scholarly journals The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers (UK-REACH): Protocol for a prospective longitudinal cohort study of healthcare and ancillary workers in UK healthcare settings

2021 ◽  
Author(s):  
Katherine Woolf ◽  
Carl Melbourne ◽  
Luke Bryant ◽  
Anna L Guyatt ◽  
Chris McManus ◽  
...  
Keyword(s):  
Healthcare Worker ◽  
Healthcare Workers ◽  
Minority Groups ◽  
Physical And Mental Health ◽  
Explanatory Variables ◽  
Healthcare Settings ◽  
The United Kingdom ◽  
Sensitive Topics ◽  
Increased Risk ◽  
Prospective Longitudinal

AbstractIntroductionThe COVID-19 pandemic has resulted in significant morbidity and mortality, and has devastated economies in many countries. Amongst the groups identified as being at increased risk from COVID-19 are healthcare workers (HCWs) and ethnic minority groups. Emerging evidence suggests HCWs from ethnic minority groups are at increased risk of adverse COVID-19-related physical and mental health outcomes. To date there has been no large-scale analysis of these risks in UK healthcare workers or ancillary workers in healthcare settings, stratified by ethnicity or occupation type, and adjusted for potential confounders. This paper reports the protocol for a prospective longitudinal questionnaire study of UK HCWs, as part of the UK-REACH programme (The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers).Methods and analysisA baseline questionnaire with follow-up questionnaires at 4 and 8 months will be administered to a national cohort of UK healthcare workers and ancillary workers in healthcare settings, and those registered with UK healthcare regulators. With consent, data will be linked to health records, and participants followed up for 25 years.Univariate associations between ethnicity and primary outcome measures (clinical COVID-19 outcomes, and physical and mental health) and key confounders/explanatory variables will be tested, followed by multivariable analyses to test for associations between ethnicity and key outcomes adjusted for the confounder/explanatory variables, with interactions included as appropriate. Using follow-up data, multilevel models will be used to model changes over time by ethnic group, facilitating understanding of absolute and relative risks in different ethnic groups, and generalisability of findings.Ethics and disseminationThe study is approved by Health Research Authority (reference 20/HRA/4718), and carries minimal risk to participants. We aim to manage the small risk of participant distress due to being asked questions on sensitive topics by clearly indicating on the participant information sheet that the questionnaire covers sensitive topics and that participants are under no obligation to answer these, or indeed any other, questions, and by providing links to support organisations. Results will be disseminated with reports to Government and papers uploaded to pre-print servers and submitted to peer reviewed journals.Registration detailsTrial ID: ISRCTN11811602STRENGTHS AND LIMITATIONS OF THIS STUDYNational, UK-wide, study, aiming to capture variety of healthcare worker job roles including ancillary workers in healthcare settings.Longitudinal study including three waves of questionnaire data collection, and linkage to administrative data over 25 years, with consent.Unique support from all major UK healthcare worker regulators, relevant healthcare worker organisations, and a Professional Expert Panel to increase participant uptake and the validity of findings.Potential for self-selection bias and low response rates, and the use of electronic invitations and online data collection makes it harder to reach ancillary workers without regular access to work email addresses.

scholarly journals The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers (UK-REACH): protocol for a prospective longitudinal cohort study of healthcare and ancillary workers in UK healthcare settings

BMJ Open ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. e050647
Author(s):  
Katherine Woolf ◽  
Carl Melbourne ◽  
Luke Bryant ◽  
Anna L Guyatt ◽  
I Chris McManus ◽  
...  
Keyword(s):  
Healthcare Workers ◽  
Minority Groups ◽  
Ethnic Minority Groups ◽  
Explanatory Variables ◽  
Healthcare Settings ◽  
The United Kingdom ◽  
Sensitive Topics ◽  
Increased Risk ◽  
Prospective Longitudinal

