - Tim Chadborn
- Department of Health and Social Care, Office for Health Improvement and Disparities, London, United Kingdom
| | - Ben Ainsworth
- Department of Psychology, University of Bath, Bath, United Kingdom
- National Institute for Health Research Biomedical Research Centre, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Lucy Yardley
- School of Psychology, University of Southampton, Southampton, United Kingdom
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
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9
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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10
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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11
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Smith LE, Potts HW, Brainard J, May T, Oliver I, Amlôt R, Yardley L, Rubin GJ. Did mpox knowledge, attitudes and beliefs affect intended behaviour in the general population and men who are gay, bisexual and who have sex with men? An online cross-sectional survey in the UK. BMJ Open 2023; 13:e070882. [PMID: 37827743 PMCID: PMC10583036 DOI: 10.1136/bmjopen-2022-070882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Accepted: 09/21/2023] [Indexed: 10/14/2023] Open
Abstract
OBJECTIVES To investigate rates of mpox beliefs, knowledge and intended behaviours in the general population and in gay, bisexual or other men who have sex with men (GBMSM), and factors associated with intended behaviours. To test the impact of motivational messages (vs a factual control) on intended behaviours. DESIGN Cross-sectional online survey including a nested randomised controlled trial. SETTING Data collected from 5 September 2022 to 6 October 2022. PARTICIPANTS Participants were aged 18 years or over and lived in the UK (general population). In addition, GBMSM were male, and gay, bisexual or had sex with men. The general population sample was recruited through a market research company. GBMSM were recruited through a market research company, the dating app Grindr and targeted adverts on Meta (Facebook and Instagram). MAIN OUTCOME MEASURES Intention to self-isolate, seek medical help, stop all sexual contact, share details of recent sexual contacts and accept vaccination. RESULTS Sociodemographic characteristics differed by sample. There was no effect of very brief motivational messaging on behavioural intentions. Respondents from Grindr and Meta were more likely to intend to seek help immediately, completely stop sexual behaviour and be vaccinated or intend to be vaccinated, but being less likely to intend to self-isolate (ps<0.001). In the general population sample, intending to carry out protective behaviours was generally associated with being female, older, having less financial hardship, greater worry, higher perceived risk to others and higher perceived susceptibility to and severity of mpox (ps<0.001). There were fewer associations with behaviours in the Grindr sample, possibly due to reduced power. CONCLUSIONS GBMSM were more likely to intend to enact protective behaviours, except for self-isolation. This may reflect targeted public health efforts and engagement with this group. Associations with socioeconomic factors suggest that providing financial support may encourage people to engage with protective behaviours.
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Affiliation(s)
- Louise E Smith
- Department of Psychological Medicine, King's College London, London, UK
| | - Henry Ww Potts
- Institute of Health Informatics, University College London, London, UK
| | - Julii Brainard
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Tom May
- School of Psychological Science, University of Bristol, Bristol, UK
| | | | | | - Lucy Yardley
- School of Psychological Science, University of Bristol, Bristol, UK
| | - G James Rubin
- Department of Psychological Medicine, King's College London, London, UK
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12
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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13
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Woodland L, Brooks SK, Webster RK, Amlôt R, Rubin GJ. Risk factors for school-based presenteeism in children: a systematic review. BMC Psychol 2023; 11:169. [PMID: 37221597 DOI: 10.1186/s40359-023-01207-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 05/10/2023] [Indexed: 05/25/2023] Open
Abstract
INTRODUCTION Children attending school whilst unwell, known as school-based presenteeism, results in negative impacts on education and mental and physical health. We aimed to identify the risk factors for this behaviour. METHOD We conducted a systematic search of five databases (11 July 2022) using words associated with school (e.g., school and childcare) and presenteeism (e.g., presenteeism and sick leave). The studies are synthesised according to the risk factors associated with school-based presenteeism and are grouped into themes by related topics. RESULTS Our review included 18 studies, with quantitative, qualitative, and mixed-method study designs. Children, parents, and school staff reported past incidents and intentions for future presenteeism. We identified five themes from these reports: perceptions about the illness / signs and symptom(s); children's characteristics; children's and parents' motivations and attitudes towards school; organisational factors; and school sickness policy. Increased risk of school-based presenteeism was commonly linked to symptoms that were perceived low in severity and unidentifiable, children with a high school absence record, disbelief in children's illness, unsupportive employers, vague school policies and financial consequences. CONCLUSIONS School-based presenteeism is complex due to the competing interests of the multiple individuals involved, such as children, parents, and school staff. Sickness policies need to include clear and specific guidance about illness and the signs and symptoms of diseases and should be communicated to all relevant individuals to mitigate against discrepancies in how the policy is interpreted. Furthermore, parents and school staff need support, such as financial and childcare, to be able to manage children when they are unwell.
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Affiliation(s)
- Lisa Woodland
- Department of Psychological Medicine, King's College London, London, UK.
- NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, United Kingdom.
| | - Samantha K Brooks
- Department of Psychological Medicine, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, United Kingdom
| | | | - Richard Amlôt
- Behavioural Science and Insights Unit, Health Security Agency, Salisbury, United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, United Kingdom
| | - G James Rubin
- Department of Psychological Medicine, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response at King's College London, London, United Kingdom
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14
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Davidson L, Dennis A, Theodoropoulou A, Carter H, Amlôt R, Hesketh I. "I don't want to be a victim again": the impact of repeat assault on police officers. Front Psychol 2023; 14:1145944. [PMID: 37275687 PMCID: PMC10232816 DOI: 10.3389/fpsyg.2023.1145944] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 04/27/2023] [Indexed: 06/07/2023] Open
Abstract
Introduction The frequency of assaults on police officers in the United Kingdom is rising and evidence suggests that exposure to work-place violence can negatively impact wellbeing, for example, increased perceived stress, feeling worn out and tired, and emotional exhaustion. Despite the prevalence of assaults on police officers, little research has examined the impact of repeat assaults on officers' wellbeing. Method For the current study, 12 semi-structured interviews were conducted to investigate the impact of repeat assaults on wellbeing and occupational outcomes in police officers and staff, including impacts on their mental and physical heath, impacts on their work, the impact of prior assaults on future assaults, and what support they were provided with. Results Findings indicate that repeat assaults had a negative impact on participants mental and physical wellbeing. Furthermore, a lack of support both from management and peers within the police force was found to further exacerbate the impact of repeat assaults. However, the provision of support was also identified as a mitigating factor when it was available and provided to participants which helped to protect participants from some of the negative impact of repeat assaults. Discussion Findings provide a unique in-depth perspective into police officers' experiences following repeat assaults, which can in turn inform national policies and help tailor effective support services within the police force.
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Affiliation(s)
- Louise Davidson
- Behavioural Science and Insights Unit, UK Health Security Agency (UKHSA), London, United Kingdom
| | - Amelia Dennis
- Behavioural Science and Insights Unit, UK Health Security Agency (UKHSA), London, United Kingdom
| | - Andriana Theodoropoulou
- Behavioural Science and Insights Unit, UK Health Security Agency (UKHSA), London, United Kingdom
| | - Holly Carter
- Behavioural Science and Insights Unit, UK Health Security Agency (UKHSA), London, United Kingdom
| | - Richard Amlôt
- Behavioural Science and Insights Unit, UK Health Security Agency (UKHSA), London, United Kingdom
| | - Ian Hesketh
- National Forum for Health and Wellbeing at Work, The University of Manchester, Manchester, United Kingdom
- Workforce Development, College of Policing, Ryton on Dunsmore, United Kingdom
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15
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Forbes L, Armes J, Shafi S, Mohamed A, Mustafa R, Dar O, Vandrevala T, Amlôt R, Hayward A, Asaria M, Pirani T, Weston D, Shah S, Zumla A, Ala A. Novel intervention to promote COVID-19 protective behaviours among Black and South Asian communities in the UK: protocol for a mixed-methods pilot evaluation. BMJ Open 2023; 13:e061207. [PMID: 37041047 PMCID: PMC10105914 DOI: 10.1136/bmjopen-2022-061207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/13/2023] Open
Abstract
INTRODUCTION Culturally appropriate interventions to promote COVID-19 health protective measures among Black and South Asian communities in the UK are needed. We aim to carry out a preliminary evaluation of an intervention to reduce risk of COVID-19 comprising a short film and electronic leaflet. METHODS AND ANALYSIS This mixed methods study comprises (1) a focus group to understand how people from the relevant communities interpret and understand the intervention's messages, (2) a before-and-after questionnaire study examining the extent to which the intervention changes intentions and confidence to carry out COVID-19 protective behaviours and (3) a further qualitative study exploring the views of Black and South Asian people of the intervention and the experiences of health professionals offering the intervention. Participants will be recruited through general practices. Data collection will be carried out in the community. ETHICS AND DISSEMINATION The study received Health Research Authority approval in June 2021 (Research Ethics Committee Reference 21/LO/0452). All participants provided informed consent. As well as publishing the findings in peer-reviewed journals, we will disseminate the findings through the UK Health Security Agency, NHS England and the Office for Health Improvement and Disparities and ensure culturally appropriate messaging for participants and other members of the target groups.
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Affiliation(s)
- Lindsay Forbes
- Centre for Health Services Studies, University of Kent, Canterbury, UK
| | - Jo Armes
- School of Health Sciences, University of Surrey, Guildford, UK
| | - Shuja Shafi
- Mass Gatherings and Global Health Network, Harrow, UK
| | - Amran Mohamed
- Department of Access and Medicine, Royal Surrey NHS Foundation Trust, Guildford, UK
| | - Reham Mustafa
- Department of Access and Medicine, Royal Surrey NHS Foundation Trust, Guildford, UK
| | - Osman Dar
- Global Public Health Directorate, UK Health Security Agency, London, UK
| | - Tushna Vandrevala
- Centre for Applied Health and Social Care Research, Faculty of Health, Social Care and Education, Kingston University, London, UK
| | - Richard Amlôt
- Epidemiological and Behavioural Sciences Directorate, UK Health Security Agency, London, UK
| | - Andrew Hayward
- Epidemiology and Public Health, University College London, London, UK
| | - Miqdad Asaria
- Department of Health Policy, London School of Economics, London, UK
| | - Tasneem Pirani
- Department of Critical Care Medicine, King's College Hospital NHS Foundation Trust, London, UK
- School of Immunology & Microbial Sciences, King's College London, London, UK
| | - Dale Weston
- Epidemiological and Behavioural Sciences Directorate, UK Health Security Agency, London, UK
| | | | - Alimuddin Zumla
- Infection and Immunity, University College London, London, UK
| | - Aftab Ala
- Gastroenterology and Hepatology, Royal Surrey County Hospital NHS Foundation Trust, Guildford, UK
- Department of Clinical and Experimental Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
- Institute of Liver Studies, King's College Hospital, London, UK
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Smith LE, Sim J, Cutts M, Dasch H, Amlôt R, Sevdalis N, Rubin GJ, Sherman SM. Psychosocial factors affecting COVID-19 vaccine uptake in the UK: A prospective cohort study (CoVAccS - Wave 3). Vaccine X 2023; 13:100276. [PMID: 36819214 PMCID: PMC9924044 DOI: 10.1016/j.jvacx.2023.100276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023] Open
Abstract
Background We investigated factors associated with COVID-19 vaccine uptake, future vaccination intentions, and changes in beliefs and attitudes over time. Methods Prospective cohort study. 1500 participants completed an online survey in January 2021 (T1, start of vaccine rollout in the UK), of whom 1148 (response rate 76.5 %) completed another survey in October 2021 (T2, all UK adults offered two vaccine doses). Binary logistic regression analysis was used to investigate factors associated with subsequent vaccine uptake. Content analysis was used to investigate the main reasons behind future vaccine intentions (T2). Changes in beliefs and attitudes were investigated using analysis of variance. Findings At T2, 90.0 % (95 % CI 88.2-91.7 %) of participants had received two doses of a COVID-19 vaccine, 2.2 % (95 % CI 1.3-3.0 %) had received one dose, and 7.4 % (95 % CI 5.9-8.9 %) had not been vaccinated. Uptake was associated with higher intention to be vaccinated at T1, greater perceived vaccination social norms, necessity of vaccination, and perceived safety of the vaccine. People who had initiated vaccination reported being likely to complete it, while those who had not yet received a vaccine reported being unlikely to be vaccinated in the future. At T2, participants perceived greater susceptibility to, but lower severity of, COVID-19 (p < 0.001) than at T1. Perceived safety and adequacy of vaccine information were higher (p < 0.001). Interpretation Targeting modifiable beliefs about the safety and effectiveness of vaccination may increase uptake.
