scholarly journals Understanding patterns of adherence to COVID-19 mitigation measures: a qualitative interview study

2021 ◽  
Author(s):  
Sarah Denford ◽  
Kate S Morton ◽  
Helen Lambert ◽  
Juan Zhang ◽  
Louise E Smith ◽  
...  
Keyword(s):  
Low Income ◽  
Population Level ◽  
Mitigation Measures ◽  
Structured Interviews ◽  
Topic Guide ◽  
Protective Measures ◽  
Qualitative Interview Study ◽  
Reduce Risk ◽  
Nuanced Understanding ◽  
Minority Ethnic

Abstract Background Evidence highlights the disproportionate impact of measures that have been introduced to reduce the spread of coronavirus on individuals from Black, Asian and minority ethnic (BAME) communities, and among those on a low income. An understanding of barriers to adherence in these populations is needed. In this qualitative study, we examined the patterns of adherence to mitigation measures and reasons underpinning these behaviors. Methods Semi-structured interviews were conducted with 20 participants from BAME and low-income White backgrounds. The topic guide was designed to explore how individuals are adhering to social distancing and self-isolation during the pandemic and to explore the reasons underpinning this behavior. Results We identified three categories of adherence to lockdown measures: (i) caution-motivated super-adherence (ii) risk-adapted partial-adherence and (iii) necessity-driven partial-adherence. Decisions about adherence considered potential for exposure to the virus, ability to reduce risk through use of protective measures and perceived importance of/need for the behavior. Conclusions This research highlights a need for a more nuanced understanding of adherence to lockdown measures. Provision of practical and financial support could reduce the number of people who have to engage in necessity-driven partial-adherence. More evidence is required on population level risks of people adopting risk-adapted partial-adherence.

scholarly journals Understanding patterns of adherence to COVID-19 mitigation measures: A qualitative interview study.

2020 ◽  
Author(s):  
Sarah Denford ◽  
Kate S Morton ◽  
Helen Lambert ◽  
Juan Zhang ◽  
Louise E. Smith ◽  
...  
Keyword(s):  
Low Income ◽  
Population Level ◽  
Mitigation Measures ◽  
Structured Interviews ◽  
Protective Measures ◽  
Qualitative Interview Study ◽  
Nuanced Understanding ◽  
The Uk ◽  
Detrimental Impact ◽  
Minority Ethnic

In an effort to reduce the spread of COVID-19, the UK government has introduced a series of mitigation measures. The success of these measures in preventing transmission is dependent on adherence, which is currently considered to be low. Evidence highlights the disproportionate impact of mitigation measures on individuals from Black, Asian and minority ethnic (BAME) groups, as well as among those on a low income, and an understanding of barriers to adherence in these populations is needed. In this qualitative study we examined patterns of adherence to mitigation measures and reasons underpinning these behaviors among people from BAME and low income communities. Semi-structured interviews were conducted with 20 participants from BAME and low-income White backgrounds. The topic guide was designed to explore how individuals are adhering to social distancing and self-isolation measures during the COVID-19 pandemic, and to explore in detail the reasons underpinning this behavior. Data were analyzed using thematic analysis following which charts were used to help compare concepts within and between participants and develop an understanding of patterns of adherence. Participants were confused by the constantly changing and seemingly contradictory rules and guidance. As a result, decisions were made about how best to protect themselves and their household from COVID-19, and from the detrimental impact of lockdown restrictions. This was not always in line with government advice. We identified three categories of adherence to lockdown measures 1) caution motivated super-adherence 2) risk-adapted partial-adherence and 3) necessity-driven partial-adherence. Decisions about adherence considered potential for exposure to the virus, ability to reduce risk through use of protective measures, and perceived importance of/need for the behavior. This research highlights a need for a more nuanced understanding of adherence to lockdown measures. Provision of practical and financial support could reduce the number of people who have to engage in necessity-driven partial-adherence. Information about viral transmission could help people assess the risk associated with partial-adherence more accurately. More evidence is required on population level risks of people adopting risk-adapted partial-adherence.

