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Middleton C, Larremore DB. Modeling the transmission mitigation impact of testing for infectious diseases. SCIENCE ADVANCES 2024; 10:eadk5108. [PMID: 38875334 PMCID: PMC11177932 DOI: 10.1126/sciadv.adk5108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 05/10/2024] [Indexed: 06/16/2024]
Abstract
A fundamental question of any program focused on the testing and timely diagnosis of a communicable disease is its effectiveness in reducing transmission. Here, we introduce testing effectiveness (TE)-the fraction by which testing and post-diagnosis isolation reduce transmission at the population scale-and a model that incorporates test specifications and usage, within-host pathogen dynamics, and human behaviors to estimate TE. Using TE to guide recommendations, we show that today's rapid diagnostics should be used immediately upon symptom onset to control influenza A and respiratory syncytial virus but delayed by up to two days to control omicron-era severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Furthermore, while rapid tests are superior to reverse transcription quantitative polymerase chain reaction (RT-qPCR) to control founder-strain SARS-CoV-2, omicron-era changes in viral kinetics and rapid test sensitivity cause a reversal, with higher TE for RT-qPCR despite longer turnaround times. Last, we illustrate the model's flexibility by quantifying trade-offs in the use of post-diagnosis testing to shorten isolation times.
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Affiliation(s)
- Casey Middleton
- Department of Computer Science, University of Colorado Boulder, Boulder, CO, USA
- BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, USA
| | - Daniel B. Larremore
- Department of Computer Science, University of Colorado Boulder, Boulder, CO, USA
- BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, USA
- Santa Fe Institute, Santa Fe, NM, USA
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2
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Williams C, Rauwolf P, Boulter M, Parkinson JA. Closing the Gap: How Psychological Distance Influences Willingness to Engage in Risky COVID Behavior. Behav Sci (Basel) 2024; 14:449. [PMID: 38920782 PMCID: PMC11201267 DOI: 10.3390/bs14060449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Revised: 05/22/2024] [Accepted: 05/24/2024] [Indexed: 06/27/2024] Open
Abstract
Pandemics, and other risk-related contexts, require dynamic changes in behavior as situations develop. Human behavior is influenced by both explicit (cognitive) and implicit (intuitive) factors. In this study, we used psychological distance as a lens to understand what influences our decision-making with regard to risk in the context of COVID-19. This study was based on the rationale that our relational needs are more concrete to us than the risk of the virus. First, we explored the impact of social-psychological distance on participants' risk perceptions and behavioral willingness. As hypothesized, we found that close social relationships of agents promoted willingness to engage in risky behavior. In the second phase, we tested an intervention designed to increase the concreteness of information about virus transmission as a mechanism to mitigate the bias of social influence. We found that the concreteness intervention resulted in significantly reduced willingness to engage in risky behavior. As such, communications aimed at changing the behavior of citizens during times of increased risk or danger should consider conceptually concrete messaging when communicating complex risk, and hence may provide a valuable tool in promoting health-related behavior.
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Affiliation(s)
- Ceridwen Williams
- Wales Centre for Behaviour Change, Department of Psychology, Bangor University, Bangor LL57 2AS, UK; (C.W.); (P.R.)
| | - Paul Rauwolf
- Wales Centre for Behaviour Change, Department of Psychology, Bangor University, Bangor LL57 2AS, UK; (C.W.); (P.R.)
| | - Matt Boulter
- School of Health and Life Sciences, University of the West of Scotland, Glasgow G72 0LH, UK;
| | - John A. Parkinson
- Wales Centre for Behaviour Change, Department of Psychology, Bangor University, Bangor LL57 2AS, UK; (C.W.); (P.R.)
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Kinsman RH, Jim HL, Casey RA, Ruiz-Izaguirre E, Owczarczak-Garstecka S, Cooper B, Tasker S, Murray JK. Puppy Socialisation Experiences in Relation to Age and COVID-19 Lockdown Restrictions in the UK and ROI. Animals (Basel) 2024; 14:1471. [PMID: 38791688 PMCID: PMC11117371 DOI: 10.3390/ani14101471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2024] [Revised: 05/13/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
Limited socialisation can contribute to the development of undesirable dog behaviours. The COVID-19 lockdown potentially limited socialisation opportunities, which may negatively impact the future behaviour of puppies raised during lockdown. Data were gathered from longitudinal study participants in the United Kingdom/Republic of Ireland via multiple questionnaires between May 2016 and November 2022. The impact of age and lockdown phase (pre-, during, and post-) on the types of socialisation experiences of 8-to-19-week-old puppies and the recency of socialisation experiences of approximately 6-month-old puppies were examined. Puppies under 19-weeks had significantly more types of socialisation experiences (from a predefined list) as they aged, and pre-lockdown compared to post-lockdown, but not between other lockdown phases. Most 6-month-old puppies had met a new adult or dog outside the household, a familiar dog, and/or a child within the last 1-7 days, and this was similar between lockdown phases. During lockdown, 6-month-old puppies experienced longer periods between meeting a new adult in their home. Puppies were hypothesised to have had fewer experiences during lockdown, but this was not found. However, the quantity and quality of these experiences may have been affected. Future research within this longitudinal study will explore relationships between the timing and type of experiences had by puppies and their subsequent behaviour.
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Affiliation(s)
| | - Hoi-Lam Jim
- Dogs Trust, London EC1V 7RQ, UK
- Institute for Advanced Study, Kyoto University, Kyoto 6068501, Japan
- Japan Society for the Promotion of Science, Tokyo 1020083, Japan
| | | | | | | | | | - Séverine Tasker
- Bristol Veterinary School, University of Bristol, Bristol BS40 5DU, UK
- Linnaeus Veterinary Limited, Shirley, Solihull B90 4BN, UK
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Sobieraj E, Goławski J, Sikora A, Duda-Duma Ł, Korzeń M, Pasek O, Pyzio K, Gańczak M. Knowledge and preventive practices regarding COVID-19 disease among Ukrainian refugees in Poland. Medicine (Baltimore) 2024; 103:e37833. [PMID: 38640299 PMCID: PMC11029944 DOI: 10.1097/md.0000000000037833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/10/2024] [Accepted: 03/15/2024] [Indexed: 04/21/2024] Open
Abstract
Russia's invasion of Ukraine contributed one of the largest migration movements in the 21st century. Refugees may become a source of severe acute respiratory syndrome coronavirus 2 infections for the residents of host countries. The study aim was to assess knowledge and preventive practices regarding coronavirus disease 2019 (COVID-19) among Ukrainian refugees in Poland. The cross-sectional study was conducted between March and April 2022 among Ukrainian refugees registering consecutively in Zielona Góra, Poland. Knowledge and preventive practices were assessed by giving 1 point for each correct answer by anonymous, self-administered questionnaire. The response rate was 96%, 190 participated (mean age 37.8 ± 15.5 years; 57.9% females); 61.6% self-reported their socio-economic status (SES) as high, 38.9% reported high level of education. The mean COVID-19 knowledge score was 3.06 ± 1.95; 19.5% scored >50%. The knowledge level was higher among migrants with high SES (P = .003). The mean preventive practices score was 2.56 ± 1.38; 54.0% scored ≥ 60%. 40.5% declared social distancing, 62.6% followed coughing etiquette, 69.0% home isolate themselves during COVID-19. 57.9% always used masks in public space, however 74.2% wore masks with uncovered nose. Refugees with higher education, high SES and knowledge level had significantly greater preventive practices scores (P = .002; P = .02; P = .03, respectively). The knowledge and preventive practices level was insufficient. Educational campaigns oriented to raising knowledge and prevention behavior skills should be implemented, especially targeting high-risk groups to avoid spread of COVID-19.
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Affiliation(s)
- Ewa Sobieraj
- Student Research Group, Collegium Medicum, University of Zielona Gora, Zielona Gora, Poland
| | - Jakub Goławski
- Student Research Group, Collegium Medicum, University of Zielona Gora, Zielona Gora, Poland
| | - Anna Sikora
- Student Research Group, Collegium Medicum, University of Zielona Gora, Zielona Gora, Poland
| | - Łukasz Duda-Duma
- Student Research Group, Collegium Medicum, University of Zielona Gora, Zielona Gora, Poland
| | - Marcin Korzeń
- Department of Methods of Artificial Intelligence and Applied Mathematics, West Pomeranian University of Technology, Szczecin, Poland
| | - Oskar Pasek
- Student Research Group, Collegium Medicum, University of Zielona Gora, Zielona Gora, Poland
| | - Klaudia Pyzio
- Student Research Group, Collegium Medicum, University of Zielona Gora, Zielona Gora, Poland
| | - Maria Gańczak
- Department of Infectious Diseases, Collegium Medicum, University of Zielona Gora, Zielona Gora, Poland
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Keene CM, Dickinson S, Naidoo R, Andersen-Waine B, Ferguson-Lewis A, Polner A, Amswych M, White L, Molyneux S, Wanat M. Decision to self-isolate during the COVID-19 pandemic in the UK: a rapid scoping review. BMJ Open 2024; 14:e084437. [PMID: 38553081 PMCID: PMC10982762 DOI: 10.1136/bmjopen-2024-084437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 02/27/2024] [Indexed: 04/02/2024] Open
Abstract
OBJECTIVE Testing for COVID-19 was a key component of the UK's response to the COVID-19 pandemic. This strategy relied on positive individuals self-isolating to reduce transmission, making isolation the lynchpin in the public health approach. Therefore, we scoped evidence to systematically identify and categorise barriers and facilitators to compliance with self-isolation guidance during the COVID-19 pandemic in the UK, to inform public health strategies in future pandemics. DESIGN A rapid scoping review was conducted. SEARCH STRATEGY Key terms were used to search literature databases (PubMed, Scopus and the WHO COVID-19 Research Database, on 7 November 2022), Google Scholar and stakeholder-identified manuscripts, ultimately including evidence published in English from UK-based studies conducted between 2020 and 2022. DATA EXTRACTION AND SYNTHESIS Data were extracted and synthesised into themes, organised broadly into capability, opportunity and motivation, and reviewed with key stakeholders from the UK Health Security Agency (UKHSA). RESULTS We included 105 sources, with 63 identified from UKHSA and used to inform their decision-making during the pandemic. Influences on the decision to comply with isolation guidance were categorised into six themes: perceived ability to isolate; information and guidance; logistics; social influences, including trust; perceived value; and perceived consequences. Individuals continuously assessed these factors in deciding whether or not to comply with guidance and self-isolate. CONCLUSIONS Decisions to self-isolate after a positive test were influenced by multiple factors, including individuals' beliefs, concerns, priorities and personal circumstances. Future testing strategies must facilitate meaningful financial, practical and mental health support to allow individuals to overcome the perceived and actual negative consequences of isolating. Clear, consistent communication of the purpose and procedures of isolating will also be critical to support compliance with self-isolation guidance, and should leverage people's perceived value in protecting others. Building public trust is also essential, but requires investment before the next pandemic starts.
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Affiliation(s)
- Claire Marriott Keene
- Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Sophie Dickinson
- UKI Health Sciences and Wellness, Ernst & Young (EY), London, UK
| | - Reshania Naidoo
- Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- UKI Health Sciences and Wellness, Ernst & Young (EY), London, UK
| | | | | | - Anastasia Polner
- UKI Health Sciences and Wellness, Ernst & Young (EY), London, UK
| | - Ma'ayan Amswych
- UKI Health Sciences and Wellness, Ernst & Young (EY), London, UK
| | - Lisa White
- Department of Biology, University of Oxford, Oxford, UK
| | - Sassy Molyneux
- Centre for Global Health Research, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Marta Wanat
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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6
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Zomer CL, Kroese F, Sanders JG, Janssen R, de Bruin M. Estimating the impact of COVID-19 self-test availability and modifications in test-strategy on overall test uptake using an experimental vignette study. Sci Rep 2024; 14:5887. [PMID: 38467654 PMCID: PMC10928216 DOI: 10.1038/s41598-024-54988-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/19/2024] [Indexed: 03/13/2024] Open
Abstract
To inform future Dutch COVID-19 testing policies we did an experimental vignette study to investigate whether inclusion of the less reliable lateral flow tests (self-tests) would change test-uptake sufficiently to improve population-level test sensitivity. A representative sample (n = 3,270) participated in a 2-by-2 online experiment to evaluate the effects of test-guidelines including self-testing advice (IV1), and the effects of self-test availability (IV2) on expected test uptake (PCR test, self-test or no test) and sensitivity of the overall test strategy (primary outcome). Across four scenarios, changing test advice did not affect expected testing behaviour. Self-test availability, however, increased the timeliness of testing, the number of people testing, and overall test strategy sensitivity. Based on these findings, we recommend that (national) policy facilitates a supply of self-tests at home, for example through free and pro-active distribution of test-kits during a pandemic. This could substantially enhance the chances of timely detecting and isolating patients.
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Affiliation(s)
- Colene L Zomer
- Corona Behavioural Unit, National Institute of Public Health and the Environment, Bilthoven, The Netherlands.
