The more the merrier! Barriers and facilitators to the general public’s use of a COVID-19 contact tracing app in New Zealand

2021 ◽  
pp. 1-12
Author(s):  
Norina Gasteiger ◽  
Chiara Gasteiger ◽  
Kavita Vedhara ◽  
Elizabeth Broadbent
Keyword(s):  
New Zealand ◽  
Barriers And Facilitators ◽  
Contact Tracing

scholarly journals Barriers and Facilitators to Colorectal Cancer Diagnosis in New Zealand: A Qualitative Study

2020 ◽  
Author(s):  
Tania Blackmore ◽  
Kimberley Norman ◽  
Jacquie Kidd ◽  
Shemana Cassim ◽  
Lynne Chepulis ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
New Zealand ◽  
Help Seeking ◽  
Barriers And Facilitators ◽  
Diagnostic Process ◽  
Interpersonal Competence ◽  
Technical Competence ◽  
Positive Experience ◽  
The Impact ◽  
Diagnostic Intervals

Abstract Background: New Zealand (NZ) has high rates of colorectal cancer but low rates of early diagnosis. Due to a lack of understanding of the pre-diagnostic experience from the patient’s perspective, it is necessary to investigate potential patient and health system factors that contribute to longer diagnostic intervals. Previous qualitative studies have discussed delays using The Model of Pathways to Treatment, but this has not been explored in the NZ context. This study aimed to understand the patient experience and perception of their general practitioner (GP) through the diagnostic process in the Waikato region of NZ. In particular, we sought to investigate potential barriers and facilitators that contribute to longer diagnostic intervals.Methods: Ethical approval for this study was granted by the New Zealand Health and Disability Ethics Committee. Twenty-eight participants, diagnosed with colorectal cancer, were interviewed about their experience. Semi-structured interviews were audio recorded, transcribed verbatim and analysed thematically using The Model of Pathways to Treatment framework (intervals: appraisal, help-seeking, diagnostic).Results: Participant appraisal of symptoms was a barrier to prompt diagnosis, particularly if symptoms were normalised, intermittent, or isolated in occurrence. Successful self-management techniques also resulted in delayed help-seeking. However if symptoms worsened, disruption to work and daily routines were important facilitators to seeking a GP consultation. Participants positively appraised GPs if they showed good technical competence and were proactive in investigating symptoms. Negative GP appraisals were associated with a lack of physical examinations and misdiagnosis, and left participants feeling dehumanised during the diagnostic process. However high levels of GP interpersonal competence could override poor technical competence, resulting in an overall positive experience, even if the cancer was diagnosed at an advanced stage. Māori participants often appraised symptoms inclusive of their sociocultural environment and considered the impact of their symptoms in relation to family.Conclusions: The findings of this study highlight the importance of tailored colorectal cancer symptom communication in health campaigns, and indicate the significance of the interpersonal competence aspect of GP-patient interactions. These findings suggest that interpersonal competence be overtly displayed in all GP interactions to ensure a higher likelihood of a positive experience for the patient.

scholarly journals Why are there gaps in our management of those with high cardiovascular risk?

2012 ◽  
Vol 4 (1) ◽  
pp. 21 ◽  
Author(s):  
Fiona Doolan-Noble ◽  
Jocelyn Tracey ◽  
Stewart Mann
Keyword(s):  
Health Care ◽  
General Practice ◽  
Primary Health Care ◽  
Cardiovascular Risk ◽  
New Zealand ◽  
Barriers And Facilitators ◽  
Care Providers ◽  
High Cardiovascular Risk ◽  
Text Data ◽  
Primary Health