IntroductionThe COVID-19 pandemic has resulted in significant morbidity and mortality and devastated economies globally. Among groups at increased risk are healthcare workers (HCWs) and ethnic minority groups. Emerging evidence suggests that HCWs from ethnic minority groups are at increased risk of adverse COVID-19-related outcomes. To date, there has been no large-scale analysis of these risks in UK HCWs or ancillary workers in healthcare settings, stratified by ethnicity or occupation, and adjusted for confounders. This paper reports the protocol for a prospective longitudinal questionnaire study of UK HCWs, as part of the UK-REACH programme (The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers).Methods and analysisA baseline questionnaire will be administered to a national cohort of UK HCWs and ancillary workers in healthcare settings, and those registered with UK healthcare regulators, with follow-up questionnaires administered at 4 and 8 months. With consent, questionnaire data will be linked to health records with 25-year follow-up. Univariate associations between ethnicity and clinical COVID-19 outcomes, physical and mental health, and key confounders/explanatory variables will be tested. Multivariable analyses will test for associations between ethnicity and key outcomes adjusted for the confounder/explanatory variables. We will model changes over time by ethnic group, facilitating understanding of absolute and relative risks in different ethnic groups, and generalisability of findings.Ethics and disseminationThe study is approved by Health Research Authority (reference 20/HRA/4718), and carries minimal risk. We aim to manage the small risk of participant distress about questions on sensitive topics by clearly participant information that the questionnaire covers sensitive topics and there is no obligation to answer these or any other questions, and by providing support organisation links. Results will be disseminated with reports to Government and papers submitted to pre-print servers and peer reviewed journals.Trial registration numberISRCTN11811602; Pre-results.

scholarly journals Ethnic Disparities in the Development of Sight-Threatening Diabetic Retinopathy in a UK Multi-Ethnic Population with Diabetes: An Observational Cohort Study

2021 ◽  
Vol 11 (8) ◽  
pp. 740
Author(s):  
Manjula D. Nugawela ◽  
Sarega Gurudas ◽  
Andrew Toby Prevost ◽  
Rohini Mathur ◽  
John Robson ◽  
...  
Keyword(s):  
Ethnic Groups ◽  
Ethnic Differences ◽  
Minority Groups ◽  
Treatment Options ◽  
Ethnic Disparities ◽  
Ethnic Minority Groups ◽  
The United Kingdom ◽  
Increased Risk ◽  
Observational Cohort ◽  
General Practices

There is little data on ethnic differences in incidence of DR and sight threatening DR (STDR) in the United Kingdom. We aimed to determine ethnic differences in the development of DR and STDR and to identify risk factors of DR and STDR in people with incident or prevalent type II diabetes (T2DM). We used electronic primary care medical records of people registered with 134 general practices in East London during the period from January 2007–January 2017. There were 58,216 people with T2DM eligible to be included in the study. Among people with newly diagnosed T2DM, Indian, Pakistani and African ethnic groups showed an increased risk of DR with Africans having highest risk of STDR compared to White ethnic groups (HR: 1.36 95% CI 1.02–1.83). Among those with prevalent T2DM, Indian, Pakistani, Bangladeshi and Caribbean ethnic groups showed increased risk of DR and STDR with Indian having the highest risk of any DR (HR: 1.24 95% CI 1.16–1.32) and STDR (HR: 1.38 95% CI 1.17–1.63) compared with Whites after adjusting for all covariates considered. It is important to optimise prevention, screening and treatment options in these ethnic minority groups to avoid health inequalities in diabetes eye care.

scholarly journals “Data makes the story come to life.” Understanding the ethical and legal implications of Big Data research involving ethnic minority healthcare workers: a qualitative study

2021 ◽  
Author(s):  
Edward S. Dove ◽  
Ruby Reed-Berendt ◽  
Manish Pareek
Keyword(s):  
Public Health ◽  
Big Data ◽  
Ethnic Minority ◽  
Health Research ◽  
Healthcare Workers ◽  
Minority Groups ◽  
Significant Implication ◽  
Structured Interviews ◽  
Increased Risk ◽  
The Uk