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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, UK,Corresponding author at: Department of Psychological Medicine, King’s College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK
| | - Julius Sim
- School of Medicine, Keele University, UK
| | | | - Hannah Dasch
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK,Centre for Implementation Science, King’s College London, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK,Behavioural Science and Insights Unit, UK Health Security Agency, UK
| | - Nick Sevdalis
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, UK,Centre for Implementation Science, King’s 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, UK
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17
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Davies R, Martin AF, Smith LE, Mowbray F, Woodland L, Amlôt R, Rubin GJ. The impact of "freedom day" on COVID-19 health protective behaviour in England: An observational study of hand hygiene, face covering use and physical distancing in public spaces pre and post the relaxing of restrictions. JRSM Open 2023; 14:20542704231153563. [PMID: 36895854 PMCID: PMC9989406 DOI: 10.1177/20542704231153563] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Objectives To study the prevalence of COVID-19 health protective behaviours before and after rules eased in England on the 19th July 2021. Design Observational study pre (12th-18th July) and post (26th July-1st August) 19th July, and a cross-sectional online survey (26th to 27th July). Setting Observations occurred in supermarkets (n = 10), train stations (n = 10), bus stops (n = 10), a coach station (n = 1) and a London Underground station (n = 1). The survey recruited a nationally representative sample. Participants All adults entering the observed locations during a one-hour period (n = 3819 pre- and n = 2948 post-19th July). In the online survey, 1472 respondents reported having been shopping for groceries/visited a pharmacy and 566 reported having used public transport or having been in a taxi/minicab in the last week. Main outcome measures We observed whether people wore a face covering, maintained distance from others and cleaned their hands. We investigated self-reports of wearing a face covering while in shops or using public transport. Results In most locations observed, the proportion of people wearing face coverings, cleaning the hands and maintaining physical distance declined post 19th July. Pre 19th July, 70.2% (95% CI 68.7 to 71.7%) of people were observed to be wearing a face covering versus 55.8% (54.2 to 57.9%) post 19th July. Equivalent rates for physical distancing were 40.9% (39.0 to 42.8%) versus 29.5% (27.4 to 31.7%), and for hand hygiene were 4.4% (3.8 to 5.1%) versus 3.9% (3.2 to 4.6%). Self-reports of "always" wearing face coverings were broadly similar to observed rates. Conclusions Adherence to protective behaviours was sub-optimal and declined during the relaxation of restrictions, despite appeals to exercise caution. Self-reports of "always" wearing a face covering in specific locations appear valid.
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Affiliation(s)
- Rachel Davies
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Alex F Martin
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Louise E Smith
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Fiona Mowbray
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Lisa Woodland
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, United Kingdom of Great Britain and Northern Ireland
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, United Kingdom of Great Britain and Northern Ireland.,Behavioural Science and Insights Unit, UK Health Security Agency, London, United Kingdom of Great Britain and Northern Ireland
| | - G James Rubin
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, United Kingdom of Great Britain and Northern Ireland
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18
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Smith LE, Sim J, Sherman SM, Amlôt R, Cutts M, Dasch H, Sevdalis N, Rubin GJ. Psychological factors associated with reporting side effects following COVID-19 vaccination: A prospective cohort study (CoVAccS - Wave 3). J Psychosom Res 2023; 164:111104. [PMID: 36495757 PMCID: PMC9708101 DOI: 10.1016/j.jpsychores.2022.111104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2022] [Revised: 11/24/2022] [Accepted: 11/26/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To investigate symptom reporting following the first and second COVID-19 vaccine doses, attribution of symptoms to the vaccine, and factors associated with symptom reporting. METHODS Prospective cohort study (T1: 13-15 January 2021, T2: 4-15 October 2021). Participants were aged 18 years or older, living in the UK. Personal, clinical, and psychological factors were investigated at T1. Symptoms were reported at T2. We used logistic regression analyses to investigate associations. RESULTS After the first COVID-19 vaccine dose, 74.1% (95% CI 71.4% to 76.7%, n = 762/1028) of participants reported at least one injection-site symptom, while 65.0% (95% CI 62.0% to 67.9%, n = 669/1029) reported at least one other (non-injection-site) symptom. Symptom reporting was associated with being a woman and younger. After the second dose, 52.9% (95% CI 49.8% to 56.0%, n = 532/1005) of participants reported at least one injection-site symptom and 43.7% (95% CI 40.7% to 46.8%, n = 440/1006) reported at least one other (non-injection-site) symptom. Symptom reporting was associated with having reported symptoms after the first dose, having an illness that put one at higher risk of COVID-19 (non-injection-site symptoms only), and not believing that one had enough information about COVID-19 to make an informed decision about vaccination (injection-site symptoms only). CONCLUSIONS Women and younger people were more likely to report symptoms from vaccination. People who had reported symptoms from previous doses were also more likely to report symptoms subsequently, although symptom reporting following the second vaccine was lower than following the first vaccine. Few psychological factors were associated with symptom reporting.
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Affiliation(s)
- Louise E. Smith
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Weston Education Centre, King’s College London, London SE5 9RJ, UK,NIHR Health Protection Research Unit in Emergency Preparedness and Response, Weston Education Centre, King’s College London, London SE5 9RJ, UK,Corresponding author at: Department of Psychological Medicine, Weston Education Centre, Cutcombe Road, London, SE5 9RJ, UK
| | - Julius Sim
- School of Medicine, David Weatherall Building, University Road, Keele University, Staffordshire, ST5 5BG, UK
| | - Susan M. Sherman
- School of Psychology, Dorothy Hodgkin Building, Keele University, Staffordshire, ST5 5BG, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, Weston Education Centre, King’s College London, London SE5 9RJ, UK,UK Health Security Agency, Chief Scientific Officer’s Group, 17 Smith Square, London, SW1P 3HX, UK
| | - Megan Cutts
- School of Psychology, Dorothy Hodgkin Building, Keele University, Staffordshire, ST5 5BG, UK
| | - Hannah Dasch
- Centre for Implementation Science, NIHR ARC South London, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - Nick Sevdalis
- Centre for Implementation Science, NIHR ARC South London, King’s College London, Institute of Psychiatry, Psychology & Neuroscience, De Crespigny Park, London SE5 8AF, UK
| | - G. James Rubin
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Weston Education Centre, King’s College London, London SE5 9RJ, UK,NIHR Health Protection Research Unit in Emergency Preparedness and Response, Weston Education Centre, King’s College London, London SE5 9RJ, UK
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19
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Smith LE, Sherman SM, Sim J, Amlôt R, Cutts M, Dasch H, Sevdalis N, Rubin GJ. Parents' intention to vaccinate their child for COVID-19: A mixed-methods study (CoVAccS-wave 3). PLoS One 2022; 17:e0279285. [PMID: 36574421 PMCID: PMC9794060 DOI: 10.1371/journal.pone.0279285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 12/02/2022] [Indexed: 12/29/2022] Open
Abstract
AIM To investigate UK parents' vaccination intention at a time when COVID-19 vaccination was available to some children. METHODS Data reported are from the second wave of a prospective cohort study. We conducted a mixed-methods study using an online survey of 270 UK parents (conducted 4-15 October 2021). At this time, vaccination was available to 16- and 17-year-olds and had become available to 12- to 15-year-olds two weeks prior. We asked participants whose child had not yet been vaccinated how likely they were to vaccinate their child for COVID-19. Linear regression analyses were used to investigate factors associated with intention (quantitative component). Parents were also asked for their main reasons behind vaccination intention. Open-ended responses were analysed using content analysis (qualitative component). RESULTS Parental vaccination intention was mixed (likely: 39.3%, 95% CI 32.8%, 45.7%; uncertain: 33.9%, 95% CI 27.7%, 40.2%; unlikely: 26.8%, 95% CI 20.9%, 32.6%). Intention was associated with: parental COVID-19 vaccination status; greater perceived necessity and social norms regarding COVID-19 vaccination; greater COVID-19 threat appraisal; and lower vaccine safety and novelty concerns. In those who intended to vaccinate their child, the main reasons for doing so were to protect the child and others. In those who did not intend to vaccinate their child, the main reason was safety concerns. CONCLUSIONS Parent COVID-19 vaccination status and psychological factors explained a large percentage of the variance in vaccination intention for one's child. Further study is needed to see whether parents' intention to vaccinate their child is affected by fluctuating infection rates, more children being vaccinated, and the UK's reliance on vaccination as a strategy to live with COVID-19.
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Affiliation(s)
- Louise E. Smith
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, England
- * E-mail:
| | - Susan M. Sherman
- Keele University, School of Psychology, Newcastle, United Kingdom
| | - Julius Sim
- Keele University, School of Medicine, Newcastle, United Kingdom
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, England
- UK Health Security Agency, Behavioural Science and Insights Unit, England
| | - Megan Cutts
- Keele University, School of Psychology, Newcastle, United Kingdom
| | - Hannah Dasch
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- King’s College London, Centre for Implementation Science, London, United Kingdom
| | - Nick Sevdalis
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- King’s College London, Centre for Implementation Science, London, United Kingdom
| | - G. James Rubin
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, England
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20
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Davidson L, Carter H, Amlôt R, Drury J, Haslam SA, Radburn M, Stott C. A social identity perspective on interoperability in the emergency services: Emergency responders' experiences of multiagency working during the COVID‐19 response in the UK. Contingencies & Crisis Mgmt 2022. [DOI: 10.1111/1468-5973.12443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Louise Davidson
- School of Psychology University of Sussex Brighton UK
- School of Psychology, Behavioural Science and Insights Unit UK Health Security Agency London UK
| | - Holly Carter
- School of Psychology, Behavioural Science and Insights Unit UK Health Security Agency London UK
| | - Richard Amlôt
- School of Psychology, Behavioural Science and Insights Unit UK Health Security Agency London UK
| | - John Drury
- School of Psychology University of Sussex Brighton UK
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21
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Woodland L, Hodson A, Webster RK, Amlôt R, Smith LE, Rubin GJ. A qualitative study about how families coped with managing their well-being, children's physical activity and education during the COVID-19 school closures in England. PLoS One 2022; 17:e0279355. [PMID: 36548349 PMCID: PMC9778504 DOI: 10.1371/journal.pone.0279355] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
In 2020, schools in England closed for six months due to COVID-19, resulting in children being home-schooled. There is limited understanding about the impacts of this on children's mental and physical health and their education. Therefore, we explored how families coped with managing these issues during the school closures. We conducted 30 qualitative interviews with parents of children aged 18 years and under (who would usually be in school) between 16 and 21 April 2020. We identified three themes and eight sub-themes that impacted how families coped whilst schools were closed. We found that family dynamics, circumstances, and resources (Theme 1), changes in entertainment activities and physical movement (Theme 2) and worries about the COVID-19 pandemic (Theme 3) impacted how well families were able to cope. A key barrier to coping was struggles with home-schooling (e.g., lack of resources and support from the school). However, parents being more involved in their children's personal development and education were considered a benefit to home-schooling. Managing the lack of entertainment activities and in-person interactions, and additional health worries about loved ones catching COVID-19 were challenges for families. Parents reported adverse behaviour changes in their children, although overall, they reported they were coping well. However, pre-existing social and educational inequalities are at risk of exacerbation. Families with more resources (e.g., parental supervision, access to green space, technology to facilitate home-schooling and no special educational needs) were better able to cope when schools were closed. On balance, however, families appeared to be able to adapt to the schools being closed. We suggest that policy should focus on supporting families to mitigate the widening health and educational gap between families with more and less resources.
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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, England
- * E-mail:
| | - Ava Hodson
- Department of War Studies, King’s College London, London, 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, England
- Behavioural Science and Insights Unit, UK Health Security Agency, Salisbury, 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, England
| | - G. James Rubin
- Department of Psychological Medicine, King’s College London, London, United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, England
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22
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Lasseter G, Compston P, Robin C, Lambert H, Hickman M, Denford S, Reynolds R, Zhang J, Cai S, Zhang T, Smith LE, Rubin GJ, Yardley L, Amlôt R, Oliver I. Exploring the impact of shielding advice on the wellbeing of individuals identified as clinically extremely vulnerable amid the COVID-19 pandemic: a mixed-methods evaluation. BMC Public Health 2022; 22:2145. [PMID: 36418978 PMCID: PMC9685010 DOI: 10.1186/s12889-022-14368-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 10/17/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND The national shielding programme was introduced by UK Government at the beginning of the COVID-19 pandemic, with individuals identified as clinically extremely vulnerable (CEV) offered advice and support to stay at home and avoid all non-essential contact. This study aimed to explore the impact and responses of "shielding" on the health and wellbeing of CEV individuals in Southwest England during the first COVID-19 lockdown. METHODS A two-stage mixed methods study, including a structured survey (7 August-23 October 2020) and semi-structured telephone interviews (26 August-30 September 2020) with a sample of individuals who had been identified as CEV and advised to "shield" by Bristol, North Somerset & South Gloucestershire (BNSSG) Clinical Commissioning Group (CCG). RESULTS The survey was completed by 203 people (57% female, 54% > 69 years, 94% White British, 64% retired) in Southwest England identified as CEV by BNSSG CCG. Thirteen survey respondents participated in follow-up interviews (53% female, 40% > 69 years, 100% White British, 61% retired). Receipt of 'official' communication from NHS England or General Practitioner (GP) was considered by participants as the legitimate start of shielding. 80% of survey responders felt they received all relevant advice needed to shield, yet interviewees criticised the timing of advice and often sought supplementary information. Shielding behaviours were nuanced, adapted to suit personal circumstances, and waned over time. Few interviewees received community support, although food boxes and informal social support were obtained by some. Worrying about COVID-19 was common for survey responders (90%). Since shielding had begun, physical and mental health reportedly worsened for 35% and 42% of survey responders respectively. 21% of survey responders scored ≥ 10 on the PHQ-9 questionnaire indicating possible depression and 15% scored ≥ 10 on the GAD-7 questionnaire indicating possible anxiety. CONCLUSIONS This research highlights the difficulties in providing generic messaging that is applicable and appropriate given the diversity of individuals identified as CEV and the importance of sharing tailored and timely advice to inform shielding decisions. Providing messages that reinforce self-determined action and assistance from support services could reduce the negative impact of shielding on mental health and feelings of social isolation.
