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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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Taylor-Egbeyemi J, Carter H, Robin C. Thematic analysis of national online narratives on regular asymptomatic testing for Covid-19 in schools in England. BMC Public Health 2023; 23:1028. [PMID: 37259158 PMCID: PMC10230123 DOI: 10.1186/s12889-023-15991-3] [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: 01/26/2023] [Accepted: 05/26/2023] [Indexed: 06/02/2023] Open
Abstract
OBJECTIVE To understand the public perceptions of the schools Covid-19 testing programme in England. DESIGN Qualitative social media analysis. SETTING Online users of parenting forums (Mumsnet and Netmums), Facebook newspaper pages and Daily Mail online readers, who responded to posts or articles about the schools testing programme in England, between 1 and 31 March, 2021. RESULTS Overall, seven main themes were identified, these were divided into barriers and facilitators to engaging in testing for Covid-19. Barriers were: uncertainty around testing in the absence of symptoms; concerns about testing; implications about testing positive; mistrust in the Government. Facilitators were: desire to protect others; desire to return to normality; and hearing others' positive experiences. CONCLUSIONS Our analysis highlighted that alongside well-established barriers to engaging in asymptomatic testing, parents were having to negotiate additional complex decisions around balancing their child's anxiety over testing alongside acknowledgement of the implications of regular testing, such as return to normality and protecting others. Parents and children would benefit from additional practical and social support to facilitate engagement with the schools testing programme.
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Affiliation(s)
- Jo Taylor-Egbeyemi
- Behavioural Science and Insights Unit, UK Health Security Agency, London, UK
| | - Holly Carter
- Behavioural Science and Insights Unit, UK Health Security Agency, London, UK
| | - Charlotte Robin
- Behavioural Science and Insights Unit, UK Health Security Agency, London, UK.
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Walsh L, Hyett N, Juniper N, Li C, Hill S. The Experiences of Stakeholders Using Social Media as a Tool for Health Service Design and Quality Improvement: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph192214851. [PMID: 36429570 PMCID: PMC9690250 DOI: 10.3390/ijerph192214851] [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: 10/03/2022] [Revised: 11/08/2022] [Accepted: 11/08/2022] [Indexed: 05/12/2023]
Abstract
BACKGROUND Health organisations and stakeholders use social media for a range of functions, including engaging stakeholders in the design and quality improvement (QI) of services. Social media may help overcome some of the limitations of traditional stakeholder engagement methods. This scoping review explores the benefits, risks, barriers and enablers for using social media as a tool for stakeholder engagement in health service design and QI. METHODS The searches were conducted on 16 August 2022. Inclusion criteria were: studies of any health service stakeholders, in any health setting, where social media was used as a tool for service design or QI. Data was analysed using deductive content analysis. A committee of stakeholders provided input on research questions, data analysis and key findings. RESULTS 61 studies were included. Benefits included improved organisational communication and relationship building. Risks/limitations included low quality of engagement and harms to users. Limited access and familiarity with social media were frequently reported barriers. Making discussions safe and facilitating access were common enablers. CONCLUSION The benefits, risks, barriers and enablers identified highlight the complexity of social media as an engagement tool for health service design and QI. Understanding these experiences may help implementers design more effective social media-based engagement activities.
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Affiliation(s)
- Louisa Walsh
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3083, Australia
- Correspondence: ; Tel.: +61-3-9479-1578
| | - Nerida Hyett
- La Trobe Rural Health School, La Trobe University, Bendigo, VIC 3550, Australia
| | | | - Chi Li
- Albury Wodonga Health, Wodonga, VIC 3690, Australia
| | - Sophie Hill
- Centre for Health Communication and Participation, School of Psychology and Public Health, La Trobe University, Melbourne, VIC 3083, Australia
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Blake H, Somerset S, Mahmood I, Mahmood N, Corner J, Ball JK, Denning C. A Qualitative Evaluation of the Barriers and Enablers for Implementation of an Asymptomatic SARS-CoV-2 Testing Service at the University of Nottingham: A Multi-Site Higher Education Setting in England. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13140. [PMID: 36293719 PMCID: PMC9603241 DOI: 10.3390/ijerph192013140] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 09/24/2022] [Accepted: 10/09/2022] [Indexed: 06/16/2023]
Abstract
Asymptomatic testing for SARS-CoV-2 RNA has been used to prevent and manage COVID-19 outbreaks in university settings, but few studies have explored their implementation. The aim of the study was to evaluate how an accredited asymptomatic SARS-CoV-2 testing service (ATS) was implemented at the University of Nottingham, a multi-campus university in England, to identify barriers and enablers of implementation and to draw out lessons for implementing pandemic response initiatives in higher education settings. A qualitative interview study was conducted with 25 ATS personnel between May and July 2022. Interviews were conducted online, audio-recorded, and transcribed. Participants were asked about their experience of the ATS, barriers and enablers of implementation. Transcripts were thematically analysed. There were four overarching themes: (1) social responsibility and innovation, (2) when, how and why people accessed testing, (3) impact of the ATS on the spread of COVID-19, and (4) lessons learned for the future. In establishing the service, the institution was seen to be valuing its community and socially responsible. The service was viewed to be broadly successful as a COVID-19 mitigation approach. Challenges to service implementation were the rapidly changing pandemic situation and government advice, delays in service accreditation and rollout to staff, ambivalence towards testing and isolating in the target population, and an inability to provide follow-up support for positive cases within the service. Facilitators included service visibility, reduction in organisational bureaucracy and red tape, inclusive leadership, collaborative working with regular feedback on service status, flexibility in service delivery approaches and simplicity of saliva testing. The ATS instilled a perception of early 'return to normality' and impacted positively on staff feelings of safety and wellbeing, with wider benefits for healthcare services and local communities. In conclusion, we identified common themes that have facilitated or hindered the implementation of a SARS-CoV-2 testing service at a university in England. Lessons learned from ATS implementation will inform future pandemic response interventions in higher education settings.