- Radboud University Medical Center, Institute of Health Sciences, Nijmegen, The Netherlands.
| | - Floor Kroese
- Corona Behavioural Unit, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
- Department of Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands
| | - Jet G Sanders
- Corona Behavioural Unit, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
- Department of Psychological and Behavioural Science, London School of Economics and Political Sciences, London, UK
| | - Riny Janssen
- Centre for Infectious Disease Control, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
| | - Marijn de Bruin
- Corona Behavioural Unit, National Institute of Public Health and the Environment, Bilthoven, The Netherlands
- Radboud University Medical Center, Institute of Health Sciences, Nijmegen, The Netherlands
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7
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Middleton C, Larremore DB. Modeling the Transmission Mitigation Impact of Testing for Infectious Diseases. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.09.22.23295983. [PMID: 37808825 PMCID: PMC10557819 DOI: 10.1101/2023.09.22.23295983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/10/2023]
Abstract
A fundamental question of any program focused on the testing and timely diagnosis of a communicable disease is its effectiveness in reducing transmission. Here, we introduce testing effectiveness (TE)-the fraction by which testing and post-diagnosis isolation reduce transmission at the population scale-and a model that incorporates test specifications and usage, within-host pathogen dynamics, and human behaviors to estimate TE. Using TE to guide recommendations, we show that today's rapid diagnostics should be used immediately upon symptom onset to control influenza A and respiratory syncytial virus (RSV), but delayed by up to 2d to control omicron-era SARS-CoV-2. Furthermore, while rapid tests are superior to RT-qPCR for control of founder-strain SARS-CoV-2, omicron-era changes in viral kinetics and rapid test sensitivity cause a reversal, with higher TE for RT-qPCR despite longer turnaround times. Finally, we illustrate the model's flexibility by quantifying tradeoffs in the use of post-diagnosis testing to shorten isolation times.
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Affiliation(s)
- Casey Middleton
- Department of Computer Science, University of Colorado Boulder, Boulder, CO, USA
- BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, USA
| | - Daniel B Larremore
- Department of Computer Science, University of Colorado Boulder, Boulder, CO, USA
- BioFrontiers Institute, University of Colorado Boulder, Boulder, CO, USA
- Santa Fe Institute, Santa Fe, NM, USA
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8
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Ray D, Dhami R, Lecouturier J, McGowan LJ, Mukherjee A, Vlaev I, Kelly MP, Sniehotta FF. Falsification of home rapid antigen lateral flow tests during the COVID-19 pandemic. Sci Rep 2024; 14:3322. [PMID: 38336852 PMCID: PMC10858045 DOI: 10.1038/s41598-024-53383-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 01/31/2024] [Indexed: 02/12/2024] Open
Abstract
During the COVID-19 pandemic, lateral flow tests (LFTs) were used to regulate access to work, education, social activities, and travel. However, falsification of home LFT results was a concern. Falsification of test results during an ongoing pandemic is a sensitive issue. Consequently, respondents may not answer truthfully to questions about LFT falsification behaviours (FBs) when asked directly. Indirect questioning techniques such as the Extended Crosswise model (ECWM) can provide more reliable prevalence estimates of sensitive behaviors than direct questioning. Here we report the prevalence of LFT FBs in a representative sample in England (n = 1577) using direct questioning (DQ) and the ECWM. We examine the role of demographic and psychological variables as predictors of LFT FBs. We show that the prevalence estimates of the FBs in the DQ condition were significantly lower than the ECWM estimates, e.g., reporting a negative result without conducting a test: 5.7% DQ vs 18.4% ECWM. Moral norms, subjective norms, anticipated regret, perception of risk to self, and trust in government predicted some of the FBs. Indirect questioning techniques can help provide more realistic and higher quality data about compliance with behavioural regulations to government and public health agencies.
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Affiliation(s)
- Devashish Ray
- NIHR Policy Research Unit in Behavioural Science-Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK.
| | - Raenhha Dhami
- NIHR Policy Research Unit in Behavioural Science-Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Jan Lecouturier
- NIHR Policy Research Unit in Behavioural Science-Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Laura J McGowan
- NIHR Policy Research Unit in Behavioural Science-Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
| | - Aritra Mukherjee
- Biostatistics Research Group, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Ivo Vlaev
- NIHR Policy Research Unit in Behavioural Science-Behavioural Science Group, Warwick Business School, University of Warwick, Coventry, UK
| | - Michael P Kelly
- NIHR Policy Research Unit in Behavioural Science-Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Forvie Site, Cambridge, CB2 0SR, UK
| | - Falko F Sniehotta
- NIHR Policy Research Unit in Behavioural Science-Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle Upon Tyne, UK
- Department of Public Health, Preventive and Social Medicine, Center for Preventive Medicine and Digital Health Baden-Wuerttemberg, Heidelberg University, Heidelberg, Germany
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9
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Jütte D, Hennig-Thurau T, Cziehso G, Sattler H. When the antidote is the poison: Investigating the relationship between people's social media usage and loneliness when face-to-face communication is restricted. PLoS One 2024; 19:e0296423. [PMID: 38335211 PMCID: PMC10857570 DOI: 10.1371/journal.pone.0296423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 12/12/2023] [Indexed: 02/12/2024] Open
Abstract
When governments mandated lockdowns to limit the spread of the coronavirus, the resulting reduction of face-to-face communication threatened many people's psychological well-being by fostering feelings of loneliness. Given social media's eponymous social nature, we study the relationship between people's social media usage and their loneliness during these times of physical social restrictions. We contrast literature highlighting the social value of social media with a competing logic based on the "internet paradox," according to which increased social media usage may paradoxically be associated with increasing, not decreasing, levels of loneliness. As the extant literature provides opposing correlational insights into the general relationship of social media usage and loneliness, we offer competing hypotheses and offer novel longitudinal insights into the phenomenon of interest. In the empirical context of Germany's initial lockdown, our research uses survey panel data from February 2020 (before the lockdown) and April 2020 (during the lockdown) to contribute longitudinal evidence to the matter. We find that more usage of social media in the studied lockdown setting is indeed associated with more, not less loneliness. Thus, our results suggest a "social media paradox" when physical social restrictions are mandated and caution social media users and policy makers to not consider social media as a valuable alternative for social interaction. A post-hoc analysis suggests that more communication via richer digital media which are available during physical lockdowns (e.g., video chats) softens the "social media paradox". Conclusively, this research provides deeper insights into the social value of social interactions via digital media during lockdowns and contributes novel insights into the relationship between social media and loneliness during such times when physical social interaction is heavily restricted.
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Affiliation(s)
- David Jütte
- Marketing Center Münster, University of Münster, Münster, Germany
| | | | - Gerrit Cziehso
- Marketing Center Münster, University of Münster, Münster, Germany
| | - Henrik Sattler
- Marketing & Branding, University of Hamburg, Hamburg, Germany
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Brierley MEE, Yaw SJL, Jongenelis MI. Perceptions of Australia's e-cigarette regulations and recommendations for future reforms: a qualitative study of adolescents and adults. BMJ Open 2024; 14:e081032. [PMID: 38316596 PMCID: PMC10860001 DOI: 10.1136/bmjopen-2023-081032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/24/2024] [Indexed: 02/07/2024] Open
Abstract
OBJECTIVE To assess public perceptions of the effectiveness of e-cigarette regulations in minimising use among adolescents and those who have never smoked. Specifically, we explored (1) perceived effectiveness of current regulations relating to e-cigarettes and (2) ideas for further regulations that could reduce use. DESIGN AND PARTICIPANTS Focus groups (n=16) were conducted with Australian adolescents (14-17 years), young adults (18-24 years) and adults (25-39 years). Groups were stratified by age, gender and e-cigarette use status. Data were analysed using reflexive thematic analysis. SETTING Focus groups were conducted in-person in two major Australian cities. RESULTS Groups lacked a comprehensive understanding of e-cigarette regulations in Australia. When informed of these regulations, half of the groups considered the prescription model for nicotine e-cigarette products to be effective when enforced appropriately. Almost all groups considered access to non-nicotine products problematic. All groups suggested a range of demand reduction regulations, including plain packaging, health warnings, flavour restrictions and increased vape-free areas. Most groups (predominantly those who had never vaped) also recommended supply reduction regulations such as banning all e-cigarettes. The need for supply reduction measures to include addiction and mental health supports was discussed. CONCLUSIONS The regulations recommended by participants largely align with those that are to be introduced in Australia, indicating that these reforms are likely to be accepted by the public. Ensuring these reforms are complemented by formal supports for young people experiencing nicotine dependence and related mental health concerns is critical.
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Affiliation(s)
- Mary-Ellen E Brierley
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Sean J L Yaw
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Michelle I Jongenelis
- Melbourne Centre for Behaviour Change, Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Victoria, Australia
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11
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Hubbard G, Daas CD, Johnston M, Dunsmore J, Maier M, Polson R, Dixon D. Behavioural Sciences Contribution to Suppressing Transmission of Covid-19 in the UK: A Systematic Literature Review. Int J Behav Med 2024; 31:1-18. [PMID: 37059924 PMCID: PMC10104693 DOI: 10.1007/s12529-023-10171-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2023] [Indexed: 04/16/2023]
Abstract
BACKGROUND Governments have relied on their citizens to adhere to a variety of transmission-reducing behaviours (TRBs) to suppress the Covid-19 pandemic. Understanding the psychological and sociodemographic predictors of adherence to TRBs will be heavily influenced by the particular theories used by researchers. This review aims to identify the theories and theoretical constructs used to understand adherence to TRBs during the pandemic within the UK social and legislative context. METHODS A systematic review identified studies to understand TRBs of adults in the UK during the pandemic. Identified theoretical constructs were coded to the Theoretical Domains Framework. Data are presented as a narrative summary. RESULTS Thirty-five studies (n = 211,209) investigated 123 TRBs, applied 13 theoretical frameworks and reported 50 sociodemographic characteristics and 129 psychological constructs. Most studies used social cognition theories to understand TRBs and employed cross-sectional designs. Risk of sampling bias was high. Relationships between constructs and TRBs varied, but in general, beliefs about the disease (e.g. severity and risk perception) and about TRBs (e.g. behavioural norms) influenced behavioural intentions and self-reported adherence. More studies than not found that older people and females were more adherent. CONCLUSIONS Behavioural scientists in the UK generated a significant and varied body of work to understand TRBs during the pandemic. However, more use of theories that do not rely on deliberative processes to effect behaviour change and study designs better able to support causal inferences should be used in future to inform public health policy and practice. PROSPERO REGISTRATION CRD42021282699.
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Affiliation(s)
- Gill Hubbard
- Department of Nursing, University of the Highlands and Islands, Inverness, UK.
- Centre for Health Science, Older Perth Road, Inverness, IV2 3JH, UK.
| | - Chantal den Daas
- Health Psychology Group, University of Aberdeen Institute of Applied Health Sciences, Aberdeen, Scotland
| | - Marie Johnston
- Health Psychology Group, University of Aberdeen Institute of Applied Health Sciences, Aberdeen, Scotland
| | - Jennifer Dunsmore
- Health Psychology Group, University of Aberdeen Institute of Applied Health Sciences, Aberdeen, Scotland
| | - Mona Maier
- Health Psychology Group, University of Aberdeen Institute of Applied Health Sciences, Aberdeen, Scotland
| | - Rob Polson
- Department of Nursing, University of the Highlands and Islands, Inverness, UK
| | - Diane Dixon
- Department of Nursing, University of the Highlands and Islands, Inverness, UK
- School of Applied Sciences, Edinburgh Napier University, 9 Sighthill Court, EH11 4BN, Edinburgh, Scotland
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12
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Rizi AK, Keating LA, Gleeson JP, O'Sullivan DJP, Kivelä M. Effectiveness of contact tracing on networks with cliques. Phys Rev E 2024; 109:024303. [PMID: 38491705 DOI: 10.1103/physreve.109.024303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Accepted: 01/08/2024] [Indexed: 03/18/2024]
Abstract
Contact tracing, the practice of isolating individuals who have been in contact with infected individuals, is an effective and practical way of containing disease spread. Here we show that this strategy is particularly effective in the presence of social groups: Once the disease enters a group, contact tracing not only cuts direct infection paths but can also pre-emptively quarantine group members such that it will cut indirect spreading routes. We show these results by using a deliberately stylized model that allows us to isolate the effect of contact tracing within the clique structure of the network where the contagion is spreading. This will enable us to derive mean-field approximations and epidemic thresholds to demonstrate the efficiency of contact tracing in social networks with small groups. This analysis shows that contact tracing in networks with groups is more efficient the larger the groups are. We show how these results can be understood by approximating the combination of disease spreading and contact tracing with a complex contagion process where every failed infection attempt will lead to a lower infection probability in the following attempts. Our results illustrate how contact tracing in real-world settings can be more efficient than predicted by models that treat the system as fully mixed or the network structure as locally treelike.