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Affiliation(s)
- Gemma Lasseter
- grid.5337.20000 0004 1936 7603NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN UK
| | - Polly Compston
- grid.515304.60000 0005 0421 4601Field Epidemiology Service, UK Health Security Agency, Cambridge, UK
| | - Charlotte Robin
- grid.5337.20000 0004 1936 7603NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN UK ,grid.515304.60000 0005 0421 4601Field Epidemiology, Field Service, National Infection Service, UK Health Security Agency, Liverpool, UK ,grid.10025.360000 0004 1936 8470NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK ,grid.10025.360000 0004 1936 8470NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
| | - Helen Lambert
- grid.5337.20000 0004 1936 7603NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN UK
| | - Matthew Hickman
- grid.5337.20000 0004 1936 7603NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN UK
| | - Sarah Denford
- grid.5337.20000 0004 1936 7603NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN UK ,grid.5337.20000 0004 1936 7603School of Psychological Science, University of Bristol, Bristol, UK
| | - Rosy Reynolds
- grid.5337.20000 0004 1936 7603NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN UK
| | - Juan Zhang
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Shenghan Cai
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Tingting Zhang
- grid.5337.20000 0004 1936 7603Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Louise E. Smith
- grid.13097.3c0000 0001 2322 6764NIHR Health Protection Research Unit in Emergency Preparedness and Response, King’s College London, London, UK ,grid.13097.3c0000 0001 2322 6764Department of Psychological Medicine, King’s College London, London, UK
| | - G James Rubin
- grid.13097.3c0000 0001 2322 6764NIHR Health Protection Research Unit in Emergency Preparedness and Response, King’s College London, London, UK ,grid.13097.3c0000 0001 2322 6764Department of Psychological Medicine, King’s College London, London, UK
| | - Lucy Yardley
- grid.5337.20000 0004 1936 7603NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN UK ,grid.5337.20000 0004 1936 7603School of Psychological Science, University of Bristol, Bristol, UK ,grid.5491.90000 0004 1936 9297Psychology Department, University of Southampton, Southampton, UK
| | - Richard Amlôt
- grid.5337.20000 0004 1936 7603NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN UK ,grid.515304.60000 0005 0421 4601Behavioural Science and Insights Unit, UK Health Security Agency, Salisbury, UK
| | - Isabel Oliver
- grid.5337.20000 0004 1936 7603NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, BS8 2BN UK ,grid.515304.60000 0005 0421 4601Field Epidemiology Service, UK Health Security Agency, Cambridge, UK
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23
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Smith LE, Potts HW, Amlôt R, Fear NT, Michie S, Rubin GJ. How has the emergence of the Omicron SARS-CoV-2 variant of concern influenced worry, perceived risk and behaviour in the UK? A series of cross-sectional surveys. BMJ Open 2022; 12:e061203. [PMID: 36038165 PMCID: PMC9437738 DOI: 10.1136/bmjopen-2022-061203] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To investigate changes in beliefs and behaviours following news of the Omicron variant and changes to guidance understanding of Omicron-related guidance, and factors associated with engaging with protective behaviours. DESIGN Series of cross-sectional surveys (1 November to 16 December 2021, five waves of data collection). SETTING Online. PARTICIPANTS People living in England, aged 16 years or over (n=1622-1902 per wave). PRIMARY AND SECONDARY OUTCOME MEASURES Levels of worry and perceived risk, and engagement with key behaviours (out-of-home activities, risky social mixing, wearing a face covering and testing uptake). RESULTS Degree of worry and perceived risk of COVID-19 (to oneself and people in the UK) fluctuated over time, increasing slightly around the time of the announcement about Omicron (p<0.001). Understanding of rules in England was varied, ranging between 10.3% and 91.9%, with people overestimating the stringency of the new rules. Rates of wearing a face covering and testing increased over time (p<0.001). Meeting up with people from another household decreased around the time of the announcement of Omicron (29 November to 1 December), but then returned to previous levels (p=0.002). Associations with protective behaviours were investigated using regression analyses. There was no evidence for significant associations between out-of-home activity and worry or perceived risk (COVID-19 generally or Omicron-specific, p≥0.004; Bonferroni adjustment p<0.002 applied). Engaging in highest risk social mixing and always wearing a face covering were associated with worry and perceived risk about COVID-19 (p≤0.001). Always wearing a face covering in shops was associated with having heard more about Omicron (p<0.001). CONCLUSIONS Almost 2 years into the COVID-19 outbreak, the emergence of a novel variant of concern only slightly influenced worry and perceived risk. The main protective behaviour (wearing a face covering) promoted by new guidance showed significant re-uptake, but other protective behaviours showed little or no change.
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Affiliation(s)
- Louise E Smith
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
| | - Henry Ww Potts
- Institute of Health Informatics, University College London, London, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
- Behavioural Science and Insights Unit, UK Health Security Agency, Salisbury, UK
| | - Nicola T Fear
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- King's Centre for Military Health Research and Academic Department of Military Mental Health, King's College, London, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
| | - G James Rubin
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
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24
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Denford S, Martin AF, Towler L, Mowbray F, Essery R, Bloomer R, Ready D, Love N, Amlôt R, Oliver I, Rubin GJ, Yardley L. A qualitative process analysis of daily contact testing as an alternative to self-isolation following close contact with a confirmed carrier of SARS-CoV-2. BMC Public Health 2022; 22:1373. [PMID: 35850742 PMCID: PMC9294818 DOI: 10.1186/s12889-022-13800-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 07/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In July 2021, a randomised controlled trial was conducted to compare the effect on SARS-CoV-2 transmission of seven days of Daily Contact Testing (DCT) using Lateral Flow Test (LFT) and two Polymerase Chain Reaction (PCR) tests as an alternative to 10 days of standard self-isolation with one PCR, following close contact with a SARS-CoV-2 carrier. In this qualitative study, we used a nested process evaluation to aid interpretation of the trial and provide insight into factors influencing use of tests, understanding of test results, and how tests were used to inform behavioural decisions. METHODS Interviews were conducted with 60 participants (42 randomised to DCT and 18 randomised to self-isolation) who had been in close contact with a confirmed SARS-CoV-2 carrier and had consented to take part in the trial. RESULTS Data were organised into three overarching themes: (1) assessing the risks and benefits of DCT (2) use of testing during the study period and (3) future use of testing. Attitudes toward DCT as an alternative to self-isolation and behaviour during the testing period appeared to be informed by an assessment of the associated risks and benefits. Participants reported how important it was for them to avoid isolation, how necessary self-isolation was considered to be, and the ability of LFTs to detect infection. Behaviour during the testing period was modified to reduce risks and harms as much as possible. Testing was considered a potential compromise, reducing both risk of transmission and the negative impact of self-isolation, and was regarded as a way to return to normal. CONCLUSION Participants in this study viewed DCT as a sensible, feasible, and welcome means of avoiding unnecessary self-isolation. Although negative LFTs provided reassurance, most people still restricted their activity as recommended. DCT was also highly valued by those in vulnerable households as a means of providing reassurance of the absence of infection and as an important means of detecting infection and prompting self-isolation when necessary.
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Affiliation(s)
- Sarah Denford
- Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol in Collaboration With UK Health Security Agency, Bristol, UK. .,Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, BS8 1TU, Bristol, UK. .,School of Psychological Science, University of Bristol, Bristol, UK.
| | - Alex F Martin
- Health Protection Research Unit in Emergency Preparedness and Response at King's College London in Collaboration With UK Health Security Agency, London, UK
| | - Lauren Towler
- School of Psychological Science, University of Bristol, Bristol, UK.,School of Psychology, University of Southampton, Southampton, UK
| | - Fiona Mowbray
- Health Protection Research Unit in Emergency Preparedness and Response at King's College London in Collaboration With UK Health Security Agency, London, UK
| | - Rosie Essery
- Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol in Collaboration With UK Health Security Agency, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, BS8 1TU, Bristol, UK.,School of Psychological Science, University of Bristol, Bristol, UK.,School of Psychology, University of Southampton, Southampton, UK
| | - Rachael Bloomer
- Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, BS8 1TU, Bristol, UK
| | - Derren Ready
- Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol in Collaboration With UK Health Security Agency, Bristol, UK.,UK Health Security Agency, London, England, UK
| | - Nicola Love
- Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol in Collaboration With UK Health Security Agency, Bristol, UK.,UK Health Security Agency, London, England, UK
| | - Richard Amlôt
- Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol in Collaboration With UK Health Security Agency, Bristol, UK.,Health Protection Research Unit in Emergency Preparedness and Response at King's College London in Collaboration With UK Health Security Agency, London, UK.,UK Health Security Agency, London, England, UK
| | - Isabel Oliver
- Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol in Collaboration With UK Health Security Agency, Bristol, UK.,UK Health Security Agency, London, England, UK
| | - G James Rubin
- Health Protection Research Unit in Emergency Preparedness and Response at King's College London in Collaboration With UK Health Security Agency, London, UK
| | - Lucy Yardley
- Health Protection Research Unit in Behavioural Science and Evaluation at the University of Bristol in Collaboration With UK Health Security Agency, Bristol, UK.,Population Health Sciences, Bristol Medical School, University of Bristol, Priory Road Complex, BS8 1TU, Bristol, UK.,School of Psychological Science, University of Bristol, Bristol, UK.,School of Psychology, University of Southampton, Southampton, UK
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25
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Davidson L, Carter H, Drury J, Amlôt R, Haslam SA. Advancing a social identity perspective on interoperability in the emergency services: Evidence from the Pandemic Multi-Agency Response Teams during the UK COVID-19 response. Int J Disaster Risk Reduct 2022; 77:103101. [PMID: 35706912 PMCID: PMC9181307 DOI: 10.1016/j.ijdrr.2022.103101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/01/2022] [Accepted: 06/02/2022] [Indexed: 06/15/2023]
Abstract
Previous research shows there are persistent challenges with multi-agency response centring on problems of communication and coordination. The Social Identity Approach provides an important psychological framework for analysing relations within and between groups which can be used to understand why challenges in multi-agency response occur, and what can be done to prevent them re-occurring in the future. To explore this issue, we conducted semi-structured interviews with 14 responders from the Police, and Fire and Rescue Services who were involved in Pandemic Multi-Agency Response Teams (PMART) during the initial months of the COVID-19. These teams responded to suspected COVID-19 deaths in the community. Interviews were analysed using thematic analysis. Results show that responders appeared to share the pre-existing superordinate identity of all being members of the blue-light service. This identity was made salient as a result of responders experiencing positive contact with each other. Responders also shared the situational superordinate identity of PMART which was both created, and then made salient, through positive contact with each other, as well as responders sharing difficult experiences. At the same time though, structural factors such as inequalities in building access and different shift patterns increased the salience of sub-group identities in ways that created conflict between these identities, as well as operational challenges for joint working. This research advances our understanding of multi-agency working from a social identity perspective by providing evidence of a shared social identity at an operational level of emergency response. Practical implications of this research are discussed.
