Facilitators and barriers to compliance with COVID-19 guidelines: a structural topic modelling analysis of free-text data from 17,500 UK adults

Abstract Background During the COVID-19 pandemic, the UK government implemented a series of guidelines, rules, and restrictions to change citizens’ behaviour to tackle the spread of the virus, such as the promotion of face masks and the imposition of lockdown stay-at-home orders. The success of such measures requires active co-operation on the part of citizens, but compliance was not complete. Detailed research is required on the factors that aided or hindered compliance with these measures. Methods To understand the facilitators and barriers to compliance with COVID-19 guidelines, we used structural topic modelling, a text mining technique, to extract themes from over 26,000 free-text survey responses from 17,500 UK adults, collected between 17 November and 23 December 2020. Results The main factors facilitating compliance were desires to reduce risk to oneself and one’s family and friends and to, a lesser extent, the general public. Also of importance were a desire to return to normality, the availability of activities and technological means to contact family and friends, and the ability to work from home. Identified barriers were difficulties maintaining social distancing in public (due to the actions of other people or environmental constraints), the need to provide or receive support from family and friends, social isolation, missing loved ones, and mental health impacts, perceiving the risks as low, social pressure to not comply, and difficulties understanding and keep abreast of changing rules. Several of the barriers and facilitators raised were related to participant characteristics. Notably, women were more likely to discuss needing to provide or receive mental health support from friends and family. Conclusion The results demonstrated an array of factors contributed to compliance with guidelines. Of particular policy importance, the results suggest that government communication that emphasizes the potential risks of the virus and provides simple, consistent guidance on how to reduce the spread of the virus would improve compliance with preventive behaviours as COVID-19 continues and for future pandemics.

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Facilitators and Barriers to Compliance with COVID-19 Guidelines: A Structural Topic Modelling Analysis of Free-Text Data from 17,500 UK Adults

10.1101/2021.06.28.21259621 ◽

2021 ◽

Author(s):

Liam Wright ◽

Elise Paul ◽

Andrew Steptoe ◽

Daisy Fancourt

Keyword(s):

Mental Health ◽

Free Text ◽

Topic Modelling ◽

Loved One ◽

Work From Home ◽

Improve Compliance ◽

Facilitators And Barriers ◽

Technological Means ◽

The Uk ◽

Survey Responses

Background: During the COVID-19 pandemic, the UK government has implemented a series of guidelines, rules, and restrictions to change citizens' behaviour to tackle the spread of the virus, such as the promotion of face-masks and the imposition of lockdown stay-at-home orders. The success of these measures requires active co-operation on the part of citizens, but compliance has not been complete. Detailed data is required on the factors aiding or hindering compliance with these measures. Methods: To understand the facilitators and barriers to compliance with COVID-19 guidelines, we used structural topic modelling, a text mining technique, to extract themes from over 26,000 free-text survey responses from 17,500 UK adults, collected between 17 November and 23 December 2020. Results: The main factors facilitating compliance were desires to reduce risk to one's self and one's family and friends and to, a lesser extent, the general public. Also of importance were a desire to return to normality, the availability of activities and technological means to contact family and friends, and the ability to work from home. Identified barriers were difficulties maintaining social distancing in public (due to the actions of other people or environmental constraints), the need to provide or receive support from family and friends, social isolation, missing loved one, and mental health impacts, perceiving the risks as low, social pressure to not comply, and difficulties understanding and keep abreast of changing rules. Several of the barriers and facilitators raised were related to participant characteristics. Notably, women were more likely to discuss needing to provide or receive mental health support from friends and family. Conclusion: The results demonstrate an array of factors contribute to compliance with guidelines. Of particular policy importance, the results suggest that government communications that emphasizes the potential risks of COVID-19 and provides simple, consistent guidance on how to reduce the spread of the virus would improve compliance with preventive behaviours.