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Affiliation(s)
- Holly Blake
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK
- NIHR Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UK
| | - Sarah Somerset
- NIHR Nottingham Biomedical Research Centre, Nottingham NG7 2UH, UK
- School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | - Ikra Mahmood
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK
- School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
| | - Neelam Mahmood
- School of Health Sciences, University of Nottingham, Nottingham NG7 2HA, UK
| | - Jessica Corner
- Executive Office, University of Nottingham, Nottingham NG7 2RD, UK
| | - Jonathan K. Ball
- School of Life Sciences, University of Nottingham, Nottingham NG7 2UH, UK
- Biodiscovery Institute, University of Nottingham, Nottingham NG7 2RD, UK
| | - Chris Denning
- School of Medicine, University of Nottingham, Nottingham NG7 2RD, UK
- Biodiscovery Institute, University of Nottingham, Nottingham NG7 2RD, UK
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van der Scheer JW, Ansari A, McLaughlin M, Cox C, Liddell K, Burt J, George J, Kenny R, Cousens R, Leach B, McGowan J, Morley K, Willars J, Dixon-Woods M. Guiding organisational decision-making about COVID-19 asymptomatic testing in workplaces: mixed-method study to inform an ethical framework. BMC Public Health 2022; 22:1747. [PMID: 36109810 PMCID: PMC9476340 DOI: 10.1186/s12889-022-13993-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 08/08/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Workplace programmes to test staff for asymptomatic COVID-19 infection have become common, but raise a number of ethical challenges. In this article, we report the findings of a consultation that informed the development of an ethical framework for organisational decision-making about such programmes. METHODS We conducted a mixed-method consultation - a survey and semi-structured interviews during November-December 2020 in a UK case study organisation that had introduced asymptomatic testing for all staff working on-site in its buildings. Analysis of closed-ended survey data was conducted descriptively. An analysis approach based on the Framework Method was used for the open-ended survey responses and interview data. The analyses were then integrated to facilitate systematic analysis across themes. Inferences were based on the integrated findings and combined with other inputs (literature review, ethical analysis, legal and public health guidance, expert discussions) to develop an ethical framework. RESULTS The consultation involved 61 staff members from the case study organisation (50 survey respondents and 11 interview participants). There was strong support for the asymptomatic testing programme: 90% of the survey respondents viewed it as helpful or very helpful. Open-ended survey responses and interviews gave insight into participants' concerns, including those relating to goal drift, risk of false negatives, and potential negative impacts for household members and people whose roles lacked contractual and financial stability. Integration of the consultation findings and the other inputs identified the importance of a whole-system approach with appropriate support for the key control measure of isolation following positive tests. The need to build trust in the testing programme, for example through effective communication from leaders, was also emphasised. CONCLUSIONS The consultation, together with other inputs, informed an ethical framework intended to support employers. The framework may support organisational decision-making in areas ranging from design and operation of the programme through to choices about participation. The framework is likely to benefit from further consultation and refinement in new settings.
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Affiliation(s)
- Jan W. van der Scheer
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
| | - Akbar Ansari
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
| | - Meredith McLaughlin
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
- Homerton College, Hills Rd, Cambridge, CB2 8PH UK
| | - Caitríona Cox
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
| | - Kathleen Liddell
- Faculty of Law, The David Williams Building, 10 West Rd, Cambridge, CB3 9DZ UK
| | - Jenni Burt
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
| | - Jenny George
- RAND Europe, Westbrook Centre/Milton Rd, Cambridge, CB4 1YG UK
| | - Rebecca Kenny
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
| | - Ruth Cousens
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
| | - Brandi Leach
- RAND Europe, Westbrook Centre/Milton Rd, Cambridge, CB4 1YG UK
| | - James McGowan
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
| | | | - Janet Willars
- Department of Health Sciences, University of Leicester, George Davies Centre, University Road, Leicester, LE1 7RH UK
| | - Mary Dixon-Woods
- THIS Institute, University of Cambridge, Cambridge Biomedical Campus, Clifford Allbutt Building, Cambridge, CB2 0AH UK
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Kwok HF. The significance of advanced COVID-19 diagnostic testing in pandemic control measures. Int J Biol Sci 2022; 18:4610-4617. [PMID: 35874951 PMCID: PMC9305263 DOI: 10.7150/ijbs.72837] [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: 03/13/2022] [Accepted: 05/02/2022] [Indexed: 12/11/2022] Open
Abstract
During the 2 years since the start of the novel coronavirus disease 2019 (COVID-19) pandemic, the scientific world made an enormous effort to fight against this disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has high transmissibility. Advancements in vaccine and treatment strategies have reduced both the hospitalization and mortality rates. However, the virus has shown its ability to evolve and evade from our COVID-19 combating armamentaria by the most common evolution mechanism—mutation. Diagnostic testing has been the first line of defense following the identification of the causative agent. Ever since, the scientific community has developed nuclei acid-based, antigen-based, and antibody-based diagnostic tests, and these testing methodologies are still playing a central role in slowing down viral transmission. These testing methods have different sensitivity and specificity and could be optimally used in areas facing different challenges owing to different level and conditions of COVID-19 outbreak. In this review, we discuss these testing methodologies as well as the considerations on how to apply these diagnostic tests optimally in the community to cope with the ever-changing pandemic conditions.
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Affiliation(s)
- Hang Fai Kwok
- Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Avenida de Universidade, Taipa, Macau SAR.,Department of Biomedical Sciences, Faculty of Health Sciences, University of Macau, Avenida de Universidade, Taipa, Macau SAR
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