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Affiliation(s)
- Louise Davidson
- School of Psychology, University of Sussex, Brighton, BN1 9QH, United Kingdom
- Behavioural Science and Insights Unit, UK Health Security Agency, Porton Down, SP4 0JG, United Kingdom
| | - Holly Carter
- Behavioural Science and Insights Unit, UK Health Security Agency, Porton Down, SP4 0JG, United Kingdom
| | - John Drury
- School of Psychology, University of Sussex, Brighton, BN1 9QH, United Kingdom
| | - Richard Amlôt
- Behavioural Science and Insights Unit, UK Health Security Agency, Porton Down, SP4 0JG, United Kingdom
| | - S Alexander Haslam
- School of Psychology, University of Queensland, St Lucia, Queensland, Australia, QLD, 4072
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26
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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. Int J Environ Res 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] [What about the content of this article? (0)] [Affiliation(s)] [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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27
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Denford S, Mowbray F, Towler L, Wehling H, Lasseter G, Amlôt R, Oliver I, Yardley L, Hickman M. Exploration of attitudes regarding uptake of COVID-19 vaccines among vaccine hesitant adults in the UK: a qualitative analysis. BMC Infect Dis 2022; 22:407. [PMID: 35473486 PMCID: PMC9039596 DOI: 10.1186/s12879-022-07380-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/11/2022] [Indexed: 11/10/2022] Open
Abstract
Background The aim of this work was to explore barriers and facilitators to uptake of COVID-19 vaccines and to explore views and reactions to efforts to improve vaccine uptake among vaccine hesitant individuals. Methods Semi-structured interviews were conducted with people between the age of 18–29 years who had not had a COVID-19 vaccine, and those between 30 and 49 years who had not had a second dose of a COVID-19 vaccine. Results A total of 70 participants took part in the study, 35 participants had received one dose, and 35 had not been vaccinated. Participants described a willingness to be vaccinated to keep themselves and those around them safe and to avoid restrictions. Barriers to uptake included: (1) perceived lack of need for COVID-19 vaccinations, (2) concerns about the efficacy of vaccinations, (3) concerns about safety, and (4) access issues. Uptake appeared to be influenced by age and health status, trust in government, and knowledge and understanding of science. Introduction of vaccine passes may provide a motive for having a vaccine but may be viewed as coercive. Conclusion Participants were hesitant, rather than opposed, and had questions about their need for, and the safety and efficacy of the vaccine. Young people did not consider themselves to be at risk of becoming ill from COVID-19, did not think the vaccination was effective in preventing transmission, and did not think sufficient research had been conducted regarding possible long-term side-effects. Concerns were exacerbated by a lack of trust in government, and misunderstanding of science. To promote uptake, public health campaigns should focus on the provision of information from trusted sources that explains the benefits of vaccination and addresses safety concerns more effectively. To overcome inertia in people with low levels of motivation to be vaccinated, appointments must be easily accessible. Supplementary Information The online version contains supplementary material available at 10.1186/s12879-022-07380-9.
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Affiliation(s)
- Sarah Denford
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK. .,NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation at the University of Bristol, a partnership between the UK Health Security Agency (UKHSA) and the University of Bristol, Bristol, UK. .,School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK.
| | - Fiona Mowbray
- NIHR Health Protection Research Unit (HPRU) in Emergency Preparedness and Response, a partnership between the UK Health Security Agency (UKHSA) and King's College London, London, UK
| | - Lauren Towler
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,School of Psychology, University of Southampton, Southampton, UK
| | - Helena Wehling
- Behavioural Science Insight Unit, UK Health Security Agency, Porton Down, Salisbury, UK
| | - Gemma Lasseter
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation at the University of Bristol, a partnership between the UK Health Security Agency (UKHSA) and the University of Bristol, Bristol, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation at the University of Bristol, a partnership between the UK Health Security Agency (UKHSA) and the University of Bristol, Bristol, UK.,NIHR Health Protection Research Unit (HPRU) in Emergency Preparedness and Response, a partnership between the UK Health Security Agency (UKHSA) and King's College London, London, UK.,Behavioural Science Insight Unit, UK Health Security Agency, Porton Down, Salisbury, UK
| | - Isabel Oliver
- NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation at the University of Bristol, a partnership between the UK Health Security Agency (UKHSA) and the University of Bristol, Bristol, UK.,UK Health Security Agency, London, UK
| | - Lucy Yardley
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation at the University of Bristol, a partnership between the UK Health Security Agency (UKHSA) and the University of Bristol, Bristol, UK.,School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK.,School of Psychology, University of Southampton, Southampton, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.,NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation at the University of Bristol, a partnership between the UK Health Security Agency (UKHSA) and the University of Bristol, Bristol, UK
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28
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Smith G, Harcourt S, Hoang U, Lemanska A, Elliot A, Morbey R, Hughes H, Lake I, Edeghere O, Oliver I, Sherlock J, Amlôt R, de Lusignan S. Observational study of mental health presentations across healthcare setting during the first 9 months of the COVID-19 pandemic in England. JMIR Public Health Surveill 2022; 8:e32347. [PMID: 35486809 PMCID: PMC9359118 DOI: 10.2196/32347] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 03/15/2022] [Accepted: 04/26/2022] [Indexed: 11/13/2022] Open
Abstract
Background The COVID-19 pandemic has resulted in an unprecedented impact on the day-to-day lives of people, with several features potentially adversely affecting mental health. There is growing evidence of the size of the impact of COVID-19 on mental health, but much of this is from ongoing population surveys using validated mental health scores. Objective This study investigated the impact of the pandemic and control measures on mental health conditions presenting to a spectrum of national health care services monitored using real-time syndromic surveillance in England. Methods We conducted a retrospective observational descriptive study of mental health presentations (those calling the national medical helpline, National Health Service [NHS] 111; consulting general practitioners [GPs] in and out-of-hours; calling ambulance services; and attending emergency departments) from January 1, 2019, to September 30, 2020. Estimates for the impact of lockdown measures were provided using an interrupted time series analysis. Results Mental health presentations showed a marked decrease during the early stages of the pandemic. Postlockdown, attendances for mental health conditions reached higher than prepandemic levels across most systems—a rise of 10% compared to that expected for NHS 111 and 21% for GP out-of-hours service—while the number of consultations to GP in-hours service was 13% lower compared to the same time previous year. Increases were observed in calls to NHS 111 for sleep problems. Conclusions These analyses showed marked changes in the health care attendances and prescribing for common mental health conditions across a spectrum of health care provision, with some of these changes persisting. The reasons for such changes are likely to be complex and multifactorial. The impact of the pandemic on mental health may not be fully understood for some time, and therefore, these syndromic indicators should continue to be monitored.
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Affiliation(s)
- Gillian Smith
- Real-time Syndromic Surveillance Team, Field Service, UK Health Security Agency, 1st Floor, 5 St Philips Place, Birmingham, GB.,NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, GB
| | - Sally Harcourt
- Real-time Syndromic Surveillance Team, Field Service, UK Health Security Agency, 1st Floor, 5 St Philips Place, Birmingham, GB
| | - Uy Hoang
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, GB
| | - Agnieszka Lemanska
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, GB
| | - Alex Elliot
- Real-time Syndromic Surveillance Team, Field Service, UK Health Security Agency, 1st Floor, 5 St Philips Place, Birmingham, GB.,NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, GB
| | - Roger Morbey
- Real-time Syndromic Surveillance Team, Field Service, UK Health Security Agency, 1st Floor, 5 St Philips Place, Birmingham, GB.,NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, GB
| | - Helen Hughes
- Real-time Syndromic Surveillance Team, Field Service, UK Health Security Agency, 1st Floor, 5 St Philips Place, Birmingham, GB
| | - Iain Lake
- School of Environmental Science, University of East Anglia, Norwich, GB.,NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, GB
| | - Obaghe Edeghere
- Real-time Syndromic Surveillance Team, Field Service, UK Health Security Agency, 1st Floor, 5 St Philips Place, Birmingham, GB.,NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, GB
| | - Isabel Oliver
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Population Health Sciences, University of Bristol, Bristol, GB.,Chief Scientist Advisor Group, UK Health Security Agency, London, GB
| | - Julian Sherlock
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, GB
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, GB.,NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Population Health Sciences, University of Bristol, Bristol, GB.,Behavioural Science and Insights Unit, UK Health Security Agency, London, GB
| | - Simon de Lusignan
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, GB.,Faculty of Health and Medical Sciences, University of Surrey, Surrey, GB.,Royal College of General Practitioners, London, GB
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29
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McPhedran R, Gold N, Bemand C, Weston D, Rosen R, Scott R, Chadborn T, Amlôt R, Mawby M, Toombs B. Location, location, location: a discrete choice experiment to inform COVID-19 vaccination programme delivery in the UK. BMC Public Health 2022; 22:431. [PMID: 35246082 PMCID: PMC8894545 DOI: 10.1186/s12889-022-12823-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2021] [Accepted: 02/21/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Large-scale vaccination is fundamental to combatting COVID-19. In March 2021, the UK's vaccination programme had delivered vaccines to large proportions of older and more vulnerable population groups; however, there was concern that uptake would be lower among young people. This research was designed to elicit the preferences of 18-29-year-olds regarding key delivery characteristics and assess the influence of these on intentions to get vaccinated, to inform planning for this cohort. METHODS From 25 March to 2 April 2021, an online sample of 2012 UK adults aged 18-29 years participated in a Discrete Choice Experiment. Participants made six choices, each involving two SMS invitations to book a vaccination appointment and an opt-out. Invitations had four attributes (1 × 5 levels, 3 × 3 levels): delivery mode, appointment timing, proximity, and sender. These were systematically varied according to a d-optimal design. Responses were analysed using a mixed logit model. RESULTS The main effects logit model revealed a large alternative-specific constant (β = 1.385, SE = 0.067, p < 0.001), indicating a strong preference for 'opting in' to appointment invitations. Pharmacies were dispreferred to the local vaccination centre (β = - 0.256, SE = 0.072, p < 0.001), appointments in locations that were 30-45 min travel time from one's premises were dispreferred to locations that were less than 15 min away (β = - 0.408, SE = 0.054, p < 0.001), and, compared to invitations from the NHS, SMSs forwarded by 'a friend' were dispreferred (β = - 0.615, SE = 0.056, p < 0.001) but invitations from the General Practitioner were preferred (β = 0.105, SE = 0.048, p = 0.028). CONCLUSIONS The results indicated that the existing configuration of the UK's vaccination programme was well-placed to deliver vaccines to 18-29-year-olds; however, some adjustments might enhance acceptance. Local pharmacies were not preferred; long travel times were a disincentive but close proximity (0-15 min from one's premises) was not necessary; and either the 'NHS' or 'Your GP' would serve as adequate invitation sources. This research informed COVID-19 policy in the UK, and contributes to a wider body of Discrete Choice Experiment evidence on citizens' preferences, requirements and predicted behaviours regarding COVID-19.
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Affiliation(s)
- Robert McPhedran
- Kantar Public UK Behavioural Practice, 4 Millbank, Westminster, London, SW1P 3JA, UK.
| | - Natalie Gold
- Kantar Public UK Behavioural Practice, 4 Millbank, Westminster, London, SW1P 3JA, UK.,Public Health England Behavioural Insights, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK.,Centre for Philosophy of Natural and Social Science, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK
| | - Charlotte Bemand
- Solent NHS Trust, NHS England, Highpoint Venue, Bursledon Rd, Southampton, Hampshire, SO19 8BR, UK
| | - Dale Weston
- Behavioural Science and Insights Unit, UK Health Security Agency, Porton Down, Salisbury, Wilts, SP4 0JG, UK
| | - Rachel Rosen
- Economics and Strategic Analysis Team, NHS England and NHS Improvement, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Robert Scott
- Economics and Strategic Analysis Team, NHS England and NHS Improvement, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Tim Chadborn
- Public Health England Behavioural Insights, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
| | - Richard Amlôt
- Behavioural Science and Insights Unit, UK Health Security Agency, Porton Down, Salisbury, Wilts, SP4 0JG, UK
| | - Max Mawby
- Kantar Public UK Behavioural Practice, 4 Millbank, Westminster, London, SW1P 3JA, UK
| | - Ben Toombs
- Kantar Public UK Behavioural Practice, 4 Millbank, Westminster, London, SW1P 3JA, UK
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30
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Woodland L, Mowbray F, Smith LE, Webster RK, Amlôt R, Rubin GJ. What influences whether parents recognise COVID-19 symptoms, request a test and self-isolate: A qualitative study. PLoS One 2022; 17:e0263537. [PMID: 35196349 PMCID: PMC8865653 DOI: 10.1371/journal.pone.0263537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 01/20/2022] [Indexed: 11/19/2022] Open
Abstract
Background
Using test, trace and isolate systems can help reduce the spread of COVID-19. Parents have the additional responsibility of using these systems for themselves and acting on behalf of their children to help control COVID-19. We explored factors associated with the use of England’s NHS Test and Trace service among parents of school-aged children.
Methods
One-to-one telephone interviews with parents (n = 18) of school-aged (4 to 18 years) children living in England between 30 November to 11 December 2020. Data were explored using thematic analysis.