scholarly journals Homecare for sick family members while waiting for medical help during the 2014-2015 Ebola outbreak in Sierra Leone: a mixed methods study

2020 ◽  
Vol 5 (7) ◽  
pp. e002732
Author(s):  
Kirsten Schmidt-Hellerau ◽  
Maike Winters ◽  
Padraig Lyons ◽  
Bailah Leigh ◽  
Mohammad B Jalloh ◽  
...  
Keyword(s):  
Sierra Leone ◽  
Disease Transmission ◽  
Household Survey ◽  
Population Level ◽  
Protective Measure ◽  
Structured Interviews ◽  
Specific Knowledge ◽  
Protective Measures ◽  
Practical Advice ◽  
Sick Person

IntroductionCaring for an Ebola patient is a known risk factor for disease transmission. In Sierra Leone during the outbreak in 2014/2015, isolation of patients in specialised facilities was not always immediately available and caring for a relative at home was sometimes the only alternative. This study sought to assess population-level protective caregiving intentions, to understand how families cared for their sick and to explore perceived barriers and facilitators influencing caregiving behaviours.MethodsData from a nationwide household survey conducted in December 2014 were used to assess intended protective behaviours if caring for a family member with suspected Ebola. Their association with socio-demographic variables, Ebola-specific knowledge and risk perception was analysed using multilevel logistic regression. To put the results into context, semi-structured interviews with caregivers were conducted in Freetown.ResultsEbola-specific knowledge was positively associated with the intention to avoid touching a sick person and their bodily fluids (adjusted OR (AOR) 1.29; 95% CI 1.01 to 1.54) and the intention to take multiple protective measures (AOR 1.38; 95% CI 1.16 to 1.63). Compared with residing in the mostly urban Western Area, respondents from the initial epicentre of the outbreak (Eastern Province) had increased odds to avoid touching a sick person or their body fluids (AOR 4.74; 95% CI 2.55 to 8.81) and to take more than one protective measure (AOR 2.94; 95% CI 1.37 to 6.34). However, interviews revealed that caregivers, who were mostly aware of the risk of transmission and general protective measures, felt constrained by different contextual factors. Withholding care was not seen as an option and there was a perceived lack of practical advice.ConclusionsEbola outbreak responses need to take the sociocultural reality of caregiving and the availability of resources into account, offering adapted and acceptable practical advice. The necessity to care for a loved one when no alternatives exist should not be underestimated.

scholarly journals COVID-19 at the Deep End: A Qualitative Interview Study of Primary Care Staff Working in the Most Deprived Areas of England during the COVID-19 Pandemic

2021 ◽  
Vol 18 (16) ◽  
pp. 8689
Author(s):  
Claire Norman ◽  
Josephine M. Wildman ◽  
Sarah Sowden
Keyword(s):  
Primary Care ◽  
Low Income ◽  
Care Staff ◽  
Snowball Sampling ◽  
Structured Interviews ◽  
Social Prescribing ◽  
Qualitative Interview Study ◽  
The Impact ◽  
Primary Care Staff ◽  
Deprived Areas

COVID-19 is disproportionately impacting people in low-income communities. Primary care staff in deprived areas have unique insights into the challenges posed by the pandemic. This study explores the impact of COVID-19 from the perspective of primary care practitioners in the most deprived region of England. Deep End general practices serve communities in the region’s most socioeconomically disadvantaged areas. This study used semi-structured interviews followed by thematic analysis. In total, 15 participants were interviewed (11 General Practitioners (GPs), 2 social prescribing link workers and 2 nurses) with Deep End careers ranging from 3 months to 31 years. Participants were recruited via purposive and snowball sampling. Interviews were conducted using video-conferencing software. Data were analysed using thematic content analysis through a social determinants of health lens. Our results are categorised into four themes: the immediate health risks of COVID-19 on patients and practices; factors likely to exacerbate existing deprivation; the role of social prescribing during COVID-19; wider implications for remote consulting. We add qualitative understanding to existing quantitative data, showing patients from low socioeconomic backgrounds have worse outcomes from COVID-19. Deep End practitioners have valuable insights into the impact of social distancing restrictions and remote consulting on patients’ health and wellbeing. Their experiences should guide future pandemic response measures and any move to “digital first” primary care to ensure that existing inequalities are not worsened.

