Resilience in railway workers: Exploring what has challenged and protected railway keyworker's mental wellbeing during the COVID-19 pandemic (preprint)

Railway workers are reportedly at risk of developing traumatic stress-related conditions, yet little is known about the effects of COVID-19 on the mental wellbeing of railway workers. The study consisted of a cross-sectional online survey exploring the effects of COVID-19 on the mental wellbeing of railway workers (n=906) in the UK. The aim was to explore whether protective factors (adaptive resilience, team resilience and help-seeking intentions) mediated the relationship between COVID-19 risk factors (stress, risk perception and burnout) and railway workers’ mental wellbeing. Responses to psychometrically valid measures were analysed using multiple regression and parallel mediation analyses. Free text data exploring railway workers’ views on the impact of COVID-19 on their mental wellbeing, were analysed using content analysis. Protective factors significantly mediated the relationship between mental wellbeing and COVID-19 risk factors. Railway workers reported that they experienced mental health decline throughout the pandemic, loss of workplace supports, increased need for psychological support, and concerns for the future. Work-based supports and access to psychological input for railway workers who need it is highlighted. Building a resilient railway workforce moving forward requires attention to staff mental wellbeing and to ensuring that support systems are robust, safe and accessible.

What have we learned about what works in sustaining mental health care and support services during a pandemic? Transferable insights from the COVID-19 response (preprint)

Efforts have been made to adapt the delivery of mental health care and support services to the demands of COVID-19. Here we detail the perspectives and experiences of mental health workers (MHWs), in relation to what they found helpful when adapting mental health services during the COVID-19 pandemic and responding to its demands. We were interested in exploring what has helped to support MHWs’ own health and wellbeing given that staff wellbeing is central to sustaining the delivery of quality mental health services moving forward. Individual interviews were conducted with MHWs (n = 30) during the third COVID-19 lockdown. Interviews were audio-recorded, transcribed and managed using NVIVO. Qualitative data was analyzed using an inductive thematic approach. Three major themes were created, which emphasized the importance of: (1) 'self-care and peer support (checking in with each other)', (2) 'team cohesion and collaboration' and (3) 'visible and supportive management and leadership (new ways of working)'. Our findings emphasize the importance of individual, team and systems-based support in helping MHWs maintain their own wellbeing, whilst adapting and responding to the challenges in providing mental health care and support during this pandemic. Guidance and direction from management, with adaptive leadership in providing sustained, efficient, and equitable delivery of mental healthcare, is essential. Our findings support future policy, research and mental health practice developments through sharing important salutogenic lessons learned and transferable insights which may help with preparedness for future pandemics.

How Did The First COVID-19 Lockdown Affect Persons With Concurrent Mental Health and Substance Use Disorders in Norway? A Qualitative Study (preprint)

Background: The outbreak of COVID-19 with its severe social restrictions touched the daily life of most people. While everyday social life becomes difficult for citizens with economic and cultural capital, it becomes even worse for vulnerable groups such as persons with mental health and substance use disorders, who are particularly vulnerable to social exclusion. The aim of this study is to investigate how the first COVID-19 lockdown affected the everyday life and health of persons with co-occurring mental health and substance use disorders. Methods: : This qualitative study reports data from 17 individual interviews and one focus group of five participants, all with a self-reported mental health and substance use disorder. Interviews were conducted based on a semi-structured interview guide in September and October 2020 in a medium-sized local authority in Norway. Data were analysed using thematic analysis. A reference group of people with varied knowledge and experiences of the phenomenon were involved in study design, recruitment, data generation and analysis. Results: : The analysis identified four interrelated main themes, describing how the first lockdown affected the everyday life and health of persons suffering from a mental health and substance use disorder: 1) The COVID-19 outbreak as a perceived challenge, 2) A decline in mental health and well-being, 3) Increased substance use challenges, and 4) Diverse experiences with health and social services. The results show that people with a co-occurring disorder have challenges with digital tools and/or do not have the appropriate equipment. Further, participants were not concerned about becoming infected themselves, but infecting others. Conclusion: Persons with a mental health and substance use disorder face major challenges during the COVID-19 pandemic. There is a need to maintain continuous low-threshold services especially directed towards persons with co-occurring disorders during the pandemic. Furthermore, it is important to improve the digital skills of every service user or offer alternatives to digital consultations and meetings.

Towards intervention development to increase the uptake of COVID-19 vaccination among those at high risk: outlining evidence-based and theoretically informed future intervention content (preprint)

ObjectivesDevelopment of a vaccine against COVID-19 will be key to controlling the pandemic. We need to understand the barriers and facilitators to receiving a future COVID-19 vaccine so that we can provide recommendations for the design of interventions aimed at maximising public acceptance. DesignCross-sectional UK survey with older adults and patients with chronic respiratory disease. MethodsDuring the UKs early April 2020 lockdown period, 527 participants (311 older adults, mean age = 70.4 years; 216 chronic respiratory participants, mean age = 43.8 years) completed an online questionnaire assessing willingness to receive a COVID-19 vaccine, perceptions of COVID-19, and intention to receive influenza and pneumococcal vaccinations. A free text response (n=502) examined barriers and facilitators to uptake. The Behaviour Change Wheel informed the analysis of these responses, which were coded to the Theoretical Domains Framework (TDF). Behaviour change techniques (BCTs) were identified. ResultsEighty-six percent of respondents want to receive a COVID-19 vaccine. This was positively correlated with the perception that COVID-19 will persist over time, and negatively associated with perceiving the media to have over-exaggerated the risk. The majority of barriers and facilitators were mapped onto the beliefs about consequences TDF domain, with themes relating to personal health, health consequences to others, concerns of vaccine safety, and severity of COVID-19. ConclusionsWillingness to receive a COVID-19 vaccination is currently high among high-risk individuals. Mass media interventions aimed at maximising vaccine uptake should utilise the BCTs of information about health, emotional, social and environmental consequences, and salience of consequences. Statement of ContributionO_ST_ABSWhat is already known on this subject?C_ST_ABSO_LIUptake of a vaccine for COVID-19 will be vital for controlling the pandemic, but the success of this strategy relies on public acceptance of the vaccine. C_LIO_LIUptake of vaccinations and public confidence in vaccines has been falling in recent years. C_LIO_LIEvidence suggests that 74% of the French population want to receive a COVID-19 vaccination. C_LI What does this study add?O_LIThis study found that 86% of our sample of high-risk participants in the UK are willing to receive a future vaccine for COVID-19. C_LIO_LIThis study showed that perceived barriers and facilitators to uptake of the COVID-19 vaccination concentrated on the beliefs about consequences TDF domain. C_LIO_LIThis study suggests that the content of mass media interventions to improve vaccine uptake should focus on the BCTs of information about health, emotional, social and environmental consequences, and salience of consequences. These techniques should be pitched in relation to both self and, most importantly, to others. C_LI