Results
Three themes and eight sub-themes emerged. In terms of recognising symptoms of COVID-19, parents needed prompting before recalling the main symptoms described by the NHS. Parents suggested several factors relating to the nature of the symptom(s) and contextual information that might lead to or prevent them from seeking a test. Although parents supported symptomatic testing and described trusting official sources of information (e.g., Government and NHS websites). However, some concerns were raised regarding the accuracy of test results, safety at testing centres and logistics of testing but none of the concerns appeared to prevent engagement with testing. Parents perceived adherence to testing and self-isolation as pro-social behaviour, although family resources and circumstances impacted their ability to adhere fully.
Conclusions
Our study identified several barriers to parents using NHS Test and Trace as needed. Information about the eligibility of testing (main symptoms of COVID-19 and the age of eligibility) needs to be more precise and resources provided to enable families to adhere to self-isolation if the efficiency of test, trace and isolate systems is to be optimised.
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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, London, United Kingdom
- * E-mail:
| | - Fiona Mowbray
- Department of Psychological Medicine, King’s College London, London, United Kingdom
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, 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, London, 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, London, United Kingdom
- Behavioural Science and Insights Unit, UK Health Security Agency, Salisbury, 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, London, United Kingdom
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31
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Smith LE, Potts HW, Amlôt R, Fear NT, Michie S, Rubin GJ. Who is engaging with lateral flow testing for COVID-19 in the UK? The COVID-19 Rapid Survey of Adherence to Interventions and Responses (CORSAIR) study. BMJ Open 2022; 12:e058060. [PMID: 35144956 PMCID: PMC8845094 DOI: 10.1136/bmjopen-2021-058060] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVES To investigate uptake of lateral flow testing, reporting of test results and psychological, contextual and socio-demographic factors associated with testing. DESIGN A series of four fortnightly online cross-sectional surveys. SETTING Data collected from 19 April 2021 to 2 June 2021. PARTICIPANTS People living in England and Scotland, aged 18 years or over, excluding those who reported their most recent test was a polymerase chain reaction (PCR) test (n=6646, n≈1600 per survey). MAIN OUTCOME MEASURES Having completed at least one lateral flow test (LFT) in the last 7 days. RESULTS We used binary logistic regressions to investigate factors associated with having taken at least one LFT. Increased uptake of testing was associated with being vaccinated (adjusted ORs (aORs)=1.52-2.45, 95% CI 1.25 to 3.07, analysed separately by vaccine dose), employed (aOR=1.94, 95% CI 1.63 to 2.32), having been out to work in the last week (aOR=2.30, 95% CI 1.94 to 2.73) and working in a sector that adopted LFT early (aOR=2.54, 95% CI 2.14 to 3.02) . Uptake was higher in people who reported cardinal COVID-19 symptoms in the last week (aOR=1.89, 95% CI 1.34 to 2.66). People who had heard more about LFTs (aOR=2.28, 95% CI 2.06 to 2.51) and knew they were eligible to receive regular LFTs (aOR=2.98, 95% CI 2.35 to 3.78) were also more likely to have tested. Factors associated with not taking a test included agreeing that you do not need to test for COVID-19 unless you have come into contact with a case (aOR=0.51, 95% CI 0.47 to 0.55). CONCLUSIONS Uptake of lateral flow testing is low. Encouraging testing through workplaces and places of study is likely to increase uptake, although care should be taken not to pressurise employees and students. Increasing knowledge that everyone is eligible for regular asymptomatic testing and addressing common misconceptions may drive uptake.
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Affiliation(s)
- Louise E Smith
- Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, UK
| | - Henry Ww Potts
- Institute of Health Informatics, University College London, London, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, UK
- UK Health Security Agency, Salisbury, UK
| | - Nicola T Fear
- Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- King's Centre for Military Health Research and Academic Department of Military Mental Health, King's College London, London, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
| | - G James Rubin
- Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London, UK
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Anderson NC, Kesten JM, Ayres R, Hickman M, Amlôt R, Michie S, Lorencatto F. Acceptability of, and barriers and facilitators to, a pilot physical health service for people who inject drugs: A qualitative study with service users and providers. Int J Drug Policy 2022; 99:103437. [PMID: 34600415 DOI: 10.1016/j.drugpo.2021.103437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 07/27/2021] [Accepted: 08/25/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND People who inject drugs may experience difficulty accessing or maintaining involvement with traditional healthcare services. This is associated with increased health inequalities and bio-psychosocial difficulties. Embedding physical healthcare services within community-based drug services may provide a practical and feasible approach to increase access and delivery of healthcare. This study explored the acceptability of, and barriers and facilitators to, embedding a pilot physical healthcare service within a community-based drug service in the United Kingdom (Bristol, England). METHODS Semi-structured interviews were conducted with service users (people who inject drugs) (n = 13), and a focus group was conducted with service providers (n = 11: nine harm reduction workers, two nurses, one service manager). Topic guides included questions to explore barriers and facilitators to using and delivering the service (based on the COM-B Model), and acceptability of the service (using the Theoretical Framework of Acceptability). Transcripts were analysed using a combined deductive framework and inductive thematic analysis approach. RESULTS The service was viewed as highly acceptable. Service users and providers were confident they could access and provide the service respectively, and perceived it to be effective. Barriers included competing priorities of service users (e.g. drug use) and the wider service (e.g. equipment), and the potential impact of the service being removed in future was viewed as a barrier to overall healthcare access. Both service users and providers viewed embedding the physical health service within an existing community-based drug service as facilitating accessible and holistic care which reduced stigma and discrimination. CONCLUSIONS The current study demonstrated embedding a physical health service within an existing community-drug based and alcohol service was acceptable and beneficial. Future studies are required to demonstrate cost-effectiveness and ensure long-term sustainability, and to determine transferability of findings to other settings, organisations and countries.
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Affiliation(s)
- Niall C Anderson
- Centre for Behaviour Change, University College London, London, WC1E 7HB, UK; National Institute for Health Research (NIHR) Health Protection Research Unit in Behavioural Science and Evaluation, Bristol, BS8 2BN, UK.
| | - Joanna M Kesten
- National Institute for Health Research (NIHR) Health Protection Research Unit in Behavioural Science and Evaluation, Bristol, BS8 2BN, UK; Population Health Sciences, University of Bristol, BS8 1QU, UK; NIHR Applied Research Collaboration West (ARC West), Bristol, BS1 2NT, UK
| | | | - Matthew Hickman
- National Institute for Health Research (NIHR) Health Protection Research Unit in Behavioural Science and Evaluation, Bristol, BS8 2BN, UK; Population Health Sciences, University of Bristol, BS8 1QU, UK
| | - Richard Amlôt
- National Institute for Health Research (NIHR) Health Protection Research Unit in Behavioural Science and Evaluation, Bristol, BS8 2BN, UK; Health Protection Agency, Public Health England, Bristol, BS1 6EH, UK; Health Protection Research Unit in Emergency Preparedness and Response, Public Health England, Salisbury, SP4 0JG, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, WC1E 7HB, UK
| | - Fabiana Lorencatto
- Centre for Behaviour Change, University College London, London, WC1E 7HB, UK
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Smith LE, Sim J, Amlôt R, Cutts M, Dasch H, Sevdalis N, Rubin GJ, Sherman SM. Side-effect expectations from COVID-19 vaccination: Findings from a nationally representative cross-sectional survey (CoVAccS - wave 2). J Psychosom Res 2021; 152:110679. [PMID: 34823113 PMCID: PMC8595305 DOI: 10.1016/j.jpsychores.2021.110679] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVES Concern about side effects is one of the most common reasons for refusing vaccination. Side-effect expectations are known to predict perception of side effects. We aimed to investigate the percentage of people who thought side effects from COVID-19 vaccination were likely and investigate factors associated with side-effect expectation. METHODS Online cross-sectional survey of 1470 UK adults who had not been vaccinated for COVID-19 (conducted 13 to 15 January 2021). We asked participants how likely they thought side effects from COVID-19 vaccination were. Linear regression analyses were used to investigate associations with side-effect expectations. RESULTS Most participants were uncertain whether they would experience side effects from a COVID-19 vaccine; only a minority reported that side effects were very likely (9.4%, 95% CI 7.9% to 10.9%, n = 138/1470). Personal and clinical characteristics, general, and COVID-19 vaccination beliefs and attitudes explained 29.7% of the variance in side-effect expectation, with COVID-19 vaccination beliefs alone accounting for 17.2%. Side-effect expectations were associated with: older age, being clinically extremely vulnerable to COVID-19, being afraid of needles, lower perceived social norms for COVID-19 vaccination, lower perceived necessity and safety of COVID-19 vaccination, and perceived lack of information about COVID-19 and vaccination. CONCLUSIONS Side-effect expectation was associated with believing that COVID-19 vaccination was unsafe, ineffective and that others would be less likely to approve of you having a COVID-19 vaccination. Communications should emphasise the safety, effectiveness, and widespread uptake of vaccination, while promoting accurate perceptions of the incidence of vaccination side effects.
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Affiliation(s)
- Louise E Smith
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK; NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK.
| | - Julius Sim
- Keele University, School of Medicine, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK; UK Health Security Agency, Behavioural Science and Insights Unit, UK
| | | | - Hannah Dasch
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK; King's College London, Centre for Implementation Science, UK
| | - Nick Sevdalis
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK; King's College London, Centre for Implementation Science, UK
| | - G James Rubin
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK; NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK
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Michie S, West R, Pidgeon N, Reicher S, Amlôt R, Bear L. Staying 'Covid-safe': Proposals for embedding behaviours that protect against Covid-19 transmission in the UK. Br J Health Psychol 2021; 26:1238-1257. [PMID: 34463407 PMCID: PMC8646269 DOI: 10.1111/bjhp.12557|] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/11/2021] [Indexed: 12/29/2023]
Abstract
OBJECTIVES The Scientific Pandemic Insights group on Behaviours (SPI-B) as part of England's Scientific Advisory Group on Emergencies (SAGE), were commissioned by the UK Cabinet Office to identify strategies to embed infection control behaviours to minimize Covid-19 transmission in the long term. METHODS With minimal direct evidence available, three sources of information were used to develop a set of proposals: (1) a scoping review of literature on sustaining behaviour change, (2) a review of key principles used in risk and safety management, and (3) prior reports and reviews on behaviour change from SPI-B. The information was collated and refined through discussion with SPI-B and SAGE colleagues to finalize the proposals. RESULTS Embedding infection control behaviours in the long-term will require changes to the financial, social, and physical infrastructure so that people in all sections of society have the capability, opportunity, and motivation needed to underpin those behaviours. This will involve building Covid-safe educational programmes, regulating to ensure minimum standards of safety in public spaces and workspaces, using communications and social marketing to develop a Covid-safe culture and identity, and providing resources so that all sections of society can build Covid-safe behaviours into their daily lives. CONCLUSIONS Embedding 'Covid-safe' behaviours into people's everyday routines will require a co-ordinated programme to shape the financial, physical, and social infrastructure in the United Kingdom. Education, regulation, communications, and social marketing, and provision of resources will be required to ensure that all sections of society have the capability, opportunity, and motivation to enact the behaviours long term.
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Affiliation(s)
- Susan Michie
- Centre for Behaviour ChangeUniversity College LondonUK
| | - Robert West
- Institute of Epidemiology and HealthUniversity College LondonUK
| | - Nick Pidgeon
- Understanding Risk Research GroupSchool of PsychologyCardiff UniversityUK
| | - Stephen Reicher
- School of Psychology and NeuroscienceUniversity of St. AndrewsUK
| | - Richard Amlôt
- Behavioural Science and Insights UnitPublic Health EnglandUK
| | - Laura Bear
- Department of Social AnthropologyLondon School of Economics and Political ScienceUK
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Sherman SM, Sim J, Cutts M, Dasch H, Amlôt R, Rubin GJ, Sevdalis N, Smith LE. COVID-19 vaccination acceptability in the UK at the start of the vaccination programme: a nationally representative cross-sectional survey (CoVAccS - wave 2). Public Health 2021; 202:1-9. [PMID: 34856520 PMCID: PMC8520876 DOI: 10.1016/j.puhe.2021.10.008] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 10/06/2021] [Accepted: 10/09/2021] [Indexed: 01/14/2023]
Abstract
Objectives Investigate factors associated with the intention to have the COVID-19 vaccination following initiation of the UK national vaccination programme. Study design An online cross-sectional survey completed by 1500 adults (13th–15th January 2021). Methods Linear regression analyses were used to investigate associations between intention to be vaccinated for COVID-19 and sociodemographic factors, previous influenza vaccination, attitudes and beliefs about COVID-19 and COVID-19 vaccination and vaccination in general. Participants’ main reasons for likely vaccination (non-)uptake were also solicited. Results 73.5% of participants (95% CI 71.2%, 75.7%) reported being likely to be vaccinated against COVID-19, 17.3% (95% CI 15.4%, 19.3%) were unsure, and 9.3% (95% CI 7.9%, 10.8%) reported being unlikely to be vaccinated. The full regression model explained 69.8% of the variance in intention. Intention was associated with: having been/intending to be vaccinated for influenza last winter/this winter; stronger beliefs about social acceptability of a COVID-19 vaccine; the perceived need for vaccination; adequacy of information about the vaccine; and weaker beliefs that the vaccine is unsafe. Beliefs that only those at serious risk of illness should be vaccinated and that the vaccines are just a means for manufacturers to make money were negatively associated with vaccination intention. Conclusions Most participants reported being likely to get the COVID-19 vaccination. COVID-19 vaccination attitudes and beliefs are a crucial factor underpinning vaccine intention. Continued engagement with the public with a focus on the importance and safety of vaccination is recommended.