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Affiliation(s)
- Abbas K Rizi
- Department of Computer Science, School of Science, Aalto University, FI-00076 Aalto, Finland
| | - Leah A Keating
- MACSI, Department of Mathematics and Statistics, University of Limerick, Limerick V94 T9PX, Ireland
- Department of Mathematics, University of California, Los Angeles, California 90095, USA
| | - James P Gleeson
- MACSI, Department of Mathematics and Statistics, University of Limerick, Limerick V94 T9PX, Ireland
| | - David J P O'Sullivan
- MACSI, Department of Mathematics and Statistics, University of Limerick, Limerick V94 T9PX, Ireland
| | - Mikko Kivelä
- Department of Computer Science, School of Science, Aalto University, FI-00076 Aalto, Finland
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13
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Atkinson M, Neville F, Ntontis E, Reicher S. Social identification and risk dynamics: How perceptions of (inter)personal and collective risk impact the adoption of COVID-19 preventative behaviors. RISK ANALYSIS : AN OFFICIAL PUBLICATION OF THE SOCIETY FOR RISK ANALYSIS 2024; 44:322-332. [PMID: 37137869 PMCID: PMC10952649 DOI: 10.1111/risa.14155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Public adoption of preventative behaviors to reduce the transmission of COVID-19 is crucial to managing the pandemic, and so it is vital to determine what factors influence the uptake of those behaviors. Previous studies have identified COVID-19 risk perceptions as a key factor, but this work has typically been limited both in assuming that risk means risk to the personal self, and in being reliant on self-reported data. Drawing on the social identity approach, we conducted two online studies in which we investigated the effects of two different types of risk on preventative measure taking: risk to the personal self and risk to the collective self (i.e., members of a group with which one identifies). Both studies involved behavioral measures using innovative interactive tasks. In Study 1 (n = 199; data collected 27 May 2021), we investigated the effects of (inter)personal and collective risk on physical distancing. In Study 2 (n = 553; data collected 20 September 2021), we investigated the effects of (inter)personal and collective risk on the speed at which tests are booked as COVID-19 symptoms develop. In both studies, we find that perceptions of collective risk, but not perceptions of (inter)personal risk, influence the extent to which preventative measures are adopted. We discuss the implications both conceptually (as they relate to both the conceptualization of risk and social identity processes) and also practically (in terms of the implications for public health communications).
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Affiliation(s)
- Mark Atkinson
- School of ManagementUniversity of St AndrewsSt AndrewsUK
- School of Psychology and NeuroscienceUniversity of St AndrewsSt AndrewsUK
| | - Fergus Neville
- School of ManagementUniversity of St AndrewsSt AndrewsUK
| | - Evangelos Ntontis
- School of Psychology & CounsellingThe Open UniversityMilton KeynesUK
| | - Stephen Reicher
- School of Psychology and NeuroscienceUniversity of St AndrewsSt AndrewsUK
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14
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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] [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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15
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Ahmad S, Jafree SR. Influence of gender identity on the adoption of religious-spiritual, preventive and emotion-focused coping strategies during the COVID-19 pandemic in Pakistan. Ann Med 2023; 55:2291464. [PMID: 38105479 PMCID: PMC10732200 DOI: 10.1080/07853890.2023.2291464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 11/30/2023] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Academic research has highlighted the gendered impacts and amplifications of gender disparities of COVID-19. Traditionally, Pakistan is a patriarchal society, where it is a parenthood norm to socialize specific gender social roles. OBJECTIVES The current research asserts that these normative gender roles may influence individuals throughout their life course, even during the COVID-19 pandemic. Therefore, the present study explored the influence of gender identity in adopting different coping strategies such as religious-spiritual, preventive, emotion-focused and non-constructive coping against the COVID-19 pandemic. METHODS Due to the lockdown in various areas of Pakistan, data were collected through an online questionnaire using Qualtrics. In a cross-sectional study, 955 respondents completed responses. Factors analysis and reliability analysis were run to ensure the scales' reliability, validity and robustness for different coping strategies. Multivariate linear regression analysis was used to find model fitness. CONCLUSIONS For theoretical explanation, the current study used social role theory that argues that each gender benefits differently from distinct coping behaviours. The findings highlighted that women were more likely to adopt most coping strategies, with the most significant difference in religious-spiritual coping and preventative coping strategies even in the presence of control variables such as level of education, household monthly income, family structure, marital status and family size. There was no gender difference in adopting non-constructive strategies. The empirical evidence suggested that females might be at an increased risk of stress due to the burden of unbalanced household-based social norms and care responsibilities. The current research also expanded the base of coping to religious-spiritual coping, emotion-focused coping and non-constructive coping.
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Affiliation(s)
- Saeed Ahmad
- Department of Sociology and Anthropology, Utah State University, Logan, UT, USA
| | - Sara Rizvi Jafree
- Department of Sociology, Forman Christian College University (FCCU), Lahore, Pakistan
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16
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Bondaronek P, Papakonstantinou T, Stefanidou C, Chadborn T. User feedback on the NHS test & Trace Service during COVID-19: The use of machine learning to analyse free-text data from 37,914 England adults. PUBLIC HEALTH IN PRACTICE 2023; 6:100401. [PMID: 38099087 PMCID: PMC10719408 DOI: 10.1016/j.puhip.2023.100401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 06/19/2023] [Accepted: 06/19/2023] [Indexed: 12/17/2023] Open
Abstract
Objectives The UK government's approach to the pandemic relies on a test, trace and isolate strategy, mainly implemented via the digital NHS Test & Trace Service. Feedback on user experience is central to the successful development of public-facing Services. As the situation dynamically changes and data accumulate, interpretation of feedback by humans becomes time-consuming and unreliable. The specific objectives were to 1) evaluate a human-in-the-loop machine learning technique based on structural topic modelling in terms of its Service ability in the analysis of vast volumes of free-text data, 2) generate actionable themes that can be used to increase user satisfaction of the Service. Methods We evaluated an unsupervised Topic Modelling approach, testing models with 5-40 topics and differing covariates. Two human coders conducted thematic analysis to interpret the topics. We identified a Structural Topic Model with 25 topics and metadata as covariates as the most appropriate for acquiring insights. Results Results from analysis of feedback by 37,914 users from May 2020 to March 2021 highlighted issues with the Service falling within three major themes: multiple contacts and incompatible contact method and incompatible contact method, confusion around isolation dates and tracing delays, complex and rigid system. Conclusions Structural Topic Modelling coupled with thematic analysis was found to be an effective technique to rapidly acquire user insights. Topic modelling can be a quick and cost-effective method to provide high quality, actionable insights from free-text feedback to optimize public health Services.
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Affiliation(s)
- P. Bondaronek
- Office for Health Improvement & Disparities, Department of Health and Social Care, London, SW1H 0EU, United Kingdom
- Institute of Health Informatics, University College London, London, NW1 2DA, United Kingdom
| | - T. Papakonstantinou
- Office for Health Improvement & Disparities, Department of Health and Social Care, London, SW1H 0EU, United Kingdom
| | - C. Stefanidou
- Office for Health Improvement & Disparities, Department of Health and Social Care, London, SW1H 0EU, United Kingdom
| | - T. Chadborn
- Office for Health Improvement & Disparities, Department of Health and Social Care, London, SW1H 0EU, United Kingdom
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17
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Hwang S. Non-standard employment and COVID-19 testing in South Korean workers. Public Health 2023; 225:133-140. [PMID: 37925837 DOI: 10.1016/j.puhe.2023.09.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 08/28/2023] [Accepted: 09/26/2023] [Indexed: 11/07/2023]
Abstract
OBJECTIVES SARS-CoV-2 testing has been critical in monitoring and containing the COVID-19 pandemic, but there is a dearth of studies on how individuals' adherence to testing varies according to their working conditions. This study aimed to investigate the association between the type of employment contract and COVID-19 testing among wage workers in South Korea. STUDY DESIGN We used a nationally representative sample of employees aged 20-65 years collected from March 24 to 31, 2022. To focus on individual responses when the test was recommended, our sample consisted of 1266 participants who had experienced symptoms of COVID-19 or had been exposed to a confirmed case in the household. METHODS We used multivariate logistic regression to estimate the association between the odds of receiving a PCR test and the type of employment contract while controlling for other potential covariates. RESULTS The percentage of participants who had a SARS-CoV-2 PCR test was 77.8%. After adjusting for all potential covariates, daily workers (OR = 0.35, 95% CI 0.18 to 0.70, P = 0.003) and part-time workers (OR = 0.58, 95% CI 0.39 to 0.86, P = 0.007) had significantly lower odds of being tested relative to standard workers. Other temporary or atypical workers showed no significant differences from standard workers. CONCLUSION Our findings suggested that individuals in the most vulnerable job positions, with less job security and working hours, exhibited a decreased inclination to undergo COVID-19 testing. More effective job retention and income support policies are required to improve compliance.
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Affiliation(s)
- S Hwang
- Department of Economics, Pukyong National University, 45 Yongso-ro, Nam-gu, Busan, 48513, Republic of Korea.
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18
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de Meijere G, Castellano C. Limited efficacy of forward contact tracing in epidemics. Phys Rev E 2023; 108:054305. [PMID: 38115421 DOI: 10.1103/physreve.108.054305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/16/2023] [Indexed: 12/21/2023]
Abstract
Infectious diseases that spread silently through asymptomatic or pre-symptomatic infections represent a challenge for policy makers. A traditional way of achieving isolation of silent infectors from the community is through forward contact tracing, aimed at identifying individuals that might have been infected by a known infected person. In this work we investigate how efficient this measure is in preventing a disease from becoming endemic. We introduce an SIS-based compartmental model where symptomatic individuals may self-isolate and trigger a contact tracing process aimed at quarantining asymptomatic infected individuals. Imperfect adherence and delays affect both measures. We derive the epidemic threshold analytically and find that contact tracing alone can only lead to a very limited increase of the threshold. We quantify the effect of imperfect adherence and the impact of incentivizing asymptomatic and symptomatic populations to adhere to isolation. Our analytical results are confirmed by simulations on complex networks and by the numerical analysis of a much more complex model incorporating more realistic in-host disease progression.
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Affiliation(s)
- Giulia de Meijere
- Gran Sasso Science Institute, Viale F. Crispi 7, 67100 L'Aquila, Italy
- Istituto dei Sistemi Complessi (ISC-CNR), Via dei Taurini 19, I-00185 Roma, Italy
| | - Claudio Castellano
- Istituto dei Sistemi Complessi (ISC-CNR), Via dei Taurini 19, I-00185 Roma, Italy
- Centro Ricerche Enrico Fermi, Piazza del Viminale, 1, I-00184 Rome, Italy
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19
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Robin C, Reynolds R, Lambert H, Hickman M, Rubin GJ, Smith LE, Yardley L, Cai S, Zhang T, Mook P, McManus O, Lasseter G, Compston P, Denford S, Zhang J, Amlôt R, Oliver I. Understanding adherence to self-isolation in the first phase of the COVID-19 pandemic in England: a cross-sectional mixed-methods study. BMC Public Health 2023; 23:2074. [PMID: 37872611 PMCID: PMC10594856 DOI: 10.1186/s12889-023-16674-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 08/31/2023] [Indexed: 10/25/2023] Open
Abstract
BACKGROUND During the early "containment" phase of the COVID-19 response in England (January-March 2020), contact tracing was managed by Public Health England (PHE). Adherence to self-isolation during this phase and how people were making those decisions has not previously been determined. The aim of this study was to gain a better understanding of decisions around adherence to self-isolation during the first phase of the COVID-19 response in England. METHODS A mixed-methods cross sectional study was conducted, including an online survey and qualitative interviews. The overall pattern of adherence was described as never leaving home, leaving home for lower-contact reasons and leaving home for higher-contact reasons. Fisher's exact test was used to test associations between adherence and potentially predictive binary factors. Factors showing evidence of association overall were then considered in relation to the three aspects of adherence individually. Qualitative data were analysed using inductive thematic analysis. RESULTS Of 250 respondents who were advised to self-isolate, 63% reported not leaving home at all during their isolation period, 20% reported leaving only for lower-contact activities (dog walking or exercise) and 16% reported leaving for higher-contact, and therefore higher-risk, reasons. Factors associated with adherence to never going out included: the belief that following isolation advice would save lives, experiencing COVID-19 symptoms, being advised to stay in their room, having help from outside and having regular contact by text message from PHE. Factors associated with non-adherence included being angry about the advice to isolate, being unable to get groceries delivered and concerns about losing touch with friends and family. Interviews highlighted that a sense of duty motivated people to adhere to isolation guidance and where people did leave their homes, these decisions were based on rational calculations of the risk of transmission - people would only leave their homes when they thought they were unlikely to come into contact with others. CONCLUSIONS Understanding adherence to isolation and associated reasoning during the early stages of the pandemic is essential to pandemic preparedness for future emerging infectious disease outbreaks. Individuals make complex decisions around adherence by calibrating transmission risks, therefore treating adherence as binary should be avoided.
