ABSTRACT
Introduction: Despite the ongoing roll-out of the vaccination programme in Wales, self-isolation remains a crucial strategy to reduce transmission of COVID-19, especially as cases remain high. Test, Trace, Protect (TTP) is Wales' contact tracing programme where people are asked to isolate and provided with information and resources. Public Health Wales ran a real-time text message survey of contacts of cases of COVID-19 to provide insight as people were starting a period of self-isolation after notification from NHS Wales Test Trace Protect (Adherence Confidence Text Survey (ACTS)). This research study was designed to investigate what those being asked to self-isolate felt was good about their experience with TTP and what do they feel could be done better based on their text responses. Method: Text responses between 15th November 2020 and 2nd May 2021 (N = 12,092) were analysed using an automated content analysis (ACA) and sentiment analysis using the software Leximancer. Next, we conducted a qualitative thematic analysis using the software NVivo to explore further the findings of the ACA, as well as to look more deeply into some of the reasons behind people's views of TTP at two time periods for comparison, T1: 15th November- 5th December 2020 (n=2956) and T2: 1st March - 31st 2021 (n = 515). Results: ACA revealed that there were substantially more (roughly ten times as many) instances of favorable (positive affective) (n=4,963) terms within the data than unfavorable (negative affective) (n=425). NVivo analysis were in keeping with this finding as the majority reported a positive experience with TTP (T1 N = 1717, 58%;T2 N = 355, 69%). One of the sources of confusion was the date of the end of required isolation (T1 N= 101, 3.4%;T2 N = 11, 2.1%) though clarity improved from T1 to T2. Another concern was the time it took to be contacted following a positive test (T1 N = 205, 6.9%, T2 N = 14, 2.7%) again improving with time. Less than 1% reported financial concerns at both time periods. Conclusions: The Welsh population responding to the text sent by PHW had a positive experience with TTP. Automated content analysis is a viable method to process large datasets of qualitative content such as text responses.
ABSTRACT
Introduction: The coronavirus pandemic presents the greatest challenge to public health in living memory. To slow the spread of the virus the UK initiated periods of strict social distancing, or lockdown. The ongoing social and psychological impacts of the pandemic and lockdowns are still under investigation. We aimed to explore longitudinally the attitudes and behaviors of members of the UK public from the start of UK lockdowns in March, 2020. We focused on mental health, adherence to health behaviours and government regulations, perceptions of vaccinations, and impact on Black, Asian, Minority Ethnic (BAME) participants. Method: Focus groups (2-8 people, 60 min) and surveys were conducted with 57 UK residents from March 23, 2020 to the present at 5 different timepoints that captured lockdowns and firebreaks (93% retention). Participants were 51% Female, mean age 37.1 (Range: 20-60), 72% White, 5% Mixed or Multiple ethnic groups, 16% Asian or Asian British, and 7% Black, African, Caribbean or Black British. Surveys included the Patient Health Questionnaire - Somatic, Anxiety, and Depressive Symptoms (PHQ-SADS), the Capabilities, Opportunities, Motivations and Behaviours questionnaire (COM-B), and coronavirus specific questions such as vaccination intention. Qualitative results: The central theme was that of loss;'practical losses' e.g. income and 'psychological losses' e.g. motivation. Loss improved, but uncertainty and anticipatory anxiety continued across timepoints. Reported mental health issues improved over Summer 2020 and worsened in Nov 2020. Alert fatigue and learned helplessness emerged as the main themes at that time and marginalization by BAME participants. Behavioural adherence and vaccination uptake focused around perception of risk and community vs individual responsibility. Quantitative results: Data will be analysed following the current wave of data collection (Nov-Dec 2021) and will presented in March, 2022. Conclusion: Mental health fluctuated with the ability to socially connect with others outside of the household. Feelings of loss improved over time. Alert fatigue and general mistrust in government increased as did learned helplessness resulting in a loss of motivation. Results have had a significant policy and media impact in the UK and resulted in several publications to date.