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Affiliation(s)
| | - J Sim
- Keele University, School of Medicine, UK
| | - M Cutts
- Keele University, School of Psychology, UK
| | - H Dasch
- King's College London, Centre for Implementation Science, UK; King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - R Amlôt
- Public Health England, Behavioural Science Team, Emergency Response Department Science and Technology, UK; NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK
| | - G J Rubin
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK; NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK
| | - N Sevdalis
- King's College London, Centre for Implementation Science, UK; King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK
| | - L E Smith
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, UK; NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK
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36
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Michie S, West R, Pidgeon N, Reicher S, Amlôt R, Bear L. Staying 'Covid-safe': Proposals for embedding behaviours that protect against Covid-19 transmission in the UK. Br J Health Psychol 2021; 26:1238-1257. [PMID: 34463407 PMCID: PMC8646269 DOI: 10.1111/bjhp.12557] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/11/2021] [Indexed: 01/04/2023]
Abstract
Objectives The Scientific Pandemic Insights group on Behaviours (SPI‐B) as part of England’s Scientific Advisory Group on Emergencies (SAGE), were commissioned by the UK Cabinet Office to identify strategies to embed infection control behaviours to minimize Covid‐19 transmission in the long term. Methods With minimal direct evidence available, three sources of information were used to develop a set of proposals: (1) a scoping review of literature on sustaining behaviour change, (2) a review of key principles used in risk and safety management, and (3) prior reports and reviews on behaviour change from SPI‐B. The information was collated and refined through discussion with SPI‐B and SAGE colleagues to finalize the proposals. Results Embedding infection control behaviours in the long‐term will require changes to the financial, social, and physical infrastructure so that people in all sections of society have the capability, opportunity, and motivation needed to underpin those behaviours. This will involve building Covid‐safe educational programmes, regulating to ensure minimum standards of safety in public spaces and workspaces, using communications and social marketing to develop a Covid‐safe culture and identity, and providing resources so that all sections of society can build Covid‐safe behaviours into their daily lives. Conclusions Embedding ‘Covid‐safe’ behaviours into people’s everyday routines will require a co‐ordinated programme to shape the financial, physical, and social infrastructure in the United Kingdom. Education, regulation, communications, and social marketing, and provision of resources will be required to ensure that all sections of society have the capability, opportunity, and motivation to enact the behaviours long term.
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Affiliation(s)
- Susan Michie
- Centre for Behaviour Change, University College London, UK
| | - Robert West
- Institute of Epidemiology and Health, University College London, UK
| | - Nick Pidgeon
- Understanding Risk Research Group, School of Psychology, Cardiff University, UK
| | - Stephen Reicher
- School of Psychology and Neuroscience, University of St. Andrews, UK
| | - Richard Amlôt
- Behavioural Science and Insights Unit, Public Health England, UK
| | - Laura Bear
- Department of Social Anthropology, London School of Economics and Political Science, UK
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Collins S, Williams N, Southworth F, James T, Davidson L, Orchard E, Marczylo T, Amlôt R. Evaluating the impact of decontamination interventions performed in sequence for mass casualty chemical incidents. Sci Rep 2021; 11:14995. [PMID: 34294861 PMCID: PMC8298482 DOI: 10.1038/s41598-021-94644-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Accepted: 07/12/2021] [Indexed: 11/23/2022] Open
Abstract
The Initial Operational Response (IOR) to chemical incidents is a suite of rapid strategies including evacuation, disrobe and improvised and interim decontamination. IOR and Specialist Operational Response (SOR) decontamination protocols involving mass decontamination units would be conducted in sequence by UK emergency services following a chemical incident, to allow for safe onward transfer of casualties. As part of a series of human volunteer studies, we examined for the first time, the effectiveness of UK IOR and SOR decontamination procedures alone and in sequence. Specifically, we evaluated the additional contribution of SOR, when following improvised and interim decontamination. Two simulants, methyl salicylate (MeS) with vegetable oil and benzyl salicylate (BeS), were applied to participants’ skin. Participants underwent improvised dry, improvised wet, interim wet, specialist decontamination and a no decontamination control. Skin analysis and UV photography indicated significantly lower levels of both simulants remaining following decontamination compared to controls. There were no significant differences in MeS levels recovered between decontamination conditions. Analysis of BeS, a more persistent simulant than MeS, showed that recovery from skin was significantly reduced following combined IOR with SOR than IOR alone. These results show modest additional benefits of decontamination interventions conducted in sequence, particularly for persistent chemicals, supporting current UK operational procedures.
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Affiliation(s)
- Samuel Collins
- Chemicals and Environmental Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot, Oxfordshire, UK.
| | - Natalie Williams
- Behavioural Science Team, Emergency Response Department Science and Technology, Health Protection Directorate, Public Health England, Porton Down, UK
| | - Felicity Southworth
- Behavioural Science Team, Emergency Response Department Science and Technology, Health Protection Directorate, Public Health England, Porton Down, UK
| | - Thomas James
- Chemicals and Environmental Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot, Oxfordshire, UK
| | - Louise Davidson
- Behavioural Science Team, Emergency Response Department Science and Technology, Health Protection Directorate, Public Health England, Porton Down, UK
| | - Emily Orchard
- Behavioural Science Team, Emergency Response Department Science and Technology, Health Protection Directorate, Public Health England, Porton Down, UK
| | - Tim Marczylo
- Toxicology Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot, Oxfordshire, UK
| | - Richard Amlôt
- Behavioural Science Team, Emergency Response Department Science and Technology, Health Protection Directorate, Public Health England, Porton Down, UK.,Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Sherman SM, Sim J, Amlôt R, Cutts M, Dasch H, Rubin GJ, Sevdalis N, Smith LE. Intention to have the seasonal influenza vaccination during the COVID-19 pandemic among eligible adults in the UK: a cross-sectional survey. BMJ Open 2021; 11:e049369. [PMID: 34257095 PMCID: PMC8282414 DOI: 10.1136/bmjopen-2021-049369] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVE To investigate the likelihood of having the seasonal influenza vaccination during the COVID-19 pandemic in individuals who were eligible to receive it. DESIGN We conducted a cross-sectional online survey in July 2020. We included predictors informed by previous research, in the following categories: sociodemographic variables; uptake of influenza vaccine last winter and beliefs about vaccination. PARTICIPANTS 570 participants (mean age: 53.07; 56.3% female, 87.0% white) who were eligible for the free seasonal influenza vaccination in the UK. RESULTS 59.7% of our sample indicated they were likely to have the seasonal influenza vaccination, 22.1% reported being unlikely to have the vaccination and 18.2% were unsure. We used logistic regression to investigate variables associated with intention to receive a seasonal influenza vaccine in the 2020-2021 season. A positive attitude to vaccination in general predicted intention to have the influenza vaccine in 2020-2021 (OR 1.45, 95% CI 1.19 to 1.77, p<0.001) but the strongest predictor of intention was previous influenza vaccination behaviour (OR 278.58, 95% CI 78.04 to 994.46, p<0.001). CONCLUSIONS Previous research suggests that increasing uptake of the influenza vaccination may help contain a COVID-19 outbreak, so steps need to be taken to convert intention into behaviour and to reach those individuals who reported being unlikely or unsure about having the vaccine.
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Affiliation(s)
| | - Julius Sim
- School of Medicine, Keele University, Keele, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
- Emergency Response Department Science and Technology, Public Health England, Salisbury, UK
| | - Megan Cutts
- School of Psychology, Keele University, Keele, UK
| | - Hannah Dasch
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Implementation Science, King's College London, London, UK
| | - G James Rubin
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nick Sevdalis
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centre for Implementation Science, King's College London, London, UK
| | - Louise E Smith
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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41
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Gold N, Hu XY, Denford S, Xia RY, Towler L, Groot J, Gledhill R, Willcox M, Ainsworth B, Miller S, Moore M, Little P, Amlôt R, Chadborn T, Yardley L. Effectiveness of digital interventions to improve household and community infection prevention and control behaviours and to reduce incidence of respiratory and/or gastro-intestinal infections: a rapid systematic review. BMC Public Health 2021; 21:1180. [PMID: 34154553 PMCID: PMC8215628 DOI: 10.1186/s12889-021-11150-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 05/26/2021] [Indexed: 12/27/2022] Open
Abstract
Background Digital interventions have potential to efficiently support improved hygiene practices to reduce transmission of COVID-19. Objective To evaluate the evidence for digital interventions to improve hygiene practices within the community. Methods We reviewed articles published between 01 January 2000 and 26 May 2019 that presented a controlled trial of a digital intervention to improve hygiene behaviours in the community. We searched MEDLINE, Embase, PsycINFO, Cochrane Controlled Register of Trials (CENTRAL), China National Knowledge Infrastructure and grey literature. Trials in hospitals were excluded, as were trials aiming at prevention of sexually transmitted infections; only target diseases with transmission mechanisms similar to COVID-19 (e.g. respiratory and gastrointestinal infections) were included. Trials had to evaluate a uniquely digital component of an intervention. Study designs were limited to randomised controlled trials, controlled before-and-after trials, and interrupted time series analyses. Outcomes could be either incidence of infections or change in hygiene behaviours. The Risk of Bias 2 tool was used to assess study quality. Results We found seven studies that met the inclusion criteria. Six studies reported successfully improving self-reported hygiene behaviour or health outcomes, but only one of these six trials, Germ Defence, confirmed improvements using objective measures (reduced consultations and antibiotic prescriptions). Settings included kindergartens, workplaces, and service station restrooms. Modes of delivery were diverse: WeChat, website, text messages, audio messages to mobiles, electronic billboards, and electronic personal care records. Four interventions targeted parents of young children with educational materials. Two targeted the general population; these also used behaviour change techniques or theory to inform the intervention. Only one trial had low risk of bias, Germ Defence; the most common concerns were lack of information about the randomisation, possible bias in reporting of behavioural outcomes, and lack of an analysis plan and possible selective reporting of results. Conclusion There was only one trial that was judged to be at low risk of bias, Germ Defence, which reduced incidence and severity of illness, as confirmed by objective measures. Further evaluation is required to determine the effectiveness of the other interventions reviewed. Trial registration PROSPERO CRD42020189919. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-021-11150-8.
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Affiliation(s)
- Natalie Gold
- Public Health England Behavioural Insights, Public Health England, London, UK. .,Centre for Philosophy of Natural and Social Science, London School of Economics and Political Science, London, England.
| | - Xiao-Yang Hu
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Sarah Denford
- Faculty of Health Sciences, Bristol Medical School (PHS), University of Bristol, Bristol, UK.,School of Psychological Science, University of Bristol, Bristol, UK
| | - Ru-Yu Xia
- Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Lauren Towler
- School of Psychology, University of Southampton, Southampton, UK
| | - Julia Groot
- Department of Psychology, University of Bath, Bath, UK
| | - Rachel Gledhill
- Public Health England Behavioural Insights, Public Health England, London, UK
| | - Merlin Willcox
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Ben Ainsworth
- Department of Psychology, University of Bath, Bath, UK
| | - Sascha Miller
- School of Psychology, University of Southampton, Southampton, UK
| | - Michael Moore
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Paul Little
- Primary Care Research Centre, University of Southampton, Southampton, UK
| | - Richard Amlôt
- Public Health England Behavioural Insights, Public Health England, London, UK
| | - Tim Chadborn
- Public Health England Behavioural Insights, Public Health England, London, UK
| | - Lucy Yardley
- School of Psychological Science, University of Bristol, Bristol, UK.,School of Psychology, University of Southampton, Southampton, UK
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42
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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43
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Sherman SM, Smith LE, Sim J, Amlôt R, Cutts M, Dasch H, Rubin GJ, Sevdalis N. COVID-19 vaccination intention in the UK: results from the COVID-19 vaccination acceptability study (CoVAccS), a nationally representative cross-sectional survey. Hum Vaccin Immunother 2021; 17:1612-1621. [PMID: 33242386 PMCID: PMC8115754 DOI: 10.1080/21645515.2020.1846397] [Citation(s) in RCA: 410] [Impact Index Per Article: 136.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/08/2020] [Accepted: 10/29/2020] [Indexed: 01/21/2023] Open
Abstract
To investigate factors associated with intention to be vaccinated against COVID-19 we conducted a cross-sectional survey of 1,500 UK adults, recruited from an existing online research panel. Data were collected between 14th and 17th July 2020. We used linear regression analyses to investigate associations between intention to be vaccinated for COVID-19 "when a vaccine becomes available to you" and sociodemographic factors, previous influenza vaccination, general vaccine attitudes and beliefs, attitudes and beliefs about COVID-19, and attitudes and beliefs about a COVID-19 vaccination. 64% of participants reported being very likely to be vaccinated against COVID-19, 27% were unsure, and 9% reported being very unlikely to be vaccinated. Personal and clinical characteristics, previous influenza vaccination, general vaccination beliefs, and beliefs and attitudes about COVID-19 and a COVID-19 vaccination explained 76% of the variance in vaccination intention. Intention to be vaccinated was associated with more positive general COVID-19 vaccination beliefs and attitudes, weaker beliefs that the vaccination would cause side effects or be unsafe, greater perceived information sufficiency to make an informed decision about COVID-19 vaccination, greater perceived risk of COVID-19 to others (but not risk to oneself), older age, and having been vaccinated for influenza last winter (2019/20). Despite uncertainty around the details of a COVID-19 vaccination, most participants reported intending to be vaccinated for COVID-19. Actual uptake may be lower. Vaccination intention reflects general vaccine beliefs and attitudes. Campaigns and messaging about a COVID-19 vaccination could consider emphasizing the risk of COVID-19 to others and necessity for everyone to be vaccinated.