The aim of UK-REACH (“The United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers”) is to understand if, how, and why healthcare workers (HCWs) in the UK from ethnic minority groups are at increased risk of poor outcomes from COVID-19. In this article, we present findings from Work Package 3, the ethico-legal stream, which undertook qualitative research seeking to understand and address legal, ethical, and social acceptability issues around data protection, privacy, and information governance associated with the linkage of HCWs’ registration data and healthcare data. We interviewed 22 key opinion leaders in healthcare and health research from across the UK in two-to-one semi-structured interviews. Transcripts were manually coded using qualitative thematic analysis. Participants told us that a significant implication across all stages of Big Data research in public health are drivers of mistrust – of the research itself, research staff and funders, and broader concerns of mistrust within participant communities, particularly in the context of COVID-19 and those situated in more marginalised community settings. However, despite the challenges, participants also identified ways in which legally compliant and ethically informed approaches to research can be crafted to mitigate or overcome mistrust and establish confidence in Big Data public health research. Overall, our research indicates that a “Big Data Ethics by Design” approach can help assure 1) that meaningful engagement is taking place and that extant challenges are addressed, and 2) that any new challenges or hitherto unknown unknowns can be rapidly and properly considered to ensure potential (but material) harms are identified and minimised where necessary. Our findings indicate such an approach, in turn, will help drive better scientific breakthroughs that translate into medical innovations and effective public health interventions, which benefit the publics studied.

Violations of Suicide-Prevention Guidelines in US Media Coverage of Physician's Suicide Death During the COVID-19 Pandemic

Crisis ◽  
2021 ◽  
Author(s):  
Erika E. Lynn-Green ◽  
Klaudia Jaźwińska ◽  
Adam L. Beckman ◽  
Stephen R. Latham
Keyword(s):  
Healthcare Worker ◽  
Suicide Prevention ◽  
News Media ◽  
Media Coverage ◽  
Healthcare Workers ◽  
Best Practice ◽  
Reporting Guidelines ◽  
Increased Risk ◽  
The Media ◽  
Media Practices

Abstract. Background: Healthcare workers are at elevated risk for suicide; though it has yet to be studied, this risk may be exacerbated by the COVID-19 pandemic. News media coverage of high-profile suicide is associated with an increased risk of subsequent suicides. No analysis has yet been published of US media practices for reporting on healthcare worker suicides during the pandemic. Aims: The researchers aimed to evaluate pandemic-era media practices by investigating adherence to best-practice suicide reporting guidelines in coverage of Dr. Lorna Breen's death. Methods: The researchers conducted a content analysis of all unique articles by top outlets reporting Dr. Breen's death between April 26 and 29, 2020, and scored them based on their adherence to the 15 best-practice suicide reporting guidelines. Results: Every media outlet violated an average of at least 5 of 15 suicide guidelines in reporting on Dr. Breen's death; some abided by as few as 2 of 15 recommended guidelines. Seven of 15 guidelines were adhered to by fewer than one third of articles. The National Suicide Prevention Lifeline number, notably easy to include, appeared in only 75% of articles. Limitations: The researchers were limited to reviewing media coverage of one specific instance of COVID-era healthcare worker suicide, making these findings applicable as a prominent case study rather than forming a generalizable claim about suicide reporting during the pandemic or about reporting on healthcare suicides. Conclusion: These violations highlight a range of opportunities to improve suicide prevention in the media, which has a responsibility to ensure reporting does not exacerbate the risk of suicide. Improved adherence to these guidelines could reduce harm for healthcare workers during the pandemic.

scholarly journals Delivering digital health and well-being at scale: lessons learned during the implementation of the dallas program in the United Kingdom

2015 ◽  
Vol 23 (1) ◽  
pp. 48-59 ◽  
Author(s):  
Alison M Devlin ◽  
Marilyn McGee-Lennon ◽  
Catherine A O’Donnell ◽  
Matt-Mouley Bouamrane ◽  
Ruth Agbakoba ◽  
...  
Keyword(s):  
United Kingdom ◽  
Qualitative Data ◽  
Sociological Theory ◽  
Digital Health ◽  
Well Being ◽  
Lessons Learned ◽  
Healthcare Settings ◽  
The United Kingdom ◽  
Prospective Longitudinal ◽  
Health And Well Being