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Public Opinion about the UK Government during COVID-19 and Implications for Public Health: A Topic Modelling Analysis of Open-Ended Survey Response Data

10.1101/2021.03.24.21254094 ◽

2021 ◽

Author(s):

Liam Wright ◽

Alexandra Burton ◽

Alison McKinlay ◽

Andrew Steptoe ◽

Daisy Fancourt

Keyword(s):

Public Opinion ◽

Mental Wellbeing ◽

Free Text ◽

Topic Modelling ◽

Response Data ◽

Modelling Analysis ◽

Uk Government ◽

The Government ◽

The Uk ◽

Survey Responses

Confidence in the central UK Government has declined since the beginning of the COVID-19 pandemic, and while this may be linked to specific government actions to curb the spread of the virus, understanding is still incomplete. Examining public opinion is important, as research suggests that low confidence in government increases the extent of non-compliance with infection-dampening rules (for instance, social distancing); however, the detailed reasons for this association are still unclear. To understand public opinion on the central UK government during COVID-19, we used structural topic modelling, a text mining technique, to extract themes from over 4000 free-text survey responses, collected between 14 October and 26 November 2020. We identified eleven topics, among which were topics related to perceived government corruption and cronyism, complaints about inconsistency in rules and messaging, lack of clear planning, and lack of openness and transparency. Participants reported that elements of the government's approach had made it difficult to comply with guidelines (e.g., changing rules) or were having impacts on mental wellbeing (e.g., inability to plan for the future). Results suggested that consistent, transparent communication and messaging from the government is critical to improving compliance with measures to contain the virus, as well as protecting mental health during health emergencies.

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Mental Health, Information and Being Connected: Qualitative Experiences of Social Media Use during the COVID-19 Pandemic from a Trans-National Sample

Healthcare ◽

10.3390/healthcare9060735 ◽

2021 ◽

Vol 9 (6) ◽

pp. 735

Author(s):

Schoultz Mariyana ◽

Leung Janni ◽

Bonsaksen Tore ◽

Ruffolo Mary ◽

Thygesen Hilde ◽

...

Keyword(s):

Mental Health ◽

Social Media ◽

Health Information ◽

Online Survey ◽

Negative Impact ◽

National Study ◽

Free Text ◽

Cross Sectional ◽

Mental Health Information ◽

The Uk

Background: Due to the COVID-19 pandemic and the strict national policies regarding social distancing behavior in Europe, America and Australia, people became reliant on social media as a means for gathering information and as a tool for staying connected to family, friends and work. This is the first trans-national study exploring the qualitative experiences and challenges of using social media while in lockdown or shelter-in-place during the current pandemic. Methods: This study was part of a wider cross-sectional online survey conducted in Norway, the UK, USA and Australia during April/May 2020. The manuscript reports on the qualitative free-text component of the study asking about the challenges of social media users during the COVID-19 pandemic in the UK, USA and Australia. A total of 1991 responses were included in the analysis. Thematic analysis was conducted independently by two researchers. Results: Three overarching themes identified were: Emotional/Mental Health, Information and Being Connected. Participants experienced that using social media during the pandemic amplified anxiety, depression, fear, panic, anger, frustration and loneliness. They felt that there was information overload and social media was full of misleading or polarized opinions which were difficult to switch off. Nonetheless, participants also thought that there was an urge for connection and learning, which was positive and stressful at the same time. Conclusion: Using social media while in a shelter-in-place or lockdown could have a negative impact on the emotional and mental health of some of the population. To support policy and practice in strengthening mental health care in the community, social media could be used to deliver practical advice on coping and stress management. Communication with the public should be strengthened by unambiguous and clear messages and clear communication pathways. We should be looking at alternative ways of staying connected.

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Rates and predictors of uptake of mental health support during the COVID-19 pandemic: an analysis of 26,720 adults in the UK in lockdown

Social Psychiatry and Psychiatric Epidemiology ◽

10.1007/s00127-021-02105-w ◽

2021 ◽

Author(s):

Feifei Bu ◽

Hei Wan Mak ◽

Daisy Fancourt

Keyword(s):

Mental Health ◽

Mental Health Professionals ◽

Social Study ◽

Active Role ◽

Service Planning ◽

Gender Education ◽

Mental Health Support ◽

Health Support ◽

Negative Impacts ◽

The Uk

Abstract Purpose The coronavirus disease 2019 (COVID-19) pandemic has put a great strain on people’s mental health. A growing number of studies have shown worsening mental health measures globally during the pandemic. However, there is a lack of empirical study on how people support their mental health during the COVID-19 pandemic. This study aimed to examine a number of formal and informal mental health support. Further, it explored factors that might be associated with the use of different types mental health support. Methods Data from 26,720 adults in the UCL COVID-19 Social Study were analysed between 13th April 2020 and 3rd July 2020. Data were analysed using logistic and Poisson regression models. Results About 45% of people reported talking to friends or family members to support their mental health, 43% engaging in self-care activities, 20% taking medication, 9% speaking to mental health professionals, 8% talking to a GP or other health professional, and another 8% using helpline or online services. Gender, education, living status, loneliness, pre-existing mental health conditions, general depression and anxiety, coping and personality were found to be associated with the use of mental health support. Conclusion While the negative impacts caused by the COVID-19 pandemic are inevitable, people can play an active role in managing their mental health. Understanding the patterns and predictors of various kinds of mental health support during the pandemic is crucial for future service planning and delivery through recognising potential barriers to mental health care faced by certain groups.