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Affiliation(s)
- Susan M. Sherman
- School of Psychology, Keele University, Newcastle-under-Lyme, UK
| | - Louise E. Smith
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
| | - Julius Sim
- School of Medicine, Keele University, Newcastle-under-Lyme, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
- Emergency Response Department Science and Technology, Public Health England, Behavioural Science Team, Wiltshire, UK
| | - Megan Cutts
- School of Psychology, Keele University, Newcastle-under-Lyme, UK
| | - Hannah Dasch
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Centre for Implementation Science, King’s College London, London, UK
| | - G James Rubin
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
| | - Nick Sevdalis
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Centre for Implementation Science, King’s College London, London, UK
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44
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Gold N, Watson R, Weston D, Greaves F, Amlôt R. A randomized controlled trial to test the effect of simplified guidance with visuals on comprehension of COVID-19 guidelines and intention to stay home if symptomatic. BMC Public Health 2021; 21:892. [PMID: 33971855 PMCID: PMC8108739 DOI: 10.1186/s12889-021-10787-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 03/17/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND In the COVID-19 pandemic, it is imperative that people understand and comply with self-isolation guidelines. We tested whether a simplified version of the guidelines and a simplified version with visual aids would affect comprehension and intention to self-isolate during the containment phase of the pandemic in the UK, in March 2020, compared to the standard guidelines. METHODS We conducted an online, three-armed parallel randomized controlled trial. Participants were English and over 18. The survey software randomized them into conditions; they were blind to condition. The control group read the 7-page standard guidelines (the current version at the time of the trial). The intervention groups were given either a 3-page simplified version, with a summary box on the front page and numbered bullet points, or the same simplified version with pictograms illustrating the points in the box. Primary outcomes were comprehension of the guidelines, as measured by the number of correct answers given to six questions about the content, and the proportion who answered that they would 'definitely' stay at home for 7 days if symptomatic. FINDINGS Recruitment was from 13 to 16 March 2020, with 1845 participants randomised and all data analysed. The Control group averaged 4.27 correct answers, the Simplified 4.20, and the Simplified + visual aids 4.13, out of a possible total of 6 correct answers. There were no differences in comprehension in the unadjusted models; however, when the model was adjusted for demographic variables, there was lower comprehension in the simplified + visual aids condition than in the control, (ß = - 0.16, p = 0.04998). There were no statistically significant differences in intention to stay home: Control was 85%, Simplified 83%, and Simplified + visual aids condition 84%. CONCLUSION Simplified guidance did not improve comprehension compared to the standard guidance issued in the containment phase of the COVID-19 pandemic in March 2020, and simplified guidance with visual aids may even have worsened comprehension. Simplified guidance had no effect on intention to stay home if symptomatic. This trial informed COVID-19 policy and provides insights relevant to guidance production in the acute phase of a major public health emergency.
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Affiliation(s)
- Natalie Gold
- Public Health England Behavioural Insights, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK.
- Centre for Philosophy of Natural and Social Science, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
| | - Robin Watson
- Public Health England Behavioural Insights, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, UK
- Department of Anthropology, Durham University, Dawson Building, South Road, Durham, DH1 3LE, UK
| | - Dale Weston
- Behavioural Science Team, Emergency Response Department Science and Technology, Health Protection Directorate, Public Health England, Porton Down, Salisbury, Wilts, SP4 0JG, UK
| | - Felix Greaves
- Department of Primary Care and Public Health, Imperial College London, South Kensington, London, SW7 2AZ, UK
| | - Richard Amlôt
- Behavioural Science Team, Emergency Response Department Science and Technology, Health Protection Directorate, Public Health England, Porton Down, Salisbury, Wilts, SP4 0JG, UK
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45
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Horwood J, Chalder M, Ainsworth B, Denison-Day J, de Vocht F, Elwenspoek MMC, Craggs P, Denholm R, Sterne J, Rice C, Miller S, Stuart B, Little P, Moore M, Willcox M, Macleod J, Gullford M, Morton K, Towler L, Francis N, Amlôt R, Yardley L. Primary Care implementation of Germ Defence, a digital behaviour change intervention to improve household infection control during the COVID-19 pandemic: A structured summary of a study protocol for a randomised controlled trial. Trials 2021; 22:263. [PMID: 33836825 PMCID: PMC8033092 DOI: 10.1186/s13063-021-05188-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/11/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To examine the effectiveness of randomising dissemination of the Germ Defence behaviour change website via GP practices across England UK. TRIAL DESIGN A two-arm (1:1 ratio) cluster randomised controlled trial implementing Germ Defence via GP practices compared with usual care. PARTICIPANTS Setting: All Primary care GP practices in England. PARTICIPANTS All patients aged 16 years and over who were granted access by participating GP practices. INTERVENTION AND COMPARATOR Intervention: We will ask staff at GP practices randomised to the intervention arm to share the weblink to Germ Defence with all adult patients registered at their practice during the 4-month trial implementation period and care will otherwise follow current standard management. Germ Defence is an interactive website ( http://GermDefence.org/ ) employing behaviour change techniques and practical advice on how to reduce the spread of infection in the home. The coronavirus version of Germ Defence helps people understand what measures to take and when to take them to avoid infection. This includes hand washing, avoiding sharing rooms and surfaces, dealing with deliveries and ventilating rooms. Using behaviour change techniques, it helps users think through and adopt better home hygiene habits and find ways to solve any barriers, providing personalised goal setting and tailored advice that fits users' personal circumstances and problem solving to overcome barriers. Comparator: Patients at GP practices randomised to the usual care arm will receive current standard management for the 4-month trial period after which we will ask staff to share the link to Germ Defence with all adult patients registered at their practice. MAIN OUTCOMES The primary outcome is the effects of implementing Germ Defence on prevalence of all respiratory tract infection diagnoses during the 4-month trial implementation period. The secondary outcomes are: 1) incidence of COVID-19 diagnoses 2) incidence of COVID-19 symptom presentation 3) incidence of gastrointestinal infections 4) number of primary care consultations 5) antibiotic usage 6) hospital admissions 7) uptake of GP practices disseminating Germ Defence to their patients 8) usage of the Germ Defence website by individuals who were granted access by their GP practice RANDOMISATION: GP practices will be randomised on a 1:1 basis by the independent Bristol Randomised Trials Collaboration (BRTC). Clinical Commission Groups (CCGs) in England will be divided into blocks according to region, and equal numbers in each block will be randomly allocated to intervention or usual care. The randomisation schedule will be generated in Stata statistical software by a statistician not otherwise involved in the enrolment of general practices into the study. BLINDING (MASKING) The principal investigators, the statistician and study collaborators will remain blinded from the identity of randomised practices until the end of the study. NUMBERS TO BE RANDOMISED (SAMPLE SIZE) To detect planned effect size (based on PRIMIT trial, Little et al, 2015): 11.1 million respondents from 6822 active GP practices. Assuming 25% of these GP practices will engage, we will contact all GP practices in England spread across 135 Clinical Commissioning Groups. TRIAL STATUS Protocol version 2.0, dated 13 January 2021. Implementation is ongoing. The implementation period started on 10 November 2020 and will end on 10 March 2021. TRIAL REGISTRATION This trial was registered in the ISRCTN registry ( isrctn.com/ ISRCTN14602359 ) on 12 August 2020. FULL PROTOCOL The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol.
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Affiliation(s)
- Jeremy Horwood
- National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West) University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK. .,Centre for Academic Primary Care (CAPC), Bristol Medical School, Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK. .,NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol, Bristol, UK.
| | - Melanie Chalder
- Centre for Academic Primary Care (CAPC), Bristol Medical School, Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Ben Ainsworth
- Department of Psychology, University of Bath, Bath, UK
| | | | - Frank de Vocht
- National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West) University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.,Centre for Academic Primary Care (CAPC), Bristol Medical School, Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Martha M C Elwenspoek
- National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West) University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.,Centre for Academic Primary Care (CAPC), Bristol Medical School, Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Pippa Craggs
- National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West) University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK
| | - Rachel Denholm
- National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West) University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.,Centre for Academic Primary Care (CAPC), Bristol Medical School, Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | - Jonathan Sterne
- Centre for Academic Primary Care (CAPC), Bristol Medical School, Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK
| | | | - Sascha Miller
- School of Psychology, University of Southampton, Southampton, UK
| | - Beth Stuart
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Paul Little
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Michael Moore
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Merlin Willcox
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - John Macleod
- National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West) University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.,Centre for Academic Primary Care (CAPC), Bristol Medical School, Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.,NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol, Bristol, UK
| | - Martin Gullford
- School of Population Health and Environmental Sciences at King's College London, London, UK
| | - Kate Morton
- School of Psychology, University of Southampton, Southampton, UK
| | - Lauren Towler
- School of Psychology, University of Southampton, Southampton, UK
| | - Nick Francis
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Richard Amlôt
- Behavioural Science Team, Emergency Response Department, Public Health England, Salisbury, UK
| | - Lucy Yardley
- National Institute for Health Research, Applied Research Collaboration West (NIHR ARC West) University Hospitals Bristol and Weston NHS Foundation Trust, 9th Floor, Whitefriars, Lewins Mead, Bristol, BS1 2NT, UK.,Centre for Academic Primary Care (CAPC), Bristol Medical School, Population Health Sciences, University of Bristol, Canynge Hall, 39 Whatley Road, Bristol, BS8 2PS, UK.,NIHR Health Protection Research Unit (HPRU) in Behavioural Science and Evaluation, University of Bristol, Bristol, UK.,School of Psychological Science, University of Bristol, Bristol, UK
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46
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Zhang T, Robin C, Cai S, Sawyer C, Rice W, Smith LE, Amlôt R, Rubin GJ, Reynolds R, Yardley L, Hickman M, Oliver I, Lambert H. Public health information on COVID-19 for international travellers: lessons learned from a mixed-method evaluation. Public Health 2021; 193:116-123. [PMID: 33780897 PMCID: PMC7874910 DOI: 10.1016/j.puhe.2021.01.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 01/22/2021] [Accepted: 01/25/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES In the containment phase of the response to the COVID-19 outbreak, Public Health England (PHE) delivered advice to travellers arriving at major UK ports. We aimed to rapidly evaluate the impact and effectiveness of these communication materials for passengers in the early stages of the pandemic. STUDY DESIGN The study design used is the mixed-methods evaluation. METHODS A questionnaire survey and follow-up interviews with passengers arriving at London Heathrow Airport on scheduled flights from China and Singapore. The survey assessed passengers' knowledge of symptoms, actions to take, and attitudes towards PHE COVID-19 public health information; interviews explored their views of official public health information and self-isolation. RESULTS One hundred and twenty-one passengers participated in the survey and 15 in follow-up interviews. Eighty three percentage of surveyed passengers correctly identified all three COVID-19 associated symptoms listed in PHE information at that time. Most could identify the recommended actions and found the advice understandable and trustworthy. Interviews revealed that passengers shared concerns about the lack of wider official action, and that passengers' knowledge had been acquired elsewhere as much from PHE. Respondents also noted their own agency in choosing to self-isolate, partially as a self-protective measure. CONCLUSION PHE COVID-19 public health information was perceived as clear and acceptable, but we found that passengers acquired knowledge from various sources and they saw the provision of information alone on arrival as an insufficient official response. Our study provides fresh insights into the importance of taking greater account of diverse information sources and of the need for public assurance in creating public health information materials to address global health threats.