Abstract Objective To identify implementation lessons from the United Kingdom Delivering Assisted Living Lifestyles at Scale (dallas) program—a large-scale, national technology program that aims to deliver a broad range of digital services and products to the public to promote health and well-being. Materials and Methods Prospective, longitudinal qualitative research study investigating implementation processes. Qualitative data collected includes semi-structured e-Health Implementation Toolkit–led interviews at baseline/mid-point ( n = 38), quarterly evaluation, quarterly technical and barrier and solutions reports, observational logs, quarterly evaluation alignment interviews with project leads, observational data collected during meetings, and ethnographic data from dallas events ( n > 200 distinct pieces of qualitative data). Data analysis was guided by Normalization Process Theory, a sociological theory that aids conceptualization of implementation issues in complex healthcare settings. Results Five key challenges were identified: 1) The challenge of establishing and maintaining large heterogeneous, multi-agency partnerships to deliver new models of healthcare; 2) The need for resilience in the face of barriers and set-backs including the backdrop of continually changing external environments; 3) The inherent tension between embracing innovative co-design and achieving delivery at pace and at scale ; 4) The effects of branding and marketing issues in consumer healthcare settings; and 5) The challenge of interoperability and information governance, when commercial proprietary models are dominant. Conclusions The magnitude and ambition of the dallas program provides a unique opportunity to investigate the macro level implementation challenges faced when designing and delivering digital health and wellness services at scale. Flexibility, adaptability, and resilience are key implementation facilitators when shifting to new digitally enabled models of care.

scholarly journals Work team identification associated with less stress and burnout among front-line emergency department staff amid the COVID-19 pandemic

BMJ Leader ◽  
2020 ◽  
pp. leader-2020-000331
Author(s):  
Rohit B Sangal ◽  
Amy Wrzesniewski ◽  
Julia DiBenigno ◽  
Eleanor Reid ◽  
Andrew Ulrich ◽  
...  
Keyword(s):  
Emergency Department ◽  
Work Stress ◽  
Healthcare Workers ◽  
Well Being ◽  
Team Identification ◽  
Work Team ◽  
Physical And Mental Health ◽  
Front Line ◽  
Cross Sectional ◽  
Prospective Longitudinal

BackgroundThe COVID-19 pandemic has exposed front-line healthcare workers to unprecedented risks and stressors threatening both physical and mental health. Prior work in the military has found that team identification, or the sense that one was a part of a team, can help reduce stress and prevent burnout during prolonged stress.MethodsWe conducted repeated cross-sectional surveys embedded within emergency department workflow to understand whether team identification was associated with reduced reports of stress and burnout among front-line workers.ResultsDuring the 10-week study which spanned the first wave of COVID-19, 327 of 431 (76%) front-line healthcare workers responded to at least one round of the survey. Higher team identification was associated with significantly less work stress (B=−0.60, 95% CI −0.84 to to -0.40, p<0.001) and burnout (B=−12.87, 95% CI −17.73 to -8.02, p<0.001) in cross-sectional analyses. Further evidence of the protective effect of team identification for work stress (B=−0.36, 95% CI −0.76 to 0.05, p=0.09) and burnout (B=−13.25, 95% CI −17.77 to -8.73, p<0.001) was also found in prospective longitudinal evidence.ConclusionThis work suggests work team identification is a key buffering factor against feelings of stress and burnout. Efforts to promote team identification may offer a promising way for leaders to support front-line healthcare workers’ well-being during the COVID-19 pandemic. These results can inform ongoing COVID-19 operational and quality improvement initiatives.

scholarly journals Roll-out of SARS-CoV-2 testing for healthcare workers at a large NHS Foundation Trust in the United Kingdom, March 2020

2020 ◽  
Vol 25 (14) ◽  
Author(s):  
Alexander J Keeley ◽  
Cariad Evans ◽  
Hayley Colton ◽  
Michael Ankcorn ◽  
Alison Cope ◽  
...  
Keyword(s):  
United Kingdom ◽  
Severe Acute Respiratory Syndrome ◽  
Healthcare Workers ◽  
Teaching Hospitals ◽  
Risk Of Infection ◽  
Staffing Levels ◽  
The United Kingdom ◽  
Vulnerable Patients ◽  
Increased Risk ◽  
Roll Out

Healthcare workers (HCW) are potentially at increased risk of infection with coronavirus disease (COVID-19) and may transmit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to vulnerable patients. We present results from staff testing at Sheffield Teaching Hospitals NHS Foundation Trust, United Kingdom. Between 16 and 29 March 2020, 1,533 symptomatic HCW were tested, of whom 282 (18%) were positive for SARS-CoV-2. Testing HCW is a crucial strategy to optimise staffing levels during this outbreak.