scholarly journals Socio–Economic Analysis of Riverine Flooding on Low-Income Dwellings: Adayar River, a Case Study

2020 ◽  
Vol 30 (2) ◽  
pp. 133-157
Author(s):  
Suriya Saravanan ◽  
Mudgal Basavaraj ◽  
Prakash Nelliyat
Keyword(s):  
Low Income ◽  
Flood Plain ◽  
Flood Damage ◽  
Vital Role ◽  
Flood Mitigation ◽  
Mitigation Measures ◽  
Structured Interviews ◽  
The Impact ◽  
Sustainable Mitigation

AbstractFlood damage assessment plays a vital role in providing information to policy developers. Nowadays, due to urbanization, the impact of flooding on communities is extensive, including tangible damage to property, the environment, and infrastructure as well as intangible damage due to stress, health hazards, and hardship. This paper provides an overview of a detailed flood assessment study conducted in the Kotturpuram Housing board area, located on the flood plain of the Adayar River in Chennai, India. A relatively simple approach to data collection was adopted, being a Questionnaire Survey (QS) as well as semi-structured interviews and observation techniques, due to data and research limitations. Losses due to damage to belongings and extra spending to buy essential commodities during flooding are also dealt with in this study. The flood mitigation costs for flooding that occurred in the year 2015 are also evaluated. A stage-damage curve was arrived at based on the information collected. Optimal and sustainable mitigation measures can be achieved only when the socio-economic aspects are adequately considered. Thus, this analysis was designed to estimate the effects of flooding on a community’s social and economic welfare, and thereby help to educate the community, including residents and officials, about the impact and magnitude of flooding. The outputs of the study will be the key inputs for designing flood mitigation and relief measures.

scholarly journals Processes of Change and Nonsuicidal Self-Injury: A Qualitative Interview Study With Individuals at Various Stages of Change

2019 ◽  
Vol 6 ◽  
pp. 233339361985293 ◽  
Author(s):  
Kaylee Payne Kruzan ◽  
Janis Whitlock
Keyword(s):  
Behavior Change ◽  
Stages Of Change ◽  
Processes Of Change ◽  
Structured Interviews ◽  
Treatment And Prevention ◽  
Self Injury ◽  
Qualitative Interview Study ◽  
Self Knowledge ◽  
Nuanced Understanding ◽  
Nonsuicidal Self Injury

Nonsuicidal self-injury (NSSI) is a pervasive and potentially lethal behavior that affects many youth and adolescents. Effective treatment and prevention efforts are critical but often lack a nuanced understanding of the behavior change process. To address this gap, this research employs a stage of change model to identify and understand the most salient and widespread processes that facilitate NSSI behavior change. Thirty-one semi-structured interviews were conducted with individuals with current or past self-injury. Individuals were recruited to represent all stages of change including those who have not thought about changing behavior to those who have been NSSI-free for years. We employ a directed content analysis to code for dimensions derived from the model and an inductive approach to surface more nuanced change levers. Four organizing dimensions emerged: relational, behavioral, self-knowledge, and barriers. Common change levers of value in clinical practice or in intervention modalities are discussed.

SUSTAINING FAMILY ROUTINES AFTER TRANSITIONING INTO PARENTHOOD: COUPLES’ PERCEPTIONS OF ASSISTING FACTORS

2016 ◽  
Vol 28 (1) ◽  
pp. 3-17
Author(s):  
Christine De Goede ◽  
Abraham P Greeff
Keyword(s):  
Low Income ◽  
Transition To Parenthood ◽  
Specific Problem ◽  
Family Members ◽  
Major Theme ◽  
Structured Interviews ◽  
Theory Analysis ◽  
Family Routines ◽  
Temporal Complexity ◽  
Context Specific