INTRODUCTION: Multiple New Zealand and other international studies have identified gaps in the management of those identified at high risk of a future cardiovascular (CV) event. This study sought to explore the views of health professionals about the barriers and facilitators present within the current primary health care system to the optimal management of those at high CV risk. METHODS: This qualitative study utilised a focus group methodology to examine the barriers and facilitators within primary health care (PHC), and employed a general inductive approach to analyse the text data. FINDINGS: The analysis of text data resulted in the emergence of interrelated themes, underpinned by subthemes. The patient, their circumstances and their characteristics and perceptions provided the first key theme and subthemes. The next key theme was primary health care providers, with subthemes of communication and values and beliefs. The general practice was the third theme and included multiple subthemes: implementation planning and pathway development, time and workload and roles and responsibilities. The final main theme was the health system with the subthemes linking to funding and leadership. CONCLUSION: This study determined the factors that act as barriers and facilitators to the effective management of those at high CV risk within the New Zealand PHC sector. General practice has a pivotal role in preventive health care, but to succeed there needs to be a refocusing of the PHC sector, requiring support from policy makers, District Health Boards and Primary Health Organisations, as well as those working in the sector. KEYWORDS: Primary health care; high cardiovascular risk management; general practitioners; practice nurses; barriers; facilitators

scholarly journals How can we increase notification of exposure to STIs between gay and bisexual men?: intervention development using stakeholder engagement, qualitative methods and behavioural science

2021 ◽  
Author(s):  
Paul Flowers ◽  
Makeda Gerressu ◽  
Julie McLeod ◽  
Jean McQueen ◽  
Gabriele Vojt ◽  
...  
Keyword(s):  
Stakeholder Engagement ◽  
Intervention Development ◽  
Gay And Bisexual Men ◽  
Barriers And Facilitators ◽  
Contact Tracing ◽  
Bisexual Men ◽  
Sex Partners ◽  
Risk Of Infection ◽  
Intervention Content ◽  
And Bisexual

Rationale: The first key step in contact tracing for sexually transmitted infections (STIs) is to notify recent exposed sex partners. Gay and bisexual men and other men who have sex with men (GBMSM) bear a high burden of STIs and one-off partners contribute disproportionately to community transmission, posing a particular challenge to contact tracing. Here we explore and theorise the barriers and facilitators of GBMSM telling their one-off sexual partners about their exposure to STIs. Design: Using focus groups with diverse GBMSM from Leeds, Glasgow, London and on-line (n=28) we used a multi-level approach to intervention development to enhance contact tracing. This framework included initial stakeholder engagement; deductive thematic analysis to identify key barriers and facilitators to contact tracing with one-off partners; the use of the theoretical domains framework (TDF) to theorise these barriers and facilitators and subsequently the use of the behaviour change wheel (BCW), incorporating the behaviour change technique taxonomy (BCTT), to suggest intervention content to enhance the key step of notifying partners; and final stakeholder input to ensure this content was fit for purpose and satisfied the APEASE criteria. Results: In relation to the TDF, the barriers and facilitators primarily related to beliefs about consequences. Having used the BCW and further stakeholder engagement, our final intervention recommendations related to focussed efforts to change the culture and corresponding norms and social practice of notifying sex partners about the risk of infection in GBMSM communities. This could usefully be achieved through dedicated community engagement and partnership work, through focussed mass and social media interventions twinned with focussed peer-led work to normalise and destigmatise contact tracing. Conclusion: Through systematically working with key stakeholders, GBMSM communities and using a range of tools from the behavioural sciences, we have developed a suite of evidence-based and theoretically informed intervention content which, if developed further, could enhance GBMSMs willingness to notify sex partners about their risk of infection.

scholarly journals A structured model for COVID-19 spread: modelling age and healthcare inequities

2020 ◽  
Author(s):  
Alex James ◽  
Michael J Plank ◽  
Rachelle N Binny ◽  
Kate Hannah ◽  
Shaun C Hendy ◽  
...  
Keyword(s):  
New Zealand ◽  
Process Model ◽  
Healthcare Access ◽  
Age Groups ◽  
Access To Healthcare ◽  
Contact Tracing ◽  
Infection Rates ◽  
School Closures ◽  
Community Needs ◽  
Socially Isolated

