Covid-19 in the UK: policy on children and schools

Implementation in an emergency: Qualitative longitudinal research on the experience of implementing Covid-19 prevention in English schools

Implementation studies rarely examine how health interventions are delivered in emergencies. Informed by May's general theory of implementation (GTI), we undertook qualitative longitudinal research to investigate how schools in England implemented Covid-19-prevention measures and how this evolved over the 2020–2021 school year in a rapidly changing epidemiological and policy context. We conducted 74 semi-structured interviews over two time-points with headteachers, teachers, parents and students across eight primary and secondary schools. School leaders rapidly made sense of government guidance despite many challenges. They developed and disseminated prevention plans to staff, parents and students. As defined by GTI, ‘cognitive participation’ and ‘collective action’ to enact handwashing, one-way systems within schools and enhanced cleaning were sustained over time. However, measures such as physical distancing and placing students in separated groups were perceived to conflict with schools' mission to promote student education and wellbeing. Commitment to implement these was initially high during the emergency phase but later fluctuated dependant on perceived risk and local disease epidemiology. They were not considered sustainable in the long term. Adherence to some measures, such as wearing face-coverings, initially considered unworkable, improved as they were routinised. Implementing home-based asymptomatic testing was considered feasible. Formal and informal processes of ‘reflexive monitoring’ by staff informed improvements in intervention workability and implementation. Leaders also developed skills and confidence, deciding on locally appropriate actions, some of which deviated from official guidance. However, over time, accumulating staff burnout and absence eroded school capacity to collectively enact implementation. Qualitative longitudinal research allowed us to understand how implementation in an emergency involved the above emergent processes. GTI was useful in understanding school implementation processes in a pandemic context but may need adaptation to take into account the changing and sometimes contradictory objectives, time-varying factors and feedback loops that can characterise implementation of health interventions in emergencies.

Exploring pandemic preparedness in higher education: lessons learnt from students' lived experiences during a critical time

Background

The COVID-19 pandemic has had a marked impact on educational disruption and progression of students. Linked to this, studies have demonstrated increases in depression, anxiety, and stress, with long-term outcomes yet to be understood. Students in Higher Education (HE) were at particular risk due to circumstances such as financial stress from job loss, shifting to online learning and uncertainties about the future, with many international students isolated from social support networks. This study explored lived experiences of determinants for academic disruption in HE students during the COVID-19 pandemic across Germany and the UK.

Methods

The study used qualitative secondary data collected from extension and mitigation claim forms from 2019 until 2021 from a university with campuses in the UK and Germany. A phenomenological perspective was utilised to draw out experiences and insights into determinants for mitigation from students to enhance our understanding of real problems encountered during a period of crisis. Thematic data analysis was used to create themes of influence for mitigation of assessments.

Results

Themes identified pre and during the COVID-19 pandemic included; pre-COVID: work-related commitments; bereavement; illness of a family member; mental and physical health issues; natural disasters, during 2020/21, themes created were; COVID-19 social impacts; workplace and financial demands; psychological distress; physical illness, with subthemes evolving such as family responsibilities; and caring for others; furlough and its financial impacts; heavy workload for frontline health care workers; mental health impacts; physical abuse and crime, COVID-19 physical symptoms.

Conclusion

We suggest an Integrated 'Determinants of Wellbeing Framework' for supporting HE students during critical times such as a pandemic. Our suggested framework was adapted from determining health inequalities and the concept of the 'flourishing student' that maps the relationship between the student, their environment and well-being. It is hoped the framework will serve to inform future theories around disruption to student progression and to explore the relevant impact on educational outcomes in HE thus assisting in appropriate support planning.