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Affiliation(s)
- T Zhang
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - C Robin
- Field Epidemiology, Field Service, National Infection Service, Public Health England, Bristol, UK; NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Health Protection Research Unit in Emerging and Zoonotic Infections, University of Liverpool, Liverpool, UK; NIHR Health Protection Research Unit in Gastrointestinal Infections, University of Liverpool, Liverpool, UK
| | - S Cai
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - C Sawyer
- UK Field Epidemiology Training Programme, Global Public Health Division, Public Health England, London, UK; Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, UK
| | - W Rice
- Field Epidemiology, Field Service, National Infection Service, Public Health England, Bristol, UK
| | - L E Smith
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
| | - R Amlôt
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK; Behavioural Science Team, Emergency Response Department Science and Technology, Public Health England, UK
| | - G J Rubin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
| | - R Reynolds
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol Medical School, University of Bristol, Bristol, UK
| | - L Yardley
- NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol Medical School, University of Bristol, Bristol, UK; School of Psychological Sciences, University of Bristol, Bristol, UK; Department of Psychology, University of Southampton, Southampton, UK
| | - M Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol Medical School, University of Bristol, Bristol, UK
| | - I Oliver
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Field Epidemiology, Field Service, National Infection Service, Public Health England, Bristol, UK; NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol Medical School, University of Bristol, Bristol, UK
| | - H Lambert
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Health Protection Research Unit in Behavioural Science and Evaluation, Bristol Medical School, University of Bristol, Bristol, UK.
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Abstract
OBJECTIVE To investigate rates of adherence to the UK's test, trace, and isolate system over the initial 11 months of the covid-19 pandemic. DESIGN Series of cross sectional online surveys. SETTING 37 nationally representative surveys in the UK, 2 March 2020 to 27 January 2021. PARTICIPANTS 74 697 responses from 53 880 people living in the UK, aged 16 years or older (37 survey waves, about 2000 participants in each wave). MAIN OUTCOME MEASURES Identification of the main symptoms of covid-19 (cough, high temperature or fever, and loss of sense of smell or taste), self-reported adherence to self-isolation if symptoms were present and intention to self-isolate if symptoms were to develop, requesting a test for covid-19 if symptoms were present and intention to request a test if symptoms were to develop, and intention to share details of close contacts. RESULTS Only 51.5% of participants (95% confidence interval 51.0% to 51.9%, n=26 030/50 570) identified the main symptoms of covid-19; the corresponding values in the most recent wave of data collection (25-27 January 2021) were 50.8% (48.6% to 53.0%, n=1019/2007). Across all waves, duration adjusted adherence to full self-isolation was 42.5% (95% confidence interval 39.7% to 45.2%, n=515/1213); in the most recent wave of data collection (25-27 January 2021), it was 51.8% (40.8% to 62.8%, n=43/83). Across all waves, requesting a test for covid-19 was 18.0% (95% confidence interval 16.6% to 19.3%, n=552/3068), increasing to 22.2% (14.6% to 29.9%, n=26/117) from 25 to 27 January. Across all waves, intention to share details of close contacts was 79.1% (95% confidence interval 78.8% to 79.5%, n=36 145/45 680), increasing to 81.9% (80.1% to 83.6%, n=1547/1890) from 25 to 27 January. Non-adherence was associated with being male, younger age, having a dependent child in the household, lower socioeconomic grade, greater financial hardship during the pandemic, and working in a key sector. CONCLUSIONS Levels of adherence to test, trace, and isolate are low, although some improvement has occurred over time. Practical support and financial reimbursement are likely to improve adherence. Targeting messaging and policies to men, younger age groups, and key workers might also be necessary.
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Affiliation(s)
- Louise E Smith
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Weston Education Centre, King's College London, London SE5 9RJ, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
| | - Henry W W Potts
- Institute of Health Informatics, University College London, London, UK
| | - Richard Amlôt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
- Public Health England, Behavioural Science Team, Emergency Response Department Science and Technology, Porton Down, Salisbury, UK
| | - Nicola T Fear
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Weston Education Centre, King's College London, London SE5 9RJ, UK
- King's Centre for Military Health Research and Academic Department of Military Mental Health, King's College London, London, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London, UK
| | - G James Rubin
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Weston Education Centre, King's College London, London SE5 9RJ, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, King's College London, London, UK
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48
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Collins S, James T, Carter H, Symons C, Southworth F, Foxall K, Marczylo T, Amlôt R. Mass Casualty Decontamination for Chemical Incidents: Research Outcomes and Future Priorities. Int J Environ Res Public Health 2021; 18:3079. [PMID: 33802722 PMCID: PMC8002470 DOI: 10.3390/ijerph18063079] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/09/2021] [Accepted: 03/13/2021] [Indexed: 01/22/2023]
Abstract
Planning for major incidents involving the release of hazardous chemicals has been informed by a multi-disciplinary research agenda which has sought to inform all aspects of emergency response, but with a focus in recent years on mass casualty decontamination. In vitro and human volunteer studies have established the relative effectiveness of different decontamination protocols for a range of chemical agents. In parallel, a programme of research has focused on communicating with and managing large numbers of contaminated casualties at the scene of an incident. We present an accessible overview of the evidence underpinning current casualty decontamination strategies. We highlight where research outcomes can directly inform response planning, including the critical importance of beginning the decontamination process as soon as possible, the benefits of early removal of contaminated clothing, the evidence under-pinning dry and wet decontamination and how effective communication is essential to any decontamination response. We identify a range of priority areas for future research including establishing the significance of the 'wash-in' effect and developing effective strategies for the decontamination of hair. We also highlight several areas of future methodological development, such as the need for novel chemical simulants. Whilst considerable progress has been made towards incorporating research outcomes into operational policy and practice, we outline how this developing evidence-base might be used to inform future iterations of mass casualty decontamination guidance.
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Affiliation(s)
- Samuel Collins
- Chemicals and Environmental Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot OX11 0RQ, UK;
| | - Thomas James
- Chemicals and Environmental Effects Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot OX11 0RQ, UK;
| | - Holly Carter
- COVID-19 Behavioural Science and Insights Unit, Public Health England, Public Health England, London SE1 8UG, UK; (H.C.); (C.S.); (R.A.)
| | - Charles Symons
- COVID-19 Behavioural Science and Insights Unit, Public Health England, Public Health England, London SE1 8UG, UK; (H.C.); (C.S.); (R.A.)
| | - Felicity Southworth
- Behavioural Science, Emergency Response Department Science & Technology, Health Protection Directorate, Public Health England, Porton SP4 0JG, UK;
| | - Kerry Foxall
- Toxicology Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot OX11 0RQ, UK; (K.F.); (T.M.)
| | - Tim Marczylo
- Toxicology Department, Centre for Radiation, Chemical and Environmental Hazards, Public Health England, Didcot OX11 0RQ, UK; (K.F.); (T.M.)
| | - Richard Amlôt
- COVID-19 Behavioural Science and Insights Unit, Public Health England, Public Health England, London SE1 8UG, UK; (H.C.); (C.S.); (R.A.)
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College, London SE1 1UL, UK
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49
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Ainsworth B, Miller S, Denison-Day J, Stuart B, Groot J, Rice C, Bostock J, Hu XY, Morton K, Towler L, Moore M, Willcox M, Chadborn T, Gold N, Amlôt R, Little P, Yardley L. Infection Control Behavior at Home During the COVID-19 Pandemic: Observational Study of a Web-Based Behavioral Intervention (Germ Defence). J Med Internet Res 2021; 23:e22197. [PMID: 33566791 PMCID: PMC7909304 DOI: 10.2196/22197] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 12/15/2020] [Accepted: 01/24/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND To control the COVID-19 pandemic, people should adopt protective behaviors at home (self-isolation, social distancing, putting shopping and packages aside, wearing face coverings, cleaning and disinfecting, and handwashing). There is currently limited support to help individuals conduct these behaviors. OBJECTIVE This study aims to report current household infection control behaviors in the United Kingdom and examine how they might be improved. METHODS This was a pragmatic cross-sectional observational study of anonymous participant data from Germ Defence between May 6-24, 2020. Germ Defence is an open-access fully automated website providing behavioral advice for infection control within households. A total of 28,285 users sought advice from four website pathways based on household status (advice to protect themselves generally, to protect others if the user was showing symptoms, to protect themselves if household members were showing symptoms, and to protect a household member who is at high risk). Users reported current infection control behaviors within the home and intentions to change these behaviors. RESULTS Current behaviors varied across all infection control measures but were between sometimes (face covering: mean 1.61, SD 1.19; social distancing: mean 2.40, SD 1.22; isolating: mean 2.78, SD 1.29; putting packages and shopping aside: mean 2.75, SD 1.55) and quite often (cleaning and disinfecting: mean 3.17, SD 1.18), except for handwashing (very often: mean 4.00, SD 1.03). Behaviors were similar regardless of the website pathway used. After using Germ Defence, users recorded intentions to improve infection control behavior across all website pathways and for all behaviors (overall average infection control score mean difference 0.30, 95% CI 0.29-0.31). CONCLUSIONS Self-reported infection control behaviors other than handwashing are lower than is optimal for infection prevention, although handwashing is much higher. Advice using behavior change techniques in Germ Defence led to intentions to improve these behaviors. Promoting Germ Defence within national and local public health and primary care guidance could reduce COVID-19 transmission.
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Affiliation(s)
- Ben Ainsworth
- Department of Psychology, University of Bath, Bath, United Kingdom
- National Institute for Health Research Biomedical Research Centre, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Sascha Miller
- School of Psychology, University of Southampton, Southampton, United Kingdom
| | - James Denison-Day
- School of Psychology, University of Southampton, Southampton, United Kingdom
| | - Beth Stuart
- Primary Care Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom
| | - Julia Groot
- Department of Psychology, University of Bath, Bath, United Kingdom
| | - Cathy Rice
- School of Psychology, University of Southampton, Southampton, United Kingdom
| | - Jennifer Bostock
- Policy Research Unit, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Xiao-Yang Hu
- Primary Care Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom
| | - Katherine Morton
- School of Psychology, University of Southampton, Southampton, United Kingdom
| | - Lauren Towler
- School of Psychology, University of Southampton, Southampton, United Kingdom
| | - Michael Moore
- Primary Care Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom
| | - Merlin Willcox
- Primary Care Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom
| | - Tim Chadborn
- Public Health England Behavioural Insights, Public Health England, London, United Kingdom
| | - Natalie Gold
- Public Health England Behavioural Insights, Public Health England, London, United Kingdom
- Centre for the Philosophy of Natural and Social Sciences, London School of Economics, London, United Kingdom
| | - Richard Amlôt
- Behavioural Science Team, Emergency Response Department Science and Technology, Public Health England, London, United Kingdom
| | - Paul Little
- Primary Care Population Sciences and Medical Education, University of Southampton, Southampton, United Kingdom
| | - Lucy Yardley
- School of Psychology, University of Southampton, Southampton, United Kingdom
- School of Psychological Science, University of Bristol, Bristol, United Kingdom
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50
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Woodland L, Smith LE, Webster RK, Amlôt R, Rubin A, Wessely S, Rubin JG. Why did some parents not send their children back to school following school closures during the COVID-19 pandemic: a cross-sectional survey. BMJ Paediatr Open 2021; 5:e001014. [PMID: 34611551 PMCID: PMC8482536 DOI: 10.1136/bmjpo-2020-001014] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 05/15/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND On 23 March 2020, schools closed to most children in England in response to COVID-19 until September 2020. Schools were kept open to children of key workers and vulnerable children on a voluntary basis. Starting 1 June 2020, children in reception (4-5 years old), year 1 (5-6 years old) and year 6 (10-11 years old) also became eligible to attend school. METHODS 1373 parents or guardians of children eligible to attend school completed a cross-sectional survey between 8 and 11 June 2020. We investigated factors associated with whether children attended school or not. RESULTS 46% (n=370/803) of children in year groups eligible to attend school and 13% (n=72/570) of children of key workers had attended school in the past 7 days. The most common reasons for sending children to school were that the child's education would benefit, the child wanted to go to school and the parent needed to work. A child was significantly more likely to attend if the parent believed the child had already had COVID-19, they had special educational needs or a person in the household had COVID-19 symptoms. CONCLUSIONS Following any future school closure, helping parents to feel comfortable returning their child to school will require policy makers and school leaders to communicate about the adequacy of their policies to: (A) ensure that the risk to children in school is minimised; (B) ensure that the educational potential within schools is maximised; and (C) ensure that the benefits of school for the psychological well-being of children are prioritised.
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Affiliation(s)
- Lisa Woodland
- Institution of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - Louise E Smith
- Institution of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | | | | | | | - Simon Wessely
- Institution of Psychiatry Psychology and Neuroscience, King's College London, London, UK
| | - James G Rubin
- Institution of Psychiatry Psychology and Neuroscience, King's College London, London, UK
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