Healthcare workers novel coronavirus (nCOVID 19) life-threatening situation during the pandemic

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 1222-1225
Author(s):  
Shweta Dadarao Parwe ◽  
Avinash Sukhdeorao Ingle ◽  
Milind Abhimanyu Nisargandha ◽  
Bharat Rathi
Keyword(s):  
Public Health ◽  
Respiratory Infection ◽  
Healthcare Workers ◽  
Global Public Health ◽  
Physical And Mental Health ◽  
Increased Risk ◽  
Severe Acute Respiratory Infection ◽  
Life Threatening ◽  
Novel Coronavirus ◽  
Threatening Situation

Healthcare workers (HCWs) are the professional workers directly acquired infection during this coronavirus outbreak. Coronavirus potentially severe acute respiratory infection caused by nCOVID-19 has been declared by pandemic on 11th March 2020 by Word health organisation (WHO). The previous study has reported high susceptibility of respiratory infection in the HCWs. The HCWs are at increased risk for severe respiratory syndrome coronavirus infection. The spread of coronavirus became global public health event, threatening physical and Mental Health of HCWs. This study reviews the possible risk factors for being infected HCWs and avoid transmission of infection at the workplace. Spreading the coronavirus day by day is the life-threatening condition for Health care workers during a pandemic. The community should understand the HCW’s increased responsibility during this public health emergency and must provide the necessary social support as well. There should be enough protective and preventive measures for avoiding transmission in HCWs. Apart from heavy duties HCWs while using PPEs they also have physical and mental exhaustion along with the fear produced out of risk-specific exposures. 

scholarly journals Previous COVID-19 infection but not Long-COVID is associated with increased adverse events following BNT162b2/Pfizer vaccination

2021 ◽  
Author(s):  
Rachael K. Raw ◽  
Clive Kelly ◽  
Jon Rees ◽  
Caroline Wroe ◽  
David R. Chadwick
Keyword(s):  
Sensitivity Analysis ◽  
United Kingdom ◽  
Adverse Events ◽  
Observational Study ◽  
Healthcare Workers ◽  
Vaccine Hesitancy ◽  
Prior History ◽  
The United Kingdom ◽  
Increased Risk ◽  
History Of

AbstractImportanceUnderstanding Adverse Events (AEs) associated with SARS-CoV-2 vaccination has public health implications, especially with regards to vaccine hesitancy.ObjectiveTo establish whether individuals with prior history of COVID-19 were more likely to experience AEs after BNT162b2/Pfizer vaccination, than those without previous COVID-19, and whether COVID-19-vaccination interval influenced AE severity.DesignAn observational study explored AEs after vaccination. Participants were invited to complete an electronic survey, capturing self-reported COVID-19 symptoms, PCR/antibody results, and AEs following first dose of BNT162b2/Pfizer vaccine. In a subset where PCR/antibody results could be verified, a sensitivity analysis was conducted.SettingThree North-East England hospital Trusts in the United Kingdom.ParticipantsHealthcare workers formed an opportunistic sample – 265 of 974 reported prior positive SARS-CoV-2 PCR and/or antibody.ExposureAll participants had received their first dose of BNT162b2/Pfizer vaccine.Main Outcomes and MeasuresNature, severity, duration, and onset of self-reported AEs (reported via a modified version of the FDA Toxicity Grading Scale for vaccine-associated AEs), was compared between those with and without a prior history of COVID-19, using 2-way ANCOVA and logistic regression. Effects of age, gender, illness-vaccine interval, and ongoing symptoms (‘Long-COVID’) on AEs, were also explored.ResultsOf 974 respondents (81% female, mean age 48), 265 (27%) reported previous COVID-19 infection. Within this group (symptoms median 8.9 months pre-vaccination), 30 (11%) complained of Long-COVID. The proportion reporting one moderate/severe symptom was higher in the previous COVID-19 group (56% v 47%, OR=1.5 [95%CI, 1.1–2.0], p=.009), with fever, fatigue, myalgia-arthralgia and lymphadenopathy significantly more common. There was no significant relationship between illness-vaccine interval and symptom composite score (rs=0.09, p=.44). Long-COVID was not associated with worse AEs in comparison to the group without previous COVID-19. In the smaller sensitivity analysis cohort (412 people) similar findings were obtained although only myalgia and arthralgia remained significant.Conclusions and RelevancePrior COVID-19 infection but not ongoing Long-COVID symptoms were associated with an increase in the risk of self-reported adverse events following BNT162b2/Pfizer vaccination. COVID-19 illness-vaccination interval did not significantly influence AEs. This data can support education around vaccine-associated AEs and, through improved understanding, help to combat vaccine hesitancy.Key PointsQuestionDoes previous COVID-19 infection or ‘Long-COVID’ increase the frequency of Adverse Events (AEs) following first dose of BNT162b2/Pfizer vaccination?FindingsIn a survey-based observational study, healthcare workers in the United Kingdom reported AEs experienced after their first dose of BNT162b2/Pfizer vaccine. Prior COVID-19 infection, but not Long-COVID, were associated with increased risk of self-reported AEs including lymphadenopathy post-vaccination. Duration since COVID-19 infection did not affect severity of AEs.MeaningOur study can inform education and understanding of AEs associated with COVID-19 vaccination and help to combat vaccine hesitancy.