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Affiliation(s)
- Charlotte Robin
- Behavioural Science and Insights Unit, UK Health Security Agency, Liverpool, L3 1DS, UK.
| | - Rosy Reynolds
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Helen Lambert
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - G James Rubin
- Department of Psychological Medicine, King's College London, London, UK
| | - Louise E Smith
- Department of Psychological Medicine, King's College London, London, UK
| | - Lucy Yardley
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Psychology Department, University of Southampton, Southampton, UK
| | - Shenghan Cai
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Tingting Zhang
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Piers Mook
- UKHSA, Field Service, Health Protection Operations, London, UK
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Oliver McManus
- UKHSA, Field Service, Health Protection Operations, London, UK
| | - Gemma Lasseter
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Polly Compston
- UKHSA, Field Service, Health Protection Operations, Cambridge, UK
| | - Sarah Denford
- School of Psychological Science, University of Bristol, Bristol, UK
| | - Juan Zhang
- Department of Anthropology and Archaeology, University of Bristol, Bristol, UK
| | - Richard Amlôt
- Behavioural Science and Insights Unit, UK Health Security Agency, Salisbury, UK
| | - Isabel Oliver
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- UKHSA, Field Service, Health Protection Operations, Bristol, UK
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20
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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] [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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21
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Carlini J, Fry ML, Grace D, Fox M, Zimmerman PA. Mass behaviour change amid COVID-19: How public health information and social norms explain the transformation. Health Mark Q 2023; 40:352-374. [PMID: 36576207 DOI: 10.1080/07359683.2022.2160854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
COVID-19 is a severe and ongoing threat globally, with the spread disrupting lives and society. Despite the developments of vaccines, the key measure to reduce the transmission of variants has stemmed from mass changes to personal behaviours. COVID-19 pandemic offers a unique context, where the protection behaviours enacted by an individual are necessary to keep the community safe. A social psychological perspective can be used to understand the reasons for adherence to policies and determine what other factors can shape preventive behaviours. To resolve this, in partnership with health consumers we use an online survey, with the findings substantiating preventive behaviours are positively related to COVID-19 information access and descriptive norms. Additionally, findings demonstrate the mediating role of injunctive norms on preventive behaviour suggesting that policy makers can influence decision-making by promoting health information that provides guidance on acceptable behaviours, but also demonstrates subsequent success. The integrity of the model is substantiated by partial least squares (PLS) testing.
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Affiliation(s)
- Joan Carlini
- Department of Marketing, Griffith Business School, Griffith University, Australia
- Menzies Health Institute, Queensland, Australia
| | - Marie-Louise Fry
- Department of Marketing, Griffith Business School, Griffith University, Australia
| | - Debra Grace
- Department of Marketing, Griffith Business School, Griffith University, Australia
| | - Melissa Fox
- Health Consumers Queensland, Brisbane, Queensland, Australia
| | - Peta-Anne Zimmerman
- Menzies Health Institute, Queensland, Australia
- School of Nursing and Midwifery, Griffith University, Gold Coast, Australia
- Department of Infection Control Gold Coast Hospital and Health Service, Griffith University, Gold Coast, QLD, Australia
- Collaborative for the Advancement of Infection Prevention and Control, Australia
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22
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Silberberg B, Young C, Bag S, Moreira C, Norton S, Wells J, Shaban RZ. Socioeconomic disadvantage and engagement with digital contact tracing for COVID-19 in Western Sydney: A secondary analysis of surveillance data. Aust N Z J Public Health 2023; 47:100087. [PMID: 37738808 DOI: 10.1016/j.anzjph.2023.100087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/30/2023] [Accepted: 08/21/2023] [Indexed: 09/24/2023] Open
Abstract
OBJECTIVE COVID-19 outcomes were highly inequitably distributed in Australia and worldwide. The digitalisation of public health interventions offers resource-efficiency and increased capacity for pandemic responses, but risks excluding the elderly and disadvantaged, reinforcing existing inequalities. Despite this, there has been little evaluation of the determinants of uptake of digital contact tracing. This paper describes the use of digital contact tracing for COVID-19 in a population in metropolitan Sydney and the determinants of engagement in this population. METHODS Routinely collected surveillance data for residents of Western Sydney Local Health District, returning a positive SARS-CoV-2 result between 1st August 2021 and 12th February 2022, were extracted including responses to a digital contact tracing questionnaire. Individual records were linked to area-level socioeconomic indices of disadvantage. Descriptive analyses explored characteristics of non-responders and geospatial variation. Logistic regression was undertaken to evaluate the effect of age, sex and socioeconomic disadvantage on the odds of response. RESULTS Of the 133 055 individuals included, 130 645 (98%) were issued a digital contact tracing questionnaire, and 106 432 (81%) responded. Odds of responding were lower in males (odds ratio: 0.79), individuals aged 80+ (odds ratio: 0.17) and the most disadvantaged communities (odds ratio: 0.32). CONCLUSIONS Digital data collection for contact tracing was a scalable and efficient tool in the context of the Western Sydney Local Health District COVID-19 response. However, older people and individuals in disadvantaged communities were less likely to engage. IMPLICATIONS FOR PUBLIC HEALTH Responses to future pandemics should leverage the resource-efficiency of digital interventions but should avoid compounding existing health inequalities.
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Affiliation(s)
- Benjamin Silberberg
- Centre for Population Health, Western Sydney Local Health District, Australia.
| | - Christian Young
- NSW Biostatistics Training Program, NSW Ministry of Health, Australia
| | - Shopna Bag
- Centre for Population Health, Western Sydney Local Health District, Australia; Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Australia
| | - Conrad Moreira
- Centre for Population Health, Western Sydney Local Health District, Australia
| | - Sophie Norton
- Centre for Population Health, Western Sydney Local Health District, Australia
| | - Jessica Wells
- Centre for Population Health, Western Sydney Local Health District, Australia
| | - Ramon Z Shaban
- Centre for Population Health, Western Sydney Local Health District, Australia; Sydney Institute for Infectious Diseases and Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Australia
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23
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Bu F, Steptoe A, Fancourt D. Longitudinal changes in home confinement and mental health implications: a 17-month follow-up study in England during the COVID-19 pandemic. Psychol Med 2023; 53:3943-3951. [PMID: 35357294 PMCID: PMC10317799 DOI: 10.1017/s0033291722000605] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 02/15/2022] [Accepted: 02/16/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has brought about significant behavioural changes, one of which is increased time spent at home. This could have important public health implications. This study aimed to explore longitudinal patterns of 'home confinement' (defined as not leaving the house/garden) during the COVID-19 pandemic, and the associated predictors and mental health outcomes. METHODS Data were from the UCL COVID-19 Social Study. The analytical sample consisted of 25 390 adults in England who were followed up for 17 months (March 2020-July 2021). Data were analysed using growth mixture models. RESULTS Our analyses identified three classes of growth trajectories, including one class showing a high level of persistent home confinement (the home-confined, 24.8%), one changing class with clear alignment with national containment measures (the adaptive, 32.0%), and one class with a persistently low level of confinement (the unconfined, 43.1%). A range of factors were associated with the class membership of home-confinement trajectories, such as age, gender, income, employment status, social relationships and health. The home-confined class had the highest number of depressive (diff = 1.34-1.68, p < 0.001) and anxiety symptoms (diff = 0.84-1.05, p < 0.001) at the end of the follow-up than the other two classes. CONCLUSIONS There was substantial heterogeneity in longitudinal patterns of home confinement during the COVID-19 pandemic. People with a persistent high level of confinement had the worst mental health outcomes, calling for special attention in mental health action plans, in particular targeted interventions for at-risk groups.
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Affiliation(s)
- Feifei Bu
- Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK
| | - Andrew Steptoe
- Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK
| | - Daisy Fancourt
- Department of Behavioural Science and Health, Institute of Epidemiology & Health Care, University College London, London, UK
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Kearney PM, Stamenic D, Gajewska K, O'Sullivan MB, Doyle S, O'Reilly O, Buckley CM. Cross-sectional survey of compliance behaviour, knowledge and attitudes among cases and close contacts during COVID-19 pandemic. PUBLIC HEALTH IN PRACTICE 2023; 5:100370. [PMID: 36817733 PMCID: PMC9930406 DOI: 10.1016/j.puhip.2023.100370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/09/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023] Open
Abstract
Objectives A key public health intervention is self-isolation for cases and restriction of movement for contacts. This study aimed to identify predictors of compliance behaviour and describe knowledge and attitudes among cases and contacts identified by the national Contact Management Programme to inform the global public health response. Study design Secondary data analysis of anonymised cross-sectional survey data on national sample of cases and close contacts. Methods A sample of 1000 cases and 1000 contacts was calculated to estimate compliance within a margin of error of 3% with 95% confidence. A telephone survey administered by trained interviewers collected information on socio-demographics, compliance behaviours, knowledge, and attitudes to COVID-19 from cases and close contacts. Data analysis included chi-squared statistics and multivariable logistic regression. Results Most cases and contacts complied with public health guidance with similar characteristics in those who did and did not comply. Reasons for non-compliance included exercise, medical appointment, shopping, and work. Cases and contacts reported high levels of understanding about symptoms of COVID-19 and satisfaction with available information. Conclusion Achieving high compliance with public health guidance is feasible and requires political leadership, policy changes and practical solutions.
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Affiliation(s)
- Patricia M. Kearney
- School of Public Health, University College Cork, Ireland,Corresponding author
| | - Danko Stamenic
- School of Public Health, University College Cork, Ireland
| | | | | | - Sarah Doyle
- Department of Public Health, Health Services Executive, HSE South, Ireland
| | - Orlaith O'Reilly
- Clinical Design and Innovation, Health Services Executive, Ireland
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Santos JV, Gomes da Costa J, Costa E, Almeida S, Cima J, Pita-Barros P. Factors associated with non-pharmaceutical interventions compliance during COVID-19 pandemic: a Portuguese cross-sectional survey. J Public Health (Oxf) 2023; 45:47-56. [PMID: 35220434 PMCID: PMC8903464 DOI: 10.1093/pubmed/fdac001] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The use of non-pharmaceutical interventions (NPI) is one of the main tools used in the coronavirus disease 2019 (COVID-19) pandemic response, including physical distancing, frequent hand washing, face mask use, respiratory hygiene and use of contact tracing apps. Literature on compliance with NPI during the COVID-19 pandemic is limited. METHODS We studied this compliance and associated factors in Portugal, between 28th October 2020 and 11th January 2021 (Portuguese second and third waves of the pandemic), using logistic regressions. Data were collected through a web-based survey and included questions regarding NPI compliance, COVID-19-related concerns, perception of institutions' performance, agreement with the measures implemented and socio-demographic characteristics. RESULTS From the 1263 eligible responses, we found high levels of compliance among all COVID-19 related NPI, except for the contact tracing app. Females and older participants showed the highest compliance levels, whereas the opposite was observed for previously infected participants. There was heterogeneity of COVID-19 NPI compliance across Portuguese regions and a clear gradient between concern, government performance's perception or agreement and compliance. CONCLUSIONS Results suggested areas for further study with important implications for pandemic management and communication, for future preparedness, highlighting other factors to be accounted for when recommending policy measures during public health threats.
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Affiliation(s)
- João Vasco Santos
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, 4200-450 Porto, Portugal.,CINTESIS-Centre for Health Technology and Services Research, 4200-450 Porto, Portugal.,Public Health Unit, ACES Grande Porto VIII - Espinho/Gaia, ARS Norte, 4405-535 VIla Nova de Gaia, Portugal
| | | | - Eduardo Costa
- Nova School of Business and Economics, Universidade NOVA de Lisboa, 2775-405 Carcavelos, Portugal
| | - Sara Almeida
- Nova School of Business and Economics, Universidade NOVA de Lisboa, 2775-405 Carcavelos, Portugal
| | - Joana Cima
- NIPE - Centre for Research in Economics and Management, University of Minho, 4710-057 Braga, Portugal
| | - Pedro Pita-Barros
- Nova School of Business and Economics, Universidade NOVA de Lisboa, 2775-405 Carcavelos, Portugal
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26
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Smith LE, West R, Potts HWW, Amlȏt R, Fear NT, Rubin GJ, Michie S. Knowledge of Self-Isolation Rules in the UK for Those Who Have Symptoms of COVID-19: A Repeated Cross-Sectional Survey Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1952. [PMID: 36767316 PMCID: PMC9914733 DOI: 10.3390/ijerph20031952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVES To investigate knowledge of self-isolation rules and factors associated with knowledge. METHODS Repeated cross-sectional online surveys (n ≈ 2000 UK adults) between 9 November 2020 and 16 February 2022 (78,573 responses from 51,881 participants). We computed a composite measure of knowledge of self-isolation rules and investigated associations between knowledge and survey wave, socio-demographic characteristics (age, gender, UK nation, index of multiple deprivation), trust in government, and participants' belief that they had received enough information about self-isolation. RESULTS In total, 87.9% (95% CI 87.7% to 88.1%, n = 67,288/76,562) of participants knew that if they had symptoms of COVID-19 they should 'self-isolate'. However, only 62.8% (n = 48,058/76,562, 95% CI 62.4% to 63.1%) knew the main rules regarding what that meant. Younger people had less knowledge than older people, and men had less knowledge than women. Knowledge was lower in people living in England versus in Scotland, Wales, and Northern Ireland. The pattern of association between knowledge and trust in government was unclear. Knowledge was lower in people living in a more deprived area and those who did not believe they had enough information about self-isolation. Knowledge was lower in December 2020 to January 2021, compared with before and after this period. CONCLUSIONS Approximately 63% of UK adults between November 2020 and February 2022 appeared to know the main rules regarding self-isolation if symptomatic with COVID-19. Knowledge was lower in younger than older people, men than women, those living in England compared with Scotland, Wales or Northern Ireland, and those living in more deprived areas.