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The impact of mental health support for the chronically ill on hospital utilisation: Evidence from the UK

Social Science & Medicine ◽

10.1016/j.socscimed.2021.114675 ◽

2021 ◽

pp. 114675

Author(s):

Jonathan Gruber ◽

Grace Lordan ◽

Stephen Pilling ◽

Carol Propper ◽

Rob Saunders

Keyword(s):

Mental Health ◽

Chronically Ill ◽

Mental Health Support ◽

Health Support ◽

Hospital Utilisation ◽

The Uk ◽

The Impact

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Unsupervised identification of crime problems from police free-text data

Crime Science ◽

10.1186/s40163-020-00127-4 ◽

2020 ◽

Vol 9 (1) ◽

Author(s):

Daniel Birks ◽

Alex Coleman ◽

David Jackson

Keyword(s):

Crime Reduction ◽

Free Text ◽

Topic Modelling ◽

Modus Operandi ◽

Text Data ◽

Machine Learning Methods ◽

Major Metropolitan Area ◽

Operational Decision Making ◽

The Uk ◽

Crime Classification

Abstract We present a novel exploratory application of unsupervised machine-learning methods to identify clusters of specific crime problems from unstructured modus operandi free-text data within a single administrative crime classification. To illustrate our proposed approach, we analyse police recorded free-text narrative descriptions of residential burglaries occurring over a two-year period in a major metropolitan area of the UK. Results of our analyses demonstrate that topic modelling algorithms are capable of clustering substantively different burglary problems without prior knowledge of such groupings. Subsequently, we describe a prototype dashboard that allows replication of our analytical workflow and could be applied to support operational decision making in the identification of specific crime problems. This approach to grouping distinct types of offences within existing offence categories, we argue, has the potential to support crime analysts in proactively analysing large volumes of modus operandi free-text data—with the ultimate aims of developing a greater understanding of crime problems and supporting the design of tailored crime reduction interventions.

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Student perspectives on mental health support and services in the UK

Journal of Further and Higher Education ◽

10.1080/0309877x.2019.1579896 ◽

2019 ◽

Vol 44 (4) ◽

pp. 483-497 ◽

Cited By ~ 1

Author(s):

Rachel Batchelor ◽

Emma Pitman ◽

Alex Sharpington ◽

Melissa Stock ◽

Eilidh Cage

Keyword(s):

Mental Health ◽

Student Perspectives ◽

Mental Health Support ◽

Health Support ◽

The Uk

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Participant Perceptions of Facilitators and Barriers to Adherence in a Digital Mental Health Intervention for a Nonclinical Cohort: Content Analysis

Journal of Medical Internet Research ◽

10.2196/25358 ◽

2021 ◽

Vol 23 (4) ◽

pp. e25358

Author(s):

Melanie Elise Renfrew ◽

Darren Peter Morton ◽

Maria Northcote ◽

Jason Kyle Morton ◽

Jason Scott Hinze ◽

...

Keyword(s):

Mental Health ◽

Mobile App ◽

Free Text ◽

Personal Factors ◽

Time Investment ◽

Health Distress ◽

Facilitators And Barriers ◽

Health Promotion Interventions ◽

Mental Health Distress ◽

App Design

Background Digital mental health promotion interventions (MHPIs) present a scalable opportunity to attenuate the risk of mental health distress among nonclinical cohorts. However, adherence is frequently suboptimal, and little is known about participants’ perspectives concerning facilitators and barriers to adherence in community-based settings. Objective This study aimed to examine participants’ perceptions of facilitators and barriers to adherence in a web- and mobile app–based MHPI for a nonclinical cohort. Methods This qualitative study used inductive, reflexive thematic analysis to explore free-text responses in a postintervention evaluation of a 10-week digital MHPI. The intervention was administered using a web and mobile app from September to December 2018. Participants (N=320) were Australian and New Zealand members of a faith-based organization who self-selected into the study, owned a mobile phone with messaging capability, had an email address and internet access, were fluent in English, provided informed consent, and gave permission for their data to be used for research. The postintervention questionnaire elicited participants’ perceptions of facilitators and barriers to adherence during the intervention period. Results Key factors that facilitated adherence were engaging content, time availability and management, ease of accessibility, easy or enjoyable practical challenges, high perceived value, and personal motivation to complete the intervention. The primary perceived barrier to adherence was the participants’ lack of time. Other barriers included completing and recording practical activities, length of video content, technical difficulties, and a combination of personal factors. Conclusions Time scarcity was the foremost issue for the nonclinical cohort engaged in this digital MHPI. Program developers should streamline digital interventions to minimize the time investment for participants. This may include condensed content, optimization of intuitive web and app design, simplified recording of activities, and greater participant autonomy in choosing optional features. Nonetheless, participants identified a multiplicity of other interindividual factors that facilitated or inhibited adherence.