scholarly journals Healthcare workers' views on mandatory SARS-CoV-2 vaccination in the United Kingdom: findings from the UK-REACH prospective longitudinal cohort study

2022 ◽  
Author(s):  
Katherine Woolf ◽  
Mayuri Gogoi ◽  
Christopher A Martin ◽  
Padmasayee Panineni ◽  
Susie Lagrata ◽  
...  
Keyword(s):  
Cohort Study ◽  
United Kingdom ◽  
Healthcare Workers ◽  
Free Text ◽  
Online Questionnaire ◽  
Research And Innovation ◽  
The United Kingdom ◽  
Health And Social Care ◽  
Mandatory Vaccination ◽  
Prospective Longitudinal

Background Several countries now have mandatory SARS-CoV-2/COVID-19 vaccination for healthcare workers (HCWs) or the general population. HCWs' views on this are largely unknown. Methods We administered an online questionnaire to 17891 United Kingdom (UK) HCWs in Spring 2021 as part of the United Kingdom Research study into Ethnicity And COVID-19 outcomes in Healthcare workers (UK-REACH) nationwide prospective cohort study. We categorised responses to a free-text question 'What should society do if people don't get vaccinated against COVID-19?' using content analysis. We collapsed categories into a binary variable: favours mandatory vaccination or not and used logistic regression to calculate its demographic predictors, and occupational, health and attitudinal predictors adjusted for demographics. Findings Of 5633 questionnaire respondents, 3235 answered the freetext question; 18% (n=578) of those favoured mandatory vaccination but the most frequent suggestion was education (32%, n=1047). Older HCWs, HCWs vaccinated against influenza (OR 1.48; 95%CI 1.10-1.99, vs none) and with more positive vaccination attitudes generally (OR 1.10; 95%CI 1.06-1.14) were more likely to favour mandatory vaccination (OR 1.26; 95%CI 1.17-1.37, per decade increase), whereas female HCWs (OR= 0.80, 95%CI 0.65-0.99, vs male), Black HCWs (OR= 0.48, 95%CI 0.26-0.87, vs White), those hesitant about COVID-19 vaccination (OR= 0.56; 95%CI 0.43-0.71, vs not hesitant), in an Allied Health Profession (OR 0.67; 95%CI 0.51-0.88, vs Medical), or who trusted their organisation (OR 0.78; 95%CI 0.63-0.96) were less likely to. Interpretation Only one in six of the HCWs in this large, diverse, UK-wide sample favoured mandatory vaccination. Building trust, educating and supporting HCWs who are hesitant about vaccination may be more acceptable, effective and equitable. Funding MRC-UK Research and Innovation grant (MR/V027549/1) and the Department of Health and Social Care via the National Institute for Health Research.

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