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Affiliation(s)
- Louise E. Smith
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 9RJ, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London SE5 9RJ, UK
| | - Robert West
- Department of Behavioural Science and Health, University College London, London WC1E 6BT, UK
| | - Henry W. W. Potts
- Institute of Health Informatics, University College London, London NW1 2DA, UK
| | - Richard Amlȏt
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London SE5 9RJ, UK
- Behavioural Science and Insights Unit, UK Health Security Agency, London SW1P 3HX, UK
| | - Nicola T. Fear
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 9RJ, UK
- Academic Department of Military Mental Health, King’s Centre for Military Health Research, London SE5 9RJ, UK
| | - G. James Rubin
- Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London SE5 9RJ, UK
- NIHR Health Protection Research Unit in Emergency Preparedness and Response, London SE5 9RJ, UK
| | - Susan Michie
- Centre for Behaviour Change, University College London, London WC1E 7HB, UK
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Woolley SD, Chambers R, Bishop JRB, Logan A, McMillan P, Fletcher TE, Taegtmeyer M, O'Shea MK. COVID-19 risk, attitudes and behaviour study (CRAB study): A knowledge, attitudes, and practise qualitative study of COVID-19 in the Royal Navy. Front Public Health 2023; 10:1101817. [PMID: 36711341 PMCID: PMC9878343 DOI: 10.3389/fpubh.2022.1101817] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 12/23/2022] [Indexed: 01/15/2023] Open
Abstract
Introduction Outbreaks of SARS-CoV-2 onboard maritime platforms spread rapidly and have high attack rates. The aim of the COVID-19 Risk, Attitudes and Behaviour (CRAB) study was to investigate the knowledge, attitudes, and practises in the Royal Navy in relation to COVID-19 prevention. Methods The CRAB study was a cross-sectional survey, using a census sampling method, conducted in May and June 2021. An online questionnaire was distributed to all serving Royal Navy regular personnel using either the MyNavy application or via a QR code through email for a continuous 14 day period. The questionnaire was based on an existing validated questionnaire used for avian influenza epidemics. Questions investigated individual perceptions of COVID-19 seriousness, compliance with prevention methods, explored vaccination intention and vaccine hesitancy (unvaccinated individuals who declined or were unsure about receiving a COVID-19 vaccine). The chi-squared test of best fit was used to compare the demographic responses against the whole organisation, with p-value < 0.05 deemed significant. Odds ratios were used to investigate associations between demographic groups and responses to questions, with an odds ratio crossing 1.0 deemed non-significant. Results The response rate was 6% (2,080/33,200), with 315 responses collated in the pilot phase and 1,765 in the main study phase. Male participants were less likely to rate COVID-19 as serious (OR 0.34; 95% CI: 0.23-0.49). BAME ethnicity (OR 2.41; 95% CI: 1.12-5.17) rated it as more serious. At the time of the study 62% of respondents had received one dose of a COVID-19 vaccine. In the 797 unvaccinated personnel, vaccine hesitancy accounted for 24.2% (193/797), of whom 136 were white males. Those who had a higher COVID-19 serious rating, the most significant factor for non-adherence to COVID-19 prevention measures in both vaccinated (OR 1.61 [95%CI: 1.20-2.17]) and vaccine-hesitant (OR 3.24 [95%CI: 1.63-6.41]) individuals was colleagues' non-adherence. The most trusted source of information on vaccines was provided by the Defence Medical Services (77.2% [1,606/2,080]). Conclusion This study has identified reasons for COVID-19 protective measure adherence, sources of information trusted by respondents and vaccine hesitancy, in the Royal Navy. The questionnaire can be used to investigate attitudes and behaviours in future emerging infectious diseases.
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Affiliation(s)
- Stephen D. Woolley
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom,Institute of Naval Medicine, Alverstoke, United Kingdom,Tropical and Infectious Diseases Unit, Liverpool University Hospitals Foundation NHS Trust, Liverpool, United Kingdom,*Correspondence: Stephen D. Woolley ✉
| | - Robert Chambers
- Royal Navy Healthcare, Royal Navy Headquarters, HMS EXCELLENT, Portsmouth, United Kingdom
| | - Jonathan R. B. Bishop
- NIHR SRMRC, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom
| | - Amy Logan
- Royal Navy Healthcare, Royal Navy Headquarters, HMS EXCELLENT, Portsmouth, United Kingdom
| | - Peter McMillan
- Royal Navy Healthcare, Royal Navy Headquarters, HMS EXCELLENT, Portsmouth, United Kingdom
| | - Thomas E. Fletcher
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom,Tropical and Infectious Diseases Unit, Liverpool University Hospitals Foundation NHS Trust, Liverpool, United Kingdom,Academic Department of Military Medicine, Royal Centre for Defence Medicine, Joint Hospital Group, ICT Building, Birmingham Research Park, Birmingham, United Kingdom
| | - Miriam Taegtmeyer
- Tropical and Infectious Diseases Unit, Liverpool University Hospitals Foundation NHS Trust, Liverpool, United Kingdom,Department of International Public Health, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
| | - Matthew K. O'Shea
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Joint Hospital Group, ICT Building, Birmingham Research Park, Birmingham, United Kingdom,Institute of Immunology and Immunotherapy, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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28
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Zhou H, Cárdenas D, Reynolds KJ. Norms and COVID‐19 health behaviours: A longitudinal investigation of group factors. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2023. [DOI: 10.1002/ejsp.2932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Haochen Zhou
- Research School of Psychology Australian National University Canberra Australia
| | - Diana Cárdenas
- Research School of Psychology Australian National University Canberra Australia
- Deparment of Psychology University of Montreal Montréal Canada
| | - Katherine J. Reynolds
- Research School of Psychology Australian National University Canberra Australia
- Melbourne Graduate School of Education The University of Melbourne Melbourne Australia
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Serisier A, Beale S, Boukari Y, Hoskins S, Nguyen V, Byrne T, Fong WLE, Fragaszy E, Geismar C, Kovar J, Yavlinsky A, Hayward A, Aldridge RW. A case-crossover study of the effect of vaccination on SARS-CoV-2 transmission relevant behaviours during a period of national lockdown in England and Wales. Vaccine 2023; 41:511-518. [PMID: 36496282 PMCID: PMC9721283 DOI: 10.1016/j.vaccine.2022.11.073] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/11/2022]
Abstract
BACKGROUND Studies of COVID-19 vaccine effectiveness show increases in COVID-19 cases within 14 days of a first dose, potentially reflecting post-vaccination behaviour changes associated with SARS-CoV-2 transmission before vaccine protection. However, direct evidence for a relationship between vaccination and behaviour is lacking. We aimed to examine the association between vaccination status and self-reported non-household contacts and non-essential activities during a national lockdown in England and Wales. METHODS Participants (n = 1154) who had received the first dose of a COVID-19 vaccine reported non-household contacts and non-essential activities from February to March 2021 in monthly surveys during a national lockdown in England and Wales. We used a case-crossover study design and conditional logistic regression to examine the association between vaccination status (pre-vaccination vs 14 days post-vaccination) and self-reported contacts and activities within individuals. Stratified subgroup analyses examined potential effect heterogeneity by sociodemographic characteristics such as sex, household income or age group. RESULTS 457/1154 (39.60 %) participants reported non-household contacts post-vaccination compared with 371/1154 (32.15 %) participants pre-vaccination. 100/1154 (8.67 %) participants reported use of non-essential shops or services post-vaccination compared with 74/1154 (6.41 %) participants pre-vaccination. Post-vaccination status was associated with increased odds of reporting non-household contacts (OR 1.65, 95 % CI 1.31-2.06, p < 0.001) and use of non-essential shops or services (OR 1.50, 95 % CI 1.03-2.17, p = 0.032). This effect varied between men and women and different age groups. CONCLUSION Participants had higher odds of reporting non-household contacts and use of non-essential shops or services within 14 days of their first COVID-19 vaccine compared to pre-vaccination. Public health emphasis on maintaining protective behaviours during this post-vaccination time period when individuals have yet to develop full protection from vaccination could reduce risk of SARS-CoV-2 infection.
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Affiliation(s)
- Aimee Serisier
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Sarah Beale
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK; Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK.
| | - Yamina Boukari
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
| | - Susan Hoskins
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Vincent Nguyen
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK; Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
| | - Thomas Byrne
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
| | - Wing Lam Erica Fong
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
| | - Ellen Fragaszy
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK; Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, Keppel Street, London WC1E 7HT, UK
| | - Cyril Geismar
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK; Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
| | - Jana Kovar
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Alexei Yavlinsky
- Centre for Public Health Data Science, Institute of Health Informatics, University College London, NW1 2DA, UK
| | - Andrew Hayward
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
| | - Robert W Aldridge
- Institute of Epidemiology and Health Care, University College London, London WC1E 7HB, UK
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30
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Gostoli U, Silverman E. Self-Isolation and Testing Behaviour During the COVID-19 Pandemic: An Agent-Based Model. ARTIFICIAL LIFE 2023; 29:94-117. [PMID: 36269874 DOI: 10.1162/artl_a_00392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Since the beginning of the COVID-19 pandemic, various models of virus spread have been proposed. While most of these models focused on the replication of the interaction processes through which the virus is passed on from infected agents to susceptible ones, less effort has been devoted to the process through which agents modify their behaviour as they adapt to the risks posed by the pandemic. Understanding the way agents respond to COVID-19 spread is important, as this behavioural response affects the dynamics of virus spread by modifying interaction patterns. In this article, we present an agent-based model that includes a behavioural module determining agent testing and isolation propensity in order to understand the role of various behavioural parameters in the spread of COVID-19.
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Affiliation(s)
- Umberto Gostoli
- University of Glasgow, MRC/CSO Social and Public Health Sciences Unit.
| | - Eric Silverman
- University of Glasgow, MRC/CSO Social and Public Health Sciences Unit
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31
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Evensen D, Warren G, Bouder F. Satisfaction With Governmental Risk Communication Both Increases and Decreases COVID-19 Mitigation Behaviours. Int J Public Health 2023; 68:1604966. [PMID: 36938300 PMCID: PMC10014469 DOI: 10.3389/ijph.2023.1604966] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Accepted: 02/20/2023] [Indexed: 03/04/2023] Open
Abstract
Objectives: Over 3 years of the COVID-19 pandemic, and intense societal and governmental response, a wealth of research has examined risk perceptions and public risk mitigation behaviours. The vast majority of this inquiry has focused on health risks. Nevertheless, as a "total social fact" influencing nearly every aspect of quotidian life, the pandemic engenders a wide range of risk perceptions. Methods: Via a survey (N = 4,206) of representative samples of the general public in five European countries (Germany, Norway, Sweden, Switzerland, United Kingdom), we explore perceptions of a range of personal/public health, economic, and societal risks. We also investigate the effects of perceptions of official governmental risk communication in one's country on risk perceptions and risk mitigation behaviours. Results: Structural equation modelling reveals that whilst perceptions of effective risk communication directly increase behaviours that mitigate COVID-19 health risks, these same perceptions indirectly decrease behaviour frequency via a mediated relationship with societal risk perceptions. Conclusion: The findings highlight the import of governmental authorities analysing and communicating about the range of risk perceptions citizens might have about a "total social fact" such as COVID-19.
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Affiliation(s)
- Darrick Evensen
- Department of Politics and International Relations, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Frederic Bouder
- Risk Management and Societal Safety Research Group, University of Stavanger, Stavanger, Norway
- *Correspondence: Frederic Bouder,
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Ranieri V, Kamboj SK, Edwards SJL. Perceived coercion, perceived pressures and procedural justice arising from global lockdowns during the COVID-19 pandemic: A scoping review. PLOS GLOBAL PUBLIC HEALTH 2023; 3:e0001250. [PMID: 36962987 PMCID: PMC10019622 DOI: 10.1371/journal.pgph.0001250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 02/08/2023] [Indexed: 03/18/2023]
Abstract
This aim of this scoping review is to map what is known about perceived coercion, perceived pressures and procedural justice within the context of the general population's experience of 'lockdowns' imposed by governments worldwide in response to the increased transmission of COVID-19. Arksey & O'Malley's (2005) framework for conducting scoping reviews was chosen. A sensitive search strategy was devised and conducted using PubMed, Scopus, and Web of Science using the following search terms: (adherence OR acceptance OR agreement OR trust OR distrust OR compliance OR willing*) OR (perceived coerc* OR percept* coerc* OR pressure OR force OR influence OR control OR threat OR justice) AND (lockdown) AND (COVID OR SARS-CoV-2 OR COVID-19). The database search initially produced 41,628 articles to screen. A total of 40 articles were included in this review and the following five themes were identified from the studies: perceived acceptability and willingness to adhere to lockdown; perceived control during lockdown; perceived pressures arising from lockdown; perceived threat of sanction from others and the procedural (in)justice of lockdown. Our synthesis suggests that i) individuals experienced an initial willingness and tolerance of lockdown that lessened over time as perceptions of personal control decreased; ii) that social influences may pressure individuals to follow or break lockdown rules; and iii) that justifiability and proportionality together with individuals' perceptions of harm from COVID-19 may impact the extent to which individuals adhere to lockdown. Furthermore, the review found an absence of information regarding specific individual characteristics and circumstances that increase the likelihood of experiencing perceived coercion and its related constructs and highlights a need for a better understanding of the cultural and socioeconomic factors affecting perceptions of, and adherence to, lockdown.