We use a stochastic branching process model, structured by age and level of healthcare access, to look at the heterogeneous spread of COVID-19 within a population. We examine the effect of control scenarios targeted at particular groups, such as school closures or social distancing by older people. Although we currently lack detailed empirical data about contact and infection rates between age groups and groups with different levels of healthcare access within New Zealand, these scenarios illustrate how such evidence could be used to inform specific interventions. We find that an increase in the transmission rates amongst children from reopening schools is unlikely to significantly increase the number of cases, unless this is accompanied by a change in adult behaviour. We also find that there is a risk of undetected outbreaks occurring in communities that have low access to healthcare and that are socially isolated from more privileged communities. The greater the degree of inequity and extent of social segregation, the longer it will take before any outbreaks are detected. Well-established evidence for health inequities, particularly in accessing primary healthcare and testing, indicates that Māori and Pacific peoples are at higher risk of undetected outbreaks in Aotearoa New Zealand. This highlights the importance of ensuring that community needs for access to healthcare, including early proactive testing, rapid contact tracing, and the ability to isolate, are being met equitably. Finally, these scenarios illustrate how information concerning contact and infection rates across different demographic groups may be useful in informing specific policy interventions.

scholarly journals Technology, Privacy, and User Opinions of COVID-19 Mobile Apps for Contact Tracing: Systematic Search and Content Analysis

10.2196/23467 ◽  
2021 ◽  
Vol 23 (2) ◽  
pp. e23467
Author(s):  
Mahmoud Elkhodr ◽  
Omar Mubin ◽  
Zainab Iftikhar ◽  
Maleeha Masood ◽  
Belal Alsinglawi ◽  
...  
Keyword(s):  
New Zealand ◽  
Personal Information ◽  
Mobile Apps ◽  
The United States ◽  
Contact Tracing ◽  
Policy Makers ◽  
App Store ◽  
Technical Issues ◽  
Google Play ◽  
Privacy Issues

Background Many countries across the globe have released their own COVID-19 contact tracing apps. This has resulted in the proliferation of several apps that used a variety of technologies. With the absence of a standardized approach used by the authorities, policy makers, and developers, many of these apps were unique. Therefore, they varied by function and the underlying technology used for contact tracing and infection reporting. Objective The goal of this study was to analyze most of the COVID-19 contact tracing apps in use today. Beyond investigating the privacy features, design, and implications of these apps, this research examined the underlying technologies used in contact tracing apps. It also attempted to provide some insights into their level of penetration and to gauge their public reception. This research also investigated the data collection, reporting, retention, and destruction procedures used by each of the apps under review. Methods This research study evaluated 13 apps corresponding to 10 countries based on the underlying technology used. The inclusion criteria ensured that most COVID-19-declared epicenters (ie, countries) were included in the sample, such as Italy. The evaluated apps also included countries that did relatively well in controlling the outbreak of COVID-19, such as Singapore. Informational and unofficial contact tracing apps were excluded from this study. A total of 30,000 reviews corresponding to the 13 apps were scraped from app store webpages and analyzed. Results This study identified seven distinct technologies used by COVID-19 tracing apps and 13 distinct apps. The United States was reported to have released the most contact tracing apps, followed by Italy. Bluetooth was the most frequently used underlying technology, employed by seven apps, whereas three apps used GPS. The Norwegian, Singaporean, Georgian, and New Zealand apps were among those that collected the most personal information from users, whereas some apps, such as the Swiss app and the Italian (Immuni) app, did not collect any user information. The observed minimum amount of time implemented for most of the apps with regard to data destruction was 14 days, while the Georgian app retained records for 3 years. No significant battery drainage issue was reported for most of the apps. Interestingly, only about 2% of the reviewers expressed concerns about their privacy across all apps. The number and frequency of technical issues reported on the Apple App Store were significantly more than those reported on Google Play; the highest was with the New Zealand app, with 27% of the reviewers reporting technical difficulties (ie, 10% out of 27% scraped reviews reported that the app did not work). The Norwegian, Swiss, and US (PathCheck) apps had the least reported technical issues, sitting at just below 10%. In terms of usability, many apps, such as those from Singapore, Australia, and Switzerland, did not provide the users with an option to sign out from their apps. Conclusions This article highlighted the fact that COVID-19 contact tracing apps are still facing many obstacles toward their widespread and public acceptance. The main challenges are related to the technical, usability, and privacy issues or to the requirements reported by some users.