The aim of this qualitative study was to explore what assists couples in sustaining family routines after the transition to parenthood. Participants were recruited from two day-care centres in Cape Town, South Africa. In-depth, semi-structured interviews were conducted with 10 couples, mostly from low-income households, who had gone through this transition between one and four years previously. Grounded theory analysis revealed one major theme, Factors that decrease task and temporal complexity, with seven subthemes: Support from the wider family network; Couple cooperation and tag-teaming; Planning and pre-empting future problems; Adhering to schedules; Facilitative characteristics and skills of individual family members; Parents’ sense of commitment and responsibility towards family members; and idiosyncratic accommodations. Results underscore the need for professionals to help parents gain support from relatives; strengthen partner teamwork; foster schedule consistency; improve skills such as planning; foster their caretaker self-concepts; and facilitate context-specific problem-solving.

scholarly journals The role of research in improving responsiveness of palliative care to migrants and other underserved populations in the Netherlands: a qualitative interview study

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
M. Torensma ◽  
B. D. Onwuteaka-Philipsen ◽  
X. de Voogd ◽  
D. L. Willems ◽  
J. L. Suurmond
Keyword(s):  
Palliative Care ◽  
Healthcare Professionals ◽  
Underserved Populations ◽  
Ethnic Disparities ◽  
Migration Background ◽  
Structured Interviews ◽  
Migrant Populations ◽  
Funding Agencies ◽  
Qualitative Interview Study ◽  
Palliative Patient

Abstract Background The aging of migrant populations across Europe challenges researchers in palliative care to produce knowledge that can be used to respond to the needs of the growing group of patients with a migration background and address ethnic disparities in palliative care. The aim of this study was to identify what factors influence researchers’ efforts to address responsiveness of palliative care to patients with a migration background and other underserved populations in their projects. Methods We conducted semi-structured interviews with 11 researchers involved in seven projects under the Dutch national program for palliative care innovation. Results Researchers’ efforts to address responsiveness of palliative care in their projects were influenced by individual factors, i.e. awareness of the need for responsiveness to patients with a migration background; experience with responsiveness; and, differences in perceptions on responsiveness in palliative care. Researchers’ efforts were furthermore influenced by institutional factors, i.e. the interaction with healthcare institutions and healthcare professionals as they rely on their ability to identify the palliative patient with a migration background, address the topic of palliative care, and enrol these patients in research; scientific standards that limit the flexibility needed for responsive research; and, the responsiveness requirements set by funding agencies. Conclusion Researchers play a key role in ensuring research addresses responsiveness to patients with a migration background. Such responsiveness may also benefit other underserved populations. However, at times researchers lack the knowledge and experience needed for responsive research. To address this we recommend training in responsiveness for researchers in the field of palliative care. We also recommend training for healthcare professionals involved in research projects to increase enrolment of patients with a migration background and other underrepresented populations. Lastly, we encourage researchers as well as research institutions and funding agencies to allow flexibility in research practices and set a standard for responsive research practice.

scholarly journals “My coupons are like gold”: experiences and perceived outcomes of low-income adults participating in the British Columbia Farmers’ Market Nutrition Coupon Program

2021 ◽  
pp. 1-30
Author(s):  
Stéphanie Caron-Roy ◽  
Sayeeda Amber Sayed ◽  
Katrina Milaney ◽  
Bonnie Lashewicz ◽  
Sharlette Dunn ◽  
...  
Keyword(s):  
British Columbia ◽  
Rural Communities ◽  
Low Income ◽  
Well Being ◽  
Qualitative Description ◽  
Farmers Markets ◽  
Social Connections ◽  
Structured Interviews ◽  
Program Outcomes ◽  
Farmers Market