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Affiliation(s)
- Veronica Ranieri
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
- Department of Science, Technology, Engineering and Public Policy (STEaPP), University College London, London, United Kingdom
- * E-mail:
| | - Sunjeev K. Kamboj
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Sarah J. L. Edwards
- Department of Science, Technology, Engineering and Public Policy (STEaPP), University College London, London, United Kingdom
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Paschoalotto MAC, Costa EPPA, Almeida SVD, Cima J, Costa JGD, Santos JV, Passador CS, Passador JL, Barros PP. Perceptions of institutional performance and compliance to non-pharmaceutical interventions: How performance perceptions and policy compliance affect public health in a decentralized health system. PLoS One 2023; 18:e0285289. [PMID: 37172055 PMCID: PMC10180683 DOI: 10.1371/journal.pone.0285289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 04/18/2023] [Indexed: 05/14/2023] Open
Abstract
Trust in institutions is a key driver to shape population attitudes and behavior, such as compliance of non-pharmaceutical interventions (NPI). During the COVID-19 pandemic, this was fundamental and its compliance was supported by governmental and non-governmental institutions. Nevertheless, the situation of political polarization in some countries with decentralized health systems increased the difficulty of such interventions. This study analyzes the association between non-pharmaceutical interventions' compliance and individual perception regarding institutions' performance during the COVID-19 pandemic in Brazil. A web survey was conducted in Brazil between November 2020 and February 2021. Bivariate analysis and ordered logit regressions were performed to assess the association between NPIs compliance and perceived institutions' performance. Results suggest a negative association between NPIs' compliance and Federal Government and Ministry of health perceived performance, which may reflect the political positioning of the respondents. Moreover, we find a positive association between NPI compliance and the perceived performance of the remaining institutions (state government, federal supreme court, national congress, WHO, media and SUS). Our contribution goes beyond the study of a relationship between non-pharmaceutical interventions' compliance and institutions' performance, by pointing out the importance of subnational and local governmental spheres in a decentralized health system, as well as highlighting the importance of social communication based on health organizations' information and scientific institutions.
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Affiliation(s)
| | | | | | - Joana Cima
- Centre for Research in Economics and Management (NIPE), University of Minho, Braga, Portugal
| | - Joana Gomes da Costa
- Center for Economics and Finance, School of Economics and Management, University of Porto, Porto, Portugal
| | - João Vasco Santos
- MEDCIDS-Department of Community Medicine, Information and Health Decision Sciences, Faculty of Medicine, University of Porto, Porto, Portugal
- CINTESIS-Center for Health Technology and Services Research, Faculty of Medicine, University of Porto, Porto, Portugal
- Public Health Unit, ACES Grande Porto VIII-Espinho/Gaia, ARS Norte, Porto, Portugal
| | - Claudia Souza Passador
- School of Economics, Business Administration and Accounting at Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - João Luiz Passador
- School of Economics, Business Administration and Accounting at Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil
| | - Pedro Pita Barros
- Nova School of Business and Economics, Nova University of Lisbon, Lisbon, Portugal
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34
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Twamley K, Faircloth C, Iqbal H. COVID labour: Making a 'livable' life under lockdown. THE SOCIOLOGICAL REVIEW 2023; 71:85-104. [PMID: 38603380 PMCID: PMC9713535 DOI: 10.1177/00380261221138203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
Drawing on qualitative longitudinal data from 38 families with children in the UK collected between May 2020 and June 2021, this article discusses the extra everyday labour which individuals experienced in going about their daily lives during COVID-19. In particular, we examine in detail the everyday practices of negotiating risk and caring for self and others within the context of the pandemic. We call this COVID labour - the work involved in living through and adjusting to a pandemic. We identify this as constituting three main aspects: seeking and interpreting information; assessing risk; and minimising risk. Like other forms of labour, it is stratified by gender, class and ethnicity. Overall, the analysis contributes to a greater understanding of everyday life 'under lockdown' for families with children, and how 'livable' lives are made under times of great risk.
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Affiliation(s)
| | | | - Humera Iqbal
- Social Research Institute, University College
London, UK
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Liu R, Zheng X, Wang Z, Zhou M, Weng J, Li YM, Chen X. COVID-19 symptoms and compliance: The mediating role of fundamental social motives. Front Psychol 2023; 14:1093875. [PMID: 37020914 PMCID: PMC10067610 DOI: 10.3389/fpsyg.2023.1093875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 02/28/2023] [Indexed: 04/07/2023] Open
Abstract
Background Understanding the compliance of infected individuals and the psychological process underlying compliance during pandemics is important for preventing and controlling the spread of pathogens. Our study investigated whether fundamental social motives mediate the relationship between having infectious disease and compliance. Methods An online survey was conducted in March 2020, during the severe phase of the COVID-19 outbreak in China to collect data from 15,758 participants. The survey comprised self-report questionnaires with items pertaining to current symptoms (COVID-19 symptoms, other symptoms or no symptoms), the Fundamental Social Motive Inventory, and measures of compliance. Correlation analysis, linear regression analysis, and structural equation model were used for data analysis. Results The participants with COVID-19 symptoms had lower levels of compliance than those without symptoms, and their lower compliance was caused by a decrease in disease avoidance (indirect effect = -0.058, 95% CI = [-0.061, -0.056]) and familial motives (indirect effect = -0.113, 95% CI = [-0.116, -0.062]). Whereas exclusion concern (indirect effect = 0.014, 95% CI = [0.011, 0.017]) suppressed the effects of COVID-19 symptoms on compliance, the effect disappeared in the multiple mediation model, while those of disease avoidance and familial motives remained. Conclusion Our findings emphasize the critical role of disease avoidance and familial motives in promoting compliance with public health norms during pandemics and suggest that enhancing these motives may serve as an effective intervention strategy to mitigate noncompliance among potentially infected individuals.
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Affiliation(s)
- Ruoting Liu
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xueying Zheng
- Department of Endocrinology, The First Affiliated Hospital of University of Science and Technology of China Anhui Provincial Hospital, Hefei, Anhui Province, China
- Department of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
| | - Ziyu Wang
- Department of Linguistics and Cognitive Science, College of Arts and Sciences, University of Delaware, Newark, DE, United States
| | - Mingjie Zhou
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
| | - Jianping Weng
- Department of Endocrinology, The First Affiliated Hospital of University of Science and Technology of China Anhui Provincial Hospital, Hefei, Anhui Province, China
- Department of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui Province, China
| | - Yan-mei Li
- Key Laboratory of Behavioral Science, Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- *Correspondence: Yan-mei Li,
| | - Xuefeng Chen
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
- Institute of Psychology, Chinese Academy of Sciences (CAS), Beijing, China
- Xuefeng Chen,
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Rojek JJ, Waszak P, Bidzan-Bluma I, Sanewska A, Stępień J, Michalski T, Lorettu L, Meloni R, Chu CS, Abboud M, Grabowski J. Self-Assessed Personality Traits and Adherence to the COVID-19 Lockdown. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:521. [PMID: 36612843 PMCID: PMC9819452 DOI: 10.3390/ijerph20010521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/20/2022] [Accepted: 12/24/2022] [Indexed: 06/17/2023]
Abstract
Introduction: The COVID-19 pandemic, caused by the SARS-CoV-2 coronavirus, has forced all countries affected by it to introduce quarantine and isolation to prevent the spread of the virus, as well as masking and distancing. Not everyone is equally willing to follow the rules related to limit the extent of the coronavirus epidemic. This might be connected with personality traits, especially openness, positive attitude, and optimism. Materials and Methods: An online survey was created and completed by participants in April-May 2020. Self-assessment of personality traits and adherence to lockdown recommendations were assessed. A total of 7404 participants took part in the study, mainly from Poland (83.6%) and Italy (12.7%). Univariate and multivariate regression analysis was performed. Results: The participants were divided into groups depending on the degree of compliance with the lockdown rules. In the multivariate analysis, variables that increased the odds for stricter lockdown compliance were temporary work suspension OR 1.27 (95% CI 1.10-1.48), income level "we can't handle this situation" OR 1.67 (95%CI 1.20-2.33), and junior high school education OR 1.68 (95% CI 1.13-2.50). Other significant factors included age and place of residence. Each point of self-assessed sociability OR 1.07 (95% CI 1.00-1.13) also increased the likelihood of adhering to lockdown rules. Conclusions: Taking the basic demographic characteristics as well as working and health environment conditions traits into account may be helpful when forecasting epidemiological compliance during a pandemic, as well as in other public health tasks. The key role of self-assessed personality traits was not confirmed in this study. Reliability of the results is limited by significant disproportions in the size of the study groups.
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Affiliation(s)
- Jakub Jan Rojek
- Adult Psychiatry Scientific Circle, Department of Developmental Psychiatry, Psychotic and Geriatric Disorders, Medical University of Gdańsk, 80-282 Gdańsk, Poland
| | - Przemysław Waszak
- Departament of Hygiene and Epidemiology, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Ilona Bidzan-Bluma
- Departament of Psychology, Gdańsk University of Physical Education and Sport, 80-336 Gdansk, Poland
- Institute of Psychology, Faculty of Social Sciences, University of Gdansk, 80-309 Gdansk, Poland
| | - Aleksandra Sanewska
- Adult Psychiatry Scientific Circle, Department of Developmental Psychiatry, Psychotic and Geriatric Disorders, Medical University of Gdańsk, 80-282 Gdańsk, Poland
| | - Joanna Stępień
- Department of Socio-Economic Geography, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland
| | - Tomasz Michalski
- Department of Regional Development, Faculty of Social Sciences, University of Gdańsk, 80-309 Gdańsk, Poland
| | - Liliana Lorettu
- Psychiatric Clinic, Department of Medical, Surgical and Experimental Sciences, University of Sassari, 07100 Sassari, Italy
| | | | - Che-Sheng Chu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Myriam Abboud
- Department of Natural Science and Public Health, Zayed University, Dubai P.O. Box 19282, United Arab Emirates
| | - Jakub Grabowski
- Department of Developmental Psychiatry, Psychotic and Geriatric Disorders, Medical University of Gdańsk, 80-282 Gdańsk, Poland
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Kale D, Herbec A, Beard E, Gold N, Shahab L. Patterns and predictors of adherence to health-protective measures during COVID-19 pandemic in the UK: cross-sectional and longitudinal findings from the HEBECO study. BMC Public Health 2022; 22:2347. [PMID: 36517788 PMCID: PMC9749621 DOI: 10.1186/s12889-022-14509-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 11/01/2022] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Adherence to health-protective behaviours (regularly washing hands, wearing masks indoors, maintaining physical distancing, carrying disinfectant) remains paramount for the successful control of COVID-19 at population level. It is therefore important to monitor adherence and to identify factors associated with it. This study assessed: 1) rates of adherence, to key COVID-19 health-protective behaviours and 2) the socio-demographic, health and COVID-19-related factors associated with adherence. METHODS Data were collected on a sample of UK-based adults during August-September 2020 (n = 1,969; lockdown restrictions were eased in the UK; period 1) and November 2020- January 2021 (n = 1944; second UK lockdown; period 2). RESULTS Adherence ranged between 50-95%, with higher adherence during the period of stricter measures. Highest adherence was observed for wearing masks indoors (period 1: 80.2%, 95%CI 78.4%-82.0%, period 2: 92.4%, 95%CI 91.1%-93.6%) and lowest for carrying own disinfectant (period 1: 48.4%, 95%CI 46.2%-50.7%, period 2: 50.7%, 95%CI 48.4%-53.0%). Generalized estimating equation models indicated that key factors of greater odds of adherence included being female, older age, having higher income, residing in England, living with vulnerable individuals and perceived high risk of COVID-19. CONCLUSIONS Targeted messages to different demographic groups may enhance adherence to health-protective behaviours, which is paramount for the control of airborne respiratory diseases. PROTOCOL AND ANALYSIS PLAN REGISTRATION The analysis plan was pre-registered, and it is available at https://osf.io/6tnc9/ .
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Affiliation(s)
- Dimitra Kale
- grid.83440.3b0000000121901201Department of Behavioural Science and Health, University College London, London, UK ,SPECTRUM Consortium, London, UK
| | - Aleksandra Herbec
- grid.83440.3b0000000121901201Department of Behavioural Science and Health, University College London, London, UK ,grid.83440.3b0000000121901201Department of Clinical, Educational and Health Psychology, UCL, London, UK ,grid.467042.30000 0001 0054 1382 Institute–European Observatory of Health Inequalities, Calisia University, Kalisz, Poland
| | - Emma Beard
- grid.83440.3b0000000121901201Department of Behavioural Science and Health, University College London, London, UK ,SPECTRUM Consortium, London, UK
| | - Natalie Gold
- grid.271308.f0000 0004 5909 016XBehavioural Insights, Public Health England, London, UK
| | - Lion Shahab
- grid.83440.3b0000000121901201Department of Behavioural Science and Health, University College London, London, UK ,SPECTRUM Consortium, London, UK
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COVID-19 isolation/quarantine rules in home care patients. Epidemiol Infect 2022; 150:e206. [PMID: 36468444 PMCID: PMC9767896 DOI: 10.1017/s0950268822001844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/10/2022] Open
Abstract
The spread of Severe Acute Respiratory Syndrome Coronavirus 2 new variants increased the number of subjects in home isolation and quarantine. The aim of this study was to assess the compliance with coronavirus disease 2019 home isolation rules for 32 subjects in home care in Marche Region, Italy. The results showed that subjects in home isolation were better informed about isolation rules (P = 0.007) than those who were in quarantine. They had lower educational level (P < 0.001) and none/single income (P < 0.001) and higher rate of clinical manifestation. The education for a safe quarantine should be strengthened widely, especially among disadvantaged subjects.