A tale of two contact-tracing apps – comparing Australia’s CovidSafe and New Zealand’s NZ Covid Tracer

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
Bronwyn Howell ◽  
Petrus H. Potgieter
Keyword(s):  
New Zealand ◽  
Design Methodology ◽  
Population Based ◽  
Contact Tracing ◽  
Qr Code ◽  
Content Type ◽  
Form Part ◽  
Efficiency And Effectiveness ◽  
Fit For Purpose ◽  
Economic Engagement

Purpose The Australian and New Zealand governments have released smartphone-based apps to complement contact tracing in the event that they face a resurgence of COVID-19 infections. The apps form part of both countries’ policies to support a return to social and economic engagement following extended lockdowns. This paper aims to investigate the extent to which the two approaches are fit for purpose and compare their functional characteristics. Design/methodology/approach Using process mapping and analysis, this paper evaluates the potential of the two apps to improve the performance of existing contact tracing systems across a range of efficiency and effectiveness criteria with an emphasis on the framework proposed by Verrall (2020). Findings The Bluetooth-based Australian app appears likely to assist that country’s contact tracing system to perform more efficiently and effectively in the event of a resurgence of the virus and should increase confidence in re-engagement. The New Zealand QR code-based app, however, is not well-aligned with these objectives. Its interaction with a range of other regulations and obligations, combined with the inconvenience it imposes on its users, is likely to militate against its use. Bluetooth-based apps based on interactions between individuals likely better support these population-based objectives than QR code-based location-specific apps. Originality/value This paper provides an original and extensive analysis of the functionality and effectiveness of Australia and New Zealand’s official contact-tracing apps.

HealthPathways: creating a pathway for health systems reform

2015 ◽  
Vol 39 (1) ◽  
pp. 9 ◽  
Author(s):  
Suzanne Robinson ◽  
Richard Varhol ◽  
Colin Bell ◽  
Frances Quirk ◽  
Learne Durrington
Keyword(s):  
New Zealand ◽  
System Integration ◽  
Secondary Care ◽  
Waiting Times ◽  
Barriers And Facilitators ◽  
Care Services ◽  
Early Evidence ◽  
The Right ◽  
The Impact ◽  
Delivery Of Health Services

Inefficiencies in the co-ordination and integration of primary and secondary care services in Australia, have led to increases in waiting times, unnecessary presentations to emergency departments and issues around poor discharge of patients. HealthPathways is a program developed in Canterbury, New Zealand, that builds relationships between General Practitioners and Specialists and uses information technology so that efficiency is maximised and the right patient is given the right care at the right time. Healthpathways is being implemented by a number of Medicare Locals across Australia however, little is known about the impact HealthPathways may have in Australia. This article provides a short description of HealthPathways and considers what it may offer in the Australian context and some of the barriers and facilitators to implementation. What is known about the topic? Early evidence on HealthPathways suggests that the program does seem to be strengthening relationships between GPs and secondary care specialists. In New Zealand advances in efficiency and system integration have been noted. However, there is limited evidence on the effectiveness of HealthPathways in Australia. What does this paper add? It is one of the first published papers to provide a perspective around HealthPathways and draws existing evidence and research to explore some of the barriers and facilitators to the development and implementation of HealthPathways in Australia. What are the implications for practitioners’? Early evidence suggests HealthPathways could help GPs and other practitioners’ in the delivery of health services, it could also help to strengthen practitioner relationships.

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