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Wellbeing during the COVID-19 pandemic in the UK: a secondary data analysis

10.31235/osf.io/pv4qs ◽

2021 ◽

Author(s):

Jen Murphy ◽

Mark Elliot

Keyword(s):

Mental Health ◽

Online Survey ◽

National Level ◽

Secondary Data ◽

Well Being ◽

Ordinary Least Squares ◽

Least Squares Regression ◽

The Uk ◽

Survey Responses ◽

The Impact

Introduction: In March 2020 in response to the COVID pandemic the UK government declared a national lockdown where citizens were required to stay at home. The impact of this lockdown on levels of well-being has been a source of concern for citizens and mental health professionals.Objectives: We investigated the trajectory of well-being over the course of the ?first wave and sought to determine whether the change in well-being is distributed equally across the population. Speci?fically we investigated pre-existing medical conditions, social isolation, ?financial stress and deprivation as a predictor for well-being and whether there were community level characteristics which protect against poorer well-being.Methods: Using online survey responses from the COVID19 modules of Understanding society, we linked 8,379 English cases across ?five waves of data collection to location based deprivation statistics. We used ordinary least squares regression to estimate the association between deprivation, pre-existing conditions and socio-demographic factors and the change in well-being scores over time, as measured by the GHQ-12 questionnaire.Results: A decline in well-being was observed at the beginning of the fi?rst lock down period at the beginning of March 2020. This was matched with a corresponding recovery between April and July as restrictions were gradually lifted. There was no association between the decline and deprivation, nor between deprivation and recovery. The strongest predictor of well-being during the lockdown, was the baseline score, with the counterintuitive finding that for those will pre-existing poor well-being, the impact of pandemic restrictions on mental health were minimal, but for those who had previously felt well, the restrictions and the impact of the pandemic on well-being were much greater.Conclusion: These data show no evidence of a social gradient in well-being related to the pandemic. In fact, wellbeing was shown to be highly elastic in this period indicating a national level of resilience which cut across the usually observed health inequalities.

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Plant Fetish: A Creative Challenge to Mental Health Stigma

Genealogy ◽

10.3390/genealogy4020040 ◽

2020 ◽

Vol 4 (2) ◽

pp. 40

Author(s):

Salma Qasim ◽

Mick McKeown ◽

Chanje Kunda ◽

John Peter Wainwright ◽

Roxanne Khan

Keyword(s):

Mental Health ◽

Interpretative Phenomenological Analysis ◽

Public Awareness ◽

Group Discussion ◽

Mental Health Stigma ◽

Post Traumatic Stress ◽

Levels Of Care ◽

Alternative Means ◽

Mental Health Support ◽

The Uk

People of BAMME (Black, Asian, Minority, and Migrant ethnic) heritage in the UK experience various anomalies when engaging with mental health services. Typically concentrated at secondary and secure levels of care, these discrepant experiences interact with a reticence to uptake mental health support at the primary care level. Official, national anti-stigma campaigns often reproduce messages that do not connect with BAMME communities, raising questions about how best to challenge stigma in this context. This research paper describes a case study of an alternative means to address stigma, drawing from a dramatic comedy performance, Plant Fetish, written and performed by an artist who carries a diagnosis of complex post-traumatic stress disorder (Complex PTSD). The study comprised of an individual interview with the artist, audience feedback, and a group discussion conducted after the show. Data were subject to interpretative phenomenological analysis. Findings are discussed in relation to the importance of using creativity to increase public awareness of mental health and inform efforts to reduce stigma. We conclude that such approaches show promise and merit further exploration in a context of growing discursive interest in mental health amidst acknowledged deficiencies of contemporary anti-stigma efforts, especially as they apply to BAMME people, their families, and their communities.

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