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Sustaining self-restraint until the middle of the COVID-19 pandemic in Tokyo. Sci Rep 2022; 12:20825. [PMID: 36460752 PMCID: PMC9716496 DOI: 10.1038/s41598-022-25489-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/29/2022] [Indexed: 12/03/2022] Open
Abstract
We analyzed time-series changes in people's purpose-specific mobility characteristics owing to the COVID-19 pandemic in the Tokyo area of Japan, where only legally non-binding requests for self-restraint were enforced. A multiple regression analysis was conducted with the objective variable being the mobile population in the Tokyo area per 500 m square grid estimated from mobile spatial statistical data for 2 years from 10/01/2019 to 9/30/2021. This study period ranges from pre- to mid-pandemic. The explanatory variable was the number of buildings by type per 500 m square grid obtained from building statistical data to determine behavioral changes by mobility purpose. The analysis revealed that self-restraint was sustained until the middle of the COVID-19 pandemic in the Tokyo area regardless of the purpose of mobility and whether a state of emergency was declared.
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Bárcena-Martín E, Molina J, Muñoz-Fernández A, Pérez-Moreno S. Vulnerability and COVID-19 infection rates: A changing relationship during the first year of the pandemic. ECONOMICS AND HUMAN BIOLOGY 2022; 47:101177. [PMID: 36067676 PMCID: PMC9400383 DOI: 10.1016/j.ehb.2022.101177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/12/2022] [Accepted: 08/22/2022] [Indexed: 05/29/2023]
Abstract
In the first year of the COVID-19 pandemic, Spain was one of the worst-hit countries, although not all areas and social groups were affected equally. This study focuses on Malaga, a cosmopolitan tourist destination located on the southern Mediterranean coast that has the sixth largest population in Spain. Specifically, it examines the relationship between multidimensional vulnerability and COVID-19 infection rates across the city's census tracts for the period February 2020 to February 2021. The analysis uses high frequency (daily) data on the accumulated incidence of the disease at 14 days and shows that COVID-19 did not spread symmetrically across the census tracts of Malaga but had a greater impact on the most vulnerable neighbourhoods. However, the pattern of this relationship was not uniform in the period examined, with specific contextual factors driving the higher infection rates across time. Our findings show that pandemic containment regulations cannot overlook vulnerability considerations and universal restrictions to reduce the spread of disease should be supplemented by targeted regulations for specific areas.
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Affiliation(s)
| | - Julián Molina
- Applied Economics Department, Universidad de Málaga, Spain
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Who develops pandemic fatigue? Insights from Latent Class Analysis. PLoS One 2022; 17:e0276791. [DOI: 10.1371/journal.pone.0276791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 10/13/2022] [Indexed: 11/12/2022] Open
Abstract
According to the World Health Organization, pandemic fatigue poses a serious threat for managing COVID-19. Pandemic fatigue is characterized by progressive decline in adherence to social distancing (SDIS) guidelines, and is thought to be associated with pandemic-related emotional burnout. Little is known about the nature of pandemic fatigue; for example, it is unclear who is most likely to develop pandemic fatigue. We sought to evaluate this issue based on data from 5,812 American and Canadian adults recruited during the second year of the COVID-19 pandemic. Past-year decline in adherence to SDIS had a categorical latent structure according to Latent Class Analysis, consisting of a group adherent to SDIS (Class 1: 92% of the sample) and a group reporting a progressive decline in adherence to SDIS (i.e., pandemic fatigue; Class 2: 8% of the sample). Class 2, compared to Class 1, was associated with greater pandemic-related burnout, pessimism, and apathy about the COVID-19 pandemic. They also tended to be younger, perceived themselves to be more affluent, tended to have greater levels of narcissism, entitlement, and gregariousness, and were more likely to report having been previously infected with SARSCOV2, which they regarded as an exaggerated threat. People in Class 2 also self-reported higher levels of pandemic-related stress, anxiety, and depression, and described making active efforts at coping with SDIS restrictions, which they perceived as unnecessary and stressful. People in Class 1 generally reported that they engaged in SDIS for the benefit of themselves and their community, although 35% of this class also feared they would be publicly shamed if they did not comply with SDIS guidelines. The findings suggest that pandemic fatigue affects a substantial minority of people and even many SDIS-adherent people experience emotionally adverse effects (i.e., fear of being shamed). Implications for the future of SDIS are discussed.
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Mchunu GG, Harris O, Nxumalo CT. Exploring primary healthcare practitioners' experiences regarding the coronavirus disease 2019 (COVID-19) pandemic in KwaZulu-Natal, South Africa. Prim Health Care Res Dev 2022; 23:e67. [PMID: 36330843 PMCID: PMC9641673 DOI: 10.1017/s1463423622000536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 06/23/2022] [Accepted: 09/03/2022] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) has spread rapidly around the world since the initial outbreak in Wuhan, China. With the emergence of the Omicron variant, South Africa is presently the epicentre of the COVID-19 pandemic in sub-Saharan Africa. Healthcare workers have been at the forefront of the pandemic in terms of screening, early detection and clinical management of suspected and confirmed COVID-19 cases. Since the beginning of the outbreak, little has been reported on how healthcare workers have experienced the COVID-19 pandemic in South Africa, particularly within a low-income, rural primary care context. METHODS The purpose of the present qualitative study design was to explore primary healthcare practitioners' experiences regarding the COVID-19 pandemic at two selected primary healthcare facilities within a low-income rural context in KwaZulu-Natal, South Africa. Data were collected from a purposive sample of 15 participants, which consisted of nurses, physiotherapists, pharmacists, community caregivers, social workers and clinical associates. The participants were both men and women who were all above the age of 20. Data were collected through individual, in-depth face-to-face interviews using a semi-structured interview guide. Audio recordings were transcribed verbatim. Data were analysed manually by thematic analysis following Tech's steps of data analysis. RESULTS Participants reported personal, occupational and community-related experiences related to the COVID-19 pandemic in South Africa. Personal experiences of COVID-19 yielded superordinate themes of psychological distress, self-stigma, disruption of the social norm, Epiphany and conflict of interest. Occupational experiences yielded superordinate themes of staff infections, COVID-19-related courtesy stigma, resource constraints and poor dissemination of information. Community-related experiences were related to struggles with societal issues, clinician-patient relations and COVID-19 mismanagement of patients. CONCLUSION The findings of this study suggest that primary healthcare practitioners' experiences around COVID-19 are attributed to the catastrophic effects of the COVID-19 pandemic with the multitude of psychosocial consequences forming the essence of these experiences. Ensuring availability of reliable sources of information regarding the pandemic as well as psychosocial support could be valuable in helping healthcare workers cope with living and working during the pandemic.
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Affiliation(s)
- Gugu Gladness Mchunu
- Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Orlando Harris
- Department of Community Health Systems, School of Nursing, University of California San Francisco, San Fransisco, CA, USA
| | - Celenkosini Thembelenkosini Nxumalo
- Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
- College of Health Sciences, School of Nursing and Public Health, University of KwaZulu-Natal, Durban, South Africa
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Daily use of lateral flow devices by contacts of confirmed COVID-19 cases to enable exemption from isolation compared with standard self-isolation to reduce onward transmission of SARS-CoV-2 in England: a randomised, controlled, non-inferiority trial. THE LANCET. RESPIRATORY MEDICINE 2022; 10:1074-1085. [PMID: 36228640 PMCID: PMC9625116 DOI: 10.1016/s2213-2600(22)00267-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/19/2022] [Accepted: 07/12/2022] [Indexed: 11/05/2022]
Abstract
Background In the UK, during the study period (April to July, 2021), all contacts of people with COVID-19 were required to self-isolate for 10 days, which had adverse impacts on individuals and society. Avoiding the need to self-isolate for those who remain uninfected would be beneficial. We investigated whether daily use of lateral flow devices (LFDs) to test for SARS-CoV-2, with removal of self-isolation for 24 h if negative, could be a safe alternative to self-isolation as a means to minimise onward transmission of the virus. Methods We conducted a randomised, controlled, non-inferiority trial in adult contacts identified by COVID-19 contact tracing in England. Consenting participants were randomly assigned to self-isolation (single PCR test, 10-day isolation) or daily contact testing (DCT; seven LFD tests, two PCR tests, no isolation if negative on LFD); participants from a single household were assigned to the same group. Participants were prospectively followed up, with the effect of each intervention on onward transmission established from routinely collected NHS Test and Trace contact tracing data for participants who tested PCR-positive for SARS-CoV-2 during the study period and tertiary cases arising from their contacts (ie, secondary contacts). The primary outcome of the study was the attack rate, the percentage of secondary contacts (close contacts of SARS-CoV-2-positive study participants) who became COVID-19 cases (tertiary cases) in each group. Attack rates were derived from Bernoulli regression models using Huber-White (robust) sandwich estimator clustered standard errors. Attack rates were adjusted for household exposure, vaccination status, and ability to work from home. The non-inferiority margin was 1·9%. The primary analysis was a modified intention-to-treat analysis excluding those who actively withdrew from the study as data from these participants were no longer held. This study is registered with the Research Registry (number 6809). Data collection is complete; analysis is ongoing. Findings Between April 29 and July 28, 2021, 54 923 eligible individuals were enrolled in the study, with final group allocations (following withdrawals) of 26 123 (52·6%) participants in the DCT group and 23 500 (47·4%) in the self-isolation group. Overall, 4694 participants tested positive for SARS-CoV-2 by PCR (secondary cases), 2364 (10·1%) in the self-isolation group and 2330 (8·9%) in the DCT group. Adjusted attack rates (among secondary contacts) were 7·5% in the self-isolation group and 6·3% in the DCT group (difference of –1·2% [95% CI –2·3 to –0·2]; significantly lower than the non-inferiority margin of 1·9%). Interpretation DCT with 24 h exemption from self-isolation for essential activities appears to be non-inferior to self-isolation. This study, which provided evidence for the UK Government's daily lateral flow testing policy for vaccinated contacts of COVID-19 cases, indicated that daily testing with LFDs could allow individuals to reduce the risk of onward transmission while minimising the adverse effects of self-isolation. Although contacts in England are no longer required to isolate, the findings will be relevant for future policy decisions around COVID-19 or other communicable infections. Funding UK Government Department of Health and Social Care.
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Effect of Lockdowns on Hospital Staff in a COVID Center: A Retrospective Observational Study. Vaccines (Basel) 2022; 10:vaccines10111847. [PMID: 36366356 PMCID: PMC9698425 DOI: 10.3390/vaccines10111847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/26/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022] Open
Abstract
At the onset of the SARS-CoV-2 pandemic, individual and social measures were strengthened through restrictive non-pharmaceutical interventions, labelled with the term “lockdown”. In Italy, there were two lockdowns (9 March 2020−3 May 2020 and 3 November 2020−27 March 2021). As part of preventive measures, healthcare workers and the administrative staff population of Policlinico A. Gemelli underwent nasopharyngeal swab tests from 1 March 2020 to 9 February 2022, a long time interval that includes the two aforementioned lockdowns. The population included 8958 people from 1 March 2020 to 31 December 2020; 8981 people from 1 January 2021 to 31 December 2021; and 8981 people from 1 January 2022 to 9 February 2022. We then analysed pseudo-anonymized data, using a retrospective observational approach to evaluate the impact of the lockdown on the incidence of SARS-CoV-2 infections within the population. Given the 14 day contagious period, the swab positivity rate (SPR) among the staff decreased significantly at the end of the first lockdown, every day prior to 18 May 2020, by 0.093 (p < 0.0001, CI = (−0.138−−0.047)). After the fourteenth day post the end of the first lockdown (18 May 2020), the SPR increased daily at a rate of 0.024 (p < 0.0001, 95% CI = (0.013−0.034)). In addition, the SPR appeared to increase significantly every day prior to 17 November 2020 by 0.024 (p < 0.0001, CI = (0.013−0.034)). After the fourteenth day post the start of the second lockdown (17 November 2020), the SPR decreased daily at a rate of 0.039 (p < 0.0001, 95% CI = (−0.050−−0.027)). These data demonstrate that, in our Institution, the lockdowns helped to both protect healthcare workers and maintain adequate standards of care for COVID and non-COVID patients for the duration of the state of emergency in Italy.
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Postill G, Adams CL, Zanin C, Halpin M, Ritter C. Adherence of those at low risk of disease to public health measures during the COVID-19 pandemic: A qualitative study. PLoS One 2022; 17:e0276746. [PMID: 36282884 PMCID: PMC9595514 DOI: 10.1371/journal.pone.0276746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 10/12/2022] [Indexed: 11/05/2022] Open
Abstract
Public health measures (PHMs) proactively and reactively reduce the spread of disease. While these measures target individual behaviour, they require broad adherence to be effective. Consequently, the World Health Organization issued a special appeal to young adults, a known non-adherent population, for increased adherence with COVID-19 guidelines. However, little is known about why these low-risk individuals do or do not adhere to PHMs. This study investigates why young adults in a low-risk setting adhered to PHMs implemented during the COVID-19 pandemic. A qualitative research approach was chosen to gain an in-depth understanding of participants’ thoughts and experiences related to PHM adherence. Semi-structured interviews were conducted in April-May 2021 with 30 young adults living in Prince Edward Island (PEI), the province with the lowest COVID-19 case rate in Canada at that time. Thematic analysis was used to create a codebook based on the Theoretical Domains Framework, which was then inductively modified. The analysis identified eight themes that explained the adherence of young adults: (1) clear, purpose-driven adherence rationale, (2) developing trust in the local leadership, (3) adapting to novel measures, (4) manageable disruption, (5) adhering to reduce anxiety, (6) collective duty towards one’s community, (7) moral culpability and (8) using caution rather than compliance. Together, these themes demonstrate that young adults adhered to PHMs because of their sense of connection to their community, public health leadership, and concerns over stigma. We further argue that clear guidelines and communication from public health officials during both periods of high and low COVID-19 cases facilitate adherence. These findings are important for mitigating future public health emergencies as they explain why young adults, an important segment of the population whose adherence is critical to the success of PHMs, follow PHMs. Further, these findings can inform public health officials and other stakeholders aiming to develop successful adherence strategies.