ABSTRACT Objective: The British Columbia Farmers’ Market Nutrition Coupon Program (FMNCP) provides low-income households with coupons valued at $21/week for 16 weeks to purchase healthy foods in farmers’ markets. Our objective was to explore FMNCP participants’ experiences of accessing nutritious foods, and perceived program outcomes. Design: This study used qualitative description methodology. Semi-structured interviews were conducted with FMNCP participants during the 2019 farmers’ market season. Directed content analysis was used to analyse the data whereby the five domains of Freedman et al’s framework of nutritious food access provided the basis for an initial coding scheme. Data that did not fit within the framework’s domains were coded inductively. Setting: One urban and two rural communities in British Columbia, Canada. Participants: 28 adults who were participating in the FMNCP. Results: Three themes emerged: Autonomy and Dignity; Social Connections and Community Building; and Environmental and Programmatic Constraints. Firstly, the program promoted a sense of autonomy and dignity through financial support, increased access to high-quality produce, food-related education and skill development, and mitigating stigma and shame. Secondly, shopping in farmers’ markets increased social connections and fostered a sense of community. Finally, participants experienced limited food variety in rural farmers’ markets, lack of transportation, and challenges with redeeming coupons. Conclusions: Participation in the FMNCP facilitated access to nutritious foods and enhanced participants’ diet quality, well-being and health. Strategies such as increasing the amount and duration of subsidies, and expanding programs may help improve participants’ experiences and outcomes of farmers’ market food subsidy programs.

scholarly journals Drivers of Broad-Spectrum Antibiotic Overuse across Diverse Hospital Contexts—A Qualitative Study of Prescribers in the UK, Sri Lanka and South Africa

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 94
Author(s):  
Carolyn Tarrant ◽  
Andrew M. Colman ◽  
David R. Jenkins ◽  
Edmund Chattoe-Brown ◽  
Nelun Perera ◽  
...  
Keyword(s):  
South Africa ◽  
Sri Lanka ◽  
Antimicrobial Stewardship ◽  
Broad Spectrum ◽  
Low Income ◽  
System Level ◽  
Comparative Approach ◽  
Structured Interviews ◽  
Public And Private ◽  
The Uk

Antimicrobial stewardship programs focus on reducing overuse of broad-spectrum antibiotics (BSAs), primarily through interventions to change prescribing behavior. This study aims to identify multi-level influences on BSA overuse across diverse high and low income, and public and private, healthcare contexts. Semi-structured interviews were conducted with 46 prescribers from hospitals in the UK, Sri Lanka, and South Africa, including public and private providers. Interviews explored decision making about prescribing BSAs, drivers of the use of BSAs, and benefits of BSAs to various stakeholders, and were analyzed using a constant comparative approach. Analysis identified drivers of BSA overuse at the individual, social and structural levels. Structural drivers of overuse varied significantly across contexts and included: system-level factors generating tensions with stewardship goals; limited material resources within hospitals; and patient poverty, lack of infrastructure and resources in local communities. Antimicrobial stewardship needs to encompass efforts to reduce the reliance on BSAs as a solution to context-specific structural conditions.

scholarly journals Robust estimation of SARS-CoV-2 epidemic in US counties

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Hanmo Li ◽  
Mengyang Gu
Keyword(s):  
Transmission Rate ◽  
Public Awareness ◽  
Mitigation Measures ◽  
Infectious Period ◽  
Protective Measures ◽  
Social Distancing ◽  
The Public ◽  
The Us ◽  
Local Officials ◽  
Us Counties

AbstractThe COVID-19 outbreak is asynchronous in US counties. Mitigating the COVID-19 transmission requires not only the state and federal level order of protective measures such as social distancing and testing, but also public awareness of time-dependent risk and reactions at county and community levels. We propose a robust approach to estimate the heterogeneous progression of SARS-CoV-2 at all US counties having no less than 2 COVID-19 associated deaths, and we use the daily probability of contracting (PoC) SARS-CoV-2 for a susceptible individual to quantify the risk of SARS-CoV-2 transmission in a community. We found that shortening by $$5\%$$ 5 % of the infectious period of SARS-CoV-2 can reduce around $$39\%$$ 39 % (or 78 K, $$95\%$$ 95 % CI: [66 K , 89 K ]) of the COVID-19 associated deaths in the US as of 20 September 2020. Our findings also indicate that reducing infection and deaths by a shortened infectious period is more pronounced for areas with the effective reproduction number close to 1, suggesting that testing should be used along with other mitigation measures, such as social distancing and facial mask-wearing, to reduce the transmission rate. Our deliverable includes a dynamic county-level map for local officials to determine optimal policy responses and for the public to better understand the risk of contracting SARS-CoV-2 on each day.

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