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Affiliation(s)
- Gemma Postill
- Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Cindy L. Adams
- Veterinary Clinical and Diagnostic Sciences, University of Calgary, Calgary, AB, Canada
| | - Claire Zanin
- Faculty of Science, University of Guelph, East Guelph, ON, Canada
| | - Michael Halpin
- Department of Sociology and Social Anthropology, Dalhousie University, Halifax, NS, Canada
| | - Caroline Ritter
- Department of Health Management, University of Prince Edward Island, Charlottetown, PE, Canada
- * E-mail:
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Shelby T, Arechiga C, Gupta AJ, Hennein R, Schenck C, Weeks B, Bond M, Niccolai L, Davis JL, Grau LE. "I can't do it": A qualitative study exploring case and contact experiences with COVID-19 contact tracing. BMC Public Health 2022; 22:1963. [PMID: 36284292 PMCID: PMC9595089 DOI: 10.1186/s12889-022-14265-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Revised: 09/13/2022] [Accepted: 09/27/2022] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Low engagement in contact tracing for COVID-19 dramatically reduces its impact, but little is known about how experiences, environments and characteristics of cases and contacts influence engagement. METHODS We recruited a convenience sample of COVID-19 cases and contacts from the New Haven Health Department's contact tracing program for interviews about their contact tracing experiences. We analyzed transcripts thematically, organized themes using the Capability, Opportunity, Motivation, Behavior (COM-B) model, and identified candidate interventions using the linked Behavior Change Wheel Framework. RESULTS We interviewed 21 cases and 12 contacts. Many felt physically or psychologically incapable of contact tracing participation due to symptoms or uncertainty about protocols. Environmental factors and social contacts also influenced engagement. Finally, physical symptoms, emotions and low trust in and expectations of public health authorities influenced motivation to participate. CONCLUSION To improve contact tracing uptake, programs should respond to clients' physical and emotional needs; increase clarity of public communications; address structural and social factors that shape behaviors and opportunities; and establish and maintain trust. We identify multiple potential interventions that may help achieve these goals.
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Affiliation(s)
- Tyler Shelby
- grid.47100.320000000419368710Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- grid.47100.320000000419368710Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Cailin Arechiga
- grid.47100.320000000419368710Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Amanda J. Gupta
- grid.47100.320000000419368710Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Rachel Hennein
- grid.47100.320000000419368710Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- grid.47100.320000000419368710Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Christopher Schenck
- grid.47100.320000000419368710Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Brian Weeks
- New Haven Health Department, New Haven, Connecticut, United States of America
- Present Address: Norwalk Health Department, Norwalk, CT United States of America
| | - Maritza Bond
- New Haven Health Department, New Haven, Connecticut, United States of America
| | - Linda Niccolai
- grid.47100.320000000419368710Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - J. Lucian Davis
- grid.47100.320000000419368710Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
- grid.47100.320000000419368710Pulmonary, Critical Care, and Sleep Medicine Section, Yale School of Medicine, New Haven, Connecticut, United States of America
- grid.47100.320000000419368710Center for Methods in Implementation and Prevention Science, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Lauretta E. Grau
- grid.47100.320000000419368710Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, United States of America
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de la Court F, Boyd A, Coyer L, van den Elshout M, de Vries HJC, Matser A, Hoornenborg E, Prins M. The impact of COVID-19-related restrictions in 2020 on sexual healthcare use, pre-exposure prophylaxis use, and sexually transmitted infection incidence among men who have sex with men in Amsterdam, the Netherlands. HIV Med 2022; 24:212-223. [PMID: 36226479 PMCID: PMC9875115 DOI: 10.1111/hiv.13374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 07/14/2022] [Indexed: 01/27/2023]
Abstract
OBJECTIVES We studied the effects of restrictions related to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; coronavirus disease 2019 [COVID-19]) pandemic on the use of sexual healthcare and pre-exposure prophylaxis (PrEP) and on the incidence of sexually transmitted infections (STIs) among men who have sex with men (MSM) in a prospective, open-label PrEP demonstration study (AMPrEP) in Amsterdam, the Netherlands. METHODS We retrieved data from 2019 to 2020 for participants with one or more study visit in 2019 (n = 305) and from two COVID-19 questionnaires (2020: n = 203; 2021: n = 160). Analyses were stratified for three periods of pandemic-related restrictions (first: 15 March 2020-15 June 2020; second: 16 June 2020-15 September 2020; third: 16 September 2020-31 December 2020 or 1 April 2021 for the COVID-19 questionnaire). Endpoints included returning for care during the pandemic, PrEP use (increased/unchanged vs. deceased/stopped, relative to 2019), and any STI/HIV. We modelled determinants of care and PrEP use via multivariable logistic regression and STI incidence using piecewise Poisson regression, comparing the 2020 and 2019 periods. RESULTS Of the 305 MSM included in the analysis, 72.8% returned for care during the pandemic, and this was significantly more likely among daily (vs. event-driven) PrEP users (p < 0.001). Increased/unchanged PrEP use ranged from 55.2% to 58.1% across the three pandemic periods and was more likely among those reporting chemsex in the first (p = 0.001) and third (p = 0.020) periods and among those reporting an increased/unchanged number of sex partners during the second period (p = 0.010). STI incidence was significantly lower in 2020 than in 2019 during the first period (incidence rate ratio [IRR] 0.43; 95% confidence interval [CI] 0.28-0.68) and not significantly different during the second (IRR 1.38; 95% CI 0.95-2.00) and third (IRR 1.42; 95% CI 0.86-2.33) periods. No HIV was diagnosed. CONCLUSION COVID-19-related restrictions coincided with reduced care and PrEP use. Changes in STI incidence suggest delayed diagnoses. Ways to ensure continued access to sexual healthcare during restrictions are needed.
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Affiliation(s)
- Feline de la Court
- Department of Infectious DiseasesPublic Health Service of AmsterdamAmsterdamthe Netherlands
| | - Anders Boyd
- Department of Infectious DiseasesPublic Health Service of AmsterdamAmsterdamthe Netherlands,stichting hiv monitoringAmsterdamthe Netherlands
| | - Liza Coyer
- Department of Infectious DiseasesPublic Health Service of AmsterdamAmsterdamthe Netherlands
| | - Mark van den Elshout
- Department of Infectious DiseasesPublic Health Service of AmsterdamAmsterdamthe Netherlands
| | - Henry J. C. de Vries
- Department of Infectious DiseasesPublic Health Service of AmsterdamAmsterdamthe Netherlands,Amsterdam UMC location University of AmsterdamDepartment of DermatologyAmsterdamthe Netherlands
| | - Amy Matser
- Department of Infectious DiseasesPublic Health Service of AmsterdamAmsterdamthe Netherlands
| | - Elske Hoornenborg
- Department of Infectious DiseasesPublic Health Service of AmsterdamAmsterdamthe Netherlands
| | - Maria Prins
- Department of Infectious DiseasesPublic Health Service of AmsterdamAmsterdamthe Netherlands,Amsterdam UMC location University of AmsterdamDepartment of Infectious Diseases, Amsterdam institute for Infection & Immunity (AII)Amsterdamthe Netherlands
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Socan M, Erčulj VI. Confronting SARS-CoV-2 Infection: Patients' Experience in the First Pandemic Wave-Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12743. [PMID: 36232041 PMCID: PMC9566657 DOI: 10.3390/ijerph191912743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 09/30/2022] [Accepted: 10/02/2022] [Indexed: 06/16/2023]
Abstract
The aim of the study was to investigate the real-life experience of persons infected with SARS-CoV-2 in Slovenia in the first pandemic wave and how the buffering effect of social and informational support affected negative feelings. We used a self-administrated questionnaire. There were 1182 eligible notified cases with the response rate 64.9%. At least 62% of responders were able to follow the isolation rules, while 21.1% did not or could not organize their living separately from other household members. The main providers during the isolation period were close family members. The most prevalent emotion in our study was worry (70.3%) and fear (37.6%). Worry and fear during the illness were less probable for men than women, but more probable for older patients. Participants with strong emotional support had lower odds of being sad. Those who were exposed to a larger number of sources of information had higher odds of being worried. Those patients who used a higher number of more credible sources of information had higher odds of being afraid during illness. Pets did not play a special role in psychological well-being. The role of the media and public health communications should be explored further to achieve an improved response.
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Affiliation(s)
- Maja Socan
- National Institute of Public Health, 1000 Ljubljana, Slovenia
| | - Vanja Ida Erčulj
- Faculty of Criminal Justice and Security, University of Maribor, 2000 Maribor, Slovenia
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Drakesmith M, Collins B, Jones A, Nnoaham K, Thomas DR. Cost-effectiveness of a whole-area testing pilot of asymptomatic SARS-CoV-2 infections with lateral flow devices: a modelling and economic analysis study. BMC Health Serv Res 2022; 22:1190. [PMID: 36138455 PMCID: PMC9502892 DOI: 10.1186/s12913-022-08511-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 08/04/2022] [Indexed: 02/03/2023] Open
Abstract
Background Mass community testing for SARS-CoV-2 by lateral flow devices (LFDs) aims to reduce prevalence in the community. However its effectiveness as a public heath intervention is disputed. Method Data from a mass testing pilot in the Borough of Merthyr Tydfil in late 2020 was used to model cases, hospitalisations, ICU admissions and deaths prevented. Further economic analysis with a healthcare perspective assessed cost-effectiveness in terms of healthcare costs avoided and QALYs gained. Results An initial conservative estimate of 360 (95% CI: 311–418) cases were prevented by the mass testing, representing a would-be reduction of 11% of all cases diagnosed in Merthyr Tydfil residents during the same period. Modelling healthcare burden estimates that 24 (16—36) hospitalizations, 5 (3–6) ICU admissions and 15 (11–20) deaths were prevented, representing 6.37%, 11.1% and 8.2%, respectively of the actual counts during the same period. A less conservative, best-case scenario predicts 2333 (1764–3115) cases prevented, representing 80% reduction in would-be cases. Cost -effectiveness analysis indicates 108 (80–143) QALYs gained, an incremental cost-effectiveness ratio of £2,143 (£860-£4,175) per QALY gained and net monetary benefit of £6.2 m (£4.5 m-£8.4 m). In the best-case scenario, this increases to £15.9 m (£12.3 m-£20.5 m). Conclusions A non-negligible number of cases, hospitalisations and deaths were prevented by the mass testing pilot. Considering QALYs gained and healthcare costs avoided, the pilot was cost-effective. These findings suggest mass testing with LFDs in areas of high prevalence (> 2%) is likely to provide significant public health benefit. It is not yet clear whether similar benefits will be obtained in low prevalence settings or with vaccination rollout. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08511-3.
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Affiliation(s)
- Mark Drakesmith
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, Wales, UK.
| | - Brendan Collins
- Health and Social Services Group, Welsh Government, Cardiff, Wales, UK.,Department of Public Health, Policy and Systems, University of Liverpool, Liverpool, England, UK
| | - Angela Jones
- Cwm Taf Morgannwg University Health Board, Abercynon, Rhondda Cynon Taf, Wales, UK
| | - Kelechi Nnoaham
- Cwm Taf Morgannwg University Health Board, Abercynon, Rhondda Cynon Taf, Wales, UK
| | - Daniel Rhys Thomas
- Communicable Disease Surveillance Centre, Public Health Wales, Cardiff, Wales, UK.,School of Health Sciences, Cardiff Metropolitan University, Cardiff, Wales, UK
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Lockdown support, trust and COVID-19 conspiracy beliefs: Insights from the second national lockdown in France. Health Policy 2022; 126:1103-1109. [PMID: 36127162 PMCID: PMC9472707 DOI: 10.1016/j.healthpol.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Revised: 09/09/2022] [Accepted: 09/11/2022] [Indexed: 11/28/2022]
Abstract
Due to the COVID-19 pandemic, restrictive sanitary measures such as lockdowns have been implemented all around the world. Based on a representative sample of the population collected through an online cross-sectional survey, the goal of the study was to investigate the factors associated with lockdown agreement in France during the second general lockdown of fall 2020. More specifically, we aimed to investigate how trust in the government and COVID-19 conspiracy beliefs influenced lockdown agreement. Trust in the authorities and low adherence to conspiracy beliefs appeared as strong predictors of lockdown acceptance among our sample. Using a mediation analysis, we highlighted a significant indirect effect of trust in the authorities on lockdown agreement through the adherence to conspiracy beliefs: low level of trust translated into higher odds to believe in COVID-19 misinformation which in turn decreased lockdown support. The double effect of trust on lockdown agreement, both directly and indirectly, underlines the importance of careful communication from the government around decisions related to COVID-19 mitigation measures in order not to deteriorate even more the low level of trust in the health action of the government. The fight against false information also appears of the utmost importance to increase the population adherence to public authorities’ recommendations.
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